Daily Papers

Chain-of-thought (CoT) instructions can distort multiple-choice VLM evaluation when a scorer appends a reasoning cue but reads answer-label logits before the model generates any rationale. We call this CoT-prefix scoring. On ScienceQA, Qwen2.5-VL-7B drops from 80.76% to 45.48%, and across five option-content permutations 93.54% of CoT-prefix predictions select the first slot. Condition-matched linear probes recover 78.94% from the same hidden states, while free generation restores 75.24%, showing that the answer often survives the prefix and the immediate readout fails. Vocabulary and layer diagnostics explain the mismatch: probability mass moves toward continuation tokens, while answer information remains linearly accessible in late layers. The effect recurs with varying severity across datasets and models, though not universally. These results show that CoT-prefix scoring can confound model knowledge with an evaluation-interface mismatch and should be avoided unless the requested and scored output events are aligned.

Long-context inference in decoder-only language models is costly because long prompts are processed during Prefill, cached at every layer, and repeatedly attended to during autoregressive Decode. We introduce Shallow Prefill, dEEp Decode (SPEED), a phase-asymmetric KV-visibility policy that materializes non-anchor prompt-token KV states only in lower layers while keeping Decode-phase tokens full-depth. Unlike previous approaches that make upper-layer prompt KV states cheaper to store or construct, SPEED removes prefill tokens from the upper-layer Decode visibility set altogether. With a minimal BoS anchor, this simple change preserves broad benchmark quality while reducing long-context cost. In a controlled Llama-3.1-8B instruction-tuning study, SPEED using only 75\% of layers for prefill tokens reaches 51.2 average score on OLMES-style benchmarks, compared with 51.4 for the full-depth baseline, while improving TTFT by 33\%, TPOT by 22\%, and reducing active KV memory by 25.0\% at 128K context. Layer-wise diagnostics suggest that this cutoff retains the main prompt-selection and representation-stabilization regions of the full-depth model. These results show that long-context prompt tokens need not always persist as full-depth KV-cache objects when Decode-phase tokens remain full-depth.

Large language models with billions of parameters are often over-provisioned: many layers contribute little unique information yet dominate the memory and energy footprint during inference. We present LieQ, a metric-driven post-training quantization framework that addresses the critical challenge of maintaining accuracy in sub-7B models under extreme low-bit compression. Our method introduces three complementary layer-wise diagnostics-Perplexity Drop, Representational Compactness, and Top-k Energy Gain -that reveal a canonical division of labour across layers, enabling automatic bit-width allocation without gradient updates. Unlike existing approaches that suffer severe accuracy degradation at 2-3 bits precision, LieQ achieves state-of-the-art compression-accuracy trade-offs: on Qwen3-4B, it recovers 95.9% of FP16 baseline performance at 2.05-bit quantization, outperforming GPTQ by 19.7% and AWQ by 18.1% on average across seven zero-shot reasoning tasks. Applied to LLaMA3.2-3B, LieQ maintains 98.2% of baseline accuracy at 2.07-bit precision while enabling 4x memory reduction, establishing new paradigms for deploying small language models on resource-constrained edge devices.

Forward-Forward (FF) training allows each layer to learn from a local goodness criterion. In cumulative-goodness variants, however, later layers can inherit a task that earlier layers have already partially separated. We formalize this phenomenon as layer free-riding: under the softplus FF criterion, the class-discrimination gradient reaching block d decays exponentially with the positive margin accumulated by preceding blocks. We then study three local remedies -- per-block, hardness-gated, and depth-scaled -- that recover current-layer separation measures without relying on backpropagated gradients. On CIFAR-10 and CIFAR-100, these remedies dramatically improve layer-separation statistics, with 4times--45times gains in deeper layers, while changing accuracy by less than one percentage point for non-degenerate training procedures. Tiny ImageNet provides a tougher cross-dataset check for our selected block-wise configuration and reveals the same qualitative gap between layer-health diagnostics and final accuracy. Calibration experiments further show that architecture and augmentation choices have a larger effect on final accuracy than the training-rule modifications studied here. Cumulative free-riding is therefore a real and repairable optimization pathology. Nonetheless, for the FF training rules, architectures, and datasets we study, it is not the dominant factor limiting achievable accuracy.

Training loss and throughput can hide distinct internal representation in language-model training. To examine these hidden mechanics, we use spectral measurements as practical and operational diagnostics. Using a controlled family of decoder-only models adapted from the modded NanoGPT codebase, we introduce an empirical protocol based on activation covariance and per-sample gradient SVD spectra. This dual-view reveals three empirical findings and one mechanistic explanation. First, batch size acts as a latent determinant of representation geometry: runs that reach equal loss settle into systematically distinct activation spectra. Second, the activation covariance tail measured early in training reliably forecasts downstream token efficiency. Third, movement of the activation spectrum head (leading modes), together with gradient spectra, characterizes underlying learning-dynamics changes, separating learning-side architectural improvements from primarily execution-side gains. These predictive and diagnostic signals persist across the 12-, 36-, and 48-layer model tiers. Finally, a mechanistic model proves the main observations and explains how activation covariance spectra correlate with task-aligned feature learning.

Healthcare automation is shaped by local procedures and organizational constraints, so agent capabilities rarely transfer unchanged across settings. Agent skills, self-contained directories that package reusable procedures for AI agents, are emerging as a procedural layer for adapting healthcare agents across diverse healthcare settings. We present the first empirical analysis of healthcare agent skills, drawing on 557 healthcare-related skills filtered from 58,159 public skills on ClawHub and annotated along ten dimensions covering function, deployment context, autonomy, and safety. We find that public healthcare skills emphasize patient-facing workflow automation and monitoring rather than the diagnostic and treatment-oriented tasks foregrounded in healthcare-agent research; coverage of the healthcare lifecycle and specialized clinical inputs remains uneven; and general technical risk does not reliably capture clinical risk. These findings position healthcare skills as a procedural layer not yet addressed by current benchmarks and risk frameworks.

Finding interpretable directions in language-model representations is critical for understanding and controlling model behavior. Sparse autoencoders (SAEs) have become the standard tool for this purpose, but using them as the default first lens often requires training, storing, and evaluating large overcomplete dictionaries. This bottleneck limits rapid exploration and raises a fundamental question: how much interpretable structure is already visible from activation geometry before training another neural dictionary? Our intuition is simple: many interpretable directions are selective on tokens, and these directions should look less Gaussian than random directions. We therefore revisit independent component analysis (ICA), a classical method for finding non-Gaussian directions, as a compact lens for language-model interpretability. We find that ICA has been underestimated for LLM interpretability, because prior uses often relied on off-the-shelf ICA implementations that are brittle on LLM activations and lacked systematic tools for inspecting and evaluating the recovered directions. To bridge these gaps, we introduce ICALens, the first practical workflow for stable, efficient, and auditable ICA analysis of LLM representations. It combines an optimized GPU-parallel FastICA pipeline with LLM-specific stability recipes and better fitting diagnostics, enabling efficient and reliable layer-wise analysis. Across GPT-2 Small, Gemma 2 2B, and Qwen 3.5 2B Base, ICALens efficiently recovers compact, human-interpretable directions without per-layer gradient-based dictionary training. On SAEBench, ICA is competitive with public SAEs in sparse probing and outperforms them in targeted probe perturbation under small-to-medium budgets. These results suggest that ICA should not be viewed as a weak baseline, but as an efficient and complementary first lens for exploring language-model representations.

We apply the Weibull distribution -- a two-parameter family from extreme-value theory -- as a diagnostic framework for element-wise weight magnitude distributions in transformers. At initialization, i.i.d. Gaussian weights give |w| ~ HalfNormal, yielding k ~ 1.20 via middle-80% probability-plot fit (the protocol used throughout this work). This anchor makes k a principled, architecture-independent measuring stick for training dynamics; fitting each weight matrix independently at every layer at every checkpoint enables per-component, per-layer, and per-step diagnostics that aggregate statistics cannot resolve. Applying this framework to 12 model entries spanning 7 architectural families (Pythia, OLMo-1/2, LLaMA-3, Mistral, Qwen2.5/3) reveals three findings. First, FFN modules and the attention output projection W_o -- the Transmission Class -- fall in a narrow k band: median terminal k in [1.186, 1.204] across 12 entries (cross-family CV = 0.51%), shared across SwiGLU/GeLU activations, Pre-LN/QK-Norm placements, and 70M-14B sizes. Second, the attention input projections W_q, W_k -- the Selection Class -- depart from the Weibull family, with severity shaped by storage: separately-stored Q/K (OLMo-1, OLMo-2) yields k in [0.76, 0.99] (deep); GQA models yield k in [1.10, 1.16] (mild); Pythia's merged W_qkv occupies a transitional zone tracking training budget T/tau monotonically. Third, lambda grows substantially during training and scales with sqrt(eta/lambda_wd) within the Pythia family (Pearson r = 0.94, three Transmission kinds), directionally consistent with Fan et al. (2025). The two parameters carry independent information: k labels the functional class, lambda labels training progress. We release npm-weibull-py v0.4 (Python library) and DATABASE_v9_1 at https://github.com/tiexinding/NPM-Weibull-public .

Hybrid language models combine softmax attention with linear-time sequence mechanisms such as state-space or linear-attention layers, but the functional contribution of each component type remains insufficiently characterized. We study component-level ablation in two sub-1B hybrid language models, Qwen3.5-0.8B and Falcon-H1-0.5B, using likelihood-based evaluation, downstream benchmarks, layer-wise interventions, random controls, and representation-level diagnostics. Across the tested models, removing either attention or the alternative sequence-processing pathway substantially degrades performance, indicating that both component types contribute to model behavior. Likelihood metrics are especially sensitive to the linear-attention or state-space pathway, while downstream benchmark degradation depends on task and architecture. Layer-wise ablations show that component importance is position-dependent, with the strongest effects concentrated in early or mid-network components rather than uniformly across depth. Random-removal controls further show that hybrid architectures and same-family Transformer baselines degrade differently under structural perturbation. These results suggest that component ablation is a useful diagnostic for understanding hybrid language model architectures. The findings provide evidence relevant to efficient model design, compression, robustness analysis, and deployment decisions in architectures that combine attention with alternative sequence-processing mechanisms.

Steering vectors work for some concepts and layers but fail for others, and practitioners have no way to predict which setting applies before running an intervention. We introduce the Linear Accessibility Profile (LAP), a per-layer diagnostic that repurposes the logit lens as a predictor of steering vector effectiveness. The key measure, A_{lin}, applies the model's unembedding matrix to intermediate hidden states, requiring no training. Across 24 controlled binary concept families on five models (Pythia-2.8B to Llama-8B), peak A_{lin} predicts steering effectiveness at ρ= +0.86 to +0.91 and layer selection at ρ= +0.63 to +0.92. A three-regime framework explains when difference-of-means steering works, when nonlinear methods are needed, and when no method can work. An entity-steering demo confirms the prediction end-to-end: steering at the LAP-recommended layer redirects completions on Gemma-2-2B and OLMo-2-1B-Instruct, while the middle layer (the standard heuristic) has no effect on either model.

Sophisticated instrumentation for AI systems might have indicators that signal misalignment from human values, not unlike a "check engine" light in cars. One such indicator of misalignment is deceptiveness in generated responses. Future AI instrumentation may have the ability to detect when an LLM generates deceptive responses while reasoning about seemingly plausible but incorrect answers to factual questions. In this work, we demonstrate that linear probes on LLMs internal activations can detect deception in their responses with extremely high accuracy. Our probes reach a maximum of greater than 90% accuracy in distinguishing between deceptive and non-deceptive arguments generated by llama and qwen models ranging from 1.5B to 14B parameters, including their DeepSeek-r1 finetuned variants. We observe that probes on smaller models (1.5B) achieve chance accuracy at detecting deception, while larger models (greater than 7B) reach 70-80%, with their reasoning counterparts exceeding 90%. The layer-wise probe accuracy follows a three-stage pattern across layers: near-random (50%) in early layers, peaking in middle layers, and slightly declining in later layers. Furthermore, using an iterative null space projection approach, we find multitudes of linear directions that encode deception, ranging from 20 in Qwen 3B to nearly 100 in DeepSeek 7B and Qwen 14B models.

Chest X-ray plays a central role in thoracic diagnosis, and its interpretation inherently requires multi-step, evidence-grounded reasoning. However, large vision-language models (LVLMs) often generate plausible responses that are not faithfully grounded in diagnostic evidence and provide limited visual evidence for verification, while also requiring costly retraining to support new diagnostic tasks, limiting their reliability and adaptability in clinical settings. To address these limitations, we present CXReasonAgent, a diagnostic agent that integrates a large language model (LLM) with clinically grounded diagnostic tools to perform evidence-grounded diagnostic reasoning using image-derived diagnostic and visual evidence. To evaluate these capabilities, we introduce CXReasonDial, a multi-turn dialogue benchmark with 1,946 dialogues across 12 diagnostic tasks, and show that CXReasonAgent produces faithfully grounded responses, enabling more reliable and verifiable diagnostic reasoning than LVLMs. These findings highlight the importance of integrating clinically grounded diagnostic tools, particularly in safety-critical clinical settings.

The clinical translation of dermatological AI is hindered by opaque reasoning and systematic performance disparities across skin tones. Here we present SkinGPT-R1, a multimodal large language model that integrates chain-of-thought diagnostic reasoning with a fairness-aware mixture-of-experts architecture for interpretable and equitable skin disease diagnosis. Through parameter-efficient adaptation of a frozen reasoning backbone, SkinGPT-R1 generates structured diagnostic reports comprising visual findings, differential reasoning, and final diagnosis. Across seven external datasets spanning diverse pathologies and imaging conditions, SkinGPT-R1 achieves state-of-the-art accuracy on six benchmarks, including 82.50\% on a challenging 40-class long-tail classification task (+19.30\% over leading baselines). Blinded evaluation by five board-certified dermatologists on 1,000 phenotypically balanced cases yields a mean score of 3.6 out of 5, with the highest ratings in safety (3.8) and reasoning coherence (3.6), indicating that the generated rationales are clinically safe, logically grounded, and suitable for supporting diagnostic decision-making. Critically, SkinGPT-R1 mitigates algorithmic bias across the full Fitzpatrick spectrum, achieving a robust worst-group performance of 41.40\% on the Fitz17k benchmark and a five-fold relative improvement in lower-bound accuracy on the DDI dataset compared to standard multimodal baselines. These results establish a framework for trustworthy, fair, and explainable AI-assisted dermatological diagnosis.

Chest X-rays are widely used to diagnose thoracic diseases, but the lack of detailed information about these abnormalities makes it challenging to develop accurate automated diagnosis systems, which is crucial for early detection and effective treatment. To address this challenge, we employed deep learning techniques to identify patterns in chest X-rays that correspond to different diseases. We conducted experiments on the "ChestX-ray14" dataset using various pre-trained CNNs, transformers, hybrid(CNN+Transformer) models and classical models. The best individual model was the CoAtNet, which achieved an area under the receiver operating characteristic curve (AUROC) of 84.2%. By combining the predictions of all trained models using a weighted average ensemble where the weight of each model was determined using differential evolution, we further improved the AUROC to 85.4%, outperforming other state-of-the-art methods in this field. Our findings demonstrate the potential of deep learning techniques, particularly ensemble deep learning, for improving the accuracy of automatic diagnosis of thoracic diseases from chest X-rays. Code available at:https://github.com/syednabilashraf/SynthEnsemble

Existing routers rely on semantic query features or handcrafted features, which often fail to capture model-specific failures or intrinsic task difficulty. We instead route using internal LLM activations, specifically the residual stream. Our key idea, Encoder-Target Decoupling, separates the model that produces the predictive signal (the Encoder) from the model whose correctness is being estimated (the Target), allowing open-weight encoders to predict the performance of closed-source target models. We evaluate layerwise geometric probes, finding that Fisher Separability (J) effectively identifies informative layers, supported by Effective Dimensionality (d_{eff}) diagnostics. We then utilize a SharedTrunkNet, a joint multi-output MLP that predicts simultaneous correctness probabilities across candidate models using concatenated prefill features. In our experiments, SharedTrunkNet consistently outperforms semantic baselines. At its best, SharedTrunkNet closes 45.58% of the gap between the strongest standalone model and the oracle while achieving 74.31% cost savings relative to the most expensive model. These results demonstrate that prefill activations provide a robust routing signal, establishing activation-based routing as a high-performance alternative to purely semantic selection.

