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The scarcity of high-quality, labelled retinal imaging data, which presents a significant challenge in the development of machine learning models for ophthalmology, hinders progress in the field. Existing methods for synthesising Colour Fundus Photographs (CFPs) largely rely on predefined disease labels, which restricts their ability to generate images that reflect fine-grained anatomical variations, subtle disease stages, and diverse pathological features beyond coarse class categories. To overcome these challenges, we first introduce an innovative pipeline that creates a large-scale, captioned retinal dataset comprising 1.4 million entries, called RetinaLogos-1400k. Specifically, RetinaLogos-1400k uses the visual language model(VLM) to describe retinal conditions and key structures, such as optic disc configuration, vascular distribution, nerve fibre layers, and pathological features. Building on this dataset, we employ a novel three-step training framework, RetinaLogos, which enables fine-grained semantic control over retinal images and accurately captures different stages of disease progression, subtle anatomical variations, and specific lesion types. Through extensive experiments, our method demonstrates superior performance across multiple datasets, with 62.07% of text-driven synthetic CFPs indistinguishable from real ones by ophthalmologists. Moreover, the synthetic data improves accuracy by 5%-10% in diabetic retinopathy grading and glaucoma detection. Codes are available at this https URL.

MLLMs (Multimodal Large Language Models) have showcased remarkable capabilities, but their performance in high-stakes, domain-specific scenarios like surgical settings, remains largely under-explored. To address this gap, we develop \textbf{EyePCR}, a large-scale benchmark for ophthalmic surgery analysis, grounded in structured clinical knowledge to evaluate cognition across \textit{Perception}, \textit{Comprehension} and \textit{Reasoning}. EyePCR offers a richly annotated corpus with more than 210k VQAs, which cover 1048 fine-grained attributes for multi-view perception, medical knowledge graph of more than 25k triplets for comprehension, and four clinically grounded reasoning tasks. The rich annotations facilitate in-depth cognitive analysis, simulating how surgeons perceive visual cues and combine them with domain knowledge to make decisions, thus greatly improving models' cognitive ability. In particular, \textbf{EyePCR-MLLM}, a domain-adapted variant of Qwen2.5-VL-7B, achieves the highest accuracy on MCQs for \textit{Perception} among compared models and outperforms open-source models in \textit{Comprehension} and \textit{Reasoning}, rivalling commercial models like GPT-4.1. EyePCR reveals the limitations of existing MLLMs in surgical cognition and lays the foundation for benchmarking and enhancing clinical reliability of surgical video understanding models.

Accurate tongue segmentation is crucial for reliable TCM analysis. Supervised models require large annotated datasets, while SAM-family models remain prompt-driven. We present Memory-SAM, a training-free, human-prompt-free pipeline that automatically generates effective prompts from a small memory of prior cases via dense DINOv3 features and FAISS retrieval. Given a query image, mask-constrained correspondences to the retrieved exemplar are distilled into foreground/background point prompts that guide SAM2 without manual clicks or model fine-tuning. We evaluate on 600 expert-annotated images (300 controlled, 300 in-the-wild). On the mixed test split, Memory-SAM achieves mIoU 0.9863, surpassing FCN (0.8188) and a detector-to-box SAM baseline (0.1839). On controlled data, ceiling effects above 0.98 make small differences less meaningful given annotation variability, while our method shows clear gains under real-world conditions. Results indicate that retrieval-to-prompt enables data-efficient, robust segmentation of irregular boundaries in tongue imaging. The code is publicly available at this https URL.

Underwater Monocular Depth Estimation (UMDE) is a critical task that aims to estimate high-precision depth maps from underwater degraded images caused by light absorption and scattering effects in marine environments. Recently, Mamba-based methods have achieved promising performance across various vision tasks; however, they struggle with the UMDE task because their inflexible state scanning strategies fail to model the structural features of underwater images effectively. Meanwhile, existing UMDE datasets usually contain unreliable depth labels, leading to incorrect object-depth relationships between underwater images and their corresponding depth maps. To overcome these limitations, we develop a novel tree-aware Mamba method, dubbed Tree-Mamba, for estimating accurate monocular depth maps from underwater degraded images. Specifically, we propose a tree-aware scanning strategy that adaptively constructs a minimum spanning tree based on feature similarity. The spatial topological features among the tree nodes are then flexibly aggregated through bottom-up and top-down traversals, enabling stronger multi-scale feature representation capabilities. Moreover, we construct an underwater depth estimation benchmark (called BlueDepth), which consists of 38,162 underwater image pairs with reliable depth labels. This benchmark serves as a foundational dataset for training existing deep learning-based UMDE methods to learn accurate object-depth relationships. Extensive experiments demonstrate the superiority of the proposed Tree-Mamba over several leading methods in both qualitative results and quantitative evaluations with competitive computational efficiency. Code and dataset will be available at this https URL.

