Xinxing Xu

Xiaofeng Lei, Shaohua Li, Xinxing Xu et al.

Localizing anatomical landmarks are important tasks in medical image analysis. However, the landmarks to be localized often lack prominent visual features. Their locations are elusive and easily confused with the background, and thus precise localization highly depends on the context formed by their surrounding areas. In addition, the required precision is usually higher than segmentation and object detection tasks. Therefore, localization has its unique challenges different from segmentation or detection. In this paper, we propose a zoom-in attentive network (ZIAN) for anatomical landmark localization in ocular images. First, a coarse-to-fine, or "zoom-in" strategy is utilized to learn the contextualized features in different scales. Then, an attentive fusion module is adopted to aggregate multi-scale features, which consists of 1) a co-attention network with a multiple regions-of-interest (ROIs) scheme that learns complementary features from the multiple ROIs, 2) an attention-based fusion module which integrates the multi-ROIs features and non-ROI features. We evaluated ZIAN on two open challenge tasks, i.e., the fovea localization in fundus images and scleral spur localization in AS-OCT images. Experiments show that ZIAN achieves promising performances and outperforms state-of-the-art localization methods. The source code and trained models of ZIAN are available at https://github.com/leixiaofeng-astar/OMIA9-ZIAN.

Yang Bai, Xinxing Xu, Yong Liu et al.

Composed image retrieval (CIR) is the task of retrieving specific images by using a query that involves both a reference image and a relative caption. Most existing CIR models adopt the late-fusion strategy to combine visual and language features. Besides, several approaches have also been suggested to generate a pseudo-word token from the reference image, which is further integrated into the relative caption for CIR. However, these pseudo-word-based prompting methods have limitations when target image encompasses complex changes on reference image, e.g., object removal and attribute modification. In this work, we demonstrate that learning an appropriate sentence-level prompt for the relative caption (SPRC) is sufficient for achieving effective composed image retrieval. Instead of relying on pseudo-word-based prompts, we propose to leverage pretrained V-L models, e.g., BLIP-2, to generate sentence-level prompts. By concatenating the learned sentence-level prompt with the relative caption, one can readily use existing text-based image retrieval models to enhance CIR performance. Furthermore, we introduce both image-text contrastive loss and text prompt alignment loss to enforce the learning of suitable sentence-level prompts. Experiments show that our proposed method performs favorably against the state-of-the-art CIR methods on the Fashion-IQ and CIRR datasets. The source code and pretrained model are publicly available at https://github.com/chunmeifeng/SPRC

Meng Wang, Tian Lin, Lianyu Wang et al.

Failure to recognize samples from the classes unseen during training is a major limitation of artificial intelligence in the real-world implementation for recognition and classification of retinal anomalies. We established an uncertainty-inspired open-set (UIOS) model, which was trained with fundus images of 9 retinal conditions. Besides assessing the probability of each category, UIOS also calculated an uncertainty score to express its confidence. Our UIOS model with thresholding strategy achieved an F1 score of 99.55%, 97.01% and 91.91% for the internal testing set, external target categories (TC)-JSIEC dataset and TC-unseen testing set, respectively, compared to the F1 score of 92.20%, 80.69% and 64.74% by the standard AI model. Furthermore, UIOS correctly predicted high uncertainty scores, which would prompt the need for a manual check in the datasets of non-target categories retinal diseases, low-quality fundus images, and non-fundus images. UIOS provides a robust method for real-world screening of retinal anomalies.

Chun-Mei Feng, Bangjun Li, Xinxing Xu et al.

Federated Magnetic Resonance Imaging (MRI) reconstruction enables multiple hospitals to collaborate distributedly without aggregating local data, thereby protecting patient privacy. However, the data heterogeneity caused by different MRI protocols, insufficient local training data, and limited communication bandwidth inevitably impair global model convergence and updating. In this paper, we propose a new algorithm, FedPR, to learn federated visual prompts in the null space of global prompt for MRI reconstruction. FedPR is a new federated paradigm that adopts a powerful pre-trained model while only learning and communicating the prompts with few learnable parameters, thereby significantly reducing communication costs and achieving competitive performance on limited local data. Moreover, to deal with catastrophic forgetting caused by data heterogeneity, FedPR also updates efficient federated visual prompts that project the local prompts into an approximate null space of the global prompt, thereby suppressing the interference of gradients on the server performance. Extensive experiments on federated MRI show that FedPR significantly outperforms state-of-the-art FL algorithms with <6% of communication costs when given the limited amount of local training data.

Zhihao Chen, Yang Zhou, Anh Tran et al.

Medical phrase grounding (MPG) aims to locate the most relevant region in a medical image, given a phrase query describing certain medical findings, which is an important task for medical image analysis and radiological diagnosis. However, existing visual grounding methods rely on general visual features for identifying objects in natural images and are not capable of capturing the subtle and specialized features of medical findings, leading to sub-optimal performance in MPG. In this paper, we propose MedRPG, an end-to-end approach for MPG. MedRPG is built on a lightweight vision-language transformer encoder and directly predicts the box coordinates of mentioned medical findings, which can be trained with limited medical data, making it a valuable tool in medical image analysis. To enable MedRPG to locate nuanced medical findings with better region-phrase correspondences, we further propose Tri-attention Context contrastive alignment (TaCo). TaCo seeks context alignment to pull both the features and attention outputs of relevant region-phrase pairs close together while pushing those of irrelevant regions far away. This ensures that the final box prediction depends more on its finding-specific regions and phrases. Experimental results on three MPG datasets demonstrate that our MedRPG outperforms state-of-the-art visual grounding approaches by a large margin. Additionally, the proposed TaCo strategy is effective in enhancing finding localization ability and reducing spurious region-phrase correlations.

