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Large language models (LLMs) have shown success in generating high-quality responses. In order to achieve better alignment with LLMs with human preference, various works are proposed based on specific optimization process, which, however, is not suitable to Black-Box LLMs like GPT-4, due to inaccessible parameters. In Black-Box LLMs case, their performance is highly dependent on the quality of the provided prompts. Existing methods to enhance response quality often involve a prompt refinement model, yet these approaches potentially suffer from semantic inconsistencies between the refined and original prompts, and typically overlook the relationship between them. To address these challenges, we introduce a self-instructed in-context learning framework that empowers LLMs to deliver more effective responses by generating reliable derived prompts to construct informative contextual environments. Our approach incorporates a self-instructed reinforcement learning mechanism, enabling direct interaction with the response model during derived prompt generation for better alignment. We then formulate querying as an in-context learning task, using responses from LLMs combined with the derived prompts to establish a contextual demonstration for the original prompt. This strategy ensures alignment with the original query, reduces discrepancies from refined prompts, and maximizes the LLMs' in-context learning capability. Extensive experiments demonstrate that the proposed method not only generates more reliable derived prompts but also significantly enhances LLMs' ability to deliver more effective responses, including Black-Box models such as GPT-4.

Human-like large language models (LLMs), especially the most powerful and popular ones in OpenAI's GPT family, have proven to be very helpful for many natural language processing (NLP) related tasks. Therefore, various attempts have been made to apply LLMs to information extraction (IE), which is a fundamental NLP task that involves extracting information from unstructured plain text. To demonstrate the latest representative progress in LLMs' information extraction ability, we assess the information extraction ability of GPT-4 (the latest version of GPT at the time of writing this paper) from four perspectives: Performance, Evaluation Criteria, Robustness, and Error Types. Our results suggest a visible performance gap between GPT-4 and state-of-the-art (SOTA) IE methods. To alleviate this problem, considering the LLMs' human-like characteristics, we propose and analyze the effects of a series of simple prompt-based methods, which can be generalized to other LLMs and NLP tasks. Rich experiments show our methods' effectiveness and some of their remaining issues in improving GPT-4's information extraction ability., Comment: This submission was intended instead as the replacement of arXiv:2305.14450 , where it now appears as arXiv:2305.14450v2

Large Language Models (LLMs) have become a focal point in the rapidly evolving field of artificial intelligence. However, a critical concern is the presence of toxic content within the pre-training corpus of these models, which can lead to the generation of inappropriate outputs. Investigating methods for detecting internal faults in LLMs can help us understand their limitations and improve their security. Existing methods primarily focus on jailbreaking attacks, which involve manually or automatically constructing adversarial content to prompt the target LLM to generate unexpected responses. These methods rely heavily on prompt engineering, which is time-consuming and usually requires specially designed questions. To address these challenges, this paper proposes a target-driven attack paradigm that focuses on directly eliciting the target response instead of optimizing the prompts. We introduce the use of another LLM as the detector for toxic content, referred to as ToxDet. Given a target toxic response, ToxDet can generate a possible question and a preliminary answer to provoke the target model into producing desired toxic responses with meanings equivalent to the provided one. ToxDet is trained by interacting with the target LLM and receiving reward signals from it, utilizing reinforcement learning for the optimization process. While the primary focus of the target models is on open-source LLMs, the fine-tuned ToxDet can also be transferred to attack black-box models such as GPT-4o, achieving notable results. Experimental results on AdvBench and HH-Harmless datasets demonstrate the effectiveness of our methods in detecting the tendencies of target LLMs to generate harmful responses. This algorithm not only exposes vulnerabilities but also provides a valuable resource for researchers to strengthen their models against such attacks.

AI-assisted lesion detection models play a crucial role in the early screening of cancer. However, previous image-based models ignore the inter-frame contextual information present in videos. On the other hand, video-based models capture the inter-frame context but are computationally expensive. To mitigate this contradiction, we delve into Video-to-Image knowledge distillation leveraging DEtection TRansformer (V2I-DETR) for the task of medical video lesion detection. V2I-DETR adopts a teacher-student network paradigm. The teacher network aims at extracting temporal contexts from multiple frames and transferring them to the student network, and the student network is an image-based model dedicated to fast prediction in inference. By distilling multi-frame contexts into a single frame, the proposed V2I-DETR combines the advantages of utilizing temporal contexts from video-based models and the inference speed of image-based models. Through extensive experiments, V2I-DETR outperforms previous state-of-the-art methods by a large margin while achieving the real-time inference speed (30 FPS) as the image-based model., Comment: BIBM2024

Endorectal ultrasound (ERUS) is an important imaging modality that provides high reliability for diagnosing the depth and boundary of invasion in colorectal cancer. However, the lack of a large-scale ERUS dataset with high-quality annotations hinders the development of automatic ultrasound diagnostics. In this paper, we collected and annotated the first benchmark dataset that covers diverse ERUS scenarios, i.e. colorectal cancer segmentation, detection, and infiltration depth staging. Our ERUS-10K dataset comprises 77 videos and 10,000 high-resolution annotated frames. Based on this dataset, we further introduce a benchmark model for colorectal cancer segmentation, named the Adaptive Sparse-context TRansformer (ASTR). ASTR is designed based on three considerations: scanning mode discrepancy, temporal information, and low computational complexity. For generalizing to different scanning modes, the adaptive scanning-mode augmentation is proposed to convert between raw sector images and linear scan ones. For mining temporal information, the sparse-context transformer is incorporated to integrate inter-frame local and global features. For reducing computational complexity, the sparse-context block is introduced to extract contextual features from auxiliary frames. Finally, on the benchmark dataset, the proposed ASTR model achieves a 77.6% Dice score in rectal cancer segmentation, largely outperforming previous state-of-the-art methods.

