Learning Label-Efficient Interpretable Medical Image Diagnosis via Semi-supervised Hypergraph Concept Bottleneck Model

Deep learning has revolutionized medical image analysis, delivering exceptional diagnostic accuracy across diverse applications. Yet, the lack of interpretability in its decision-making hinders clinical adoption, particularly in high-stakes medical contexts where transparency is paramount for trustworthiness. For example, in Placenta Accreta Spectrum (PAS), subtle cues in ultrasound imaging challenge reliable diagnosis, rendering black-box models untrustworthy for accurate scoring. To address this, Concept Bottleneck Models (CBMs) offer a promising avenue by embedding clinically meaningful intermediate concepts into the diagnosis pipeline, enabling clinicians to scrutinize and refine model outputs. However, conventional CBMs falter in capturing complex inter-concept dependencies and demand costly, expert-driven concept annotations, limiting their scalability. This study introduces a novel semi-supervised CBM framework designed for medical imaging, which leverages dual-level hypergraph learning to model high-order concept dependencies and generate domain-adaptive pseudo-labels. Our approach achieves superior interpretability and performance by integrating a concept-level hypergraph for enhanced reasoning and an image-level hypergraph for robust pseudo-label generation. Experiments on a newly annotated PAS ultrasound dataset and a breast ultrasound public dataset demonstrate the effectiveness of the proposed concept label-efficient interpretable framework. Its universality is further validated on the dermoscopic image dataset SkinCon. The code is available at https://github.com/scott-yjyang/HyperCBM.

Attenuation-Resilient Alternating Optimization for Laparoscopic Liver Landmark Detection

Liver surface landmark detection is a fundamental prerequisite for anatomical guidance in laparoscopic liver surgery. However, it remains unreliable in practice due to two pervasive challenges: illumination attenuation in underexposed regions and the structural mismatch between pixel-wise localization and continuous curvilinear geometry. To address these limitations, we propose A2ONet, an attenuation-resilient alternating optimization network for robust liver landmark detection. To mitigate illumination attenuation, A2ONet embraces an illumination field compensation (IFC) block that adaptively enhances dark regions while preserving structural consistency. Meanwhile, we introduce a lightweight frequency-orientation selective filter (FOSF) to suppress repetitive texture interference and preserve salient curvilinear cues. Building upon these resilient representations, we design an alternating seg-curve optimization (ASCO) decoder that iteratively couples dense segmentation with explicit curve modeling, enabling mutual guidance to optimize both structural continuity and endpoint localization. Extensive evaluations on L3D-2K, L3D, and P2ILF demonstrate consistent improvements over competitive methods, establishing a more reliable foundation for intraoperative anatomy guidance. Our code will be available at https://github.com/hyperiondk115/A2ONet.

Concept-Guided Noisy Negative Suppression for Zero-Shot Classification and Grounding of Chest X-Ray Findings

Vision-language alignment using chest X-rays and radiology reports has emerged as an advanced paradigm for zero-shot classification and grounding of chest X-ray findings. However, standard contrastive learning typically treats radiographs and reports from different patients simply as negative pairs. This assumption introduces noisy negatives, as different patients frequently exhibit similar findings. Such noisy negatives cause semantic ambiguity and degrade performance in zero-shot understanding tasks. To address this challenge, we propose CoNNS, a concept-guided noisy-negative suppression framework. To support the negative suppression mechanism, unlike previous methods that use raw reports or templatized texts, we construct a hierarchical concept ontology using large language models. The ontology structures 41 key clinical concepts by explicitly modeling presence, attributes (location and characteristics), and texts (evidential segment and presence statement). Leveraging this ontology, we implement a cross-patient pair relabeling strategy comprising three steps: (1) Fine-Grained Breakdown to categorize pairs based on finding presence; (2) Noisy Negative Filtering to resolve semantic conflicts by removing false negatives; and (3) Hard Negative Mining to identify subtle attribute discrepancies using a lightweight language model. Finally, we propose a Concept-Aware NCE loss to align visual features with text while suppressing the identified noisy negatives. Extensive experiments across multi-granularity zero-shot grounding tasks and five zero-shot classification datasets validate that CoNNS outperforms existing state-of-the-art models. The code is available at https://github.com/DopamineLcy/conns.

