Daily Papers

Simulated environments enable scalable training data generation for embodied agents, but more data does not necessarily provide what a particular agent needs to learn. Existing environment-generation pipelines largely optimize generic properties such as realism, diversity, or task coverage, while different pretrained policies can fail for different environmental reasons. We therefore introduce WEDGE, a framework for weakness-guided navigation learning in which the failure modes of a pretrained agent guide the generation of training environments at each adaptation round. Given a pretrained policy, WEDGE uses an LLM to propose executable weakness features from contrasting successful and failed rollouts, automatically validates them on the diagnostic set, and selects the strongest validated weakness based on its success-rate gap. The validated weaknesses are then mapped to the environmental factors that control them. WEDGE varies these factors to construct environments in the difficulty regimes where the policy struggles, producing targeted training experience for adaptation. Across three navigation agents with different adaptation mechanisms, we find that policies exhibit distinct weakness profiles and benefit from different training environments. Weakness-conditioned adaptation consistently outperforms matched random and hard-example alternatives on ProcTHOR, while the resulting gains for Uni-NaVid and Gemini also extend to HM3D after ProcTHOR adaptation. Iterative re-diagnosis further shows that dominant weaknesses can persist or shift as the policy improves, providing updated guidance for subsequent environment construction. Together, these results show that policy failures are not only diagnostic signals, but actionable guidance for constructing training environments that target a policy's current weaknesses.

Large language models can diagnose a student program from its code, problem statement, and reference solution. Evaluating this ability requires a clear definition of what counts as the correct diagnosis. We introduce PyMETA, a Python error dataset with 48,646 student submissions to 155 problems. Every submission has a single label for the first execution error identified by an Online Judge, or No Error when the program passes all tests. A targeted subset of 97 submissions also has expert labels collected through iterative repair and re-execution. The taxonomy has three levels; its most detailed level contains 14 labels, including No Error, Logic Error, named Python exceptions, and an Other Errors category. We evaluate two finetuned models and two groups of prompted LLMs: four earlier models and four recent models. When evaluated against the first execution error, the recent prompted models reach 87.5--93.8% macro F1, above the strongest finetuned baseline at 80.6%. This is the opposite of the comparison obtained with the earlier prompted models. On the 97-item expert subset, however, exact-set match is only 43.3--48.5%, although sample F1 is about 79--81%. Output format also matters. On the same 45 audited submissions whose expert label sets do not contain Logic Error, none of the four recent models returns that label under single-error prompting, but 46.7--57.8% of their multi-error outputs include it, usually after an explicit-error label. The results show that model rankings and claims about label bias depend on the meaning of the gold label, the number of labels a model may return, and the scoring rule.

As Large Multimodal Models (LMMs) scale up and reinforcement learning (RL) methods mature, LMMs have made notable progress in complex reasoning and decision making. Yet training still relies on static data and fixed recipes, making it difficult to diagnose capability blind spots or provide dynamic, targeted reinforcement. Motivated by findings that test driven error exposure and feedback based correction outperform repetitive practice, we propose Diagnostic-driven Progressive Evolution (DPE), a spiral loop where diagnosis steers data generation and reinforcement, and each iteration re-diagnoses the updated model to drive the next round of targeted improvement. DPE has two key components. First, multiple agents annotate and quality control massive unlabeled multimodal data, using tools such as web search and image editing to produce diverse, realistic samples. Second, DPE attributes failures to specific weaknesses, dynamically adjusts the data mixture, and guides agents to generate weakness focused data for targeted reinforcement. Experiments on Qwen3-VL-8B-Instruct and Qwen2.5-VL-7B-Instruct show stable, continual gains across eleven benchmarks, indicating DPE as a scalable paradigm for continual LMM training under open task distributions. Our code, models, and data are publicly available at https://github.com/hongruijia/DPE.

Vision-Language Models (VLMs) often lose visual grounding during multi-step reasoning: as reasoning chains grow longer, later inference steps rely increasingly on language priors rather than image evidence. We identify a consistent benchmark-level signature associated with this degradation: across 2,510 re-examined samples from four benchmarks, attention entropy over image tokens typically decreases during Round 1 and rises again after image re-injection. However, we find that effective visual re-examination requires two complementary ingredients: image re-injection and targeted self-diagnosis. Without targeted diagnosis, re-examination can even hurt performance, whereas accurate self-diagnosis yields substantial gains -- a swing of several points on key benchmarks, indicating that diagnostic quality is a key factor in whether re-examination helps or hurts in our setting. We present ReGround, a two-stage framework that teaches VLMs to self-diagnose grounding failures and selectively re-examine visual evidence, without architectural modifications or external tools. Through capability bootstrapping, a stronger variant from the same model family provides diagnostic scaffolding only during data construction, while the policy model learns to diagnose autonomously at inference time and retains most of the assisted gains. Experiments on eight benchmarks across two VLM backbones demonstrate consistent gains, especially on visually intensive multi-step reasoning tasks, while incurring only modest inference overhead relative to tool-augmented baselines. Project page: https://sespoir.github.io/reground-page/ . Code: https://github.com/sespoir/ReGround .

Artificial intelligence holds great promise for expanding access to expert medical knowledge and reasoning. However, most evaluations of language models rely on static vignettes and multiple-choice questions that fail to reflect the complexity and nuance of evidence-based medicine in real-world settings. In clinical practice, physicians iteratively formulate and revise diagnostic hypotheses, adapting each subsequent question and test to what they've just learned, and weigh the evolving evidence before committing to a final diagnosis. To emulate this iterative process, we introduce the Sequential Diagnosis Benchmark, which transforms 304 diagnostically challenging New England Journal of Medicine clinicopathological conference (NEJM-CPC) cases into stepwise diagnostic encounters. A physician or AI begins with a short case abstract and must iteratively request additional details from a gatekeeper model that reveals findings only when explicitly queried. Performance is assessed not just by diagnostic accuracy but also by the cost of physician visits and tests performed. We also present the MAI Diagnostic Orchestrator (MAI-DxO), a model-agnostic orchestrator that simulates a panel of physicians, proposes likely differential diagnoses and strategically selects high-value, cost-effective tests. When paired with OpenAI's o3 model, MAI-DxO achieves 80% diagnostic accuracy--four times higher than the 20% average of generalist physicians. MAI-DxO also reduces diagnostic costs by 20% compared to physicians, and 70% compared to off-the-shelf o3. When configured for maximum accuracy, MAI-DxO achieves 85.5% accuracy. These performance gains with MAI-DxO generalize across models from the OpenAI, Gemini, Claude, Grok, DeepSeek, and Llama families. We highlight how AI systems, when guided to think iteratively and act judiciously, can advance diagnostic precision and cost-effectiveness in clinical care.

Differential Diagnosis (DDx) is a fundamental yet complex aspect of clinical decision-making, in which physicians iteratively refine a ranked list of possible diseases based on symptoms, antecedents, and medical knowledge. While recent advances in large language models (LLMs) have shown promise in supporting DDx, existing approaches face key limitations, including single-dataset evaluations, isolated optimization of components, unrealistic assumptions about complete patient profiles, and single-attempt diagnosis. We introduce a Modular Explainable DDx Agent (MEDDxAgent) framework designed for interactive DDx, where diagnostic reasoning evolves through iterative learning, rather than assuming a complete patient profile is accessible. MEDDxAgent integrates three modular components: (1) an orchestrator (DDxDriver), (2) a history taking simulator, and (3) two specialized agents for knowledge retrieval and diagnosis strategy. To ensure robust evaluation, we introduce a comprehensive DDx benchmark covering respiratory, skin, and rare diseases. We analyze single-turn diagnostic approaches and demonstrate the importance of iterative refinement when patient profiles are not available at the outset. Our broad evaluation demonstrates that MEDDxAgent achieves over 10% accuracy improvements in interactive DDx across both large and small LLMs, while offering critical explainability into its diagnostic reasoning process.

The increasing deployment of AI agents in long-horizon tasks yields massive execution logs. Diagnosing failures within these records is crucial for reliability, as it transforms outcome-level signals into actionable interventions. The sheer scale of the data renders human review impractical, driving the need for automated root-cause attribution (RCA). However, automated RCA methods using LLMs suffer from low diagnostic accuracy, especially as execution traces grow larger. They struggle because relevant information is often sparse, distributed across distant actions, and disconnected from the visible failure, reducing root-cause attribution to a massive search problem. Existing RCA methods typically rely on one-shot LLM judgments to diagnose failures from execution traces. While effective for shorter trajectories, these judges tend to settle on a plausible diagnosis early, leaving critical evidence in longer traces unexamined. We introduce Continual Search, an iterative framework that nudges the judge, over successive turns, to keep searching for unresolved diagnostic evidence. We evaluate Continual Search across four existing RCA benchmarks. Recognizing the lack of massive execution traces in current benchmarks, we introduce MegaRCA-Mix to evaluate RCA at scale. MegaRCA-Mix provides a challenging testbed of 50 human-annotated failure trials spanning long-horizon, execution-heavy tasks. Across multiple benchmark suites and model families, Continual Search consistently improves attribution performance. On MegaRCA-Mix, for example, it improves GPT-5.5's F1 score by more than 40\%, from 0.349 to 0.498. More interestingly, within the same model family, lower-tier models can even surpass their higher-tier counterparts, demonstrating that effective search supersedes raw model scale.

Clinical diagnosis is critical in medical practice, typically requiring a continuous and evolving process that includes primary diagnosis, differential diagnosis, and final diagnosis. However, most existing clinical diagnostic tasks are single-step processes, which does not align with the complex multi-step diagnostic procedures found in real-world clinical settings. In this paper, we propose a multi-step diagnostic task and annotate a clinical diagnostic dataset (MSDiagnosis). This dataset includes primary diagnosis, differential diagnosis, and final diagnosis questions. Additionally, we propose a novel and effective framework. This framework combines forward inference, backward inference, reflection, and refinement, enabling the LLM to self-evaluate and adjust its diagnostic results. To assess the effectiveness of our proposed method, we design and conduct extensive experiments. The experimental results demonstrate the effectiveness of the proposed method. We also provide a comprehensive experimental analysis and suggest future research directions for this task.

Large language model (LLM) agents are increasingly used for multi-step, stateful tool-use tasks, yet production reliability remains limited. Unlike static software repair, agent repair must recover dynamic trajectories whose early decisions can propagate into later errors and external state changes. Existing automatic remedies address only part of this problem: blind retry adds no diagnosis, outcome feedback says whether a run failed but not where or why, and self-reflection often lacks grounded evidence to prevent the same failure from recurring. We present AgentTether, a run-time repair framework that automates post-run diagnosis and guided recovery without modifying the underlying agent or environment. AgentTether abstracts each run into Transition Units, links them through a dependency-aware Critical Transition Graph, and localizes failure-critical subtrajectories by combining an offline normal-behavior model with a run-local graph detector. It then converts the localized cause into behavior-scoped guidance backed by cross-iteration Repair Memory, and can optionally apply guarded run-time intervention to keep the correction active during re-execution. The same design can be deployed as an offline diagnostic-and-guidance tool or as an online repair layer. We evaluate AgentTether on 261 tau-bench tasks across three domains with Qwen3.7-max, and test cross-model transfer on Banking with GPT-5.4. On the hardest Banking domain, AgentTether repairs 59.04% (49/83) of initially failed Qwen3.7-max tasks and 65.12% (56/86) of initially failed GPT-5.4 tasks. Overall, AgentTether improves repair effectiveness while reducing agent turns and end-to-end approach tokens, suggesting a practical reliability layer that can wrap existing agent deployments, reduce wasted re-execution, and improve recovery without retraining the agent.

Precise retrieval of scientific information is fundamentally constrained by long-tailed concepts and high fact-sensitivity of scientific corpora. These challenges often limit the effectiveness of dense retrievers and hallucination-prone LLM augmentation. To address this, we present REPAIR, a self-evolving data augmentation framework for scientific dense retrievers. REPAIR iteratively synthesizes training data to address knowledge gaps by cycling through diagnosis of long-tail concepts, API-guided evidence expansion, and differentiation via hard negative mining. This process effectively grounds retrieval in factual reality to resolve fine-grained distinctions. Extensive experiments demonstrate that REPAIR significantly outperforms 19 strong baselines on nine materials science and biomedical benchmarks. Our work highlights that diagnosing and factually augmenting data to long-tail deficits is essential for robust scientific retrieval.

Cognitive diagnosis (CD) is a fundamental task in intelligent education that profiles learner proficiency over knowledge concepts. In real-world learning platforms, newly added items continually introduce previously unseen concepts, necessitating dynamic expansion of the underlying concept space. Yet existing incremental CD models assume a fixed concept space, allowing gradients from new items to overwrite historical pathways and induce catastrophic forgetting. More critically, these methods rely solely on soft constraints to preserve historical diagnoses. Such constraints may fail to satisfy the requirement of diagnostic invariance after incremental updates, a requirement known as psychometric consistency in cognitive diagnosis. Therefore, we propose CLEAN (Continual Learning with Expandable and Architecturally Isolated Networks), a novel incremental CD framework supporting concept-space expansion while providing structural guarantees for pointwise invariance of historical diagnoses. Specifically, CLEAN first introduces a strict topological bipartition protocol, freezes historical diagnostic functions and applies deterministic orthogonal column masking to sever gradient interference. Second, to accommodate concept expansion, expandable full-rank branches with micro-variance initialization are deployed to learn novel concepts. Finally, to verify that this architectural design achieves invariance by construction, we formalize Representation Drift (RD) to quantify the perturbation of historical traits. Extensive experiments on three large-scale educational datasets demonstrate that CLEAN achieves zero RD, preserving old-item metrics identically to static anchors through architectural isolation while remaining competitive with or superior to strong continual-learning baselines on new items.

Medical vision-language models (VLMs) excel at image-text understanding but typically rely on a single-pass reasoning that neglects localized visual cues. In clinical practice, however, human experts iteratively scan, focus, and refine the regions of interest before reaching a final diagnosis. To narrow this machine-human perception gap, we introduce ViTAR, a novel VLM framework that emulates the iterative reasoning process of human experts through a cognitive chain of "think-act-rethink-answer". ViTAR treats medical images as interactive objects, enabling models to engage multi-step visual reasoning. To support this approach, we curate a high-quality instruction dataset comprising 1K interactive examples that encode expert-like diagnostic behaviors. In addition, a 16K visual question answering training data has been curated towards fine-grained visual diagnosis. We introduce a two-stage training strategy that begins with supervised fine-tuning to guide cognitive trajectories, followed by the reinforcement learning to optimize decision-making. Extensive evaluations demonstrate that ViTAR outperforms strong state-of-the-art models. Visual attention analysis reveals that from the "think" to "rethink" rounds, ViTAR increasingly anchors visual grounding to clinically critical regions and maintains high attention allocation to visual tokens during reasoning, providing mechanistic insight into its improved performance. These findings demonstrate that embedding expert-style iterative thinking chains into VLMs enhances both performance and trustworthiness of medical AI.

Recently computer-aided diagnosis has demonstrated promising performance, effectively alleviating the workload of clinicians. However, the inherent sample imbalance among different diseases leads algorithms biased to the majority categories, leading to poor performance for rare categories. Existing works formulated this challenge as a long-tailed problem and attempted to tackle it by decoupling the feature representation and classification. Yet, due to the imbalanced distribution and limited samples from tail classes, these works are prone to biased representation learning and insufficient classifier calibration. To tackle these problems, we propose a new Long-tailed Medical Diagnosis (LMD) framework for balanced medical image classification on long-tailed datasets. In the initial stage, we develop a Relation-aware Representation Learning (RRL) scheme to boost the representation ability by encouraging the encoder to capture intrinsic semantic features through different data augmentations. In the subsequent stage, we propose an Iterative Classifier Calibration (ICC) scheme to calibrate the classifier iteratively. This is achieved by generating a large number of balanced virtual features and fine-tuning the encoder using an Expectation-Maximization manner. The proposed ICC compensates for minority categories to facilitate unbiased classifier optimization while maintaining the diagnostic knowledge in majority classes. Comprehensive experiments on three public long-tailed medical datasets demonstrate that our LMD framework significantly surpasses state-of-the-art approaches. The source code can be accessed at https://github.com/peterlipan/LMD.

