Frontier artificial intelligence (AI) models, such as OpenAI's GPT-5 and Meta's DINOv3, have advanced rapidly through training on internet-scale public data, yet such systems lack access to private clinical data. Neuroimaging, in particular, is underrepresented in the public domain due to identifiable facial features within MRI and CT scans, fundamentally restricting model performance in clinical medicine. Here, we show that frontier models underperform on neuroimaging tasks and that learning directly from uncurated data generated during routine clinical care at health systems, a paradigm we call health system learning, yields high-performance, generalist neuroimaging models. We introduce NeuroVFM, a visual foundation model trained on 5.24 million clinical MRI and CT volumes using a scalable volumetric joint-embedding predictive architecture. NeuroVFM learns comprehensive representations of brain anatomy and pathology, achieving state-of-the-art performance across multiple clinical tasks, including radiologic diagnosis and report generation. The model exhibits emergent neuroanatomic understanding and interpretable visual grounding of diagnostic findings. When paired with open-source language models through lightweight visual instruction tuning, NeuroVFM generates radiology reports that surpass frontier models in accuracy, clinical triage, and expert preference. Through clinically grounded visual understanding, NeuroVFM reduces hallucinated findings and critical errors, offering safer clinical decision support. These results establish health system learning as a paradigm for building generalist medical AI and provide a scalable framework for clinical foundation models.

Language models traditionally used for cross-domain generalization have recently demonstrated task-specific reasoning. However, their top-down training approach on general corpora is insufficient for acquiring abstractions needed for deep domain expertise. This may require a bottom-up approach that acquires expertise by learning to compose simple domain concepts into more complex ones. A knowledge graph (KG) provides this compositional structure, where domain primitives are represented as head-relation-tail edges and their paths encode higher-level concepts. We present a task generation pipeline that synthesizes tasks directly from KG primitives, enabling models to acquire and compose them for reasoning. We fine-tune language models on the resultant KG-grounded curriculum to demonstrate domain-specific superintelligence. While broadly applicable, we validate our approach in medicine, where reliable KGs exist. Using a medical KG, we curate 24,000 reasoning tasks paired with thinking traces derived from diverse medical primitives. We fine-tune the QwQ-32B model on this curriculum to obtain QwQ-Med-3 that takes a step towards medical superintelligence. We also introduce ICD-Bench, an evaluation suite to quantify reasoning abilities across 15 medical domains. Our experiments demonstrate that QwQ-Med-3 significantly outperforms state-of-the-art reasoning models on ICD-Bench categories. Further analysis reveals that QwQ-Med-3 utilizes acquired primitives to widen the performance gap on the hardest tasks of ICD-Bench. Finally, evaluation on medical question-answer benchmarks shows that QwQ-Med-3 transfers acquired expertise to enhance the base model's performance. While the industry's approach to artificial general intelligence (AGI) emphasizes broad expertise, we envision a future in which AGI emerges from the composable interaction of efficient domain-specific superintelligent agents.

Ear diseases affect billions of people worldwide, leading to substantial health and socioeconomic burdens. Computed tomography (CT) plays a pivotal role in accurate diagnosis, treatment planning, and outcome evaluation. The objective of this study is to present the establishment and design of UltraEar Database, a large-scale, multicentric repository of isotropic 0.1 mm ultra-high-resolution CT (U-HRCT) images and associated clinical data dedicated to ear diseases. UltraEar recruits patients from 11 tertiary hospitals between October 2020 and October 2035, integrating U-HRCT images, structured CT reports, and comprehensive clinical information, including demographics, audiometric profiles, surgical records, and pathological findings. A broad spectrum of otologic disorders is covered, such as otitis media, cholesteatoma, ossicular chain malformation, temporal bone fracture, inner ear malformation, cochlear aperture stenosis, enlarged vestibular aqueduct, and sigmoid sinus bony deficiency. Standardized preprocessing pipelines have been developed for geometric calibration, image annotation, and multi-structure segmentation. All personal identifiers in DICOM headers and metadata are removed or anonymized to ensure compliance with data privacy regulation. Data collection and curation are coordinated through monthly expert panel meetings, with secure storage on an offline cloud system. UltraEar provides an unprecedented ultra-high-resolution reference atlas with both technical fidelity and clinical relevance. This resource has significant potential to advance radiological research, enable development and validation of AI algorithms, serve as an educational tool for training in otologic imaging, and support multi-institutional collaborative studies. UltraEar will be continuously updated and expanded, ensuring long-term accessibility and usability for the global otologic research community.

Cerebral aneurysms and arteriovenous malformations are life-threatening hemodynamic pathologies of the brain. While surgical intervention is often essential to prevent fatal outcomes, it carries significant risks both during the procedure and in the postoperative period, making the management of these conditions highly challenging. Parameters of cerebral blood flow, routinely monitored during medical interventions, could potentially be utilized in machine learning-assisted protocols for risk assessment and therapeutic prognosis. To this end, we developed a linear oscillatory model of blood velocity and pressure for clinical data acquired from neurosurgical operations. Using the method of Sparse Identification of Nonlinear Dynamics (SINDy), the parameters of our model can be reconstructed online within milliseconds from a short time series of the hemodynamic variables. The identified parameter values enable automated classification of the blood-flow pathologies by means of logistic regression, achieving an accuracy of 73 %. Our results demonstrate the potential of this model for both diagnostic and prognostic applications, providing a robust and interpretable framework for assessing cerebral blood vessel conditions.

Morphological development into evolutionary patterns under structural instability is ubiquitous in living systems and often of vital importance for engineering structures. Here we propose a data-driven approach to understand and predict their spatiotemporal complexities. A machine-learning framework is proposed based on the physical modeling of morphogenesis triggered by internal or external forcing. Digital libraries of structural patterns are constructed from the simulation data, which are then used to recognize the abnormalities, predict their development, and assist in risk assessment and prognosis. The capabilities to identify the key bifurcation characteristics and predict the history-dependent development from the global and local features are demonstrated by examples of brain growth and aerospace structural design, which offer guidelines for disease diagnosis/prognosis and instability-tolerant design.

Comedian TJ Miller, of HBO's Silicon Valley, performs a standup in which he tells of an entertaining, yet extremely terrifying time in which he suffered a life-threatening brain malformation. He was in the middle of pitching a movie idea when he collapsed to the floor while seizing, and was rushed to the hospital. His story continues, he explains that he suffered from an arteriovenous malformation (AVM) hemorrhage, which is essentially an abnormal connection between the veins and arteries. When Miller awoke from his coma in the Cedars-Sinai ICU neurology ward, he found a nurse standing over him saying, "Your doctor cannot be here, but a proxy will be here in just a bit." He then explains how he was given little to no information about his condition. Next thing he knew, what looked like an iPad on a Segway rolled in the room and on the screen, was his doctor, who was video calling from a different location.