Kai Yu, Yang Zhou, Yang Bai et al.

Retinal foundation models aim to learn generalizable representations from diverse retinal images, facilitating label-efficient model adaptation across various ophthalmic tasks. Despite their success, current retinal foundation models are generally restricted to a single imaging modality, such as Color Fundus Photography (CFP) or Optical Coherence Tomography (OCT), limiting their versatility. Moreover, these models may struggle to fully leverage expert annotations and overlook the valuable domain knowledge essential for domain-specific representation learning. To overcome these limitations, we introduce UrFound, a retinal foundation model designed to learn universal representations from both multimodal retinal images and domain knowledge. UrFound is equipped with a modality-agnostic image encoder and accepts either CFP or OCT images as inputs. To integrate domain knowledge into representation learning, we encode expert annotation in text supervision and propose a knowledge-guided masked modeling strategy for model pre-training. It involves reconstructing randomly masked patches of retinal images while predicting masked text tokens conditioned on the corresponding retinal image. This approach aligns multimodal images and textual expert annotations within a unified latent space, facilitating generalizable and domain-specific representation learning. Experimental results demonstrate that UrFound exhibits strong generalization ability and data efficiency when adapting to various tasks in retinal image analysis. By training on ~180k retinal images, UrFound significantly outperforms the state-of-the-art retinal foundation model trained on up to 1.6 million unlabelled images across 8 public retinal datasets. Our code and data are available at https://github.com/yukkai/UrFound.

Chun-Mei Feng, Kai Yu, Nian Liu et al.

Federated learning (FL) is a distributed learning paradigm that enables multiple clients to learn a powerful global model by aggregating local training. However, the performance of the global model is often hampered by non-i.i.d. distribution among the clients, requiring extensive efforts to mitigate inter-client data heterogeneity. Going beyond inter-client data heterogeneity, we note that intra-client heterogeneity can also be observed on complex real-world data and seriously deteriorate FL performance. In this paper, we present a novel FL algorithm, i.e., FedIns, to handle intra-client data heterogeneity by enabling instance-adaptive inference in the FL framework. Instead of huge instance-adaptive models, we resort to a parameter-efficient fine-tuning method, i.e., scale and shift deep features (SSF), upon a pre-trained model. Specifically, we first train an SSF pool for each client, and aggregate these SSF pools on the server side, thus still maintaining a low communication cost. To enable instance-adaptive inference, for a given instance, we dynamically find the best-matched SSF subsets from the pool and aggregate them to generate an adaptive SSF specified for the instance, thereby reducing the intra-client as well as the inter-client heterogeneity. Extensive experiments show that our FedIns outperforms state-of-the-art FL algorithms, e.g., a 6.64\% improvement against the top-performing method with less than 15\% communication cost on Tiny-ImageNet. Our code and models will be publicly released.

Meng Wang, Lianyu Wang, Xinxing Xu et al.

Deep learning models have shown promising performance in the field of diabetic retinopathy (DR) staging. However, collaboratively training a DR staging model across multiple institutions remains a challenge due to non-iid data, client reliability, and confidence evaluation of the prediction. To address these issues, we propose a novel federated uncertainty-aware aggregation paradigm (FedUAA), which considers the reliability of each client and produces a confidence estimation for the DR staging. In our FedUAA, an aggregated encoder is shared by all clients for learning a global representation of fundus images, while a novel temperature-warmed uncertainty head (TWEU) is utilized for each client for local personalized staging criteria. Our TWEU employs an evidential deep layer to produce the uncertainty score with the DR staging results for client reliability evaluation. Furthermore, we developed a novel uncertainty-aware weighting module (UAW) to dynamically adjust the weights of model aggregation based on the uncertainty score distribution of each client. In our experiments, we collect five publicly available datasets from different institutions to conduct a dataset for federated DR staging to satisfy the real non-iid condition. The experimental results demonstrate that our FedUAA achieves better DR staging performance with higher reliability compared to other federated learning methods. Our proposed FedUAA paradigm effectively addresses the challenges of collaboratively training DR staging models across multiple institutions, and provides a robust and reliable solution for the deployment of DR diagnosis models in real-world clinical scenarios.

Yuanyang He, Zitong Huang, Xinxing Xu et al.

Black-box tuning has attracted recent attention due to that the structure or inner parameters of advanced proprietary models are not accessible. Proxy-tuning provides a test-time output adjustment for tuning black-box language models. It applies the difference of the output logits before and after tuning a smaller white-box "proxy" model to improve the black-box model. However, this technique serves only as a decoding-time algorithm, leading to an inconsistency between training and testing which potentially limits overall performance. To address this problem, we introduce Consistent Proxy Tuning (CPT), a simple yet effective black-box tuning method. Different from Proxy-tuning, CPT additionally exploits the frozen large black-box model and another frozen small white-box model, ensuring consistency between training-stage optimization objective and test-time proxies. This consistency benefits Proxy-tuning and enhances model performance. Note that our method focuses solely on logit-level computation, which makes it model-agnostic and applicable to any task involving logit classification. Extensive experimental results demonstrate the superiority of our CPT in both black-box tuning of Large Language Models (LLMs) and Vision-Language Models (VLMs) across various datasets. The code is available at https://github.com/chunmeifeng/CPT.

Baohao Liao, Hanze Dong, Xinxing Xu et al.