The ODELIA Breast MRI Challenge 2025 addresses a critical issue in breast cancer screening: improving early detection through more efficient and accurate interpretation of breast MRI scans. Even though methods for general-purpose whole-body lesion segmentation as well as multi-time-point analysis exist, breast cancer detection remains highly challenging, largely due to the limited availability of high-quality segmentation labels. Therefore, developing robust classification-based approaches is crucial for the future of early breast cancer detection, particularly in applications such as large-scale screening. In this write-up, we provide a comprehensive overview of our approach to the challenge. We begin by detailing the underlying concept and foundational assumptions that guided our work. We then describe the iterative development process, highlighting the key stages of experimentation, evaluation, and refinement that shaped the evolution of our solution. Finally, we present the reasoning and evidence that informed the design choices behind our final submission, with a focus on performance, robustness, and clinical relevance. We release our full implementation publicly at https://github.com/MIC-DKFZ/MeisenMeister

We introduce Reprompting, an iterative sampling algorithm that searches for the Chain-of-Thought (CoT) recipes for a given task without human intervention. Through Gibbs sampling, we infer CoT recipes that work consistently well for a set of training samples. Our method iteratively samples new recipes using previously sampled solutions as parent prompts to solve other training problems. On five Big-Bench Hard tasks that require multi-step reasoning, Reprompting achieves consistently better performance than the zero-shot, few-shot, and human-written CoT baselines. Reprompting can also facilitate transfer of knowledge from a stronger model to a weaker model leading to substantially improved performance of the weaker model. Overall, Reprompting brings up to +17 point improvements over the previous state-of-the-art method that uses human-written CoT prompts.

The emergent abilities of large language models (LLMs) have demonstrated great potential in solving medical questions. They can possess considerable medical knowledge, but may still hallucinate and are inflexible in the knowledge updates. While Retrieval-Augmented Generation (RAG) has been proposed to enhance the medical question-answering capabilities of LLMs with external knowledge bases, it may still fail in complex cases where multiple rounds of information-seeking are required. To address such an issue, we propose iterative RAG for medicine (i-MedRAG), where LLMs can iteratively ask follow-up queries based on previous information-seeking attempts. In each iteration of i-MedRAG, the follow-up queries will be answered by a vanilla RAG system and they will be further used to guide the query generation in the next iteration. Our experiments show the improved performance of various LLMs brought by i-MedRAG compared with vanilla RAG on complex questions from clinical vignettes in the United States Medical Licensing Examination (USMLE), as well as various knowledge tests in the Massive Multitask Language Understanding (MMLU) dataset. Notably, our zero-shot i-MedRAG outperforms all existing prompt engineering and fine-tuning methods on GPT-3.5, achieving an accuracy of 69.68\% on the MedQA dataset. In addition, we characterize the scaling properties of i-MedRAG with different iterations of follow-up queries and different numbers of queries per iteration. Our case studies show that i-MedRAG can flexibly ask follow-up queries to form reasoning chains, providing an in-depth analysis of medical questions. To the best of our knowledge, this is the first-of-its-kind study on incorporating follow-up queries into medical RAG.

Iterative self-training (self-distillation) repeatedly refits a model on pseudo-labels generated by its own predictions. We study this procedure in overparameterized linear regression: an initial estimator is trained on noisy labels, and each subsequent iterate is trained on fresh covariates with noiseless pseudo-labels from the previous model. In the high-dimensional regime, we derive deterministic-equivalent recursions for the prediction risk and effective noise across iterations, and prove that the empirical quantities concentrate sharply around these limits. The recursion separates two competing forces: a systematic component that grows with iteration due to progressive signal forgetting, and a stochastic component that decays due to denoising via repeated data-dependent projections. Their interaction yields a U-shaped test-risk curve and an optimal early-stopping time. In spiked covariance models, iteration further acts as an iteration-dependent spectral filter that preserves strong eigendirections while suppressing weaker ones, inducing an implicit form of soft feature selection distinct from ridge regression. Finally, we propose an iterated generalized cross-validation criterion and prove its uniform consistency for estimating the risk along the self-training trajectory, enabling fully data-driven selection of the stopping time and regularization. Experiments on synthetic covariances validate the theory and illustrate the predicted denoising-forgetting trade-off.

Clinical diagnosis is a highly specialized discipline requiring both domain expertise and strict adherence to rigorous guidelines. While current AI-driven medical research predominantly focuses on knowledge graphs or natural text pretraining paradigms to incorporate medical knowledge, these approaches primarily rely on implicitly encoded knowledge within model parameters, neglecting task-specific knowledge required by diverse downstream tasks. To address this limitation, we propose Retrieval-Augmented Diagnosis (RAD), a novel framework that explicitly injects external knowledge into multimodal models directly on downstream tasks. Specifically, RAD operates through three key mechanisms: retrieval and refinement of disease-centered knowledge from multiple medical sources, a guideline-enhanced contrastive loss that constrains the latent distance between multi-modal features and guideline knowledge, and the dual transformer decoder that employs guidelines as queries to steer cross-modal fusion, aligning the models with clinical diagnostic workflows from guideline acquisition to feature extraction and decision-making. Moreover, recognizing the lack of quantitative evaluation of interpretability for multimodal diagnostic models, we introduce a set of criteria to assess the interpretability from both image and text perspectives. Extensive evaluations across four datasets with different anatomies demonstrate RAD's generalizability, achieving state-of-the-art performance. Furthermore, RAD enables the model to concentrate more precisely on abnormal regions and critical indicators, ensuring evidence-based, trustworthy diagnosis. Our code is available at https://github.com/tdlhl/RAD.

Iterative retrieval refers to the process in which the model continuously queries the retriever during generation to enhance the relevance of the retrieved knowledge, thereby improving the performance of Retrieval-Augmented Generation (RAG). Existing work typically employs few-shot prompting or manually constructed rules to implement iterative retrieval. This introduces additional inference overhead and overlooks the remarkable reasoning capabilities of Large Language Models (LLMs). In this paper, we introduce Auto-RAG, an autonomous iterative retrieval model centered on the LLM's powerful decision-making capabilities. Auto-RAG engages in multi-turn dialogues with the retriever, systematically planning retrievals and refining queries to acquire valuable knowledge. This process continues until sufficient external information is gathered, at which point the results are presented to the user. To this end, we develop a method for autonomously synthesizing reasoning-based decision-making instructions in iterative retrieval and fine-tuned the latest open-source LLMs. The experimental results indicate that Auto-RAG is capable of autonomous iterative interaction with the retriever, effectively leveraging the remarkable reasoning and decision-making abilities of LLMs, which lead to outstanding performance across six benchmarks. Further analysis reveals that Auto-RAG can autonomously adjust the number of iterations based on the difficulty of the questions and the utility of the retrieved knowledge, without requiring any human intervention. Moreover, Auto-RAG expresses the iterative retrieval process in natural language, enhancing interpretability while providing users with a more intuitive experienceCode is available at \url{https://github.com/ictnlp/Auto-RAG.

I investigate a stronger form of regularization by deactivating neurons for extended periods, a departure from the temporary changes of methods like Dropout. However, this long-term dynamism introduces a critical challenge: severe training instability when neurons are revived with random weights. To solve this, I propose the Lifecycle (LC) principle, a regularization mechanism centered on a key innovation: state memory. Instead of re-initializing a revived neuron, my method restores its parameters to their last known effective state. This process preserves learned knowledge and avoids destructive optimization shocks. My theoretical analysis reveals that the LC principle smooths the loss landscape, guiding optimization towards flatter minima associated with better generalization. Experiments on image classification benchmarks demonstrate that my method improves generalization and robustness. Crucially, ablation studies confirm that state memory is essential for achieving these gains.

Many real world learning tasks involve complex or hard-to-specify objectives, and using an easier-to-specify proxy can lead to poor performance or misaligned behavior. One solution is to have humans provide a training signal by demonstrating or judging performance, but this approach fails if the task is too complicated for a human to directly evaluate. We propose Iterated Amplification, an alternative training strategy which progressively builds up a training signal for difficult problems by combining solutions to easier subproblems. Iterated Amplification is closely related to Expert Iteration (Anthony et al., 2017; Silver et al., 2017), except that it uses no external reward function. We present results in algorithmic environments, showing that Iterated Amplification can efficiently learn complex behaviors.

Retrieval-Augmented Generation (RAG) extends large language models (LLMs) beyond parametric knowledge, yet it is unclear when iterative retrieval-reasoning loops meaningfully outperform static RAG, particularly in scientific domains with multi-hop reasoning, sparse domain knowledge, and heterogeneous evidence. We provide the first controlled, mechanism-level diagnostic study of whether synchronized iterative retrieval and reasoning can surpass an idealized static upper bound (Gold Context) RAG. We benchmark eleven state-of-the-art LLMs under three regimes: (i) No Context, measuring reliance on parametric memory; (ii) Gold Context, where all oracle evidence is supplied at once; and (iii) Iterative RAG, a training-free controller that alternates retrieval, hypothesis refinement, and evidence-aware stopping. Using the chemistry-focused ChemKGMultiHopQA dataset, we isolate questions requiring genuine retrieval and analyze behavior with diagnostics spanning retrieval coverage gaps, anchor-carry drop, query quality, composition fidelity, and control calibration. Across models, Iterative RAG consistently outperforms Gold Context, with gains up to 25.6 percentage points, especially for non-reasoning fine-tuned models. Staged retrieval reduces late-hop failures, mitigates context overload, and enables dynamic correction of early hypothesis drift, but remaining failure modes include incomplete hop coverage, distractor latch trajectories, early stopping miscalibration, and high composition failure rates even with perfect retrieval. Overall, staged retrieval is often more influential than the mere presence of ideal evidence; we provide practical guidance for deploying and diagnosing RAG systems in specialized scientific settings and a foundation for more reliable, controllable iterative retrieval-reasoning frameworks.

The rapid advancement of large-scale vision-language models has showcased remarkable capabilities across various tasks. However, the lack of extensive and high-quality image-text data in medicine has greatly hindered the development of large-scale medical vision-language models. In this work, we present a diagnosis-guided bootstrapping strategy that exploits both image and label information to construct vision-language datasets. Based on the constructed dataset, we developed MedDr, a generalist foundation model for healthcare capable of handling diverse medical data modalities, including radiology, pathology, dermatology, retinography, and endoscopy. Moreover, during inference, we propose a simple but effective retrieval-augmented medical diagnosis strategy, which enhances the model's generalization ability. Extensive experiments on visual question answering, medical report generation, and medical image diagnosis demonstrate the superiority of our method.

Whole-slide images (WSIs) are challenging for vision-language reasoning because diagnostically relevant morphology is sparse, heterogeneous, and distributed across gigapixel-scale images and multiple spatial resolutions. Existing WSI models and pathology agents can aggregate slide features or actively acquire evidence, but the information retained after exploration is often difficult to access semantically while preserving its connection to the original visual evidence. We introduce SlideBank, a training-free framework that represents each WSI as a persistent, concept-indexed, and spatially grounded evidence bank. SlideBank performs question-independent coarse-to-fine exploration to identify informative regions and multi-scale views, converts them into explicit morphological observations, and grounds pathology signals to their supporting patches and WSI coordinates. At inference time, questions are routed to relevant signals and evidence scales, and the linked global, regional, and patch evidence is integrated through confidence-based cross-level consensus. Experiments on WSI-VQA and SlideBench-BCNB show that with Patho-R1, SlideBank reaches 52.77% on WSI-VQA and with Quilt-LLaVA, it reaches 50.92% average accuracy on SlideBench-BCNB, while structured signal-guided retrieval consistently outperforms random evidence sampling. Reusing the same bank across repeated queries further achieves over 99% rephrasing consistency and substantially reduces amortized inference cost through persistent evidence reuse.

Automated data labeling techniques are crucial for accelerating the development of deep learning models, particularly in complex medical imaging applications. However, ensuring accuracy and efficiency remains challenging. This paper presents iterative refinement strategies for automated data labeling in facial landmark diagnosis to enhance accuracy and efficiency for deep learning models in medical applications, including dermatology, plastic surgery, and ophthalmology. Leveraging feedback mechanisms and advanced algorithms, our approach iteratively refines initial labels, reducing reliance on manual intervention while improving label quality. Through empirical evaluation and case studies, we demonstrate the effectiveness of our proposed strategies in deep learning tasks across medical imaging domains. Our results highlight the importance of iterative refinement in automated data labeling to enhance the capabilities of deep learning systems in medical imaging applications.

Objective: To allow efficient learning using the Recurrent Inference Machine (RIM) for image reconstruction whereas not being strictly dependent on the training data distribution so that unseen modalities and pathologies are still accurately recovered. Methods: Theoretically, the RIM learns to solve the inverse problem of accelerated-MRI reconstruction whereas being robust to variable imaging conditions. The efficiency and generalization capabilities with different training datasets were studied, as well as recurrent network units with decreasing complexity: the Gated Recurrent Unit (GRU), the Minimal Gated Unit (MGU), and the Independently Recurrent Neural Network (IndRNN), to reduce inference times. Validation was performed against Compressed Sensing (CS) and further assessed based on data unseen during training. A pathology study was conducted by reconstructing simulated white matter lesions and prospectively undersampled data of a Multiple Sclerosis patient. Results: Training on a single modality of 3T T_1-weighted brain data appeared sufficient to also reconstruct 7T T_{2}^*-weighted brain and 3T T_2-weighted knee data. The IndRNN is an efficient recurrent unit, reducing inference time by 68\% compared to CS, whereas maintaining performance. The RIM was able to reconstruct lesions unseen during training more accurately than CS when trained on T_2-weighted knee data. Training on T_1-weighted brain data and on combined data slightly enhanced the signal compared to CS. Conclusion: The RIM is efficient when decreasing its complexity, which reduces the inference time, whereas still being able to reconstruct data and pathology that was unseen during training.

We introduce Iterated Integrated Attributions (IIA) - a generic method for explaining the predictions of vision models. IIA employs iterative integration across the input image, the internal representations generated by the model, and their gradients, yielding precise and focused explanation maps. We demonstrate the effectiveness of IIA through comprehensive evaluations across various tasks, datasets, and network architectures. Our results showcase that IIA produces accurate explanation maps, outperforming other state-of-the-art explanation techniques.

Incentivizing the reasoning ability of Multimodal Large Language Models (MLLMs) is essential for medical applications to transparently analyze medical scans and provide reliable diagnosis. However, existing medical MLLMs rely solely on internal knowledge during reasoning, leading to hallucinated reasoning and factual inaccuracies when encountering cases beyond their training scope. Although recent Agentic Retrieval-Augmented Generation (RAG) methods elicit the medical model's proactive retrieval ability during reasoning, they are confined to unimodal LLMs, neglecting the crucial visual information during reasoning and retrieval. Consequently, we propose the first Multimodal Medical Reasoning-with-Retrieval framework, Med-RwR, which actively retrieves external knowledge by querying observed symptoms or domain-specific medical concepts during reasoning. Specifically, we design a two-stage reinforcement learning strategy with tailored rewards that stimulate the model to leverage both visual diagnostic findings and textual clinical information for effective retrieval. Building on this foundation, we further propose a Confidence-Driven Image Re-retrieval (CDIR) method for test-time scaling when low prediction confidence is detected. Evaluation on various public medical benchmarks demonstrates Med-RwR's significant improvements over baseline models, proving the effectiveness of enhancing reasoning capabilities with external knowledge integration. Furthermore, Med-RwR demonstrates remarkable generalizability to unfamiliar domains, evidenced by 8.8% performance gain on our proposed EchoCardiography Benchmark (ECBench), despite the scarcity of echocardiography data in the training corpus. Our data, model, and codes will be made publicly available at https://github.com/xmed-lab/Med-RwR.

Treatment reasoning underpins every therapeutic decision, integrating disease context, comorbidities, medications, contraindications, and evolving biomedical knowledge to select an appropriate therapy. It is inherently iterative: candidates are weighed against many constraints, revised as evidence emerges, and grounded in verifiable sources. Here we introduce ATHENA-R1, an AI agent for treatment reasoning across all FDA approved drugs since 1939, trained by reinforcement learning over a universe of 212 biomedical tools. At each step it identifies missing information, selects and runs relevant tools, and incorporates the evidence. To train it without human-annotated traces, we build a two-level self-learning framework: multi-agent systems construct the tools, tasks, and reasoning trajectories for supervised fine-tuning, then reinforcement learning with scientific feedback rewards reasoning quality (evidence gathering, grounded tool use, logical non-redundancy). Across five benchmarks of 3,168 drug reasoning tasks and 456 patient treatment cases, ATHENA-R1 outperforms language models and tool-use systems, reaching 94.7% accuracy on open-ended drug reasoning and 82.9% on treatment reasoning, 17.8 and 10.7 points above GPT-5. In blinded evaluations by experts from 28 rare disease organizations, it is preferred over reference models on all criteria, and physicians rated it favorably on complex hospitalized cardiovascular and infectious-disease cases. Adverse-event hypotheses it generated, tested in electronic health records from 5.4 million patients, reached adjusted odds ratios of 1.48-1.84, with no elevation among negative controls. Because it requires knowing what evidence to seek before concluding, treatment reasoning has long been hard for AI; we show it can be reframed as a learnable process of iterative evidence gathering that reinforcement learning can train AI to perform.

