Zihao Zhao

Chenxiao Fan, Chongming Gao, Wentao Shi et al.

Accurate and safe medication recommendations are critical for effective clinical decision-making, especially in multimorbidity cases. However, existing systems rely on point-wise prediction paradigms that overlook synergistic drug effects and potential adverse drug-drug interactions (DDIs). We propose FLAME, a fine-grained list-wise alignment framework for large language models (LLMs), enabling drug-by-drug generation of drug lists. FLAME formulates recommendation as a sequential decision process, where each step adds or removes a single drug. To provide fine-grained learning signals, we devise step-wise Group Relative Policy Optimization (GRPO) with potential-based reward shaping, which explicitly models DDIs and optimizes the contribution of each drug to the overall prescription. Furthermore, FLAME enhances patient modeling by integrating structured clinical knowledge and collaborative information into the representation space of LLMs. Experiments on benchmark datasets demonstrate that FLAME achieves state-of-the-art performance, delivering superior accuracy, controllable safety-accuracy trade-offs, and strong generalization across diverse clinical scenarios. Our code is available at https://github.com/cxfann/Flame.

Lin Teng, Zihao Zhao, Jiawei Huang et al.

Automatic and accurate segmentation of brain MR images throughout the human lifespan into tissue and structure is crucial for understanding brain development and diagnosing diseases. However, challenges arise from the intricate variations in brain appearance due to rapid early brain development, aging, and disorders, compounded by the limited availability of manually-labeled datasets. In response, we present a two-step segmentation framework employing Knowledge-Guided Prompt Learning (KGPL) for brain MRI. Specifically, we first pre-train segmentation models on large-scale datasets with sub-optimal labels, followed by the incorporation of knowledge-driven embeddings learned from image-text alignment into the models. The introduction of knowledge-wise prompts captures semantic relationships between anatomical variability and biological processes, enabling models to learn structural feature embeddings across diverse age groups. Experimental findings demonstrate the superiority and robustness of our proposed method, particularly noticeable when employing Swin UNETR as the backbone. Our approach achieves average DSC values of 95.17% and 94.19% for brain tissue and structure segmentation, respectively. Our code is available at https://github.com/TL9792/KGPL.

Nishchal Sapkota, Yejia Zhang, Zihao Zhao et al.

Osteochondrodysplasia, affecting 2-3% of newborns globally, is a group of bone and cartilage disorders that often result in head malformations, contributing to childhood morbidity and reduced quality of life. Current research on this disease using mouse models faces challenges since it involves accurately segmenting the developing cartilage in 3D micro-CT images of embryonic mice. Tackling this segmentation task with deep learning (DL) methods is laborious due to the big burden of manual image annotation, expensive due to the high acquisition costs of 3D micro-CT images, and difficult due to embryonic cartilage's complex and rapidly changing shapes. While DL approaches have been proposed to automate cartilage segmentation, most such models have limited accuracy and generalizability, especially across data from different embryonic age groups. To address these limitations, we propose novel DL methods that can be adopted by any DL architectures -- including CNNs, Transformers, or hybrid models -- which effectively leverage age and spatial information to enhance model performance. Specifically, we propose two new mechanisms, one conditioned on discrete age categories and the other on continuous image crop locations, to enable an accurate representation of cartilage shape changes across ages and local shape details throughout the cranial region. Extensive experiments on multi-age cartilage segmentation datasets show significant and consistent performance improvements when integrating our conditional modules into popular DL segmentation architectures. On average, we achieve a 1.7% Dice score increase with minimal computational overhead and a 7.5% improvement on unseen data. These results highlight the potential of our approach for developing robust, universal models capable of handling diverse datasets with limited annotated data, a key challenge in DL-based medical image analysis.