Group Relative Policy Optimization (GRPO) has recently emerged as a practical recipe for aligning large language models with verifiable objectives. However, under sparse terminal rewards, GRPO often stalls because rollouts within a group frequently receive identical rewards, causing relative advantages to collapse and updates to vanish. We propose self-hint aligned GRPO with privileged supervision (SAGE), an on-policy reinforcement learning framework that injects privileged hints during training to reshape the rollout distribution under the same terminal verifier reward. For each prompt $x$, the model samples a compact hint $h$ (e.g., a plan or decomposition) and then generates a solution $τ$ conditioned on $(x,h)$. Crucially, the task reward $R(x,τ)$ is unchanged; hints only increase within-group outcome diversity under finite sampling, preventing GRPO advantages from collapsing under sparse rewards. At test time, we set $h=\varnothing$ and deploy the no-hint policy without any privileged information. Moreover, sampling diverse self-hints serves as an adaptive curriculum that tracks the learner's bottlenecks more effectively than fixed hints from an initial policy or a stronger external model. Experiments over 6 benchmarks with 3 LLMs show that SAGE consistently outperforms GRPO, on average +2.0 on Llama-3.2-3B-Instruct, +1.2 on Qwen2.5-7B-Instruct and +1.3 on Qwen3-4B-Instruct. The code is available at https://github.com/BaohaoLiao/SAGE.

Linyang He, Qiyao Yu, Hanze Dong et al.

Mathematical reasoning is a hallmark of human intelligence, and whether large language models (LLMs) can meaningfully perform it remains a central question in artificial intelligence and cognitive science. As LLMs are increasingly integrated into scientific workflows, rigorous evaluation of their mathematical capabilities becomes a practical necessity. Existing benchmarks are limited by synthetic settings and data contamination. We present LiveMathematicianBench, a dynamic multiple-choice benchmark for research-level mathematical reasoning built from recent arXiv papers published after model training cutoffs. By grounding evaluation in newly published theorems, it provides a realistic testbed beyond memorized patterns. The benchmark introduces a thirteen-category logical taxonomy of theorem types (e.g., implication, equivalence, existence, uniqueness), enabling fine-grained evaluation across reasoning forms. It employs a proof-sketch-guided distractor pipeline that uses high-level proof strategies to construct plausible but invalid answer choices reflecting misleading proof directions, increasing sensitivity to genuine understanding over surface-level matching. We also introduce a substitution-resistant mechanism to distinguish answer recognition from substantive reasoning. Evaluation shows the benchmark is far from saturated: Gemini-3.1-pro-preview, the best model, achieves only 43.5%. Under substitution-resistant evaluation, accuracy drops sharply: GPT-5.4 scores highest at 30.6%, while Gemini-3.1-pro-preview falls to 17.6%, below the 20% random baseline. A dual-mode protocol reveals that proof-sketch access yields consistent accuracy gains, suggesting models can leverage high-level proof strategies for reasoning. Overall, LiveMathematicianBench offers a scalable, contamination-resistant testbed for studying research-level mathematical reasoning in LLMs.

Yufei He, Juncheng Liu, Zhiyuan Hu et al.

Prevailing medical AI operates on an unrealistic ''one-shot'' model, diagnosing from a complete patient file. However, real-world diagnosis is an iterative inquiry where Clinicians sequentially ask questions and order tests to strategically gather information while managing cost and time. To address this, we first propose Med-Inquire, a new benchmark designed to evaluate an agent's ability to perform multi-turn diagnosis. Built upon a dataset of real-world clinical cases, Med-Inquire simulates the diagnostic process by hiding a complete patient file behind specialized Patient and Examination agents. They force the agent to proactively ask questions and order tests to gather information piece by piece. To tackle the challenges posed by Med-Inquire, we then introduce EvoClinician, a self-evolving agent that learns efficient diagnostic strategies at test time. Its core is a ''Diagnose-Grade-Evolve'' loop: an Actor agent attempts a diagnosis; a Process Grader agent performs credit assignment by evaluating each action for both clinical yield and resource efficiency; finally, an Evolver agent uses this feedback to update the Actor's strategy by evolving its prompt and memory. Our experiments show EvoClinician outperforms continual learning baselines and other self-evolving agents like memory agents. The code is available at https://github.com/yf-he/EvoClinician

Xingyu Miao, Yang Bai, Haoran Duan et al.

Self-supervised monocular depth estimation methods typically rely on the reprojection error to capture geometric relationships between successive frames in static environments. However, this assumption does not hold in dynamic objects in scenarios, leading to errors during the view synthesis stage, such as feature mismatch and occlusion, which can significantly reduce the accuracy of the generated depth maps. To address this problem, we propose a novel dynamic cost volume that exploits residual optical flow to describe moving objects, improving incorrectly occluded regions in static cost volumes used in previous work. Nevertheless, the dynamic cost volume inevitably generates extra occlusions and noise, thus we alleviate this by designing a fusion module that makes static and dynamic cost volumes compensate for each other. In other words, occlusion from the static volume is refined by the dynamic volume, and incorrect information from the dynamic volume is eliminated by the static volume. Furthermore, we propose a pyramid distillation loss to reduce photometric error inaccuracy at low resolutions and an adaptive photometric error loss to alleviate the flow direction of the large gradient in the occlusion regions. We conducted extensive experiments on the KITTI and Cityscapes datasets, and the results demonstrate that our model outperforms previously published baselines for self-supervised monocular depth estimation.

Manna Dai, Yang Jiang, Feng Yang et al.

Metasurfaces have widespread applications in fifth-generation (5G) microwave communication. Among the metasurface family, free-form metasurfaces excel in achieving intricate spectral responses compared to regular-shape counterparts. However, conventional numerical methods for free-form metasurfaces are time-consuming and demand specialized expertise. Alternatively, recent studies demonstrate that deep learning has great potential to accelerate and refine metasurface designs. Here, we present XGAN, an extended generative adversarial network (GAN) with a surrogate for high-quality free-form metasurface designs. The proposed surrogate provides a physical constraint to XGAN so that XGAN can accurately generate metasurfaces monolithically from input spectral responses. In comparative experiments involving 20000 free-form metasurface designs, XGAN achieves 0.9734 average accuracy and is 500 times faster than the conventional methodology. This method facilitates the metasurface library building for specific spectral responses and can be extended to various inverse design problems, including optical metamaterials, nanophotonic devices, and drug discovery.

