Huahui Yi

Ziyuan Qin, Huahui Yi, Qicheng Lao et al.

The large-scale pre-trained vision language models (VLM) have shown remarkable domain transfer capability on natural images. However, it remains unknown whether this capability can also apply to the medical image domain. This paper thoroughly studies the knowledge transferability of pre-trained VLMs to the medical domain, where we show that well-designed medical prompts are the key to elicit knowledge from pre-trained VLMs. We demonstrate that by prompting with expressive attributes that are shared between domains, the VLM can carry the knowledge across domains and improve its generalization. This mechanism empowers VLMs to recognize novel objects with fewer or without image samples. Furthermore, to avoid the laborious manual designing process, we develop three approaches for automatic generation of medical prompts, which can inject expert-level medical knowledge and image-specific information into the prompts for fine-grained grounding. We conduct extensive experiments on thirteen different medical datasets across various modalities, showing that our well-designed prompts greatly improve the zero-shot performance compared to the default prompts, and our fine-tuned models surpass the supervised models by a significant margin.

Huahui Yi, Ziyuan Qin, Qicheng Lao et al.

Inevitable domain and task discrepancies in real-world scenarios can impair the generalization performance of the pre-trained deep models for medical data. Therefore, we audaciously propose that we should build a general-purpose medical AI system that can be seamlessly adapted to downstream domains/tasks. Since the domain/task adaption procedures usually involve additional labeling work for the target data, designing a data-efficient adaption algorithm is desired to save the cost of transferring the learned knowledge. Our recent work found that vision-language models (VLMs) are efficient learners with extraordinary cross-domain ability. Therefore, in this work, we further explore the possibility of leveraging pre-trained VLMs as medical foundation models for building general-purpose medical AI, where we thoroughly investigate three machine-learning paradigms, i.e., domain/task-specialized learning, joint learning, and continual learning, for training the VLMs and evaluate their generalization performance on cross-domain and cross-task test sets. To alleviate the catastrophic forgetting during sequential training, we employ rehearsal learning and receive a sharp boost in terms of generalization capability. In a nutshell, our empirical evidence suggests that continual learning may be a practical and efficient learning paradigm for the medical foundation model. And we hope researchers can use our empirical evidence as basement to further explore the path toward medical foundation model.

Haolong Hu, Hanyu Li, Tiancheng He et al.

MLLMs are increasingly deployed in multi-turn settings, where attackers can escalate unsafe intent through the evolving visual-text history and exploit long-context safety decay. Yet safety alignment is still dominated by single-turn data and fixed-template dialogues, leaving a mismatch between training and deployment.To bridge this gap, we propose SaFeR-Steer, a progressive multi-turn alignment framework that combines staged synthetic bootstrapping with tutor-in-the-loop GRPO to train a single student under adaptive, on-policy attacks. We also introduce TCSR, which uses trajectory minimum/average safety to propagate late-turn failures to earlier turns.I. Dataset. We release STEER, a multi-turn multimodal safety dataset with STEER-SFT (12,934), STEER-RL (2,000), and STEER-Bench (3,227) dialogues spanning 2~10 turns.II. Experiment. Starting from Qwen2.5-VL-3B/7B, SaFeR-Steer substantially improves Safety/Helpfulness on both single-turn (48.30/45.86 -> 81.84/70.77 for 3B; 56.21/60.32 -> 87.89/77.40 for 7B) and multi-turn benchmarks (12.55/27.13 -> 55.58/70.27 for 3B; 24.66/46.48 -> 64.89/72.35 for 7B), shifting failures to later turns and yielding robustness beyond scaling alone.Codes are available at https://github.com/Ed-Bg/SaFeR-Steer

Zixuan Xu, Tiancheng He, Huahui Yi et al.

