Lightweight Adaptation of EEG Foundation Models for Stroke Motor Imagery Decoding: Domain Shift and Subject-Level Robustness

Motor imagery (MI) electroencephalography (EEG) decoding could support post-stroke rehabilitation, but models developed on healthy cohorts may not transfer reliably to pathological EEG. We evaluated whether Low-Rank Adaptation (LoRA) can efficiently adapt three pretrained EEG foundation models (i.e., LaBraM-base, REVE-base, and REVE-large) for binary left- versus right-hand MI decoding. Frozen-backbone head-only baselines and LoRA adaptation were evaluated using subject-wise five-fold cross-validation on the PhysioNet EEG Motor Movement/Imagery Dataset and a binary subset of the UET175 dataset comprising 30 stroke participants. On EEGMMIDB, LoRA increased accuracy to 0.822 for LaBraM-base and 0.957 for REVE-base. On UET175, all head-only models performed near chance. With LoRA, LaBraM-base remained near chance (0.499$\pm$0.009), whereas REVE-base reached 0.847$\pm$0.194 and outperformed REVE-large (0.806$\pm$0.178), indicating that increased model capacity alone did not improve stroke-domain adaptation. The strongest stroke configuration, REVE-base LoRA, was further evaluated using within-cohort leave-one-subject-out cross-validation (LOOCV), showing 0.952 mean accuracy, but subject-wise accuracy ranged from 0.586 to 1.000, revealing a small low-performing tail. Zero-shot transfer from EEGMMIDB to UET175 remained near chance (0.464$\pm$0.072). These findings show that healthy-benchmark performance does not ensure transfer to stroke EEG. Translation of EEG foundation models to pseudo-online or real-time rehabilitation BCIs should therefore include target-domain adaptation and subject-level assessment of temporal informativeness, spatial sensitivity, and physiological discriminability.

On the Role of MRI Sequences in Cross-Dataset Generalization for Brain Tumor Segmentation

Brain tumor segmentation in magnetic resonance imaging (MRI) is a critical task for diagnosis and treatment planning. Despite the success of deep learning architectures such as U-Net and its variants, performance degradation across datasets remains a major challenge, particularly under domain shift and limited annotated data. To address this issue, this study systematically evaluates how individual MRI sequences influence model robustness across two well-known datasets. A ResUNet-based framework is employed, where each modality is trained independently to isolate its effect under a controlled cross-dataset evaluation protocol with tumor size stratification, without target-domain training, or with limited domain adaptation. Results show that the T2f/FLAIR sequence achieves the best cross-dataset performance, with Dice scores exceeding 75%. It consistently outperforms other modalities across most tumor size ranges, while multi-sequence training further improves performance. Additionally, even limited target-domain adaptation yields rapid initial gains, reducing the need for extensive annotations and costly retraining. Our source code is publicly available at https://github.com/henrique-zan/brain_tumor_segmentation/.

EXPOSE: Explainable and Domain-Robust Embeddings from Pathology Vision Foundation Models using Sparse Autoencoders

Vision Foundation Models (VFMs) are widely used in computational pathology but remain sensitive to domain shifts arising from variations in staining, tissue preparation, and scanner hardware. A key limitation is that VFM embeddings entangle biological with domain-specific information, hindering cross-domain generalization. We propose Explainable Probing of Cross-Domain Sparse Embeddings (EXPOSE), a framework that uses Sparse Autoencoders (SAEs) as an explainable bottleneck to identify and suppress domain-specific components in VFM embeddings. We train a sparse representation of VFM features, use a linear classifier to identify domain-specific latent dimensions, and mask these features prior to downstream relapse prediction without retraining the backbone model. Experiments on a large prostate cancer dataset with multiple acquisition domains show that SAE features capture both domain- and task-specific information, which are partially disentangled in the latent space. Removing domain-specific features improves cross-domain performance and increases embedding robustness as measured by the Domain Robustness Index (DoRI). Code is available at https://github.com/imsb-uke/expose .

Unsupervised Adaptation of 3D CT Foundation Models for 3D CBCT Segmentation

Accurate 3D segmentation of cone-beam CT (CBCT) is critical for interventional and radiation therapy applications, yet it remains limited by two compounding challenges: the scarcity of annotated CBCT data and the large domain shift from diagnostic CT. Interventional CBCT exhibits fundamental modality differences from conventional CT, driven by acquisition and physics effects as well as contrast-specific vascular content, thereby limiting effective cross-modality model transfer. We propose a novel unsupervised domain adaptation (UDA) framework based on redundancy-reducing feature alignment, enabling 3D CBCT segmentation with no target-domain annotations or inference-time adaptation. Our framework is architecture-agnostic, seamlessly adapting both CNN-based and ViT-based foundation models. We evaluate our method on two challenging CT-CBCT liver segmentation benchmarks: one for interventional vascular procedures and one for radiation therapy, demonstrating that even large-scale pretrained segmentation networks require explicit feature-space bridging to generalize across acquisition modalities, and that our approach consistently outperforms existing pretrained foundation model and UDA strategies. To support reproducibility and benchmarking, we release the liver segmentations for a public CBCT dataset, along with the code, trained models, and weights.