Time-series diagnostic systems rarely rely on retrieving relevant historical cases, and when they do, retrieval is evaluated only indirectly through downstream prediction. We introduce READ-Bench, a benchmark for historical-case retrieval across 12 diagnostic datasets, centered on multivariate time series, that defines relevance by shared fault or event type rather than signal shape, so visually different traces of the same fault count as relevant while similar-looking traces of different faults do not. Treating retrieval as a base retriever followed by a reranker, we evaluate classical distances, symbolic retrievers, self-supervised and foundation-model embedders, and their fusion, plus label-aware and language-model rerankers, under one protocol that varies supervision, pollution, and corpus scale with significance testing. Under a common channel-independent interface, pretrained representations offer no statistically detectable advantage over strong classical and symbolic baselines for search alone. The decisive factor is a small amount of resolved-case supervision at reranking, namely a Gaussian-process reranker that propagates a few neighbor labels in embedding space, which helps far more than more sophisticated representations or language-model reasoning and holds under pollution and at full corpus scale. Guided by these findings, we fuse a normal-residual-scored embedder with a dynamic time warping leg via reciprocal-rank fusion, then rerank with the Gaussian-process reranker, improving NDCG@10 over its own search stage on all 12 datasets, by +0.11 from reranking and +0.16 over the strongest single base retriever.

Disease progression simulation is a crucial area of research that has significant implications for clinical diagnosis, prognosis, and treatment. One major challenge in this field is the lack of continuous medical imaging monitoring of individual patients over time. To address this issue, we develop a novel framework termed Progressive Image Editing (PIE) that enables controlled manipulation of disease-related image features, facilitating precise and realistic disease progression simulation. Specifically, we leverage recent advancements in text-to-image generative models to simulate disease progression accurately and personalize it for each patient. We theoretically analyze the iterative refining process in our framework as a gradient descent with an exponentially decayed learning rate. To validate our framework, we conduct experiments in three medical imaging domains. Our results demonstrate the superiority of PIE over existing methods such as Stable Diffusion Walk and Style-Based Manifold Extrapolation based on CLIP score (Realism) and Disease Classification Confidence (Alignment). Our user study collected feedback from 35 veteran physicians to assess the generated progressions. Remarkably, 76.2% of the feedback agrees with the fidelity of the generated progressions. To our best knowledge, PIE is the first of its kind to generate disease progression images meeting real-world standards. It is a promising tool for medical research and clinical practice, potentially allowing healthcare providers to model disease trajectories over time, predict future treatment responses, and improve patient outcomes.

Diagnostic consultation is an online sequential decision-making process in which clinicians gather evidence through patient interaction until a diagnosis is sufficiently supported. Automating this process requires adaptive inquiry and interpretable decisions. Bayesian networks offer a natural foundation by updating diagnostic posteriors as evidence accumulates, but their use in open-ended consultation raises two challenges: linking diagnostic hypotheses to potential inquiries and translating evolving posteriors into consultation decisions. We introduce AutoDisym, an automated pipeline that integrates diagnostic knowledge with heterogeneous diagnosis-labeled clinical narratives to construct a Disorder--Symptom Bayesian Network (DSBN). Building on the DSBN, we propose ConsultMind, an uncertainty-aware framework that updates disorder posteriors after each response and uses posterior uncertainty to guide inquiry and diagnosis. We evaluate both methods across psychiatry, respiratory medicine, fever clinics, and three public datasets. The results show that AutoDisym can automatically construct high-quality DSBNs and that ConsultMind consistently improves diagnostic performance and explanation soundness. For example, AutoDisym achieves macro-averaged F1 scores of 81.37 for canonical symptoms and 72.19 for manifestations using GPT-5.6-Sol. ConsultMind improves Top-1 and Top-3 diagnostic accuracy by up to 22.15 and 37.89 percentage points, respectively. Physician evaluation further shows that ConsultMind improves the quality of ranking explanations, differential diagnoses, and diagnosis rationales across LLMs of different scales. This work offers a promising approach to automatic diagnostic consultation.

Transformers have revolutionized medical image restoration, but the quadratic complexity still poses limitations for their application to high-resolution medical images. The recent advent of the Receptance Weighted Key Value (RWKV) model in the natural language processing field has attracted much attention due to its ability to process long sequences efficiently. To leverage its advanced design, we propose Restore-RWKV, the first RWKV-based model for medical image restoration. Since the original RWKV model is designed for 1D sequences, we make two necessary modifications for modeling spatial relations in 2D medical images. First, we present a recurrent WKV (Re-WKV) attention mechanism that captures global dependencies with linear computational complexity. Re-WKV incorporates bidirectional attention as basic for a global receptive field and recurrent attention to effectively model 2D dependencies from various scan directions. Second, we develop an omnidirectional token shift (Omni-Shift) layer that enhances local dependencies by shifting tokens from all directions and across a wide context range. These adaptations make the proposed Restore-RWKV an efficient and effective model for medical image restoration. Even a lightweight variant of Restore-RWKV, with only 1.16 million parameters, achieves comparable or even superior results compared to existing state-of-the-art (SOTA) methods. Extensive experiments demonstrate that the resulting Restore-RWKV achieves SOTA performance across a range of medical image restoration tasks, including PET image synthesis, CT image denoising, MRI image super-resolution, and all-in-one medical image restoration. Code is available at: https://github.com/Yaziwel/Restore-RWKV.

In this paper, we argue that looped Transformers need their own residual connections to prevent performance degradation as the number of iterations grows. We observe that increasing loop iterations can reduce reasoning accuracy: noisy state updates overwrite correct intermediate deductions and even undo completed solutions. This leaves subsequent iterations to recover lost information from an already degraded representation: once an error arises in an earlier loop, often as a result of long-range propagation through the recurrence, later loops find it difficult to correct. In this paper, we introduce InfiLoop, a loop-native residual connection that learns which past computations to retain and how much to accept from each new update. InfiLoop combines content-based weighting with learned temporal decay to maintain a running summary of recurrent states. An exact streaming recurrence keeps its persistent aggregation memory constant as the loop count grows. The resulting adaptive update suppresses unreliable proposals and preserves useful intermediate states. Across extensive reasoning tasks, a 7M-parameter InfiLoop model outperforms existing recursive architectures, reaching 97.9% exact accuracy on Sudoku-Extreme, and 13.6% pass@2 on ARC-AGI-2. Notably, on Sudoku-Extreme, InfiLoop continues to improve with test-time looping beyond 20,000 effective steps, showing that added depth translates directly into stronger reasoning. Our code is available at https://github.com/pixeli99/InfiLoop.

Image quality is a critical factor in delivering visually appealing content on web platforms. However, images often suffer from degradation due to lossy operations applied by online social networks (OSNs), negatively affecting user experience. Image restoration is the process of recovering a clean high-quality image from a given degraded input. Recently, multi-task (all-in-one) image restoration models have gained significant attention, due to their ability to simultaneously handle different types of image degradations. However, these models often come with an excessively high number of trainable parameters, making them computationally inefficient. In this paper, we propose a strategy for compressing multi-task image restoration models. We aim to discover highly sparse subnetworks within overparameterized deep models that can match or even surpass the performance of their dense counterparts. The proposed model, namely MIR-L, utilizes an iterative pruning strategy that removes low-magnitude weights across multiple rounds, while resetting the remaining weights to their original initialization. This iterative process is important for the multi-task image restoration model's optimization, effectively uncovering "winning tickets" that maintain or exceed state-of-the-art performance at high sparsity levels. Experimental evaluation on benchmark datasets for the deraining, dehazing, and denoising tasks shows that MIR-L retains only 10% of the trainable parameters while maintaining high image restoration performance. Our code, datasets and pre-trained models are made publicly available at https://github.com/Thomkat/MIR-L.

Automating radiology report generation can significantly alleviate radiologists' workloads. Previous research has primarily focused on realizing highly concise observations while neglecting the precise attributes that determine the severity of diseases (e.g., small pleural effusion). Since incorrect attributes will lead to imprecise radiology reports, strengthening the generation process with precise attribute modeling becomes necessary. Additionally, the temporal information contained in the historical records, which is crucial in evaluating a patient's current condition (e.g., heart size is unchanged), has also been largely disregarded. To address these issues, we propose RECAP, which generates precise and accurate radiology reports via dynamic disease progression reasoning. Specifically, RECAP first predicts the observations and progressions (i.e., spatiotemporal information) given two consecutive radiographs. It then combines the historical records, spatiotemporal information, and radiographs for report generation, where a disease progression graph and dynamic progression reasoning mechanism are devised to accurately select the attributes of each observation and progression. Extensive experiments on two publicly available datasets demonstrate the effectiveness of our model.

Despite achieving high accuracy on medical benchmarks, LLMs exhibit the Einstellung Effect in clinical diagnosis--relying on statistical shortcuts rather than patient-specific evidence, causing misdiagnosis in atypical cases. Existing benchmarks fail to detect this critical failure mode. We introduce MedEinst, a counterfactual benchmark with 5,383 paired clinical cases across 49 diseases. Each pair contains a control case and a "trap" case with altered discriminative evidence that flips the diagnosis. We measure susceptibility via Bias Trap Rate--probability of misdiagnosing traps despite correctly diagnosing controls. Extensive Evaluation of 17 LLMs shows frontier models achieve high baseline accuracy but severe bias trap rates. Thus, we propose ECR-Agent, aligning LLM reasoning with Evidence-Based Medicine standard via two components: (1) Dynamic Causal Inference (DCI) performs structured reasoning through dual-pathway perception, dynamic causal graph reasoning across three levels (association, intervention, counterfactual), and evidence audit for final diagnosis; (2) Critic-Driven Graph and Memory Evolution (CGME) iteratively refines the system by storing validated reasoning paths in an exemplar base and consolidating disease-specific knowledge into evolving illness graphs. Source code is to be released.

Building upon our previous investigations of O1 replication (Part 1: Journey Learning [Qin et al., 2024] and Part 2: Distillation [Huang et al., 2024]), this work explores the potential of inference-time scaling in large language models (LLMs) for medical reasoning tasks, ranging from diagnostic decision-making to treatment planning. Through extensive experiments on medical benchmarks of varying complexity (MedQA, Medbullets, and JAMA Clinical Challenges), our investigation reveals several key insights: (1) Increasing inference time does lead to improved performance. With a modest training set of 500 samples, our model yields substantial performance improvements of 6%-11%. (2) Task complexity directly correlates with the required length of reasoning chains, confirming the necessity of extended thought processes for challenging problems. (3) The differential diagnoses generated by our model adhere to the principles of the hypothetico-deductive method, producing a list of potential conditions that may explain a patient's symptoms and systematically narrowing these possibilities by evaluating the evidence. These findings demonstrate the promising synergy between inference-time scaling and journey learning in advancing LLMs' real-world clinical reasoning capabilities.

Operations Research practitioners debug infeasible models through an iterative process: inspecting Irreducible Infeasible Subsystems ( IIS), identifying constraint conflicts, and repairing formulations until feasibility is restored. Existing LLM benchmarks mostly treat OR as one-shot translation from problem descriptions to solver code, omitting this diagnostic loop. We formalize infeasible-model repair as a solver-in-the-loop Markov Decision Process in which each action triggers solver re-execution and IIS recomputation, yielding deterministic, verifiable feedback. We introduce ORLoopBench, a benchmark suite with two components: OR-Debug-Bench releases 5,362 LP/MILP repair instances, while OR-Bias-Bench evaluates closed-form operational decision rationality across inventory settings. Solver-verified RLVR training enables an 8B model to surpass frontier APIs on LP repair (95.3% vs 92.4% RR @5), improves diagnostic behavior, and transfers to MILP repair. The same evaluation exposes semantic drift in whole-model code regeneration: feasible regenerated MILPs can solve the wrong problem. Process-level evaluation with solver oracles enables targeted training for reliable OR self-correction.

Large Language Models (LLMs) often generate code with subtle but critical bugs, especially for complex tasks. Existing automated repair methods typically rely on superficial pass/fail signals, offering limited visibility into program behavior and hindering precise error localization. In addition, without a way to learn from prior failures, repair processes often fall into repetitive and inefficient cycles. To overcome these challenges, we present TraceCoder, a collaborative multi-agent framework that emulates the observe-analyze-repair process of human experts. The framework first instruments the code with diagnostic probes to capture fine-grained runtime traces, enabling deep insight into its internal execution. It then conducts causal analysis on these traces to accurately identify the root cause of the failure. This process is further enhanced by a novel Historical Lesson Learning Mechanism (HLLM), which distills insights from prior failed repair attempts to inform subsequent correction strategies and prevent recurrence of similar mistakes. To ensure stable convergence, a Rollback Mechanism enforces that each repair iteration constitutes a strict improvement toward the correct solution. Comprehensive experiments across multiple benchmarks show that TraceCoder achieves up to a 34.43\% relative improvement in Pass@1 accuracy over existing advanced baselines. Ablation studies verify the significance of each system component, with the iterative repair process alone contributing a 65.61\% relative gain in accuracy. Furthermore, TraceCoder significantly outperforms leading iterative methods in terms of both accuracy and cost-efficiency.

Agents are widely deployed as assistants over documents, tools, and code. However, they typically act only on explicit user requests, which surface only the problems the user has noticed, while many other important problems coexist, hidden in plain sight, within the broader user context, with their total number unknown in advance. We frame this as the task of discovering multiple hidden problems from context, in which coexisting problems should be uncovered, grounded in supporting evidence, and paired with concrete actions. To this end, we introduce TIDE, a template-guided iterative framework with two complementary mechanisms. Specifically, motivated by the observation that single-pass prediction anchors on the most salient cases and yields generic claims, we propose iterative discovery, which surfaces a small batch of candidates per round while conditioning on what has already been found, so subsequent rounds extend coverage; and thought templates, reusable schemas distilled from previously solved cases that specify what contextual signals to attend to and how to connect them, anchoring each prediction in a recognizable problem class. We validate TIDE on two realistic settings, personal workspaces and software repositories, across four model backbones, showing substantial gains over single-shot and parallel multi-agent baselines on task coverage, identification, and resolution.

This paper presents a large publicly available multi-center lumbar spine magnetic resonance imaging (MRI) dataset with reference segmentations of vertebrae, intervertebral discs (IVDs), and spinal canal. The dataset includes 447 sagittal T1 and T2 MRI series from 218 patients with a history of low back pain. It was collected from four different hospitals and was divided into a training (179 patients) and validation (39 patients) set. An iterative data annotation approach was used by training a segmentation algorithm on a small part of the dataset, enabling semi-automatic segmentation of the remaining images. The algorithm provided an initial segmentation, which was subsequently reviewed, manually corrected, and added to the training data. We provide reference performance values for this baseline algorithm and nnU-Net, which performed comparably. We set up a continuous segmentation challenge to allow for a fair comparison of different segmentation algorithms. This study may encourage wider collaboration in the field of spine segmentation, and improve the diagnostic value of lumbar spine MRI.

Medical vision-language models can automate the generation of radiology reports but struggle with accurate visual grounding and factual consistency. Existing models often misalign textual findings with visual evidence, leading to unreliable or weakly grounded predictions. We present CURE, an error-aware curriculum learning framework that improves grounding and report quality without any additional data. CURE fine-tunes a multimodal instructional model on phrase grounding, grounded report generation, and anatomy-grounded report generation using public datasets. The method dynamically adjusts sampling based on model performance, emphasizing harder samples to improve spatial and textual alignment. CURE improves grounding accuracy by +0.37 IoU, boosts report quality by +0.188 CXRFEScore, and reduces hallucinations by 18.6%. CURE is a data-efficient framework that enhances both grounding accuracy and report reliability. Code is available at https://github.com/PabloMessina/CURE and model weights at https://huggingface.co/pamessina/medgemma-4b-it-cure

This paper presents our team's participation in the MEDIQA-ClinicalNLP2024 shared task B. We present a novel approach to diagnosing clinical dermatology cases by integrating large multimodal models, specifically leveraging the capabilities of GPT-4V under a retriever and a re-ranker framework. Our investigation reveals that GPT-4V, when used as a retrieval agent, can accurately retrieve the correct skin condition 85% of the time using dermatological images and brief patient histories. Additionally, we empirically show that Naive Chain-of-Thought (CoT) works well for retrieval while Medical Guidelines Grounded CoT is required for accurate dermatological diagnosis. Further, we introduce a Multi-Agent Conversation (MAC) framework and show its superior performance and potential over the best CoT strategy. The experiments suggest that using naive CoT for retrieval and multi-agent conversation for critique-based diagnosis, GPT-4V can lead to an early and accurate diagnosis of dermatological conditions. The implications of this work extend to improving diagnostic workflows, supporting dermatological education, and enhancing patient care by providing a scalable, accessible, and accurate diagnostic tool.

