Broad-spectrum Ebola vaccine
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arXiv:2606.12120v1 Announce Type: new Abstract: Low-rank optimal transport (OT) mitigates the quadratic scaling of classical solvers, yet existing approaches rely heavily on first-order mirror-descent updates that require careful hyperparameter tuning and ignore the optimization landscape's curvature. To address these limitations, we propose a unified Riemannian geometric framework for low-rank OT, modeling balanced and unbalanced rank-$r$ positive factored couplings as novel smooth embedded submanifolds of the positive orthant. By equipping these manifolds with the Fisher-Rao product metric, we derive tractable formulations for Riemannian projectors, retractions, and Hessian-vector products. Our cost-agnostic framework seamlessly extends to linear OT, Gromov-Wasserstein (GW), fused GW, and their unbalanced counterparts. For balanced OT, our geometric ingredients are computed via efficient conjugate-gradient and iterative Bregman updates. For the unbalanced OT, our operations elegantly reduce to closed-form scalings, completely eliminating inner iterative loops. In both regimes, per-iteration complexity scales linearly with dataset size, and we provide a rank-sufficiency certificate for global optimality verification. Extensive experiments across a range of problem sizes demonstrate that our regularization-free first- and second-order solvers achieve faster convergence and superior performance over existing state-of-the-art low-rank OT solvers.
Carbohydrates are among the most abundant and structurally diverse biomolecules in nature, playing central roles in energy storage, molecular recognition, and cell signaling. Within this domain, C-glycosides1-3, in which the oxygen atom of the glycosidic bond in O-glycosides is replaced by carbon, have emerged as valuable motifs in medicinal chemistry due to their resistance to enzymatic hydrolysis2,4. Of particular importance are C-aryl glycosides, exemplified by the SGLT2 inhibitors dapagliflozin, canagliflozin, and empagliflozin, which are frontline therapies for type 2 diabetes5-7. However, scalable syntheses of C-aryl glycosides have traditionally relied on protected sugar derivatives, lengthy sequences, or conventional cross-couplings that often suffer from poor selectivity, limited scope, and extensive protecting-group manipulation6. Herein, we report a practical approach to C-aryl glycosides using glycosyl sulfonyl hydrazides as redox-neutral radical precursors for cross-coupling. Prepared directly from unprotected native sugars, these reagents generate glycosyl radicals under mild conditions and enable efficient access to diverse C-aryl glycosides, including all approved SGLT2 inhibitors, natural products such as salmochelins and neopetrosins, and medicinally relevant probes. Beyond anomeric functionalization, this platform enables C–C bond formation at multiple positions on carbohydrate scaffolds and supports stereoretentive radical coupling that can override inherent stereochemical biases, expanding practical access to carbohydrate-derived therapeutics and chemical tools.
arXiv:2602.24012v2 Announce Type: replace Abstract: Contrastive learning has become a cornerstone of modern representation learning, allowing training with massive unlabeled data for both task-specific and general (foundation) models. A prototypical loss in contrastive training is InfoNCE and its variants. In this work, we show that the InfoNCE objective induces Gaussian structure in representations that emerge from contrastive training. We establish this result in two complementary regimes. First, we show that under certain alignment and concentration assumptions, projections of the high-dimensional representation asymptotically approach a multivariate Gaussian distribution. Next, under less strict assumptions, we show that adding a small asymptotically vanishing regularization term that promotes low feature norm and high feature entropy leads to similar asymptotic results. We support our analysis with experiments on synthetic and CIFAR-10 datasets across multiple encoder architectures and sizes, demonstrating consistent Gaussian behavior. This perspective provides a principled explanation for commonly observed Gaussianity in contrastive representations. The resulting Gaussian model enables principled analytical treatment of learned representations and is expected to support a wide range of applications in contrastive learning.
