Zekai Chen
Publications
The Patient is not a Moving Document: A World Model Training Paradigm for Longitudinal EHR
Large language models (LLMs) trained with next-word-prediction have achieved success as clinical foundation models. Representations from these language backbones yield strong linear probe performance across biomedical tasks, suggesting that patient semantics emerge from next-token prediction at scale. However, this paradigm treats patients as a document to be summarized rather than a dynamical system to be simulated; a patient's trajectory emerges from their state evolving under interventions and time, requiring models that simulate dynamics rather than predict tokens. To address this, we introduce SMB-Structure, a world model for structured EHR that grounds a joint-embedding prediction architecture (JEPA) with next-token prediction (SFT). SFT grounds our model to reconstruct future patient states in token space, while JEPA predicts those futures in latent space from the initial patient representation alone, forcing trajectory dynamics to be encoded before the next state is observed. We validate across two large-scale cohorts: Memorial Sloan Kettering (23,319 oncology patients; 323,000+ patient-years) and INSPECT (19,402 pulmonary embolism patients). Using a linear probe evaluated at multiple points along the disease trajectory, we demonstrate that our training paradigm learns embeddings that capture disease dynamics not recoverable by autoregressive baselines, enabling SMB-Structure to achieve competitive performance on complex tasks characterized by high patient heterogeneity. Model weights are available at https://huggingface.co/standardmodelbio/SMB-v1-1.7B-Structure.
LION: A Clifford Neural Paradigm for Multimodal-Attributed Graph Learning
Recently, the rapid advancement of multimodal domains has driven a data-centric paradigm shift in graph ML, transitioning from text-attributed to multimodal-attributed graphs. This advancement significantly enhances data representation and expands the scope of graph downstream tasks, such as modality-oriented tasks, thereby improving the practical utility of graph ML. Despite its promise, limitations exist in the current neural paradigms: (1) Neglect Context in Modality Alignment: Most existing methods adopt topology-constrained or modality-specific operators as tokenizers. These aligners inevitably neglect graph context and inhibit modality interaction, resulting in suboptimal alignment. (2) Lack of Adaptation in Modality Fusion: Most existing methods are simple adaptations for 2-modality graphs and fail to adequately exploit aligned tokens equipped with topology priors during fusion, leading to poor generalizability and performance degradation. To address the above issues, we propose LION (c\underline{LI}ff\underline{O}rd \underline{N}eural paradigm) based on the Clifford algebra and decoupled graph neural paradigm (i.e., propagation-then-aggregation) to implement alignment-then-fusion in multimodal-attributed graphs. Specifically, we first construct a modality-aware geometric manifold grounded in Clifford algebra. This geometric-induced high-order graph propagation efficiently achieves modality interaction, facilitating modality alignment. Then, based on the geometric grade properties of aligned tokens, we propose adaptive holographic aggregation. This module integrates the energy and scale of geometric grades with learnable parameters to improve modality fusion. Extensive experiments on 9 datasets demonstrate that LION significantly outperforms SOTA baselines across 3 graph and 3 modality downstream tasks.