Automated clinical diagnosis remains a core challenge in medical AI, which usually requires models to integrate multi-modal data and reason across complex, case-specific contexts. Although recent methods have advanced medical report generation (MRG) and visual question answering (VQA) with medical vision-language models (VLMs), these methods, however, predominantly operate under a sample-isolated inference paradigm, as such processing cases independently without access to longitudinal electronic health records (EHRs) or structurally related patient examples. This paradigm limits reasoning to image-derived information alone, which ignores external complementary medical evidence for potentially more accurate diagnosis. To overcome this limitation, we propose HyperWalker, a Deep Diagnosis framework that reformulates clinical reasoning via dynamic hypergraphs and test-time training. First, we construct a dynamic hypergraph, termed iBrochure, to model the structural heterogeneity of EHR data and implicit high-order associations among multimodal clinical information. Within this hypergraph, a reinforcement learning agent, Walker, navigates to and identifies optimal diagnostic paths. To ensure comprehensive coverage of diverse clinical characteristics in test samples, we incorporate a linger mechanism, a multi-hop orthogonal retrieval strategy that iteratively selects clinically complementary neighborhood cases reflecting distinct clinical attributes. Experiments on MRG with MIMIC and medical VQA on EHRXQA demonstrate that HyperWalker achieves state-of-the-art performance. Code is available at: https://github.com/Bean-Young/HyperWalker

Recent advancements in Large Language Models (LLMs) have demonstrated significant promise in clinical diagnosis. However, current models struggle to emulate the iterative, diagnostic hypothesis-driven reasoning of real clinical scenarios. Specifically, current LLMs suffer from three critical limitations: (1) generating hallucinated medical content due to weak grounding in verified knowledge, (2) asking redundant or inefficient questions rather than discriminative ones that hinder diagnostic progress, and (3) losing coherence over multi-turn dialogues, leading to contradictory or inconsistent conclusions. To address these challenges, we propose MedKGI, a diagnostic framework grounded in clinical practices. MedKGI integrates a medical knowledge graph (KG) to constrain reasoning to validated medical ontologies, selects questions based on information gain to maximize diagnostic efficiency, and adopts an OSCE-format structured state to maintain consistent evidence tracking across turns. Experiments on clinical benchmarks show that MedKGI outperforms strong LLM baselines in both diagnostic accuracy and inquiry efficiency, improving dialogue efficiency by 30% on average while maintaining state-of-the-art accuracy.

Traditionally, AI research in medical diagnosis has largely centered on image analysis. While this has led to notable advancements, the absence of patient-reported symptoms continues to hinder diagnostic accuracy. To address this, we propose a Pre-Consultation Dialogue Framework (PCDF) that mimics real-world diagnostic procedures, where doctors iteratively query patients before reaching a conclusion. Specifically, we simulate diagnostic dialogues between two vision-language models (VLMs): a DocVLM, which generates follow-up questions based on the image and dialogue history, and a PatientVLM, which responds using a symptom profile derived from the ground-truth diagnosis. We additionally conducted a small-scale clinical validation of the synthetic symptoms generated by our framework, with licensed clinicians confirming their clinical relevance, symptom coverage, and overall realism. These findings indicate that the resulting DocVLM-PatientVLM interactions form coherent, multi-turn consultations paired with images and diagnoses, which we then use to fine-tune the DocVLM. This dialogue-based supervision leads to substantial gains over image-only training, highlighting the value of realistic symptom elicitation for diagnosis.

Large language models (LLMs) demonstrate exceptional performance in numerous tasks but still heavily rely on knowledge stored in their parameters. Moreover, updating this knowledge incurs high training costs. Retrieval-augmented generation (RAG) methods address this issue by integrating external knowledge. The model can answer questions it couldn't previously by retrieving knowledge relevant to the query. This approach improves performance in certain scenarios for specific tasks. However, if irrelevant texts are retrieved, it may impair model performance. In this paper, we propose Retrieval Augmented Iterative Self-Feedback (RA-ISF), a framework that iteratively decomposes tasks and processes them in three submodules to enhance the model's problem-solving capabilities. Experiments show that our method outperforms existing benchmarks, performing well on models like GPT3.5, Llama2, significantly enhancing factual reasoning capabilities and reducing hallucinations.

The success of large-scale language models like GPT can be attributed to their ability to efficiently predict the next token in a sequence. However, these models rely on constant computational effort regardless of the complexity of the token they are predicting, lacking the capacity for iterative refinement. In this paper, we introduce a novel Loop-Residual Neural Network, which achieves better performance by utilizing longer computational time without increasing the model size. Our approach revisits the input multiple times, refining the prediction by iteratively looping over a subset of the model with residual connections. We demonstrate the effectiveness of this method through experiments comparing versions of GPT-2 with our Loop-Residual models, showing improved performance in language modeling tasks while maintaining similar parameter counts. Importantly, these improvements are achieved without the need for extra training data.

Retrieval-based factuality evaluation, where LLM-generated claims are verified against evidence from authoritative medical corpora, has become the dominant paradigm for scalable hallucination detection in high-stakes clinical settings. Despite the urgency of reliable and transparent medical fact verification, most systems measure performance with aggregate metrics like F1, which obscure where and why failures occur. Existing RAG diagnostics require gold answers or annotated gold evidence, neither of which exists in this regime. We introduce two comprehensive taxonomies, grounded in a case study on the open-ended MedExpert dataset and 3 closed-ended datasets, decomposing failures into retrieval-stage errors along five quality dimensions, and verifier-reasoning errors into six consecutive steps. We adapt an automatic pattern induction pipeline using LLM-as-Judge to label evidence quality and classify verifier reasoning errors at scale, and then stress-test our findings across 4 retrieval methods and 6 frontier verifier models. Our analysis reveals that scaling model size, adding reasoning effort, expanding to authoritative web sources, and applying medical fine-tuning do not resolve these failure modes, demonstrating that they represent fundamental limitations of the retrieve-then-verify paradigm in open-ended medical settings rather than artifacts of outdated systems. We release our code and data at https://anonymous.4open.science/r/Medical_RAG_eval-4AB5 for the full reproducibility of our results.

AI-driven medical history-taking is an important component in symptom checking, automated patient intake, triage, and other AI virtual care applications. As history-taking is extremely varied, machine learning models require a significant amount of data to train. To overcome this challenge, existing systems are developed using indirect data or expert knowledge. This leads to a training-inference gap as models are trained on different kinds of data than what they observe at inference time. In this work, we present a two-stage re-ranking approach that helps close the training-inference gap by re-ranking the first-stage question candidates using a dialogue-contextualized model. For this, we propose a new model, global re-ranker, which cross-encodes the dialogue with all questions simultaneously, and compare it with several existing neural baselines. We test both transformer and S4-based language model backbones. We find that relative to the expert system, the best performance is achieved by our proposed global re-ranker with a transformer backbone, resulting in a 30% higher normalized discount cumulative gain (nDCG) and a 77% higher mean average precision (mAP).

We present Recurrent Fitting (ReFit), a neural network architecture for single-image, parametric 3D human reconstruction. ReFit learns a feedback-update loop that mirrors the strategy of solving an inverse problem through optimization. At each iterative step, it reprojects keypoints from the human model to feature maps to query feedback, and uses a recurrent-based updater to adjust the model to fit the image better. Because ReFit encodes strong knowledge of the inverse problem, it is faster to train than previous regression models. At the same time, ReFit improves state-of-the-art performance on standard benchmarks. Moreover, ReFit applies to other optimization settings, such as multi-view fitting and single-view shape fitting. Project website: https://yufu-wang.github.io/refit_humans/

The Multi-Prize Lottery Ticket Hypothesis posits that randomly initialized neural networks contain several subnetworks that achieve comparable accuracy to fully trained models of the same architecture. However, current methods require that the network is sufficiently overparameterized. In this work, we propose a modification to two state-of-the-art algorithms (Edge-Popup and Biprop) that finds high-accuracy subnetworks with no additional storage cost or scaling. The algorithm, Iterative Weight Recycling, identifies subsets of important weights within a randomly initialized network for intra-layer reuse. Empirically we show improvements on smaller network architectures and higher prune rates, finding that model sparsity can be increased through the "recycling" of existing weights. In addition to Iterative Weight Recycling, we complement the Multi-Prize Lottery Ticket Hypothesis with a reciprocal finding: high-accuracy, randomly initialized subnetwork's produce diverse masks, despite being generated with the same hyperparameter's and pruning strategy. We explore the landscapes of these masks, which show high variability.

Generating high-quality code that solves complex programming tasks is challenging, especially with current decoder-based models that produce highly stochastic outputs. In code generation, even minor errors can easily break the entire solution. Leveraging multiple sampled solutions can significantly improve the overall output quality. One effective way to enhance code generation is by pairing a code generation model with a reranker model, which selects the best solution from the generated samples. We propose a novel iterative self-training approach for self-training reranker models using Proximal Policy Optimization (PPO), aimed at improving both reranking accuracy and the overall code generation process. Unlike traditional PPO approaches, where the focus is on optimizing a generative model with a reward model, our approach emphasizes the development of a robust reward/reranking model. This model improves the quality of generated code through reranking and addresses problems and errors that the reward model might overlook during PPO alignment with the reranker. Our method iteratively refines the training dataset by re-evaluating outputs, identifying high-scoring negative examples, and incorporating them into the training loop, that boosting model performance. Our evaluation on the MultiPL-E dataset demonstrates that our 13.4B parameter model outperforms a 33B model in code generation quality while being three times faster. Moreover, it achieves performance comparable to GPT-4 and surpasses it in one programming language.

Fine-tuning multi-turn dialogue systems requires high-quality supervision but often suffers from degraded performance when exposed to low-quality data. Supervision errors in early turns can propagate across subsequent turns, undermining coherence and response quality. Existing methods typically address data quality via static prefiltering, which decouples quality control from training and fails to mitigate turn-level error propagation. In this context, we propose ReSURE (Regularizing Supervision UnREliability), an adaptive learning method that dynamically down-weights unreliable supervision without explicit filtering. ReSURE estimates per-turn loss distributions using Welford's online statistics and reweights sample losses on the fly accordingly. Experiments on both single-source and mixed-quality datasets show improved stability and response quality. Notably, ReSURE enjoys positive Spearman correlations (0.21 ~ 1.0 across multiple benchmarks) between response scores and number of samples regardless of data quality, which potentially paves the way for utilizing large-scale data effectively. Code is publicly available at https://github.com/Elvin-Yiming-Du/ReSURE_Multi_Turn_Training.

In this paper, we present a framework for training large language models (LLMs) as diagnostic agents with reinforcement learning, enabling them to manage multi-turn diagnostic processes, adaptively select examinations, and commit to final diagnoses. Unlike instruction-tuned models trained on static case summaries, our method acquires diagnostic strategies through interactive exploration and outcome-based feedback. Our contributions are fourfold: (i) We present DiagGym, a diagnostics world model trained with electronic health records that emits examination outcomes conditioned on patient history and recommended examination, serving as a virtual clinical environment for realistic diagnosis training and evaluation; (ii) We train DiagAgent via end-to-end, multi-turn reinforcement learning to learn diagnostic policies that optimize both information yield and diagnostic accuracy; (iii) We introduce DiagBench, a diagnostic benchmark comprising 750 cases with physician-validated examination recommendations and 99 cases annotated with 973 physician-written rubrics on diagnosis process; (iv) we demonstrate superior performance across diverse diagnostic settings. DiagAgent significantly outperforms 10 state-of-the-art LLMs, including DeepSeek-v3 and GPT-4o, as well as two prompt-engineered agents. In single-turn settings, DiagAgent achieves 9.34% higher diagnostic accuracy and 44.03% improvement in examination recommendation hit ratio. In end-to-end settings, it delivers 15.12% increase in diagnostic accuracy and 23.09% boost in examination recommendation F1 score. In rubric-based evaluation, it surpasses the next-best model, Claude-sonnet-4, by 7.1% in weighted rubric score. These findings indicate that learning policies in interactive clinical environments confers dynamic and clinically meaningful diagnostic management abilities unattainable through passive training alone.

Multiple instance learning (MIL) is the most widely used framework in computational pathology, encompassing sub-typing, diagnosis, prognosis, and more. However, the existing MIL paradigm typically requires an offline instance feature extractor, such as a pre-trained ResNet or a foundation model. This approach lacks the capability for feature fine-tuning within the specific downstream tasks, limiting its adaptability and performance. To address this issue, we propose a Re-embedded Regional Transformer (R^2T) for re-embedding the instance features online, which captures fine-grained local features and establishes connections across different regions. Unlike existing works that focus on pre-training powerful feature extractor or designing sophisticated instance aggregator, R^2T is tailored to re-embed instance features online. It serves as a portable module that can seamlessly integrate into mainstream MIL models. Extensive experimental results on common computational pathology tasks validate that: 1) feature re-embedding improves the performance of MIL models based on ResNet-50 features to the level of foundation model features, and further enhances the performance of foundation model features; 2) the R^2T can introduce more significant performance improvements to various MIL models; 3) R^2T-MIL, as an R^2T-enhanced AB-MIL, outperforms other latest methods by a large margin.The code is available at: https://github.com/DearCaat/RRT-MIL.

Continual post-training enables models to absorb emerging knowledge after deployment, but repeatedly updating shared parameters can accumulate weight drift, potentially causing catastrophic forgetting and degrading general capabilities. Retrieval-augmented generation avoids such parameter drift, yet often lacks the depth of parametric knowledge integration. In this paper, we propose ReGrad (Retrievable Gradients), a new paradigm that treats gradients as retrievable units of knowledge. ReGrad pre-computes document-specific gradients offline, stores them in an indexed Gradient Bank, and retrieves only query-relevant gradients at inference time for temporary weight adaptation. However, raw language-modeling gradients are optimized for token-level document reconstruction rather than for query-driven knowledge use. We therefore introduce a bi-level meta-learning objective that reshapes document-derived gradients into generalizable adaptation signals for downstream tasks. Experiments across general and domain-specific settings show that ReGrad outperforms CPT and RAG baselines, enabling scalable and reversible parametric knowledge injection without accumulating weight drift.

Large language models (LLMs) inherently absorb harmful knowledge, misinformation, and personal data during pretraining on large-scale web corpora, with no native mechanism for selective removal. While machine unlearning offers a principled solution, existing approaches are provider-centric, requiring retraining pipelines, curated retain datasets, and direct intervention by model service providers (MSPs), thereby excluding end users from controlling their own data. We introduce Interactive Machine Unlearning (IMU), a new paradigm in which users can instruct LLMs to forget targeted knowledge through natural language at inference time. To realize IMU, we propose RePAIR, a prompt-aware model repair framework comprising (i) a watchdog model for unlearning intent detection, (ii) a surgeon model for generating repair procedures, and (iii) a patient model whose parameters are updated autonomously. At the core of RePAIR, we develop Steering Through Activation Manipulation with PseudoInverse (STAMP), a training-free, single-sample unlearning method that redirects MLP activations toward a refusal subspace via closed-form pseudoinverse updates. Its low-rank variant reduces computational complexity from O(d^3) to O(r^3 + r^2 * d), enabling efficient on-device unlearning with up to ~3x speedup over training-based baselines. Extensive experiments across harmful knowledge suppression, misinformation correction, and personal data erasure demonstrate that RePAIR achieves near-zero forget scores (Acc_f = 0.00, F-RL = 0.00) while preserving model utility (Acc_r up to 84.47, R-RL up to 0.88), outperforming six state-of-the-art baselines. These results establish RePAIR as an effective and practical framework for user-driven model editing, advancing transparent and on-device control over learned knowledge, with potential extensions to multimodal foundation models.

Long-term conversational memory requires retrieving evidence scattered across multiple sessions, yet single-pass retrieval fails on temporal and multi-hop questions. Existing iterative methods refine queries via generated content or document-level signals, but none explicitly diagnoses the evidence gap, namely what is missing from the accumulated retrieval set, leaving query refinement untargeted. We present EviMem, combining IRIS (Iterative Retrieval via Insufficiency Signals), a closed-loop framework that detects evidence gaps through sufficiency evaluation, diagnoses what is missing, and drives targeted query refinement, with LaceMem (Layered Architecture for Conversational Evidence Memory), a coarse-to-fine memory hierarchy supporting fine-grained gap diagnosis. On LoCoMo, EviMem improves Judge Accuracy over MIRIX on temporal (73.3% to 81.6%) and multi-hop (65.9% to 85.2%) questions at 4.5x lower latency. Code: https://github.com/AIGeeksGroup/EviMem.