AI coding agents have rapidly transformed software engineering, powering widely used interactive coding assistants. Despite their interactive real-world use, existing benchmarks evaluate them as fully-autonomous systems. In this work, we introduce Dialogue SWE-Bench, an automatic benchmark dataset for evaluating the ability of coding agents to resolve real-world software engineering problems through dialogue with a user. We design a novel, persona-grounded user simulator to support our task evaluation, and augment our task evaluation with automatic evaluations of dialogue quality. We also propose a new schema-guided agent, aimed at improving the dialogue capabilities of off-the-shelf coding agents, which improves over strong baselines by 3-14%. Our results indicate that better coding models do not always correspond to better dialogue models, suggesting that dialogue capability is a distinct and currently understudied dimension of coding agent performance.
Reinforcement learning (RL) has emerged as a powerful paradigm for training Large Language Models (LLMs) as agents. However, conventional RL methods for long-horizon agentic tasks often struggle with sparse outcome rewards. Intuitively, this overlooks the rich environment dynamics information contained in rollout interaction trajectories. We argue that the interaction experience inherently serves as an implicit supervision signal, reveals the underlying transition mechanisms of the environment, and enables the agent to construct a more accurate internal model of the environment.. Therefore, in this work, we investigate how to leverage this additional signal to improve policy learning. Specifically, we propose EnvRL, a framework that incorporates environment dynamics learning into agentic RL via two auxiliary objectives: state prediction and inverse dynamics. By jointly optimizing with the primary RL objective, we encourage the agent to internalize environment dynamics from its own interaction experience. Extensive experiments on two long-horizon agentic benchmarks demonstrate that EnvRL achieves significant improvements on success-rates over RL-only baselines, e.g., when trained with GRPO, lifting Qwen-2.5-1.5B-Instruct from 72.8% to 77.4% on ALFWorld, and from 56.8% to 67.0% on WebShop.
More efficient environmental risk assessment and stronger protection are achievable.
arXiv:2606.24672v1 Announce Type: new Abstract: In many decision-making scenarios, acquiring information incurs different costs. We consider the problem of constructing a deterministic evaluation strategy that minimizes the expected cost of evaluating a propositional formula under variable costs and a probability distribution over truth assignments. We present a branch-and-bound algorithm with variable-selection heuristics, pruning, and caching. To the best of our knowledge, it is the first practical exact algorithm for this level of generality. Experiments on random instances demonstrate scalability and quantify the efficiency-quality trade-off of a greedy beam-search variant. We additionally evaluate a structured heart-disease diagnosis instance. Finally, we prove that the problem is $\#P$-hard and contained in $\mathrm{PSPACE}$.
RNAs are important therapeutic targets, however identifying ligandable small-molecule binding pockets remains a major barrier to RNA-targeted drug discovery. Here, SMARTPocket, an atomic-level geometric deep learning framework for predicting RNA-small molecule binding pockets directly from three-dimensional structure is introduced. SMARTPocket represents RNA as full-atom point clouds and uses transfer learning from more than 110,000 protein binding interface structures to overcome the limited number of experimentally elucidated RNA-ligand complexes. Across four established single-chain benchmarks and three broader curated benchmarks, SMARTPocket consistently outperforms existing RNA pocket predictors and general biomolecular modeling approaches. The model generalizes to apo RNA structures when conformational changes are modest, identifies cryptic ligandable pockets, and recapitulates experimentally validated binding sites in the SARS-CoV-2 frameshifting element and an RNA aptamer evolved to bind small molecules. SMARTPocket-guided docking further improves near-native RNA-ligand pose recovery and computational efficiency compared with blind docking. These results establish SMARTPocket as a generalizable framework for structure-based identification of ligandable RNA pockets and for accelerating discovery of RNA-targeted small molecules.
