SAM-aware Test-time Adaptation for Universal Medical Image Segmentation

Universal medical image segmentation using the Segment Anything Model (SAM) remains challenging due to its limited adaptability to medical domains. Existing adaptations, such as MedSAM, enhance SAM's performance in medical imaging but at the cost of reduced generalization to unseen data. Therefore, in this paper, we propose SAM-aware Test-Time Adaptation (SAM-TTA), a fundamentally different pipeline that preserves the generalization of SAM while improving its segmentation performance in medical imaging via a test-time framework. SAM-TTA tackles two key challenges: (1) input-level discrepancies caused by differences in image acquisition between natural and medical images and (2) semantic-level discrepancies due to fundamental differences in object definition between natural and medical domains (e.g., clear boundaries vs. ambiguous structures). Specifically, our SAM-TTA framework comprises (1) Self-adaptive Bezier Curve-based Transformation (SBCT), which adaptively converts single-channel medical images into three-channel SAM-compatible inputs while maintaining structural integrity, to mitigate the input gap between medical and natural images, and (2) Dual-scale Uncertainty-driven Mean Teacher adaptation (DUMT), which employs consistency learning to align SAM's internal representations to medical semantics, enabling efficient adaptation without auxiliary supervision or expensive retraining. Extensive experiments on five public datasets demonstrate that our SAM-TTA outperforms existing TTA approaches and even surpasses fully fine-tuned models such as MedSAM in certain scenarios, establishing a new paradigm for universal medical image segmentation. Code can be found at https://github.com/JianghaoWu/SAM-TTA.

DeepChest: Dynamic Gradient-Free Task Weighting for Effective Multi-Task Learning in Chest X-ray Classification

While Multi-Task Learning (MTL) offers inherent advantages in complex domains such as medical imaging by enabling shared representation learning, effectively balancing task contributions remains a significant challenge. This paper addresses this critical issue by introducing DeepChest, a novel, computationally efficient and effective dynamic task-weighting framework specifically designed for multi-label chest X-ray (CXR) classification. Unlike existing heuristic or gradient-based methods that often incur substantial overhead, DeepChest leverages a performance-driven weighting mechanism based on effective analysis of task-specific loss trends. Given a network architecture (e.g., ResNet18), our model-agnostic approach adaptively adjusts task importance without requiring gradient access, thereby significantly reducing memory usage and achieving a threefold increase in training speed. It can be easily applied to improve various state-of-the-art methods. Extensive experiments on a large-scale CXR dataset demonstrate that DeepChest not only outperforms state-of-the-art MTL methods by 7% in overall accuracy but also yields substantial reductions in individual task losses, indicating improved generalization and effective mitigation of negative transfer. The efficiency and performance gains of DeepChest pave the way for more practical and robust deployment of deep learning in critical medical diagnostic applications. The code is publicly available at https://github.com/youssefkhalil320/DeepChest-MTL

The Role of AI in Early Detection of Life-Threatening Diseases: A Retinal Imaging Perspective

Retinal imaging has emerged as a powerful, non-invasive modality for detecting and quantifying biomarkers of systemic diseases-ranging from diabetes and hypertension to Alzheimer's disease and cardiovascular disorders but current insights remain dispersed across platforms and specialties. Recent technological advances in optical coherence tomography (OCT/OCTA) and adaptive optics (AO) now deliver ultra-high-resolution scans (down to 5 {\mu}m ) with superior contrast and spatial integration, allowing early identification of microvascular abnormalities and neurodegenerative changes. At the same time, AI-driven and machine learning (ML) algorithms have revolutionized the analysis of large-scale retinal datasets, increasing sensitivity and specificity; for example, deep learning models achieve > 90 \% sensitivity for diabetic retinopathy and AUC = 0.89 for the prediction of cardiovascular risk from fundus photographs. The proliferation of mobile health technologies and telemedicine platforms further extends access, reduces costs, and facilitates community-based screening and longitudinal monitoring. Despite these breakthroughs, translation into routine practice is hindered by heterogeneous imaging protocols, limited external validation of AI models, and integration challenges within clinical workflows. In this review, we systematically synthesize the latest OCT/OCT and AO developments, AI/ML approaches, and mHealth/Tele-ophthalmology initiatives and quantify their diagnostic performance across disease domains. Finally, we propose a roadmap for multicenter protocol standardization, prospective validation trials, and seamless incorporation of retinal screening into primary and specialty care pathways-paving the way for precision prevention, early intervention, and ongoing treatment of life-threatening systemic diseases.