Background and Aims: Large language models (LLMs) have shown remarkable generalization and transfer capabilities by learning from vast corpora of text and web data. Their semantic representations allow cross-task knowledge transfer and reasoning, offering promising opportunities for data-scarce and heterogeneous domains such as clinical medicine. Yet, in diagnostic tasks like sarcopenia, major challenges remain: interpretability, transparency, and deployment efficiency. Traditional machine learning (TML) models provide stable performance and feature-level attribution, ensuring traceable and auditable decision logic, but lack semantic breadth. Conversely, LLMs enable flexible inference but often function as opaque predictors. Existing integration strategies remain shallow, rarely embedding the structured reasoning of TML into LLM inference. Methods: Using sarcopenia diagnosis as a case study, SHapley Additive exPlanations (SHAP) were extracted from a baseline XGBoost model and transformed into structured, LLM-compatible representations. An actor-critic reinforcement learning (RL) strategy guided the LLM to reason over these SHAP-based inputs, producing calibrated rationales and refined decision rules. The distilled reasoning was consolidated into a structured knowledge repository and deployed via retrieval-augmented generation (RAG) for case-based inference. Results: (Omitted here.) Conclusion: By coupling SHAP-derived statistical evidence with reinforcement-trained LLM reasoning, CANDLE mitigates the interpretability-performance trade-off, enhances predictive accuracy, and preserves high decision consistency. The framework offers a scalable approach to knowledge assetization of TML models, enabling interpretable, reproducible, and clinically aligned decision support in sarcopenia and potentially broader medical domains.

Airway mucus is a complex gel with an anisotropic three-dimensional network structure. As a crucial component of the respiratory defense barrier, it plays a vital role in maintaining airway hydration and supporting the function of airway epithelial cells. Through linear and nonlinear rheological mechanisms such as ciliary motion and coughing, airway mucus expels foreign pathogens and toxic nano- and microparticles while selectively allowing the passage of specific nutrients and proteins. These protective and clearance functions depend on the proper rheological properties of mucus under normal physiological conditions. However, in respiratory disease such as CF, COPD, asthma, and COVID-19, excessive mucus secretion is often accompanied by abnormal rheological behaviors. This leads to impaired mucus flow, airway obstruction, and potentially life-threatening conditions. Therefore, this review examines the rheological behaviors of airway mucus in relation to health and disease, focusing on both macrorheology and microrheology. The review highlights those changes in the chemical composition and microstructure of airway mucus, especially under pathological conditions, that can significantly alter its rheological behavior. Rheological parameters can also serve as biological indicators to study the role of mucus in clearance functions and aid in developing pulmonary drug delivery systems. By integrating findings from both macro- and microrheological studies, this review aims to enhance our understanding of the complex behavior of airway mucus, supporting better diagnosis, treatment, and management of chronic respiratory diseases.