Hidden-state probes effectively detect LLM hallucinations, but the geometry of the signal remains poorly characterized, driving increasingly complex probe architectures. Across three 7B-scale models and three datasets in a paired-example paradigm, we find the signal overwhelmingly dominated by a single mean-shift component, and removing this direction collapses detection to chance. Shrinkage linear discriminant analysis closes about 73% of the gap between 1D and full-dimensional classifiers, so apparent architectural complexity largely reflects high-dimensional covariance estimation difficulty rather than exploitable non-linearity. A simple L2-regularized logistic regression (0.952 AUROC) bounds or outperforms twelve controlled architectural alternatives, and our multi-layer aggregation exceeds CLAP cross-layer attention probing under matched paradigm. Because the signal spans a contiguous layer band, LayerMix aggregates it to match oracle-layer performance without oracle access. Our claims characterize the geometry within the controlled paired-example paradigm. Our code is available at https://github.com/js-lee-AI/LayerMix.

Neural network models have a reputation for being black boxes. We propose to monitor the features at every layer of a model and measure how suitable they are for classification. We use linear classifiers, which we refer to as "probes", trained entirely independently of the model itself. This helps us better understand the roles and dynamics of the intermediate layers. We demonstrate how this can be used to develop a better intuition about models and to diagnose potential problems. We apply this technique to the popular models Inception v3 and Resnet-50. Among other things, we observe experimentally that the linear separability of features increase monotonically along the depth of the model.

Diagnosing lung cancer typically involves physicians identifying lung nodules in Computed tomography (CT) scans and generating diagnostic reports based on their morphological features and medical expertise. Although advancements have been made in using multimodal large language models for analyzing lung CT scans, challenges remain in accurately describing nodule morphology and incorporating medical expertise. These limitations affect the reliability and effectiveness of these models in clinical settings. Collaborative multi-agent systems offer a promising strategy for achieving a balance between generality and precision in medical applications, yet their potential in pathology has not been thoroughly explored. To bridge these gaps, we introduce LungNoduleAgent, an innovative collaborative multi-agent system specifically designed for analyzing lung CT scans. LungNoduleAgent streamlines the diagnostic process into sequential components, improving precision in describing nodules and grading malignancy through three primary modules. The first module, the Nodule Spotter, coordinates clinical detection models to accurately identify nodules. The second module, the Radiologist, integrates localized image description techniques to produce comprehensive CT reports. Finally, the Doctor Agent System performs malignancy reasoning by using images and CT reports, supported by a pathology knowledge base and a multi-agent system framework. Extensive testing on two private datasets and the public LIDC-IDRI dataset indicates that LungNoduleAgent surpasses mainstream vision-language models, agent systems, and advanced expert models. These results highlight the importance of region-level semantic alignment and multi-agent collaboration in diagnosing nodules. LungNoduleAgent stands out as a promising foundational tool for supporting clinical analyses of lung nodules.

Pre-trained Transformers often exhibit over-confidence in source patterns and difficulty in forming new target-domain patterns during fine-tuning. We formalize the mechanism of output saturation leading to gradient suppression through standard cross-entropy and softmax analysis, showing that gradient suppression at inflection layers confines adaptation to high-level recombination of existing features while preventing low-level reconstruction. We introduce a set of layer-wise diagnostic metrics -- attention entropy (saturation proxy), activation gradient norm, parameter gradient norm, and Delta-CKA under a shared PCA basis -- to identify inflection layers characterized by both low attention entropy and steep gradient decay. Building on these findings, we propose a diagnose-first, inject-light fine-tuning strategy: selectively inserting LoRA adapters at inflection layers to restore suppressed backward signals with minimal parameter overhead. Experiments on BERT-base transfer from SST-2 to Rotten Tomatoes under under-trained and over-trained source regimes reveal that over-trained initialization benefits from inflection-layer LoRA injection, while under-trained initialization suffers performance degradation. When base features are strong, unblocking inflection layers facilitates high-level compositional adaptation; when base features are weak, full-pathway unblocking is required for low-level reconstruction, as supported by joint analysis of layer-wise activation gradients and Delta-CKA dynamics.

Manipulation understanding requires reliable relational evidence, such as contact, support, containment, motion coupling, grasp, release, and active-hand involvement. Although these visual predicates are widely used in event-chain, graph-based, and neuro-symbolic models, their reliability under visual degradation is rarely analyzed directly. This paper introduces a predicate-level reliability framework for robust manipulation understanding under blur, occlusion, illumination change, low resolution, frame dropping, and detection noise. The framework defines a structured predicate vocabulary, confidence-aware predicate estimation, and reliability metrics for predicate preservation, degradation sensitivity, temporal consistency, confidence-weighted stability, and downstream impact. Experiments on controlled manipulation videos and public egocentric or bimanual datasets, including VISOR/EPIC-KITCHENS, H2O, and ARCTIC, show that predicate failures are structured rather than uniform. Static spatial predicates remain comparatively robust, whereas contact-sensitive, dynamic, and derived predicates such as grasp and release are more fragile. Under severe degradation, detection noise, occlusion, and frame dropping cause the strongest reliability losses. Downstream analysis shows that degraded predicates reduce manipulation-understanding accuracy from 0.89 to 0.58, while removing confidence weighting under moderate degradation reduces accuracy from 0.74 to 0.64. These results show that predicate reliability provides a diagnostic layer between visual perception and structured manipulation reasoning.

Large language models(LLMs) excel at text generation and knowledge question-answering tasks, but they are prone to generating hallucinated content, severely limiting their application in high-risk domains. Current hallucination detection methods based on uncertainty estimation and external knowledge retrieval suffer from the limitation that they still produce erroneous content at high confidence levels and rely heavily on retrieval efficiency and knowledge coverage. In contrast, probe methods that leverage the model's hidden-layer states offer real-time and lightweight advantages. However, traditional linear probes struggle to capture nonlinear structures in deep semantic spaces.To overcome these limitations, we propose a neural network-based framework for token-level hallucination detection. By freezing language model parameters, we employ lightweight MLP probes to perform nonlinear modeling of high-level hidden states. A multi-objective joint loss function is designed to enhance detection stability and semantic disambiguity. Additionally, we establish a layer position-probe performance response model, using Bayesian optimization to automatically search for optimal probe insertion layers and achieve superior training results.Experimental results on LongFact, HealthBench, and TriviaQA demonstrate that MLP probes significantly outperform state-of-the-art methods in accuracy, recall, and detection capability under low false-positive conditions.

Recent Vision-Language Models (e.g., ColPali) enable fine-grained Visual Document Retrieval (VDR) but incur prohibitive multi-vector index storage overhead. Existing training-free pruning methods either rely on heuristic layer choices or degrade sharply under aggressive compression, leading prior work to argue that effective high-compression pruning requires query-dependent training. We challenge this view with Structural Anchor Pruning (SAP), a self-calibrating, training-free, and query-agnostic index-time pruning framework with three components: (i) Score Retention (SR), a white-box per-layer compression diagnostic; (ii) SR-guided window selection, a procedure that automatically locates the structural pruning region for any backbone with no per-model hyperparameters; and (iii) a visual in-degree centrality scorer that identifies anchor patches within the selected window. On the ViDoRe v1/v2 benchmarks across three architectures spanning 18, 28, and 36 backbone layers, SAP retains over 90\% of NDCG@5 while pruning more than 90\% of visual tokens, without any per-model parameter tuning. Our layer-resolved SR analysis reveals an Alignment-Aggregation Divergence: the document's visual structure is preserved as a stable ``Structural Plateau'' within the backbone, but the final layers reshape this representation into a sparse, query-aligned form that is no longer suitable for pruning. This is the mechanistic reason SAP succeeds where final-layer methods fail.

We present Darwin Family, a framework for training-free evolutionary merging of large language models via gradient-free weight-space recombination. We ask whether frontier-level reasoning performance can be improved without additional training, by reorganizing latent capabilities already encoded in existing checkpoints. Darwin introduces three key ideas: (i) a 14-dimensional adaptive merge genome enabling fine-grained component- and block-level recombination; (ii) MRI-Trust Fusion, which adaptively balances diagnostic layer-importance signals with evolutionary search through a learnable trust parameter; and (iii) an Architecture Mapper that enables cross-architecture breeding between heterogeneous model families. Empirically, the flagship Darwin-27B-Opus achieves 86.9% on GPQA Diamond, ranking #6 among 1,252 evaluated models, and outperforming its fully trained foundation model without any gradient-based training. Across scales from 4B to 35B parameters, Darwin models consistently improve over their parents, support recursive multi-generation evolution, and enable a training-free evolutionary merge that combines Transformer- and Mamba-based components. Together, the Darwin Family demonstrates that diagnostic-guided evolutionary merging is a practical and reproducible alternative to costly post-training pipelines for reasoning-centric language models.

Magnetic Resonance Imaging (MRI) is a widely-accepted imaging technique for knee injury analysis. Its advantage of capturing knee structure in three dimensions makes it the ideal tool for radiologists to locate potential tears in the knee. In order to better confront the ever growing workload of musculoskeletal (MSK) radiologists, automated tools for patients' triage are becoming a real need, reducing delays in the reading of pathological cases. In this work, we present the Efficiently-Layered Network (ELNet), a convolutional neural network (CNN) architecture optimized for the task of initial knee MRI diagnosis for triage. Unlike past approaches, we train ELNet from scratch instead of using a transfer-learning approach. The proposed method is validated quantitatively and qualitatively, and compares favorably against state-of-the-art MRNet while using a single imaging stack (axial or coronal) as input. Additionally, we demonstrate our model's capability to locate tears in the knee despite the absence of localization information during training. Lastly, the proposed model is extremely lightweight (< 1MB) and therefore easy to train and deploy in real clinical settings. The code for our model is provided at: https://github.com/mxtsai/ELNet.

Accurate diagnosis with medical large language models is hindered by knowledge gaps and hallucinations. Retrieval and tool-augmented methods help, but their impact is limited by weak use of external knowledge and poor feedback-reasoning traceability. To address these challenges, We introduce Deep-DxSearch, an agentic RAG system trained end-to-end with reinforcement learning (RL) that enables steer tracebale retrieval-augmented reasoning for medical diagnosis. In Deep-DxSearch, we first construct a large-scale medical retrieval corpus comprising patient records and reliable medical knowledge sources to support retrieval-aware reasoning across diagnostic scenarios. More crutially, we frame the LLM as the core agent and the retrieval corpus as its environment, using tailored rewards on format, retrieval, reasoning structure, and diagnostic accuracy, thereby evolving the agentic RAG policy from large-scale data through RL. Experiments demonstrate that our end-to-end agentic RL training framework consistently outperforms prompt-engineering and training-free RAG approaches across multiple data centers. After training, Deep-DxSearch achieves substantial gains in diagnostic accuracy, surpassing strong diagnostic baselines such as GPT-4o, DeepSeek-R1, and other medical-specific frameworks for both common and rare disease diagnosis under in-distribution and out-of-distribution settings. Moreover, ablation studies on reward design and retrieval corpus components confirm their critical roles, underscoring the uniqueness and effectiveness of our approach compared with traditional implementations. Finally, case studies and interpretability analyses highlight improvements in Deep-DxSearch's diagnostic policy, providing deeper insight into its performance gains and supporting clinicians in delivering more reliable and precise preliminary diagnoses. See https://github.com/MAGIC-AI4Med/Deep-DxSearch.

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.

Vision-language models, such as contrastive language-image pre-training (CLIP)-based approaches, have reached state-of-the-art (SOTA) results in medical artificial intelligence. However, recent work reveals that CLIP-based models remain vulnerable to shortcuts. We investigate how real-world shortcuts manifest across different layers of the medical CLIP-based model, MedCLIP, and its vision encoder, a frozen ResNet-50. We attach 17 linear classification probes to the intermediate layers of the ResNet-50 and train them on three different dataset configurations and targets: NIH-CXR14 (pneumothorax) and PadChest (cardiomegaly and pneumothorax). This setup allows us to observe model behaviour during evaluation using subgroup-based calibration and layer-wise confidence curves. We find that the final linear probes achieve a high AUROC but poor calibration in the models. The layer-wise confidence analyses suggest that shortcuts emerge at different depths. Patterns consistent with localised shortcuts, such as drains, appear at later layers, while patterns consistent with diffuse shortcuts, such as scanner-specific noise patterns, emerge earlier, aligning with previous work. Finally, we conduct a manual analysis of the images, which reveals data quality issues in both NIH-CXR14 and PadChest. Our findings underscore that even SOTA models remain vulnerable to shortcuts, and the need for high-quality and well-annotated datasets to draw solid conclusions. Code can be found on our GitHub: https://github.com/nikodice4/MedCLIP_shortcuts.

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.

This work examines whether activating latent subspaces in language models (LLMs) can steer scientific code generation toward a specific programming language. Five causal LLMs were first evaluated on scientific coding prompts to quantify their baseline bias among four programming languages. A static neuron-attribution method, perturbing the highest activated MLP weight for a C++ or CPP token, proved brittle and exhibited limited generalization across prompt styles and model scales. To address these limitations, a gradient-refined adaptive activation steering framework (G-ACT) was developed: per-prompt activation differences are clustered into a small set of steering directions, and lightweight per-layer probes are trained and refined online to select the appropriate steering vector. In LLaMA-3.2 3B, this approach reliably biases generation towards the CPP language by increasing the average probe classification accuracy by 15% and the early layers (0-6) improving the probe classification accuracy by 61.5% compared to the standard ACT framework. For LLaMA-3.3 70B, where attention-head signals become more diffuse, targeted injections at key layers still improve language selection. Although per-layer probing introduces a modest inference overhead, it remains practical by steering only a subset of layers and enables reproducible model behavior. These results demonstrate a scalable, interpretable and efficient mechanism for concept-level control for practical agentic systems.

Foundation Models (FMs) have recently redefined the state-of-the-art in histopathology by providing robust representations for whole-slide image (WSI) analysis. However, selecting the optimal foundation model (FM) for a specific clinical cohort currently requires multiple preprocessing steps, followed by computationally expensive feature extraction and the training of a Multiple Instance Learning (MIL) aggregator for every model. In this work, we investigate whether efficient tile-level linear probing can serve as a reliable proxy for slide-level performance, reducing the need to run full slide-level pipelines for every candidate encoder. We benchmark 19 state-of-the-art FMs on 42 slide-level and 16 tile-level tasks, comparing tile probing metrics against slide-level outcomes using ABMIL and Mean Pooling aggregations. We observe a high correlation between tile and slide performance across varying task difficulties, indicating that encoder representation quality is the primary determinant of WSI success. Sensitivity analyses show that transferability is stable across models and is more influenced by cohort sizes and numbers of tiles per slide than by average task difficulty. We also measure the agreement in best performing models between tile and slide-level tasks, showing tile benchmarks reliably shortlist strong candidates. Overall, our study indicates that tile-level benchmarking provides an efficient and practical first step for narrowing down candidate models, while slide-level evaluation remains essential for final validation on clinical tasks.

