Context-Aware Asymmetric Ensembling for Interpretable Retinopathy of Prematurity Screening via Active Query and Vascular Attention

Retinopathy of Prematurity (ROP) is among the major causes of preventable childhood blindness. Automated screening remains challenging, primarily due to limited data availability and the complex condition involving both structural staging and microvascular abnormalities. Current deep learning models depend heavily on large private datasets and passive multimodal fusion, which commonly fail to generalize on small, imbalanced public cohorts. We thus propose the Context-Aware Asymmetric Ensemble Model (CAA Ensemble) that simulates clinical reasoning through two specialized streams. First, the Multi-Scale Active Query Network (MS-AQNet) serves as a structure specialist, utilizing clinical contexts as dynamic query vectors to spatially control visual feature extraction for localization of the fibrovascular ridge. Secondly, VascuMIL encodes Vascular Topology Maps (VMAP) within a gated Multiple Instance Learning (MIL) network to precisely identify vascular tortuosity. A synergistic meta-learner ensembles these orthogonal signals to resolve diagnostic discordance across multiple objectives. Tested on a highly imbalanced cohort of 188 infants (6,004 images), the framework attained State-of-the-Art performance on two distinct clinical tasks: achieving a Macro F1-Score of 0.93 for Broad ROP staging and an AUC of 0.996 for Plus Disease detection. Crucially, the system features `Glass Box' transparency through counterfactual attention heatmaps and vascular threat maps, proving that clinical metadata dictates the model's visual search. Additionally, this study demonstrates that architectural inductive bias can serve as an effective bridge for the medical AI data gap.

Reasoning under Ambiguity: Uncertainty-Aware Multilingual Emotion Classification under Partial Supervision

Contemporary knowledge-based systems increasingly rely on multilingual emotion identification to support intelligent decision-making, yet they face major challenges due to emotional ambiguity and incomplete supervision. Emotion recognition from text is inherently uncertain because multiple emotional states often co-occur and emotion annotations are frequently missing or heterogeneous. Most existing multi-label emotion classification methods assume fully observed labels and rely on deterministic learning objectives, which can lead to biased learning and unreliable predictions under partial supervision. This paper introduces Reasoning under Ambiguity, an uncertainty-aware framework for multilingual multi-label emotion classification that explicitly aligns learning with annotation uncertainty. The proposed approach uses a shared multilingual encoder with language-specific optimization and an entropy-based ambiguity weighting mechanism that down-weights highly ambiguous training instances rather than treating missing labels as negative evidence. A mask-aware objective with positive-unlabeled regularization is further incorporated to enable robust learning under partial supervision. Experiments on English, Spanish, and Arabic emotion classification benchmarks demonstrate consistent improvements over strong baselines across multiple evaluation metrics, along with improved training stability, robustness to annotation sparsity, and enhanced interpretability.

CLEAR-HPV: Interpretable Concept Discovery for HPV-Associated Morphology in Whole-Slide Histology

Human papillomavirus (HPV) status is a critical determinant of prognosis and treatment response in head and neck and cervical cancers. Although attention-based multiple instance learning (MIL) achieves strong slide-level prediction for HPV-related whole-slide histopathology, it provides limited morphologic interpretability. To address this limitation, we introduce Concept-Level Explainable Attention-guided Representation for HPV (CLEAR-HPV), a framework that restructures the MIL latent space using attention to enable concept discovery without requiring concept labels during training. Operating in an attention-weighted latent space, CLEAR-HPV automatically discovers keratinizing, basaloid, and stromal morphologic concepts, generates spatial concept maps, and represents each slide using a compact concept-fraction vector. CLEAR-HPV's concept-fraction vectors preserve the predictive information of the original MIL embeddings while reducing the high-dimensional feature space (e.g., 1536 dimensions) to only 10 interpretable concepts. CLEAR-HPV generalizes consistently across TCGA-HNSCC, TCGA-CESC, and CPTAC-HNSCC, providing compact, concept-level interpretability through a general, backbone-agnostic framework for attention-based MIL models of whole-slide histopathology.