FAN-LoRA: A Fourier-Adaptive Nonlinear Low-Rank Adaptor for Medical Foundation Model Domain Adaptation

The advent of vision foundation models, notably the Segment Anything Model (SAM), has catalyzed significant advancements in natural image segmentation. However, their direct transfer to medical imaging remains severely bottlenecked by profound domain gaps, such as cross-modality and cross-center shifts. Existing Parameter-Efficient Fine-Tuning (PEFT) methods facilitate the adaptation of SAM to medical domains; nevertheless, they frequently suffer from performance degradation under severe distribution shifts. This vulnerability primarily stems from the implicit entanglement of heterogeneous frequency components within a shared low-rank subspace, which directly exacerbates sub-optimal structural alignment and localized boundary blurring. To overcome this representational bottleneck, we propose the Fourier-Adaptive Nonlinear Low-Rank Adaptor (FAN-LoRA), a novel frequency-decoupled fine-tuning architecture. FAN-LoRA explicitly separates the optimization space by employing a B-spline-driven low-pass branch for global structural alignment, synergistically coupled with a discrete Fourier high-pass branch for local textural compensation. Extensive experiments across three challenging cross-modality and cross-center benchmarks demonstrate that FAN-LoRA consistently outperforms state-of-the-art PEFT baselines. Compared to the strongest competitors, our method achieves consistent improvements in average Dice scores and notable reductions in boundary errors, while maintaining a compact module size without compromising computational efficiency.

Improving Cross-Site Whole-Heart Segmentation

Whole-heart segmentation from CT and MRI is essential for quantitative cardiac image analysis, but remains challenging under multi-center and multi-modality distribution shift. In the CARE whole-heart segmentation task, models must generalize from limited labeled sites to unseen acquisition distributions, where variation in spacing, intensity, reconstruction texture, and anatomy can degrade out-of-distribution performance. We propose a modality-routed 3D cardiac segmentation pipeline that combines TotalSegmentator-initialized nnU-Netv2 models with site-characterized, label-preserving appearance augmentation. We first characterize the available sites using measurable image properties and use this analysis to motivate candidate data-space generalization routes. The final retained recipe applies Bias Field + Bezier appearance augmentation, combining smooth spatial intensity perturbation with nonlinear intensity remapping, followed by lightweight class-wise largest-connected-component cleanup. On the primary held-out-site validation splits, the final configuration improves CT mean Dice from 0.8350 to 0.9135 and MRI mean Dice from 0.7695 to 0.7830, while also reducing HD95. These results suggest that site-motivated appearance augmentation is a practical strategy for improving cross-site robustness in limited-data whole-heart segmentation. Our code can be found in https://github.com/Purdue-M2/Improving-Cross-Site-Whole-Heart-Segmentation

SymmAdapt: Symmetrical Flow Matching for Source-Free Domain Adaptation in Medical Image Segmentation

Domain shift across imaging modalities and acquisition sites remains a significant barrier to the clinical deployment of segmentation models. Source-free unsupervised domain adaptation (SFUDA) addresses this by adapting a pretrained model to an unlabeled target domain without requiring access to sensitive source data. We introduce a novel SFUDA framework built on Symmetrical Flow Matching, a unified generative model that segments an input image and synthesizes a source-like image from a mask within the same learned flow. By initializing inference from a domain-agnostic Gaussian origin, the model preserves structural consistency across domains and grounds predictions in learned anatomy rather than shifted texture statistics. Our pipeline leverages this symmetry to generate reliable pseudo-labels and corresponding source-like synthetic images from unlabeled target data, creating a generative replay buffer that anchors source knowledge during a generative self-training stage that fine-tunes on a joint set of real target and synthetic source-like images. We evaluate on abdominal multi-organ and cardiac segmentation, covering cross-modality MRI<->CT shifts, and multi-site prostate segmentation. Our approach outperforms SFUDA baselines and is competitive with conventional UDA methods.

SCORE: Subject Coordinate Recovery for Label-Free Cross-Subject EEG-to-Image Retrieval

Accurate visual decoding can reveal how the brain represents visual information and recover perceived content from neural signals such as electroencephalography (EEG), with potential for neural communication. However, current EEG-to-image retrieval methods perform far below their within-subject counterparts for new users without labeled calibration, limiting real-world deployment. To understand this gap, we analyze EEG features across subjects and find that different subjects preserve similar relationships among concepts but express them along different coordinate directions. We therefore propose Subject Coordinate Recovery (SCORE), a target label-free framework combining recovery-aware source training with coordinate alignment at deployment. During training, SCORE aligns source subject EEG with a common image space and simulates unseen-subject recovery through source-only episodes. At deployment, with both encoders frozen, SCORE selects reliable EEG-image landmarks through hubness-corrected matching and estimates an orthogonal transformation to recover target EEG coordinates without source data or target labels. In 200-way retrieval on two public benchmarks, SCORE outperforms the unadapted baseline for every target subject and achieves the best overall accuracy. It reaches 53.23%/83.55% and 12.01%/32.16% Top-1/Top-5 on THINGS-EEG2 and Alljoined-1.6M, respectively, surpassing the strongest baselines by 17.45/15.70 and 3.08/4.62 percentage points. Without target labels or encoder updates, SCORE brings brain-based visual decoding closer to robust, practical, low-latency deployment across users.

