Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences

Scientific image sequences often feature recurring structures with unknown appearance and dynamics. While traditional methods using predefined templates, noise models, or motion classes work well when targets are known, such assumptions can hinder exploratory analysis where discovering that knowledge is the primary goal. This work presents a self-supervised framework that maps noisy video into a discrete vocabulary of local states and their spatiotemporal relationships. The method operates without clean targets, pretrained representations, semantic labels, feature templates, or prescribed trajectories, assuming only that informative structures recur for a finite duration within a bounded spatial neighborhood. A temporally masked vector-quantized network predicts the missing central frame from its neighbors, while a masked Transformer refines token assignments by weighing encoder evidence against contextual compatibility. Project-specific token sets define the feature family, while a support model quantifies the temporal evidence for individual occurrences, facilitating optional conservative suppression. The framework is first demonstrated on synthetic videos of moving particles. Without access to clean frames or particle coordinates during learning and selection, the learned states recover compact, point-spread-function-like structures. Tests on low-signal particle-tracking benchmarks yield frame-wise component precision between 87.0% and 94.5%, with recall decreasing as particle density rises. An experimental example using E. coli further shows that discrete states can separate biological structures from illumination and acquisition artifacts. In all cases, the primary outputs are interpretable state, activity, support, and component maps; rendered images serve as diagnostics rather than optimization targets.

Simulation models are widely used to support counterfactual inference in settings where direct experimental validation is difficult or infeasible. However, for phenomenological models calibrated to observational time series, goodness-of-fit does not necessarily establish that the structural assumptions underlying such inferences are uniquely supported by the data. Here, we examine this issue using a published COVID-19 transmission model for Japan that incorporates empirical inputs including human mobility, variant prevalence, and vaccination and has been used to estimate the effects of alternative vaccination scenarios. Using the publicly archived code together with a reconstructed substitute for a restricted-access input file required by the released implementation, we first reproduced the published model behaviour. We then performed two complementary computational stress tests. First, the vaccination-related input was suppressed and the remaining parameters were re-estimated against the original epidemic trajectory. Second, as a complementary test of trajectory-level flexibility, the model was refitted to synthetic target series with qualitatively different temporal structures while retaining the empirical mobility and variant inputs. The model retained substantial fitting capacity in both tests: suppression of the vaccination-related input caused only a limited deterioration in fit to the original trajectory, while qualitatively different synthetic trajectories could also be reproduced through parameter adjustment. Variation in fitted parameters across these conditions was also consistent with compensatory parameter behaviour. These results do not imply that vaccination had no effect or that the original model is invalid. Rather, they provide empirical evidence that, in this case, goodness-of-fit to the observed epidemic trajectory alone does not uniquely support the structural interpretation required for vaccination-related counterfactual inference. The study illustrates the value of reproducible computational stress testing as a complement to, rather than a substitute for, formal identifiability or model-comparison analyses.

Host immunity acquired through prior infections is a key factor shaping the spread of emerging variants. However, accounting for complete infection histories in mathematical models is challenging because the number of possible histories grows exponentially with the number of variants. Here, we present a flexible framework for modeling the co-circulation of multiple variants emerging at arbitrary times while incorporating cross-immunity and variant-specific characteristics. We introduce three tractable approximations: truncation, which retains only infection histories up to a given number of strains; one variant at a time, which is exact when variants circulation does not overlap; and two variants at a time, which is exact when at most two strains co-circulate. We systematically evaluate these approximations across a range of cross-immunity levels and inter-variant emergence delays. Truncation approximations perform best under short emergence delays and strong cross-immunity, whereas the other approaches outperform them at longer delays. When applied to SARS-CoV-2 variant dynamics, the second-order truncation and the two variants at a time approximation accurately capture incidence patterns, whereas the other approaches perform well only for specific subsets of variants. These results identify the parameter regimes in which simplifying assumptions remain valid, provide guidance for model selection, and highlight the key role of infection history in shaping epidemic trajectories.