Zhiyuan Hu, Yunhai Hu, Juncheng Liu et al.

Multi-agent systems have evolved into practical LLM-driven collaborators for many applications, gaining robustness from diversity and cross-checking. However, multi-agent RL (MARL) training is resource-intensive and unstable: co-adapting teammates induce non-stationarity, and rewards are often sparse and high-variance. Therefore, we introduce \textbf{Multi-Agent Test-Time Reinforcement Learning (MATTRL)}, a framework that injects structured textual experience into multi-agent deliberation at inference time. MATTRL forms a multi-expert team of specialists for multi-turn discussions, retrieves and integrates test-time experiences, and reaches consensus for final decision-making. We also study credit assignment for constructing a turn-level experience pool, then reinjecting it into the dialogue. Across challenging benchmarks in medicine, math, and education, MATTRL improves accuracy by an average of 3.67\% over a multi-agent baseline, and by 8.67\% over comparable single-agent baselines. Ablation studies examine different credit-assignment schemes and provide a detailed comparison of how they affect training outcomes. MATTRL offers a stable, effective and efficient path to distribution-shift-robust multi-agent reasoning without tuning.

Zitong Huang, Ze Chen, Zhixing Chen et al.

Few-shot Class-Incremental Learning (FSCIL) aims to continuously learn new classes based on very limited training data without forgetting the old ones encountered. Existing studies solely relied on pure visual networks, while in this paper we solved FSCIL by leveraging the Vision-Language model (e.g., CLIP) and propose a simple yet effective framework, named Learning Prompt with Distribution-based Feature Replay (LP-DiF). We observe that simply using CLIP for zero-shot evaluation can substantially outperform the most influential methods. Then, prompt tuning technique is involved to further improve its adaptation ability, allowing the model to continually capture specific knowledge from each session. To prevent the learnable prompt from forgetting old knowledge in the new session, we propose a pseudo-feature replay approach. Specifically, we preserve the old knowledge of each class by maintaining a feature-level Gaussian distribution with a diagonal covariance matrix, which is estimated by the image features of training images and synthesized features generated from a VAE. When progressing to a new session, pseudo-features are sampled from old-class distributions combined with training images of the current session to optimize the prompt, thus enabling the model to learn new knowledge while retaining old knowledge. Experiments on three prevalent benchmarks, i.e., CIFAR100, mini-ImageNet, CUB-200, and two more challenging benchmarks, i.e., SUN-397 and CUB-200$^*$ proposed in this paper showcase the superiority of LP-DiF, achieving new state-of-the-art (SOTA) in FSCIL. Code is publicly available at https://github.com/1170300714/LP-DiF.

Yang Zhou, Tan Li Hui Faith, Yanyu Xu et al.

Medical Vision-Language Pretraining (MedVLP) shows promise in learning generalizable and transferable visual representations from paired and unpaired medical images and reports. MedVLP can provide useful features to downstream tasks and facilitate adapting task-specific models to new setups using fewer examples. However, existing MedVLP methods often differ in terms of datasets, preprocessing, and finetuning implementations. This pose great challenges in evaluating how well a MedVLP method generalizes to various clinically-relevant tasks due to the lack of unified, standardized, and comprehensive benchmark. To fill this gap, we propose BenchX, a unified benchmark framework that enables head-to-head comparison and systematical analysis between MedVLP methods using public chest X-ray datasets. Specifically, BenchX is composed of three components: 1) Comprehensive datasets covering nine datasets and four medical tasks; 2) Benchmark suites to standardize data preprocessing, train-test splits, and parameter selection; 3) Unified finetuning protocols that accommodate heterogeneous MedVLP methods for consistent task adaptation in classification, segmentation, and report generation, respectively. Utilizing BenchX, we establish baselines for nine state-of-the-art MedVLP methods and found that the performance of some early MedVLP methods can be enhanced to surpass more recent ones, prompting a revisiting of the developments and conclusions from prior works in MedVLP. Our code are available at https://github.com/yangzhou12/BenchX.

Han Yuan, Chuan Hong, Nguyen Tuan Anh Tran et al.

Pneumothorax is a medical emergency caused by abnormal accumulation of air in the pleural space - the potential space between the lungs and chest wall. On 2D chest radiographs, pneumothorax occurs within the thoracic cavity and outside of the mediastinum and we refer to this area as "lung+ space". While deep learning (DL) has increasingly been utilized to segment pneumothorax lesions in chest radiographs, many existing DL models employ an end-to-end approach. These models directly map chest radiographs to clinician-annotated lesion areas, often neglecting the vital domain knowledge that pneumothorax is inherently location-sensitive. We propose a novel approach that incorporates the lung+ space as a constraint during DL model training for pneumothorax segmentation on 2D chest radiographs. To circumvent the need for additional annotations and to prevent potential label leakage on the target task, our method utilizes external datasets and an auxiliary task of lung segmentation. This approach generates a specific constraint of lung+ space for each chest radiograph. Furthermore, we have incorporated a discriminator to eliminate unreliable constraints caused by the domain shift between the auxiliary and target datasets. Our results demonstrated significant improvements, with average performance gains of 4.6%, 3.6%, and 3.3% regarding Intersection over Union (IoU), Dice Similarity Coefficient (DSC), and Hausdorff Distance (HD). Our research underscores the significance of incorporating medical domain knowledge about the location-specific nature of pneumothorax to enhance DL-based lesion segmentation.