Dual Co-Train: Cross-Dataset Ultrasound Tongue Segmentation Under Extreme Data Scarcity

Ultrasound tongue contour segmentation remains challenging under cross-dataset domain shift, where limited annotations, probe variability, and acquisition noise often degrade model generalization. We present a source-free domain adaptation framework for robust ultrasound tongue segmentation built on a lightweight UltraUNet backbone. Starting from a checkpoint pretrained on only five labeled source images, simulating an underfitted constrained source model, the proposed method adapts to a fully-unlabeled target domain by iteratively refining pseudo-labels, filtering unreliable masks with a contour-based quality-control module, and generating target-style synthetic image-mask pairs through a segmentation-guided conditional GAN. The student model is then trained on a mixture of clean pseudo-labeled target images, noisy pseudo-labels with consistency regularization, and synthetic samples, enabling closed-loop adaptation without access to source data. We evaluate the method on 12 source-target transfer pairs across eight ultrasound tongue imaging datasets, and conduct source-size scaling experiments and ablation studies. Across all comparisons, the proposed framework improves segmentation overlap and contour accuracy over the baselines, including supervised ones. These results suggest that task-specific pseudo-label refinement and synthetic target-style augmentation can substantially improve source-free adaptation for ultrasound tongue imaging.

Looking Beyond the Scale: Do Surgical Skill Models Learn Transferable Representations Across Assessment Rubrics?

Vision-based surgical skill assessment has shown strong in-domain results, yet a fundamental question remains unasked: do these models learn transferable representations of surgical proficiency, or do they merely encode dataset-specific visual patterns? This paper systematically analyzes what limits cross-domain skill transfer between the GOALS and OSATS assessment scales using the LASANA and JIGSAWS datasets. Each evaluated method serves a targeted diagnostic purpose: end-to-end training to test whether supervised skill learning transfers directly, Adaptive Sharpness-Aware Minimization (ASAM) to probe whether flatter loss landscapes improve generalization, and augmentation-based self-supervised and contrastive learning to assess whether domain-invariant pretraining decouples skill from visual context. Transfer is evaluated in both directions using a disjoint-participant held-out test set for JIGSAWS. Results reveal an asymmetry: backbones pretrained on JIGSAWS achieve CCC values of 0.77 to 0.80 on LASANA, closely matching the end-to-end baseline, showing cross-rubric transfer is feasible when the target domain provides consistent supervision. Transfer to JIGSAWS fails across all methods, likely due to annotation inconsistencies. Control experiments with a Kinetics-pretrained backbone suggest task-specific heads carry the majority of the skill prediction burden, while the backbone need only provide adequate spatiotemporal features. These findings offer a new perspective on vision-based skill assessment: the central question of whether skill representations transfer across scoring systems has not been previously investigated. Results indicate the visual component is dominant but not solely responsible for skill prediction; further work is needed to conclusively disentangle transferable skill features from those bound to a specific visual domain.

Few-Shot Cross-Dataset Adaptation for Tuberculosis Detection Using DenseNet

Tuberculosis (TB) is one of the most common and dangerous bacterial ailments. Every year, it causes a large number of deaths worldwide. Although many deep learning models can detect tuberculosis from chest X-rays quite accurately, severe domain shift across datasets makes the task challenging. Different imaging protocols, patient demographics, and equipment across domains make the task of generalization difficult. In real-world settings, a model may perform well on one dataset but show a noticeable drop in performance when tested on another. In this work, we address this domain adaptation challenge through a few-shot scaling study. A controlled cross-dataset evaluation is presented in this paper using TBX11K as the source domain and the Mendeley TB dataset as the target domain. It is investigated how varying the number of target samples affects model performance under three training regimes: frozen backbone adaptation, full fine-tuning of a source-pretrained DenseNet121 model, and training from scratch. The results indicate that the model can perform well even with limited data and can achieve 98.36\% accuracy with just 75 labeled samples per class. The adaptation curves demonstrate how fine-tuning effectively mitigates domain shift. These findings establish full fine-tuning of pretrained models as a highly effective and practical strategy for mitigating domain shift in low-resource clinical deployment scenarios.

Decodable but Not Accessible: Auditing Distance-Based Reliability Estimation on Disentangled Skin-Lesion Representations

Distance-based reliability estimation assumes that a representation's geometry reflects its trustworthiness, yet this assumption is rarely tested under training interventions that reshape geometry directly. We audit this assumption under domain-adversarial representation learning using a disentanglement dose-response ladder. Three checkpoint families share the same architecture and a 16-dimensional representation, differing only in orthogonality strength (lambda = 0, 1, 5). Representation geometry changed substantially with disentanglement strength: the condition number shifted by two orders of magnitude (Kendall tau = 0.84, exact p = 2.8e-5). This change was not accompanied by improved reliability estimation: Mahalanobis-distance AUROC (ISIC-test vs. PAD-UFES) remained flat and below chance (about 0.40) at every level, with no significant association with any of five geometry metrics tested. The same failure was observed for cosine-to-centroid and pooled k-nearest-neighbor scorers, plus three non-distance-based scorers: an energy-based confidence score, Virtual-Logit Matching, and a kernel density estimator. Seven of eight scorers converged on the same result; the energy-based score showed an isolated upward trend that we report but do not treat as evidence against the overall pattern. A supervised probe with no access to the training objective recovered domain membership from the identical embeddings at 0.72-0.81 AUROC across every level, showing that the relevant information was not absent from the representation. These findings indicate that classification performance alone can overlook whether information in a learned representation is organized in a form that downstream reliability estimators can use. Information can remain decodable while becoming largely inaccessible to non-probing reliability estimators.