The Transport-of-Intensity Equation (TIE) and polarization differential phase contrast (pDPC) exhibit transfer characteristics that limit their use as standalone quantitative phase imaging modalities. TIE provides stable recovery of low spatial frequencies but attenuates fine structure, while pDPC enhances phase gradients but is intrinsically insensitive near zero frequency. We present a hybrid reconstruction framework that combines a single-shot pDPC measurement with an in-focus-defocused TIE image pair and fuses the resulting phase estimates in the Fourier domain using frequency-selective weighting. The illumination geometry is co-designed to enforce angular separation between modalities, enabling high-frequency phase-gradient acquisition in a single exposure while preserving low-frequency sensitivity through low-numerical-aperture symmetric illumination. The proposed method requires three intensity measurements without requiring interferometric stability or sequential asymmetric illumination. Experimental results demonstrate improved phase fidelity across spatial frequencies, reduced halo artifacts, and enhanced recovery of both smooth and fine structural features. This approach provides a compact and robust method that moves towards extended spatial-frequency phase imaging for dynamic and resource-constrained applications.

Image scanning microscopy (ISM) is emerging as the natural evolution of confocal laser-scanning microscopy, combining optical sectioning and a two-fold improvement in lateral resolution with high signal-to-noise ratio. Single-photon avalanche diode (SPAD) array detectors enable an effective implementation of ISM by recording a micro-image at each scan position with single-photon sensitivity, negligible readout noise, and without the fixed frame-readout constraints of conventional cameras. Nevertheless, SPAD array-based ISM remains largely confined to laboratories with expertise in microscope development. Here, we present BrightEyes-Scope, a reference implementation of a SPAD array-based ISM system. We provide step-by-step guidelines for optical design, system construction, alignment, calibration, data acquisition, and image reconstruction. Presented as a complete ISM microscope, BrightEyes-Scope also serves as a reference for upgrading existing laser-scanning microscopes. We anticipate that it will accelerate the adoption of ISM for quantitative super-resolution imaging.

Oscillatory and saturating dynamics in regulatory gene networks govern processes such as cell cycle timing, circadian rhythms, and inflammatory signaling, and sparse regression methods such as SINDy offer an interpretable method for recovering their governing equations from time-series data. However, these networks are typically governed by Hill-type nonlinearities that become nearly collinear with polynomial candidates over most bounds of an oscillating curve, and placing them in a shared library produces ill-conditioned regressions and unreliable coefficient estimates. Standard approaches such as ridge regularization, library normalization, and orthogonalization can marginally improve conditioning but cannot remove the structural multicollinearity of these systems, in turn limiting our ability to produce accurate parameter estimates. To address this issue, we propose the Regulation-Informed Sparse Identification of Nonlinear Dynamics (RI-SINDy) method, which removes known regulatory terms from the regression and recovers their coefficients directly from an asymptotic drift-balance condition. Because the time averaged derivative of a bounded trajectory approaches zero, the coefficients of regulatory nonlinearities can be computed independently by constraining them to offset the mean contribution of the remaining terms. We demonstrate that this method effectively reduces library collinearity and improves conditioning numbers by 3-45x, substantially improving coefficient recovery and regression accuracy. We test the RI-SINDy method on experimental Hes1 data and on synthetic Goodwin and NF-{kappa}B models. On Hes1, it achieves the lowest trajectory error among the compared methods (Traditional SINDy, SR3, and Nullcline Reconstruction). On the synthetic systems, it recovers the correct sparse structure with lower trajectory error than SR3 and Nullcline Reconstruction, and in a Goodwin noise sweep it recovers all active terms at noise levels up to 15%, where Traditional SINDy and E-SINDy fail to. In conclusion, the RI-SINDy method provides a robust framework to overcome the issue of multicollinearity for system identification in biological systems.

