Automatic cardiac image segmentation is pivotal for diagnosing and treating cardiac diseases. In this work, we introduce MCSeg, a volumetric transformer-based network tailored for multi-modal cardiac segmentation. To overcome the architectural mismatch inherent in existing hybrid networks, we propose a novel Scaling Feature Pyramid (SFP). Unlike conventional skip connections, the SFP effectively bridges the single-scale 3D Vision Transformer (ViT) encoder and the multi-scale CNN decoder by transforming the ViT's output into a hierarchical feature pyramid, ensuring that global contextual information is effectively leveraged. For the training paradigm, the ViT encoder first undergoes self-supervised pre-training via masked image modeling. Subsequently, the network is fine-tuned on downstream tasks, during which a regional mutual information (RMI) loss is integrated to improve boundary segmentation accuracy. In experiments, MCSeg consistently outperforms eleven SOTA methods on CT dataset ImageCHD, multi-modal dataset MM-WHS, MRI dataset HVSMR-2.0 and MSD Heart, highlighting the effectiveness of our MCSeg for multi-modal cardiac segmentation tasks. Furthermore, MCSeg's superior performance in few-shot experiment showcases its significant potential in adapting to limited data scenarios. Codes and pre-trained ViT-B weights are open-sourced at https://openi.pcl.ac.cn/OpenMedIA/MCSeg
Modern mental healthcare faces a critical shortage of senior supervisory oversight, leading to a "supervision gap" where novice therapists manage high-stakes risks with delayed professional feedback. This paper proposes a new framework utilizing a fine-tuned Mistral-7B-instruct model as an automated "Supervisor-in-the-Loop" system. By leveraging 106 sessions from the DAIC-WOZ dataset, the model performs a tri-stream analysis: (1) Therapeutic Alliance tracking via semantic adherence, (2) Latent risk prediction using attention-weighted analytics, and (3) Supervisory Triage via a Dynamic Clinical Urgency Index (D-CUI). Our multi-modal VAL (Visual-Acoustic-Linguistic) framework achieves 95% technique identification accuracy [95% CI: 75.1%-99.9%], alliance assessment MAE of 0.105 on a 5-point scale [95% CI: 0.059-0.151], therapeutic fidelity alpha = 0.423, and mean D-CUI of 0.370 [95% CI: 0.322-0.419]. Training converged in 105 steps with 85.2% loss reduction on a single Tesla T4 GPU. The system reduces supervisory triage latency from 72 hours to real time (~10 seconds per session), enabling proactive intervention in high-risk cases. The system addresses the cold-start problem through Bayesian priors and implements timestamp-based modality synchronization for robust multi-modal fusion.
Yaling Shen, Maja Christensen, Yiwen Jiang +4cs.CL
Dementia diagnosis requires integrating multi-modal clinical assessments from diverse informants and clinicians under incomplete and heterogeneous data conditions. Yet most AI-driven approaches remain Alzheimer's disease (AD)-centric, framing the problem as binary AD detection or three-stage AD progression modeling within well-curated research settings. This pathology-driven paradigm overlooks the broader, syndrome-level nature of dementia, which spans multiple stages, phenotypes, and etiologies. In this paper, we propose Dementia-Agents, a clinically aligned multi-agent framework for real-world dementia staging and phenotyping. The framework follows a three-step workflow: (1) a data agent translates structured clinical records into semantically faithful textual representations that preserve missing-data signals and routes them to domain-aligned experts; (2) five fine-tuned expert agents generate domain-level predictions; and (3) a coordinator agent performs probabilistic aggregation to produce final staging and phenotyping decisions. We develop and evaluate Dementia-Agents on a real-world clinical cohort of 1,066 patients from two cognitive neurology services. Compared with monolithic multi-modal large language models (MLLMs) and prior medical multi-agent systems, our approach achieves consistent improvements in diagnostic performance for real-world syndrome-level dementia staging and phenotyping, while preserving domain-level interpretability.
The Zygomaticomaxillary Suture is a key circummaxillary structure that connects the zygomatic bone and the maxilla, which serves as a primary site of resistance during maxillary advancement, and its maturation status directly influences the timing and efficacy of orthopedic interventions. However, accurate staging of ZMS maturation remains challenging due to subtle high-frequency transitions in suture lines and the global semantic ambiguity between adjacent stages. To address this, we present the first public ZMS dataset, comprising 3,790 ZMS images covering the entire age range from 4 to 24 years. Based on this dataset, we propose SKMamba, a Structure-aware and Knowledge-guided Mamba-based multi-modal framework for automated ZMS maturation assessment. SKMamba adopts a decoupled dual-path architecture that mimics the hierarchical diagnostic process used by experienced orthodontists. We first introduce an Implicit Edge Extractor (IEE), which leverages structural pre-training to reduce trabecular noise and accentuate sutural boundaries. Complementarily, a Cross-Modal Semantic Alignment (CSA) module is designed to incorporate anatomical descriptions from a large language model (LLM). This module helps align local morphological cues with global semantic descriptions while ensuring that objective morphological evidence remains the primary basis for decisions. Extensive experiments on our ZMS dataset demonstrate that SKMamba achieves state-of-the-art performance compared to existing methods. Code is available at https://github.com/galaxygxq1116/SKMamba.