The scarcity and complexity of voxel-level annotations in 3D medical imaging present significant challenges, particularly due to the domain gap between labeled datasets from well-resourced centers and unlabeled datasets from less-resourced centers. This disparity affects the fairness of artificial intelligence algorithms in healthcare. We introduce Diffuse-UDA, a novel method leveraging diffusion models to tackle Unsupervised Domain Adaptation (UDA) in medical image segmentation. Diffuse-UDA generates high-quality image-mask pairs with target domain characteristics and various structures, thereby enhancing UDA tasks. Initially, pseudo labels for target domain samples are generated. Subsequently, a specially tailored diffusion model, incorporating deformable augmentations, is trained on image-label or image-pseudo-label pairs from both domains. Finally, source domain labels guide the diffusion model to generate image-label pairs for the target domain. Comprehensive evaluations on several benchmarks demonstrate that Diffuse-UDA outperforms leading UDA and semi-supervised strategies, achieving performance close to or even surpassing the theoretical upper bound of models trained directly on target domain data. Diffuse-UDA offers a pathway to advance the development and deployment of AI systems in medical imaging, addressing disparities between healthcare environments. This approach enables the exploration of innovative AI-driven diagnostic tools, improves outcomes, saves time, and reduces human error.

Visualizing colonoscopy is crucial for medical auxiliary diagnosis to prevent undetected polyps in areas that are not fully observed. Traditional feature-based and depth-based reconstruction approaches usually end up with undesirable results due to incorrect point matching or imprecise depth estimation in realistic colonoscopy videos. Modern deep-based methods often require a sufficient number of ground truth samples, which are generally hard to obtain in optical colonoscopy. To address this issue, self-supervised and domain adaptation methods have been explored. However, these methods neglect geometry constraints and exhibit lower accuracy in predicting detailed depth. We thus propose a novel reconstruction pipeline with a bi-directional adaptation architecture named ToDER to get precise depth estimations. Furthermore, we carefully design a TNet module in our adaptation architecture to yield geometry constraints and obtain better depth quality. Estimated depth is finally utilized to reconstruct a reliable colon model for visualization. Experimental results demonstrate that our approach can precisely predict depth maps in both realistic and synthetic colonoscopy videos compared with other self-supervised and domain adaptation methods. Our method on realistic colonoscopy also shows the great potential for visualizing unobserved regions and preventing misdiagnoses.

The field of medical diagnosis has undergone a significant transformation with the advent of large language models (LLMs), yet the challenges of interpretability within these models remain largely unaddressed. This study introduces Chain-of-Diagnosis (CoD) to enhance the interpretability of LLM-based medical diagnostics. CoD transforms the diagnostic process into a diagnostic chain that mirrors a physician's thought process, providing a transparent reasoning pathway. Additionally, CoD outputs the disease confidence distribution to ensure transparency in decision-making. This interpretability makes model diagnostics controllable and aids in identifying critical symptoms for inquiry through the entropy reduction of confidences. With CoD, we developed DiagnosisGPT, capable of diagnosing 9604 diseases. Experimental results demonstrate that DiagnosisGPT outperforms other LLMs on diagnostic benchmarks. Moreover, DiagnosisGPT provides interpretability while ensuring controllability in diagnostic rigor.

Enabling bistatic radar sensing within the context of integrated sensing and communication (ISAC) for future sixth generation mobile networks demands strict synchronization accuracy, which is particularly challenging to be achieved with over-the-air synchronization. Existing algorithms handle time and frequency offsets adequately, but provide insufficiently accurate sampling frequency offset (SFO) estimates that result in degradation of obtained radar images in the form of signal-to-noise ratio loss and migration of range and Doppler shift. This article introduces an SFO estimation algorithm named tilt inference of time offset (TITO) for orthogonal frequency-division multiplexing (OFDM)-based ISAC. Using available pilot subcarriers, TITO obtains channel impulse response estimates and extracts information on the SFO-induced delay migration to a dominant reference path with constant range, Doppler shift, and angle between transmit and receive ISAC nodes. TITO then adaptively selects the delay estimates that are only negligibly impaired by SFO-induced intersymbol interference, ultimately employing them to estimate the SFO. Assuming a scenario without a direct line-of-sight (LoS) between the aforementioned transmitting and receiving ISAC nodes, a system concept with a relay reflective intelligent surface (RIS) is used to create the aforementioned reference path is proposed. Besides a mathematical derivation of accuracy bounds, simulation and measurements at 26.2 GHz are presented to demonstrate TITO's superiority over existing methods in terms of SFO estimation accuracy and robustness., Comment: This work has been submitted to the IEEE for possible publication

The rapid development of multimodal large language models (MLLMs), such as GPT-4V, has led to significant advancements. However, these models still face challenges in medical multimodal capabilities due to limitations in the quantity and quality of medical vision-text data, stemming from data privacy concerns and high annotation costs. While pioneering approaches utilize PubMed's large-scale, de-identified medical image-text pairs to address these limitations, they still fall short due to inherent data noise. To tackle this, we refined medical image-text pairs from PubMed and employed MLLMs (GPT-4V) in an 'unblinded' capacity to denoise and reformat the data, resulting in the creation of the PubMedVision dataset with 1.3 million medical VQA samples. Our validation demonstrates that: (1) PubMedVision can significantly enhance the medical multimodal capabilities of current MLLMs, showing significant improvement in benchmarks including the MMMU Health & Medicine track; (2) manual checks by medical experts and empirical results validate the superior data quality of our dataset compared to other data construction methods. Using PubMedVision, we train a 34B medical MLLM HuatuoGPT-Vision, which shows superior performance in medical multimodal scenarios among open-source MLLMs.

The recent success of Large Language Models (LLMs) has had a significant impact on the healthcare field, providing patients with medical advice, diagnostic information, and more. However, due to a lack of professional medical knowledge, patients are easily misled by generated erroneous information from LLMs, which may result in serious medical problems. To address this issue, we focus on tuning the LLMs to be medical assistants who collaborate with more experienced doctors. We first conduct a two-stage survey by inspiration-feedback to gain a broad understanding of the real needs of doctors for medical assistants. Based on this, we construct a Chinese medical dataset called DoctorFLAN to support the entire workflow of doctors, which includes 92K Q\&A samples from 22 tasks and 27 specialists. Moreover, we evaluate LLMs in doctor-oriented scenarios by constructing the DoctorFLAN-\textit{test} containing 550 single-turn Q\&A and DotaBench containing 74 multi-turn conversations. The evaluation results indicate that being a medical assistant still poses challenges for existing open-source models, but DoctorFLAN can help them significantly. It demonstrates that the doctor-oriented dataset and benchmarks we construct can complement existing patient-oriented work and better promote medical LLMs research.