Reading and interpreting chest X-ray images is one of the most radiologist's routines. However, it still can be challenging, even for the most experienced ones. Therefore, we proposed a multi-model deep learning-based automated chest X-ray report generator system designed to assist radiologists in their work. The basic idea of the proposed system is by utilizing multi binary-classification models for detecting multi abnormalities, with each model responsible for detecting one abnormality, in a single image. In this study, we limited the radiology abnormalities detection to only cardiomegaly, lung effusion, and consolidation. The system generates a radiology report by performing the following three steps: image pre-processing, utilizing deep learning models to detect abnormalities, and producing a report. The aim of the image pre-processing step is to standardize the input by scaling it to 128x128 pixels and slicing it into three segments, which covers the upper, lower, and middle parts of the lung. After pre-processing, each corresponding model classifies the image, resulting in a 0 (zero) for no abnormality detected and a 1 (one) for the presence of an abnormality. The prediction outputs of each model are then concatenated to form a 'result code'. The 'result code' is used to construct a report by selecting the appropriate pre-determined sentence for each detected abnormality in the report generation step. The proposed system is expected to reduce the workload of radiologists and increase the accuracy of chest X-ray diagnosis.

Long-horizon agents depend on context management: systems compress, summarize, and evict old tokens so tasks can continue beyond finite windows. That is safe only when dropped information is no longer needed or has been internalized. Plans are the stress case: they are written early, used for many steps, and first to be evicted. We introduce replay pairing, a diagnostic that runs the same trajectory with and without the plan in history and measures hidden-state cosine distance. On Llama-3.1-70B, plan signal spikes to 0.453 one step after the plan, then falls 4.1x in a single action-observation step; HotpotQA falls 12.4x. This is evidence that standard LLM agents do not carry plans forward as persistent state, and instead depend on the plan remaining in context. A layer-L32 probe detects this decay as a diagnostic, not as proof that it reads plan content itself. Reasoning models add a measurement confound: their `<think>` traces re-derive plan content, so standard stripping leaves plan evidence in the stripped condition. We name this the reasoning-trace confound and fix it with strict stripping, which removes prior `<think>` blocks from the stripped run only. It recovers +163% of the step+1 signal in-sample and +153% held out, while not meaningfully changing non-reasoning Llama (+4.8%). On DeepSeek-R1-Distill-Llama-70B, a Llama-trained probe transfers at AUROC 0.748 (p=6e-4), while R1-specific probes reach 1.000, suggesting R1 encodes plan signal in a different hidden-state direction. Finally, a compression stress test shows the practical cost: naive plan eviction cuts ALFWorld success by 34.7pp, while probe-gated re-surfacing does not recover it. The contribution is a measurement and stress-test framework showing that agent-critical information can be context-resident rather than persistent. Context management is load bearing, but plan protection alone is not enough.

Interpreting chest X-rays is inherently challenging due to the overlap between anatomical structures and the subtle presentation of many clinically significant pathologies, making accurate diagnosis time-consuming even for experienced radiologists. Recent radiology-focused foundation models, such as LLaVA-Rad and Maira-2, have positioned multi-modal large language models (MLLMs) at the forefront of automated radiology report generation (RRG). However, despite these advances, current foundation models generate reports in a single forward pass. This decoding strategy diminishes attention to visual tokens and increases reliance on language priors as generation proceeds, which in turn introduces spurious pathology co-occurrences in the generated reports. To mitigate these limitations, we propose Category-Wise Contrastive Decoding (CWCD), a novel and modular framework designed to enhance structured radiology report generation (SRRG). Our approach introduces category-specific parameterization and generates category-wise reports by contrasting normal X-rays with masked X-rays using category-specific visual prompts. Experimental results demonstrate that CWCD consistently outperforms baseline methods across both clinical efficacy and natural language generation metrics. An ablation study further elucidates the contribution of each architectural component to overall performance.

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.

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.

Diagnosing and treating skin diseases require advanced visual skills across domains and the ability to synthesize information from multiple imaging modalities. While current deep learning models excel at specific tasks like skin cancer diagnosis from dermoscopic images, they struggle to meet the complex, multimodal requirements of clinical practice. Here, we introduce PanDerm, a multimodal dermatology foundation model pretrained through self-supervised learning on over 2 million real-world skin disease images from 11 clinical institutions across 4 imaging modalities. We evaluated PanDerm on 28 diverse benchmarks, including skin cancer screening, risk stratification, differential diagnosis of common and rare skin conditions, lesion segmentation, longitudinal monitoring, and metastasis prediction and prognosis. PanDerm achieved state-of-the-art performance across all evaluated tasks, often outperforming existing models when using only 10% of labeled data. We conducted three reader studies to assess PanDerm's potential clinical utility. PanDerm outperformed clinicians by 10.2% in early-stage melanoma detection through longitudinal analysis, improved clinicians' skin cancer diagnostic accuracy by 11% on dermoscopy images, and enhanced non-dermatologist healthcare providers' differential diagnosis by 16.5% across 128 skin conditions on clinical photographs. These results demonstrate PanDerm's potential to improve patient care across diverse clinical scenarios and serve as a model for developing multimodal foundation models in other medical specialties, potentially accelerating the integration of AI support in healthcare. The code can be found at https://github.com/SiyuanYan1/PanDerm.

Automated multi-label chest X-rays (CXR) image classification has achieved substantial progress in clinical diagnosis via utilizing sophisticated deep learning approaches. However, most deep models have high computational demands, which makes them less feasible for compact devices with low computational requirements. To overcome this problem, we propose a knowledge distillation (KD) strategy to create the compact deep learning model for the real-time multi-label CXR image classification. We study different alternatives of CNNs and Transforms as the teacher to distill the knowledge to a smaller student. Then, we employed explainable artificial intelligence (XAI) to provide the visual explanation for the model decision improved by the KD. Our results on three benchmark CXR datasets show that our KD strategy provides the improved performance on the compact student model, thus being the feasible choice for many limited hardware platforms. For instance, when using DenseNet161 as the teacher network, EEEA-Net-C2 achieved an AUC of 83.7%, 87.1%, and 88.7% on the ChestX-ray14, CheXpert, and PadChest datasets, respectively, with fewer parameters of 4.7 million and computational cost of 0.3 billion FLOPS.

Mixed-precision quantization must decide which parts of a model to keep at higher precision. A common premise, shared by sensitivity-based methods such as HAWQ and CoopQ, is that the loss from quantizing a set of layers can be reconstructed from per-layer or pairwise sensitivities measured in isolation. We test this premise at the 4-bit weight-and-activation precisions now being deployed, treating the change in loss f(S) from quantizing a layer set S as a set function on the Boolean cube and analyzing it through two classical changes of basis. This analysis yields two findings. First, across configurations drawn from the deployment distribution, 85--93\% of the variance of f is explained by per-layer effects alone. Second, a monotone transform of a sum of per-layer terms reproduces f's ranking of configurations, misordering at most 2\% of pairs. We propose the coverage model f(S)=cbigl(1-prod_{iin S}(1-a_i)bigr), which reproduces the measured variance profile of f to within a few percent from its L fitted break-rates. This structure supports two predictors of a configuration's loss, each with L+1 parameters. The additive model is the optimal first-order predictor. By Parseval's identity its mean-squared error equals the variance of f left unexplained by per-layer effects, which we measure on full lattices, estimate out of sample at full-network scale, and report with every result as a certificate of how well any additive model can do. The coverage model itself is the second predictor. As allocators at matched memory, they attain the lowest KL divergence among the compared allocators on models from 30B to 355B parameters. Below four bits, the resulting allocations continue to solve code and reasoning tasks at budgets where allocations from gradient sensitivities no longer produce terminating generations.

Reasoning in multimodal large language models (MLLMs) has shown strong promise in medical imaging. However, this reasoning is usually free-form text judged only by its final answer, making it hard to interpret and verify, especially in 3D radiology, where a diagnosis should be traceable to evidence in the scan. Existing chest CT question-answering datasets compound this by reducing expert radiology reports to answer-only pairs, dropping the reasoning that links findings to conclusions and omitting the patient history clinicians rely on. As a result, reasoning-capable 3D chest CT MLLMs remain out of reach, as neither the structured supervision needed to train them nor the protocol needed to verify their reasoning yet exists. We introduce CORTEX (Clinically Organized Reasoning and sTructured EXplanation), a structured reasoning benchmark for 3D chest CT. For each question, CORTEX restores the missing reasoning as a four-stage diagnostic trace mirroring a radiologist's workflow: task understanding, visual observation, diagnostic reasoning, and answer synthesis. We generate these traces using frontier large language models with broad medical and general-domain knowledge, then filter and verify them with a stage-level evaluation protocol combining automated rubric scoring with expert radiologist review. Crucially, both the reasoning structure and evaluation rubrics are designed in close collaboration with clinicians. Built on CT-RATE, a large, publicly available chest CT dataset without reasoning annotations, CORTEX comprises 76,177 validated reasoning traces across open-ended VQA, closed-ended VQA, and report generation, providing both the structured supervision and the stage-level evaluation protocol needed to build and evaluate trustworthy reasoning models for 3D chest CT. Our dataset and evaluation code will be made publicly available upon acceptance.

Skin cancer is one of the most threatening diseases worldwide. However, diagnosing skin cancer correctly is challenging. Recently, deep learning algorithms have emerged to achieve excellent performance on various tasks. Particularly, they have been applied to the skin disease diagnosis tasks. In this paper, we present a review on deep learning methods and their applications in skin disease diagnosis. We first present a brief introduction to skin diseases and image acquisition methods in dermatology, and list several publicly available skin datasets for training and testing algorithms. Then, we introduce the conception of deep learning and review popular deep learning architectures. Thereafter, popular deep learning frameworks facilitating the implementation of deep learning algorithms and performance evaluation metrics are presented. As an important part of this article, we then review the literature involving deep learning methods for skin disease diagnosis from several aspects according to the specific tasks. Additionally, we discuss the challenges faced in the area and suggest possible future research directions. The major purpose of this article is to provide a conceptual and systematically review of the recent works on skin disease diagnosis with deep learning. Given the popularity of deep learning, there remains great challenges in the area, as well as opportunities that we can explore in the future.

Conventional imaging diagnostics frequently encounter bottlenecks due to manual inspection, which can lead to delays and inconsistencies. Although deep learning offers a pathway to automation and enhanced accuracy, foundational models in computer vision often emphasize global context at the expense of local details, which are vital for medical imaging diagnostics. To address this, we harness the Swin Transformer's capacity to discern extended spatial dependencies within images through the hierarchical framework. Our novel contribution lies in refining local feature representations, orienting them specifically toward the final distribution of the classifier. This method ensures that local features are not only preserved but are also enriched with task-specific information, enhancing their relevance and detail at every hierarchical level. By implementing this strategy, our model demonstrates significant robustness and precision, as evidenced by extensive validation of two established benchmarks for Knee OsteoArthritis (KOA) grade classification. These results highlight our approach's effectiveness and its promising implications for the future of medical imaging diagnostics. Our implementation is available on https://github.com/mtliba/KOA_NLCS2024

Current evaluation protocols for Vision-Language Models (VLMs) in Radiology Report Generation (RRG) rely on report-level metrics that measure lexical overlap or aggregate clinical correctness. However, such metrics do not test whether individual diagnostic statements stem from the actual pathological evidence visible in the image. This allows models to achieve competitive scores by exploiting learned priors or spurious correlations, a failure mode we refer to as vision shortcut. We introduce SHOVIR, a benchmark for evaluating vision shortcut behavior in RRG. SHOVIR extends two spatially annotated chest X-ray datasets, MIMIC-CXR and PadChest-GR, with per-box CheXpert labels, and defines image-level and disease-level occlusion experiments that contrast baseline performance on clean images against localized, region-specific perturbations. Comparing predictions across these conditions isolates two failure modes at the disease-class level: direct shortcuts, where a finding persists after its visual evidence is removed, and contextual shortcuts, where detection degrades once co-occurring pathologies are occluded despite the target region remaining intact. Benchmarking eight state-of-the-art VLMs, we find that shortcut behavior varies substantially across architectures and datasets. Models achieving the highest baseline report quality do not necessarily rank highest in spatial grounding, revealing that clinically fluent generation can coexist with shallow reliance on visual evidence. These findings expose a blind spot in current RRG evaluation and motivate region-aware assessment protocols.

Respiratory diseases remain major global health challenges, and traditional auscultation is often limited by subjectivity, environmental noise, and inter-clinician variability. This study presents an explainable multimodal deep learning framework for automatic lung-disease detection using respiratory audio signals. The proposed system integrates two complementary representations: a spectral-temporal encoder based on a CNN-BiLSTM Attention architecture, and a handcrafted acoustic-feature encoder capturing physiologically meaningful descriptors such as MFCCs, spectral centroid, spectral bandwidth, and zero-crossing rate. These branches are combined through late-stage fusion to leverage both data-driven learning and domain-informed acoustic cues. The model is trained and evaluated on the Asthma Detection Dataset Version 2 using rigorous preprocessing, including resampling, normalization, noise filtering, data augmentation, and patient-level stratified partitioning. The study achieved strong generalization with 91.21% accuracy, 0.899 macro F1-score, and 0.9866 macro ROC-AUC, outperforming all ablated variants. An ablation study confirms the importance of temporal modeling, attention mechanisms, and multimodal fusion. The framework incorporates Grad-CAM, Integrated Gradients, and SHAP, generating interpretable spectral, temporal, and feature-level explanations aligned with known acoustic biomarkers to build clinical transparency. The findings demonstrate the framework's potential for telemedicine, point-of-care diagnostics, and real-world respiratory screening.

Vision-language pre-training for chest X-rays has made significant strides, primarily by utilizing paired radiographs and radiology reports. However, existing approaches often face challenges in encoding medical knowledge effectively. While radiology reports provide insights into the current disease manifestation, medical definitions (as used by contemporary methods) tend to be overly abstract, creating a gap in knowledge. To address this, we propose DeViDe, a novel transformer-based method that leverages radiographic descriptions from the open web. These descriptions outline general visual characteristics of diseases in radiographs, and when combined with abstract definitions and radiology reports, provide a holistic snapshot of knowledge. DeViDe incorporates three key features for knowledge-augmented vision language alignment: First, a large-language model-based augmentation is employed to homogenise medical knowledge from diverse sources. Second, this knowledge is aligned with image information at various levels of granularity. Third, a novel projection layer is proposed to handle the complexity of aligning each image with multiple descriptions arising in a multi-label setting. In zero-shot settings, DeViDe performs comparably to fully supervised models on external datasets and achieves state-of-the-art results on three large-scale datasets. Additionally, fine-tuning DeViDe on four downstream tasks and six segmentation tasks showcases its superior performance across data from diverse distributions.

Whole-slide images (WSIs) are gigapixel-scale digital scans of histopathology tissue and serve as the primary basis for cancer diagnosis. Existing histopathology generative models operate at the patch scale, producing fixed-size tiles of at most 1024times1024 pixels which encompass only a small fraction of the WSI. In contrast, text reports for clinical diagnoses and slide-level diagnostic labels -- the supervision that exists at scale -- operate at the whole-slide level. We present BigCell, the first approach to generate coherent whole-slide histopathology images at native gigapixel resolution. BigCell trains a flow-matching transformer at 2048times2048 pixels on over 120,000 publicly available WSIs spanning multiple organ types. Conditioning on embeddings from pathology foundation models and using an inference-time sliding-window pipeline, BigCell generates coherent images of up to 32,768times32,768 pixels, outperforming prior tile generators on both tile-level and slide-level fidelity metrics. To make gigapixel synthesis practical, we introduce an adaptive scheduling strategy that prioritizes important slide regions, speeding up image generation by over 3\ttimes with minimal quality degradation. Furthermore, we propose the first text-to-image synthesis at 8k resolution by training a separate model that produces dense conditioning grids directly from pathology text reports. We demonstrate that augmenting with synthetic samples improves slide-level few-shot classification performance by up to 18 % over baselines trained on real data.

