Jiayu Qian

Yuan Wu, Zongxian Yang, Jiayu Qian et al.

Large vision-language models (VLMs) often benefit from chain-of-thought (CoT) prompting in general domains, yet its efficacy in medical vision-language tasks remains underexplored. We report a counter-intuitive trend: on medical visual question answering, CoT frequently underperforms direct answering (DirA) across general-purpose and medical-specific models. We attribute this to a \emph{medical perception bottleneck}: subtle, domain-specific cues can weaken visual grounding, and CoT may compound early perceptual uncertainty rather than correct it. To probe this hypothesis, we introduce two training-free, inference-time grounding interventions: (i) \emph{perception anchoring} via region-of-interest cues and (ii) \emph{description grounding} via high-quality textual guidance. Across multiple benchmarks and model families, these interventions improve accuracy, mitigate CoT degradation, and in several settings reverse the CoT--DirA inversion. Our findings suggest that reliable clinical VLMs require robust visual grounding and cross-modal alignment, beyond extending text-driven reasoning chains. Code is available \href{https://github.com/TianYin123/Better_Eyes_Better_Thoughts}{here}.

Qingping Zhou, Jiayu Qian, Junqi Tang et al.

Combining the strengths of model-based iterative algorithms and data-driven deep learning solutions, deep unrolling networks (DuNets) have become a popular tool to solve inverse imaging problems. While DuNets have been successfully applied to many linear inverse problems, nonlinear problems tend to impair the performance of the method. Inspired by momentum acceleration techniques that are often used in optimization algorithms, we propose a recurrent momentum acceleration (RMA) framework that uses a long short-term memory recurrent neural network (LSTM-RNN) to simulate the momentum acceleration process. The RMA module leverages the ability of the LSTM-RNN to learn and retain knowledge from the previous gradients. We apply RMA to two popular DuNets -- the learned proximal gradient descent (LPGD) and the learned primal-dual (LPD) methods, resulting in LPGD-RMA and LPD-RMA respectively. We provide experimental results on two nonlinear inverse problems: a nonlinear deconvolution problem, and an electrical impedance tomography problem with limited boundary measurements. In the first experiment we have observed that the improvement due to RMA largely increases with respect to the nonlinearity of the problem. The results of the second example further demonstrate that the RMA schemes can significantly improve the performance of DuNets in strongly ill-posed problems.

Jiayu Qian, Yuanyuan Liu, Jingya Yang et al.

Bayesian inference with deep generative prior has received considerable interest for solving imaging inverse problems in many scientific and engineering fields. The selection of the prior distribution is learned from, and therefore an important representation learning of, available prior measurements. The SA-Roundtrip, a novel deep generative prior, is introduced to enable controlled sampling generation and identify the data's intrinsic dimension. This prior incorporates a self-attention structure within a bidirectional generative adversarial network. Subsequently, Bayesian inference is applied to the posterior distribution in the low-dimensional latent space using the Hamiltonian Monte Carlo with preconditioned Crank-Nicolson (HMC-pCN) algorithm, which is proven to be ergodic under specific conditions. Experiments conducted on computed tomography (CT) reconstruction with the MNIST and TomoPhantom datasets reveal that the proposed method outperforms state-of-the-art comparisons, consistently yielding a robust and superior point estimator along with precise uncertainty quantification.

Siyuan Ma, Bo Gao, Zikai Xiao et al.

Recent test-time reasoning methods improve performance by generating more candidate chains or searching over larger reasoning trees, but they typically lack explicit control over when to expand, what to prune, how to repair, and when to abstain. We introduce CoT2-Meta, a training-free metacognitive reasoning framework that combines object-level chain-of-thought generation with meta-level control over partial reasoning trajectories. The framework integrates four components: strategy-conditioned thought generation, tree-structured search, an online process oracle for step-level reasoning evaluation, and a meta-controller that allocates computation through expansion, pruning, repair, stopping, and fallback decisions. Under matched inference budgets, CoT2-Meta consistently outperforms strong single-path, sampling-based, and search-based baselines, including ReST-MCTS. On the default backbone, it achieves 92.8 EM on MATH, 90.4 accuracy on GPQA, 98.65 EM on GSM8K, 75.8 accuracy on BBEH, 85.6 accuracy on MMMU-Pro, and 48.8 accuracy on HLE, with gains over the strongest non-CoT2-Meta baseline of +3.6, +5.2, +1.15, +2.0, +4.3, and +4.3 points, respectively. Beyond these core results, the framework remains effective across a broader 15-benchmark suite spanning knowledge and QA, multi-hop reasoning, coding, and out-of-distribution evaluation. Additional analyses show better compute scaling, improved calibration, stronger selective prediction, targeted repair behavior, and consistent gains across backbone families. These results suggest that explicit metacognitive control is a practical design principle for reliable and compute-efficient test-time reasoning systems.

