Yankai Jiang

Yankai Jiang, Mingze Sun, Heng Guo et al.

Self-supervised learning (SSL) has recently achieved promising performance for 3D medical image analysis tasks. Most current methods follow existing SSL paradigm originally designed for photographic or natural images, which cannot explicitly and thoroughly exploit the intrinsic similar anatomical structures across varying medical images. This may in fact degrade the quality of learned deep representations by maximizing the similarity among features containing spatial misalignment information and different anatomical semantics. In this work, we propose a new self-supervised learning framework, namely Alice, that explicitly fulfills Anatomical invariance modeling and semantic alignment via elaborately combining discriminative and generative objectives. Alice introduces a new contrastive learning strategy which encourages the similarity between views that are diversely mined but with consistent high-level semantics, in order to learn invariant anatomical features. Moreover, we design a conditional anatomical feature alignment module to complement corrupted embeddings with globally matched semantics and inter-patch topology information, conditioned by the distribution of local image content, which permits to create better contrastive pairs. Our extensive quantitative experiments on three 3D medical image analysis tasks demonstrate and validate the performance superiority of Alice, surpassing the previous best SSL counterpart methods and showing promising ability for united representation learning. Codes are available at https://github.com/alibaba-damo-academy/alice.

Baolin Li, Yankai Jiang, Vijay Gadepally et al.

This survey offers a comprehensive overview of recent advancements in Large Language Model (LLM) serving systems, focusing on research since the year 2023. We specifically examine system-level enhancements that improve performance and efficiency without altering the core LLM decoding mechanisms. By selecting and reviewing high-quality papers from prestigious ML and system venues, we highlight key innovations and practical considerations for deploying and scaling LLMs in real-world production environments. This survey serves as a valuable resource for LLM practitioners seeking to stay abreast of the latest developments in this rapidly evolving field.

Qiaoru Li, Shaotian Liang, Jintao Chen et al.

Latent reasoning enables reasoning over continuous hidden states rather than explicit tokens, avoiding the language bottleneck and inference overhead of chain-of-thought for medical VQA. However, existing methods suffer from modality collapse, insufficient visual supervision, and train-inference mismatch. Moreover, their opaque latent states offer no interpretability, which is critical in clinical applications. We propose VITAL, a latent-space reasoning framework for medical MLLMs with visual-semantic dual supervision: an auxiliary text decoder reconstructs reasoning chains from latent states, while a visual projector regresses ROI features from a frozen, independent medical vision encoder. Both modules are discarded at inference with zero overhead, yet can be re-attached post-hoc for dual interpretability, providing textual and visual explanations of the reasoning process without sacrificing efficiency. We construct a 61K dataset spanning 9 imaging modalities, exceeding prior medical visual latent reasoning datasets by an order of magnitude. Experiments on 7 benchmarks show that VITAL consistently and substantially outperforms the backbone, all latent reasoning baselines, and medical MLLMs trained on far larger data, achieving state-of-the-art results competitive with trillion-parameter proprietary models.

Chao Ding, Mouxiao Bian, Tianbin Li et al.

Large language models(LLMs) increasingly match expert performance on licensing examinations, yet routine clinical use remains limited because governance requires auditable reasoning, safety and ethics alignment, and resilience to adversarial misuse. Here we present SafeMed-R1, trained with a traceable Clinical Trust Signals(CTS) pipeline that links each reasoning instance to clinician rubric scores and edit histories, and aligned through safety and ethics supervision and red team stress testing. SafeMed-R1 attains a macro-averaged accuracy of 79.6% across clinical benchmarks. Under adversarial safety testing, it shows the lowest aggregated risk and reduces unsafe outputs by about 3 to 5% relative to its baseline. In a paired expert study of 30 medication safety vignettes, SafeMed-R1 matches PGY1 and PGY2 residents on medical correctness and scores higher for medication safety, guideline consistency, and clinical usefulness. Collectively, these results suggest that clinician-audited supervision provenance, together with domain-tailored safety and ethics alignment, can strengthen governance-relevant evidence without relying on inference-time retrieval or citation grounding.

Yankai Jiang, Wenjie Lou, Lilong Wang et al.