Wei Xiong, Chenlu Ye, Baohao Liao et al.

Reinforcement learning applied to large language models (LLMs) for reasoning tasks is often bottlenecked by unstable gradient estimates due to fixed and uniform sampling of responses across prompts. Prior work such as GVM-RAFT addresses this by dynamically allocating inference budget per prompt to minimize stochastic gradient variance under a budget constraint. Inspired by this insight, we propose Reinforce-Ada, an adaptive sampling framework for online RL post-training of LLMs that continuously reallocates sampling effort to the prompts with the greatest uncertainty or learning potential. Unlike conventional two-stage allocation methods, Reinforce-Ada interleaves estimation and sampling in an online successive elimination process, and automatically stops sampling for a prompt once sufficient signal is collected. To stabilize updates, we form fixed-size groups with enforced reward diversity and compute advantage baselines using global statistics aggregated over the adaptive sampling phase. Empirical results across multiple model architectures and reasoning benchmarks show that Reinforce-Ada accelerates convergence and improves final performance compared to GRPO, especially when using the balanced sampling variant. Our work highlights the central role of variance-aware, adaptive data curation in enabling efficient and reliable reinforcement learning for reasoning-capable LLMs. Code is available at https://github.com/RLHFlow/Reinforce-Ada.

Xiuchao Sui, Shaohua Li, Xue Geng et al.

Optical flow estimation aims to find the 2D motion field by identifying corresponding pixels between two images. Despite the tremendous progress of deep learning-based optical flow methods, it remains a challenge to accurately estimate large displacements with motion blur. This is mainly because the correlation volume, the basis of pixel matching, is computed as the dot product of the convolutional features of the two images. The locality of convolutional features makes the computed correlations susceptible to various noises. On large displacements with motion blur, noisy correlations could cause severe errors in the estimated flow. To overcome this challenge, we propose a new architecture "CRoss-Attentional Flow Transformer" (CRAFT), aiming to revitalize the correlation volume computation. In CRAFT, a Semantic Smoothing Transformer layer transforms the features of one frame, making them more global and semantically stable. In addition, the dot-product correlations are replaced with transformer Cross-Frame Attention. This layer filters out feature noises through the Query and Key projections, and computes more accurate correlations. On Sintel (Final) and KITTI (foreground) benchmarks, CRAFT has achieved new state-of-the-art performance. Moreover, to test the robustness of different models on large motions, we designed an image shifting attack that shifts input images to generate large artificial motions. Under this attack, CRAFT performs much more robustly than two representative methods, RAFT and GMA. The code of CRAFT is is available at https://github.com/askerlee/craft.

Huihui Fang, Fei Li, Junde Wu et al.

With the rapid development of artificial intelligence (AI) in medical image processing, deep learning in color fundus photography (CFP) analysis is also evolving. Although there are some open-source, labeled datasets of CFPs in the ophthalmology community, large-scale datasets for screening only have labels of disease categories, and datasets with annotations of fundus structures are usually small in size. In addition, labeling standards are not uniform across datasets, and there is no clear information on the acquisition device. Here we release a multi-annotation, multi-quality, and multi-device color fundus image dataset for glaucoma analysis on an original challenge -- Retinal Fundus Glaucoma Challenge 2nd Edition (REFUGE2). The REFUGE2 dataset contains 2000 color fundus images with annotations of glaucoma classification, optic disc/cup segmentation, as well as fovea localization. Meanwhile, the REFUGE2 challenge sets three sub-tasks of automatic glaucoma diagnosis and fundus structure analysis and provides an online evaluation framework. Based on the characteristics of multi-device and multi-quality data, some methods with strong generalizations are provided in the challenge to make the predictions more robust. This shows that REFUGE2 brings attention to the characteristics of real-world multi-domain data, bridging the gap between scientific research and clinical application.

Shaohua Li, Xiuchao Sui, Jie Fu et al.

Deep neural networks (DNNs) trained on one set of medical images often experience severe performance drop on unseen test images, due to various domain discrepancy between the training images (source domain) and the test images (target domain), which raises a domain adaptation issue. In clinical settings, it is difficult to collect enough annotated target domain data in a short period. Few-shot domain adaptation, i.e., adapting a trained model with a handful of annotations, is highly practical and useful in this case. In this paper, we propose a Polymorphic Transformer (Polyformer), which can be incorporated into any DNN backbones for few-shot domain adaptation. Specifically, after the polyformer layer is inserted into a model trained on the source domain, it extracts a set of prototype embeddings, which can be viewed as a "basis" of the source-domain features. On the target domain, the polyformer layer adapts by only updating a projection layer which controls the interactions between image features and the prototype embeddings. All other model weights (except BatchNorm parameters) are frozen during adaptation. Thus, the chance of overfitting the annotations is greatly reduced, and the model can perform robustly on the target domain after being trained on a few annotated images. We demonstrate the effectiveness of Polyformer on two medical segmentation tasks (i.e., optic disc/cup segmentation, and polyp segmentation). The source code of Polyformer is released at https://github.com/askerlee/segtran.

Shaohua Li, Xiuchao Sui, Xiangde Luo et al.

