Volumetric medical imaging offers great potential for understanding complex pathologies. Yet, traditional 2D slices provide little support for interpreting spatial relationships, forcing users to mentally reconstruct anatomy into three dimensions. Direct volumetric path tracing and VR rendering can improve perception but are computationally expensive, while precomputed representations, like Gaussian Splatting, require planning ahead. Both approaches limit interactive use.We propose a hybrid rendering approach for high-quality, interactive, and immersive anatomical visualization. Our method combines streamed foveated path tracing with a lightweight Gaussian Splatting approximation of the periphery. The peripheral model generation is optimized with volume data and continuously refined using foveal renderings, enabling interactive updates. Depth-guided reprojection further improves robustness to latency and allows users to balance fidelity with refresh rate. We compare our method against direct path tracing and Gaussian Splatting. Our results highlight how their combination can preserve strengths in visual quality while re-generating the peripheral model in under a second, eliminating extensive preprocessing and approximations. This opens new options for interactive medical visualization.

Abstract Fine-tuning large language models (LLMs) with limited data poses a practical challenge in low-resource languages, specialized domains, and constrained deployment settings. While pre-trained LLMs provide strong foundations, effective adaptation under data scarcity requires focused and efficient fine-tuning techniques. This paper presents a structured and practical survey of recent methods for fine-tuning LLMs in data-scarce scenarios. We systematically review parameter-efficient fine-tuning techniques that lower training and deployment costs, domain and cross-lingual adaptation methods for both encoder and decoder models, and model specialization strategies. We further examine preference alignment approaches that guide model behavior using limited human or synthetic feedback, emphasizing sample and compute efficiency. Throughout, we highlight empirical trade-offs, selection criteria, and best practices for choosing suitable techniques based on task constraints, including model scaling, data scaling, and the mitigation of catastrophic forgetting. The aim is to equip researchers and practitioners with actionable insights for effectively fine-tuning LLMs when data and resources are limited.

Osteoarthritis of the knee, a widespread cause of knee disability, is commonly treated in orthopedics due to its rising prevalence. Lower extremity misalignment, pivotal in knee injury etiology and management, necessitates comprehensive mechanical alignment evaluation via frequently-requested weight-bearing long leg radiographs (LLR). Despite LLR's routine use, current analysis techniques are error-prone and time-consuming. To address this, we conducted a multicentric study to develop and validate a deep learning (DL) model for fully automated leg alignment assessment on anterior-posterior LLR, targeting enhanced reliability and efficiency. The DL model, developed using 594 patients' LLR and a 60%/10%/30% data split for training, validation, and testing, executed alignment analyses via a multi-step process, employing a detection network and nine specialized networks. It was designed to assess all vital anatomical and mechanical parameters for standard clinical leg deformity analysis and preoperative planning. Accuracy, reliability, and assessment duration were compared with three specialized orthopedic surgeons across two distinct institutional datasets (136 and 143 radiographs). The algorithm exhibited equivalent performance to the surgeons in terms of alignment accuracy (DL: 0.21 ± 0.18°to 1.06 ± 1.3°vs. OS: 0.21 ± 0.16°to 1.72 ± 1.96°), interrater reliability (ICC DL: 0.90 ± 0.05 to 1.0 ± 0.0 vs. ICC OS: 0.90 ± 0.03 to 1.0 ± 0.0), and clinically acceptable accuracy (DL: 53.9%-100% vs OS 30.8%-100%). Further, automated analysis significantly reduced analysis time compared to manual annotation (DL: 22 ± 0.6 s vs. OS; 101.7 ± 7 s, p ≤ 0.01). By demonstrating that our algorithm not only matches the precision of expert surgeons but also significantly outpaces them in both speed and consistency of measurements, our research underscores a pivotal advancement in harnessing AI to enhance clinical efficiency and decision-making in orthopaedics.