Healthcare data now span EHRs, medical imaging, genomics, and wearable sensors, but most diagnostic models still process these modalities in isolation. This limits their ability to capture early, cross-modal disease signatures. This paper introduces a multimodal foundation model built on a transformer architecture that integrates heterogeneous clinical data through modality-specific encoders and cross-modal attention. Each modality is mapped into a shared latent space and fused using multi-head attention with residual normalization. We implement the framework using a multimodal dataset that simulates early-stage disease patterns across EHR sequences, imaging patches, genomic profiles, and wearable signals, including missing-modality scenarios and label noise. The model is trained using supervised classification together with self-supervised reconstruction and contrastive alignment to improve robustness. Experimental evaluation demonstrates strong performance in early-detection settings, with stable classification metrics, reliable uncertainty estimates, and interpretable attention patterns. The approach moves toward a flexible, pretrain-and-fine-tune foundation model that supports precision diagnostics, handles incomplete inputs, and improves early disease detection across oncology, cardiology, and neurology applications.

The widespread use of chest X-rays (CXRs), coupled with a shortage of radiologists, has driven growing interest in automated CXR analysis and AI-assisted reporting. While existing vision-language models (VLMs) show promise in specific tasks such as report generation or abnormality detection, they often lack support for interactive diagnostic capabilities. In this work we present RadVLM, a compact, multitask conversational foundation model designed for CXR interpretation. To this end, we curate a large-scale instruction dataset comprising over 1 million image-instruction pairs containing both single-turn tasks -- such as report generation, abnormality classification, and visual grounding -- and multi-turn, multi-task conversational interactions. After fine-tuning RadVLM on this instruction dataset, we evaluate it across different tasks along with re-implemented baseline VLMs. Our results show that RadVLM achieves state-of-the-art performance in conversational capabilities and visual grounding while remaining competitive in other radiology tasks. Ablation studies further highlight the benefit of joint training across multiple tasks, particularly for scenarios with limited annotated data. Together, these findings highlight the potential of RadVLM as a clinically relevant AI assistant, providing structured CXR interpretation and conversational capabilities to support more effective and accessible diagnostic workflows.

We compress KV cache entries by quantizing angles in the Fast Walsh-Hadamard domain, where a random diagonal rotation makes consecutive element pairs approximately uniformly distributed on the unit circle. We extend this angular quantizer with per-layer early-boost, which independently configures K and V codebook sizes at each layer, allocating higher precision to a model-specific subset of critical layers. Across seven models (1B to 7B parameters), per-layer early-boost achieves lossless compression on four models and near-lossless quality on six of seven, at 3.28 to 3.67 angle bits per element. Asymmetric norm quantization (8-bit for keys, 4-bit log-space for values) yields 6.56 total bits per element on Mistral-7B with perplexity degradation of +0.0014 and no calibration data. A layer-group sensitivity analysis reveals model-specific bottleneck patterns, including K-dominated versus V-dominated layers and negative-transfer layers where increased precision degrades quality.

We develop an algorithm that can detect pneumonia from chest X-rays at a level exceeding practicing radiologists. Our algorithm, CheXNet, is a 121-layer convolutional neural network trained on ChestX-ray14, currently the largest publicly available chest X-ray dataset, containing over 100,000 frontal-view X-ray images with 14 diseases. Four practicing academic radiologists annotate a test set, on which we compare the performance of CheXNet to that of radiologists. We find that CheXNet exceeds average radiologist performance on the F1 metric. We extend CheXNet to detect all 14 diseases in ChestX-ray14 and achieve state of the art results on all 14 diseases.

The rapid evolution of artificial intelligence, especially in large language models (LLMs), has significantly impacted various domains, including healthcare. In chest X-ray (CXR) analysis, previous studies have employed LLMs, but with limitations: either underutilizing the multi-tasking capabilities of LLMs or lacking clinical accuracy. This paper presents M4CXR, a multi-modal LLM designed to enhance CXR interpretation. The model is trained on a visual instruction-following dataset that integrates various task-specific datasets in a conversational format. As a result, the model supports multiple tasks such as medical report generation (MRG), visual grounding, and visual question answering (VQA). M4CXR achieves state-of-the-art clinical accuracy in MRG by employing a chain-of-thought prompting strategy, in which it identifies findings in CXR images and subsequently generates corresponding reports. The model is adaptable to various MRG scenarios depending on the available inputs, such as single-image, multi-image, and multi-study contexts. In addition to MRG, M4CXR performs visual grounding at a level comparable to specialized models and also demonstrates outstanding performance in VQA. Both quantitative and qualitative assessments reveal M4CXR's versatility in MRG, visual grounding, and VQA, while consistently maintaining clinical accuracy.

Background: AI-based classification models are essential for improving lung cancer diagnosis. However, the relative performance of lesion-level versus chest-region models in internal and external datasets remains unclear. Purpose: This study evaluates the performance of lesion-level and chest-region models for lung cancer classification, comparing their effectiveness across internal Duke Lung Nodule Dataset 2024 (DLND24) and external (LUNA16, NLST) datasets, with a focus on subgroup analyses by demographics, histology, and imaging characteristics. Materials and Methods: Two AI models were trained: one using lesion-centric patches (64,64,64) and the other using chest-region patches (512,512,8). Internal validation was conducted on DLND24, while external validation utilized LUNA16 and NLST datasets. The models performances were assessed using AUC-ROC, with subgroup analyses for demographic, clinical, and imaging factors. Statistical comparisons were performed using DeLongs test. Gradient-based visualizations and probability distribution were further used for analysis. Results: The lesion-level model consistently outperformed the chest-region model across datasets. In internal validation, the lesion-level model achieved an AUC of 0.71(CI: 0.61-0.81), compared to 0.68(0.57-0.77) for the chest-region model. External validation showed similar trends, with AUCs of 0.90(0.87-0.92) and 0.81(0.79-0.82) on LUNA16 and NLST, respectively. Subgroup analyses revealed significant advantages for lesion-level models in certain histological subtypes (adenocarcinoma) and imaging conditions (CT manufacturers). Conclusion: Lesion-level models demonstrate superior classification performance, especially for external datasets and challenging subgroups, suggesting their clinical utility for precision lung cancer diagnostics.

Ensuring the quality and integrity of medical images is crucial for maintaining diagnostic accuracy in deep learning-based Computer-Aided Diagnosis and Computer-Aided Detection (CAD) systems. Covariate shifts are subtle variations in the data distribution caused by different imaging devices or settings and can severely degrade model performance, similar to the effects of adversarial attacks. Therefore, it is vital to have a lightweight and fast method to assess the quality of these images prior to using CAD models. AdverX-Ray addresses this need by serving as an image-quality assessment layer, designed to detect covariate shifts effectively. This Adversarial Variational Autoencoder prioritizes the discriminator's role, using the suboptimal outputs of the generator as negative samples to fine-tune the discriminator's ability to identify high-frequency artifacts. Images generated by adversarial networks often exhibit severe high-frequency artifacts, guiding the discriminator to focus excessively on these components. This makes the discriminator ideal for this approach. Trained on patches from X-ray images of specific machine models, AdverX-Ray can evaluate whether a scan matches the training distribution, or if a scan from the same machine is captured under different settings. Extensive comparisons with various OOD detection methods show that AdverX-Ray significantly outperforms existing techniques, achieving a 96.2% average AUROC using only 64 random patches from an X-ray. Its lightweight and fast architecture makes it suitable for real-time applications, enhancing the reliability of medical imaging systems. The code and pretrained models are publicly available.

Radiology reporting generative AI holds significant potential to alleviate clinical workloads and streamline medical care. However, achieving high clinical accuracy is challenging, as radiological images often feature subtle lesions and intricate structures. Existing systems often fall short, largely due to their reliance on fixed size, patch-level image features and insufficient incorporation of pathological information. This can result in the neglect of such subtle patterns and inconsistent descriptions of crucial pathologies. To address these challenges, we propose an innovative approach that leverages pathology-aware regional prompts to explicitly integrate anatomical and pathological information of various scales, significantly enhancing the precision and clinical relevance of generated reports. We develop an anatomical region detector that extracts features from distinct anatomical areas, coupled with a novel multi-label lesion detector that identifies global pathologies. Our approach emulates the diagnostic process of radiologists, producing clinically accurate reports with comprehensive diagnostic capabilities. Experimental results show that our model outperforms previous state-of-the-art methods on most natural language generation and clinical efficacy metrics, with formal expert evaluations affirming its potential to enhance radiology practice.

Probing studies what information is encoded in a frozen LLM's layer representations by training a lightweight predictor on top of them. Beyond analysis, probes are often used operationally in probe-then-steer pipelines: a learned concept vector is extracted from a probe and injected via additive activation steering by adding it to a layer representation during the forward pass. The effectiveness of this pipeline hinges on estimating concept vectors that are accurate, directionally stable under ablation, and inexpensive to obtain. Motivated by these desiderata, we propose RAPTOR (Ridge-Adaptive Logistic Probe), a simple L2-regularized logistic probe whose validation-tuned ridge strength yields concept vectors from normalized weights. Across extensive experiments on instruction-tuned LLMs and human-written concept datasets, RAPTOR matches or exceeds strong baselines in accuracy while achieving competitive directional stability and substantially lower training cost; these quantitative results are supported by qualitative downstream steering demonstrations. Finally, using the Convex Gaussian Min-max Theorem (CGMT), we provide a mechanistic characterization of ridge logistic regression in an idealized Gaussian teacher-student model in the high-dimensional few-shot regime, explaining how penalty strength mediates probe accuracy and concept-vector stability and yielding structural predictions that qualitatively align with trends observed on real LLM embeddings.

As deep learning models gain attraction in medical data, ensuring transparent and trustworthy decision-making is essential. In skin cancer diagnosis, while advancements in lesion detection and classification have improved accuracy, the black-box nature of these methods poses challenges in understanding their decision processes, leading to trust issues among physicians. This study leverages the CLIP (Contrastive Language-Image Pretraining) model, trained on different skin lesion datasets, to capture meaningful relationships between visual features and diagnostic criteria terms. To further enhance transparency, we propose a method called MedGrad E-CLIP, which builds on gradient-based E-CLIP by incorporating a weighted entropy mechanism designed for complex medical imaging like skin lesions. This approach highlights critical image regions linked to specific diagnostic descriptions. The developed integrated pipeline not only classifies skin lesions by matching corresponding descriptions but also adds an essential layer of explainability developed especially for medical data. By visually explaining how different features in an image relates to diagnostic criteria, this approach demonstrates the potential of advanced vision-language models in medical image analysis, ultimately improving transparency, robustness, and trust in AI-driven diagnostic systems.

General-purpose Large Vision-Language Models (LVLMs), despite their massive scale, often falter in dermatology due to "diffuse attention" - the inability to disentangle subtle pathological lesions from background noise. In this paper, we challenge the assumption that parameter scaling is the only path to medical precision. We introduce SkinFlow, a framework that treats diagnosis as an optimization of visual information transmission efficiency. Our approach utilizes a Virtual-Width Dynamic Vision Encoder (DVE) to "unfold" complex pathological manifolds without physical parameter expansion, coupled with a two-stage Reinforcement Learning strategy. This strategy sequentially aligns explicit medical descriptions (Stage I) and reconstructs implicit diagnostic textures (Stage II) within a constrained semantic space. Furthermore, we propose a clinically grounded evaluation protocol that prioritizes diagnostic safety and hierarchical relevance over rigid label matching. Empirical results are compelling: our 7B model establishes a new state-of-the-art on the Fitzpatrick17k benchmark, achieving a +12.06% gain in Top-1 accuracy and a +28.57% boost in Top-6 accuracy over the massive general-purpose models (e.g., Qwen3VL-235B and GPT-5.2). These findings demonstrate that optimizing geometric capacity and information flow yields superior diagnostic reasoning compared to raw parameter scaling.

According to the considerable growth in the avail of chest X-ray images in diagnosing various diseases, as well as gathering extensive datasets, having an automated diagnosis procedure using deep neural networks has occupied the minds of experts. Most of the available methods in computer vision use a CNN backbone to acquire high accuracy on the classification problems. Nevertheless, recent researches show that transformers, established as the de facto method in NLP, can also outperform many CNN-based models in vision. This paper proposes a multi-label classification deep model based on the Swin Transformer as the backbone to achieve state-of-the-art diagnosis classification. It leverages Multi-Layer Perceptron, also known as MLP, for the head architecture. We evaluate our model on one of the most widely-used and largest x-ray datasets called "Chest X-ray14," which comprises more than 100,000 frontal/back-view images from over 30,000 patients with 14 famous chest diseases. Our model has been tested with several number of MLP layers for the head setting, each achieves a competitive AUC score on all classes. Comprehensive experiments on Chest X-ray14 have shown that a 3-layer head attains state-of-the-art performance with an average AUC score of 0.810, compared to the former SOTA average AUC of 0.799. We propose an experimental setup for the fair benchmarking of existing methods, which could be used as a basis for the future studies. Finally, we followed up our results by confirming that the proposed method attends to the pathologically relevant areas of the chest.

The emergence of vision-language models (VLMs) has opened new possibilities for clinical reasoning and has shown promising performance in dermatological diagnosis. However, their trustworthiness and clinical utility are often limited by three major factors: (1) Data heterogeneity, where diverse datasets lack consistent diagnostic labels and clinical concept annotations; (2) Absence of grounded diagnostic rationales, leading to a scarcity of reliable reasoning supervision; and (3) Limited scalability and generalization, as models trained on small, densely annotated datasets struggle to transfer nuanced reasoning to large, sparsely-annotated ones. To address these limitations, we propose SkinR1, a novel dermatological VLM that combines deep, textbook-based reasoning with the broad generalization capabilities of reinforcement learning (RL). SkinR1 systematically resolves the key challenges through a unified, end-to-end framework. First, we design a textbook-based reasoning generator that synthesizes high-fidelity, hierarchy-aware, and differential-diagnosis (DDx)-informed trajectories, providing reliable expert-level supervision. Second, we leverage the constructed trajectories for supervised fine-tuning (SFT) empowering the model with grounded reasoning ability. Third, we develop a novel RL paradigm that, by incorporating the hierarchical structure of diseases, effectively transfers these grounded reasoning patterns to large-scale, sparse data. Extensive experiments on multiple dermatology datasets demonstrate that SkinR1 achieves superior diagnostic accuracy. The ablation study demonstrates the importance of the reasoning foundation instilled by SFT.

Rich feature representations derived from CLIP-ViT have been widely utilized in AI-generated image detection. While most existing methods primarily leverage features from the final layer, we systematically analyze the contributions of layer-wise features to this task. Our study reveals that earlier layers provide more localized and generalizable features, often surpassing the performance of final-layer features in detection tasks. Moreover, we find that different layers capture distinct aspects of the data, each contributing uniquely to AI-generated image detection. Motivated by these findings, we introduce a novel adaptive method, termed MoLD, which dynamically integrates features from multiple ViT layers using a gating-based mechanism. Extensive experiments on both GAN- and diffusion-generated images demonstrate that MoLD significantly improves detection performance, enhances generalization across diverse generative models, and exhibits robustness in real-world scenarios. Finally, we illustrate the scalability and versatility of our approach by successfully applying it to other pre-trained ViTs, such as DINOv2.

Optical Coherence Tomography (OCT) is essential for diagnosing conditions such as glaucoma, diabetic retinopathy, and age-related macular degeneration. Accurate retinal layer segmentation enables quantitative biomarkers critical for clinical decision-making, but manual segmentation is time-consuming and variable, while conventional deep learning models often lack interpretability. This work proposes an improved SegNet-based deep learning framework for automated and interpretable retinal layer segmentation. Architectural innovations, including modified pooling strategies, enhance feature extraction from noisy OCT images, while a hybrid loss function combining categorical cross-entropy and Dice loss improves performance for thin and imbalanced retinal layers. Gradient-weighted Class Activation Mapping (Grad-CAM) is integrated to provide visual explanations, allowing clinical validation of model decisions. Trained and validated on the Duke OCT dataset, the framework achieved 95.77% validation accuracy, a Dice coefficient of 0.9446, and a Jaccard Index (IoU) of 0.8951. Class-wise results confirmed robust performance across most layers, with challenges remaining for thinner boundaries. Grad-CAM visualizations highlighted anatomically relevant regions, aligning segmentation with clinical biomarkers and improving transparency. By combining architectural improvements, a customized hybrid loss, and explainable AI, this study delivers a high-performing SegNet-based framework that bridges the gap between accuracy and interpretability. The approach offers strong potential for standardizing OCT analysis, enhancing diagnostic efficiency, and fostering clinical trust in AI-driven ophthalmic tools.