arXiv:2606.10794v2 Announce Type: replace Abstract: As agentic applications increasingly route user tasks through official and third-party LLM APIs, provenance becomes an operational question: which model generated a given black-box response? We study Dynamic Black-Box LLM Provenance: identifying the source LLM from generations elicited by query-varying, non-predefined prompts rather than a fixed input set or benchmark suite. This setting is difficult because prompt semantics dominate the text, while model-specific authorship traces are weak and inconsistent at the surface level. We introduce READER (Robust Evidence-based Authorship Decoding via Extracted Representations), a lightweight provenance framework that treats a frozen proxy LLM as a reader of hidden authorship evidence. READER maps black-box outputs into proxy activation space, temporally filters token states within each response, and performs Bayesian Evidence Accumulation by summing single-response log-posterior evidence across independently sampled prompts. This avoids fragile mean-pooling of prompt-specific representations while preserving the query-wise evidence needed for calibrated confidence. On Agent500, a 50-target dataset built from agent-style prompts, READER reaches $31.0$-$42.4\%$ top-1 accuracy from a single response and $70.0$-$84.0\%$ from 50 responses, substantially outperforming sentence-encoder fingerprints. Scaling across nine proxy readers further shows that stronger LLMs expose more linearly decodable authorship structure, suggesting that authorship perception is already present in frozen LLM representations and can be converted into reliable multi-query attribution.
arXiv:2606.16517v1 Announce Type: new Abstract: Scientific reasoning models for biology combine language models with foundation models trained on multimodal biological data, including DNA, RNA, and proteins. These models are built through post-training, yet how each stage shapes reasoning and generalization remains poorly understood. We study when post-training improves performance and when it induces over-specialization. Across genomics, transcriptomics, and proteins, we train and evaluate more than 100 biological reasoning models under controlled variation in backbone, continued pre-training (CPT), supervised fine-tuning (SFT), and reinforcement learning (RL), measuring both in-domain (ID) and out-of-domain (OOD) performance. We find that each post-training stage reshapes generalization in a distinct way rather than contributing uniform gains. CPT improves downstream performance by aligning models with biological language. SFT consistently increases ID performance but causes OOD performance to peak early and decline as models fit the training distribution. RL, when applied to strong SFT checkpoints with aligned rewards, improves OOD performance and partially recovers generalization. These results show that biological reasoning does not improve monotonically with additional supervision or compute. Instead, performance depends on how training stages are composed. Under fixed post-training budgets, the strongest ID-OOD trade-off comes from brief SFT, larger RL allocations, and asymmetric adaptation capacity across stages.
arXiv:2606.19507v1 Announce Type: new Abstract: In this work we consider an Aztec diamond model split into two unequal regions which are asymptotically fixed in size. Each region is weighted with a distinct two-periodic weighting. We refer to this model as the t-split two-periodic Aztec diamond, to signify its difference from the previous work title Split Two-Periodic Aztec Diamond, where the model was split into two equal regions. We derive an integral expression for the correlation kernel of the model and give a partial description of the scaling limit behavior, along with a conjecture for the remainder. We refer to the larger and smaller sides of the model as the dominant and non-dominant sides, and to the location of the weight change as the interface. The dominant side exhibits a limit shape that depends only on its own weighting and is identical to that of the two-periodic Aztec diamond, while the non-dominant side appears to have a novel limit shape that depends on both weightings and the location of the interface. Lastly, we consider the complete limit shape in the case where the dominant side two-periodic parameter goes to 0.
General-purpose large language models (LLMs) are increasingly used for mental health-related conversations, yet safety safeguards remain inadequate and inconsistent across clinical conditions. This study evaluates six proprietary LLMs across 16 DSM-5 conditions using four adversarial attack variants, introducing an eight-dimension harm taxonomy and a multi-dimensional evaluation framework. Results show that safeguards hold reliably only for suicide and self-harm, while conditions such as eating disorders, substance use disorder, and major depressive disorder exhibit failure rates of up to 100%. We argue that ethical design and deployment of these LLMs demand clearly defined harm categories across clinical conditions and implementation of safeguards accordingly. Until such safeguards are in place, these models pose significant risks to vulnerable populations, making their growing integration into educational settings a particularly concerning.