Automatic segmentation of the bronchial tree from CT imaging is important, as it provides structural information for disease diagnosis. Despite the merits of previous automatic bronchus segmentation methods, they have paied less attention to the issue we term as \textit{Intensity Confusion}, wherein the intensity values of certain background voxels approach those of the foreground voxels within bronchi. Conversely, the intensity values of some foreground voxels are nearly identical to those of background voxels. This proximity in intensity values introduces significant challenges to neural network methodologies. To address the issue, we introduce a novel Intensity-Distance Guided loss function, which assigns adaptive weights to different image voxels for mining hard samples that cause the intensity confusion. The proposed loss estimates the voxel-level hardness of samples, on the basis of the following intensity and distance priors. We regard a voxel as a hard sample if it is in: (1) the background and has an intensity value close to the bronchus region; (2) the bronchus region and is of higher intensity than most voxels inside the bronchus; (3) the background region and at a short distance from the bronchus. Extensive experiments not only show the superiority of our method compared with the state-of-the-art methods, but also verify that tackling the intensity confusion issue helps to significantly improve bronchus segmentation. Project page: https://github.com/lhaof/ICM., Comment: IEEE International Conference on Multimedia & Expo (ICME) 2024

Recently, self-supervised learning (SSL) methods have been used in pre-training the segmentation models for 2D and 3D medical images. Most of these methods are based on reconstruction, contrastive learning and consistency regularization. However, the spatial correspondence of 2D slices from a 3D medical image has not been fully exploited. In this paper, we propose a novel self-supervised alignment learning framework to pre-train the neural network for medical image segmentation. The proposed framework consists of a new local alignment loss and a global positional loss. We observe that in the same 3D scan, two close 2D slices usually contain similar anatomic structures. Thus, the local alignment loss is proposed to make the pixel-level features of matched structures close to each other. Experimental results show that the proposed alignment learning is competitive with existing self-supervised pre-training approaches on CT and MRI datasets, under the setting of limited annotations., Comment: Accepted by (ISBI 2024) 2024 IEEE International Symposium on Biomedical Imaging

In the quest for super-human performance, Large Language Models (LLMs) have traditionally been tethered to human-annotated datasets and predefined training objectives-a process that is both labor-intensive and inherently limited. This paper presents a transformative approach: Autonomous Learning for LLMs, a self-sufficient learning paradigm that frees models from the constraints of human supervision. This method endows LLMs with the ability to self-educate through direct interaction with text, akin to a human reading and comprehending literature. Our approach eliminates the reliance on annotated data, fostering an Autonomous Learning environment where the model independently identifies and reinforces its knowledge gaps. Empirical results from our comprehensive experiments, which utilized a diverse array of learning materials and were evaluated against standard public quizzes, reveal that Autonomous Learning outstrips the performance of both Pre-training and Supervised Fine-Tuning (SFT), as well as retrieval-augmented methods. These findings underscore the potential of Autonomous Learning to not only enhance the efficiency and effectiveness of LLM training but also to pave the way for the development of more advanced, self-reliant AI systems., Comment: 20 pages, 8 figures

Fundus photography, in combination with the ultra-wide-angle fundus (UWF) techniques, becomes an indispensable diagnostic tool in clinical settings by offering a more comprehensive view of the retina. Nonetheless, UWF fluorescein angiography (UWF-FA) necessitates the administration of a fluorescent dye via injection into the patient's hand or elbow unlike UWF scanning laser ophthalmoscopy (UWF-SLO). To mitigate potential adverse effects associated with injections, researchers have proposed the development of cross-modality medical image generation algorithms capable of converting UWF-SLO images into their UWF-FA counterparts. Current image generation techniques applied to fundus photography encounter difficulties in producing high-resolution retinal images, particularly in capturing minute vascular lesions. To address these issues, we introduce a novel conditional generative adversarial network (UWAFA-GAN) to synthesize UWF-FA from UWF-SLO. This approach employs multi-scale generators and an attention transmit module to efficiently extract both global structures and local lesions. Additionally, to counteract the image blurriness issue that arises from training with misaligned data, a registration module is integrated within this framework. Our method performs non-trivially on inception scores and details generation. Clinical user studies further indicate that the UWF-FA images generated by UWAFA-GAN are clinically comparable to authentic images in terms of diagnostic reliability. Empirical evaluations on our proprietary UWF image datasets elucidate that UWAFA-GAN outperforms extant methodologies. The code is accessible at https://github.com/Tinysqua/UWAFA-GAN.

Despite the advancements and impressive performance of Multimodal Large Language Models (MLLMs) on benchmarks, their effectiveness in real-world, long-context, and multi-image tasks is unclear due to the benchmarks' limited scope. Existing benchmarks often focus on single-image and short-text samples, and when assessing multi-image tasks, they either limit the image count or focus on specific task (e.g time-series captioning), potentially obscuring the performance challenges of MLLMs. To address these limitations, we introduce MileBench, a pioneering benchmark designed to test the MultImodal Long-contExt capabilities of MLLMs. This benchmark comprises not only multimodal long contexts, but also multiple tasks requiring both comprehension and generation. We establish two distinct evaluation sets, diagnostic and realistic, to systematically assess MLLMs' long-context adaptation capacity and their ability to complete tasks in long-context scenarios. Our experimental results, obtained from testing 22 models, revealed that while the closed-source GPT-4o outperforms others, most open-source MLLMs struggle in long-context situations. Interestingly, the performance gap tends to widen with an increase in the number of images. We strongly encourage an intensification of research efforts towards enhancing MLLMs' long-context capabilities, especially in scenarios involving multiple images., Comment: 31 pages, 13 figures, 14 tables; We add results of GPT-4o in this version

Real-world datasets usually are class-imbalanced and corrupted by label noise. To solve the joint issue of long-tailed distribution and label noise, most previous works usually aim to design a noise detector to distinguish the noisy and clean samples. Despite their effectiveness, they may be limited in handling the joint issue effectively in a unified way. In this work, we develop a novel pseudo labeling method using class prototypes from the perspective of distribution matching, which can be solved with optimal transport (OT). By setting a manually-specific probability measure and using a learned transport plan to pseudo-label the training samples, the proposed method can reduce the side-effects of noisy and long-tailed data simultaneously. Then we introduce a simple yet effective filter criteria by combining the observed labels and pseudo labels to obtain a more balanced and less noisy subset for a robust model training. Extensive experiments demonstrate that our method can extract this class-balanced subset with clean labels, which brings effective performance gains for long-tailed classification with label noise.