Efficient convolutional neural network (CNN) architecture design has attracted growing research interests. However, they typically apply single receptive field (RF), small asymmetric RFs, or pyramid RFs to learn different feature representations, still encountering two significant challenges in medical image classification tasks: 1) They have limitations in capturing diverse lesion characteristics efficiently, e.g., tiny, coordination, small and salient, which have unique roles on the classification results, especially imbalanced medical image classification. 2) The predictions generated by those CNNs are often unfair/biased, bringing a high risk when employing them to real-world medical diagnosis conditions. To tackle these issues, we develop a new concept, Expert-Like Reparameterization of Heterogeneous Pyramid Receptive Fields (ERoHPRF), to simultaneously boost medical image classification performance and fairness. This concept aims to mimic the multi-expert consultation mode by applying the well-designed heterogeneous pyramid RF bag to capture lesion characteristics with varying significances effectively via convolution operations with multiple heterogeneous kernel sizes. Additionally, ERoHPRF introduces an expert-like structural reparameterization technique to merge its parameters with the two-stage strategy, ensuring competitive computation cost and inference speed through comparisons to a single RF. To manifest the effectiveness and generalization ability of ERoHPRF, we incorporate it into mainstream efficient CNN architectures. The extensive experiments show that our proposed ERoHPRF maintains a better trade-off than state-of-the-art methods in terms of medical image classification, fairness, and computation overhead. The code of this paper is available at this https URL.

Accurate tongue segmentation is crucial for reliable TCM analysis. Supervised models require large annotated datasets, while SAM-family models remain prompt-driven. We present Memory-SAM, a training-free, human-prompt-free pipeline that automatically generates effective prompts from a small memory of prior cases via dense DINOv3 features and FAISS retrieval. Given a query image, mask-constrained correspondences to the retrieved exemplar are distilled into foreground/background point prompts that guide SAM2 without manual clicks or model fine-tuning. We evaluate on 600 expert-annotated images (300 controlled, 300 in-the-wild). On the mixed test split, Memory-SAM achieves mIoU 0.9863, surpassing FCN (0.8188) and a detector-to-box SAM baseline (0.1839). On controlled data, ceiling effects above 0.98 make small differences less meaningful given annotation variability, while our method shows clear gains under real-world conditions. Results indicate that retrieval-to-prompt enables data-efficient, robust segmentation of irregular boundaries in tongue imaging. The code is publicly available at this https URL.

Psychological support hotlines are critical for crisis intervention but face significant challenges due to rising demand. Large language models (LLMs) could support crisis assessments, yet their capabilities in emotionally sensitive contexts remain unclear. We introduce PsyCrisisBench, a benchmark of 540 annotated transcripts from the Hangzhou Psychological Assistance Hotline, assessing four tasks: mood status recognition, suicidal ideation detection, suicide plan identification, and risk assessment. We evaluated 64 LLMs across 15 families (e.g., GPT, Claude, Gemini, Llama, Qwen, DeepSeek) using zero-shot, few-shot, and fine-tuning paradigms. Performance was measured by F1-score, with statistical comparisons via Welch's t-tests. LLMs performed strongly on suicidal ideation detection (F1=0.880), suicide plan identification (F1=0.779), and risk assessment (F1=0.907), improved with few-shot and fine-tuning. Mood status recognition was more challenging (max F1=0.709), likely due to lost vocal cues and ambiguity. A fine-tuned 1.5B-parameter model (Qwen2.5-1.5B) surpassed larger models on mood and suicidal ideation. Open-source models like QwQ-32B performed comparably to closed-source on most tasks (p>0.3), though closed models retained an edge in mood detection (p=0.007). Performance scaled with size up to a point; quantization (AWQ) reduced GPU memory by 70% with minimal F1 degradation. LLMs show substantial promise in structured psychological crisis assessments, especially with fine-tuning. Mood recognition remains limited due to contextual complexity. The narrowing gap between open- and closed-source models, combined with efficient quantization, suggests feasible integration. PsyCrisisBench offers a robust evaluation framework to guide model development and ethical deployment in mental health.

In mammalian cells, repair centers for DNA double-strand breaks (DSBs) have been identified. However, previous researches predominantly rely on methods that induce specific DSBs by cutting particular DNA sequences. The clustering and its spatiotemporal properties of non-specifically DSBs, especially those induced by environmental stresses such as irradiation, remains unclear. In this study, we used Dragonfly microscopy to induce high-precision damage in cells and discovered that DSB clustering during the early stages of DNA damage response (DDR) and repair, but not during the repair plateau phase. Early in DDR, DSB clustered into existing 53BP1 foci. The DSB clustering at different stages has different implications for DNA repair. By controlling the distance between adjacent damage points, we found that the probability of DSB clustering remains constant at distances of 0.8 - 1.4 um, while clustering does not occur beyond 1.4 um. Within the 0.8 um range, the probability of clustering significantly increases due to the phase separation effect of 53BP1. Using a Monte Carlo approach, we developed a dynamic model of 53BP1 foci formation, fission, and fusion. This model accurately predicts experimental outcomes and further demonstrates the temporal and spatial influences on DSB clustering. These results showed that, similarly to specifically induced DSBs, non-specifically induced DSBs can also cluster. The extent of DSB clustering is influenced by both temporal and spatial factors, which provide new insights into the dynamics of DSB clustering and the role of 53BP1 in DNA repair processes. Such findings could enhance our understanding of DNA damage responses and help us improve DNA repair therapies in disease.