Mechanistic models of infectious disease transmission provide a framework for understanding and predicting disease dynamics, but statistical inference is often computationally prohibitive. This challenge is especially pronounced for models with high-dimensional structures and many unknown parameters, where trajectory matching may require thousands of evaluations of an expensive likelihood function. We developed a surrogate-assisted optimization framework that uses Bayesian optimization to reduce the number of evaluations of the underlying mechanistic model required for parameter inference. We evaluated the approach using simulated fitting problems based on age-structured susceptible-exposed-infected-recovered models with 4, 8, and 16 age classes and a 210-compartment age-structured rotavirus transmission model. Applying surrogate-assisted optimization substantially reduced the number of likelihood evaluations required to identify good parameter estimates, with larger improvements as model dimensionality increased. In the rotavirus model, the surrogate Bayesian optimization approach reached the benchmark after approximately 0.7 hours, compared with approximately 9.4 hours using traditional Nelder-Mead optimization. These results demonstrate that surrogate-assisted optimization can substantially reduce the computational burden of trajectory matching for complex mechanistic transmission models, particularly for higher-dimensional inference problems.

Automated surveillance systems can prove to be extremely useful in detecting outbreaks of respiratory diseases that need further epidemiological investigation. In order for the system to be effective, careful attention has to be paid to the baseline used, absence of the observations, and the use of proper statistical methods. As a solution, the paper describes EpiAlert, a weekly surveillance system based on CDC FluView ILINet. The system is able to transform the number of ILI visits and the total number of visits into a ILI prevalence for the region, create the first reference from the three previous years using a +/- 2-week interval, transform the rate value, and apply two different detectors - CUSUM and EWMA. CUSUM is set at k=0.5 and h=5, whereas EWMA uses {lambda}=0.2 and H=2.7 values. Among the 55 districts, the system gives 45,138 pieces of information about the disease by transforming 44,297 pieces of data into alerts. It is found that there are 2,820 alerts in total (out of which 2,711 alerts used CUSUM, 402 used EWMA, and 293 used both detectors). Additionally, the experiments show that the sensitivity of the device depends greatly on the detector. The latest statistics can be tracked in the report for week 37 of 2026 that recently concluded in West.

Nanopore sensors have transformed single-molecule analysis, enabling real-time detection of biomolecules with unprecedented resolution. Understanding and modelling noise in nanopore sensing is essential to unlocking their full analytical potential. Although mechanistic models of nanopore noise exist, a rigorous statistical framework that characterises noise structure across diverse experimental conditions is still lacking. Here, we present a comprehensive empirical analysis of nanopore noise using twelve diverse experimental conditions acquired with different nanopores, analytes, and electronic recording systems. By employing multiple, mutually reinforcing statistical methods, we establish that nanopore noise is well described by a composite fractional model comprising multiple fractional Gaussian noise and fractional Brownian motion components. This finding is supported by confirmation of Gaussianity, rigorous interpretation of second-order exponents, multifractal analysis, and evidence that transient deviations are attributable to deterministic or experimental artefacts rather than alternative stochastic mechanisms. We further resolve quasi-deterministic structures, such as baseline trends and structural breaks, and demonstrate their separability from the underlying stochastic profile. Collectively, these results provide the first formal statistical validation of a composite fractional model for nanopore noise and establish a principled basis for noise reconstruction, realistic simulation, and statistically grounded algorithm design for nanopore sensing applications. This study provides the foundation for the creation of high-fidelity performance evaluation datasets for signal processing, and the controlled generation and augmentation of data for machine learning while maintaining statistical fidelity to experimental conditions.