Despite the vast repository of global medical knowledge predominantly being in English, local languages are crucial for delivering tailored healthcare services, particularly in areas with limited medical resources. To extend the reach of medical AI advancements to a broader population, we aim to develop medical LLMs across the six most widely spoken languages, encompassing a global population of 6.1 billion. This effort culminates in the creation of the ApolloCorpora multilingual medical dataset and the XMedBench benchmark. In the multilingual medical benchmark, the released Apollo models, at various relatively-small sizes (i.e., 0.5B, 1.8B, 2B, 6B, and 7B), achieve the best performance among models of equivalent size. Especially, Apollo-7B is the state-of-the-art multilingual medical LLMs up to 70B. Additionally, these lite models could be used to improve the multi-lingual medical capabilities of larger models without fine-tuning in a proxy-tuning fashion. We will open-source training corpora, code, model weights and evaluation benchmark., Comment: Preprint

Large language models (LLMs) have achieved superior performance in powering text-based AI agents, endowing them with decision-making and reasoning abilities akin to humans. Concurrently, there is an emerging research trend focused on extending these LLM-powered AI agents into the multimodal domain. This extension enables AI agents to interpret and respond to diverse multimodal user queries, thereby handling more intricate and nuanced tasks. In this paper, we conduct a systematic review of LLM-driven multimodal agents, which we refer to as large multimodal agents ( LMAs for short). First, we introduce the essential components involved in developing LMAs and categorize the current body of research into four distinct types. Subsequently, we review the collaborative frameworks integrating multiple LMAs , enhancing collective efficacy. One of the critical challenges in this field is the diverse evaluation methods used across existing studies, hindering effective comparison among different LMAs . Therefore, we compile these evaluation methodologies and establish a comprehensive framework to bridge the gaps. This framework aims to standardize evaluations, facilitating more meaningful comparisons. Concluding our review, we highlight the extensive applications of LMAs and propose possible future research directions. Our discussion aims to provide valuable insights and guidelines for future research in this rapidly evolving field. An up-to-date resource list is available at https://github.com/jun0wanan/awesome-large-multimodal-agents., Comment: 15 pages, 4 figures

Nuclei classification is a critical step in computer-aided diagnosis with histopathology images. In the past, various methods have employed graph neural networks (GNN) to analyze cell graphs that model inter-cell relationships by considering nuclei as vertices. However, they are limited by the GNN mechanism that only passes messages among local nodes via fixed edges. To address the issue, we develop a cell graph transformer (CGT) that treats nodes and edges as input tokens to enable learnable adjacency and information exchange among all nodes. Nevertheless, training the transformer with a cell graph presents another challenge. Poorly initialized features can lead to noisy self-attention scores and inferior convergence, particularly when processing the cell graphs with numerous connections. Thus, we further propose a novel topology-aware pretraining method that leverages a graph convolutional network (GCN) to learn a feature extractor. The pre-trained features may suppress unreasonable correlations and hence ease the finetuning of CGT. Experimental results suggest that the proposed cell graph transformer with topology-aware pretraining significantly improves the nuclei classification results, and achieves the state-of-the-art performance. Code and models are available at https://github.com/lhaof/CGT, Comment: AAAI 2024, Code and models are available at https://github.com/lhaof/CGT

The recognition of multi-class cell nuclei can significantly facilitate the process of histopathological diagnosis. Numerous pathological datasets are currently available, but their annotations are inconsistent. Most existing methods require individual training on each dataset to deduce the relevant labels and lack the use of common knowledge across datasets, consequently restricting the quality of recognition. In this paper, we propose a universal cell nucleus classification framework (UniCell), which employs a novel prompt learning mechanism to uniformly predict the corresponding categories of pathological images from different dataset domains. In particular, our framework adopts an end-to-end architecture for nuclei detection and classification, and utilizes flexible prediction heads for adapting various datasets. Moreover, we develop a Dynamic Prompt Module (DPM) that exploits the properties of multiple datasets to enhance features. The DPM first integrates the embeddings of datasets and semantic categories, and then employs the integrated prompts to refine image representations, efficiently harvesting the shared knowledge among the related cell types and data sources. Experimental results demonstrate that the proposed method effectively achieves the state-of-the-art results on four nucleus detection and classification benchmarks. Code and models are available at https://github.com/lhaof/UniCell, Comment: AAAI 2024, Code and models are available at https://github.com/lhaof/UniCell

Large vision-language models (LVLMs) have shown premise in a broad range of vision-language tasks with their strong reasoning and generalization capabilities. However, they require considerable computational resources for training and deployment. This study aims to bridge the performance gap between traditional-scale LVLMs and resource-friendly lite versions by adopting high-quality training data. To this end, we propose a comprehensive pipeline for generating a synthetic dataset. The key idea is to leverage strong proprietary models to generate (i) fine-grained image annotations for vision-language alignment and (ii) complex reasoning visual question-answering pairs for visual instruction fine-tuning, yielding 1.3M samples in total. We train a series of lite VLMs on the synthetic dataset and experimental results demonstrate the effectiveness of the proposed scheme, where they achieve competitive performance on 17 benchmarks among 4B LVLMs, and even perform on par with 7B/13B-scale models on various benchmarks. This work highlights the feasibility of adopting high-quality data in crafting more efficient LVLMs. We name our dataset \textit{ALLaVA}, and open-source it to research community for developing better resource-efficient LVLMs for wider usage., Comment: 22 pages

Intracerebral Hemorrhage (ICH) is the deadliest subtype of stroke, necessitating timely and accurate prognostic evaluation to reduce mortality and disability. However, the multi-factorial nature and complexity of ICH make methods based solely on computed tomography (CT) image features inadequate. Despite the capacity of cross-modal networks to fuse additional information, the effective combination of different modal features remains a significant challenge. In this study, we propose a joint-attention fusion-based 3D cross-modal network termed ICHPro that simulates the ICH prognosis interpretation process utilized by neurosurgeons. ICHPro includes a joint-attention fusion module to fuse features from CT images with demographic and clinical textual data. To enhance the representation of cross-modal features, we introduce a joint loss function. ICHPro facilitates the extraction of richer cross-modal features, thereby improving classification performance. Upon testing our method using a five-fold cross-validation, we achieved an accuracy of 89.11%, an F1 score of 0.8767, and an AUC value of 0.9429. These results outperform those obtained from other advanced methods based on the test dataset, thereby demonstrating the superior efficacy of ICHPro. The code is available at our Github: https://github.com/YU-deep/ICH., Comment: 6 pages,4 figures, 4 tables, accepted by ISBI