Mitigating hallucination issues is a key challenge that must be overcome to reliably deploy large language models (LLMs) in real-world scenarios. Recently, various methods have been proposed to detect and revise factual errors in LLM-generated texts, in order to reduce hallucination. In this paper, we propose Re-Ex, a method for post-editing LLM-generated responses. Re-Ex introduces a novel reasoning step dubbed as the factual error explanation step. Re-Ex revises the initial response of LLMs using 3-steps : first, external tools are used to retrieve the evidences of the factual errors in the initial LLM response; next, LLM is instructed to explain the problematic parts of the response based on the gathered evidence; finally, LLM revises the initial response using the explanations provided in the previous step. In addition to the explanation step, Re-Ex also incorporates new prompting techniques to reduce the token count and inference time required for the response revision process. Compared with existing methods including FacTool, CoVE, and RARR, Re-Ex provides better detection and revision performance with less inference time and fewer tokens in multiple benchmarks.

Despite the impressive capabilities of Large Language Models (LLMs) in general medical domains, questions remain about their performance in diagnosing rare diseases. To answer this question, we aim to assess the diagnostic performance of LLMs in rare diseases, and explore methods to enhance their effectiveness in this area. In this work, we introduce a rare disease question-answering (ReDis-QA) dataset to evaluate the performance of LLMs in diagnosing rare diseases. Specifically, we collected 1360 high-quality question-answer pairs within the ReDis-QA dataset, covering 205 rare diseases. Additionally, we annotated meta-data for each question, facilitating the extraction of subsets specific to any given disease and its property. Based on the ReDis-QA dataset, we benchmarked several open-source LLMs, revealing that diagnosing rare diseases remains a significant challenge for these models. To facilitate retrieval augmentation generation for rare disease diagnosis, we collect the first rare diseases corpus (ReCOP), sourced from the National Organization for Rare Disorders (NORD) database. Specifically, we split the report of each rare disease into multiple chunks, each representing a different property of the disease, including their overview, symptoms, causes, effects, related disorders, diagnosis, and standard therapies. This structure ensures that the information within each chunk aligns consistently with a question. Experiment results demonstrate that ReCOP can effectively improve the accuracy of LLMs on the ReDis-QA dataset by an average of 8%. Moreover, it significantly guides LLMs to generate trustworthy answers and explanations that can be traced back to existing literature.

The differential diagnosis of neurodegenerative dementias is a challenging clinical task, mainly because of the overlap in symptom presentation and the similarity of patterns observed in structural neuroimaging. To improve diagnostic efficiency and accuracy, deep learning-based methods such as Convolutional Neural Networks and Vision Transformers have been proposed for the automatic classification of brain MRIs. However, despite their strong predictive performance, these models find limited clinical utility due to their opaque decision making. In this work, we propose a framework that integrates two core components to enhance diagnostic transparency. First, we introduce a modular pipeline for converting 3D T1-weighted brain MRIs into textual radiology reports. Second, we explore the potential of modern Large Language Models (LLMs) to assist clinicians in the differential diagnosis between Frontotemporal dementia subtypes, Alzheimer's disease, and normal aging based on the generated reports. To bridge the gap between predictive accuracy and explainability, we employ reinforcement learning to incentivize diagnostic reasoning in LLMs. Without requiring supervised reasoning traces or distillation from larger models, our approach enables the emergence of structured diagnostic rationales grounded in neuroimaging findings. Unlike post-hoc explainability methods that retrospectively justify model decisions, our framework generates diagnostic rationales as part of the inference process-producing causally grounded explanations that inform and guide the model's decision-making process. In doing so, our framework matches the diagnostic performance of existing deep learning methods while offering rationales that support its diagnostic conclusions.

Large Language Models (LLMs) have shown strong promise for mining Electronic Health Records (EHRs) by reasoning over longitudinal clinical information to capture context-rich patient trajectories. However, leveraging LLMs for structured EHRs (e.g., standardized diagnosis and medication codes) presents two key challenges. First, translating time-stamped EHR sequences into plain text can obscure both temporal structure and code identities, weakening the ability to capture code co-occurrence and longitudinal regularities. Second, unlike cohort-trained predictive models that learn a shared, task-aligned representation space across patients, LLMs are often applied in a case-isolated inference setting where each patient is processed independently without leveraging population-level patterns. To address these challenges, we introduce RePrompT, a time-aware LLM framework that integrates structured EHR encoders through prompt tuning, without modifying underlying architectures. Specifically, RePrompT recurrently incorporates latent states from prior visits to preserve longitudinal information, and injects population-level information through trainable prompt tokens derived from a cohort-trained, task-aligned EHR encoder. Experiments on MIMIC-III and MIMIC-IV demonstrate that RePrompT consistently outperforms both EHR-based and LLM-based baselines across multiple clinical prediction tasks.

Vision-Language Models (VLMs) are advancing computational pathology with superior visual understanding capabilities. However, current systems often reduce diagnosis to directly output conclusions without verifiable evidence-linked reasoning, which severely limits clinical trust and hinders expert error rectification. To address these barriers, we construct PathReasoner, the first large-scale dataset of whole-slide image (WSI) reasoning. Unlike previous work reliant on unverified distillation, we develop a rigorous knowledge-guided generation pipeline. By leveraging medical knowledge graphs, we explicitly align structured pathological findings and clinical reasoning with diagnoses, generating over 20K high-quality instructional samples. Based on the database, we propose PathReasoner-R1, which synergizes trajectory-masked supervised fine-tuning with reasoning-oriented reinforcement learning to instill structured chain-of-thought capabilities. To ensure medical rigor, we engineer a knowledge-aware multi-granular reward function incorporating an Entity Reward mechanism strictly aligned with knowledge graphs. This effectively guides the model to optimize for logical consistency rather than mere outcome matching, thereby enhancing robustness. Extensive experiments demonstrate that PathReasoner-R1 achieves state-of-the-art performance on both PathReasoner and public benchmarks across various image scales, equipping pathology models with transparent, clinically grounded reasoning capabilities. Dataset and code are available at https://github.com/cyclexfy/PathReasoner-R1.

Automating scientific discovery requires more than generating papers from ideas. Real research is iterative: hypotheses are challenged from multiple perspectives, experiments fail and inform the next attempt, and lessons accumulate across cycles. Existing autonomous research systems often model this process as a linear pipeline: they rely on single-agent reasoning, stop when execution fails, and do not carry experience across runs. We present AutoResearchClaw, a multi-agent autonomous research pipeline built on five mechanisms: structured multi-agent debate for hypothesis generation and result analysis, a self-healing executor with a Pivot/Refine decision loop that transforms failures into information, verifiable result reporting that prevents fabricated numbers and hallucinated citations, human-in-the-loop collaboration with seven intervention modes spanning full autonomy to step-by-step oversight, and cross-run evolution that converts past mistakes into future safeguards. On ARC-Bench, a 25-topic experiment-stage benchmark, AutoResearchClaw outperforms AI Scientist v2 by 54.7%. A human-in-the-loop ablation across seven intervention modes reveals that precise, targeted collaboration at high-leverage decision points consistently outperforms both full autonomy and exhaustive step-by-step oversight. We position AutoResearchClaw as a research amplifier that augments rather than replaces human scientific judgment. Code is available at https://github.com/aiming-lab/AutoResearchClaw.

Aligning Video Large Multimodal Models (VLMMs) face challenges such as modality misalignment and verbose responses. Although iterative approaches such as self-rewarding or iterative direct preference optimization (DPO) recently showed a significant improvement in language model alignment, particularly on reasoning tasks, self-aligned models applied to large video-language models often result in lengthy and irrelevant responses. To address these challenges, we propose a novel method that employs self-retrospection to enhance both response generation and preference modeling, and call iterative self-retrospective judgment (i-SRT). By revisiting and evaluating already generated content and preference in loop, i-SRT improves the alignment between textual and visual modalities, reduce verbosity, and enhances content relevance. Our empirical evaluations across diverse video question answering benchmarks demonstrate that i-SRT significantly outperforms prior arts. We are committed to opensourcing our code, models, and datasets to encourage further investigation.

Autonomous research systems increasingly make the scientific workflow executable: agents can propose ideas, run code, inspect results, and draft papers. But executable workflows do not by themselves produce research judgment. We analyze where current systems lose trial experience: weak evidence becomes prose, pilot signals become broad claims, memory remains textual, and recurring process failures do not change later behavior. We introduce Sibyl-AutoResearch, a self-evolving AutoResearch framework built around Scientific Trial-and-Error Harnesses. A harness lets agents run bounded trials, preserve positive and negative outcomes, and route lessons into later planning, validation, claim scope, scheduling, critique, writing, and harness repair. We formalize this through two auditable conversion units: trial-to-behavior conversion, which links trial signals to later research actions, and trial-to-harness-behavior conversion, which links recurring process failures to system updates. We implement the framework in SIBYL, a file-backed autonomous research system that exposes the state, roles, memory, gates, and artifact traces needed to inspect these conversion paths. A retrospective audit identifies eight high-confidence conversion events, with a median latency of one iteration and a maximum latency of three iterations. A recovered-failure registry further shows how five naturally occurring failure classes, including duplicate results, stale numbers, and unsupported statistics, were blocked, downgraded, or routed into later repair. These traces do not establish a comparative performance claim; they show that the proposed conversion units are recoverable from realistic autonomous-research workspaces. The SIBYL framework and system are available at https://github.com/Sibyl-Research-Team/AutoResearch-SibylSystem.

Latent visual reasoning aims to perform multimodal reasoning through hidden-state computation rather than explicit textual chains of thought. However, visual information being present in a latent state does not imply that the model actually relies on that state when producing its answer, especially when alternative image-conditioned paths remain available. We introduce Causal Visual Recurrent Reasoning (CVRR), which preserves pretrained visual competence while making recurrent computation the required image-conditioned path to prediction. CVRR initializes recurrence from the question hidden state after the pretrained vision-language model has incorporated the image, then repeatedly updates this state while re-reading the same fixed visual evidence. Before decoding, visual states and the original multimodal KV cache are removed so that only the final recurrent state carries image-conditioned information to the answer. Across the V^*, MMVP, BLINK, and MME-RealWorld-Lite benchmarks, CVRR retains strong performance under this strict interface, while compatible latent reasoners fail to recover comparable visual competence even when retrained under the same constraint. Causal interventions further show that predictions remain sensitive to recurrent content when the question is held fixed, and that persistent visual evidence causally revises the recurrent trajectory. These results distinguish latent informativeness from latent computation that is actually used for prediction.

Rare diseases affect hundreds of millions worldwide, yet diagnosis often spans years. Convectional pipelines decouple noisy evidence extraction from downstream inferential diagnosis, and general/medical large language models (LLMs) face scarce real world electronic health records (EHRs), stale domain knowledge, and hallucinations. We assemble a large, domain specialized clinical corpus and a clinician validated reasoning set, and develop RareSeek R1 via staged instruction tuning, chain of thought learning, and graph grounded retrieval. Across multicenter EHR narratives and public benchmarks, RareSeek R1 attains state of the art accuracy, robust generalization, and stability under noisy or overlapping phenotypes. Augmented retrieval yields the largest gains when narratives pair with prioritized variants by resolving ambiguity and aligning candidates to mechanisms. Human studies show performance on par with experienced physicians and consistent gains in assistive use. Notably, transparent reasoning highlights decisive non phenotypic evidence (median 23.1%, such as imaging, interventions, functional tests) underpinning many correct diagnoses. This work advances a narrative first, knowledge integrated reasoning paradigm that shortens the diagnostic odyssey and enables auditable, clinically translatable decision support.

Catastrophic forgetting in neural networks is a significant problem for continual learning. A majority of the current methods replay previous data during training, which violates the constraints of an ideal continual learning system. Additionally, current approaches that deal with forgetting ignore the problem of catastrophic remembering, i.e. the worsening ability to discriminate between data from different tasks. In our work, we introduce Relevance Mapping Networks (RMNs) which are inspired by the Optimal Overlap Hypothesis. The mappings reflects the relevance of the weights for the task at hand by assigning large weights to essential parameters. We show that RMNs learn an optimized representational overlap that overcomes the twin problem of catastrophic forgetting and remembering. Our approach achieves state-of-the-art performance across all common continual learning datasets, even significantly outperforming data replay methods while not violating the constraints for an ideal continual learning system. Moreover, RMNs retain the ability to detect data from new tasks in an unsupervised manner, thus proving their resilience against catastrophic remembering.

Long-sequence memory tracking places two opposing demands on a recurrent state: near-lossless retention of stored bindings over long horizons, and active overwriting of stale ones. In our diagnostic suite, the strongest efficient baselines tend to solve only one side well. Continuous-time-parameterized state-space models (SSMs) such as Mamba obtain their discrete recurrence by zero-order-hold discretization of a continuous-time system; we argue that this detour is unnecessary for memory tracking and parameterize the discrete transition directly. Naju (Native Adaptive Junction Unit) factorizes the recurrent update, schematically x_n = f_nodot x_{n-1} + i_nodot(B_n u_n), into an explicit discrete pole (a learned forget gate f_n), an independent write gain i_n, and input-dependent write/read maps. Since the sigmoid pole satisfies 0<f_n<1, each frozen local coordinate is Schur-stable by construction, and the full time-varying recurrence satisfies a fading-memory/BIBO bound under uniform boundedness assumptions, with no stability regularizer. We formalize the key structural limitation of coupled designs: any non-expansive complementary single-gate recurrence ties the effective retention r and write gain w through |r|+wle 1, so near-complete retention forces weak writing; decoupling f_n from i_n removes this constraint. Empirically, Naju is the only evaluated model that remains strong on both retention and overwriting at 4x the training length. Beyond the diagnostic suite, we evaluate Naju on WikiText-103 language modeling, Long Range Arena, and multi-query associative recall. Across these settings, Naju consistently combines strong long-range memory with competitive or superior performance, outperforming the Mamba baselines in the principal comparisons while remaining competitive with the Transformer and preserving linear-time, linear-memory scaling.

High Recall Retrieval (HRR), such as eDiscovery and medical systematic review, is a search problem that optimizes the cost of retrieving most relevant documents in a given collection. Iterative approaches, such as iterative relevance feedback and uncertainty sampling, are shown to be effective under various operational scenarios. Despite neural models demonstrating success in other text-related tasks, linear models such as logistic regression, in general, are still more effective and efficient in HRR since the model is trained and retrieves documents from the same fixed collection. In this work, we leverage SPLADE, an efficient retrieval model that transforms documents into contextualized sparse vectors, for HRR. Our approach combines the best of both worlds, leveraging both the contextualization from pretrained language models and the efficiency of linear models. It reduces 10% and 18% of the review cost in two HRR evaluation collections under a one-phase review workflow with a target recall of 80%. The experiment is implemented with TARexp and is available at https://github.com/eugene-yang/LSR-for-TAR.

Continual Learning (CL) focuses on learning from dynamic and changing data distributions while retaining previously acquired knowledge. Various methods have been developed to address the challenge of catastrophic forgetting, including regularization-based, Bayesian-based, and memory-replay-based techniques. However, these methods lack a unified framework and common terminology for describing their approaches. This research aims to bridge this gap by introducing a comprehensive and overarching framework that encompasses and reconciles these existing methodologies. Notably, this new framework is capable of encompassing established CL approaches as special instances within a unified and general optimization objective. An intriguing finding is that despite their diverse origins, these methods share common mathematical structures. This observation highlights the compatibility of these seemingly distinct techniques, revealing their interconnectedness through a shared underlying optimization objective. Moreover, the proposed general framework introduces an innovative concept called refresh learning, specifically designed to enhance the CL performance. This novel approach draws inspiration from neuroscience, where the human brain often sheds outdated information to improve the retention of crucial knowledge and facilitate the acquisition of new information. In essence, refresh learning operates by initially unlearning current data and subsequently relearning it. It serves as a versatile plug-in that seamlessly integrates with existing CL methods, offering an adaptable and effective enhancement to the learning process. Extensive experiments on CL benchmarks and theoretical analysis demonstrate the effectiveness of the proposed refresh learning. Code is available at https://github.com/joey-wang123/CL-refresh-learning.