Vector flow mapping (VFM) reconstructs left-ventricular (LV) blood velocity from color-Doppler echocardiography by combining the measured beamwise component with physical and regularizing constraints. Analysis of the discrete VFM formulation shows that the inverse problem is intrinsically ill posed: the occurrence of singular modes can be predicted from the geometry of the segmented blood-pool domain, the imposed boundary conditions, and the degree of smoothing. These modes can propagate uncertainty along entire transverse bands of the reconstructed velocity field, yet conventional VFM neither quantifies this uncertainty nor allows for correcting the blood-pool segmentation. We introduce Bayesian VFM (B--VFM), a hierarchical framework that jointly infers radial and transverse velocities, a probabilistic blood-pool mask, their spatially resolved uncertainties, and hyperparameters weighting Doppler and segmentation fidelity, mass conservation, boundary conditions, and smoothness. The discretized posterior admits a closed-form gradient and exact Hessian, enabling computationally efficient, gradient-based MAP estimation, sampling, and direct analysis of ill-posed modes. Posterior inference combines Gibbs sampling of conjugate Gamma-distributed hyperparameters with conditional maximum-a-posteriori estimation and a Laplace approximation for the high-dimensional velocity and mask fields. To accommodate systematic departures from planar mass conservation, B-VFM can learn the covariance of the planar divergence residual from an ensemble of flows and incorporate it as a structured model-discrepancy prior. Independent chains converged reproducibly, while covariance priors learned from flow ensembles illustrated how model discrepancies can be incorporated into the inference. B--VFM was evaluated using Lamb-Chaplygin dipoles under ideal conditions and with Doppler corruption, Doppler voids, and segmentation defects, and using the Hicks-Moffatt family of spherical vortices to assess violations of planar mass conservation. The method produced smooth reconstructions, localized uncertainty near unreliable measurements and regions of model inconsistency, and used flow information to correct segmentation errors. Within the tested vortex family, the data-informed planar divergence prior reduced velocity bias and mask distortion. B--VFM thus provides an uncertainty-aware reconstruction method and a flexible foundation for future VFM formulations incorporating additional priors, observations, and physical models. Future work will evaluate the method using clinical data and more complex three-dimensional benchmark flows.

Introduction: In temperate regions, influenza and respiratory syncytial virus (RSV) typically exhibit seasonal epidemics during the winter months, often concurrently with SARS-CoV-2 epidemics. Monitoring past and real-time trends in infection dynamics is important for informing public health situational awareness, including identifying and characterising unusual epidemic activity. However, data used to monitor these trends can exhibit substantial noise including strong day-of-the-week variation in reporting. In addition, case data for influenza can obscure distinct trends in influenza subtypes if not combined with virological data. Aim: By quantifying trends in respiratory virus activity using statistical methods, the Australia-Aotearoa Consortium for Epidemic Forecasting and Analytics (ACEFA) aims to provide government partners with comprehensive epidemic intelligence. Methods: Analyses were performed on daily case time series data for SARS-CoV-2, RSV and influenza across Australia's eight jurisdictions. Past and real-time trends were inferred for each pathogen and each influenza subtype using Bayesian p-spline models. Results: The 2025 Winter Situational Assessment Program provided weekly reports throughout the winter season and during the out-of-season influenza A H3N2 epidemic, driven by the emergence of the novel influenza subclade ('subclade K'). Despite limited subtyping data, our analysis provided an early signal of increasing influenza A H3N2 during a period in which overall influenza cases were decreasing; increases in influenza A H3N2 activity were first detected in July, and by mid-August, increasing H3N2 activity was estimated across all jurisdictions. Discussion: Our analysis highlights the benefits of incorporating statistical methods into real-time epidemic situational assessment and in consolidating reporting across jurisdictions.

High-speed atomic force microscopy (HS-AFM) experiments provide unique insights into nanoscale biological processes by directly visualizing the surface topography dynamics of biomolecules, such as proteins, over extended periods of time and generating large imaging data sets. However, the lack of computational methods for automated data analysis has thus far limited the full utilization of these data for the quantitative understanding of single-molecule dynamic. Here, we present the AFM Analysis Arena (A3) within BioAFMviewer as a software platform for automated, high-throughput quantitative analysis of AFM topographic imaging data within a user-friendly interactive graphical interface, implementing a convenient workflow from raw HS-AFM (AFM) imaging to statistical analysis. In several applications to HS-AFM imaging data, we demonstrate methods of automatized molecule detection and dynamic tracking to highlight the available capacities, aiming to transform HS-AFM measurements from observations towards an analytical tool in nanoscale biology.