We introduce SCP: the Science Context Protocol, an open-source standard designed to accelerate discovery by enabling a global network of autonomous scientific agents. SCP is built on two foundational pillars: (1) Unified Resource Integration: At its core, SCP provides a universal specification for describing and invoking scientific resources, spanning software tools, models, datasets, and physical instruments. This protocol-level standardization enables AI agents and applications to discover, call, and compose capabilities seamlessly across disparate platforms and institutional boundaries. (2) Orchestrated Experiment Lifecycle Management: SCP complements the protocol with a secure service architecture, which comprises a centralized SCP Hub and federated SCP Servers. This architecture manages the complete experiment lifecycle (registration, planning, execution, monitoring, and archival), enforces fine-grained authentication and authorization, and orchestrates traceable, end-to-end workflows that bridge computational and physical laboratories. Based on SCP, we have constructed a scientific discovery platform that offers researchers and agents a large-scale ecosystem of more than 1,600 tool resources. Across diverse use cases, SCP facilitates secure, large-scale collaboration between heterogeneous AI systems and human researchers while significantly reducing integration overhead and enhancing reproducibility. By standardizing scientific context and tool orchestration at the protocol level, SCP establishes essential infrastructure for scalable, multi-institution, agent-driven science.

Yankai Jiang, Qiaoru Li, Binlu Xu et al.

Recent research on medical MLLMs has gradually shifted its focus from image-level understanding to fine-grained, pixel-level comprehension. Although segmentation serves as the foundation for pixel-level understanding, existing approaches face two major challenges. First, they introduce implicit segmentation tokens and require simultaneous fine-tuning of both the MLLM and external pixel decoders, which increases the risk of catastrophic forgetting and limits generalization to out-of-domain scenarios. Second, most methods rely on single-pass reasoning and lack the capability to iteratively refine segmentation results, leading to suboptimal performance. To overcome these limitations, we propose a novel agentic MLLM, named IBISAgent, that reformulates segmentation as a vision-centric, multi-step decision-making process. IBISAgent enables MLLMs to generate interleaved reasoning and text-based click actions, invoke segmentation tools, and produce high-quality masks without architectural modifications. By iteratively performing multi-step visual reasoning on masked image features, IBISAgent naturally supports mask refinement and promotes the development of pixel-level visual reasoning capabilities. We further design a two-stage training framework consisting of cold-start supervised fine-tuning and agentic reinforcement learning with tailored, fine-grained rewards, enhancing the model's robustness in complex medical referring and reasoning segmentation tasks. Extensive experiments demonstrate that IBISAgent consistently outperforms both closed-source and open-source SOTA methods.

Jiaxuan Lu, Ziyu Kong, Yemin Wang et al.

The central challenge of AI for Science is not reasoning alone, but the ability to create computational methods in an open-ended scientific world. Existing LLM-based agents rely on static, pre-defined tool libraries, a paradigm that fundamentally fails in scientific domains where tools are sparse, heterogeneous, and intrinsically incomplete. In this paper, we propose Test-Time Tool Evolution (TTE), a new paradigm that enables agents to synthesize, verify, and evolve executable tools during inference. By transforming tools from fixed resources into problem-driven artifacts, TTE overcomes the rigidity and long-tail limitations of static tool libraries. To facilitate rigorous evaluation, we introduce SciEvo, a benchmark comprising 1,590 scientific reasoning tasks supported by 925 automatically evolved tools. Extensive experiments show that TTE achieves state-of-the-art performance in both accuracy and tool efficiency, while enabling effective cross-domain adaptation of computational tools. The code and benchmark have been released at https://github.com/lujiaxuan0520/Test-Time-Tool-Evol.

Yankai Jiang, Yujie Zhang, Peng Zhang et al.

Recent reasoning based medical MLLMs have made progress in generating step by step textual reasoning chains. However, they still struggle with complex tasks that necessitate dynamic and iterative focusing on fine-grained visual regions to achieve precise grounding and diagnosis. We introduce Ophiuchus, a versatile, tool-augmented framework that equips an MLLM to (i) decide when additional visual evidence is needed, (ii) determine where to probe and ground within the medical image, and (iii) seamlessly weave the relevant sub-image content back into an interleaved, multimodal chain of thought. In contrast to prior approaches limited by the performance ceiling of specialized tools, Ophiuchus integrates the model's inherent grounding and perception capabilities with external tools, thereby fostering higher-level reasoning. The core of our method is a three-stage training strategy: cold-start training with tool-integrated reasoning data to achieve basic tool selection and adaptation for inspecting key regions; self-reflection fine-tuning to strengthen reflective reasoning and encourage revisiting tool outputs; and Agentic Tool Reinforcement Learning to directly optimize task-specific rewards and emulate expert-like diagnostic behavior. Extensive experiments show that Ophiuchus consistently outperforms both closed-source and open-source SOTA methods across diverse medical benchmarks, including VQA, detection, and reasoning-based segmentation. Our approach illuminates a path toward medical AI agents that can genuinely "think with images" through tool-integrated reasoning. Datasets, codes, and trained models will be released publicly.

