Tengyou Xu

Lina Zhang, Tonmoy Monsoor, Peizheng Li et al.

While Multimodal Large Language Models (MLLMs) have demonstrated remarkable proficiency in general video understanding, their capacity to interpret involuntary, and spatio-temporally evolving pathologic motor behaviors such as seizure semiology remains largely untested. To address this gap, we introduce Seizure-Semiology-Suite, a clinically grounded dataset and benchmark for fine-grained, structured seizure semiology understanding. The dataset includes 438 seizure videos annotated with over 35,000 dense labels covering 20 ILAE-defined semiological features. Building on this dataset, we propose a seven-task hierarchical benchmark that systematically evaluates MLLMs from low-level visual perception to temporal sequencing, narrative report generation, and seizure diagnosis. To enable clinically meaningful evaluation of generated reports, we further introduce the Report Quality Index for Seizure Semiology (Seizure-RQI). Extensive baselines across 11 open-weight MLLMs reveal systematic weaknesses in laterality reasoning, temporal localization, symptom sequencing, and clinically faithful reporting. We show that seizure-specific fine-tuning substantially improves performance across tasks, and that a two-stage neuro-symbolic framework achieves an F1 score of 0.96 on epileptic versus non-epileptic seizure classification. Seizure-Semiology-Suite establishes a rigorous benchmark for evaluating multimodal models in safety-critical medical video understanding and guides the development of clinically reliable, domain-adaptive multimodal intelligence.

Tengyou Xu, Detao Ma, Xiang 'Anthony' Chen

The rise of large language models (LLMs) has given rise to a class of prompt-based interactive systems where users primarily express their input in natural language. However, composing a prompt as a linear text string becomes unwieldy when capturing users' multifaceted intents. We present Object-Oriented Prompting (OOPrompt), an emergent interaction paradigm that enables users to create, edit, iterate, and reuse prompts as structured, manipulable artifacts, unifying and generalizing several existing point systems. We first outlined a design space from existing work and built an early prototype, which we deployed as a probe in a formative study with 20 participants. Their feedback informed an expanded OOPrompt design space. We then developed the full OOPrompt prototype and conducted a validation study to further understand OOPrompt's added values and trade-offs. We expect the OOPrompt design space to provide theoretical and empirical guidance to the design and engineering of prompt-based, LLM-enabled interactive systems.

Hongyan Gu, Ellie Onstott, Wenzhong Yan et al.

Z-stack scanning is an emerging whole slide imaging technology that captures multiple focal planes alongside the z-axis of a glass slide. Because z-stacking can offer enhanced depth information compared to the single-layer whole slide imaging, this technology can be particularly useful in analyzing small-scaled histopathological patterns. However, its actual clinical impact remains debated with mixed results. To clarify this, we investigate the effect of z-stack scanning on artificial intelligence (AI) mitosis detection of meningiomas. With the same set of 22 Hematoxylin and Eosin meningioma glass slides scanned by three different digital pathology scanners, we tested the performance of three AI pipelines on both single-layer and z-stacked whole slide images (WSIs). Results showed that in all scanner-AI combinations, z-stacked WSIs significantly increased AI's sensitivity (+17.14%) on the mitosis detection with only a marginal impact on precision. Our findings provide quantitative evidence that highlights z-stack scanning as a promising technique for AI mitosis detection, paving the way for more reliable AI-assisted pathology workflows, which can ultimately benefit patient management.

Tengyou Xu, Haochen Yang, Xiang 'Anthony' Chen et al.

This abstract presents our solution (Team Westwood) for mitosis detection and atypical mitosis classification in the MItosis DOmain Generalization (MIDOG) 2025 challenge. For mitosis detection, we trained an nnUNetV2 for initial mitosis candidate screening with high sensitivity, followed by a random forest classifier ensembling predictions of three convolutional neural networks (CNNs): EfficientNet-b3, EfficientNet-b5, and EfficientNetV2-s. For the atypical mitosis classification, we trained another random forest classifier ensembling the predictions of three CNNs: EfficientNet-b3, EfficientNet-b5, and InceptionV3. On the preliminary test set, our solution achieved an F1 score of 0.7450 for track 1 mitosis detection, and a balanced accuracy of 0.8722 for track 2 atypical mitosis classification. On the final test set, our solution achieved an F1 score of 0.6972 for track 1 mitosis detection, and a balanced accuracy of 0.8242 for track 2 atypical mitosis classification.