In the field of biomedical image analysis, the quest for architectures capable of effectively capturing long-range dependencies is paramount, especially when dealing with 3D image segmentation, classification, and landmark detection. Traditional Convolutional Neural Networks (CNNs) struggle with locality respective field, and Transformers have a heavy computational load when applied to high-dimensional medical images.In this paper, we introduce nnMamba, a novel architecture that integrates the strengths of CNNs and the advanced long-range modeling capabilities of State Space Sequence Models (SSMs). Specifically, we propose the Mamba-In-Convolution with Channel-Spatial Siamese learning (MICCSS) block to model the long-range relationship of the voxels. For the dense prediction and classification tasks, we also design the channel-scaling and channel-sequential learning methods. Extensive experiments on 6 datasets demonstrate nnMamba's superiority over state-of-the-art methods in a suite of challenging tasks, including 3D image segmentation, classification, and landmark detection. nnMamba emerges as a robust solution, offering both the local representation ability of CNNs and the efficient global context processing of SSMs, setting a new standard for long-range dependency modeling in medical image analysis. Code is available at https://github.com/lhaof/nnMamba, Comment: Code is available at https://github.com/lhaof/nnMamba

Accurate polyp detection is critical for early colorectal cancer diagnosis. Although remarkable progress has been achieved in recent years, the complex colon environment and concealed polyps with unclear boundaries still pose severe challenges in this area. Existing methods either involve computationally expensive context aggregation or lack prior modeling of polyps, resulting in poor performance in challenging cases. In this paper, we propose the Enhanced CenterNet with Contrastive Learning (ECC-PolypDet), a two-stage training \& end-to-end inference framework that leverages images and bounding box annotations to train a general model and fine-tune it based on the inference score to obtain a final robust model. Specifically, we conduct Box-assisted Contrastive Learning (BCL) during training to minimize the intra-class difference and maximize the inter-class difference between foreground polyps and backgrounds, enabling our model to capture concealed polyps. Moreover, to enhance the recognition of small polyps, we design the Semantic Flow-guided Feature Pyramid Network (SFFPN) to aggregate multi-scale features and the Heatmap Propagation (HP) module to boost the model's attention on polyp targets. In the fine-tuning stage, we introduce the IoU-guided Sample Re-weighting (ISR) mechanism to prioritize hard samples by adaptively adjusting the loss weight for each sample during fine-tuning. Extensive experiments on six large-scale colonoscopy datasets demonstrate the superiority of our model compared with previous state-of-the-art detectors., Comment: codes available at https://github.com/yuncheng97/ECC-PolypDet/tree/main

Chest X-rays (CXRs) are commonly utilized as a low-dose modality for lung screening. Nonetheless, the efficacy of CXRs is somewhat impeded, given that approximately 75% of the lung area overlaps with bone, which in turn hampers the detection and diagnosis of diseases. As a remedial measure, bone suppression techniques have been introduced. The current dual-energy subtraction imaging technique in the clinic requires costly equipment and subjects being exposed to high radiation. To circumvent these issues, deep learning-based image generation algorithms have been proposed. However, existing methods fall short in terms of producing high-quality images and capturing texture details, particularly with pulmonary vessels. To address these issues, this paper proposes a new bone suppression framework, termed BS-Diff, that comprises a conditional diffusion model equipped with a U-Net architecture and a simple enhancement module to incorporate an autoencoder. Our proposed network cannot only generate soft tissue images with a high bone suppression rate but also possesses the capability to capture fine image details. Additionally, we compiled the largest dataset since 2010, including data from 120 patients with high-definition, high-resolution paired CXRs and soft tissue images collected by our affiliated hospital. Extensive experiments, comparative analyses, ablation studies, and clinical evaluations indicate that the proposed BS-Diff outperforms several bone-suppression models across multiple metrics. Our code can be accessed at https://github.com/Benny0323/BS-Diff., Comment: 5 pages, 2 figures, accepted by IEEE ISBI 2024

Multimodal large language models (MLLMs) have broadened the scope of AI applications. Existing automatic evaluation methodologies for MLLMs are mainly limited in evaluating queries without considering user experiences, inadequately addressing the nuances of creative and associative multimodal tasks. However, the open-ended and subjective nature of such tasks poses a significant challenge to the evaluation methodology, where it is difficult to define the ground-truth answers for them. To this end, in our paper, we propose a new evaluation paradigm for MLLMs, which is evaluating MLLMs with per-sample criteria using potent MLLM as the judge. To validate the feasibility and effectiveness of this paradigm, we design a benchmark, dubbed MLLM-Bench, by curating the evaluation samples across six comprehensive cognitive levels. We benchmark 21 popular MLLMs in a pairwise-comparison fashion, showing diverse performance across models. Moreover, the validity of our benchmark manifests itself in reaching 88.02% agreement with human evaluation. We contend that the proposed paradigm explores the potential of MLLMs as effective evaluation tools with the help of per-sample criteria. See online leaderboard at \url{https://mllm-bench.llmzoo.com}., Comment: 23 pages

Adapting a language model into a specific domain, a.k.a `domain adaption', is a common practice when specialized knowledge, e.g. medicine, is not encapsulated in a general language model like Llama2. The challenge lies in the heterogeneity of data across the two training stages, as it varies in languages, genres, or formats. To tackle this and simplify the learning protocol, we propose to transform heterogeneous data, from the both pre-training and supervised stages, into a unified, simple input-output pair format. We validate the new protocol in the domains where proprietary LLMs like ChatGPT perform relatively poorly, such as Traditional Chinese Medicine. The developed model, HuatuoGPT-II, has shown state-of-the-art performance in Chinese medicine domain on a number of benchmarks, e.g. medical licensing exams. It even outperforms proprietary models like ChatGPT and GPT-4 in some aspects, especially in Traditional Chinese Medicine. Expert manual evaluations further validate HuatuoGPT-II's advantages over existing LLMs. Notably, HuatuoGPT-II was benchmarked in a fresh Chinese National Medical Licensing Examination where it achieved the best performance, showcasing not only its effectiveness but also its generalization capabilities.