Conformal prediction guarantees marginal coverage, but a single calibration threshold can still spread that coverage unevenly, over-covering easy regions and under-covering hard ones. SimplexUQ is, to our knowledge, the first benchmark and reproducible protocol for measuring this allocation problem on simplex-valued predictions; it compares existing conformal wrappers rather than proposing a new one. Its task suite, SimplexTasks-12, combines six controlled synthetic regimes with six frozen-predictor real tasks spanning class probabilities, topic mixtures, spectral abundances, cell-type fractions, age distributions, and emotion mixtures. Each comparison fixes the predictor, score, and response-free stratification map, varies only the wrapper, and reports marginal coverage, worst-stratum coverage, max disparity, and within-task radius and compute. Global calibration can look valid while failing badly: on CIFAR-10 it attains 0.900 marginal coverage but only 0.542 in the worst entropy stratum, and Mondrian calibration raises that stratum to 0.886 while reducing max disparity from 0.358 to 0.022. No wrapper dominates, however. Under smooth synthetic heterogeneity, several repairs are competitive; fixed-map analyses show that rankings depend on the evaluation groups and protocol; and in a 12-task comparison, Mondrian has lower disparity on its single target partition for all 12 tasks, whereas BatchMVP has lower disparity over overlapping groups on five. These are empirical comparisons, not new coverage guarantees. A controlled predictor-bias sweep shows that removing predictor bias only partly reduces global-threshold disparity. We release task cards, result provenance, permitted derived arrays, and rebuild instructions, and treat wrapper selection as a diagnostic comparison rather than a universal ranking.

Deep learning (DL) has proven highly effective for ultrasound-based computer-aided diagnosis (CAD) of breast cancers. In an automaticCAD system, lesion detection is critical for the following diagnosis. However, existing DL-based methods generally require voluminous manually-annotated region of interest (ROI) labels and class labels to train both the lesion detection and diagnosis models. In clinical practice, the ROI labels, i.e. ground truths, may not always be optimal for the classification task due to individual experience of sonologists, resulting in the issue of coarse annotation that limits the diagnosis performance of a CAD model. To address this issue, a novel Two-Stage Detection and Diagnosis Network (TSDDNet) is proposed based on weakly supervised learning to enhance diagnostic accuracy of the ultrasound-based CAD for breast cancers. In particular, all the ROI-level labels are considered as coarse labels in the first training stage, and then a candidate selection mechanism is designed to identify optimallesion areas for both the fully and partially annotated samples. It refines the current ROI-level labels in the fully annotated images and the detected ROIs in the partially annotated samples with a weakly supervised manner under the guidance of class labels. In the second training stage, a self-distillation strategy further is further proposed to integrate the detection network and classification network into a unified framework as the final CAD model for joint optimization, which then further improves the diagnosis performance. The proposed TSDDNet is evaluated on a B-mode ultrasound dataset, and the experimental results show that it achieves the best performance on both lesion detection and diagnosis tasks, suggesting promising application potential.

Deep learning based automated pathological diagnosis has markedly improved diagnostic efficiency and reduced variability between observers, yet its clinical adoption remains limited by opaque model decisions and a lack of traceable rationale. To address this, recent multimodal visual reasoning architectures provide a unified framework that generates segmentation masks at the pixel level alongside semantically aligned textual explanations. By localizing lesion regions and producing expert style diagnostic narratives, these models deliver the transparent and interpretable insights necessary for dependable AI assisted pathology. Building on these advancements, we propose PathMR, a cell-level Multimodal visual Reasoning framework for Pathological image analysis. Given a pathological image and a textual query, PathMR generates expert-level diagnostic explanations while simultaneously predicting cell distribution patterns. To benchmark its performance, we evaluated our approach on the publicly available PathGen dataset as well as on our newly developed GADVR dataset. Extensive experiments on these two datasets demonstrate that PathMR consistently outperforms state-of-the-art visual reasoning methods in text generation quality, segmentation accuracy, and cross-modal alignment. These results highlight the potential of PathMR for improving interpretability in AI-driven pathological diagnosis. The code will be publicly available in https://github.com/zhangye-zoe/PathMR.

Mechanistic interpretability aims to understand neural networks by identifying which learned features mediate specific behaviors. Attribution graphs reveal these feature pathways, but interpreting them requires extensive manual analysis -- a single prompt can take approximately 2 hours for an experienced circuit tracer. We present probe prompting, an automated pipeline that transforms attribution graphs into compact, interpretable subgraphs built from concept-aligned supernodes. Starting from a seed prompt and target logit, we select high-influence features, generate concept-targeted yet context-varying probes, and group features by cross-prompt activation signatures into Semantic, Relationship, and Say-X categories using transparent decision rules. Across five prompts including classic "capitals" circuits, probe-prompted subgraphs preserve high explanatory coverage while compressing complexity (Completeness 0.83, mean across circuits; Replacement 0.54). Compared to geometric clustering baselines, concept-aligned groups exhibit higher behavioral coherence: 2.3x higher peak-token consistency (0.425 vs 0.183) and 5.8x higher activation-pattern similarity (0.762 vs 0.130), despite lower geometric compactness. Entity-swap tests reveal a layerwise hierarchy: early-layer features transfer robustly (64% transfer rate, mean layer 6.3), while late-layer Say-X features specialize for output promotion (mean layer 16.4), supporting a backbone-and-specialization view of transformer computation. We release code (https://github.com/peppinob-ol/attribution-graph-probing), an interactive demo (https://huggingface.co/spaces/Peppinob/attribution-graph-probing), and minimal artifacts enabling immediate reproduction and community adoption.

Lung diseases remain a critical global health concern, and it's crucial to have accurate and quick ways to diagnose them. This work focuses on classifying different lung diseases into five groups: viral pneumonia, bacterial pneumonia, COVID, tuberculosis, and normal lungs. Employing advanced deep learning techniques, we explore a diverse range of models including CNN, hybrid models, ensembles, transformers, and Big Transfer. The research encompasses comprehensive methodologies such as hyperparameter tuning, stratified k-fold cross-validation, and transfer learning with fine-tuning.Remarkably, our findings reveal that the Xception model, fine-tuned through 5-fold cross-validation, achieves the highest accuracy of 96.21\%. This success shows that our methods work well in accurately identifying different lung diseases. The exploration of explainable artificial intelligence (XAI) methodologies further enhances our understanding of the decision-making processes employed by these models, contributing to increased trust in their clinical applications.

Digital pathology enables automatic analysis of histopathological sections using artificial intelligence (AI). Automatic evaluation could improve diagnostic efficiency and help find associations between morphological features and clinical outcome. For development of such prediction models, identifying invasive epithelial cells, and separating these from benign epithelial cells and in situ lesions would be the first step. In this study, we aimed to develop an AI model for segmentation of epithelial cells in sections from breast cancer. We generated epithelial ground truth masks by restaining hematoxylin and eosin (HE) sections with cytokeratin (CK) AE1/AE3, and by pathologists' annotations. HE/CK image pairs were used to train a convolutional neural network, and data augmentation was used to make the model more robust. Tissue microarrays (TMAs) from 839 patients, and whole slide images from two patients were used for training and evaluation of the models. The sections were derived from four cohorts of breast cancer patients. TMAs from 21 patients from a fifth cohort was used as a second test set. In quantitative evaluation, a mean Dice score of 0.70, 0.79, and 0.75 for invasive epithelial cells, benign epithelial cells, and in situ lesions, respectively, were achieved. In qualitative scoring (0-5) by pathologists, results were best for all epithelium and invasive epithelium, with scores of 4.7 and 4.4. Scores for benign epithelium and in situ lesions were 3.7 and 2.0. The proposed model segmented epithelial cells in HE stained breast cancer slides well, but further work is needed for accurate division between the classes. Immunohistochemistry, together with pathologists' annotations, enabled the creation of accurate ground truths. The model is made freely available in FastPathology and the code is available at https://github.com/AICAN-Research/breast-epithelium-segmentation

In recent years, a standard computational pathology workflow has emerged where whole slide images are cropped into tiles, these tiles are processed using a foundation model, and task-specific models are built using the resulting representations. At least 15 different foundation models have been proposed, and the vast majority are trained exclusively with tiles using the 20times magnification. However, it is well known that certain histologic features can only be discerned with larger context windows and requires a pathologist to zoom in and out when analyzing a whole slide image. Furthermore, creating 224times224 pixel crops at 20times leads to a large number of tiles per slide, which can be gigapixel in size. To more accurately capture multi-resolution features and investigate the possibility of reducing the number of representations per slide, we propose a region-level mixing encoder. Our approach jointly fuses image tile representations of a mixed magnification foundation model using a masked embedding modeling pretraining step. We explore a design space for pretraining the proposed mixed-magnification region aggregators and evaluate our models on transfer to biomarker prediction tasks representing various cancer types. Results demonstrate cancer dependent improvements in predictive performance, highlighting the importance of spatial context and understanding.

In the field of chest X-ray (CXR) diagnosis, existing works often focus solely on determining where a radiologist looks, typically through tasks such as detection, segmentation, or classification. However, these approaches are often designed as black-box models, lacking interpretability. In this paper, we introduce Interpretable Artificial Intelligence (I-AI) a novel and unified controllable interpretable pipeline for decoding the intense focus of radiologists in CXR diagnosis. Our I-AI addresses three key questions: where a radiologist looks, how long they focus on specific areas, and what findings they diagnose. By capturing the intensity of the radiologist's gaze, we provide a unified solution that offers insights into the cognitive process underlying radiological interpretation. Unlike current methods that rely on black-box machine learning models, which can be prone to extracting erroneous information from the entire input image during the diagnosis process, we tackle this issue by effectively masking out irrelevant information. Our proposed I-AI leverages a vision-language model, allowing for precise control over the interpretation process while ensuring the exclusion of irrelevant features. To train our I-AI model, we utilize an eye gaze dataset to extract anatomical gaze information and generate ground truth heatmaps. Through extensive experimentation, we demonstrate the efficacy of our method. We showcase that the attention heatmaps, designed to mimic radiologists' focus, encode sufficient and relevant information, enabling accurate classification tasks using only a portion of CXR. The code, checkpoints, and data are at https://github.com/UARK-AICV/IAI

Task-specific deep learning models in histopathology offer promising opportunities for improving diagnosis, clinical research, and precision medicine. However, development of such models is often limited by availability of high-quality data. Foundation models in histopathology that learn general representations across a wide range of tissue types, diagnoses, and magnifications offer the potential to reduce the data, compute, and technical expertise necessary to develop task-specific deep learning models with the required level of model performance. In this work, we describe the development and evaluation of foundation models for histopathology via self-supervised learning (SSL). We first establish a diverse set of benchmark tasks involving 17 unique tissue types and 12 unique cancer types and spanning different optimal magnifications and task types. Next, we use this benchmark to explore and evaluate histopathology-specific SSL methods followed by further evaluation on held out patch-level and weakly supervised tasks. We found that standard SSL methods thoughtfully applied to histopathology images are performant across our benchmark tasks and that domain-specific methodological improvements can further increase performance. Our findings reinforce the value of using domain-specific SSL methods in pathology, and establish a set of high quality foundation models to enable further research across diverse applications.

Most of the recent works on probing representations have focused on BERT, with the presumption that the findings might be similar to the other models. In this work, we extend the probing studies to two other models in the family, namely ELECTRA and XLNet, showing that variations in the pre-training objectives or architectural choices can result in different behaviors in encoding linguistic information in the representations. Most notably, we observe that ELECTRA tends to encode linguistic knowledge in the deeper layers, whereas XLNet instead concentrates that in the earlier layers. Also, the former model undergoes a slight change during fine-tuning, whereas the latter experiences significant adjustments. Moreover, we show that drawing conclusions based on the weight mixing evaluation strategy -- which is widely used in the context of layer-wise probing -- can be misleading given the norm disparity of the representations across different layers. Instead, we adopt an alternative information-theoretic probing with minimum description length, which has recently been proven to provide more reliable and informative results.

Computational pathology has made significant progress in recent years, fueling advances in both fundamental disease understanding and clinically ready tools. This evolution is driven by the availability of large amounts of digitized slides and specialized deep learning methods and models. Multiple self-supervised foundation feature extractors have been developed, enabling downstream predictive applications from cell segmentation to tumor sub-typing and survival analysis. In contrast, generative foundation models designed specifically for histopathology remain scarce. Such models could address tasks that are beyond the capabilities of feature extractors, such as virtual staining. In this paper, we introduce CytoSyn, a state-of-the-art foundation latent diffusion model that enables the guided generation of highly realistic and diverse histopathology H&E-stained images, as shown in an extensive benchmark. We explored methodological improvements, training set scaling, sampling strategies and slide-level overfitting, culminating in the improved CytoSyn-v2, and compared our work to PixCell, a state-of-the-art model, in an in-depth manner. This comparison highlighted the strong sensitivity of both diffusion models and performance metrics to preprocessing-specific details such as JPEG compression. Our model has been trained on a dataset obtained from more than 10,000 TCGA diagnostic whole-slide images of 32 different cancer types. Despite being trained only on oncology slides, it maintains state-of-the-art performance generating inflammatory bowel disease images. To support the research community, we publicly release CytoSyn's weights, its training and validation datasets, and a sample of synthetic images in this repository: https://huggingface.co/Owkin-Bioptimus/CytoSyn.

Pathology vision-language models (VLMs) have shown strong visual perception ability, but their robustness in the language domain remains poorly characterized. Existing pathology VLM benchmarks largely rely on canonical closed-set prompts or perturb only generic templates, treating language as a fixed evaluation component rather than a variable axis of model behavior. In clinical practice, however, diagnostic language varies across reports, institutions, and candidate diagnoses. We introduce PathLang, a language-centered and clinically grounded zero-shot benchmark. PathLang holds the underlying slides, ground-truth labels, and image-text evaluation direction fixed while systematically varying only the diagnostic language, so that performance differences reflect how a diagnosis is phrased rather than what is imaged. The language variation follows how pathologists actually rephrase diagnoses (terminology, specificity, and reporting style), and all prompts and candidate pools are validated by six board-certified pathologists. PathLang covers four task families: (1) zero-shot classification with image-text alignment analysis, (2) cross-modal retrieval, (3) paraphrase robustness, including semantic-equivalence paraphrases, length and reporting-style variation, and prompt ensembling, and (4) open-vocabulary diagnosis retrieval over four candidate pools with distinct forms of semantic competition. Across nine VLMs and five public datasets spanning four organs, we find that performance is highly sensitive to clinically equivalent paraphrases, varies substantially across forms of semantic competition, and that image-text alignment quality does not necessarily translate into inter-class separability. We release the prompt corpus, candidate pools, pre-computed text embeddings, and evaluation code at https://anonymous.4open.science/r/PathLang.

Diagnosing a whole-slide image is an interactive, multi-stage process involving changes in magnification and movement between fields. Although recent pathology foundation models are strong, practical agentic systems that decide what field to examine next, adjust magnification, and deliver explainable diagnoses are still lacking. The blocker is data: scalable, clinically aligned supervision of expert viewing behavior that is tacit and experience-based, not written in textbooks or online, and therefore absent from large language model training. We introduce the AI Session Recorder, which works with standard WSI viewers to unobtrusively record routine navigation and convert the viewer logs into standardized behavioral commands (inspect or peek at discrete magnifications) and bounding boxes. A lightweight human-in-the-loop review turns AI-drafted rationales into the Pathology-CoT dataset, a form of paired "where to look" and "why it matters" supervision produced at roughly six times lower labeling time. Using this behavioral data, we build Pathologist-o3, a two-stage agent that first proposes regions of interest and then performs behavior-guided reasoning. On gastrointestinal lymph-node metastasis detection, it achieved 84.5% precision, 100.0% recall, and 75.4% accuracy, exceeding the state-of-the-art OpenAI o3 model and generalizing across backbones. To our knowledge, this constitutes one of the first behavior-grounded agentic systems in pathology. Turning everyday viewer logs into scalable, expert-validated supervision, our framework makes agentic pathology practical and establishes a path to human-aligned, upgradeable clinical AI.