Medical image segmentation is important for computer-aided diagnosis. Good segmentation demands the model to see the big picture and fine details simultaneously, i.e., to learn image features that incorporate large context while keep high spatial resolutions. To approach this goal, the most widely used methods -- U-Net and variants, extract and fuse multi-scale features. However, the fused features still have small "effective receptive fields" with a focus on local image cues, limiting their performance. In this work, we propose Segtran, an alternative segmentation framework based on transformers, which have unlimited "effective receptive fields" even at high feature resolutions. The core of Segtran is a novel Squeeze-and-Expansion transformer: a squeezed attention block regularizes the self attention of transformers, and an expansion block learns diversified representations. Additionally, we propose a new positional encoding scheme for transformers, imposing a continuity inductive bias for images. Experiments were performed on 2D and 3D medical image segmentation tasks: optic disc/cup segmentation in fundus images (REFUGE'20 challenge), polyp segmentation in colonoscopy images, and brain tumor segmentation in MRI scans (BraTS'19 challenge). Compared with representative existing methods, Segtran consistently achieved the highest segmentation accuracy, and exhibited good cross-domain generalization capabilities. The source code of Segtran is released at https://github.com/askerlee/segtran.

Han Yuan, Chuan Hong, Pengtao Jiang et al.

Background: Pneumothorax is an acute thoracic disease caused by abnormal air collection between the lungs and chest wall. To address the opaqueness often associated with deep learning (DL) models, explainable artificial intelligence (XAI) methods have been introduced to outline regions related to pneumothorax diagnoses made by DL models. However, these explanations sometimes diverge from actual lesion areas, highlighting the need for further improvement. Method: We propose a template-guided approach to incorporate the clinical knowledge of pneumothorax into model explanations generated by XAI methods, thereby enhancing the quality of these explanations. Utilizing one lesion delineation created by radiologists, our approach first generates a template that represents potential areas of pneumothorax occurrence. This template is then superimposed on model explanations to filter out extraneous explanations that fall outside the template's boundaries. To validate its efficacy, we carried out a comparative analysis of three XAI methods with and without our template guidance when explaining two DL models in two real-world datasets. Results: The proposed approach consistently improved baseline XAI methods across twelve benchmark scenarios built on three XAI methods, two DL models, and two datasets. The average incremental percentages, calculated by the performance improvements over the baseline performance, were 97.8% in Intersection over Union (IoU) and 94.1% in Dice Similarity Coefficient (DSC) when comparing model explanations and ground-truth lesion areas. Conclusions: In the context of pneumothorax diagnoses, we proposed a template-guided approach for improving AI explanations. We anticipate that our template guidance will forge a fresh approach to elucidating AI models by integrating clinical domain expertise.

Chun-Mei Feng, Yang Bai, Tao Luo et al.

Albeit progress has been made in Composed Image Retrieval (CIR), we empirically find that a certain percentage of failure retrieval results are not consistent with their relative captions. To address this issue, this work provides a Visual Question Answering (VQA) perspective to boost the performance of CIR. The resulting VQA4CIR is a post-processing approach and can be directly plugged into existing CIR methods. Given the top-C retrieved images by a CIR method, VQA4CIR aims to decrease the adverse effect of the failure retrieval results being inconsistent with the relative caption. To find the retrieved images inconsistent with the relative caption, we resort to the "QA generation to VQA" self-verification pipeline. For QA generation, we suggest fine-tuning LLM (e.g., LLaMA) to generate several pairs of questions and answers from each relative caption. We then fine-tune LVLM (e.g., LLaVA) to obtain the VQA model. By feeding the retrieved image and question to the VQA model, one can find the images inconsistent with relative caption when the answer by VQA is inconsistent with the answer in the QA pair. Consequently, the CIR performance can be boosted by modifying the ranks of inconsistently retrieved images. Experimental results show that our proposed method outperforms state-of-the-art CIR methods on the CIRR and Fashion-IQ datasets.

Zhi Da Soh, Yang Bai, Kai Yu et al.

Current deep learning models are mostly task specific and lack a user-friendly interface to operate. We present Meta-EyeFM, a multi-function foundation model that integrates a large language model (LLM) with vision foundation models (VFMs) for ocular disease assessment. Meta-EyeFM leverages a routing mechanism to enable accurate task-specific analysis based on text queries. Using Low Rank Adaptation, we fine-tuned our VFMs to detect ocular and systemic diseases, differentiate ocular disease severity, and identify common ocular signs. The model achieved 100% accuracy in routing fundus images to appropriate VFMs, which achieved $\ge$ 82.2% accuracy in disease detection, $\ge$ 89% in severity differentiation, $\ge$ 76% in sign identification. Meta-EyeFM was 11% to 43% more accurate than Gemini-1.5-flash and ChatGPT-4o LMMs in detecting various eye diseases and comparable to an ophthalmologist. This system offers enhanced usability and diagnostic performance, making it a valuable decision support tool for primary eye care or an online LLM for fundus evaluation.

Yufei He, Juncheng Liu, Yue Liu et al.

A fundamental limitation of current AI agents is their inability to learn complex skills on the fly at test time, often behaving like "clever but clueless interns" in novel environments. This severely limits their practical utility. To systematically measure and drive progress on this challenge, we first introduce the Jericho Test-Time Learning (J-TTL) benchmark. J-TTL is a new evaluation setup where an agent must play the same game for several consecutive episodes, attempting to improve its performance from one episode to the next. On J-TTL, we find that existing adaptation methods like reflection, memory, or reinforcement learning struggle. To address the challenges posed by our benchmark, we present EvoTest, an evolutionary test-time learning framework that improves an agent without any fine-tuning or gradients-by evolving the entire agentic system after every episode. EvoTest has two roles: the Actor Agent, which plays the game, and the Evolver Agent, which analyzes the episode transcript to propose a revised configuration for the next run. This configuration rewrites the prompt, updates memory by logging effective state-action choices, tunes hyperparameters, and learns the tool-use routines. On our J-TTL benchmark, EvoTest consistently increases performance, outperforming not only reflection and memory-only baselines but also more complex online fine-tuning methods. Notably, our method is the only one capable of winning two games (Detective and Library), while all baselines fail to win any.

Lei Zhu, Yanyu Xu, Huazhu Fu et al.