A dense, pretrained language model can be retrofitted with recurrent depth and learn an iterative latent transition that persists after outcome-only annealing. Qwen2.5-0.5B-Instruct is split into a Prelude, a weight-tied Recurrent Block, and a Coda, with an identity-preserving one-loop path and a re-entry bridge on later loops. At loop 1 the retrofit remains non-inferior to its base on a preregistered ARC battery. Three findings. First, the mechanism is a reusable procedure rather than terminal-answer lookup, and installs at two budgets: 6M trained parameters over frozen base weights and 180M full-block. With intermediate-step supervision, the model computes one task step per loop and persists when only final answers are graded. The adapter matched the full block overall (83.8% versus 84.0%), led through depth 11, and trailed beyond. Verbal fine-tuning reached 79-86% on controlled verbal renderings (zero-shot transfer was minimal), and adapter verbal training begun from the installed mechanism outpaced matched fresh training by 18.6 points, including on a held-out test set. Second, the operation extrapolates to roughly 1.5 times its supervised depth, holding 70% accuracy through depth 18. Third, a same-size scratchpad-trained model matched the recurrent model within its learned horizon but collapsed beyond it. The recurrent model won overall, 84% versus 72%, retained 53% versus 2.5% beyond depth 10, and answered 7.6 times faster. An iterative transformer can therefore perform deeper reasoning in latent space faster than comparable or larger models fine-tuned on the same task, in a system-level comparison. A second task, running the rule in reverse, exposed the limits: the inverse was learnable in isolation, but no continuation acquired it while preserving the installed mechanism and general capability, a catastrophic-interference boundary. Learned depth selection remains open.

Supervised fine-tuning (SFT) trains a base language model to imitate target responses, and these targets may require knowledge the base model has not robustly internalized. We study this as a source of hallucinations and frame a group of mitigation methods as knowledge-aligned SFT: constraining SFT training targets to the base model's parametric knowledge. Under a unified setup, we compare existing generation-based and estimation-based knowledge-alignment methods and introduce two new variants: Evidence Rewrite, which verifies base-model generations using external evidence, and Recall Rewrite, which retains claims only when they can be consistently recalled by the base model. Experiments with Qwen 3 4B and OLMo 3 7B show that knowledge-aligned SFT can reduce factual hallucinations on WildHalu and Biography while largely preserving general capabilities. Recall Rewrite yields the strongest factuality gains and improves refusal behavior on UnknownBench. It thereby confirms that SFT targets beyond the base model's knowledge drive hallucination behavior.

Almost 50% depression patients face the risk of going into relapse. The risk increases to 80% after the second episode of depression. Although, depression detection from social media has attained considerable attention, depression relapse detection has remained largely unexplored due to the lack of curated datasets and the difficulty of distinguishing relapse and non-relapse users. In this work, we present ReDepress, the first clinically validated social media dataset focused on relapse, comprising 204 Reddit users annotated by mental health professionals. Unlike prior approaches, our framework draws on cognitive theories of depression, incorporating constructs such as attention bias, interpretation bias, memory bias and rumination into both annotation and modeling. Through statistical analyses and machine learning experiments, we demonstrate that cognitive markers significantly differentiate relapse and non-relapse groups, and that models enriched with these features achieve competitive performance, with transformer-based temporal models attaining an F1 of 0.86. Our findings validate psychological theories in real-world textual data and underscore the potential of cognitive-informed computational methods for early relapse detection, paving the way for scalable, low-cost interventions in mental healthcare.

Retrieval-Augmented Generation (RAG) grounds Large Language Models (LLMs) in external knowledge but often suffers from flat context representations and stateless retrieval, leading to unstable performance. We propose Stateful Evidence-Driven RAG with Iterative Reasoning, a framework that models question answering as a progressive evidence accumulation process. Retrieved documents are converted into structured reasoning units with explicit relevance and confidence signals and maintained in a persistent evidence pool capturing both supportive and non-supportive information. The framework performs evidence-driven deficiency analysis to identify gaps and conflicts and iteratively refines queries to guide subsequent retrieval. This iterative reasoning process enables stable evidence aggregation and improves robustness to noisy retrieval. Experiments on multiple question answering benchmarks demonstrate consistent improvements over standard RAG and multi-step baselines, while effectively accumulating high-quality evidence and maintaining stable performance under substantial retrieval noise.

Counterfactual medical image generation enables clinicians to explore clinical hypotheses, such as predicting disease progression, facilitating their decision-making. While existing methods can generate visually plausible images from disease progression prompts, they produce silent predictions that lack interpretation to verify how the generation reflects the hypothesized progression -- a critical gap for medical applications that require traceable reasoning. In this paper, we propose Interpretable Counterfactual Generation (ICG), a novel task requiring the joint generation of counterfactual images that reflect the clinical hypothesis and interpretation texts that outline the visual changes induced by the hypothesis. To enable ICG, we present ICG-CXR, the first dataset pairing longitudinal medical images with hypothetical progression prompts and textual interpretations. We further introduce ProgEmu, an autoregressive model that unifies the generation of counterfactual images and textual interpretations. We demonstrate the superiority of ProgEmu in generating progression-aligned counterfactuals and interpretations, showing significant potential in enhancing clinical decision support and medical education. Project page: https://progemu.github.io.

Magnetic Resonance Imaging can produce detailed images of the anatomy and physiology of the human body that can assist doctors in diagnosing and treating pathologies such as tumours. However, MRI suffers from very long acquisition times that make it susceptible to patient motion artifacts and limit its potential to deliver dynamic treatments. Conventional approaches such as Parallel Imaging and Compressed Sensing allow for an increase in MRI acquisition speed by reconstructing MR images from sub-sampled MRI data acquired using multiple receiver coils. Recent advancements in Deep Learning combined with Parallel Imaging and Compressed Sensing techniques have the potential to produce high-fidelity reconstructions from highly accelerated MRI data. In this work we present a novel Deep Learning-based Inverse Problem solver applied to the task of Accelerated MRI Reconstruction, called the Recurrent Variational Network (RecurrentVarNet), by exploiting the properties of Convolutional Recurrent Neural Networks and unrolled algorithms for solving Inverse Problems. The RecurrentVarNet consists of multiple recurrent blocks, each responsible for one iteration of the unrolled variational optimization scheme for solving the inverse problem of multi-coil Accelerated MRI Reconstruction. Contrary to traditional approaches, the optimization steps are performed in the observation domain (k-space) instead of the image domain. Each block of the RecurrentVarNet refines the observed k-space and comprises a data consistency term and a recurrent unit which takes as input a learned hidden state and the prediction of the previous block. Our proposed method achieves new state of the art qualitative and quantitative reconstruction results on 5-fold and 10-fold accelerated data from a public multi-coil brain dataset, outperforming previous conventional and deep learning-based approaches.

Data curriculums have become central to successful LLM training, yet principles governing optimal data placement remain unclear. We introduce the *training re-evaluation curve (TREC)*, a diagnostic that retrospectively evaluates training batches *using the final model weights*. The TREC characterizes how well a trained model retains training data as a function of *when* the data was encountered during training. Analyzing TRECs for models from 111M to 3.9B parameters, we show that placing high-quality data at low points on the TREC significantly improves performance. Importantly, while a TREC is initially observable only after training, we demonstrate it can be *predicted in advance* from AdamW's implicit EMA coefficients, enabling proactive curriculum design. By predicting TRECs for published training recipes, we explain prior ablations and reveal suboptimal data placements. We also align high-quality data with TREC minima in order to improve continual pre-training of a 3.9B-parameter LLM trained on 900B tokens.

Most existing learning-based methods for solving imaging inverse problems can be roughly divided into two classes: iterative algorithms, such as plug-and-play and diffusion methods, that leverage pretrained denoisers, and unrolled architectures that are trained end-to-end for specific imaging problems. Iterative methods in the first class are computationally costly and often provide suboptimal reconstruction performance, whereas unrolled architectures are generally specific to a single inverse problem and require expensive training. In this work, we propose a novel non-iterative, lightweight architecture that incorporates knowledge about the forward operator (acquisition physics and noise parameters) without relying on unrolling. Our model is trained to solve a wide range of inverse problems beyond denoising, including deblurring, magnetic resonance imaging, computed tomography, inpainting, and super-resolution. The proposed model can be easily adapted to unseen inverse problems or datasets with a few fine-tuning steps (up to a few images) in a self-supervised way, without ground-truth references. Throughout a series of experiments, we demonstrate state-of-the-art performance from medical imaging to low-photon imaging and microscopy.

We introduce a unified framework for iterative reasoning that leverages non-Euclidean geometry via Bregman divergences, higher-order operator averaging, and adaptive feedback mechanisms. Our analysis establishes that, under mild smoothness and contractivity assumptions, a generalized update scheme not only unifies classical methods such as mirror descent and dynamic programming but also captures modern chain-of-thought reasoning processes in large language models. In particular, we prove that our accelerated iterative update achieves an O(1/t^2) convergence rate in the absence of persistent perturbations, and we further demonstrate that feedback (iterative) architectures are necessary to approximate certain fixed-point functions efficiently. These theoretical insights bridge classical acceleration techniques with contemporary applications in neural computation and optimization.

Clinical image interpretation is inherently multi-step and tool-centric: clinicians iteratively combine visual evidence with patient context, quantify findings, and refine their decisions through a sequence of specialized procedures. While LLM-based agents promise to orchestrate such heterogeneous medical tools, existing systems treat tool sets and invocation strategies as static after deployment. This design is brittle under real-world domain shifts, across tasks, and evolving diagnostic requirements, where predefined tool chains frequently degrade and demand costly manual re-design. We propose MACRO, a self-evolving, experience-augmented medical agent that shifts from static tool composition to experience-driven tool discovery. From verified execution trajectories, the agent autonomously identifies recurring effective multi-step tool sequences, synthesizes them into reusable composite tools, and registers these as new high-level primitives that continuously expand its behavioral repertoire. A lightweight image-feature memory grounds tool selection in a visual-clinical context, while a GRPO-like training loop reinforces reliable invocation of discovered composites, enabling closed-loop self-improvement with minimal supervision. Extensive experiments across diverse medical imaging datasets and tasks demonstrate that autonomous composite tool discovery consistently improves multi-step orchestration accuracy and cross-domain generalization over strong baselines and recent state-of-the-art agentic methods, bridging the gap between brittle static tool use and adaptive, context-aware clinical AI assistance. Code will be available upon acceptance.

Stronger AI agents do not automatically produce better organizations: teams must also learn which work arrangements to retain and when to reconsider them. We propose a modeling specification for recursive organization improvement and evaluate it through an executable checker, a public-record mapping, and controlled simulation. The specification connects actor-visible histories, organizational memory, decision rights, and evidence-carrying change contracts. The mechanism study crosses six decision rules, three memory conditions, and three task environments under fixed resource ceilings. In a stationary environment, cumulative evidence raises balanced evaluation's normalized net value per task from 0.45224 to 0.48007. Repeated reassessment's disadvantage relative to this comparator falls from 0.01702 with reset evidence to 0.00007 with cumulative evidence. A reversal of the best workflow reveals the opposite cost: indefinite retention delays adaptation, while a finite window restores eventual performance at a transition cost. In exploratory controls, matching trial acquisition and label reuse reduces the apparent reassessment gain from 0.00607 to 0.00191. Program replacement adds no stable benefit across the tested reversal times. The study identifies evidence acquisition, reuse, and timely updating as mechanisms that must be separated from evaluator replacement when assessing organizational improvement.

Large language models have achieved strong performance on medical reasoning benchmarks, yet their deployment in clinical settings demands rigorous verification to ensure factual accuracy. While reward models offer a scalable approach for reasoning trace verification, existing methods face two limitations: they produce only scalar reward values without explicit justification, and they rely on single-pass retrieval that precludes adaptive knowledge access as verification unfolds. We introduce method, an agentic framework that addresses these limitations by training medical reasoning verifiers to iteratively query external medical corpora during evaluation. Our approach combines tool-augmented verification with an iterative reinforcement learning paradigm that requires only trace-level supervision, alongside an adaptive curriculum mechanism that dynamically adjusts training data distribution. Across four medical reasoning benchmarks, method achieves substantial gains over existing methods, improving MedQA accuracy by 23.5% and MedXpertQA by 32.0% relative to the base generator in particular. Crucially, method demonstrates an 8times reduction in sampling budget requirement compared to prior reward model baselines. These findings establish that grounding verification in dynamically retrieved evidence offers a principled path toward more reliable medical reasoning systems.

LLM agents increasingly adapt to recurring tasks by accumulating procedural knowledge in skills. These skills are lightweight, reusable textual artifacts that are loaded into the agent's context without weight updates. Recent methods refine skills through iterative task execution, failure diagnosis, and trajectory-guided text-space updates. However, existing frameworks lack explicit diagnosis--outcome feedback and treat deletion as a generic edit operation rather than a dedicated mechanism for consolidating accumulated knowledge. We introduce SkillProx, a proximal-gradient-inspired forward--backward framework that couples closed-loop diagnostic evolution with utility-aware proximal refinement. Motivated by a composite objective balancing task loss and skill complexity, the forward stage re-executes diagnosis-driven edits on the same task batch, rolls back regressions, and feeds measured outcomes into subsequent diagnoses. The backward stage decomposes the resulting skill into auditable knowledge units, estimates their contributions using a frozen leave-one-out utility audit, and applies validation-gated consolidation, demotion, or removal. Experiments on in-distribution and out-of-distribution benchmarks across multiple backbone LLMs show that SkillProx improves average accuracy by 3.0 percentage points over the strongest gradient-based baseline. Component ablations demonstrate the complementary effects of closed-loop diagnosis and proximal refinement.

Transformer models have established new benchmarks in natural language processing; however, their increasing depth results in substantial growth in parameter counts. While existing recurrent transformer methods address this issue by reprocessing layers multiple times, they often apply recurrence indiscriminately across entire blocks of layers. In this work, we investigate Intra-Layer Recurrence (ILR), a more targeted approach that applies recurrence selectively to individual layers within a single forward pass. Our experiments show that allocating more iterations to earlier layers yields optimal results. These findings suggest that ILR offers a promising direction for optimizing recurrent structures in transformer architectures.

Machine Learning methods can learn how to reconstruct Magnetic Resonance Images and thereby accelerate acquisition, which is of paramount importance to the clinical workflow. Physics-informed networks incorporate the forward model of accelerated MRI reconstruction in the learning process. With increasing network complexity, robustness is not ensured when reconstructing data unseen during training. We aim to embed data consistency (DC) in deep networks while balancing the degree of network complexity. While doing so, we will assess whether either explicit or implicit enforcement of DC in varying network architectures is preferred to optimize performance. We propose a scheme called Cascades of Independently Recurrent Inference Machines (CIRIM) to assess DC through unrolled optimization. Herein we assess DC both implicitly by gradient descent and explicitly by a designed term. Extensive comparison of the CIRIM to CS as well as to other methods is performed: the E2EVN, CascadeNet, KIKINet, LPDNet, RIM, IRIM, and UNet. Models were trained and evaluated on T1-weighted and FLAIR contrast brain data, and T2-weighted knee data. Both 1D and 2D undersampling patterns were evaluated. Robustness was tested by reconstructing 7.5x prospectively undersampled 3D FLAIR MRI data of Multiple Sclerosis (MS) patients with white matter lesions. The CIRIM performed best when implicitly enforcing DC, while the E2EVN required an explicit DC formulation. In reconstructing MS patient data, prospectively acquired with a sampling pattern unseen during model training, the CIRIM maintained lesion contrast while efficiently denoising the images. The CIRIM showed highly promising generalization capabilities maintaining a very fair trade-off between reconstructed image quality and fast reconstruction times, which is crucial in the clinical workflow.

Generalist Large Language Models (LLMs), such as GPT-4, have shown considerable promise in various domains, including medical diagnosis. Rare diseases, affecting approximately 300 million people worldwide, often have unsatisfactory clinical diagnosis rates primarily due to a lack of experienced physicians and the complexity of differentiating among many rare diseases. In this context, recent news such as "ChatGPT correctly diagnosed a 4-year-old's rare disease after 17 doctors failed" underscore LLMs' potential, yet underexplored, role in clinically diagnosing rare diseases. To bridge this research gap, we introduce RareBench, a pioneering benchmark designed to systematically evaluate the capabilities of LLMs on 4 critical dimensions within the realm of rare diseases. Meanwhile, we have compiled the largest open-source dataset on rare disease patients, establishing a benchmark for future studies in this domain. To facilitate differential diagnosis of rare diseases, we develop a dynamic few-shot prompt methodology, leveraging a comprehensive rare disease knowledge graph synthesized from multiple knowledge bases, significantly enhancing LLMs' diagnostic performance. Moreover, we present an exhaustive comparative study of GPT-4's diagnostic capabilities against those of specialist physicians. Our experimental findings underscore the promising potential of integrating LLMs into the clinical diagnostic process for rare diseases. This paves the way for exciting possibilities in future advancements in this field.