arXiv:2606.17453v1 Announce Type: new Abstract: Large language model agents are increasingly integrated into map services. Since map services are embedded in everyday-life scenarios rather than professional task settings, users often express their needs informally, resulting in underspecified queries with many unspoken needs, namely, implicit decision factors that are critical for user satisfaction. Although clarification is an effective way to mitigate this issue, it increases user burden in daily interaction, and a capable agent should first proactively recover such factors from available information sources. However, evaluating this ability is challenging. The first challenge is to determine which implicit decision factors are suitable for evaluation. A factor is evaluable only if it affects user acceptance and can be recovered from information available to the agent before it responds. Second, user satisfaction cannot be reliably represented by a single reference answer, requiring a benchmark that converts satisfaction-relevant factors into objective and quantifiable evaluation targets. To address these challenges, we propose a restore-identify-filter framework that reconstructs complete user needs from behavior-chain evidence, identifies implicit decision factors, and retains only those supported by pre-query evidence. Building on this methodology, we construct MapSatisfyBench from large-scale, real-world anonymized user data and annotate ground truth from five dimensions and enables full-chain evaluation of satisfaction-aware map agents. Experiments show that current agents generally perform well on explicit task completion, but remain limited in satisfying implicit decision factors and proactively acquiring the evidence needed for satisfaction-aware decisions. These findings establish MapSatisfyBench as a benchmark for shifting map-agent evaluation from task completion toward satisfaction-aware spatial decision making.
arXiv:2606.24752v1 Announce Type: new Abstract: The loss of plasticity - the ability of a network to learn new information after having already learned older information - is a fundamental challenge in creating artificial neural networks capable of continual learning. Although this phenomenon has been known for decades, it has mostly been studied in older, relatively small architectures and rarely in natural-language domains. To determine whether loss of plasticity remains a problem in the modern transformer-based LLM paradigm, we study plasticity loss in GPT-style Transformer models trained on a multilingual continual learning problem. Consistent with prior work, we find evidence of plasticity loss across models ranging from 5M to 314M non-embedding parameters, as measured by deterioration on a held-out Vietnamese probing task. We further find that the onset of plasticity loss follows a predictable scaling law, growing sublinearly with model size. These results suggest that larger models may delay the measurable effects of plasticity loss, but that increasing parameter count alone is likely to be insufficient to completely prevent it. We also find evidence of plasticity loss under stationary multilingual training, challenging the view that the phenomenon is exclusive to continual learning with abrupt task changes. Overall, our results suggest that even large Transformer language models trained on natural-language will eventually lose the ability to efficiently adapt to new data after sufficiently long training, in both continual and stationary settings.
by Lijuan Wang, Yuze Wang, Chen Qiu, Liwei Xiao, Xianliang Liu, Junjie Chen Protein sequence design for tailored functional properties is a fundamental task in protein engineering, with critical applications in drug discovery and therapeutic development. Efficient navigation of the combinatorial vastness of protein sequence space to identify functional variants remains a formidable challenge. Conventional approaches, which predominantly rely on template-based local search or single-residue mutagenesis, are constrained by their susceptibility to local optima and their potential risk of destabilizing native structural stability. In this study, we introduce ProtHMSO, a heuristic multi-site optimization framework leveraging masked protein language models (ProtLMs) for context-aware sequence exploration. ProtHMSO mimics natural evolutionary mechanisms by employing ProtLM-derived substitution probabilities to guide heuristic searches for synergistic mutations, thereby constraining combinatorial search spaces through evolutionary and biophysical priors. ProtHMSO is further applied to replace the exploration strategies in genetic algorithms (GAs) and Monte Carlo tree search (MCTS) for improving their convergence efficiency. Benchmark experiments demonstrate that protein sequences generated by ProtHMSO exhibit superior functional performance and closer alignment with natural sequence distribution, compared with state-of-the-art methods. These advancements highlight that ProtHMSO has strong potential and compatibility to accelerate functional protein discovery, offering a robust framework for efficient and context-aware exploration of protein sequence space.