Vision-language models remain susceptible to multimodal jailbreaks and over-refusal because safety hinges on both visual evidence and user intent, while many alignment pipelines supervise only the final response. To address this, we present SaFeR-ToolKit, which formalizes safety decision-making as a checkable protocol. Concretely, a planner specifies a persona, a Perception $\to$ Reasoning $\to$ Decision tool set, and a constrained transition graph, while a responder outputs a typed key-value tool trace before the final answer. To make the protocol reliably followed in practice, we train a single policy with a three-stage curriculum (SFT $\to$ DPO $\to$ GRPO), where GRPO directly supervises tool usage beyond answer-level feedback. Our contributions are two-fold: I. Dataset. The first tool-based safety reasoning dataset, comprising 31,654 examples (SFT 6k, DPO 18.6k, GRPO 6k) plus 1k held-out evaluation. II. Experiments. On Qwen2.5-VL, SaFeR-ToolKit significantly improves Safety/Helpfulness/Reasoning Rigor on 3B (29.39/45.04/4.98 $\to$ 84.40/71.13/78.87) and 7B (53.21/52.92/19.26 $\to$ 86.34/80.79/85.34), while preserving general capabilities (3B: 58.67 $\to$ 59.21; 7B: 66.39 $\to$ 66.81). Codes are available at https://github.com/Duebassx/SaFeR_ToolKit.

Xi Chen, Hongru Zhou, Huahui Yi et al.

Missed and delayed diagnosis remains a major challenge in rare disease care. At the initial clinical encounters, physicians assess rare disease risk using only limited information under high uncertainty. When high-risk patients are not recognised at this stage, targeted diagnostic testing is often not initiated, resulting in missed diagnosis. Existing primary care triage processes are structurally insufficient to reliably identify patients with rare diseases at initial clinical presentation and universal screening is needed to reduce diagnostic delay. Here we present RareAlert, an early screening system which predict patient-level rare disease risk from routinely available primary-visit information. RareAlert integrates reasoning generated by ten LLMs, calibrates and weights these signals using machine learning, and distils the aligned reasoning into a single locally deployable model. To develop and evaluate RareAlert, we curated RareBench, a real-world dataset of 158,666 cases covering 33 Orphanet disease categories and more than 7,000 rare conditions, including both rare and non-rare presentations. The results showed that rare disease identification can be reconceptualised as a universal uncertainty resolution process applied to the general patient population. On an independent test set, RareAlert, a Qwen3-4B based model trained with calibrated reasoning signals, achieved an AUC of 0.917, outperforming the best machine learning ensemble and all evaluated LLMs, including GPT-5, DeepSeek-R1, Claude-3.7-Sonnet, o3-mini, Gemini-2.5-Pro, and Qwen3-235B. These findings demonstrate the diversity in LLM medical reasoning and the effectiveness of aligning such reasoning in highly uncertain clinical tasks. By incorporating calibrated reasoning into a single model, RareAlert enables accurate, privacy-preserving, and scalable rare disease risk screening suitable for large-scale local deployment.

Guangjing Yang, ZhangYuan Yu, Ziyuan Qin et al.

While recent advances in Reinforcement Fine-Tuning (RFT) have shown that rule-based reward schemes can enable effective post-training for large language models, their extension to cross-modal, vision-centric domains remains largely underexplored. This limitation is especially pronounced in the medical imaging domain, where effective performance requires both robust visual perception and structured reasoning. In this work, we address this gap by proposing VRFT-Aug, a visual reinforcement fine-tuning framework tailored for the medical domain. VRFT-Aug introduces a series of training strategies designed to augment both perception and reasoning, including prior knowledge injection, perception-driven policy refinement, medically informed reward shaping, and behavioral imitation. Together, these methods aim to stabilize and improve the RFT process. Through extensive experiments across multiple medical datasets, we show that our approaches consistently outperform both standard supervised fine-tuning and RFT baselines. Moreover, we provide empirically grounded insights and practical training heuristics that can be generalized to other medical image tasks. We hope this work contributes actionable guidance and fresh inspiration for the ongoing effort to develop reliable, reasoning-capable models for high-stakes medical applications.

Huahui Yi, Kun Wang, Qiankun Li et al.