Task-Adaptive 3D Cross-Field MRI Translation via Field-Conditioned Content-Style Pretraining

Magnetic field strength is a major source of domain shift in magnetic resonance imaging (MRI), affecting signal-to-noise ratio, tissue contrast, spatial detail, and the visibility of anatomical boundaries. The MRIxFields 2026 challenge investigates this problem through cross-field MRI translation across acquisitions at 0.1T, 1.5T, 3T, 5T, and 7T. Its three tasks, Any-to-7T, 0.1T-to-High, and Any-to-Any synthesis, require the generation of target-field image characteristics while preserving subject-specific anatomy. This problem is particularly challenging because paired acquisitions of the same subject across multiple field strengths are rarely available for training. We propose a 3D unpaired cross-field MRI translation framework based on field-conditioned content-style pretraining. The proposed framework first learns controllable field-to-field translation across all available field strengths by disentangling anatomical content from field-dependent contrast characteristics. The pretrained backbone is then adapted to task-specific target domains. Our model comprises a 3D content encoder, a 3D style encoder, a field-conditioned style generator, an AdaIN-modulated decoder, and a multi-field discriminator. Adversarial learning encourages realistic target-field appearance, while cycle-consistency, identity, content, style, and diversity constraints promote anatomical fidelity and controllable translation. We evaluate the proposed method on MRIxFields data spanning five field strengths and three MRI modalities. Experiments on paired test data demonstrate that the framework can adapt to the three challenge settings while preserving three-dimensional anatomical structure in the synthesized volumes. The implementation code is publicly available at https://github.com/Idea89560041/3D-MRI-Field-Translation.

An Agentic Generative Large Language Model for Treatment Planning of Colorectal Cancer

Treatment planning in precision oncology requires synthesizing heterogeneous patient information with rapidly evolving clinical guidelines to ensure guideline-concordant care. While large language models (LLMs) show promise in many diagnostic tasks, their adoption for high-stakes treatment planning is hindered by complex reasoning, adherence to timely clinical guidelines, and safety concerns. In this study, we present GatorOnco, an agentic LLM for colorectal cancer (CRC) treatment planning. GatorOnco is developed using a total of 282 billion tokens of biomedical text, including healthcare system-scale clinical text comprising 166 billion tokens from UF Health. We implemented a domain-adaptation method that integrates pre-training, model merging, a two-stage post-training approach, and agent-based reinforcement learning. An agentic retrieval-augmented generation (RAG) approach dynamically integrates time-sensitive clinical guidelines into the reasoning process. In a blind, randomized clinical evaluation conducted by five UF Health oncologists, GatorOnco significantly outperformed open-source LLMs (P < 0.01) and achieved expert-level performance comparable to UF Health oncologists. Compared with expert oncologists, GatorOnco received significantly higher ratings for readability (4.46 vs. 4.19, P < 0.01) and completeness (3.91 vs. 3.52, P < 0.01), while showing statistically comparable performance in correctness (4.09 vs. 4.11, P = 0.921), currency (4.04 vs. 3.98, P = 0.478), and safety (4.22 vs. 4.22, P = 0.999). These findings demonstrate that integrating agentic reasoning with large-scale domain adaptation can help bridge the gap for generative AI in high-stakes cancer treatment planning.

How Far Do Foundation Models Transfer to Infant Signals? A Cross-Dataset Transfer Audit with a Unified Need Ontology

Public infant cry corpora are small, label-incompatible, and almost always evaluated one corpus at a time. We ask what this practice hides and what fixes it. Across four cry corpora screened by a multi-level leakage audit (byte-level and embedding-level deduplication plus a within-corpus train-test near-duplicate audit), we probe four frozen encoders and a handcrafted baseline under a unified five-class need ontology and shared task formulations. The audit exposes what single-corpus evaluation conceals: within-domain macro-F1 swings by 0.57-0.80 for the same encoder, cross-corpus transfer is negative on average (negative-transfer ratio 0.19-0.35, significant in 18 of 30 directed cells, BH-FDR), and 349 content-identical clip groups carry conflicting metadata labels across corpus distributions. The same audit, however, reveals a consistent way forward. Transfer into the noisiest corpus is consistently positive in effect size at matched training size and after near-duplicate removal, offering a practical recipe for small, noisy corpora. Frozen probes saturate at modest label budgets, while stabilized fine-tuning wins with full labels; domain-adaptive pretraining significantly beats stabilized fine-tuning at 5-10-shot (the 1-shot advantage is not robust to optimization-seed variance) but shows no significant advantage at 50-shot or beyond. In the tested binary, shared-label settings, ontology-mapped joint training wins in all four encoder-by-target combinations, whereas naively merging unmapped labels costs up to 37 F1 points. We release the ontology, mapping code, and audit pipeline, turning incompatible cry corpora into a usable joint-training resource.