Background Exposure-history data collected during epidemics or pandemics within digital contact-tracing applications hold immense potential for rapid, scalable epidemiological inference. The sensitivity of these data makes privacy-preserving designs essential to secure public trust and app uptake. However, during the COVID-19 pandemic, such approaches were not yet available at the scale or maturity required for deployment. We present a Bayesian decentralised framework to infer transmission dynamics from exposure-history data while protecting user privacy. Methods Our approach is based on iterative communication between user devices and a central server, computing log-likelihood gradients on device from exposure-history data and centrally updating parameter values using only aggregated gradients. Applying this framework to synthetic exposure-history data from a hypothetical respiratory pathogen epidemic simulated on dynamic contact networks, we assessed its ability to estimate the underlying transmission parameters, perform infector attribution, and reconstruct serial-interval (SI) distributions. We systematically explored how inference was affected by incomplete exposure-history data arising from partial app adoption, case under-ascertainment, and incomplete exposure logging, and by transmission scenarios. Findings Our decentralised framework accurately recovered transmission parameters, closely matching estimates derived from centralised data with no systematic bias in posterior means. Parameter recovery remained robust when hazards from unobserved exposures were known as a daily average across the population. Although incomplete exposure-history data and specific transmission scenarios introduced compensatory parameter biases, the inferred host infectiousness profile retained sufficient accuracy, and the weekly SI distributions reconstructed from infector attributions closely resembled the ground-truth distributions. Interpretation Our findings highlight that, beyond its primary role as a control measure, digital contact tracing could help characterise transmission dynamics almost in real time and inform public health interventions while preserving user privacy. Funding Oxford Martin School Programme on Digital Pandemic Preparedness; National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections.

Behavioral variability reflects differences in internal and external parameters and provides a substrate for natural selection. However, uncovering its structure is challenging because behavior evolves nonlinearly across multiple timescales. Our goal is to reconstruct phenotypic variation from finite behavioral observations without prescribing the scales at which individuals should be compared. To achieve this, we introduce a multiscale dissimilarity that compares dynamics across all statistically resolvable resolutions by constructing reduced transfer operators at progressively finer scales and weighting their differences by finite-sampling uncertainty. This dissimilarity defines a geometry of dynamical phenotypes, which we reconstruct using diffusion maps. We show that the resulting phenotypic coordinates locally follow the parameter directions to which dynamics are most sensitive. We validate our approach in a stochastic model and apply it to bacterial and larval zebrafish behavior. In bacteria, we identify run speed as a major component of inter-individual variability, associated with the chemotaxis protein CheB. In zebrafish, we find that prior prey experience reshapes behavioral dynamics and phenotypic variability, with paramecia experience concentrating fish in a prey-capture-associated region of phenotypic space. Together, these results provide a framework for identifying internal and environmental variables that structure dynamical phenotypes across scales.

Understanding the relationship between weather conditions and infectious disease transmission has important public health implications; nevertheless, the functional form of this relationship often remains poorly understood. Humidity has previously been suggested to have a U-shaped effect on the transmission of respiratory pathogens, with optimal transmission occurring at both low and high levels. Here, to assess the impact of this functional form and of its potential misspecification, we first simulate transmission rates based on the U-shaped relationship and then test whether an exponential function accurately estimates these rates across a range of climates. We further use a transmission model to simulate case count data for a range of hypothetical pathogens, comparing outbreak dynamics under the U-shaped forcing function to those under the best-fit exponential approximation. In our simulations, the model fit for the exponential function is climate-dependent, performing best in very dry and very humid environments. In locations where specific humidity values centre around the vertex of the U-shaped function, the exponential model underestimates the amplitude and frequency of incidence peaks. These findings demonstrate the potential consequences of assuming an incorrect functional form for weather-infectious disease relationships and highlight the need for more careful consideration of this functional form in modelling practice.

Fluorescence microscopy is a central tool in biomedical image analysis, but its practical use is often constrained by incomplete and heterogeneous data. This is especially true in rare disease research, where patient cohorts are small, biological material is limited, and complex study designs frequently yield images with missing, degraded, or low-quality channels. We introduce Reliability-Mask-Conditioned DDPM (RM-DDPM), a conditional diffusion model that formulates multichannel image generation, missing-channel imputation, and degraded-channel restoration as a single reliability-guided inference problem. The model is trained on a curated subset of complete, high-quality multichannel images using a self-supervised masking objective to learn rich cross-channel dependencies from the available channels. At inference time, reliable observations condition the reverse diffusion process, allowing the same trained model to solve multiple reconstruction tasks without task-specific retraining. We evaluate RM-DDPM against task-specific baselines on one public and two in-house fluorescence microscopy datasets, comprising a rare-disease preclinical model study and a clinical patient cohort. Across these settings, RM-DDPM matches the specialized baselines in reconstruction quality, hallucinates fewer false structures, and remains more robust as degradation severity increases, while repeated sampling provides per-pixel uncertainty maps that flag unreliable reconstructions.