Constructing structural brain networks using T1-weighted magnetic resonance imaging (T1-MRI) presents a significant challenge due to the lack of direct regional connectivity information. Current methods with T1-MRI rely on predefined regions or isolated pretrained location modules to obtain atrophic regions, which neglects individual specificity. Besides, existing methods capture global structural context only on the whole-image-level, which weaken correlation between regions and the hierarchical distribution nature of brain this http URL hereby propose a novel dynamic structural brain network construction method based on T1-MRI, which can dynamically localize critical regions and constrain the hierarchical distribution among them for constructing dynamic structural brain network. Specifically, we first cluster spatially-correlated channel and generate several critical brain regions as prototypes. Further, we introduce a contrastive loss function to constrain the prototypes distribution, which embed the hierarchical brain semantic structure into the latent space. Self-attention and GCN are then used to dynamically construct hierarchical correlations of critical regions for brain network and explore the correlation, respectively. Our method is evaluated on ADNI-1 and ADNI-2 databases for mild cognitive impairment (MCI) conversion prediction, and acheive the state-of-the-art (SOTA) performance. Our source code is available at this http URL.

In this paper, we present a deep generative model based method to generate diverse human motion interpolation results. We resort to the Conditional Variational Auto-Encoder (CVAE) to learn human motion conditioned on a pair of given start and end motions, by leveraging the Recurrent Neural Network (RNN) structure for both the encoder and the decoder. Additionally, we introduce a regularization loss to further promote sample diversity. Once trained, our method is able to generate multiple plausible coherent motions by repetitively sampling from the learned latent space. Experiments on the publicly available dataset demonstrate the effectiveness of our method, in terms of sample plausibility and diversity.

A systematic and robust laser speckle contrast imaging (LSCI) method and procedure is presented, covering the LSCI system calibration, static scattering removal, and measurement noise estimation and correction to obtain a true flow speckle contrast and the flow speed from single-exposure LSCI measurements. We advocate to use as the speckle contrast instead of the conventional contrast K as the former relates simply to the flow velocity and is with additive noise alone. We demonstrate the efficacy of the proposed true flow speckle contrast by imaging phantom flow at varying speeds, showing that (1) the proposed recipe greatly enhances the linear sensitivity of the flow index (inverse decorrelation time) and the linearity covers the full span of flow speeds from 0 mm/s to 40 mm/s; and (2) the true flow speed can be recovered regardless of the overlying static scattering layers and the type of speckle statistics (temporal or spatial). The fundamental difference between the apparent temporal and spatial speckle contrasts is further revealed. The flow index recovered in the spatial domain is much more susceptible to static scattering and exhibit a shorter linearity range than that obtained in the temporal domain. The proposed LSCI analysis framework paves the way to estimate the true flow speed in the wide array of laser speckle contrast imaging applications.

Self-propelled particles with alignment, displaying ordered collective motions such as swarming, can be investigated by the well-known Vicsek model. However, challenges still remain regarding the nature of the associated phase transition. Here, we use the landscape-flux approach combined with the coarse-grained mapping method to reveal the underlying mechanism of the continuous or discontinuous order-disorder nonequilibrium phase transition in Vicsek model systems featuring diverse noise characteristics. It is found that the nonequilibrium flux inside the landscape in the density-alignment degree phase space always rotates counterclockwise, and tends to delocalize or destabilize the point attractor states, providing the dynamical driving force for altering the landscape shape and the system state. Furthermore, the variations in the averaged flux and entropy production rate exhibit pronounced differences across various noise types. This not only helps to reveal the dynamical and thermodynamical mechanisms of the order-disorder transition but also offers a useful tool to recognize the continuity of the transition. Our findings present a novel perspective for exploring nonequilibrium phase transition behaviors and other collective motions in various complex systems.