Rectifying Geometric Misalignment: Online Source-Free Adaptation for Class-Imbalanced EEG

Electroencephalography (EEG) based Brain-Computer Interfaces (BCIs) often require unsupervised domain adaptation (UDA) to generalize across subjects and sessions. While Riemannian alignment methods like the Riemannian Centering Transformation (RCT) are effective for handling covariate shifts, they implicitly assume balanced class priors. However, in realistic online BCI scenarios, the label distributions vary dynamically (label shift), causing standard alignment techniques to geometrically misalign the target data distributions. In this work, we propose OSPDIM (Online SPD manifold information maximization), a source-free online UDA framework designed to address label shifts on the Riemannian manifold. OSPDIM introduces a manifold-constrained bias parameter into the tangent space mapping, which is optimized via information maximization to correct the geometric skew caused by imbalanced data streams. Unlike offline methods relying on global batch statistics, OSPDIM estimates and corrects geometric bias on-the-fly. Simulations on 2D SPD matrices visually demonstrate that OSPDIM successfully rectifies the misalignment where standard centering fails. Extensive experiments on multiple motor imagery datasets show that OSPDIM significantly outperforms standard Riemannian baselines, particularly in challenging online adaptation scenarios with severe class imbalance, offering a robust solution for practical, plug-and-play BCI systems.

FUSEP: A Multi-Center Benchmark for Diverse Tasks in Early Pregnancy Fetal Ultrasound Screening

A large number of infants with congenital anomalies are born each year globally, especially in areas with underdeveloped medical resources. Currently, fetal ultrasound screening is the most common modality for early pregnancy anatomy detection. This modality can detect anomalies earlier and provide opportune treatment advice. However, the lack of an ultrasound dataset on early fetal gestation has slowed down the development of automated assisted diagnosis. In this work, we present a benchmark dataset for Fetal Ultrasound Screening in Early Pregnancy to facilitate intelligent ultrasound examination and assisted diagnosis called FUSEP. Our dataset consists of two ultrasound views recommended by the international guideline, i.e., Crown-rump Length (CRL) and Nuchal Translucency (NT) views in three hospitals, totaling 4,017 ultrasound images, with 45,820 box-level expert-level annotations. Our dataset and baseline present the following three contributions: 1) Our medical experts annotated a total of 14 key anatomical structures in two views using a box-level format; 2) Our data is collected extensively from different sonographers, devices, scanning angles, hospitals, etc; 3) We report the performance of the semi-supervised learning, fully supervised learning, unsupervised domain adaptation (UDA), and source-free UDA in ultrasound images multi-object detection. To the best of our knowledge, this is the first publicly available dataset and benchmark for fetal early pregnancy ultrasound screening. We believe that FUSEP and benchmark can contribute to the medical community in the development of multiple tasks such as standard plane recognition, quality control on ultrasound images, automated assisted diagnostics in early fetal pregnancy, medical multi-object detection, domain adaptation for object detection, etc.

Unsupervised Adversarial Domain Adaptation for Uterine layer Segmentation: From Labeled Cine to Unlabeled Dynamic EPI MRI

Uterine peristalsis is a key physiological phenomenon responsible for various functions across the menstrual cycle, intimately linked to uterine wall microstructure. Alterations in uterine motion and tissue properties are implicated in the etiology of gynecological diseases, yet these processes have been studied in isolation. We introduce a dynamic multi-echo gradient echo EPI framework for simultaneous characterization and correlation of uterine peristaltic activity and time-resolved T2* changes at 0.55T. Inherent susceptibility artifacts, reduced resolution, and burden of manual uterine layer annotation are addressed by an unsupervised adversarial domain adaptation framework, transferring segmentation knowledge from labeled cine MRI to unlabeled dynamic EPI. We implemented Unet-LSTM with multi-scale domain discriminators that exploits temporal layer dynamics. A Dice score of 0.88 and Jaccard index of 0.80 was achieved. Mean T2* values were 108ms, 76ms, and 124ms for the myometrium, junctional zone, and endometrium. A negative correlation between junctional zone area and T2* was observed in 14/39 cases, providing first insights into oxygenation patterns associated with junctional zone contraction and motion, demonstrating feasibility of assessing the interplay between contractility and dynamic T2* changes.

Sedentary Behavior Classification for Wearable Sensors with a CNN-BiLSTM Model

Accurate detection of sedentary behavior is important for studying health risks related to prolonged sitting, but posture-based classification remains challenging with wearable sensors, especially at the wrist. We study whether a deep learning model trained on hip-worn accelerometer data can transfer to wrist-worn accelerometer data for sitting versus non-sitting classification. We use CHAP, a CNN-BiLSTM model originally developed for hip accelerometers, and evaluate its zero-shot performance on wrist data as well as its adaptation through finetuning with varying amounts of labeled wrist data. Experiments are conducted on the iWatch dataset with ground-truth posture labels derived from wearable cameras. The hip-trained model performs strongly on hip data without retraining, but accuracy drops on wrist data due to sensor placement shift. Finetuning CHAP provides consistent advantages over transformer models trained from scratch. These findings suggest that hip-based pretraining provides a useful starting point for wrist deployment, while highlighting the need for wrist-specific adaptation to handle higher signal variability.