Background. Classical macroparasite models commonly represent worm burden heterogeneity through prescribed Poisson or negative-binomial (NB) distributions, while transmission dynamics are formulated in terms of aggregate quantities such as mean worm burden and prevalence. We revisit these assumptions using a stratified worm burden (SWB) framework that explicitly tracks the distribution of parasite burdens across heterogeneous host classes and allows demographic turnover, transmission, and interventions to be analyzed within a unified model. Methods. We derive equilibrium distributions of the SWB system under homogeneous and heterogeneous infection processes and compare them with the classical Poisson and NB distributions used in macroparasite epidemiology and control policymaking. The framework is then extended to include host demography, coupled human-snail transmission dynamics, and periodic mass drug administration (MDA). Corresponding SWB and NB-type MacDonald models are calibrated to comparable endemic prevalence and mean worm burden, allowing direct comparison of potential transmission breakpoints and intervention outcomes. Results. In the absence of demographic turnover, the SWB framework naturally generates Poisson and NB equilibrium distributions as limiting cases of homogeneous and heterogeneous infection processes. Incorporating demographic recruitment and mortality alters these benchmark distributions, producing endemic burden structures that differ systematically from their classical counterparts. Analysis of coupled human-snail systems reveals that transmission breakpoints and bistable equilibria occur only within a relatively restricted region of SWB parameter space. In contrast, comparable NB-MacDonald formulations exhibit breakpoint behavior over substantially broader parameter ranges with the net effect of overestimating the likelihood of interruption of transmission. Although calibrated models can reproduce near identical endemic prevalence and mean worm burden, they often generate markedly different responses to MDA, including differences in rebound dynamics, persistence, and elimination thresholds. Conclusions. The SWB framework links classical statistical descriptions of worm aggregation to mechanistic burden-resolved population dynamics, clarifying how endemic distributions emerge and how they are modified by demography and control interventions. Our results suggest that transmission breakpoints are not a universal feature of helminth systems but depend strongly on model structure, and that predictions of elimination and post-treatment recovery may be considerably more model-dependent than implied by prevalence-based calibration alone. The SWB approach therefore provides a flexible alternative framework for evaluating parasite transmission dynamics and predicting the outcomes of control strategies.

Significance: Fluorescence imaging remains largely qualitative and device-specific, limiting reproducibility and intersystem comparisons. SI-traceable radiometric characterization requires calibrated sources suitable for transferring known radiance to imaging systems. Aim: Establish and evaluate a compact, calibrated solid-state radiometric emitter target (RET) for SI-traceable radiance transfer, and assess methods for evaluating radiance invariance, imager responsivity, and extension of radiance transfer to digitally defined regions of interest (ROIs). Approach: The radiance invariance of an LED-based RET was evaluated by measuring its radiance across varying source-to-aperture distances and collection apertures. A previously described radiance-transfer formalism based on calibrated source radiance and collection geometry was implemented to determine imager responsivity (R{lambda}), which was evaluated across varying working distances and lens apertures. Grubbs and MAD outlier tests and one-way ANOVA were used to assess radiance and responsivity invariance. Finally, responsivity obtained using digitally defined ROIs was compared with matched physical apertures to assess ROI-based radiance transfer. Results: The measured RET radiance remained invariant across the tested source-to-aperture distances and collection apertures, with no significant differences observed across distance (p = 0.88) or aperture (p = 0.15). Imager responsivity remained stable across working distances for both tested lens configurations (p = 0.48 and p > 0.99). Responsivity was also invariant across lens apertures, except for deviations at f/11 that were consistent with practical aperture tolerances. Digitally defined ROIs reproduced responsivity values obtained using matched physical apertures, demonstrating that the radiance-transfer approach can be extended to image-defined regions. Conclusions: The presented methods provide an approach for evaluating compact LED-based sources for invariant-radiance emission and suitability for SI-traceable radiance transfer. The characterized RET supported stable imager responsivity across changes in imaging geometry and extension to digitally defined ROIs. These methods can be adapted to other LED-based sources, with further angular characterization and uncertainty analysis needed to establish broader applicability.