Unpaired Multi-Modal Learning (UMML) which leverages unpaired multi-modal data to boost model performance on each individual modality has attracted a lot of research interests in medical image analysis. However, existing UMML methods require multi-modal datasets to be fully labeled, which incurs tremendous annotation cost. In this paper, we investigate the use of partially labeled data for label-efficient unpaired multi-modal learning, which can reduce the annotation cost by up to one half. We term the new learning paradigm as Partially Supervised Unpaired Multi-Modal Learning (PSUMML) and propose a novel Decomposed partial class adaptation with snapshot Ensembled Self-Training (DEST) framework for it. Specifically, our framework consists of a compact segmentation network with modality specific normalization layers for learning with partially labeled unpaired multi-modal data. The key challenge in PSUMML lies in the complex partial class distribution discrepancy due to partial class annotation, which hinders effective knowledge transfer across modalities. We theoretically analyze this phenomenon with a decomposition theorem and propose a decomposed partial class adaptation technique to precisely align the partially labeled classes across modalities to reduce the distribution discrepancy. We further propose a snapshot ensembled self-training technique to leverage the valuable snapshot models during training to assign pseudo-labels to partially labeled pixels for self-training to boost model performance. We perform extensive experiments under different scenarios of PSUMML for two medical image segmentation tasks, namely cardiac substructure segmentation and abdominal multi-organ segmentation. Our framework outperforms existing methods significantly.

Yunlu Yan, Lei Zhu, Yuexiang Li et al.

Improving the fairness of federated learning (FL) benefits healthy and sustainable collaboration, especially for medical applications. However, existing fair FL methods ignore the specific characteristics of medical FL applications, i.e., domain shift among the datasets from different hospitals. In this work, we propose Fed-LWR to improve performance fairness from the perspective of feature shift, a key issue influencing the performance of medical FL systems caused by domain shift. Specifically, we dynamically perceive the bias of the global model across all hospitals by estimating the layer-wise difference in feature representations between local and global models. To minimize global divergence, we assign higher weights to hospitals with larger differences. The estimated client weights help us to re-aggregate the local models per layer to obtain a fairer global model. We evaluate our method on two widely used federated medical image segmentation benchmarks. The results demonstrate that our method achieves better and fairer performance compared with several state-of-the-art fair FL methods.

Chun-Mei Feng, Kai Yu, Xinxing Xu et al.

Benefited from image-text contrastive learning, pre-trained vision-language models, e.g., CLIP, allow to direct leverage texts as images (TaI) for parameter-efficient fine-tuning (PEFT). While CLIP is capable of making image features to be similar to the corresponding text features, the modality gap remains a nontrivial issue and limits image recognition performance of TaI. Using multi-label image recognition (MLR) as an example, we present a novel method, called T2I-PAL to tackle the modality gap issue when using only text captions for PEFT. The core design of T2I-PAL is to leverage pre-trained text-to-image generation models to generate photo-realistic and diverse images from text captions, thereby reducing the modality gap. To further enhance MLR, T2I-PAL incorporates a class-wise heatmap and learnable prototypes. This aggregates local similarities, making the representation of local visual features more robust and informative for multi-label recognition. For better PEFT, we further combine both prompt tuning and adapter learning to enhance classification performance. T2I-PAL offers significant advantages: it eliminates the need for fully semantically annotated training images, thereby reducing the manual annotation workload, and it preserves the intrinsic mode of the CLIP model, allowing for seamless integration with any existing CLIP framework. Extensive experiments on multiple benchmarks, including MS-COCO, VOC2007, and NUS-WIDE, show that our T2I-PAL can boost recognition performance by 3.47% in average above the top-ranked state-of-the-art methods.

Xiaofeng Lei, Yih-Chung Tham, Jocelyn Hui Lin Goh et al.

Community vision screening plays a crucial role in identifying individuals with vision loss and preventing avoidable blindness, particularly in rural communities where access to eye care services is limited. Currently, there is a pressing need for a simple and efficient process to screen and refer individuals with significant eye disease-related vision loss to tertiary eye care centers for further care. An ideal solution should seamlessly and readily integrate with existing workflows, providing comprehensive initial screening results to service providers, thereby enabling precise patient referrals for timely treatment. This paper introduces the Enhancing Community Vision Screening (ECVS) solution, which addresses the aforementioned concerns with a novel and feasible solution based on simple, non-invasive retinal photography for the detection of pathology-based visual impairment. Our study employs four distinct deep learning models: RETinal photo Quality Assessment (RETQA), Pathology Visual Impairment detection (PVI), Eye Disease Diagnosis (EDD) and Visualization of Lesion Regions of the eye (VLR). We conducted experiments on over 10 datasets, totaling more than 80,000 fundus photos collected from various sources. The models integrated into ECVS achieved impressive AUC scores of 0.98 for RETQA, 0.95 for PVI, and 0.90 for EDD, along with a DICE coefficient of 0.48 for VLR. These results underscore the promising capabilities of ECVS as a straightforward and scalable method for community-based vision screening.

Tanvi Verma, Linh Le Dinh, Nicholas Tan et al.

Visual perimetry is an important eye examination that helps detect vision problems caused by ocular or neurological conditions. During the test, a patient's gaze is fixed at a specific location while light stimuli of varying intensities are presented in central and peripheral vision. Based on the patient's responses to the stimuli, the visual field mapping and sensitivity are determined. However, maintaining high levels of concentration throughout the test can be challenging for patients, leading to increased examination times and decreased accuracy. In this work, we present RLPeri, a reinforcement learning-based approach to optimize visual perimetry testing. By determining the optimal sequence of locations and initial stimulus values, we aim to reduce the examination time without compromising accuracy. Additionally, we incorporate reward shaping techniques to further improve the testing performance. To monitor the patient's responses over time during testing, we represent the test's state as a pair of 3D matrices. We apply two different convolutional kernels to extract spatial features across locations as well as features across different stimulus values for each location. Through experiments, we demonstrate that our approach results in a 10-20% reduction in examination time while maintaining the accuracy as compared to state-of-the-art methods. With the presented approach, we aim to make visual perimetry testing more efficient and patient-friendly, while still providing accurate results.