Live or Lie: Action-Aware Capsule Multiple Instance Learning for Risk Assessment in Live Streaming Platforms

Live streaming has become a cornerstone of today's internet, enabling massive real-time social interactions. However, it faces severe risks arising from sparse, coordinated malicious behaviors among multiple participants, which are often concealed within normal activities and challenging to detect timely and accurately. In this work, we provide a pioneering study on risk assessment in live streaming rooms, characterized by weak supervision where only room-level labels are available. We formulate the task as a Multiple Instance Learning (MIL) problem, treating each room as a bag and defining structured user-timeslot capsules as instances. These capsules represent subsequences of user actions within specific time windows, encapsulating localized behavioral patterns. Based on this formulation, we propose AC-MIL, an Action-aware Capsule MIL framework that models both individual behaviors and group-level coordination patterns. AC-MIL captures multi-granular semantics and behavioral cues through a serial and parallel architecture that jointly encodes temporal dynamics and cross-user dependencies. These signals are integrated for robust room-level risk prediction, while also offering interpretable evidence at the behavior segment level. Extensive experiments on large-scale industrial datasets from Douyin demonstrate that AC-MIL significantly outperforms MIL and sequential baselines, establishing new state-of-the-art performance in room-level risk assessment for live streaming. Moreover, AC-MIL provides capsule-level interpretability, enabling identification of risky behavior segments as actionable evidence for intervention. The project page is available at: https://qiaoyran.github.io/AC-MIL/.

Multi-Scale Global-Instance Prompt Tuning for Continual Test-time Adaptation in Medical Image Segmentation

Distribution shift is a common challenge in medical images obtained from different clinical centers, significantly hindering the deployment of pre-trained semantic segmentation models in real-world applications across multiple domains. Continual Test-Time Adaptation(CTTA) has emerged as a promising approach to address cross-domain shifts during continually evolving target domains. Most existing CTTA methods rely on incrementally updating model parameters, which inevitably suffer from error accumulation and catastrophic forgetting, especially in long-term adaptation. Recent prompt-tuning-based works have shown potential to mitigate the two issues above by updating only visual prompts. While these approaches have demonstrated promising performance, several limitations remain:1)lacking multi-scale prompt diversity, 2)inadequate incorporation of instance-specific knowledge, and 3)risk of privacy leakage. To overcome these limitations, we propose Multi-scale Global-Instance Prompt Tuning(MGIPT), to enhance scale diversity of prompts and capture both global- and instance-level knowledge for robust CTTA. Specifically, MGIPT consists of an Adaptive-scale Instance Prompt(AIP) and a Multi-scale Global-level Prompt(MGP). AIP dynamically learns lightweight and instance-specific prompts to mitigate error accumulation with adaptive optimal-scale selection mechanism. MGP captures domain-level knowledge across different scales to ensure robust adaptation with anti-forgetting capabilities. These complementary components are combined through a weighted ensemble approach, enabling effective dual-level adaptation that integrates both global and local information. Extensive experiments on medical image segmentation benchmarks demonstrate that our MGIPT outperforms state-of-the-art methods, achieving robust adaptation across continually changing target domains.

AtlasPatch: An Efficient and Scalable Tool for Whole Slide Image Preprocessing in Computational Pathology

Whole-slide image (WSI) preprocessing, typically comprising tissue detection followed by patch extraction, is foundational to AI-driven computational pathology workflows. This remains a major computational bottleneck as existing tools either rely on inaccurate heuristic thresholding for tissue detection, or adopt AI-based approaches trained on limited-diversity data that operate at the patch level, incurring substantial computational complexity. We present AtlasPatch, an efficient and scalable slide preprocessing framework for accurate tissue detection and high-throughput patch extraction with minimal computational overhead. AtlasPatch's tissue detection module is trained on a heterogeneous and semi-manually annotated dataset of ~30,000 WSI thumbnails, using efficient fine-tuning of the Segment-Anything model. The tool extrapolates tissue masks from thumbnails to full-resolution slides to extract patch coordinates at user-specified magnifications, with options to stream patches directly into common image encoders for embedding or store patch images, all efficiently parallelized across CPUs and GPUs. We assess AtlasPatch across segmentation precision, computational complexity, and downstream multiple-instance learning, matching state-of-the-art performance while operating at a fraction of their computational cost. AtlasPatch is open-source and available at https://github.com/AtlasAnalyticsLab/AtlasPatch.