Developing a generalist radiology diagnosis system can greatly enhance clinical diagnostics. In this paper, we introduce RadDiag, a foundational model supporting 2D and 3D inputs across various modalities and anatomies, using a transformer-based fusion module for comprehensive disease diagnosis. Due to patient privacy concerns and the lack of large-scale radiology diagnosis datasets, we utilize high-quality, clinician-reviewed radiological images available online with diagnosis labels. Our dataset, RP3D-DiagDS, contains 40,936 cases with 195,010 scans covering 5,568 disorders (930 unique ICD-10-CM codes). Experimentally, our RadDiag achieves 95.14% AUC on internal evaluation with the knowledge-enhancement strategy. Additionally, RadDiag can be zero-shot applied or fine-tuned to external diagnosis datasets sourced from various hospitals, demonstrating state-of-the-art results. In conclusion, we show that publicly shared medical data on the Internet is a tremendous and valuable resource that can potentially support building a generalist AI for healthcare.

We present LayerSkip, an end-to-end solution to speed-up inference of large language models (LLMs). First, during training we apply layer dropout, with low dropout rates for earlier layers and higher dropout rates for later layers, and an early exit loss where all transformer layers share the same exit. Second, during inference, we show that this training recipe increases the accuracy of early exit at earlier layers, without adding any auxiliary layers or modules to the model. Third, we present a novel self-speculative decoding solution where we exit at early layers and verify and correct with remaining layers of the model. Our proposed self-speculative decoding approach has less memory footprint than other speculative decoding approaches and benefits from shared compute and activations of the draft and verification stages. We run experiments on different Llama model sizes on different types of training: pretraining from scratch, continual pretraining, finetuning on specific data domain, and finetuning on specific task. We implement our inference solution and show speedups of up to 2.16x on summarization for CNN/DM documents, 1.82x on coding, and 2.0x on TOPv2 semantic parsing task. We open source our code and checkpoints at https://github.com/facebookresearch/LayerSkip.

The rapid progress of multimodal large language models (MLLMs) has led to increasing interest in agent-based systems. While most prior work in medical imaging concentrates on automating routine clinical workflows, we study an underexplored yet clinically significant setting: distinguishing visually hard-to-separate diseases in a zero-shot setting. We benchmark representative agents on two imaging-only proxy diagnostic tasks, (1) melanoma vs. atypical nevus and (2) pulmonary edema vs. pneumonia, where visual features are highly confounded despite substantial differences in clinical management. We introduce a multi-agent framework based on contrastive adjudication. Experimental results show improved diagnostic performance (an 11-percentage-point gain in accuracy on dermoscopy data) and reduced unsupported claims on qualitative samples, although overall performance remains insufficient for clinical deployment. We acknowledge the inherent uncertainty in human annotations and the absence of clinical context, which further limit the translation to real-world settings. Within this controlled setting, this pilot study provides preliminary insights into zero-shot agent performance in visually confounded scenarios.

Chest X-ray (CXR) classification in clinical practice is often limited by imperfect supervision, arising from (i) extreme long-tailed multi-label disease distributions and (ii) missing annotations for rare or previously unseen findings. The CXR-LT 2026 challenge addresses these issues on a PadChest-based benchmark with a 36-class label space split into 30 in-distribution classes for training and 6 out-of-distribution (OOD) classes for zero-shot evaluation. We present task-specific solutions tailored to the distinct supervision regimes. For Task 1 (long-tailed multi-label classification), we adopt an imbalance-aware multi-label learning strategy to improve recognition of tail classes while maintaining stable performance on frequent findings. For Task 2 (zero-shot OOD recognition), we propose a prediction approach that produces scores for unseen disease categories without using any supervised labels or examples from the OOD classes during training. Evaluated with macro-averaged mean Average Precision (mAP), our method achieves strong performance on both tasks, ranking first on the public leaderboard of the development phase. Code and pre-trained models are available at https://github.com/hieuphamha19/CXR_LT.

Dermatological diagnosis represents a complex multimodal challenge that requires integrating visual features with specialized clinical knowledge. While vision-language pretraining (VLP) has advanced medical AI, its effectiveness in dermatology is limited by text length constraints and the lack of structured texts. In this paper, we introduce MAKE, a Multi-Aspect Knowledge-Enhanced vision-language pretraining framework for zero-shot dermatological tasks. Recognizing that comprehensive dermatological descriptions require multiple knowledge aspects that exceed standard text constraints, our framework introduces: (1) a multi-aspect contrastive learning strategy that decomposes clinical narratives into knowledge-enhanced sub-texts through large language models, (2) a fine-grained alignment mechanism that connects subcaptions with diagnostically relevant image features, and (3) a diagnosis-guided weighting scheme that adaptively prioritizes different sub-captions based on clinical significance prior. Through pretraining on 403,563 dermatological image-text pairs collected from education resources, MAKE significantly outperforms state-of-the-art VLP models on eight datasets across zero-shot skin disease classification, concept annotation, and cross-modal retrieval tasks. Our code will be made publicly available at https: //github.com/SiyuanYan1/MAKE.

Self-supervised geospatial foundation models (GeoFMs) learn transferable representations from remote sensing data, but their downstream behavior is difficult to characterize. We study six representative GeoFMs spanning joint-embedding, reconstruction, and multimodal pretraining families, and evaluate transfer across classification, regression, and segmentation benchmarks under different label availability and downstream pipelines. We find that model rankings change across tasks and adaptation settings. Layerwise probing shows that, in most cases, task-relevant information is more accessible in intermediate transformer blocks compared to final-layer embeddings, and that GeoFMs exhibit distinct depthwise profiles. In segmentation case studies on PASTIS and Sen1Floods11, downstream adaptation settings such as decoder design and fine-tuning can be as impactful as the choice of GeoFM, and standard dense-prediction heads may be poorly aligned with how GeoFMs organize information over depth. Finally, CKA analysis on case studies shows that fine-tuning does not rewrite GeoFMs uniformly across depth, and the strongest changes are localized to the first linear layer of the MLP in ViT blocks. These results help explain why GeoFM rankings shift across benchmarks and motivate more representation-aware evaluation and adaptation strategies.

Recent advances in self-supervised learning (SSL) on Transformers have significantly improved speaker verification (SV) by providing domain-general speech representations. However, existing approaches have underutilized the multi-layered nature of SSL encoders. To address this limitation, we propose the layer-aware time-delay neural network (L-TDNN), which directly performs layer/frame-wise processing on the layer-wise hidden state outputs from pre-trained models, extracting fixed-size speaker vectors. L-TDNN comprises a layer-aware convolutional network, a frame-adaptive layer aggregation, and attentive statistic pooling, explicitly modeling of the recognition and processing of previously overlooked layer dimension. We evaluated L-TDNN across multiple speech SSL Transformers and diverse speech-speaker corpora against other approaches for leveraging pre-trained encoders. L-TDNN consistently demonstrated robust verification performance, achieving the lowest error rates throughout the experiments. Concurrently, it stood out in terms of model compactness and exhibited inference efficiency comparable to the existing systems. These results highlight the advantages derived from the proposed layer-aware processing approach. Future work includes exploring joint training with SSL frontends and the incorporation of score calibration to further enhance state-of-the-art verification performance.

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.

Speech Quality Assessment (SQA) is essential for modern speech technologies, and recent non-intrusive SQA predictors increasingly rely on Speech Foundation Models (SFMs). However, because SFMs expose representations from many layers, it remains unclear which depths are most informative for MOS prediction and how multi-layer information should be combined reliably across backbones and datasets. We benchmark ten SFMs on four MOS datasets under three regimes: full fine-tuning, last-layer probing with a frozen encoder, and naive cross-layer weighted aggregation. We find that the best layer is strongly backbone- and dataset-dependent, and that naive weighted fusion can be unstable across settings. We further evaluate a layer-calibrated aggregation variant that applies per-layer adapters before pooling, which improves the robustness of multi-layer fusion and narrows the gap to full fine-tuning while keeping the backbone frozen.

The field of medical diagnosis has undergone a significant transformation with the advent of large language models (LLMs), yet the challenges of interpretability within these models remain largely unaddressed. This study introduces Chain-of-Diagnosis (CoD) to enhance the interpretability of LLM-based medical diagnostics. CoD transforms the diagnostic process into a diagnostic chain that mirrors a physician's thought process, providing a transparent reasoning pathway. Additionally, CoD outputs the disease confidence distribution to ensure transparency in decision-making. This interpretability makes model diagnostics controllable and aids in identifying critical symptoms for inquiry through the entropy reduction of confidences. With CoD, we developed DiagnosisGPT, capable of diagnosing 9604 diseases. Experimental results demonstrate that DiagnosisGPT outperforms other LLMs on diagnostic benchmarks. Moreover, DiagnosisGPT provides interpretability while ensuring controllability in diagnostic rigor.

Our work presents extensive empirical evidence that layer rotation, i.e. the evolution across training of the cosine distance between each layer's weight vector and its initialization, constitutes an impressively consistent indicator of generalization performance. In particular, larger cosine distances between final and initial weights of each layer consistently translate into better generalization performance of the final model. Interestingly, this relation admits a network independent optimum: training procedures during which all layers' weights reach a cosine distance of 1 from their initialization consistently outperform other configurations -by up to 30% test accuracy. Moreover, we show that layer rotations are easily monitored and controlled (helpful for hyperparameter tuning) and potentially provide a unified framework to explain the impact of learning rate tuning, weight decay, learning rate warmups and adaptive gradient methods on generalization and training speed. In an attempt to explain the surprising properties of layer rotation, we show on a 1-layer MLP trained on MNIST that layer rotation correlates with the degree to which features of intermediate layers have been trained.

Explainable AI (XAI) in medical histopathology is essential for enhancing the interpretability and clinical trustworthiness of deep learning models in cancer diagnosis. However, the black-box nature of these models often limits their clinical adoption. We introduce GRAPHITE (Graph-based Interpretable Tissue Examination), a post-hoc explainable framework designed for breast cancer tissue microarray (TMA) analysis. GRAPHITE employs a multiscale approach, extracting patches at various magnification levels, constructing an hierarchical graph, and utilising graph attention networks (GAT) with scalewise attention (SAN) to capture scale-dependent features. We trained the model on 140 tumour TMA cores and four benign whole slide images from which 140 benign samples were created, and tested it on 53 pathologist-annotated TMA samples. GRAPHITE outperformed traditional XAI methods, achieving a mean average precision (mAP) of 0.56, an area under the receiver operating characteristic curve (AUROC) of 0.94, and a threshold robustness (ThR) of 0.70, indicating that the model maintains high performance across a wide range of thresholds. In clinical utility, GRAPHITE achieved the highest area under the decision curve (AUDC) of 4.17e+5, indicating reliable decision support across thresholds. These results highlight GRAPHITE's potential as a clinically valuable tool in computational pathology, providing interpretable visualisations that align with the pathologists' diagnostic reasoning and support precision medicine.

Zero-shot medical detection can further improve detection performance without relying on annotated medical images even upon the fine-tuned model, showing great clinical value. Recent studies leverage grounded vision-language models (GLIP) to achieve this by using detailed disease descriptions as prompts for the target disease name during the inference phase. However, these methods typically treat prompts as equivalent context to the target name, making it difficult to assign specific disease knowledge based on visual information, leading to a coarse alignment between images and target descriptions. In this paper, we propose StructuralGLIP, which introduces an auxiliary branch to encode prompts into a latent knowledge bank layer-by-layer, enabling more context-aware and fine-grained alignment. Specifically, in each layer, we select highly similar features from both the image representation and the knowledge bank, forming structural representations that capture nuanced relationships between image patches and target descriptions. These features are then fused across modalities to further enhance detection performance. Extensive experiments demonstrate that StructuralGLIP achieves a +4.1\% AP improvement over prior state-of-the-art methods across seven zero-shot medical detection benchmarks, and consistently improves fine-tuned models by +3.2\% AP on endoscopy image datasets.

We present VinDr-CXR-VQA, a large-scale chest X-ray dataset for explainable Medical Visual Question Answering (Med-VQA) with spatial grounding. The dataset contains 17,597 question-answer pairs across 4,394 images, each annotated with radiologist-verified bounding boxes and clinical reasoning explanations. Our question taxonomy spans six diagnostic types-Where, What, Is there, How many, Which, and Yes/No-capturing diverse clinical intents. To improve reliability, we construct a balanced distribution of 41.7% positive and 58.3% negative samples, mitigating hallucinations in normal cases. Benchmarking with MedGemma-4B-it demonstrates improved performance (F1 = 0.624, +11.8% over baseline) while enabling lesion localization. VinDr-CXR-VQA aims to advance reproducible and clinically grounded Med-VQA research. The dataset and evaluation tools are publicly available at huggingface.co/datasets/Dangindev/VinDR-CXR-VQA.

The applicability of current lesion segmentation models for chest X-rays (CXRs) has been limited both by a small number of target labels and the reliance on long, detailed expert-level text inputs, creating a barrier to practical use. To address these limitations, we introduce a new paradigm: instruction-guided lesion segmentation (ILS), which is designed to segment diverse lesion types based on simple, user-friendly instructions. Under this paradigm, we construct MIMIC-ILS, the first large-scale instruction-answer dataset for CXR lesion segmentation, using our fully automated multimodal pipeline that generates annotations from chest X-ray images and their corresponding reports. MIMIC-ILS contains 1.1M instruction-answer pairs derived from 192K images and 91K unique segmentation masks, covering seven major lesion types. To empirically demonstrate its utility, we introduce ROSALIA, a vision-language model fine-tuned on MIMIC-ILS. ROSALIA can segment diverse lesions and provide textual explanations in response to user instructions. The model achieves high segmentation and textual accuracy in our newly proposed task, highlighting the effectiveness of our pipeline and the value of MIMIC-ILS as a foundational resource for pixel-level CXR lesion grounding.

LLMs for clinical decision support often fail under small but clinically meaningful input shifts such as masking a symptom or negating a finding, despite high performance on static benchmarks. These reasoning failures frequently go undetected by standard NLP metrics, which are insensitive to latent representation shifts that drive diagnosis instability. We propose a geometry-aware evaluation framework, LAPD (Latent Agentic Perturbation Diagnostics), which systematically probes the latent robustness of clinical LLMs under structured adversarial edits. Within this framework, we introduce Latent Diagnosis Flip Rate (LDFR), a model-agnostic diagnostic signal that captures representational instability when embeddings cross decision boundaries in PCA-reduced latent space. Clinical notes are generated using a structured prompting pipeline grounded in diagnostic reasoning, then perturbed along four axes: masking, negation, synonym replacement, and numeric variation to simulate common ambiguities and omissions. We compute LDFR across both foundation and clinical LLMs, finding that latent fragility emerges even under minimal surface-level changes. Finally, we validate our findings on 90 real clinical notes from the DiReCT benchmark (MIMIC-IV), confirming the generalizability of LDFR beyond synthetic settings. Our results reveal a persistent gap between surface robustness and semantic stability, underscoring the importance of geometry-aware auditing in safety-critical clinical AI.