Junde Wu, Huihui Fang, Fei Li et al.

Color fundus photography and Optical Coherence Tomography (OCT) are the two most cost-effective tools for glaucoma screening. Both two modalities of images have prominent biomarkers to indicate glaucoma suspected. Clinically, it is often recommended to take both of the screenings for a more accurate and reliable diagnosis. However, although numerous algorithms are proposed based on fundus images or OCT volumes in computer-aided diagnosis, there are still few methods leveraging both of the modalities for the glaucoma assessment. Inspired by the success of Retinal Fundus Glaucoma Challenge (REFUGE) we held previously, we set up the Glaucoma grAding from Multi-Modality imAges (GAMMA) Challenge to encourage the development of fundus \& OCT-based glaucoma grading. The primary task of the challenge is to grade glaucoma from both the 2D fundus images and 3D OCT scanning volumes. As part of GAMMA, we have publicly released a glaucoma annotated dataset with both 2D fundus color photography and 3D OCT volumes, which is the first multi-modality dataset for glaucoma grading. In addition, an evaluation framework is also established to evaluate the performance of the submitted methods. During the challenge, 1272 results were submitted, and finally, top-10 teams were selected to the final stage. We analysis their results and summarize their methods in the paper. Since all these teams submitted their source code in the challenge, a detailed ablation study is also conducted to verify the effectiveness of the particular modules proposed. We find many of the proposed techniques are practical for the clinical diagnosis of glaucoma. As the first in-depth study of fundus \& OCT multi-modality glaucoma grading, we believe the GAMMA Challenge will be an essential starting point for future research.

Shaohua Li, Xinxing Xu, Liqiang Nie et al.

Neural Style Transfer based on Convolutional Neural Networks (CNN) aims to synthesize a new image that retains the high-level structure of a content image, rendered in the low-level texture of a style image. This is achieved by constraining the new image to have high-level CNN features similar to the content image, and lower-level CNN features similar to the style image. However in the traditional optimization objective, low-level features of the content image are absent, and the low-level features of the style image dominate the low-level detail structures of the new image. Hence in the synthesized image, many details of the content image are lost, and a lot of inconsistent and unpleasing artifacts appear. As a remedy, we propose to steer image synthesis with a novel loss function: the Laplacian loss. The Laplacian matrix ("Laplacian" in short), produced by a Laplacian operator, is widely used in computer vision to detect edges and contours. The Laplacian loss measures the difference of the Laplacians, and correspondingly the difference of the detail structures, between the content image and a new image. It is flexible and compatible with the traditional style transfer constraints. By incorporating the Laplacian loss, we obtain a new optimization objective for neural style transfer named Lapstyle. Minimizing this objective will produce a stylized image that better preserves the detail structures of the content image and eliminates the artifacts. Experiments show that Lapstyle produces more appealing stylized images with less artifacts, without compromising their "stylishness".

Yong Kiam Tan, Xinxing Xu, Yong Liu

Recurrent neural networks (RNNs) were recently proposed for the session-based recommendation task. The models showed promising improvements over traditional recommendation approaches. In this work, we further study RNN-based models for session-based recommendations. We propose the application of two techniques to improve model performance, namely, data augmentation, and a method to account for shifts in the input data distribution. We also empirically study the use of generalised distillation, and a novel alternative model that directly predicts item embeddings. Experiments on the RecSys Challenge 2015 dataset demonstrate relative improvements of 12.8% and 14.8% over previously reported results on the Recall@20 and Mean Reciprocal Rank@20 metrics respectively.

Joey Tianyi Zhou, Xinxing Xu, Sinno Jialin Pan et al.

Most existing learning to hash methods assume that there are sufficient data, either labeled or unlabeled, on the domain of interest (i.e., the target domain) for training. However, this assumption cannot be satisfied in some real-world applications. To address this data sparsity issue in hashing, inspired by transfer learning, we propose a new framework named Transfer Hashing with Privileged Information (THPI). Specifically, we extend the standard learning to hash method, Iterative Quantization (ITQ), in a transfer learning manner, namely ITQ+. In ITQ+, a new slack function is learned from auxiliary data to approximate the quantization error in ITQ. We developed an alternating optimization approach to solve the resultant optimization problem for ITQ+. We further extend ITQ+ to LapITQ+ by utilizing the geometry structure among the auxiliary data for learning more precise binary codes in the target domain. Extensive experiments on several benchmark datasets verify the effectiveness of our proposed approaches through comparisons with several state-of-the-art baselines.

Xinxing Xu, Joey Tianyi Zhou, IvorW. Tsang et al.

The Support Vector Machine using Privileged Information (SVM+) has been proposed to train a classifier to utilize the additional privileged information that is only available in the training phase but not available in the test phase. In this work, we propose an efficient solution for SVM+ by simply utilizing the squared hinge loss instead of the hinge loss as in the existing SVM+ formulation, which interestingly leads to a dual form with less variables and in the same form with the dual of the standard SVM. The proposed algorithm is utilized to leverage the additional web knowledge that is only available during training for the image categorization tasks. The extensive experimental results on both Caltech101 andWebQueries datasets show that our proposed method can achieve a factor of up to hundred times speedup with the comparable accuracy when compared with the existing SVM+ method.