Temporal Generalization in fNIRS-Based Autism Classification: A Cross-Time-Window Transfer Benchmark

Functional near-infrared spectroscopy (fNIRS) is a promising modality for autism spectrum disorder (ASD) classification, yet existing approaches assume temporally aligned evaluation. In practice, the optimal observation window varies across subjects due to differences in hemodynamic delay and neurovascular coupling, creating a temporal distribution shift that degrades performance. We formalize this as a \textit{cross-time-window transfer problem}, introducing a protocol that varies window length (2.5--10\,s) and offset within biological motion trials. Using topographic map representations of fNIRS recordings, we benchmark three vision architectures under two zero-shot baselines and eight adaptation strategies under leave-one-subject-out cross-validation ($N{=}124$). Key findings: (1) zero-shot cross-window accuracy is near chance (54--69\%); (2) ${\approx}5\%$ subject-specific fine-tuning recovers 90--96\%, while a subject-specific upper bound reaches 97--100\%, identifying inter-subject variability as the dominant barrier; (3) domain-adversarial and self-supervised strategies achieve 78--90\% without target-subject data; and (4) discriminative information is recoverable from windows as short as 2.5\,s. These findings provide a practical roadmap for deploying fNIRS-based ASD classifiers under realistic temporal variability.

Harnessing Adversarial Distillation to Customise Debiased, Disease-Specific Pathology Foundation Models for Breast Cancer

Pathology foundation models (PFMs) provide strong tissue representations and have become central to digital pathology. However, deployment in disease-specific settings is limited by 1) the high computational cost of billion-parameter PFMs and 2) distribution mismatch and non-biological bias inherited from pan-cancer, multi-centre pre-training, including site-specific signatures and imbalanced disease prevalence. These factors can encourage shortcut learning and under-emphasise subtle morphology required for reliable modelling of a specific cancer type. We present SmartStu (a Smart Student), a framework to customise compact, breast-cancer-specific PFMs via distillation whilst mitigating confounding. SmartStu distils representations from multiple teacher PFMs into a lightweight student backbone. Crucially, we introduce adversarial distillation that leverages a dedicated noise model trained to predict nuisance, edge-dominated cues on the distillation set. Using this noise model as a counterexample, the adversarial objective encourages the student to recognise, yet suppress, features predictive of nuisance targets. We further incorporate multi-teacher ensemble distillation and an auxiliary self-supervised objective with artefact injection. We validate SmartStu on three external cohorts (Yale HER2, SLN-Breast, and BRACS) with multiple tiny backbones. SmartStu yields breast-cancer-specific PFMs that are over $30\times$ smaller than general PFMs whilst largely preserving, and sometimes improving, downstream performance measured by balanced accuracy (bAcc) and AUC. Code is available at https://github.com/zwchen03/advDistall.

Cross-Anesthetic ECoG State Decoding Fails at the Decision Threshold, Not the Representation

Decoders of anesthetic state from cortical activity fail across drug classes, most notoriously ketamine, but reported accuracy cannot say whether the neural representation or only the decision threshold has failed; we separate the two in a controlled preparation with ground-truth labels. We decoded awake versus anesthetized from mouse electrocorticography (the 250-Hz-bandlimited local field potential, sampled at 1875 Hz) under leave-one-anesthetic-out evaluation across five mechanistically distinct anesthetics (isoflurane, dexmedetomidine, ketamine, propofol, and midazolam), comparing a spatially blind band-power decoder, covariance/Riemannian representations, and Riemannian domain adaptation, with all statistics at the session level and mouse-level cluster bootstrapping for the ketamine fold. The representation transfers: band-power ranks awake versus anesthetized at a session AUROC of at least 0.96 on every held-out drug, ketamine included (0.980, cluster confidence interval 0.821 to 1.000). The failure is confined to the threshold: across three representations the ketamine ranking is near-invariant while its balanced accuracy swings from chance to high, and a permutation test is significant for ranking (p = 0.0025) but not for fixed-threshold accuracy (p = 0.3795). Riemannian domain adaptation is net-negative. A causal, label-free threshold anchored to the subject's own pre-induction baseline fixes ketamine (balanced accuracy 0.50 to 0.85) and dominates domain adaptation. Because the ketamine test sessions come from three mice that also contribute training drugs, this is within-subject cross-drug transfer; we do not claim population-level transfer across subjects. In cross-drug state decoding the actionable failure is calibration, not representation.