Intracerebral Hemorrhage (ICH) is a severe condition resulting from damaged brain blood vessel ruptures, often leading to complications and fatalities. Timely and accurate prognosis and management are essential due to its high mortality rate. However, conventional methods heavily rely on subjective clinician expertise, which can lead to inaccurate diagnoses and delays in treatment. Artificial intelligence (AI) models have been explored to assist clinicians, but many prior studies focused on model modification without considering domain knowledge. This paper introduces a novel deep learning algorithm, GCS-ICHNet, which integrates multimodal brain CT image data and the Glasgow Coma Scale (GCS) score to improve ICH prognosis. The algorithm utilizes a transformer-based fusion module for assessment. GCS-ICHNet demonstrates high sensitivity 81.03% and specificity 91.59%, outperforming average clinicians and other state-of-the-art methods., Comment: 6 pages, 3 figures, 5 tables, published to BIBM 2023

Cell segmentation for multi-modal microscopy images remains a challenge due to the complex textures, patterns, and cell shapes in these images. To tackle the problem, we first develop an automatic cell classification pipeline to label the microscopy images based on their low-level image characteristics, and then train a classification model based on the category labels. Afterward, we train a separate segmentation model for each category using the images in the corresponding category. Besides, we further deploy two types of segmentation models to segment cells with roundish and irregular shapes respectively. Moreover, an efficient and powerful backbone model is utilized to enhance the efficiency of our segmentation model. Evaluated on the Tuning Set of NeurIPS 2022 Cell Segmentation Challenge, our method achieves an F1-score of 0.8795 and the running time for all cases is within the time tolerance., Comment: The second place in NeurIPS 2022 cell segmentation challenge (https://neurips22-cellseg.grand-challenge.org/), released code: https://github.com/lhaof/CellSeg

Nuclei segmentation is a fundamental but challenging task in the quantitative analysis of histopathology images. Although fully-supervised deep learning-based methods have made significant progress, a large number of labeled images are required to achieve great segmentation performance. Considering that manually labeling all nuclei instances for a dataset is inefficient, obtaining a large-scale human-annotated dataset is time-consuming and labor-intensive. Therefore, augmenting a dataset with only a few labeled images to improve the segmentation performance is of significant research and application value. In this paper, we introduce the first diffusion-based augmentation method for nuclei segmentation. The idea is to synthesize a large number of labeled images to facilitate training the segmentation model. To achieve this, we propose a two-step strategy. In the first step, we train an unconditional diffusion model to synthesize the Nuclei Structure that is defined as the representation of pixel-level semantic and distance transform. Each synthetic nuclei structure will serve as a constraint on histopathology image synthesis and is further post-processed to be an instance map. In the second step, we train a conditioned diffusion model to synthesize histopathology images based on nuclei structures. The synthetic histopathology images paired with synthetic instance maps will be added to the real dataset for training the segmentation model. The experimental results show that by augmenting 10% labeled real dataset with synthetic samples, one can achieve comparable segmentation results with the fully-supervised baseline. The code is released in: https://github.com/lhaof/Nudiff, Comment: MICCAI 2023, released code: https://github.com/lhaof/Nudiff

Automatic nuclei detection and classification can produce effective information for disease diagnosis. Most existing methods classify nuclei independently or do not make full use of the semantic similarity between nuclei and their grouping features. In this paper, we propose a novel end-to-end nuclei detection and classification framework based on a grouping transformer-based classifier. The nuclei classifier learns and updates the representations of nuclei groups and categories via hierarchically grouping the nucleus embeddings. Then the cell types are predicted with the pairwise correlations between categorical embeddings and nucleus features. For the efficiency of the fully transformer-based framework, we take the nucleus group embeddings as the input prompts of backbone, which helps harvest grouping guided features by tuning only the prompts instead of the whole backbone. Experimental results show that the proposed method significantly outperforms the existing models on three datasets., Comment: MICCAI 2023, released code: https://github.com/lhaof/PGT

Automatic tissue segmentation of fetal brain images is essential for the quantitative analysis of prenatal neurodevelopment. However, producing voxel-level annotations of fetal brain imaging is time-consuming and expensive. To reduce labeling costs, we propose a practical unsupervised domain adaptation (UDA) setting that adapts the segmentation labels of high-quality fetal brain atlases to unlabeled fetal brain MRI data from another domain. To address the task, we propose a new UDA framework based on Appearance and Structure Consistency, named ASC. We adapt the segmentation model to the appearances of different domains by constraining the consistency before and after a frequency-based image transformation, which is to swap the appearance between brain MRI data and atlases. Consider that even in the same domain, the fetal brain images of different gestational ages could have significant variations in the anatomical structures. To make the model adapt to the structural variations in the target domain, we further encourage prediction consistency under different structural perturbations. Extensive experiments on FeTA 2021 benchmark demonstrate the effectiveness of our ASC in comparison to registration-based, semi-supervised learning-based, and existing UDA-based methods., Comment: MICCAI 2023, released code: https://github.com/lhaof/ASC

Deep learning (DL) has been used in the automatic diagnosis of Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD) with brain imaging data. However, previous methods have not fully exploited the relation between brain image and clinical information that is widely adopted by experts in practice. To exploit the heterogeneous features from imaging and tabular data simultaneously, we propose the Visual-Attribute Prompt Learning-based Transformer (VAP-Former), a transformer-based network that efficiently extracts and fuses the multi-modal features with prompt fine-tuning. Furthermore, we propose a Prompt fine-Tuning (PT) scheme to transfer the knowledge from AD prediction task for progressive MCI (pMCI) diagnosis. In details, we first pre-train the VAP-Former without prompts on the AD diagnosis task and then fine-tune the model on the pMCI detection task with PT, which only needs to optimize a small amount of parameters while keeping the backbone frozen. Next, we propose a novel global prompt token for the visual prompts to provide global guidance to the multi-modal representations. Extensive experiments not only show the superiority of our method compared with the state-of-the-art methods in pMCI prediction but also demonstrate that the global prompt can make the prompt learning process more effective and stable. Interestingly, the proposed prompt learning model even outperforms the fully fine-tuning baseline on transferring the knowledge from AD to pMCI., Comment: MICCAI 2023, released code: https://github.com/lhaof/VAPL