Evidential Reasoning Advances Interpretable Real-World Disease Screening

Disease screening is critical for early detection and timely intervention in clinical practice. However, most current screening models for medical images suffer from limited interpretability and suboptimal performance. They often lack effective mechanisms to reference historical cases or provide transparent reasoning pathways. To address these challenges, we introduce EviScreen, an evidential reasoning framework for disease screening that leverages region-level evidence from historical cases. The proposed EviScreen offers retrospection interpretability through regional evidence retrieved from dual knowledge banks. Using this evidential mechanism, the subsequent evidence-aware reasoning module makes predictions using both the current case and evidence from historical cases, thereby enhancing disease screening performance. Furthermore, rather than relying on post-hoc saliency maps, EviScreen enhances localization interpretability by leveraging abnormality maps derived from contrastive retrieval. Our method achieves superior performance on our carefully established benchmarks for real-world disease screening, yielding notably higher specificity at clinical-level recall. Code is publicly available at https://github.com/DopamineLcy/EviScreen.

ClawTrace: Cost-Aware Tracing for LLM Agent Skill Distillation

Skill-distillation pipelines learn reusable rules from LLM agent trajectories, but they lack a key signal: how much each step costs. Without per-step cost, a pipeline cannot distinguish adding a missing step to fix a bug from removing an expensive step that never affected the outcome. We introduce ClawTrace, an agent tracing platform that records every LLM call, tool use, and sub-agent spawn during an agent session and compiles each session into a TraceCard: a compact YAML summary with per-step USD cost, token counts, and redundancy flags. Built on ClawTrace, CostCraft is a distillation pipeline that reads TraceCards and produces three types of skill patches. Preserve patches keep behaviors that led to success. Prune patches remove expensive steps that did not matter, each backed by a counterfactual argument against a named high-cost step. Repair patches fix failures grounded in oracle evidence. Ablations on 30 held-out SpreadsheetBench tasks show that both cost attribution and prune patches independently reduce quality regressions. When the same skill is applied to 30 unrelated SkillsBench tasks, an unexpected asymmetry emerges: prune rules transferred across benchmarks and cut median cost by 32%, while preserve rules, trained on benchmark-specific conventions, caused regressions on new task types. We release ClawTrace and TraceCards as open infrastructure for cost-aware agent research.

OSA: Echocardiography Video Segmentation via Orthogonalized State Update and Anatomical Prior-aware Feature Enhancement

Accurate and temporally consistent segmentation of the left ventricle from echocardiography videos is essential for estimating the ejection fraction and assessing cardiac function. However, modeling spatiotemporal dynamics remains difficult due to severe speckle noise and rapid non-rigid deformations. Existing linear recurrent models offer efficient in-context associative recall for temporal tracking, but rely on unconstrained state updates, which cause progressive singular value decay in the state matrix, a phenomenon known as rank collapse, resulting in anatomical details being overwhelmed by noise. To address this, we propose OSA, a framework that constrains the state evolution on the Stiefel manifold. We introduce the Orthogonalized State Update (OSU) mechanism, which formulates the memory evolution as Euclidean projected gradient descent on the Stiefel manifold to prevent rank collapse and maintain stable temporal transitions. Furthermore, an Anatomical Prior-aware Feature Enhancement module explicitly separates anatomical structures from speckle noise through a physics-driven process, providing the temporal tracker with noise-resilient structural cues. Comprehensive experiments on the CAMUS and EchoNet-Dynamic datasets show that OSA achieves state-of-the-art segmentation accuracy and temporal stability, while maintaining real-time inference efficiency for clinical deployment. Codes are available at https://github.com/wangrui2025/OSA.

TextReasoningBench: Does Reasoning Really Improve Text Classification in Large Language Models?

Eliciting explicit, step-by-step reasoning traces from large language models (LLMs) has emerged as a dominant paradigm for enhancing model capabilities. Although such reasoning strategies were originally designed for problems requiring explicit multi-step reasoning, they have increasingly been applied to a broad range of NLP tasks. This expansion implicitly assumes that deliberative reasoning uniformly benefits heterogeneous tasks. However, whether such reasoning mechanisms truly benefit classification tasks remains largely underexplored, especially considering their substantial token and time costs. To fill this gap, we introduce TextReasoningBench, a systematic benchmark designed to evaluate the effectiveness and efficiency of reasoning strategies for text classification with LLMs. We compare seven reasoning strategies, namely IO, CoT, SC-CoT, ToT, GoT, BoC, and long-CoT across ten LLMs on five text classification datasets. Beyond traditional metrics such as accuracy and macro-F1, we introduce two cost-aware evaluation metrics that quantify the performance gain per reasoning token and the efficiency of performance improvement relative to token cost growth. Experimental results reveal three notable findings: (1) Reasoning does not universally improve classification performance: while moderate strategies such as CoT and SC-CoT yield consistent but limited gains (typically +1% to +3% on big models), more complex methods (e.g., ToT and GoT) often fail to outperform simpler baselines and can even degrade performance, especially on small models; (2) Reasoning is often inefficient: many reasoning strategies increase token consumption by 10$\times$ to 100$\times$ (e.g., SC-CoT and ToT) while providing only marginal performance improvements.