Deep neural networks (DNNs) have promoted the development of computer aided diagnosis (CAD) systems for fundus diseases, helping ophthalmologists reduce missed diagnosis and misdiagnosis rate. However, the majority of CAD systems are data-driven but lack of medical prior knowledge which can be performance-friendly. In this regard, we innovatively proposed a human-in-the-loop (HITL) CAD system by leveraging ophthalmologists' eye-tracking information, which is more efficient and accurate. Concretely, the HITL CAD system was implemented on the multiple instance learning (MIL), where eye-tracking gaze maps were beneficial to cherry-pick diagnosis-related instances. Furthermore, the dual-cross-attention MIL (DCAMIL) network was utilized to curb the adverse effects of noisy instances. Meanwhile, both sequence augmentation module and domain adversarial module were introduced to enrich and standardize instances in the training bag, respectively, thereby enhancing the robustness of our method. We conduct comparative experiments on our newly constructed datasets (namely, AMD-Gaze and DR-Gaze), respectively for the AMD and early DR detection. Rigorous experiments demonstrate the feasibility of our HITL CAD system and the superiority of the proposed DCAMIL, fully exploring the ophthalmologists' eye-tracking information. These investigations indicate that physicians' gaze maps, as medical prior knowledge, is potential to contribute to the CAD systems of clinical diseases.

Pathological myopia (PM) is the leading ocular disease for impaired vision worldwide. Clinically, the characteristic of pathology distribution in PM is global-local on the fundus image, which plays a significant role in assisting clinicians in diagnosing PM. However, most existing deep neural networks focused on designing complex architectures but rarely explored the pathology distribution prior of PM. To tackle this issue, we propose an efficient pyramid channel attention (EPCA) module, which fully leverages the potential of the clinical pathology prior of PM with pyramid pooling and multi-scale context fusion. Then, we construct EPCA-Net for automatic PM recognition based on fundus images by stacking a sequence of EPCA modules. Moreover, motivated by the recent pretraining-and-finetuning paradigm, we attempt to adapt pre-trained natural image models for PM recognition by freezing them and treating the EPCA and other attention modules as adapters. In addition, we construct a PM recognition benchmark termed PM-fundus by collecting fundus images of PM from publicly available datasets. The comprehensive experiments demonstrate the superiority of our EPCA-Net over state-of-the-art methods in the PM recognition task. The results also show that our method based on the pretraining-and-finetuning paradigm achieves competitive performance through comparisons to part of previous methods based on traditional fine-tuning paradigm with fewer tunable parameters, which has the potential to leverage more natural image foundation models to address the PM recognition task in limited medical data regime.

Medical image registration is vital for disease diagnosis and treatment with its ability to merge diverse information of images, which may be captured under different times, angles, or modalities. Although several surveys have reviewed the development of medical image registration, these surveys have not systematically summarized methodologies of existing medical image registration methods. To this end, we provide a comprehensive review of these methods from traditional and deep learning-based directions, aiming to help audiences understand the development of medical image registration quickly. In particular, we review recent advances in retinal image registration at the end of each section, which has not attracted much attention. Additionally, we also discuss the current challenges of retinal image registration and provide insights and prospects for future research.

FLASH radiotherapy (FLASH-RT) is a new modality of radiotherapy by delivering doses with ultra-high dose rates. FLASH-RT has the ability to suppress tumor growth while sparing normal tissues, known as the FLASH effect. Although FLASH effect has proved valid in various models by different ionizing radiations, the exact underlying mechanism is still unclear. This article summarizes mainstream hypotheses of FLASH effect at physicochemical and biological levels, including oxygen depletion and free radical reactions, nuclear and mitochondria damage, as well as immune response. These hypotheses contribute reasonable explanations to the FLASH effect, and are interconnected according to the chronological order of the organism's response to ionizing radiation. By collating the existing consensus, evidence, and hypotheses, this article provides a comprehensive overview of potential mechanisms of FLASH effect and practical guidance for future investigation in the field of FLASH-RT.