Verifying whether a language model is genuinely reasoning or pattern-matching remains an open problem: learned verifiers are expensive, and output-based heuristics are brittle. We show that valid mathematical reasoning induces a measurable, training-free spectral signature in transformer attention. By treating each attention matrix as a weighted token graph, we extract four diagnostics: Fiedler value, High-Frequency Energy Ratio (HFER), spectral entropy, and smoothness, that require no learned parameters. Experiments across seven models from four architectural families yield effect sizes up to Cohen's $d = 3.30$ ($p < 10^{-116}$), enabling $85$–$96\%$ single-threshold classification accuracy. Two findings sharpen the interpretation. First, Platonic validity: the spectral signal tracks logical coherence rather than compiler acceptance, proofs rejected for timeouts or missing imports are correctly classified as valid, a distinction confirmed by a manual audit ($\kappa = 0.82$, $n = 51$). Second, architectural determinism: Sliding Window Attention shifts the discriminative feature from HFER to smoothness ($d = 2.09$, $p < 10^{-48}$), showing that attention design governs which spectral channel encodes reasoning quality. Causal ablation confirms the signature traces induction-head circuits. The method generalises to informal chain-of-thought ($d = 0.78$, $p < 10^{-3}$), and in proof search, HFER reranking improves Best-of-16 Pass@1 by $+4.4$–$6.6$\%, matching $98\%$ of the AUC of fully supervised probes with zero labels. Spectral graph analysis is a principled, architecture-aware primitive for reasoning verification.
Large language models (LLMs) are increasingly deployed in hiring workflows, yet most research on gender bias in LLM hiring decisions has focused on English-language, Western-format resumes. This study examines whether pro-female gender bias extends to a Japanese corporate context and evaluates two practical mitigation strategies. Using a counterfactual resume design with 60 Japanese rirekisho-format resumes, 12 name pairs selected on linguistically grounded gender-signal criteria, and five state-of-the-art LLMs (Claude Sonnet 4.6, GPT-4o, DeepSeek-V3, Gemini 2.5 Flash, Llama 3.3 70B), we conducted 43,200 API calls across baseline, prompt instruction, and privacy filter conditions. A crossed random-effects linear mixed model confirms a significant pro-female bias across all five models, replicating Western findings in a non-Western context. A prompt-level gender-neutrality instruction produces no meaningful reduction in bias. A name-reliance analysis formally identifies the candidate name as the primary gender channel: removing the name from the prompt reduces the female effect by nearly its full magnitude. An unexpected incompatibility between the privacy filter and GPT-4o's content safety filter, resulting in a 42% refusal rate, highlights a practical deployment challenge for name anonymization in LLM-assisted recruitment pipelines.
Background: Multimorbidity is common in older adults, but sex differences in chronic condition clustering remain unclear. This study explored multimorbidity clusters and their associations with all-cause mortality among community-dwelling adults aged 70 years and over. Methods: This was a secondary analysis of data from 16,095 Australian ASPREE participants aged at least 70 years without prior dementia or cardiovascular disease. Fifteen baseline chronic conditions were grouped using latent class analysis (LCA). Observed-to-expected (O/E) ratios characterised conditions over-represented within clusters, and Cox proportional hazards models assessed associations with all-cause mortality. Results: Among 16,095 participants (mean age 74 years), 88.3% had multimorbidity at baseline; 4,217 deaths occurred over a median follow-up of 10.85 years. Five clusters were identified overall: hypertension and dyslipidemia (52.1%), gout and metabolic (14.4%), depressive symptoms, osteoporosis and frailty (10.0%), anaemia and kidney disease (10.2%), and hypotension, thyroid disorder and past cancer (13.3%). Sex-stratified analyses revealed three clusters in males and four in females. The frailty, depressive symptoms and osteoporosis cluster was associated with higher mortality in both sexes (aHR 1.56 [95% CI 1.40-1.73] in males; 1.68 [1.49-1.89] in females). Higher mortality was also observed for the metabolic, gout and kidney disease cluster in males (aHR 1.63 [1.47-1.81]) and the gout, anaemia and kidney disease cluster in females (aHR 1.96 [1.74-2.21]). Conclusions: Distinct multimorbidity clusters differed by sex and were associated with increased all-cause mortality. These findings may support risk stratification, targeted screening, and more person-centred management of older adults with multimorbidity.