Multi-Source Multi-View Graph Domain Adaptation with Hyperbolic Residual Encoding for Cross-Site MDD Identification from rs-fMRI

Cross-site identification of major depressive disorder (MDD) from resting-state functional magnetic resonance imaging (rs-fMRI) is hindered by inter-site distribution shifts and heterogeneous functional connectivity (FC) views. These views capture complementary neural relationships but exhibit distinct site biases and graph topologies, complicating alignment without sacrificing disease-relevant information or cross-view consistency. Existing studies largely treat multi-view connectome learning and cross-site adaptation separately. To the best of our knowledge, few studies have jointly modeled multiple FC views under multi-source unsupervised domain adaptation for cross-site rs-fMRI-based MDD classification. We construct Pearson correlation, sparse representation, and Granger causality graphs, each encoded by a view-specific graph attention network. Dual-stream adaptive fusion explicitly integrates pairwise cross-view interactions, followed by lightweight hyperbolic residual encoding for curvature-aware representation refinement. Class-wise Cauchy--Schwarz alignment reduces inter-source and source-target discrepancies, complemented by adversarial learning, information maximization, and confidence-aware pseudo-labeling. Across seven unlabeled target domains, our framework achieves 73.60% mean accuracy and 71.90% AUC, demonstrating effective generalization under heterogeneous acquisition conditions. These results highlight the effectiveness of unified heterogeneous-view modeling, curvature-aware refinement, and multi-source domain adaptation for cross-site MDD identification.The source code is at https://github.com/OPUS-Lightphenexx/MM-HyperGDA

MoPET: Parameter-Efficient Mixture-of-Experts for Unified Medical Image Classification

Adapting deep learning models to profound clinical heterogeneity typically relies on parameter-efficient fine-tuning (PEFT) to avoid the severe overfitting associated with full end-to-end network updates. Although PEFT successfully navigates limited data scenarios, it inherently forces the training of a separate, isolated adapter for every specific diagnostic task. Consolidating these isolated adapters into a single generalist network risks negative transfer, as optimization gradients from conflicting visual domains interfere. To address this, we propose MoPET, a mixture-of-experts (MoE) method that uses a learned sparse router to direct each input through a small subset of low-rank PEFT experts injected into a frozen foundation model, sharing capacity across datasets while limiting cross-domain gradient conflict. Through selected evaluations on the MedMNIST benchmark, we first establish that PEFT outperforms full network updates, improving average accuracy from 86.50% to 88.97%. We then show that a single MoPET model consolidates four heterogeneous datasets into one network, improving average accuracy over the best isolated PEFT adapters (93.46% versus 92.83%). Finally, we show that co-training with auxiliary datasets improves accuracy on data-constrained clinical targets, raising average target accuracy over the strongest isolated adapter from 81.58% to 83.58%. Our source code is publicly available at https://github.com/sdoerrich97/mopet.

Towards Practical Algorithm Selection for Unsupervised Domain Adaptation in Medical Imaging

Numerous unsupervised domain adaptation (UDA) algori-thms exist, but for clinical practice, selecting the best-suited one along with proper hyperparameters often remains unclear, as the unlabeled deployment (target) domain prevents direct evaluation. We propose a label-free criterion that jointly selects the algorithm and hyperparameters for UDA. Given a pool of candidate models from multiple algorithms trained with different hyperparameters, our approach scores each candidate against an agreement reference, and selects the one with the highest score. The agreement reference is constructed in two levels without using target labels. First, we leverage multiple label-free selection signals, using each to nominate a model within every algorithm. Second, the nominated models are aggregated across algorithms to form a reference prediction for each unlabeled target sample. The candidate whose predictions agree most with this reference is then selected for deployment. Experimental results on four brain MRI and four chest X-ray datasets across seven clinically relevant transfer scenarios show that our method achieves better selection performance than other methods and remains effective across different algorithm pools. Our approach takes a step towards practical, label-free algorithm selection for clinical deployment of UDA.

Recognition and Label-Free Adaptation Across Recording Sessions in Surface-EMG Gesture Decoding

Recognition accuracy obtained during a recording session does not persist when a user puts on the electrodes again after the electrodes had previously been removed. The electrodes may have moved slightly, the skin may be drier or wetter, or the elbow may be positioned differently; these factors all contribute to day-to-day variability and therefore represent a major obstacle to implementing successful pattern-recognition based myoelectric control systems in daily practice. However, simply recalibrating a user's hand for 20 min at every doff/don event is a clearly unrealistic expectation. A montage-agnostic encoder built for cross-user, cross-montage transfer is trained here using data collected during a particular recording session, and then applied to data collected later in a different recording session without adjusting anything, on the ten intact subjects of NinaPro DB6. The performance of this approach is compared to that of a per-user LDA classification pipeline, and to that of two published approaches that only rely on source data collected from the same recording session. Carried unchanged across recording sessions, the encoder retains 0.688 macro-F1 against 0.540 for the per-user pipeline, and, on the per-window metric the published baselines use, sits above both published source-only results, a band of two points that locates the encoder rather than ranking it. Of five label-free test-time adaptations, only feature-statistic alignment improves every subject; batch-normalisation re-estimation, a standard method in the domain-adaptation literature, collapses this architecture entirely. Aligning the encoder's feature statistics to the new session recovers about what a single labelled calibration repetition would.