In previous work, we established sufficient conditions for recovering geometry and topology from non-random information, demonstrating reconstruction with the Arecibo message. Undeciphered historical records present a related problem: one-way communication without access to their makers' intentions or encoding conventions. Here we extend this framework to the Phaistos Disc, Andean khipu, Rongorongo, Indus inscriptions and the Voynich manuscript, using Egyptian layouts and Arecibo as controls. Algorithmic information dynamics (AID) guides structural perturbations, combining classical information measures, predictive coding, compression and algorithmic-probability-based estimates. Phaistos retains 0.714 bits of excess adjacent-sign mutual information after positional controls; its authentic segmentation lies within a broad information basin, and cross-face boundary prediction achieves AUCs of 0.76 and 0.86. Repetition explains its principal recurrence, while the tested spiral embeddings provide no evidence of additional cross-winding structure. Across several corpora, comparative transfer persists beyond exact shared local pairs. Khipu knot forms distinguish authentic attachments after controlling for degree, depth, fibre and twist (adjusted p=0.009); constrained assignment recovers 8.75\% of concealed parents against 7.87\% expected by chance. Row-alignment tests yield no comparable evidence after correction. Calibrated BDM recovers Arecibo's 23-column width (search-corrected p=0.005), while executable controls detect spatial dependence and eliminate it through interventions on the generator. These findings connect information-based structural reconstruction with interventional reasoning, distinguishing recoverable organisation from semantic decipherment.

Implicit Neural Representations (INRs) have revolutionized signal processing and computer vision by modeling signals as continuous, differentiable functions parameterized by neural networks. However, their inherent formulation as a regression problem makes them prone to regression to the mean, limiting their ability to capture fine details, retain high-frequency information, and handle noise effectively. To address these challenges, we propose Iterative Implicit Neural Representations (I-INRs) a novel plug-and-play framework that enhances signal reconstruction through an iterative refinement process. I-INRs effectively recover high-frequency details, improve robustness to noise, and achieve superior reconstruction quality. Our framework seamlessly integrates with existing INR architectures, delivering substantial performance gains across various tasks. Extensive experiments show that I-INRs outperform baseline methods, including WIRE, SIREN, and Gauss, in diverse computer vision applications such as image restoration, image denoising, and object occupancy prediction.

Longitudinal chest X-ray (CXR) interpretation requires reasoning over disease evolution across multiple patient visits, yet most existing medical VQA benchmarks focus on single images or short-horizon image pairs. We introduce MI-CXR, a benchmark for standardized evaluation of Multi-Interval longitudinal reasoning over multi-visit CXR sequences, without requiring free-form report generation or additional clinical context. MI-CXR comprises five-way multiple-choice questions over five-visit patient timelines and instantiates three complementary task families: Temporal Event Localization, Interval-wise Change Reasoning, and Global Trajectory Summarization, which assess clinically grounded visual reasoning over time. Evaluating 14 state-of-the-art vision-language models (VLMs) shows low overall performance, with an average accuracy of 29.3%, only modestly above random guessing. Using stage-wise diagnostic probing, we find that models often produce locally plausible interval descriptions but fail to enforce temporal constraints or compose evidence into globally consistent decisions over the full timeline. These findings reveal key limitations of current VLMs and establish MI-CXR as a principled benchmark for longitudinal medical reasoning. The benchmark is available at https://github.com/AIDASLab/MI-CXR

Code agents increasingly help developers work with unfamiliar repositories, but every such task depends on a costly prerequisite: bootstrapping the repository into a usable development state. This process requires substantial trial-and-error exploration, yet the resulting knowledge--resolved dependencies, repair strategies--stays trapped in a single conversation, unavailable to future agents. We therefore formulate repository bootstrapping as a reusable startup knowledge problem and introduce BootstrapAgent, a multi-agent framework that distills the heuristics discovered during bootstrap exploration into a persistent, verifiable, agent-consumable .bootstrap contract. Through evidence extraction, structured planning, deterministic Docker-based verification, and trace-driven repair, BootstrapAgent generates a contract covering environment setup, diagnostic checks, minimal verification, and accumulated repair knowledge. We further propose warm repair with clean replay to accelerate iterative debugging without sacrificing cold-start reproducibility, and a delta repair with sanity check to prevent reward hacking. Experiments on three benchmarks show that BootstrapAgent achieves a 92.9% success rate, outperforming the baseline by over 10% while reducing downstream agent token usage by 25.9% and build time by 22.3%. Our code is available at https://github.com/Vossera/BootstrapAgent.

Whole slide image (WSI) analysis has become increasingly important in the medical imaging community, enabling automated and objective diagnosis, prognosis, and therapeutic-response prediction. However, in clinical practice, the ever-evolving environment hamper the utility of WSI analysis models. In this paper, we propose the FIRST continual learning framework for WSI analysis, named ConSlide, to tackle the challenges of enormous image size, utilization of hierarchical structure, and catastrophic forgetting by progressive model updating on multiple sequential datasets. Our framework contains three key components. The Hierarchical Interaction Transformer (HIT) is proposed to model and utilize the hierarchical structural knowledge of WSI. The Breakup-Reorganize (BuRo) rehearsal method is developed for WSI data replay with efficient region storing buffer and WSI reorganizing operation. The asynchronous updating mechanism is devised to encourage the network to learn generic and specific knowledge respectively during the replay stage, based on a nested cross-scale similarity learning (CSSL) module. We evaluated the proposed ConSlide on four public WSI datasets from TCGA projects. It performs best over other state-of-the-art methods with a fair WSI-based continual learning setting and achieves a better trade-off of the overall performance and forgetting on previous task

Self-correction is particularly useful when a failure constrains the next repair. Coding agents benefit from this property because compilers, tests, and execution traces turn many failures into typed recovery signals, but broad language-agent tasks often expose only a coarse task failure. This creates a tension for generic recovery playbooks: they broaden the agent's context precisely when the system needs a narrower repair interface, mixing incompatible signals for invalid actions, missing procedures, and strict-format errors. Our insight is that development-set failures can recover part of the missing diagnostic substrate by deciding which recovery interventions are admissible before test-time correction. We propose DARC, a diagnosis-guided recovery harness that profiles task-family failure modes, prunes mismatched interventions from a shared recovery library, and freezes a verifier-selected success-cost policy for deployment. This causal order makes correction selective: the harness first determines what kind of failure can be repaired, then decides how much recovery evidence to spend. In ALFWorld, AppWorld, and XBRL Finance, the same protocol yields an action-validity harness, a procedural-recovery fallback, and a format-precision retrieval policy; in each evaluated setting it improves average task performance over base agents and broad playbooks while reducing environment steps or retrieval budget. Our experiments show that failures need not trigger uniformly more context: DARC turns self-correction from prompt expansion into recovery-interface design. DARC provides a practical route toward more reliable agents in domains where compiler-like feedback is absent: making failures actionable before making contexts larger.

While Retrieval-Augmented Generation (RAG) mitigates hallucination and knowledge staleness in Large Language Models (LLMs), existing frameworks often falter on complex, multi-hop queries that require synthesizing information from disparate sources. Current advanced RAG methods, employing iterative or adaptive strategies, lack a robust mechanism to systematically identify and fill evidence gaps, often propagating noise or failing to gather a comprehensive context. We introduce FAIR-RAG, a novel agentic framework that transforms the standard RAG pipeline into a dynamic, evidence-driven reasoning process. At its core is an Iterative Refinement Cycle governed by a module we term Structured Evidence Assessment (SEA). The SEA acts as an analytical gating mechanism: it deconstructs the initial query into a checklist of required findings and audits the aggregated evidence to identify confirmed facts and, critically, explicit informational gaps. These gaps provide a precise signal to an Adaptive Query Refinement agent, which generates new, targeted sub-queries to retrieve missing information. This cycle repeats until the evidence is verified as sufficient, ensuring a comprehensive context for a final, strictly faithful generation. We conducted experiments on challenging multi-hop QA benchmarks, including HotpotQA, 2WikiMultiHopQA, and MusiQue. In a unified experimental setup, FAIR-RAG significantly outperforms strong baselines. On HotpotQA, it achieves an F1-score of 0.453 -- an absolute improvement of 8.3 points over the strongest iterative baseline -- establishing a new state-of-the-art for this class of methods on these benchmarks. Our work demonstrates that a structured, evidence-driven refinement process with explicit gap analysis is crucial for unlocking reliable and accurate reasoning in advanced RAG systems for complex, knowledge-intensive tasks.

Looped Transformers repeatedly apply the same set of Transformer layers, giving them a recurrent architecture for latent computation. Their strong performance on iterative reasoning and length-generalization tasks suggests an appealing explanation: recurrence may provide an inductive bias that lets the model reuse a learned algorithm across loops. However, weight sharing alone does not imply that every loop performs the same operation. This raises a basic question: is each loop actually repeating the same computation, and if not, what routes the shared parameters to different operations? We study this question using graph walks as a test case. In the model's native trajectories, decoded predictions can advance by different numbers of graph steps or remain at a reached target, showing that recurrent progress need not follow a fixed one-loop-one-step pattern. We then show that a frozen loop can be steered toward different transitions by modifying its entering hidden state: a learned linear layer J selects the desired transition without changing the shared Transformer layers. To test how this steering works, we use activation patching and find that attention patterns can recover its effects and switch the selected transition. Across five matched pairs of graph models, changing intermediate supervision during backbone training changes which transitions J can induce. This suggests that J selects computations learned by the backbone rather than creating new algorithms. Together, these results show that the hidden state can control shared computation, with attention routing as a causal pathway.

Large Vision-Language Models (VLMs) have demonstrated significant potential on complex visual understanding tasks through iterative optimization methods.However, these models generally lack effective self-correction mechanisms, making it difficult for them to independently rectify cognitive biases. Consequently, during multi-turn revisions, they often fall into repetitive and ineffective attempts, failing to achieve stable improvements in answer quality.To address this issue, we propose a novel iterative self-correction framework that endows models with two key capabilities: Capability Reflection and Memory Reflection. This framework guides the model to first diagnose errors and generate a correction plan via Capability Reflection, then leverage Memory Reflection to review past attempts to avoid repetition and explore new solutions, and finally, optimize the answer through rigorous re-reasoning. Experiments on the challenging OCRBench v2 benchmark show that OCR-Agent outperforms the current open-source SOTA model InternVL3-8B by +2.0 on English and +1.2 on Chinese subsets, while achieving state-of-the-art results in Visual Understanding (79.9) and Reasoning (66.5) - surpassing even larger fine-tuned models. Our method demonstrates that structured, self-aware reflection can significantly enhance VLMs' reasoning robustness without additional training. Code: https://github.com/AIGeeksGroup/OCR-Agent.

Previous research on radiology report generation has made significant progress in terms of increasing the clinical accuracy of generated reports. In this paper, we emphasize another crucial quality that it should possess, i.e., inter-report consistency, which refers to the capability of generating consistent reports for semantically equivalent radiographs. This quality is even of greater significance than the overall report accuracy in terms of ensuring the system's credibility, as a system prone to providing conflicting results would severely erode users' trust. Regrettably, existing approaches struggle to maintain inter-report consistency, exhibiting biases towards common patterns and susceptibility to lesion variants. To address this issue, we propose ICON, which improves the inter-report consistency of radiology report generation. Aiming at enhancing the system's ability to capture the similarities in semantically equivalent lesions, our approach involves first extracting lesions from input images and examining their characteristics. Then, we introduce a lesion-aware mix-up augmentation technique to ensure that the representations of the semantically equivalent lesions align with the same attributes, by linearly interpolating them during the training phase. Extensive experiments on three publicly available chest X-ray datasets verify the effectiveness of our approach, both in terms of improving the consistency and accuracy of the generated reports.

Vision-language models (VLMs) read an image and produce text in a single forward pass, whereas radiologists typically inspect an image several times and consult the literature before writing a report. We introduce GAZE (Grounded Agentic Zero-shot Evaluation), a framework that lets a medical VLM work in this iterative way by calling viewer-level tools (zoom, windowing, contrast, edge detection) and two retrieval tools backed by the U.S. National Library of Medicine (PubMed for medical literature, Open-i for radiological images), with structured outputs validated against a schema and full tool-call traces recorded for auditability. On NOVA, a benchmark of 906 brain MRI cases covering 281 rare neurological conditions, GAZE reaches 58.2 mean average precision (mAP) at intersection-over-union (IoU) 0.3 for lesion localisation and 34.9% Top-1 diagnostic accuracy under a joint protocol that scores captioning, diagnosis, and localisation from the image alone, without task-specific fine-tuning. Before any tool is used, structured prompting and schema-validated outputs already improve over the published Gemini 2.0 Flash baseline (20.2 to 29.4 mAP@0.3), so framework design is itself an experimental variable. Tool use helps rare pathologies disproportionately: the fraction of cases with IoU > 0.3 rises from 17% to 58% for diagnoses with three or fewer examples versus 25% to 68% for common conditions (geq10 cases), with gains tracking engagement (Gemini 3 Flash: Cohen's d = 0.79, 11.8 tool calls per case; Gemini 2.0 Flash: tools used in 8.2% of cases, no significant benefit). Retrieval ablations additionally reveal a model-dependent trade-off in which gains in diagnosis can coincide with losses in localisation, reinforcing the case for joint evaluation of diagnosis, localisation, and captioning in medical VLMs.

Neural architectures such as Recurrent Neural Networks (RNNs), Transformers, and State-Space Models have shown great success in handling sequential data by learning temporal dependencies. Decision Trees (DTs), on the other hand, remain a widely used class of models for structured tabular data but are typically not designed to capture sequential patterns directly. Instead, DT-based approaches for time-series data often rely on feature engineering, such as manually incorporating lag features, which can be suboptimal for capturing complex temporal dependencies. To address this limitation, we introduce ReMeDe Trees, a novel recurrent DT architecture that integrates an internal memory mechanism, similar to RNNs, to learn long-term dependencies in sequential data. Our model learns hard, axis-aligned decision rules for both output generation and state updates, optimizing them efficiently via gradient descent. We provide a proof-of-concept study on synthetic benchmarks to demonstrate the effectiveness of our approach.

Interactive language-model agents increasingly solve complex tasks through long-horizon, multi-call reasoning, where errors in beliefs or actions can compound across tool interactions. Retrospective search can recover from such failures but is prone to misallocation. Delayed outcomes obscure the contribution of intermediate search decisions, leading to Attribution Complexity, while evolving execution evidence leads to Adaptation Complexity, where previously learned estimates become stale. To address these challenges, we first introduce Search Value Dynamics (SVD), which characterizes the evolving trade-off between the gain and cost of retrospective search. Building on SVD, we propose ForkPilot, a self-evolving two-stage policy-learning framework. In the first stage, ForkPilot learns a search-value policy offline from completed trajectories through automatically constructed outcome comparisons. In the second stage, it makes search decisions based on current observations and then self-evolves by incorporating newly completed trajectories into subsequent policy updates. We evaluate ForkPilot across 6 diverse benchmarks and 7 widely used LLM backbone families, including four open-source families, GPT-5.6 Sol, and Opus 4.8 in a production agentic system, against 9 competitive baselines, including a real-world harness deployment used by hundreds of thousands of paid users. ForkPilot achieves comparable state-of-the-art performance while reducing token usage by up to 59.2%, demonstrating its efficacy.

We introduce iterative retrieval, a novel framework that empowers retrievers to make iterative decisions through policy optimization. Finding an optimal portfolio of retrieved items is a combinatorial optimization problem, generally considered NP-hard. This approach provides a learned approximation to such a solution, meeting specific task requirements under a given family of large language models (LLMs). We propose a training procedure based on reinforcement learning, incorporating feedback from LLMs. We instantiate an iterative retriever for composing in-context learning (ICL) exemplars and apply it to various semantic parsing tasks that demand synthesized programs as outputs. By adding only 4M additional parameters for state encoding, we convert an off-the-shelf dense retriever into a stateful iterative retriever, outperforming previous methods in selecting ICL exemplars on semantic parsing datasets such as CalFlow, TreeDST, and MTOP. Additionally, the trained iterative retriever generalizes across different inference LLMs beyond the one used during training.

Learning Rate Rewinding (LRR) has been established as a strong variant of Iterative Magnitude Pruning (IMP) to find lottery tickets in deep overparameterized neural networks. While both iterative pruning schemes couple structure and parameter learning, understanding how LRR excels in both aspects can bring us closer to the design of more flexible deep learning algorithms that can optimize diverse sets of sparse architectures. To this end, we conduct experiments that disentangle the effect of mask learning and parameter optimization and how both benefit from overparameterization. The ability of LRR to flip parameter signs early and stay robust to sign perturbations seems to make it not only more effective in mask identification but also in optimizing diverse sets of masks, including random ones. In support of this hypothesis, we prove in a simplified single hidden neuron setting that LRR succeeds in more cases than IMP, as it can escape initially problematic sign configurations.