Foundation models for colour fundus photography (CFP) are candidate visual encoders for multimodal medical AI, but existing models are large and are assessed under fine-tuning rather than the frozen-encoder conditions such systems impose. We present RFM (Retinal Foundation Model), a 64-million-parameter Vision Transformer initialised from DINOv3-Base and domain-adapted with the LeJEPA joint-embedding predictive self-supervised objective with domain-specific pretext tasks, on 4.3 million CFPs from the North East London Diabetic Eye Screening Programme. A single linear head per task on one frozen backbone measures representation generalisability, not fine-tuning capacity. Across six external datasets spanning diabetic retinopathy (DR) grading, glaucoma detection, ten UK Biobank biomarker phenotypes and 3-year incidence of myocardial infarction, ischaemic stroke and Parkinson's disease, RFM attains the lowest mean absolute error of any frozen model on all seven regression phenotypes and a higher area under the receiver operating characteristic curve (AUROC) than any RETFound variant on all eight matched classification benchmarks. It also attains the highest AUROC of any model evaluated on four of the five ophthalmic benchmarks, with 4.8x fewer parameters than RETFound-MAE and RETFound-DINOv2. Applied to UK Biobank without retraining, RFM exceeds the best published retinal foundation-model AUROC for 3-year myocardial infarction and ischaemic stroke; the Parkinson's endpoint (11 cases) is inconclusive. DINOv3-Base without retinal pre-training, read the same way, stays competitive on DR grading but falls clearly behind on glaucoma, and the feature-extraction convention alone is worth up to 0.154 AUROC. One lightweight backbone yields generalised representations serving ophthalmic grading, biomarker regression and incidence prediction.

Background and Objective: High-speed and high-resolution retinal imaging using adaptive optics line confocal ophthalmoscopy (AOLCO) resolves individual red blood cells (erythrocytes) flowing through the smallest retinal capillaries, but quantifying their velocity first requires removing linear and nonlinear distortions caused by eye motion that may result in a displacement of tens to hundreds of pixels between frames. We present a computational pipeline that stabilizes AOLCO capillary video and measures erythrocyte velocity in true physical units, delivered as an interactive 3D Slicer extension and a batch command-line tool sharing one analysis core. Methods: Our video analysis pipeline has four stages: preprocessing, registration, postprocessing, and velocity measurement. During preprocessing, illumination is corrected, and closed-eye frames are identified. During registration, each frame is aligned to a reference frame using affine and, when needed, B-Spline registration, initialized by our robust and fast (GPU-based) translation-registration algorithm to accommodate large eye movements (e.g., microsaccades). During postprocessing, adjacent registered frames are differenced to suppress stationary structures, and a 2D projection of the frame-difference video reveals the capillary network. During velocity measurement, an operator manually identifies capillary segments on the 2D projection image. Spatiotemporal images are then generated along these segments from the frame-difference video, and blood-flow velocity curves are obtained from these images using the Radon transform. Results: We validate the velocimetry of the pipeline against synthetic ground-truth flow data, and the experiments show that the velocimetry recovers the speed within an error of 4% The GPU-based translation registration algorithm aligns the large eye motions (~90 um per frame on average) and runs about 3.6 x (100 Hz) to 38 x (400 Hz) faster than the baseline method. Across the full cohort (2344 videos, 57 subjects, 30 Hz to 400 Hz), our registration approach improves structural similarity (SSIM) of the video frames on every acquisition from 0.73 to 0.86. The recovered blood flow velocities are physiologically plausible, of the same order as published AO measurements. Conclusions: Our computational pipeline enables AOLCO velocimetry on the capillary-level.