Empirical investigation of 3D CT Foundation Models and Unsupervised Adaptation for Head and Neck Cancer Recurrence Prediction

The rapid emergence of 3D CT foundation models has opened new avenues for predictive modeling from CT imaging, offering a compelling alternative to traditional radiomics which is known to suffer from reproducibility issues and sensitivity to acquisition protocol variations. Yet, as these models grow in availability, a critical need arises to evaluate how well their learned representations generalize across diverse clinical settings and whether adaptation to specific downstream tasks is necessary to unlock their full potential. To address these questions, we benchmarked several 3D CT foundation models for predicting recurrence-free survival in head and neck cancer across two public datasets totaling 3,644 patients, evaluating various adaptation strategies and modality fusion mechanisms. Our findings reveal persistent difficulty in identifying features that generalize consistently across different imaging distributions, as evidenced by significant performance drops on external validation cohorts. Ultimately, the integration of imaging features with clinical data remains the most accurate approach for prognostic prediction, though achieving universal generalization across varied clinical contexts continues to represent a substantial challenge for the current generation of models.

PlantBGC: Transformer for Plant BGC Discovery via Label-Free Domain Adaptation and Weak Supervision

Plant biosynthetic gene clusters (BGCs) encode specialized-metabolite pathways, yet curated plant BGC labels remain scarce, hindering supervised discovery at genome scale. Existing plant BGC mining tools are largely signature- and rule-driven and do not fully leverage recent advances in contextual representation learning for modeling long-range domain context and controlling false positives under strong domain shift. We seek an AI-assisted workflow that narrows experimental search space by transferring supervision from well-annotated microbial BGCs to plant genomes. We present PlantBGC, representing genomes as ordered Pfam-domain sequences and learning BGC-likeness with an encoder-only Transformer trained on MIBiG microbial BGCs and adapted to plants via label-free masked language modeling. On microbial benchmarks, PlantBGC achieves token-level AUC = 0.988 (10-fold CV) and 0.979 (leave-class-out). On plants, adaptation improves known-BGC recovery on n = 34 curated loci under strict 100% coverage, increasing recovery from 29.4% to 67.6% and indicating more complete boundaries. GO/KEGG-derived weak supervision reduces proxy primary-like ratio by 48.40% (GO) and 45.20% (KEGG), with consistent per-species reductions (paired Wilcoxon p = 1.53e-5). Compared to plantiSMASH, PlantBGC yields more compact loci on matched regions (median length ratio = 0.278; 93.8% of pairs are shorter).

OPERA: Offline Policy-guided Expert Routing and Adaptation for Universal Biomedical Image Analysis

Biomedical image analysis spans diverse modalities and tasks, yet real-world deployment is hindered by severe distribution shifts across scanners, protocols, and patient populations. High-performing models consequently require repeated domain-specific fine-tuning, which is a costly cycle that becomes impractical when labels are scarce or privacy constraints limit data sharing. We propose OPERA (Offline Policy-guided Expert Routing and Adaptation), a multi-agent ensemble framework that addresses this deployment bottleneck by treating expert weight assignment as an offline policy learning problem: a routing policy is learned from a small validation set without gradient updates to any expert agent, then deployed with test-time adaptation to handle distribution shift. OPERA coordinates heterogeneous specialist agents through complementary mechanisms. The expert profiling module learns selection policies offline, enabling informed allocation of expertise. Each agent undergoes confidence calibration through temperature adjustment, ensuring more reliable probabilistic outputs. OPERA also incorporates distribution aware adaptation, where class weights are dynamically adjusted at the batch level using statistics derived from unlabeled test data. Instance level routing assigns each sample to the most suitable expert by leveraging inter model agreement and predictive entropy. We evaluate OPERA on 9 datasets covering fundus photography, chest X-ray, CT, MRI, and multimodal diagnostic benchmarks, comparing against 30+ baselines across classification, segmentation, and multimodal settings. OPERA consistently improves performance and calibration quality, demonstrating that offline policy-guided expert agents coordination is a practical path to deployable biomedical AI without retraining. Code is on \href{https://github.com/HUANGLIZI/OPERA}{GitHub}.

A Cyclic Adaptation-Generalization Framework with Uncertainty-Guided Self-Paced Learning for Long-Term Brain-Machine Interfaces

Brain-Machine Interfaces (BMIs), which link the brain to external devices, hold great potential in rehabilitation, human performance augmentation, and human-centered robotics. However, invasive BMIs face a critical challenge for long-term deployment due to neural drift, which degrades decoding performance over time and necessitates frequent recalibration. Existing methods designed to mitigate neural drift typically rely on either domain adaptation (DA) or domain generalization (DG) alone and often fail to capture fine-grained distribution shifts across neural subdomains, resulting in limited performance. To overcome these limitations, we propose Uncertainty-guided Self-paced Cycling (UnSPC), a robust framework that synergizes DA and DG for target domain refining under an Uncertainty-guided Self-paced Pseudo-labeling (UnSPL) mechanism. To handle subdomain neural drift across domains, UNSPL is proposed to iteratively mine reliable pseudo-labeled samples with a noise-robust ranking strategy for further fine-tuning. Leveraging these high-quality samples, we introduce a novel Cycling Adaptation and Generalization (CycAG) strategy, which integrates DA and DG within an iterative cycle to progressively mitigate both global and subdomain drift. This cyclic process enables effective alignment to evolving target distributions while preserving robust and transferable representations, thereby mitigating performance degradation under long-term neural drifts. Extensive experiments on multiple neural decoding datasets demonstrate the effectiveness and robustness of UnSPC. To our knowledge, our proposed UnSPC is the first to cyclically integrate DA and DG with pseudo-labeling, paving the way toward stable long-term BMI controls.