Multimodal Large Reasoning Models (MLRMs) demonstrate impressive cross-modal reasoning but often amplify safety risks under adversarial or unsafe prompts, a phenomenon we call the \textit{Reasoning Tax}. Existing defenses mainly act at the output level and do not constrain the reasoning process, leaving models exposed to implicit risks. In this paper, we propose SaFeR-VLM, a safety-aligned reinforcement learning framework that embeds safety directly into multimodal reasoning. The framework integrates four components: (I) QI-Safe-10K, a curated dataset emphasizing safety-critical and reasoning-sensitive cases; (II) safety-aware rollout, where unsafe generations undergo reflection and correction instead of being discarded; (III) structured reward modeling with multi-dimensional weighted criteria and explicit penalties for hallucinations and contradictions; and (IV) GRPO optimization, which reinforces both safe and corrected trajectories. This unified design shifts safety from a passive safeguard to an active driver of reasoning, enabling scalable and generalizable safety-aware reasoning. SaFeR-VLM further demonstrates robustness against both explicit and implicit risks, supporting dynamic and interpretable safety decisions beyond surface-level filtering. SaFeR-VLM-3B achieves average performance $70.13$ and $78.97$ on safety and helpfulness across six benchmarks, surpassing both same-scale and $>10\times$ larger models such as Skywork-R1V3-38B, Qwen2.5VL-72B, and GLM4.5V-106B. Remarkably, SaFeR-VLM-7B benefits from its increased scale to surpass GPT-5-mini and Gemini-2.5-Flash by \num{6.47} and \num{16.76} points respectively on safety metrics, achieving this improvement without any degradation in helpfulness performance. Our codes are available at https://github.com/HarveyYi/SaFeR-VLM.

Gongli Xi, Ye Tian, Mengyu Yang et al.

Despite the rapid evolution of training paradigms, the decoder backbone of large vision--language models (LVLMs) remains fundamentally rooted in the residual-connection Transformer architecture. Therefore, deciphering the distinct roles of internal modules is critical for understanding model mechanics and guiding architectural optimization. While prior statistical approaches have provided valuable attribution-based insights, they often lack a unified theoretical basis. To bridge this gap, we propose a unified framework grounded in information theory and geometry to quantify the geometric and entropic nature of residual updates. Applying this unified framework reveals a fundamental functional decoupling: Attention acts as a subspace-preserving operator focused on reconfiguration, whereas FFNs serve as subspace-expanding operators driving semantic innovation. Strikingly, further experiments demonstrate that replacing learned attention weights with predefined values (e.g., Gaussian noise) yields comparable or even superior performance across a majority of datasets relative to vanilla models. These results expose severe misallocation and redundancy in current mechanisms, suggesting that state-of-the-art LVLMs effectively ``get lost in attention'' rather than efficiently leveraging visual context.

Gongli Xi, Kun Wang, Zeming Gao et al.

Large multimodal reasoning models solve challenging visual problems via explicit long-chain inference: they gather visual clues from images and decode clues into textual tokens. Yet this capability also increases hallucinations, where the model generates content that is not supported by the input image or the question. To understand this failure mode, we identify \emph{reasoning drift}: during clue gathering, the model over-focuses on question-irrelevant entities, diluting focus on task-relevant cues and gradually decoupling the reasoning trace from visual grounding. As a consequence, many inference-time localization or intervention methods developed for non-reasoning models fail to pinpoint the true clues in reasoning settings. Motivated by these insights, we introduce ClueRecall, a metric for assessing visual clue retrieval, and present ClueTracer, a training-free, parameter-free, and architecture-agnostic plugin for hallucination suppression. ClueTracer starts from the question and traces how key clues propagate along the model's reasoning pathway (question $\rightarrow$ outputs $\rightarrow$ visual tokens), thereby localizing task-relevant patches while suppressing spurious attention to irrelevant regions. Remarkably, \textbf{without any additional training}, ClueTracer improves all \textbf{reasoning} architectures (including \texttt{R1-OneVision}, \texttt{Ocean-R1}, \texttt{MM-Eureka}, \emph{etc}.) by $\mathbf{1.21\times}$ on reasoning benchmarks. When transferred to \textbf{non-reasoning} settings, it yields a $\mathbf{1.14\times}$ gain.

Ziyuan Qin, Dongjie Cheng, Haoyu Wang et al.

Contemporary Text-to-Image (T2I) models frequently depend on qualitative human evaluations to assess the consistency between synthesized images and the text prompts. There is a demand for quantitative and automatic evaluation tools, given that human evaluation lacks reproducibility. We believe that an effective T2I evaluation metric should accomplish the following: detect instances where the generated images do not align with the textual prompts, a discrepancy we define as the `hallucination problem' in T2I tasks; record the types and frequency of hallucination issues, aiding users in understanding the causes of errors; and provide a comprehensive and intuitive scoring that close to human standard. To achieve these objectives, we propose a method based on large language models (LLMs) for conducting question-answering with an extracted scene-graph and created a dataset with human-rated scores for generated images. From the methodology perspective, we combine knowledge-enhanced question-answering tasks with image evaluation tasks, making the evaluation metrics more controllable and easier to interpret. For the contribution on the dataset side, we generated 12,000 synthesized images based on 1,000 composited prompts using three advanced T2I models. Subsequently, we conduct human scoring on all synthesized images and prompt pairs to validate the accuracy and effectiveness of our method as an evaluation metric. All generated images and the human-labeled scores will be made publicly available in the future to facilitate ongoing research on this crucial issue. Extensive experiments show that our method aligns more closely with human scoring patterns than other evaluation metrics.