Diffusion LLMs (dLLMs) have recently emerged as a powerful alternative to autoregressive LLMs (AR-LLMs) with the potential to operate at significantly higher token-generation rates. To unlock this potential, we present Spiffy, a speculative decoding algorithm to accelerate dLLM inference while provably preserving the model's output distribution. This work addresses the unique challenges involved in applying ideas from speculative decoding of AR-LLMs to dLLMs. Spiffy performs auto-speculation to eliminate the overheads of an independent draft model, structuring draft states in the form of a novel directed draft graph to take advantage of the bidirectional, blockwise nature of dLLM generation. These draft graphs are calibrated offline to maximize acceptance rates and are dynamically pruned during inference for improved computational efficiency. We present a detailed formulation of Spiffy and demonstrate its ability to accelerate LLaDA, Dream, and SDAR models in combination with KV caching and threshold-based dynamic unmasking leading to up to $8.6\times$ reduction in model inferences and $6.3\times$ acceleration in token rate.
Objective: To develop and evaluate a deep learning model for five-year breast cancer risk prediction from screening breast ultrasound (BUS) examinations. Methods: This retrospective study included 295,298 breast ultrasound examinations from 122,072 women imaged between 2012 and 2020. Patients were split into training, validation, and test sets; the test set included screening examinations only. BUS-Risk-Net aggregated image features using attention-based multiple instance learning and combined them with age and ultrasound-estimated breast density to predict 2- to 5-year risk. Performance was compared with the full Tyrer-Cuzick model in a matched case-control cohort and with a reduced Tyrer-Cuzick model in the held-out test set. Risk stratification was evaluated within BI-RADS density categories. Results: In the matched case-control cohort (n = 240 women), BUS-Risk-Net achieved a 5-year AUC of 0.632 (95% CI, 0.562-0.702), versus 0.514 for the full Tyrer-Cuzick model (95% CI, 0.440-0.588; p = 0.04). Among 19,548 examinations from 9,015 women eligible for 5-year evaluation in the test set, BUS-Risk-Net achieved an AUC of 0.679 (95% CI, 0.653-0.706), versus 0.594 for the reduced Tyrer-Cuzick model (95% CI, 0.564-0.623; P < .001). Observed 5-year cancer incidence increased across AI-defined risk tiers within each BI-RADS density category, ranging from 0.0% to 5.8% after AI stratification, compared with 2.1% to 3.6% across density categories alone. Discussion: Deep learning models applied to screening breast ultrasound could enable long-term breast cancer risk prediction and stratify risk beyond breast density alone. External and prospective validation is needed before clinical use.
arXiv:2606.13377v1 Announce Type: new Abstract: Exceptional points (EPs) are non-Hermitian degeneracies at which two or more eigenvalues and their corresponding eigenvectors coalesce. In open quantum systems, exceptional points can arise in the Lindbladian governing the dissipative dynamics. Their signatures have so far been mainly identified in finite-time observables, such as transient currents, while steady-state average currents generally provide no direct evidence of the underlying exceptional-point structure. In this work, we demonstrate that signatures of Lindbladian EPs can nevertheless be accessed in the steady-state regime through current noise. We derive general expressions for current correlation functions within a Lindblad master-equation framework and show, in particular, how exceptional points affect their behaviour as a function of the time delay. We illustrate these results with the paradigmatic example of two interacting qubits coupled to two reservoirs, where the steady-state noise clearly distinguishes overdamped, underdamped, and critical regimes. Our results establish current correlation functions as a steady-state probe of Lindbladian EPs in open quantum systems.
