The advent of foundation models (FMs) is transforming medical domain. In ophthalmology, RETFound, a retina-specific FM pre-trained sequentially on 1.4 million natural images and 1.6 million retinal images, has demonstrated high adaptability across clinical applications. Conversely, DINOv2, a general-purpose vision FM pre-trained on 142 million natural images, has shown promise in non-medical domains. However, its applicability to clinical tasks remains underexplored. To address this, we conducted head-to-head evaluations by fine-tuning RETFound and three DINOv2 models (large, base, small) for ocular disease detection and systemic disease prediction tasks, across eight standardized open-source ocular datasets, as well as the Moorfields AlzEye and the UK Biobank datasets. DINOv2-large model outperformed RETFound in detecting diabetic retinopathy (AUROC=0.850-0.952 vs 0.823-0.944, across three datasets, all P<=0.007) and multi-class eye diseases (AUROC=0.892 vs. 0.846, P<0.001). In glaucoma, DINOv2-base model outperformed RETFound (AUROC=0.958 vs 0.940, P<0.001). Conversely, RETFound achieved superior performance over all DINOv2 models in predicting heart failure, myocardial infarction, and ischaemic stroke (AUROC=0.732-0.796 vs 0.663-0.771, all P<0.001). These trends persisted even with 10% of the fine-tuning data. These findings showcase the distinct scenarios where general-purpose and domain-specific FMs excel, highlighting the importance of aligning FM selection with task-specific requirements to optimise clinical performance.

Graph databases (GDBs) like Neo4j and TigerGraph excel at handling interconnected data but lack advanced inference capabilities. Neural Graph Databases (NGDBs) address this by integrating Graph Neural Networks (GNNs) for predictive analysis and reasoning over incomplete or noisy data. However, NGDBs rely on predefined queries and lack autonomy and adaptability. This paper introduces Agentic Neural Graph Databases (Agentic NGDBs), which extend NGDBs with three core functionalities: autonomous query construction, neural query execution, and continuous learning. We identify ten key challenges in realizing Agentic NGDBs: semantic unit representation, abductive reasoning, scalable query execution, and integration with foundation models like large language models (LLMs). By addressing these challenges, Agentic NGDBs can enable intelligent, self-improving systems for modern data-driven applications, paving the way for adaptable and autonomous data management solutions.

Background: RETFound, a self-supervised, retina-specific foundation model (FM), showed potential in downstream applications. However, its comparative performance with traditional deep learning (DL) models remains incompletely understood. This study aimed to evaluate RETFound against three ImageNet-pretrained supervised DL models (ResNet50, ViT-base, SwinV2) in detecting ocular and systemic diseases. Methods: We fine-tuned/trained RETFound and three DL models on full datasets, 50%, 20%, and fixed sample sizes (400, 200, 100 images, with half comprising disease cases; for each DR severity class, 100 and 50 cases were used. Fine-tuned models were tested internally using the SEED (53,090 images) and APTOS-2019 (3,672 images) datasets and externally validated on population-based (BES, CIEMS, SP2, UKBB) and open-source datasets (ODIR-5k, PAPILA, GAMMA, IDRiD, MESSIDOR-2). Model performance was compared using area under the receiver operating characteristic curve (AUC) and Z-tests with Bonferroni correction (P<0.05/3). Interpretation: Traditional DL models are mostly comparable to RETFound for ocular disease detection with large datasets. However, RETFound is superior in systemic disease detection with smaller datasets. These findings offer valuable insights into the respective merits and limitation of traditional models and FMs.

Contrastive learning, a prominent approach within self-supervised learning, has demonstrated significant effectiveness in developing generalizable models for various applications involving natural images. However, recent research indicates that these successes do not necessarily extend to the medical imaging domain. In this paper, we investigate the reasons for this suboptimal performance and hypothesize that the dense distribution of medical images poses challenges to the pretext tasks in contrastive learning, particularly in constructing positive and negative pairs. We explore model performance under different augmentation strategies and compare the results to those achieved with strong augmentations. Our study includes six publicly available datasets covering multiple clinically relevant tasks. We further assess the model's generalizability through external evaluations. The model pre-trained with weak augmentation outperforms those with strong augmentation, improving AUROC from 0.838 to 0.848 and AUPR from 0.523 to 0.597 on MESSIDOR2, and showing similar enhancements across other datasets. Our findings suggest that optimizing the scale of augmentation is critical for enhancing the efficacy of contrastive learning in medical imaging.

As Large Language Models (LLMs) excel across tasks and specialized domains, scaling LLMs based on existing models has garnered significant attention, which faces the challenge of decreasing performance when combining disparate models. Various techniques have been proposed for the aggregation of pre-trained LLMs, including model merging, Mixture-of-Experts, and stacking. Despite their merits, a comprehensive comparison and synergistic application of them to a diverse model zoo is yet to be adequately addressed. In light of this research gap, this paper introduces Model-GLUE, a holistic LLM scaling guideline. First, our work starts with a benchmarking of existing LLM scaling techniques, especially selective merging, and variants of mixture. Utilizing the insights from the benchmark results, we formulate an optimal strategy for the selection and aggregation of a heterogeneous model zoo characterizing different architectures and initialization.Our methodology involves the clustering of mergeable models and optimal merging strategy selection, and the integration of clusters through a model mixture. Finally, evidenced by our experiments on a diverse Llama-2-based model zoo, Model-GLUE shows an average performance enhancement of 5.61%, achieved without additional training. Codes are available at: https://github.com/Model-GLUE/Model-GLUE.