Kangyu Zhu, Ziyuan Qin, Huahui Yi et al.

While mainstream vision-language models (VLMs) have advanced rapidly in understanding image level information, they still lack the ability to focus on specific areas designated by humans. Rather, they typically rely on large volumes of high-quality image-text paired data to learn and generate posterior attention maps. To address this critical issue, we propose leveraging visual prompts:simple visual markers in various forms to guide and enhance the formation of region-specific attention. Thus, we introduce MedVP, a pioneering framework that integrates medical entity extraction, visual prompt generation, and dataset adaptation for visual prompt guided fine-tuning. We successfully outperform recent state-of-the-art large models across multiple medical VQA datasets. Extensive experiments and Human evaluation are conducted to analyze the impact of different visual prompt forms and how they contribute to performance improvement. The results demonstrate both the effectiveness and clinical significance of our approach.

Li Wang, Xi Chen, XiangWen Deng et al.

Multimodal large language models (MLLMs) show promising performance on medical visual question answering (VQA) and report generation, but these generation and explanation abilities do not reliably transfer to disease-specific classification. We evaluated MLLM architectures on knee osteoarthritis (OA) radiograph classification, which remains underrepresented in existing medical MLLM benchmarks, even though knee OA affects an estimated 300 to 400 million people worldwide. Through systematic ablation studies manipulating the vision encoder, the connector, and the large language model (LLM) across diverse training strategies, we measured each component's contribution to diagnostic accuracy. In our classification task, a trained vision encoder alone could outperform full MLLM pipelines in classification accuracy and fine-tuning the LLM provided no meaningful improvement over prompt-based guidance. And LoRA fine-tuning on a small, class-balanced dataset (500 images) gave better results than training on a much larger but class-imbalanced set (5,778 images), indicating that data balance and quality can matter more than raw scale for this task. These findings suggest that for domain-specific medical classification, LLMs are more effective as interpreters and report generators rather than as primary classifiers. Therefore, the MLLM architecture appears less suitable for medical image diagnostic classification tasks that demand high certainty. We recommend prioritizing vision encoder optimization and careful dataset curation when developing clinically applicable systems.

Liang Lin, Zhihao Xu, Junhao Dong et al.

Large language model (LLM) alignment faces a critical dilemma when addressing multiple human preferences: improvements in one dimension frequently come at the expense of others, creating unavoidable trade-offs between competing objectives like helpfulness and harmlessness. While prior work mainly focuses on constraint-based optimization algorithms and data selection strategies to mitigate conflicts, these approaches overlook the fundamental issue of resolving conflicts directly at the parameter level. In this paper, we present OrthAlign, an innovative approach that pioneers a new paradigm by leveraging orthogonal subspace decomposition to fundamentally resolve gradient-level conflicts in multi-objective preference alignment. OrthAlign strategically decomposes parameter update spaces into orthogonal subspaces, ensuring that optimization toward different preferences occurs in mathematically non-interfering directions. Building upon this, we provide theoretical guarantees demonstrating that when parameter increments satisfy both orthogonal subspace constraints and spectral norm bounds, the resulting updates exhibit linear Lipschitz growth rather than exponential instability, ensuring stable convergence across all preference dimensions. Extensive experiments show that: I. OrthAlign achieves maximum single-preference improvements ranging from 34.61% to 50.89% after multiple-objective alignment across helpful, harmless, and truthful dimensions. II. With an average overall reward improvement of 13.96%.

Huahui Yi, Wei Xu, Ziyuan Qin et al.