Stimulator of interferon genes (STING) is an evolutionary conserved immune signalling protein with key roles in host defence, cancer, senescence and inflammation1–3. Downstream of STING, type I interferon, inflammatory cytokine signalling and non-canonical autophagy are governed by a multilayered mechanism integrating ligand-induced structural transitions, protein–protein interactions and coordinated intracellular trafficking4–13. Despite its central role in immunity and relevance as therapeutic target14, the sequence elements that govern STING (in)activation in cells remain incompletely understood. Here we developed a massively parallel assay to systematically chart the sequence-function landscape of STING. Profiling thousands of single amino-acid variants, we identified structural and functional determinants that shape the immunostimulatory capacity of STING and its ability to translate ligand recognition into distinct signalling outputs. Cryogenic-electron microscopy structures of select STING hyperactive variants revealed new regulatory principles dictating conformational transition from inactive to signalling-competent states of STING. Mutational effects are widespread across the functional landscape and can sensitize STING towards the natural ligand 2′3′-cGAMP15–18 or decouple interferon induction from non-canonical autophagy, demonstrating a diversity of possible responses that can be accessed through single point substitutions. Finally, our data showed the clinical and evolutionary relevance of naturally occurring STING protein variants. Collectively, these findings define molecular principles that tune STING activity and chart the landscape of its functional potential across immune contexts. A massively parallel assay systematically charts the sequence-function landscape of the STING signalling protein, and the findings define molecular principles that tune STING activity and show its functional potential across immune contexts.
Fetal brain tissue segmentation from magnetic resonance imaging (MRI) is crucial for studying neurodevelopment, but remains challenging due to data heterogeneity and limited annotations. Domain randomization (DR) has recently emerged as a promising strategy for single-source domain generalization by synthesizing training images with randomized artifacts, contrast, and resolution. In this work, we investigate how to maximize the out-of-domain (OOD) generalization of DR-based methods. We evaluate several synthetic data generation strategies for DR, with a particular focus on our recently proposed framework, FetalSynthSeg. We show that simple Gaussian mixture-based intensity modeling outperforms more complex physics-based simulations, and that intensity clustering (subdividing tissue classes based on intensity) improves OOD robustness. Evaluated on 348 fetal subjects from four sites spanning 0.55-3T and both T1w and T2w contrasts, FetalSynthSeg reaches state-of-the-art performance on several FeTA 2024 testing datasets (80-85 Dice score) and, for the first time, offers robust segmentation on modalities other than T2w for fetal brain segmentation (80 Dice on dHCP-T1w dataset). Compared with state-of-the-art methods such as BOUNTI, nnU-Net ensemble, and the FeTA 2024 winner, FetalSynthSeg delivers comparable or superior accuracy while maintaining strong robustness across domain shifts. Our code, model weights, and Docker image ready for easy inference are available at https://hub.docker.com/r/vzalevskyi/fetalsynthseg.
Medical image segmentation plays a critical role in clinical diagnostics, treatment planning, disease monitoring, and neurological disorder identification. This article presents a comprehensive review of its systematic development, covering widely used public datasets, representative methods built on the U-Net, Transformer, and SAM architectures, and key evaluation metrics with their differences, followed by an analysis of major challenges from multiple perspectives. Unlike surveys that focus on a single model family or a specific clinical application, this review organizes U-Net-, Transformer-, and SAM-based methods within a unified analytical framework, with a particular focus on their effectiveness in improving segmentation accuracy and efficiency. This work aims to guide future research and support clinical translation of medical image segmentation, with all related resources publicly available in our GitHub repository: https://github.com/andrew-pengyu/Awsome_MedSeg/tree/main.