Navigating loss manifolds via rigid body dynamics: A promising avenue for robustness and generalisation

Training large neural networks through gradient-based optimization requires navigating high-dimensional loss landscapes, which often exhibit pathological geometry, leading to undesirable training dynamics. In particular, poor generalization frequently results from convergence to sharp minima that are highly sensitive to input perturbations, causing the model to overfit the training data while failing to generalize to unseen examples. Furthermore, these optimization procedures typically display strong dependence on the fine structure of the loss landscape, leading to unstable training dynamics, due to the fractal-like nature of the loss surface. In this work, we propose an alternative optimizer that simultaneously reduces this dependence, and avoids sharp minima, thereby improving generalization. This is achieved by simulating the motion of the center of a ball rolling on the loss landscape. The degree to which our optimizer departs from the standard gradient descent is controlled by a hyperparameter, representing the radius of the ball. Changing this hyperparameter allows for probing the loss landscape at different scales, making it a valuable tool for understanding its geometry.

From Generation to Detection: A Multimodal Multi-Task Dataset for Benchmarking Health Misinformation

Infodemics and health misinformation have significant negative impact on individuals and society, exacerbating confusion and increasing hesitancy in adopting recommended health measures. Recent advancements in generative AI, capable of producing realistic, human like text and images, have significantly accelerated the spread and expanded the reach of health misinformation, resulting in an alarming surge in its dissemination. To combat the infodemics, most existing work has focused on developing misinformation datasets from social media and fact checking platforms, but has faced limitations in topical coverage, inclusion of AI generation, and accessibility of raw content. To address these issues, we present MM Health, a large scale multimodal misinformation dataset in the health domain consisting of 34,746 news article encompassing both textual and visual information. MM Health includes human-generated multimodal information (5,776 articles) and AI generated multimodal information (28,880 articles) from various SOTA generative AI models. Additionally, We benchmarked our dataset against three tasks (reliability checks, originality checks, and fine-grained AI detection) demonstrating that existing SOTA models struggle to accurately distinguish the reliability and origin of information. Our dataset aims to support the development of misinformation detection across various health scenarios, facilitating the detection of human and machine generated content at multimodal levels.

TAGS: A Test-Time Generalist-Specialist Framework with Retrieval-Augmented Reasoning and Verification

Recent advances such as Chain-of-Thought prompting have significantly improved large language models (LLMs) in zero-shot medical reasoning. However, prompting-based methods often remain shallow and unstable, while fine-tuned medical LLMs suffer from poor generalization under distribution shifts and limited adaptability to unseen clinical scenarios. To address these limitations, we present TAGS, a test-time framework that combines a broadly capable generalist with a domain-specific specialist to offer complementary perspectives without any model fine-tuning or parameter updates. To support this generalist-specialist reasoning process, we introduce two auxiliary modules: a hierarchical retrieval mechanism that provides multi-scale exemplars by selecting examples based on both semantic and rationale-level similarity, and a reliability scorer that evaluates reasoning consistency to guide final answer aggregation. TAGS achieves strong performance across nine MedQA benchmarks, boosting GPT-4o accuracy by 13.8%, DeepSeek-R1 by 16.8%, and improving a vanilla 7B model from 14.1% to 23.9%. These results surpass several fine-tuned medical LLMs, without any parameter updates. The code will be available at https://github.com/JianghaoWu/TAGS.

Towards Dynamic 3D Reconstruction of Hand-Instrument Interaction in Ophthalmic Surgery