We introduce and demonstrate a new paradigm for quantitative parameter mapping in MRI. Parameter mapping techniques, such as diffusion MRI and quantitative MRI, have the potential to robustly and repeatably measure biologically-relevant tissue maps that strongly relate to underlying microstructure. Quantitative maps are calculated by fitting a model to multiple images, e.g. with least-squares or machine learning. However, the overwhelming majority of model fitting techniques assume that each voxel is independent, ignoring any co-dependencies in the data. This makes model fitting sensitive to voxelwise measurement noise, hampering reliability and repeatability. We propose a self-supervised deep variational approach that breaks the assumption of independent pixels, leveraging redundancies in the data to effectively perform data-driven regularisation of quantitative maps. We demonstrate that our approach outperforms current model fitting techniques in dMRI simulations and real data. Especially with a Gaussian mixture prior, our model enables sharper quantitative maps, revealing finer anatomical details that are not presented in the baselines. Our approach can hence support the clinical adoption of parameter mapping methods such as dMRI and qMRI.

Integrating deep learning into medical imaging is poised to greatly advance diagnostic methods but it faces challenges with generalizability. Foundation models, based on self-supervised learning, address these issues and improve data efficiency. Natural domain foundation models show promise for medical imaging, but systematic research evaluating domain adaptation, especially using self-supervised learning and parameter-efficient fine-tuning, remains underexplored. Additionally, little research addresses the issue of catastrophic forgetting during fine-tuning of foundation models. We adapted the DINOv2 vision transformer for retinal imaging classification tasks using self-supervised learning and generated two novel foundation models termed DINORET and BE DINORET. Publicly available color fundus photographs were employed for model development and subsequent fine-tuning for diabetic retinopathy staging and glaucoma detection. We introduced block expansion as a novel domain adaptation strategy and assessed the models for catastrophic forgetting. Models were benchmarked to RETFound, a state-of-the-art foundation model in ophthalmology. DINORET and BE DINORET demonstrated competitive performance on retinal imaging tasks, with the block expanded model achieving the highest scores on most datasets. Block expansion successfully mitigated catastrophic forgetting. Our few-shot learning studies indicated that DINORET and BE DINORET outperform RETFound in terms of data-efficiency. This study highlights the potential of adapting natural domain vision models to retinal imaging using self-supervised learning and block expansion. BE DINORET offers robust performance without sacrificing previously acquired capabilities. Our findings suggest that these methods could enable healthcare institutions to develop tailored vision models for their patient populations, enhancing global healthcare inclusivity.

Diffusion models have achieved remarkable success in image and video generation. In this work, we demonstrate that diffusion models can also \textit{generate high-performing neural network parameters}. Our approach is simple, utilizing an autoencoder and a standard latent diffusion model. The autoencoder extracts latent representations of a subset of the trained network parameters. A diffusion model is then trained to synthesize these latent parameter representations from random noise. It then generates new representations that are passed through the autoencoder's decoder, whose outputs are ready to use as new subsets of network parameters. Across various architectures and datasets, our diffusion process consistently generates models of comparable or improved performance over trained networks, with minimal additional cost. Notably, we empirically find that the generated models are not memorizing the trained networks. Our results encourage more exploration on the versatile use of diffusion models.

Meanwhile, efficiently dealing with the growing data scale has become a challenge. Data publicly available are from different sources with various qualities, and it is impractical to do manual cleaning against noise and redundancy given today's data scale. There are existing techniques for cleaning/selecting the collected data. However, these methods are mainly proposed for offline settings that target one of the cleanness and redundancy problems. In practice, data are growing exponentially with both problems. This leads to repeated data curation with sub-optimal efficiency. To tackle this challenge, we propose InfoGrowth, an efficient online algorithm for data cleaning and selection, resulting in a growing dataset that keeps up to date with awareness of cleanliness and diversity. InfoGrowth can improve data quality/efficiency on both single-modal and multi-modal tasks, with an efficient and scalable design. Its framework makes it practical for real-world data engines.

Training diffusion models is always a computation-intensive task. In this paper, we introduce a novel speed-up method for diffusion model training, called, which is based on a closer look at time steps. Our key findings are: i) Time steps can be empirically divided into acceleration, deceleration, and convergence areas based on the process increment. ii) These time steps are imbalanced, with many concentrated in the convergence area. iii) The concentrated steps provide limited benefits for diffusion training. To address this, we design an asymmetric sampling strategy that reduces the frequency of steps from the convergence area while increasing the sampling probability for steps from other areas. Additionally, we propose a weighting strategy to emphasize the importance of time steps with rapid-change process increments. As a plug-and-play and architecture-agnostic approach, SpeeD consistently achieves 3-times acceleration across various diffusion architectures, datasets, and tasks. Notably, due to its simple design, our approach significantly reduces the cost of diffusion model training with minimal overhead. Our research enables more researchers to train diffusion models at a lower cost.