Multi-View Stenosis Classification Leveraging Transformer-Based Multiple-Instance Learning Using Real-World Clinical Data

Coronary artery stenosis is a leading cause of cardiovascular disease, diagnosed by analyzing the coronary arteries from multiple angiography views. Although numerous deep-learning models have been proposed for stenosis detection from a single angiography view, their performance heavily relies on expensive view-level annotations, which are often not readily available in hospital systems. Moreover, these models fail to capture the temporal dynamics and dependencies among multiple views, which are crucial for clinical diagnosis. To address this, we propose SegmentMIL, a transformer-based multi-view multiple-instance learning framework for patient-level stenosis classification. Trained on a real-world clinical dataset, using patient-level supervision and without any view-level annotations, SegmentMIL jointly predicts the presence of stenosis and localizes the affected anatomical region, distinguishing between the right and left coronary arteries and their respective segments. SegmentMIL obtains high performance on internal and external evaluations and outperforms both view-level models and classical MIL baselines, underscoring its potential as a clinically viable and scalable solution for coronary stenosis diagnosis. Our code is available at https://github.com/NikolaCenic/mil-stenosis.

A Multi-scale Linear-time Encoder for Whole-Slide Image Analysis

We introduce Multi-scale Adaptive Recurrent Biomedical Linear-time Encoder (MARBLE), the first \textit{purely Mamba-based} multi-state multiple instance learning (MIL) framework for whole-slide image (WSI) analysis. MARBLE processes multiple magnification levels in parallel and integrates coarse-to-fine reasoning within a linear-time state-space model, efficiently capturing cross-scale dependencies with minimal parameter overhead. WSI analysis remains challenging due to gigapixel resolutions and hierarchical magnifications, while existing MIL methods typically operate at a single scale and transformer-based approaches suffer from quadratic attention costs. By coupling parallel multi-scale processing with linear-time sequence modeling, MARBLE provides a scalable and modular alternative to attention-based architectures. Experiments on five public datasets show improvements of up to \textbf{6.9\%} in AUC, \textbf{20.3\%} in accuracy, and \textbf{2.3\%} in C-index, establishing MARBLE as an efficient and generalizable framework for multi-scale WSI analysis.

Enabling Progressive Whole-slide Image Analysis with Multi-scale Pyramidal Network

Multiple-instance Learning (MIL) is commonly used to undertake computational pathology (CPath) tasks, and the use of multi-scale patches allows diverse features across scales to be learned. Previous studies using multi-scale features in clinical applications rely on multiple inputs across magnifications with late feature fusion, which does not retain the link between features across scales while the inputs are dependent on arbitrary, manufacturer-defined magnifications, being inflexible and computationally expensive. In this paper, we propose the Multi-scale Pyramidal Network (MSPN), which is plug-and-play over attention-based MIL that introduces progressive multi-scale analysis on WSI. Our MSPN consists of (1) grid-based remapping that uses high magnification features to derive coarse features and (2) the coarse guidance network (CGN) that learns coarse contexts. We benchmark MSPN as an add-on module to 4 attention-based frameworks using 4 clinically relevant tasks across 3 types of foundation model, as well as the pre-trained MIL framework. We show that MSPN consistently improves MIL across the compared configurations and tasks, while being lightweight and easy-to-use.

From Inexact Gradients to Byzantine Robustness: Acceleration and Optimization under Similarity

Standard federated learning algorithms are vulnerable to adversarial nodes, a.k.a. Byzantine failures. To solve this issue, robust distributed learning algorithms have been developed, which typically replace parameter averaging by robust aggregations. While generic conditions on these aggregations exist to guarantee the convergence of (Stochastic) Gradient Descent (SGD), the analyses remain rather ad-hoc. This hinders the development of more complex robust algorithms, such as accelerated ones. In this work, we show that Byzantine-robust distributed optimization can, under standard generic assumptions, be cast as a general optimization with inexact gradient oracles (with both additive and multiplicative error terms), an active field of research. This allows for instance to directly show that GD on top of standard robust aggregation procedures obtains optimal asymptotic error in the Byzantine setting. Going further, we propose two optimization schemes to speed up the convergence. The first one is a Nesterov-type accelerated scheme whose proof directly derives from accelerated inexact gradient results applied to our formulation. The second one hinges on Optimization under Similarity, in which the server leverages an auxiliary loss function that approximates the global loss. Both approaches allow to drastically reduce the communication complexity compared to previous methods, as we show theoretically and empirically.