Accurate 3D reconstruction of hands and instruments is critical for vision-based analysis of ophthalmic microsurgery, yet progress has been hampered by the lack of realistic, large-scale datasets and reliable annotation tools. In this work, we introduce OphNet-3D, the first extensive RGB-D dynamic 3D reconstruction dataset for ophthalmic surgery, comprising 41 sequences from 40 surgeons and totaling 7.1 million frames, with fine-grained annotations of 12 surgical phases, 10 instrument categories, dense MANO hand meshes, and full 6-DoF instrument poses. To scalably produce high-fidelity labels, we design a multi-stage automatic annotation pipeline that integrates multi-view data observation, data-driven motion prior with cross-view geometric consistency and biomechanical constraints, along with a combination of collision-aware interaction constraints for instrument interactions. Building upon OphNet-3D, we establish two challenging benchmarks-bimanual hand pose estimation and hand-instrument interaction reconstruction-and propose two dedicated architectures: H-Net for dual-hand mesh recovery and OH-Net for joint reconstruction of two-hand-two-instrument interactions. These models leverage a novel spatial reasoning module with weak-perspective camera modeling and collision-aware center-based representation. Both architectures outperform existing methods by substantial margins, achieving improvements of over 2mm in Mean Per Joint Position Error (MPJPE) and up to 23% in ADD-S metrics for hand and instrument reconstruction, respectively.

Seeing Far and Clearly: Mitigating Hallucinations in MLLMs with Attention Causal Decoding

Recent advancements in multimodal large language models (MLLMs) have significantly improved performance in visual question answering. However, they often suffer from hallucinations. In this work, hallucinations are categorized into two main types: initial hallucinations and snowball hallucinations. We argue that adequate contextual information can be extracted directly from the token interaction process. Inspired by causal inference in the decoding strategy, we propose to leverage causal masks to establish information propagation between multimodal tokens. The hypothesis is that insufficient interaction between those tokens may lead the model to rely on outlier tokens, overlooking dense and rich contextual cues. Therefore, we propose to intervene in the propagation process by tackling outlier tokens to enhance in-context inference. With this goal, we present FarSight, a versatile plug-and-play decoding strategy to reduce attention interference from outlier tokens merely by optimizing the causal mask. The heart of our method is effective token propagation. We design an attention register structure within the upper triangular matrix of the causal mask, dynamically allocating attention to capture attention diverted to outlier tokens. Moreover, a positional awareness encoding method with a diminishing masking rate is proposed, allowing the model to attend to further preceding tokens, especially for video sequence tasks. With extensive experiments, FarSight demonstrates significant hallucination-mitigating performance across different MLLMs on both image and video benchmarks, proving its effectiveness.

Divide by Question, Conquer by Agent: SPLIT-RAG with Question-Driven Graph Partitioning

Retrieval-Augmented Generation (RAG) systems empower large language models (LLMs) with external knowledge, yet struggle with efficiency-accuracy trade-offs when scaling to large knowledge graphs. Existing approaches often rely on monolithic graph retrieval, incurring unnecessary latency for simple queries and fragmented reasoning for complex multi-hop questions. To address these challenges, this paper propose SPLIT-RAG, a multi-agent RAG framework that addresses these limitations with question-driven semantic graph partitioning and collaborative subgraph retrieval. The innovative framework first create Semantic Partitioning of Linked Information, then use the Type-Specialized knowledge base to achieve Multi-Agent RAG. The attribute-aware graph segmentation manages to divide knowledge graphs into semantically coherent subgraphs, ensuring subgraphs align with different query types, while lightweight LLM agents are assigned to partitioned subgraphs, and only relevant partitions are activated during retrieval, thus reduce search space while enhancing efficiency. Finally, a hierarchical merging module resolves inconsistencies across subgraph-derived answers through logical verifications. Extensive experimental validation demonstrates considerable improvements compared to existing approaches.

The Eye as a Window to Systemic Health: A Survey of Retinal Imaging from Classical Techniques to Oculomics

The unique vascularized anatomy of the human eye, encased in the retina, provides an opportunity to act as a window for human health. The retinal structure assists in assessing the early detection, monitoring of disease progression and intervention for both ocular and non-ocular diseases. The advancement in imaging technology leveraging Artificial Intelligence has seized this opportunity to bridge the gap between the eye and human health. This track paves the way for unveiling systemic health insight from the ocular system and surrogating non-invasive markers for timely intervention and identification. The new frontiers of oculomics in ophthalmology cover both ocular and systemic diseases, and getting more attention to explore them. In this survey paper, we explore the evolution of retinal imaging techniques, the dire need for the integration of AI-driven analysis, and the shift of retinal imaging from classical techniques to oculomics. We also discuss some hurdles that may be faced in the progression of oculomics, highlighting the research gaps and future directions.