Multi-class cell nuclei detection is a fundamental prerequisite in the diagnosis of histopathology. It is critical to efficiently locate and identify cells with diverse morphology and distributions in digital pathological images. Most existing methods take complex intermediate representations as learning targets and rely on inflexible post-refinements while paying less attention to various cell density and fields of view. In this paper, we propose a novel Affine-Consistent Transformer (AC-Former), which directly yields a sequence of nucleus positions and is trained collaboratively through two sub-networks, a global and a local network. The local branch learns to infer distorted input images of smaller scales while the global network outputs the large-scale predictions as extra supervision signals. We further introduce an Adaptive Affine Transformer (AAT) module, which can automatically learn the key spatial transformations to warp original images for local network training. The AAT module works by learning to capture the transformed image regions that are more valuable for training the model. Experimental results demonstrate that the proposed method significantly outperforms existing state-of-the-art algorithms on various benchmarks., Comment: ICCV 2023, released code: https://github.com/lhaof/ACFormer

This paper is devoted to the development of a localized Large Language Model (LLM) specifically for Arabic, a language imbued with unique cultural characteristics inadequately addressed by current mainstream models. Significant concerns emerge when addressing cultural sensitivity and local values. To address this, the paper proposes a comprehensive solution that includes further pre-training with Arabic texts, Supervised Fine-Tuning (SFT) utilizing native Arabic instructions, and GPT-4 responses in Arabic, alongside Reinforcement Learning with AI Feedback (RLAIF) employing a reward model attuned to local culture and values. The goal is to cultivate culturally cognizant and value-aligned Arabic LLMs capable of accommodating the diverse, application-specific needs of Arabic-speaking communities. Comprehensive evaluations reveal that the resulting model, dubbed `AceGPT', sets the state-of-the-art standard for open Arabic LLMs across various benchmarks. Codes, data, and models are in https://github.com/FreedomIntelligence/AceGPT., Comment: Accepted to NAACL main conference. https://github.com/FreedomIntelligence/AceGPT

Colonoscopy analysis, particularly automatic polyp segmentation and detection, is essential for assisting clinical diagnosis and treatment. However, as medical image annotation is labour- and resource-intensive, the scarcity of annotated data limits the effectiveness and generalization of existing methods. Although recent research has focused on data generation and augmentation to address this issue, the quality of the generated data remains a challenge, which limits the contribution to the performance of subsequent tasks. Inspired by the superiority of diffusion models in fitting data distributions and generating high-quality data, in this paper, we propose an Adaptive Refinement Semantic Diffusion Model (ArSDM) to generate colonoscopy images that benefit the downstream tasks. Specifically, ArSDM utilizes the ground-truth segmentation mask as a prior condition during training and adjusts the diffusion loss for each input according to the polyp/background size ratio. Furthermore, ArSDM incorporates a pre-trained segmentation model to refine the training process by reducing the difference between the ground-truth mask and the prediction mask. Extensive experiments on segmentation and detection tasks demonstrate the generated data by ArSDM could significantly boost the performance of baseline methods., Comment: Accepted by MICCAI-2023

The unparalleled performance of closed-sourced ChatGPT has sparked efforts towards its democratization, with notable strides made by leveraging real user and ChatGPT dialogues, as evidenced by Vicuna. However, due to challenges in gathering dialogues involving human participation, current endeavors like Baize and UltraChat rely on ChatGPT conducting roleplay to simulate humans based on instructions, resulting in overdependence on seeds, diminished human-likeness, limited topic diversity, and an absence of genuine multi-round conversational dynamics. To address the above issues, we propose a paradigm to simulate human behavior better and explore the benefits of incorporating more human-like questions in multi-turn conversations. Specifically, we directly target human questions extracted from genuine human-machine conversations as a learning goal and provide a novel user simulator called `Socratic'. The experimental results show our response model, `PlatoLM', achieves SoTA performance among LLaMA-based 7B models in MT-Bench. Our findings further demonstrate that our method introduces highly human-like questioning patterns and rich topic structures, which can teach the response model better than previous works in multi-round conversations., Comment: 23 pages

Large Language Models (LLMs) provide a possibility to make a great breakthrough in medicine. The establishment of a standardized medical benchmark becomes a fundamental cornerstone to measure progression. However, medical environments in different regions have their local characteristics, e.g., the ubiquity and significance of traditional Chinese medicine within China. Therefore, merely translating English-based medical evaluation may result in \textit{contextual incongruities} to a local region. To solve the issue, we propose a localized medical benchmark called CMB, a Comprehensive Medical Benchmark in Chinese, designed and rooted entirely within the native Chinese linguistic and cultural framework. While traditional Chinese medicine is integral to this evaluation, it does not constitute its entirety. Using this benchmark, we have evaluated several prominent large-scale LLMs, including ChatGPT, GPT-4, dedicated Chinese LLMs, and LLMs specialized in the medical domain. We hope this benchmark provide first-hand experience in existing LLMs for medicine and also facilitate the widespread adoption and enhancement of medical LLMs within China. Our data and code are publicly available at https://github.com/FreedomIntelligence/CMB., Comment: Accepted to NAACL 2024 Main Conference

Visual grounding (VG) aims to establish fine-grained alignment between vision and language. Ideally, it can be a testbed for vision-and-language models to evaluate their understanding of the images and texts and their reasoning abilities over their joint space. However, most existing VG datasets are constructed using simple description texts, which do not require sufficient reasoning over the images and texts. This has been demonstrated in a recent study~\cite{luo2022goes}, where a simple LSTM-based text encoder without pretraining can achieve state-of-the-art performance on mainstream VG datasets. Therefore, in this paper, we propose a novel benchmark of \underline{S}cene \underline{K}nowledge-guided \underline{V}isual \underline{G}rounding (SK-VG), where the image content and referring expressions are not sufficient to ground the target objects, forcing the models to have a reasoning ability on the long-form scene knowledge. To perform this task, we propose two approaches to accept the triple-type input, where the former embeds knowledge into the image features before the image-query interaction; the latter leverages linguistic structure to assist in computing the image-text matching. We conduct extensive experiments to analyze the above methods and show that the proposed approaches achieve promising results but still leave room for improvement, including performance and interpretability. The dataset and code are available at \url{https://github.com/zhjohnchan/SK-VG}., Comment: Computer Vision and Natural Language Processing. 21 pages, 14 figures. CVPR-2023