Retrieval-Augmented Generation (RAG) models are designed to incorporate external knowledge, reducing hallucinations caused by insufficient parametric (internal) knowledge. However, even with accurate and relevant retrieved content, RAG models can still produce hallucinations by generating outputs that conflict with the retrieved information. Detecting such hallucinations requires disentangling how Large Language Models (LLMs) utilize external and parametric knowledge. Current detection methods often focus on one of these mechanisms or without decoupling their intertwined effects, making accurate detection difficult. In this paper, we investigate the internal mechanisms behind hallucinations in RAG scenarios. We discover hallucinations occur when the Knowledge FFNs in LLMs overemphasize parametric knowledge in the residual stream, while Copying Heads fail to effectively retain or integrate external knowledge from retrieved content. Based on these findings, we propose ReDeEP, a novel method that detects hallucinations by decoupling LLM's utilization of external context and parametric knowledge. Our experiments show that ReDeEP significantly improves RAG hallucination detection accuracy. Additionally, we introduce AARF, which mitigates hallucinations by modulating the contributions of Knowledge FFNs and Copying Heads.

When we speak of recursive self-improvement (RSI), are we speaking of a phenomenon, a mechanism, or a prospect? Towards autonomous and evolving intelligence, RSI is being claimed at many scales, while no single framework that formally describes these emerging instances exists. Its counterpart in the classical realm, iterative policy improvement, is characterized by generalized policy iteration (GPI), a framework of broad applicability with well-understood theoretical properties, but only where the update principle and the evaluation base lie outside the agent. In this paper, we propose Generalized Agent Iteration (GAI), a formal framework that describes iterative policy improvement and RSI as two cases of a single learning paradigm. GAI defines the agent as a configuration of modifiable components within a system and models the learning process as a cycle of agent evaluation and agent improvement. Two pivotal dials then distinguish the instances: whether the improving mechanism is part of the agent and whether the standard it is measured against is grounded outside it. The former dial delineates the boundary between GPI and RSI, and the latter determines a system's polarity as anchored, goal drift, or fully self-referential. Moreover, we use these coordinates to place existing systems on the same two axes and make the defects of recursive self-improvement statable one condition at a time. We see this paper as a first step toward exploring a formal characterization of RSI that rests on the classical account, makes existing systems comparable, and provides a principled basis for analyzing and designing new ones.

Iterative methods are ubiquitous in large-scale scientific computing applications, and a number of approaches based on meta-learning have been recently proposed to accelerate them. However, a systematic study of these approaches and how they differ from meta-learning is lacking. In this paper, we propose a framework to analyze such learning-based acceleration approaches, where one can immediately identify a departure from classical meta-learning. We show that this departure may lead to arbitrary deterioration of model performance. Based on our analysis, we introduce a novel training method for learning-based acceleration of iterative methods. Furthermore, we theoretically prove that the proposed method improves upon the existing methods, and demonstrate its significant advantage and versatility through various numerical applications.

Medical imaging artificial intelligence has achieved strong performance in isolated image interpretation, but remains poorly aligned with radiological practice, where diagnosis and follow-up rely on comparison across prior studies and analogous reference cases. Here we formulate radiological comparison as an entity-aware cross-image reasoning problem and introduce a framework that supports both reference-case retrieval and temporal comparative interpretation. We construct MedReCo-DB, a large-scale comparative imaging resource derived from routine image-report pairs, comprising more than 690,000 images from over 160,000 patients across eight institutions, four countries and seven imaging modalities. Reports are decomposed into anatomical structures, abnormal findings and pathological conditions to provide supervision for entity-conditioned retrieval and comparative visual question answering. Using this resource, we develop MedReCo, an entity-aware visual encoder for controllable retrieval of clinically analogous cases, and MedReCo-VLM, a vision--language extension for generative interpretation of interval change. Across internal, external and cross-center evaluations, MedReCo achieved the highest Recall@1 in all 12 internal retrieval settings and improved external retrieval by a mean of 6.0 percentage points. In clinically confusable differential groups, it consistently outperformed the strongest baselines. MedReCo-VLM achieved the best performance across all comparative generation evaluations and improved longitudinal follow-up accuracy by 14.5-46.5 percentage points on chest radiographs and 13.0-27.9 percentage points on CT. These findings suggest that entity-aware comparative reasoning can be learned from routine clinical data at scale and may provide a more clinically aligned foundation for medical imaging AI.

Vision-Language Models (VLMs) excel at visual understanding but often suffer from visual hallucinations, where they generate descriptions of nonexistent objects, actions, or concepts, posing significant risks in safety-critical applications. Existing hallucination mitigation methods typically follow one of two paradigms: generation adjustment, which modifies decoding behavior to align text with visual inputs, and post-hoc verification, where external models assess and correct outputs. While effective, generation adjustment methods often rely on heuristics and lack correction mechanisms, while post-hoc verification is complicated, typically requiring multiple models and tending to reject outputs rather than refine them. In this work, we introduce REVERSE, a unified framework that integrates hallucination-aware training with on-the-fly self-verification. By leveraging a new hallucination-verification dataset containing over 1.3M semi-synthetic samples, along with a novel inference-time retrospective resampling technique, our approach enables VLMs to both detect hallucinations during generation and dynamically revise those hallucinations. Our evaluations show that REVERSE achieves state-of-the-art hallucination reduction, outperforming the best existing methods by up to 12% on CHAIR-MSCOCO and 28% on HaloQuest. Our dataset, model, and code are available at: https://reverse-vlm.github.io.

Recent advancements demonstrated by DeepSeek-R1 have shown that complex reasoning abilities in large language models (LLMs), including sophisticated behaviors such as self-verification and self-correction, can be achieved by RL with verifiable rewards and significantly improves model performance on challenging tasks such as AIME. Motivated by these findings, our study investigates whether similar reasoning capabilities can be successfully integrated into large vision-language models (LVLMs) and assesses their impact on challenging multimodal reasoning tasks. We consider an approach that iteratively leverages supervised fine-tuning (SFT) on lightweight training data and Reinforcement Learning (RL) to further improve model generalization. Initially, reasoning capabilities were distilled from pure-text R1 models by generating reasoning steps using high-quality captions of the images sourced from diverse visual datasets. Subsequently, iterative RL training further enhance reasoning skills, with each iteration's RL-improved model generating refined SFT datasets for the next round. This iterative process yielded OpenVLThinker, a LVLM exhibiting consistently improved reasoning performance on challenging benchmarks such as MathVista, MathVerse, and MathVision, demonstrating the potential of our strategy for robust vision-language reasoning. The code, model and data are held at https://github.com/yihedeng9/OpenVLThinker.

Medical imaging is widely used in clinical practice for diagnosis and treatment. Report-writing can be error-prone for unexperienced physicians, and time- consuming and tedious for experienced physicians. To address these issues, we study the automatic generation of medical imaging reports. This task presents several challenges. First, a complete report contains multiple heterogeneous forms of information, including findings and tags. Second, abnormal regions in medical images are difficult to identify. Third, the re- ports are typically long, containing multiple sentences. To cope with these challenges, we (1) build a multi-task learning framework which jointly performs the pre- diction of tags and the generation of para- graphs, (2) propose a co-attention mechanism to localize regions containing abnormalities and generate narrations for them, (3) develop a hierarchical LSTM model to generate long paragraphs. We demonstrate the effectiveness of the proposed methods on two publicly available datasets.

Depression poses significant challenges to patients and healthcare organizations, necessitating efficient assessment methods. Existing paradigms typically focus on a patient-doctor way that overlooks multi-role interactions, such as family involvement in the evaluation and caregiving process. Moreover, current automatic depression detection (ADD) methods usually model depression detection as a classification or regression task, lacking interpretability for the decision-making process. To address these issues, we developed InterMind, a doctor-patient-family interactive depression assessment system empowered by large language models (LLMs). Our system enables patients and families to contribute descriptions, generates assistive diagnostic reports for doctors, and provides actionable insights, improving diagnostic precision and efficiency. To enhance LLMs' performance in psychological counseling and diagnostic interpretability, we integrate retrieval-augmented generation (RAG) and chain-of-thoughts (CoT) techniques for data augmentation, which mitigates the hallucination issue of LLMs in specific scenarios after instruction fine-tuning. Quantitative experiments and professional assessments by clinicians validate the effectiveness of our system.

Mental health disorders represent a burgeoning global public health challenge. While Large Language Models (LLMs) have demonstrated potential in psychiatric assessment, their clinical utility is severely constrained by benchmarks that lack ecological validity and fine-grained diagnostic supervision. To bridge this gap, we introduce MentalDx Bench, the first benchmark dedicated to disorder-level psychiatric diagnosis within real-world clinical settings. Comprising 712 de-identified electronic health records annotated by board-certified psychiatrists under ICD-11 guidelines, the benchmark covers 76 disorders across 16 diagnostic categories. Evaluation of 18 LLMs reveals a critical paradigm misalignment: strong performance at coarse diagnostic categorization contrasts with systematic failure at disorder-level diagnosis, underscoring a gap between pattern-based modeling and clinical hypothetico-deductive reasoning. In response, we propose MentalSeek-Dx, a medical-specialized LLM trained to internalize this clinical reasoning process through supervised trajectory construction and curriculum-based reinforcement learning. Experiments on MentalDx Bench demonstrate that MentalSeek-Dx achieves state-of-the-art (SOTA) performance with only 14B parameters, establishing a clinically grounded framework for reliable psychiatric diagnosis.

Conversational memory changes during use, so endpoint question answering alone cannot establish how a persistent state accumulates, ages, or incorporates revisions. We introduce LSREP, a Longitudinal State-Replay Evaluation Protocol combining ordered replay, explicit lifecycle schedules, repeated probes, evolving reference answers, and mechanism-fidelity checks. Its architectural case study is ICE v2, a local-first memory middleware with typed stores, retrieval fusion, and dynamic context budgets. The private, single-user instantiation contains 1,985 turns, 219 distinct probes, and 1,211 probe-checkpoint observations across 52 checkpoints. On three ordinary-density datasets, ICE v2 has a near-zero mean quality difference from vector-RAG while selecting 32% fewer fragments but using 6.6% more estimated prompt tokens. A fourth, dense dataset exposes catastrophic failures of the unbudgeted baseline. The fidelity audit limits attribution: procedural retrieval is defective, several mechanisms are unexercised, and graph utility is not established. In a complementary matched public diagnostic, ICE v2 loses decisively to pure vector-RAG on LongMemEval: 50.8% versus 72.8% in the evidence-only oracle and 43.0% versus 69.5% in full-S. Paired differences are -22.0 points (95% CI [-26.6, -17.4]) and -26.5 ([-31.3, -21.8]). Conservative abstention accompanies severe multi-session and temporal failures. ICE uses less context in this diagnostic, establishing a quality-cost trade-off rather than superior efficiency. Together, replay, fidelity auditing, and public endpoint testing expose distinct failure modes that neither architectural descriptions nor aggregate scores identify alone.

Artificial intelligence has significantly advanced healthcare, particularly through large language models (LLMs) that excel in medical question answering benchmarks. However, their real-world clinical application remains limited due to the complexities of doctor-patient interactions. To address this, we introduce AI Hospital, a multi-agent framework simulating dynamic medical interactions between Doctor as player and NPCs including Patient, Examiner, Chief Physician. This setup allows for realistic assessments of LLMs in clinical scenarios. We develop the Multi-View Medical Evaluation (MVME) benchmark, utilizing high-quality Chinese medical records and NPCs to evaluate LLMs' performance in symptom collection, examination recommendations, and diagnoses. Additionally, a dispute resolution collaborative mechanism is proposed to enhance diagnostic accuracy through iterative discussions. Despite improvements, current LLMs exhibit significant performance gaps in multi-turn interactions compared to one-step approaches. Our findings highlight the need for further research to bridge these gaps and improve LLMs' clinical diagnostic capabilities. Our data, code, and experimental results are all open-sourced at https://github.com/LibertFan/AI_Hospital.

Large language models (LLMs) show promise in medical diagnosis, but real-world deployment remains challenging due to high-stakes clinical decisions and imperfect reasoning reliability. As a result, careful inspection of model behavior is essential for assessing whether diagnostic reasoning is reliable and clinically grounded. However, debugging medical LLMs remains difficult. First, developers often lack sufficient medical domain expertise to interpret model errors in clinically meaningful terms. Second, models can fail across a large and diverse set of instances involving different input types, tasks, and reasoning steps, making it challenging for developers to prioritize which errors deserve focused inspection. Third, developers struggle to identify recurring error patterns across cases, as existing debugging practices are largely instance-centric and rely on manual inspection of isolated failures. To address these challenges, we present VeriLLMed, a visual analytics system that integrates external biomedical knowledge to audit and debug medical LLM diagnostic reasoning. VeriLLMed transforms model outputs into comparable reasoning paths, constructs knowledge graph-grounded reference paths, and identifies three recurring classes of diagnosis errors: relation errors, branch errors, and missing errors. Case studies and expert evaluation demonstrate that VeriLLMed helps developers identify clinically implausible reasoning and generate actionable insights that can inform the improvement of medical LLMs.

Idiopathic pulmonary fibrosis (IPF) is a progressive disease that irreversibly transforms lung tissue into rigid fibrotic structures, leading to debilitating symptoms such as shortness of breath and chronic fatigue. The heterogeneity and complexity of this disease, particularly regarding its severity and progression rate, have made predicting its future course a complex and challenging task. Besides, traditional diagnostic methods based on clinical evaluations and imaging have limitations in capturing the disease's complexity. Using the Kaggle Pulmonary Fibrosis Progression dataset, which includes computed tomography images, and clinical information, the model predicts changes in forced vital capacity (FVC), a key progression indicator. Our method uses a proposed context-aware sequential-parallel hybrid transformer model and clinical information enrichment for its prediction. The proposed method achieved a Laplace Log-Likelihood score of -6.508, outperforming prior methods and demonstrating superior predictive capabilities. These results highlight the potential of advanced deep learning techniques to provide more accurate and timely predictions, offering a transformative approach to the diagnosis and management of IPF, with implications for improved patient outcomes and therapeutic advancements.

The application of large language models (LLMs) in clinical decision support faces significant challenges of "tunnel vision" and diagnostic hallucinations present in their processing unstructured electronic health records (EHRs). To address these challenges, we propose a novel chain-based clinical reasoning framework, called DxChain, which transforms the diagnostic workflow into an iterative process by mirroring a clinician's cognitive trajectory that consists of "Memory Anchoring", "Navigation" and "Verification" phases. DxChain introduces three key methodological innovations to elicit the potential of LLM: (i) a Profile-Then-Plan paradigm to mitigate cold-start hallucinations by establishing a panoramic patient baseline, (ii) a Medical Tree-of-Thoughts (Med-ToT) algorithm for strategic look ahead planning and resource aware navigation, and (iii) a Dialectical Diagnostic Verification procedure utilizing "Angel-Devil" adversarial debates to resolve complex evidence conflicts. Evaluated on two real world benchmarks, MIMIC-IV-Ext Cardiac Disease and MIMIC-IV-Ext CDM, DxChain achieves state-of-the-art performances in both diagnostic accuracy and logical consistency, offering a modular and reliable architecture for next-generation clinical AI. The code is at https://anonymous.4open.science/r/Dx-Chain.

Artificial intelligence has advanced in Medical Visual Question Answering (Med-VQA), but prevalent research tends to focus on the accuracy of the answers, often overlooking the reasoning paths and interpretability, which are crucial in clinical settings. Besides, current Med-VQA algorithms, typically reliant on singular models, lack the robustness needed for real-world medical diagnostics which usually require collaborative expert evaluation. To address these shortcomings, this paper presents MedCoT, a novel hierarchical expert verification reasoning chain method designed to enhance interpretability and accuracy in biomedical imaging inquiries. MedCoT is predicated on two principles: The necessity for explicit reasoning paths in Med-VQA and the requirement for multi-expert review to formulate accurate conclusions. The methodology involves an Initial Specialist proposing diagnostic rationales, followed by a Follow-up Specialist who validates these rationales, and finally, a consensus is reached through a vote among a sparse Mixture of Experts within the locally deployed Diagnostic Specialist, which then provides the definitive diagnosis. Experimental evaluations on four standard Med-VQA datasets demonstrate that MedCoT surpasses existing state-of-the-art approaches, providing significant improvements in performance and interpretability.