Existing prompt-based approaches have demonstrated impressive performance in continual learning, leveraging pre-trained large-scale models for classification tasks; however, the tight coupling between foreground-background information and the coupled attention between prompts and image-text tokens present significant challenges in incremental medical object detection tasks, due to the conceptual gap between medical and natural domains. To overcome these challenges, we introduce the \method~framework, which comprises two main components: 1) Instance-level Prompt Generation (\ipg), which decouples fine-grained instance-level knowledge from images and generates prompts that focus on dense predictions, and 2) Decoupled Prompt Attention (\dpa), which decouples the original prompt attention, enabling a more direct and efficient transfer of prompt information while reducing memory usage and mitigating catastrophic forgetting. We collect 13 clinical, cross-modal, multi-organ, and multi-category datasets, referred to as \dataset, and experiments demonstrate that \method~outperforms existing SOTA methods, with FAP improvements of 5.44\%, 4.83\%, 12.88\%, and 4.59\% in full data, 1-shot, 10-shot, and 50-shot settings, respectively.

Hao Wu, Yuan Gao, Ruijian Gou et al.

Reliable long-term forecasting of Earth system dynamics is fundamentally limited by instabilities in current artificial intelligence (AI) models during extended autoregressive simulations. These failures often originate from inherent spectral bias, leading to inadequate representation of critical high-frequency, small-scale processes and subsequent uncontrolled error amplification. Inspired by the nested grids in numerical models used to resolve small scales, we present TritonCast. At the core of its design is a dedicated latent dynamical core, which ensures the long-term stability of the macro-evolution at a coarse scale. An outer structure then fuses this stable trend with fine-grained local details. This design effectively mitigates the spectral bias caused by cross-scale interactions. In atmospheric science, it achieves state-of-the-art accuracy on the WeatherBench 2 benchmark while demonstrating exceptional long-term stability: executing year-long autoregressive global forecasts and completing multi-year climate simulations that span the entire available $2500$-day test period without drift. In oceanography, it extends skillful eddy forecast to $120$ days and exhibits unprecedented zero-shot cross-resolution generalization. Ablation studies reveal that this performance stems from the synergistic interplay of the architecture's core components. TritonCast thus offers a promising pathway towards a new generation of trustworthy, AI-driven simulations. This significant advance has the potential to accelerate discovery in climate and Earth system science, enabling more reliable long-term forecasting and deeper insights into complex geophysical dynamics.

Huahui Yi, Xiaofei Wang, Kang Li et al.

Multimodal learning, integrating histology images and genomics, promises to enhance precision oncology with comprehensive views at microscopic and molecular levels. However, existing methods may not sufficiently model the shared or complementary information for more effective integration. In this study, we introduce a Unified Modeling Enhanced Multimodal Learning (UMEML) framework that employs a hierarchical attention structure to effectively leverage shared and complementary features of both modalities of histology and genomics. Specifically, to mitigate unimodal bias from modality imbalance, we utilize a query-based cross-attention mechanism for prototype clustering in the pathology encoder. Our prototype assignment and modularity strategy are designed to align shared features and minimizes modality gaps. An additional registration mechanism with learnable tokens is introduced to enhance cross-modal feature integration and robustness in multimodal unified modeling. Our experiments demonstrate that our method surpasses previous state-of-the-art approaches in glioma diagnosis and prognosis tasks, underscoring its superiority in precision neuro-Oncology.

Huahui Yi, Ziyuan Qin, Wei Xu et al.

Large pre-trained vision-language models have shown great prominence in transferring pre-acquired knowledge to various domains and downstream tasks with appropriate prompting or tuning. Existing prevalent tuning methods can be generally categorized into three genres: 1) prompt engineering by creating suitable prompt texts, which is time-consuming and requires domain expertise; 2) or simply fine-tuning the whole model, which is extremely inefficient; 3) prompt tuning through parameterized prompt embeddings with the text encoder. Nevertheless, all methods rely on the text encoder for bridging the modality gap between vision and language. In this work, we question the necessity of the cumbersome text encoder for a more lightweight and efficient tuning paradigm as well as more representative prompt embeddings closer to the image representations. To achieve this, we propose a Concept Embedding Search (ConES) approach by optimizing prompt embeddings -- without the need of the text encoder -- to capture the 'concept' of the image modality through a variety of task objectives. By dropping the text encoder, we are able to significantly speed up the learning process, \eg, from about an hour to just ten minutes in our experiments for personalized text-to-image generation without impairing the generation quality. Moreover, our proposed approach is orthogonal to current existing tuning methods since the searched concept embeddings can be further utilized in the next stage of fine-tuning the pre-trained large models for boosting performance. Extensive experiments show that our approach can beat the prompt tuning and textual inversion methods in a variety of downstream tasks including objection detection, instance segmentation, and image generation. Our approach also shows better generalization capability for unseen concepts in specialized domains, such as the medical domain.