Zongxian Yang, Jiayu Qian, Zegao Peng et al.

Large reasoning models have recently made significant strides in mathematical and code reasoning, yet their success has not transferred smoothly to the medical domain. While multiple factors contribute to this disparity, a critical issue is the inadequate focus on the quality of intermediate reflection steps, which is particularly crucial in high-stakes medical scenarios. To address this challenge, we propose Med-REFL, a \underline{\textbf{Med}}ical \underline{\textbf{R}}easoning \underline{\textbf{E}}nhancement via self-corrected \underline{\textbf{F}}ine-grained ref\underline{\textbf{L}}ection. Our method leverages a tree-of-thought approach to decompose medical questions into fine-grained reasoning paths, quantitatively evaluating each step and its subsequent reflections. These assessments enable automatic construction of direct preference optimization data, reducing reliance on expensive expert annotations while guiding models to identify and correct reasoning errors. Experimental results on the MedQA-USMLE benchmark demonstrate Med-REFL achieves consistent improvements, with average gains up to 4.11\%. Notably, it further boosts the state-of-the-art performance of 7B/8B models by an additional 4.13\%. Furthermore, Med-REFL exhibits strong generalization capabilities and robustness across several challenging medical question-answering datasets. Our work illustrates that prioritizing reflection quality leads to more accurate and trustworthy reasoning in medical AI applications. Checkpoints, code, and data can be found in https://github.com/TianYin123/Med-REFL.

Jinyue Li, Yuci Liang, Qiankun Li et al.

Computational pathology demands both visual pattern recognition and dynamic integration of structured domain knowledge, including taxonomy, grading criteria, and clinical evidence. In practice, diagnostic reasoning requires linking morphological evidence with formal diagnostic and grading criteria. Although multimodal large language models (MLLMs) demonstrate strong vision language reasoning capabilities, they lack explicit mechanisms for structured knowledge integration and interpretable memory control. As a result, existing models struggle to consistently incorporate pathology-specific diagnostic standards during reasoning. Inspired by the hierarchical memory process of human pathologists, we propose PathMem, a memory-centric multimodal framework for pathology MLLMs. PathMem organizes structured pathology knowledge as a long-term memory (LTM) and introduces a Memory Transformer that models the dynamic transition from LTM to working memory (WM) through multimodal memory activation and context-aware knowledge grounding, enabling context-aware memory refinement for downstream reasoning. PathMem achieves SOTA performance across benchmarks, improving WSI-Bench report generation (12.8% WSI-Precision, 10.1% WSI-Relevance) and open-ended diagnosis by 9.7% and 8.9% over prior WSI-based models.

Zongxian Yang, Jiayu Qian, Zhi-An Huang et al.

Large language models (LLMs) face significant challenges in specialized biomedical tasks due to the inherent complexity of medical reasoning and the sensitive nature of clinical data. Existing LLMs often struggle with intricate medical terminology and the need for accurate clinical insights, leading to performance reduction when quantized for resource-constrained deployment. To address these issues, we propose Quantized Medical Tree of Thought (QM-ToT), a path-based reasoning framework. QM-ToT leverages a Tree of Thought (ToT) reasoning approach to decompose complex medical problems into manageable subtasks, coupled with evaluator assessment layers. This framework facilitates substantial performance improvements in INT4-quantized models on the challenging MedQAUSMLE dataset. Specifically, we demonstrate a remarkable accuracy increase from 34% to 50% for the LLaMA2-70b model and from 58.77% to 69.49% for LLaMA-3.1-8b. Besides, we also proposed an effect data distillation method based on ToT. Compared to the traditional distillation method, we achieved an improvement of 86. 27% while using only 3.9% of the data.This work, for the first time, showcases the potential of ToT to significantly enhance performance on complex biomedical tasks, establishing a crucial foundation for future advances in deploying high-performing quantized LLM in resource-limited medical settings.