Multiscale Switch for Semi-Supervised and Contrastive Learning in Medical Ultrasound Image Segmentation

Medical ultrasound image segmentation faces significant challenges due to limited labeled data and characteristic imaging artifacts including speckle noise and low-contrast boundaries. While semi-supervised learning (SSL) approaches have emerged to address data scarcity, existing methods suffer from suboptimal unlabeled data utilization and lack robust feature representation mechanisms. In this paper, we propose Switch, a novel SSL framework with two key innovations: (1) Multiscale Switch (MSS) strategy that employs hierarchical patch mixing to achieve uniform spatial coverage; (2) Frequency Domain Switch (FDS) with contrastive learning that performs amplitude switching in Fourier space for robust feature representations. Our framework integrates these components within a teacher-student architecture to effectively leverage both labeled and unlabeled data. Comprehensive evaluation across six diverse ultrasound datasets (lymph nodes, breast lesions, thyroid nodules, and prostate) demonstrates consistent superiority over state-of-the-art methods. At 5\% labeling ratio, Switch achieves remarkable improvements: 80.04\% Dice on LN-INT, 85.52\% Dice on DDTI, and 83.48\% Dice on Prostate datasets, with our semi-supervised approach even exceeding fully supervised baselines. The method maintains parameter efficiency (1.8M parameters) while delivering superior performance, validating its effectiveness for resource-constrained medical imaging applications. The source code is publicly available at https://github.com/jinggqu/Switch

Symmetry-Reduced Physics-Informed Learning of Tensegrity Dynamics

Tensegrity structures possess intrinsic geometric symmetries that govern their dynamic behavior. However, most existing physics-informed neural network (PINN) approaches for tensegrity dynamics do not explicitly exploit these symmetries, leading to high computational complexity and unstable optimization. In this work, we propose a symmetry-reduced physics-informed neural network (SymPINN) framework that embeds group-theory-based symmetry directly into both the solution expression and the neural network architecture to predict tensegrity dynamics. By decomposing nodes into symmetry orbits and representing free nodal coordinates using a symmetry basis, the proposed method constructs a reduced coordinate representation that preserves geometric symmetry of the structure. The full coordinates are then recovered via symmetry transformations of the reduced solution learned by the network, ensuring that the predicted configurations automatically satisfy the symmetry constraints. In this framework, equivariance is enforced through orbit-based coordinate generation, symmetry-consistent message passing, and physics residual constraints. In addition, SymPINN improves training effectiveness by encoding initial conditions as hard constraints, incorporating Fourier feature encoding to enhance the representation of dynamic motions, and employing a two-stage optimization strategy. Extensive numerical experiments on symmetric T-bars and lander structures demonstrate significantly improved prediction accuracy and computational efficiency compared to standard physics-informed models, indicating the great potential of symmetry-aware learning for structure-preserving modeling of tensegrity dynamics.

Preoperative-to-intraoperative Liver Registration for Laparoscopic Surgery via Latent-Grounded Correspondence Constraints

In laparoscopic liver surgery, augmented reality technology enhances intraoperative anatomical guidance by overlaying 3D liver models from preoperative CT/MRI onto laparoscopic 2D views. However, existing registration methods lack explicit modeling of reliable 2D-3D geometric correspondences supported by latent evidence, leading to limited interpretability and potentially unstable alignment in clinical scenarios. In this work, we introduce Land-Reg, a correspondence-driven deformable registration framework that explicitly learns latent-grounded 2D-3D landmark correspondences as an interpretable intermediate representation to bridge cross-modal alignment. For rigid registration, Land-Reg embraces a Cross-modal Latent Alignment module to map multi-modal features into a unified latent space. Further, an Uncertainty-enhanced Overlap Landmark Detector with similarity matching is proposed to robustly estimate explicit 2D-3D landmark correspondences. For non-rigid registration, we design a novel shape-constrained supervision strategy that anchors shape deformation to matched landmarks through reprojection consistency and incorporates local-isometric regularization to alleviate inherent 2D-3D depth ambiguity, while a rendered-mask alignment enforces global shape consistency. Experimental results on the P2ILF dataset demonstrate the superiority of our method on both rigid pose estimation and non-rigid deformation. Our code will be available at https://github.com/cuiruize/Land-Reg.