As the field of artificial intelligence progresses, assistive technologies are becoming more widely used across all industries. The healthcare industry is no different, with numerous studies being done to develop assistive tools for healthcare professionals. Automatic diagnostic systems are one such beneficial tool that can assist with a variety of tasks, including collecting patient information, analyzing test results, and diagnosing patients. However, the idea of developing systems that can provide a differential diagnosis has been largely overlooked in most of these research studies. In this study, we propose a transformer-based approach for providing differential diagnoses based on a patient's age, sex, medical history, and symptoms. We use the DDXPlus dataset, which provides differential diagnosis information for patients based on 49 disease types. Firstly, we propose a method to process the tabular patient data from the dataset and engineer them into patient reports to make them suitable for our research. In addition, we introduce two data modification modules to diversify the training data and consequently improve the robustness of the models. We approach the task as a multi-label classification problem and conduct extensive experiments using four transformer models. All the models displayed promising results by achieving over 97% F1 score on the held-out test set. Moreover, we design additional behavioral tests to get a broader understanding of the models. In particular, for one of our test cases, we prepared a custom test set of 100 samples with the assistance of a doctor. The results on the custom set showed that our proposed data modification modules improved the model's generalization capabilities. We hope our findings will provide future researchers with valuable insights and inspire them to develop reliable systems for automatic differential diagnosis.

This study proposes a two-phase methodology for detecting and classifying auxiliary insulation in structural components. In the detection phase, a YOLOv8x model is trained on a dataset of complete structural blueprints, each annotated with bounding boxes indicating areas that should contain insulation. In the classification phase, these detected insulation patches are cropped and categorized into two classes: present or missing. These are then used to train a YOLOv8x-CLS model that determines the presence or absence of auxiliary insulation. Preprocessing steps for both datasets included annotation, augmentation, and appropriate cropping of the insulation regions. The detection model achieved a mean average precision (mAP) score of 82%, while the classification model attained an accuracy of 98%. These findings demonstrate the effectiveness of the proposed approach in automating insulation detection and classification, providing a foundation for further advancements in this domain.

In this article, we describe the design and implementation of a publicly accessible dermatology image analysis benchmark challenge. The goal of the challenge is to sup- port research and development of algorithms for automated diagnosis of melanoma, a lethal form of skin cancer, from dermoscopic images. The challenge was divided into sub-challenges for each task involved in image analysis, including lesion segmentation, dermoscopic feature detection within a lesion, and classification of melanoma. Training data included 900 images. A separate test dataset of 379 images was provided to measure resultant performance of systems developed with the training data. Ground truth for both training and test sets was generated by a panel of dermoscopic experts. In total, there were 79 submissions from a group of 38 participants, making this the largest standardized and comparative study for melanoma diagnosis in dermoscopic images to date. While the official challenge duration and ranking of participants has concluded, the datasets remain available for further research and development.

This study investigates the integration of diverse patient data sources into multimodal language models for automated chest X-ray (CXR) report generation. Traditionally, CXR report generation relies solely on CXR images and limited radiology data, overlooking valuable information from patient health records, particularly from emergency departments. Utilising the MIMIC-CXR and MIMIC-IV-ED datasets, we incorporate detailed patient information such as aperiodic vital signs, medications, and clinical history to enhance diagnostic accuracy. We introduce a novel approach to transform these heterogeneous data sources into embeddings that prompt a multimodal language model, significantly enhancing the diagnostic accuracy of generated radiology reports. Our comprehensive evaluation demonstrates the benefits of using a broader set of patient data, underscoring the potential for enhanced diagnostic capabilities and better patient outcomes through the integration of multimodal data in CXR report generation.

The visual examination of tissue biopsy sections is fundamental for cancer diagnosis, with pathologists analyzing sections at multiple magnifications to discern tumor cells and their subtypes. However, existing attention-based multiple instance learning (MIL) models, used for analyzing Whole Slide Images (WSIs) in cancer diagnostics, often overlook the contextual information of tumor and neighboring tiles, leading to misclassifications. To address this, we propose the Context-Aware Multiple Instance Learning (CAMIL) architecture. CAMIL incorporates neighbor-constrained attention to consider dependencies among tiles within a WSI and integrates contextual constraints as prior knowledge into the MIL model. We evaluated CAMIL on subtyping non-small cell lung cancer (TCGA-NSCLC) and detecting lymph node (CAMELYON16) metastasis, achieving test AUCs of 0.959\% and 0.975\%, respectively, outperforming other state-of-the-art methods. Additionally, CAMIL enhances model interpretability by identifying regions of high diagnostic value.

Current AI-assisted skin image diagnosis has achieved dermatologist-level performance in classifying skin cancer, driven by rapid advancements in deep learning architectures. However, unlike traditional vision tasks, skin images in general present unique challenges due to the limited availability of well-annotated datasets, complex variations in conditions, and the necessity for detailed interpretations to ensure patient safety. Previous segmentation methods have sought to reduce image noise and enhance diagnostic performance, but these techniques require fine-grained, pixel-level ground truth masks for training. In contrast, with the rise of foundation models, the Segment Anything Model (SAM) has been introduced to facilitate promptable segmentation, enabling the automation of the segmentation process with simple yet effective prompts. Efforts applying SAM predominantly focus on dermatoscopy images, which present more easily identifiable lesion boundaries than clinical photos taken with smartphones. This limitation constrains the practicality of these approaches to real-world applications. To overcome the challenges posed by noisy clinical photos acquired via non-standardized protocols and to improve diagnostic accessibility, we propose a novel Cross-Attentive Fusion framework for interpretable skin lesion diagnosis. Our method leverages SAM to generate visual concepts for skin diseases using prompts, integrating local visual concepts with global image features to enhance model performance. Extensive evaluation on two skin disease datasets demonstrates our proposed method's effectiveness on lesion diagnosis and interpretability.

Recent studies on hallucination detection have shown that hallucination-related signals are more strongly encoded in intermediate layers than in the final layer of large language models (LLMs). Although a growing body of work has sought to exploit this property for hallucination detection, how to automate the selection of high-performing layers remains underexplored, and principled methods for this purpose are still lacking. To address this gap, we first propose several hypotheses for why such signals emerge in intermediate layers and evaluate corresponding criteria for automatic layer selection across diverse LLM architectures, scales, and tasks, covering both question answering and summarization hallucination detection benchmarks. However, we find that none of these criteria consistently delivers satisfactory performance. We therefore propose a new selection criterion, First Effective Peak of Intrinsic Dimension (FEPoID), which consistently identify optimal or near-optimal layers and outperforms both the aforementioned criteria and existing hallucination detection baselines. FEPoID is training-free and incurs negligible computational overhead. In addition, we study the generation behaviors of LLMs and introduce a simple yet effective truncation strategy, which further amplifies hallucination-related signals and substantially improves overall detection performance. Code is publicly available at https://github.com/DesoloYw/Automatic-Layer-Selection-for-Hallucination-Detection.git

Layer-wise mixed-precision quantization (LMPQ) enables effective compression under extreme low-bit settings by allocating higher precision to sensitive layers. However, existing methods typically treat all intra-layer weight modules uniformly and rely on a single numerical property when estimating sensitivity, overlooking their distinct operational roles and structural characteristics. To address this, we propose NSDS, a novel calibration-free LMPQ framework driven by Numerical and Structural Dual-Sensitivity. Specifically, it first mechanistically decomposes each layer into distinct operational roles and quantifies their sensitivity from both numerical and structural perspectives. These dual-aspect scores are then aggregated into a unified layer-wise metric through a robust aggregation scheme based on MAD-Sigmoid and Soft-OR to guide bit allocation. Extensive experiments demonstrate that NSDS consistently achieves superior performance compared to various baselines across diverse models and downstream tasks, without relying on any calibration data.

Previous work has showcased the intriguing capability of large language models (LLMs) in retrieving facts and processing context knowledge. However, only limited research exists on the layer-wise capability of LLMs to encode knowledge, which challenges our understanding of their internal mechanisms. In this paper, we devote the first attempt to investigate the layer-wise capability of LLMs through probing tasks. We leverage the powerful generative capability of ChatGPT to construct probing datasets, providing diverse and coherent evidence corresponding to various facts. We employ mathcal V-usable information as the validation metric to better reflect the capability in encoding context knowledge across different layers. Our experiments on conflicting and newly acquired knowledge show that LLMs: (1) prefer to encode more context knowledge in the upper layers; (2) primarily encode context knowledge within knowledge-related entity tokens at lower layers while progressively expanding more knowledge within other tokens at upper layers; and (3) gradually forget the earlier context knowledge retained within the intermediate layers when provided with irrelevant evidence. Code is publicly available at https://github.com/Jometeorie/probing_llama.

Remarkable strides in computational pathology have been made in the task-agnostic foundation model that advances the performance of a wide array of downstream clinical tasks. Despite the promising performance, there are still several challenges. First, prior works have resorted to either vision-only or image-caption data, disregarding pathology reports with more clinically authentic information from pathologists and gene expression profiles which respectively offer distinct knowledge for versatile clinical applications. Second, the current progress in pathology FMs predominantly concentrates on the patch level, where the restricted context of patch-level pretraining fails to capture whole-slide patterns. Even recent slide-level FMs still struggle to provide whole-slide context for patch representation. In this study, for the first time, we develop a pathology foundation model incorporating three levels of modalities: pathology slides, pathology reports, and gene expression data, which resulted in 26,169 slide-level modality pairs from 10,275 patients across 32 cancer types, amounting to over 116 million pathological patch images. To leverage these data for CPath, we propose a novel whole-slide pretraining paradigm that injects the multimodal whole-slide context into the patch representation, called Multimodal Self-TAught PRetraining (mSTAR). The proposed paradigm revolutionizes the pretraining workflow for CPath, enabling the pathology FM to acquire the whole-slide context. To the best of our knowledge, this is the first attempt to incorporate three modalities at the whole-slide context for enhancing pathology FMs. To systematically evaluate the capabilities of mSTAR, we built the largest spectrum of oncological benchmark, spanning 7 categories of oncological applications in 15 types of 97 practical oncological tasks.

Recent radiology multi-modal language models have made substantial progress in chest X-ray report generation, visual question answering, and temporal reasoning. While longitudinal chest X-ray interpretation compares sequential examinations to describe change, visual grounding aims to connect clinical language with localized image evidence. Although longitudinal modeling and visual grounding have each advanced radiology language models, how localized visual evidence can support longitudinal interpretation remains under-explored. We introduce CheXGround, a region-grounded longitudinal chest X-ray language model that represents paired studies through corresponding anatomical regions. CheXGround extracts anatomical regions from current and prior radiographs, encodes them as temporally enhanced Region-of-Interest (ROI) tokens, and combines them with global temporal image context during generation. To connect these region tokens with clinical text, we propose Temporal Region--Phrase Alignment, a pretraining objective that aligns temporal anatomical representations with localized report phrases. We evaluate CheXGround on single-study and longitudinal Visual Question Answering (VQA), longitudinal findings generation, temporal grounded VQA, and anatomical grounding. Across these tasks, CheXGround improves clinical language quality, temporal reasoning, and localization accuracy over recent baselines. Our results suggest that organizing longitudinal evidence at the anatomical level is a strong representation for grounded radiology language modeling. Project page: https://adonaydem.github.io/chexground-website

We introduce MURA, a large dataset of musculoskeletal radiographs containing 40,561 images from 14,863 studies, where each study is manually labeled by radiologists as either normal or abnormal. To evaluate models robustly and to get an estimate of radiologist performance, we collect additional labels from six board-certified Stanford radiologists on the test set, consisting of 207 musculoskeletal studies. On this test set, the majority vote of a group of three radiologists serves as gold standard. We train a 169-layer DenseNet baseline model to detect and localize abnormalities. Our model achieves an AUROC of 0.929, with an operating point of 0.815 sensitivity and 0.887 specificity. We compare our model and radiologists on the Cohen's kappa statistic, which expresses the agreement of our model and of each radiologist with the gold standard. Model performance is comparable to the best radiologist performance in detecting abnormalities on finger and wrist studies. However, model performance is lower than best radiologist performance in detecting abnormalities on elbow, forearm, hand, humerus, and shoulder studies. We believe that the task is a good challenge for future research. To encourage advances, we have made our dataset freely available at https://stanfordmlgroup.github.io/competitions/mura .

The emergence of groundbreaking large language models capable of performing complex reasoning tasks holds significant promise for addressing various scientific challenges, including those arising in complex clinical scenarios. To enable their safe and effective deployment in real-world healthcare settings, it is urgently necessary to benchmark the diagnostic capabilities of current models systematically. Given the limitations of existing medical benchmarks in evaluating advanced diagnostic reasoning, we present DiagnosisArena, a comprehensive and challenging benchmark designed to rigorously assess professional-level diagnostic competence. DiagnosisArena consists of 1,113 pairs of segmented patient cases and corresponding diagnoses, spanning 28 medical specialties, deriving from clinical case reports published in 10 top-tier medical journals. The benchmark is developed through a meticulous construction pipeline, involving multiple rounds of screening and review by both AI systems and human experts, with thorough checks conducted to prevent data leakage. Our study reveals that even the most advanced reasoning models, o3-mini, o1, and DeepSeek-R1, achieve only 45.82%, 31.09%, and 17.79% accuracy, respectively. This finding highlights a significant generalization bottleneck in current large language models when faced with clinical diagnostic reasoning challenges. Through DiagnosisArena, we aim to drive further advancements in AIs diagnostic reasoning capabilities, enabling more effective solutions for real-world clinical diagnostic challenges. We provide the benchmark and evaluation tools for further research and development https://github.com/SPIRAL-MED/DiagnosisArena.

Keyword-matching benchmarks can credit small models for tool use they never perform. We document such a false positive in a matched-architecture pair of Spanish security language models and propose a ladder of strict, cheap diagnostics. A 661.6M parameter model (approx. 65% code/technical text; no dedicated SFT) and a 1,109M model (web-heavy multi-phase curriculum; 6B-token tool-SFT) share decoder, tokenizer, and special tokens, scoring almost identically on lenient tool-use metrics (B4: 0.660 vs. 0.650). Verbatim-reproduction checks on training examples separate them completely: the 600M emits valid tool calls with generalized arguments on 6/6 examples; the 1B does so on 0/6 across checkpoints. A first-token probe localizes the 1B's failure to a missing prior (prob. 10^{-4}--10^{-5} on <|tool_call|>), which was erased by its web-heavy training phase. A targeted SFT recipe (diverse corpus, 5x higher learning rate, 2,202 steps, ~3.3 GPU-hours) repairs the 1B using three orders of magnitude fewer tokens than the failed phase. On all 269 corpus rows, valid emission rises from 0.100 to 0.959 (600M: 0.926). On 238 unseen prompts, the repaired 1B passes 0.536 vs. the 600M's 0.428 (p = 0.004). Embedding-drift checks show the repair did not move the trigger token's tied embedding (97.7% of the bf16 table remains bit-identical), meaning changes live in the surrounding network. Both models over-trigger, rarely answering negative prompts without a call (0.09 for 600M, 0.17 for repaired 1B). Factorial analyses confirm all repair configurations install the format, though suppression benefits from a diverse corpus remain a hypothesis due to seed sensitivity. This cheap diagnostic ladder costs minutes of CPU time and should gate tool-use claims on small models.

Deep learning has driven significant advances in medical image analysis, yet its adoption in clinical practice remains constrained by the large size and lack of transparency in modern models. Advances in interpretability techniques such as DL-Backtrace, Layer-wise Relevance Propagation, and Integrated Gradients make it possible to assess the contribution of individual components within neural networks trained on medical imaging tasks. In this work, we introduce an interpretability-guided pruning framework that reduces model complexity while preserving both predictive performance and transparency. By selectively retaining only the most relevant parts of each layer, our method enables targeted compression that maintains clinically meaningful representations. Experiments across multiple medical image classification benchmarks demonstrate that this approach achieves high compression rates with minimal loss in accuracy, paving the way for lightweight, interpretable models suited for real-world deployment in healthcare settings.

Future short or long-term space missions require a new generation of monitoring and diagnostic systems due to communication impasses as well as limitations in specialized crew and equipment. Machine learning supported diagnostic systems present a viable solution for medical and technical applications. We discuss challenges and applicability of such systems in light of upcoming missions and outline an example use case for a next-generation medical diagnostic system for future space operations. Additionally, we present approach recommendations and constraints for the successful generation and use of machine learning models aboard a spacecraft.