Parameter Efficient Tuning (PET) has gained attention for reducing the number of parameters while maintaining performance and providing better hardware resource savings, but few studies investigate dense prediction tasks and interaction between modalities. In this paper, we do an investigation of efficient tuning problems on referring image segmentation. We propose a novel adapter called Bridger to facilitate cross-modal information exchange and inject task-specific information into the pre-trained model. We also design a lightweight decoder for image segmentation. Our approach achieves comparable or superior performance with only 1.61\% to 3.38\% backbone parameter updates, evaluated on challenging benchmarks. The code is available at \url{https://github.com/kkakkkka/ETRIS}., Comment: Computer Vision and Natural Language Processing. 14 pages, 8 figures. ICCV-2023

Masked language modeling (MLM) has been one of the most popular pretraining recipes in natural language processing, e.g., BERT, one of the representative models. Recently, contrastive language-image pretraining (CLIP) has also attracted attention, especially its vision models that achieve excellent performance on a broad range of vision tasks. However, few studies are dedicated to studying the text encoders learned by CLIP. In this paper, we analyze the difference between BERT-style and CLIP-style text encoders from three experiments: (i) general text understanding, (ii) vision-centric text understanding, and (iii) text-to-image generation. Experimental analyses show that although CLIP-style text encoders underperform BERT-style ones for general text understanding tasks, they are equipped with a unique ability, i.e., synesthesia, for the cross-modal association, which is more similar to the senses of humans., Comment: Natural Language Processing. 10 pages, 1 figure. Findings of ACL-2023

In this paper, we present HuatuoGPT, a large language model (LLM) for medical consultation. The core recipe of HuatuoGPT is to leverage both \textit{distilled data from ChatGPT} and \textit{real-world data from doctors} in the supervised fine-tuned stage. The responses of ChatGPT are usually detailed, well-presented and informative while it cannot perform like a doctor in many aspects, e.g. for integrative diagnosis. We argue that real-world data from doctors would be complementary to distilled data in the sense the former could tame a distilled language model to perform like doctors. To better leverage the strengths of both data, we train a reward model to align the language model with the merits that both data bring, following an RLAIF (reinforced learning from AI feedback) fashion. To evaluate and benchmark the models, we propose a comprehensive evaluation scheme (including automatic and manual metrics). Experimental results demonstrate that HuatuoGPT achieves state-of-the-art results in performing medical consultation among open-source LLMs in GPT-4 evaluation, human evaluation, and medical benchmark datasets. It is worth noting that by using additional real-world data and RLAIF, the distilled language model (i.e., HuatuoGPT) outperforms its teacher model ChatGPT in most cases. Our code, data, and models are publicly available at \url{https://github.com/FreedomIntelligence/HuatuoGPT}. The online demo is available at \url{https://www.HuatuoGPT.cn/}.

Pre-trained language models (PLMs) were considered to be able to store relational knowledge present in the training data. However, some relational knowledge seems to be discarded unsafely in PLMs due to \textbf{report bias}: low-frequency relational knowledge might be underexpressed compared to high-frequency one in PLMs. This gives us a hint that relational knowledge might not be redundant to the stored knowledge of PLMs, but rather be complementary. To additionally inject relational knowledge into PLMs, we propose a simple-yet-effective approach to inject relational knowledge into PLMs, which is inspired by three observations (namely, polymorphism, synonymous substitution, and association). In particular, we switch entities in the training corpus to related entities (either hypernyms/hyponyms/synonyms, or arbitrarily-related concepts). Experimental results show that the proposed approach could not only better capture relational knowledge, but also improve the performance in various biomedical downstream tasks. Our model is available in \url{https://github.com/StevenZHB/BioPLM_InjectingKnowledge}.

Human-like large language models (LLMs), especially the most powerful and popular ones in OpenAI's GPT family, have proven to be very helpful for many natural language processing (NLP) related tasks. Therefore, various attempts have been made to apply LLMs to information extraction (IE), which is a fundamental NLP task that involves extracting information from unstructured plain text. To demonstrate the latest representative progress in LLMs' information extraction ability, we assess the information extraction ability of GPT-4 (the latest version of GPT at the time of writing this paper) from four perspectives: Performance, Evaluation Criteria, Robustness, and Error Types. Our results suggest a visible performance gap between GPT-4 and state-of-the-art (SOTA) IE methods. To alleviate this problem, considering the LLMs' human-like characteristics, we propose and analyze the effects of a series of simple prompt-based methods, which can be generalized to other LLMs and NLP tasks. Rich experiments show our methods' effectiveness and some of their remaining issues in improving GPT-4's information extraction ability., Comment: 52 pages, Version 2.0; This article has an original arxiv version entitled "Is Information Extraction Solved by ChatGPT? An Analysis of Performance, Evaluation Criteria, Robustness and Errors'', whose url link is arXiv:2305.14450v1

In this paper, we release a largest ever medical Question Answering (QA) dataset with 26 million QA pairs. We benchmark many existing approaches in our dataset in terms of both retrieval and generation. Experimental results show that the existing models perform far lower than expected and the released dataset is still challenging in the pre-trained language model era. Moreover, we also experimentally show the benefit of the proposed dataset in many aspects: (i) trained models for other QA datasets in a zero-shot fashion; and (ii) as external knowledge for retrieval-augmented generation (RAG); and (iii) improving existing pre-trained language models by using the QA pairs as a pre-training corpus in continued training manner. We believe that this dataset will not only contribute to medical research but also facilitate both the patients and clinical doctors. See \url{https://github.com/FreedomIntelligence/Huatuo-26M}.

This paper presents our efforts to democratize ChatGPT across language. We release a large language model "Phoenix", achieving competitive performance among open-source English and Chinese models while excelling in languages with limited resources (covering both Latin and non-Latin languages). We believe this work will be beneficial to make ChatGPT more accessible, especially in countries where people cannot use ChatGPT due to restrictions from OpenAI or local goverments. Our data, code, and models are available at https://github.com/FreedomIntelligence/LLMZoo.