Chest X-rays play a pivotal role in diagnosing respiratory diseases such as pneumonia, tuberculosis, and COVID-19, which are prevalent and present unique diagnostic challenges due to overlapping visual features and variability in image quality. Severe class imbalance and the complexity of medical images hinder automated analysis. This study leverages deep learning techniques, including transfer learning on pre-trained models (AlexNet, ResNet, and InceptionNet), to enhance disease detection and classification. By fine-tuning these models and incorporating focal loss to address class imbalance, significant performance improvements were achieved. Grad-CAM visualizations further enhance model interpretability, providing insights into clinically relevant regions influencing predictions. The InceptionV3 model, for instance, achieved a 28% improvement in AUC and a 15% increase in F1-Score. These findings highlight the potential of deep learning to improve diagnostic workflows and support clinical decision-making.

Automated diagnostic systems (ADS) have shown significant potential in the early detection of polyps during endoscopic examinations, thereby reducing the incidence of colorectal cancer. However, due to high annotation costs and strict privacy concerns, acquiring high-quality endoscopic images poses a considerable challenge in the development of ADS. Despite recent advancements in generating synthetic images for dataset expansion, existing endoscopic image generation algorithms failed to accurately generate the details of polyp boundary regions and typically required medical priors to specify plausible locations and shapes of polyps, which limited the realism and diversity of the generated images. To address these limitations, we present Polyp-Gen, the first full-automatic diffusion-based endoscopic image generation framework. Specifically, we devise a spatial-aware diffusion training scheme with a lesion-guided loss to enhance the structural context of polyp boundary regions. Moreover, to capture medical priors for the localization of potential polyp areas, we introduce a hierarchical retrieval-based sampling strategy to match similar fine-grained spatial features. In this way, our Polyp-Gen can generate realistic and diverse endoscopic images for building reliable ADS. Extensive experiments demonstrate the state-of-the-art generation quality, and the synthetic images can improve the downstream polyp detection task. Additionally, our Polyp-Gen has shown remarkable zero-shot generalizability on other datasets. The source code is available at https://github.com/CUHK-AIM-Group/Polyp-Gen.

Explaining deep learning models is essential for clinical integration of medical image analysis systems. A good explanation highlights if a model depends on spurious features that undermines generalization and harms a subset of patients or, conversely, may present novel biological insights. Although techniques like GradCAM can identify influential features, they are measurement tools that do not themselves form an explanation. We propose a human-machine-VLM interaction system tailored to explaining classifiers in computational pathology, including multi-instance learning for whole-slide images. Our proof of concept comprises (1) an AI-integrated slide viewer to run sliding-window experiments to test claims of an explanation, and (2) quantification of an explanation's predictiveness using general-purpose vision-language models. The results demonstrate that this allows us to qualitatively test claims of explanations and can quantifiably distinguish competing explanations. This offers a practical path from explainable AI to explained AI in digital pathology and beyond. Code and prompts are available at https://github.com/nki-ai/x2x.

Interstitial lung diseases (ILD) present diagnostic challenges due to their varied manifestations and overlapping imaging features. To address this, we propose a machine learning approach that utilizes CLIP, a multimodal (image and text) self-supervised model, for ILD classification. We extensively integrate zero-shot CLIP throughout our workflow, starting from the initial extraction of image patches from volumetric CT scans and proceeding to ILD classification using "patch montages". Furthermore, we investigate how domain adaptive pretraining (DAPT) CLIP with task-specific images (CT "patch montages" extracted with ILD-specific prompts for CLIP) and/or text (lung-specific sections of radiology reports) affects downstream ILD classification performance. By leveraging CLIP-extracted "patch montages" and DAPT, we achieve strong zero-shot ILD classification results, including an AUROC of 0.893, without the need for any labeled training data. This work highlights the versatility and potential of multimodal models like CLIP for medical image classification tasks where labeled data is scarce.

With the widespread application of artificial intelligence (AI), particularly deep learning (DL) and vision-based large language models (VLLMs), in skin disease diagnosis, the need for interpretability becomes crucial. However, existing dermatology datasets are limited in their inclusion of concept-level meta-labels, and none offer rich medical descriptions in natural language. This deficiency impedes the advancement of LLM-based methods in dermatological diagnosis. To address this gap and provide a meticulously annotated dermatology dataset with comprehensive natural language descriptions, we introduce SkinCAP: a multi-modal dermatology dataset annotated with rich medical captions. SkinCAP comprises 4,000 images sourced from the Fitzpatrick 17k skin disease dataset and the Diverse Dermatology Images dataset, annotated by board-certified dermatologists to provide extensive medical descriptions and captions. Notably, SkinCAP represents the world's first such dataset and is publicly available at https://huggingface.co/datasets/joshuachou/SkinCAP.

Large Multimodal Models (LMMs) have shown remarkable progress in the field of medical Visual Question Answering (Med-VQA), achieving high accuracy on existing benchmarks. However, their reliability under robust evaluation is questionable. This study reveals that state-of-the-art models, when subjected to simple probing evaluation, perform worse than random guessing on medical diagnosis questions. To address this critical evaluation problem, we introduce the Probing Evaluation for Medical Diagnosis (ProbMed) dataset to rigorously assess LMM performance in medical imaging through probing evaluation and procedural diagnosis. Particularly, probing evaluation features pairing original questions with negation questions with hallucinated attributes, while procedural diagnosis requires reasoning across various diagnostic dimensions for each image, including modality recognition, organ identification, clinical findings, abnormalities, and positional grounding. Our evaluation reveals that top-performing models like GPT-4V and Gemini Pro perform worse than random guessing on specialized diagnostic questions, indicating significant limitations in handling fine-grained medical inquiries. Besides, models like LLaVA-Med struggle even with more general questions, and results from CheXagent demonstrate the transferability of expertise across different modalities of the same organ, showing that specialized domain knowledge is still crucial for improving performance. This study underscores the urgent need for more robust evaluation to ensure the reliability of LMMs in critical fields like medical diagnosis, and current LMMs are still far from applicable to those fields.

The recent 'Mpox' outbreak, formerly known as 'Monkeypox', has become a significant public health concern and has spread to over 110 countries globally. The challenge of clinically diagnosing mpox early on is due, in part, to its similarity to other types of rashes. Computer-aided screening tools have been proven valuable in cases where Polymerase Chain Reaction (PCR) based diagnosis is not immediately available. Deep learning methods are powerful in learning complex data representations, but their efficacy largely depends on adequate training data. To address this challenge, we present the "Mpox Skin Lesion Dataset Version 2.0 (MSLD v2.0)" as a follow-up to the previously released openly accessible dataset, one of the first datasets containing mpox lesion images. This dataset contains images of patients with mpox and five other non-mpox classes (chickenpox, measles, hand-foot-mouth disease, cowpox, and healthy). We benchmark the performance of several state-of-the-art deep learning models, including VGG16, ResNet50, DenseNet121, MobileNetV2, EfficientNetB3, InceptionV3, and Xception, to classify mpox and other infectious skin diseases. In order to reduce the impact of racial bias, we utilize a color space data augmentation method to increase skin color variability during training. Additionally, by leveraging transfer learning implemented with pre-trained weights generated from the HAM10000 dataset, an extensive collection of pigmented skin lesion images, we achieved the best overall accuracy of 83.59pm2.11%. Finally, the developed models are incorporated within a prototype web application to analyze uploaded skin images by a user and determine whether a subject is a suspected mpox patient.

Pre-training datasets, like ImageNet, have become the gold standard in medical image analysis. However, the emergence of self-supervised learning (SSL), which leverages unlabeled data to learn robust features, presents an opportunity to bypass the intensive labeling process. In this study, we explored if SSL for pre-training on non-medical images can be applied to chest radiographs and how it compares to supervised pre-training on non-medical images and on medical images. We utilized a vision transformer and initialized its weights based on (i) SSL pre-training on natural images (DINOv2), (ii) SL pre-training on natural images (ImageNet dataset), and (iii) SL pre-training on chest radiographs from the MIMIC-CXR database. We tested our approach on over 800,000 chest radiographs from six large global datasets, diagnosing more than 20 different imaging findings. Our SSL pre-training on curated images not only outperformed ImageNet-based pre-training (P<0.001 for all datasets) but, in certain cases, also exceeded SL on the MIMIC-CXR dataset. Our findings suggest that selecting the right pre-training strategy, especially with SSL, can be pivotal for improving artificial intelligence (AI)'s diagnostic accuracy in medical imaging. By demonstrating the promise of SSL in chest radiograph analysis, we underline a transformative shift towards more efficient and accurate AI models in medical imaging.

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.

Layer dropout (a.k.a. stochastic depth) has been shown to enable faster training, higher accuracy, and robustness to zero-shot layer pruning in both language and vision transformers. However, as models and datasets have scaled, dropout - particularly layer dropout - has largely disappeared from large language models (LLMs) pre-training recipes. While some prior work has reported that dropout can degrade accuracy, no comprehensive study has quantified, let alone mitigated, this effect. In this study, we show that layer dropout should be used in state-of-the-art LLM training, establishing best practices and scaling analysis for both training and post-training benefits. Concretely, with optimal layer distribution, time schedule, and optimizer hyperparameters, we observe that at the same training FLOPs layer dropout leads to lower loss. For a given number of training steps, LLMs can achieve lower or similar validation loss while saving upto 25% of training FLOPs. Moreover, layer dropout enables significant post-training optimizations, such as early exit, intermediate-layer skipping, and self-speculative decoding, yielding up to 1.5x inference speedup with negligible accuracy loss. Across more than 2400 training experiments, spanning models from 271M to 8.2B parameters and datasets up to 160B tokens, we demonstrate that these findings extend reliably to large-scale training regimes. All pre-training experiments were run on Cerebras CS-3 systems.

This paper conducts a comprehensive layer-wise analysis of self-supervised learning (SSL) models for audio deepfake detection across diverse contexts, including multilingual datasets (English, Chinese, Spanish), partial, song, and scene-based deepfake scenarios. By systematically evaluating the contributions of different transformer layers, we uncover critical insights into model behavior and performance. Our findings reveal that lower layers consistently provide the most discriminative features, while higher layers capture less relevant information. Notably, all models achieve competitive equal error rate (EER) scores even when employing a reduced number of layers. This indicates that we can reduce computational costs and increase the inference speed of detecting deepfakes by utilizing only a few lower layers. This work enhances our understanding of SSL models in deepfake detection, offering valuable insights applicable across varied linguistic and contextual settings. Our trained models and code are publicly available: https://github.com/Yaselley/SSL_Layerwise_Deepfake.

Chest X-rays (CXRs) are the most frequently performed imaging test in clinical practice. Recent advances in the development of vision-language foundation models (FMs) give rise to the possibility of performing automated CXR interpretation, which can assist physicians with clinical decision-making and improve patient outcomes. However, developing FMs that can accurately interpret CXRs is challenging due to the (1) limited availability of large-scale vision-language datasets in the medical image domain, (2) lack of vision and language encoders that can capture the complexities of medical data, and (3) absence of evaluation frameworks for benchmarking the abilities of FMs on CXR interpretation. In this work, we address these challenges by first introducing CheXinstruct - a large-scale instruction-tuning dataset curated from 28 publicly-available datasets. We then present CheXagent - an instruction-tuned FM capable of analyzing and summarizing CXRs. To build CheXagent, we design a clinical large language model (LLM) for parsing radiology reports, a vision encoder for representing CXR images, and a network to bridge the vision and language modalities. Finally, we introduce CheXbench - a novel benchmark designed to systematically evaluate FMs across 8 clinically-relevant CXR interpretation tasks. Extensive quantitative evaluations and qualitative reviews with five expert radiologists demonstrate that CheXagent outperforms previously-developed general- and medical-domain FMs on CheXbench tasks. Furthermore, in an effort to improve model transparency, we perform a fairness evaluation across factors of sex, race and age to highlight potential performance disparities. Our project is at https://stanford-aimi.github.io/chexagent.html.

Cancer screening is a reasoning task. A radiologist observes findings, compares them to prior scans, integrates clinical context, and reaches a diagnostic conclusion confirmed by pathology. We present RadThinking, a Visual Question Answering (VQA) dataset that makes this reasoning explicit and trainable. RadThinking releases VQA pairs at three difficulty tiers. Foundation VQAs are atomic perception questions. Single-step reasoning VQAs apply one clinical rule. Compositional VQAs require multi-step chain-of-thought to reach a guideline category such as LI-RADS-5. For every compositional VQA, we release the chain of foundation VQAs that solves it. The chain follows the rules of the governing clinical reporting standard. The dataset spans 20,362 CT scans from 9,131 patients across 43 cancer groups, plus 2,077 verified healthy controls with >1-year follow-up. To our knowledge, RadThinking is the first cancer-screening VQA corpus that stratifies questions by reasoning depth and grounds compositions in clinical reporting standards. The foundation tier supplies atomic perception supervision. The compositional tier supplies chain-of-thought data and verifiable rewards for reinforcement-learning recipes such as DeepSeek-R1 and OpenAI o1. RadThinking enables systematic training and evaluation of whether AI systems can reason about cancer, not merely detect it.

Despite advances in transformer-based language models (LMs), a fundamental question remains largely unanswered: Are all layers activated during inference? We investigate this question by detecting unactivated layers (which we refer to as Voids) using a non-trainable and parameter-free adaptive computation method called L2 Adaptive Computation (LAC). We adapt LAC from its original efficiency-focused application to trace activated layers during inference. This method monitors changes in the L2-norm of activations to identify voids. We analyze layer activation in instruction-tuned LMs across two phases: Prompt Processing (PP), where we trace activated layers for each token in the input prompts, and Response Generation (RG), where we trace activated layers for each generated token. We further demonstrate that distinct layers are activated during these two phases. To show the effectiveness of our method, we evaluated three distinct instruction-tuned LMs from the Llama, Mistral, and Qwen families on three benchmarks: MMLU, GPQA Diamond, and BoolQ. For example, on MMLU with a zero-shot setting, skipping voids in Qwen2.5-7B-Instruct resulted in an improvement from 69.24 to 71.29 while the model uses only 30% of the layers. Similarly, Mistral-7B-Instruct-v0.3 on GPQA Diamond improved from 13.88 to 18.36 when using 70% of the layers during both the PP and RG phases. These results show that not all layers contribute equally during inference, and that selectively skipping most of them can improve the performance of models on certain tasks.

Linear probes trained on LLM activations are increasingly proposed as deception-detection metrics, yet report AUROC exceeding 0.96 on clean benchmarks while collapsing under distributional shift. This paper systematically pressure-tests probe-based metrics across the Gemma 3 model family (1B-27B parameters), diagnosing why they fail rather than merely documenting that they fail. We test four hypotheses about deception encoding: (1) single linear direction, (2) multi-dimensional subspace, (3) convex conic hull, (4) entropy proxy. Our design includes cross-domain transfer matrices, multi-dimensional probe analysis with permutation null baselines, entropy-residualization tests, and distractor evaluations across 8 stylistic shifts. We find that: (a) probes achieve near-perfect AUROC (>=0.998) on clean data but collapse under stylistic shifts; style-augmented probes recover near-perfect detection (mean AUROC 0.979-0.983) on unseen styles; (b) the single-direction hypothesis is rejected (k=1 captures only 0.61-0.80 AUROC), with cross-domain transfer failure confirmed as geometric rather than layer-mismatch-driven; (c) the entropy-proxy hypothesis is rejected (max |rho|=0.454, max Delta-AUROC after residualization=0.004); and (d) deception does not form a significant linear subspace (per-domain k*=0), yet multi-dimensional probes (k>=5) recover the signal through distributed sub-threshold features. Probe fragility reflects distributional narrowness rather than an architectural limitation: style-augmented probes recover near-perfect detection at both 4B and 27B, establishing that the inverse scaling pattern is a training-distribution artifact rather than a genuine scale-dependent phenomenon.