Shiyang Feng, Runmin Ma, Xiangchao Yan et al.

We introduce InternAgent-1.5, a unified system designed for end-to-end scientific discovery across computational and empirical domains. The system is built on a structured architecture composed of three coordinated subsystems for generation, verification, and evolution. These subsystems are supported by foundational capabilities for deep research, solution optimization, and long horizon memory. The architecture allows InternAgent-1.5 to operate continuously across extended discovery cycles while maintaining coherent and improving behavior. It also enables the system to coordinate computational modeling and laboratory experimentation within a single unified system. We evaluate InternAgent-1.5 on scientific reasoning benchmarks such as GAIA, HLE, GPQA, and FrontierScience, and the system achieves leading performance that demonstrates strong foundational capabilities. Beyond these benchmarks, we further assess two categories of discovery tasks. In algorithm discovery tasks, InternAgent-1.5 autonomously designs competitive methods for core machine learning problems. In empirical discovery tasks, it executes complete computational or wet lab experiments and produces scientific findings in earth, life, biological, and physical domains. Overall, these results show that InternAgent-1.5 provides a general and scalable framework for autonomous scientific discovery.

Lisheng Zhang, Lilong Wang, Xiangyu Sun et al.

Computational drug discovery, particularly the complex workflows of drug molecule screening and optimization, requires orchestrating dozens of specialized tools in multi-step workflows, yet current AI agents struggle to maintain robust performance and consistently underperform in these high-complexity scenarios. Here we present MolClaw, an autonomous agent that leads drug molecule evaluation, screening, and optimization. It unifies over 30 specialized domain resources through a three-tier hierarchical skill architecture (70 skills in total) that facilitates agent long-term interaction at runtime: tool-level skills standardize atomic operations, workflow-level skills compose them into validated pipelines with quality check and reflection, and a discipline-level skill supplies scientific principles governing planning and verification across all scenarios in the field. Additionally, we introduce MolBench, a benchmark comprising molecular screening, optimization, and end-to-end discovery challenges spanning 8 to 50+ sequential tool calls. MolClaw achieves state-of-the-art performance across all metrics, and ablation studies confirm that gains concentrate on tasks that demand structured workflows while vanishing on those solvable with ad hoc scripting, establishing workflow orchestration competence as the primary capability bottleneck for AI-driven drug discovery.

Haoran Sun, Yankai Jiang, Wenjie Lou et al.

Multimodal large language models (MLLMs) have begun to demonstrate robust reasoning capabilities on general tasks, yet their application in the medical domain remains in its early stages. Constructing chain-of-thought (CoT) training data is essential for bolstering the reasoning abilities of medical MLLMs. However, existing approaches exhibit a deficiency in offering a comprehensive framework for searching and evaluating effective reasoning paths towards critical diagnosis. To address this challenge, we propose Mentor-Intern Collaborative Search (MICS), a novel reasoning-path searching scheme to generate rigorous and effective medical CoT data. MICS first leverages mentor models to initialize the reasoning, one step at a time, then prompts each intern model to continue the thinking along those initiated paths, and finally selects the optimal reasoning path according to the overall reasoning performance of multiple intern models. The reasoning performance is determined by an MICS-Score, which assesses the quality of generated reasoning paths. Eventually, we construct MMRP, a multi-task medical reasoning dataset with ranked difficulty, and Chiron-o1, a new medical MLLM devised via a curriculum learning strategy, with robust visual question-answering and generalizable reasoning capabilities. Extensive experiments demonstrate that Chiron-o1, trained on our CoT dataset constructed using MICS, achieves state-of-the-art performance across a list of medical visual question answering and reasoning benchmarks. Codes are available at https://github.com/manglu097/Chiron-o1

Yuan Tian, Kaiyuan Ji, Rongzhao Zhang et al.

Medical image re-identification (MedReID) is under-explored so far, despite its critical applications in personalized healthcare and privacy protection. In this paper, we introduce a thorough benchmark and a unified model for this problem. First, to handle various medical modalities, we propose a novel Continuous Modality-based Parameter Adapter (ComPA). ComPA condenses medical content into a continuous modality representation and dynamically adjusts the modality-agnostic model with modality-specific parameters at runtime. This allows a single model to adaptively learn and process diverse modality data. Furthermore, we integrate medical priors into our model by aligning it with a bag of pre-trained medical foundation models, in terms of the differential features. Compared to single-image feature, modeling the inter-image difference better fits the re-identification problem, which involves discriminating multiple images. We evaluate the proposed model against 25 foundation models and 8 large multi-modal language models across 11 image datasets, demonstrating consistently superior performance. Additionally, we deploy the proposed MedReID technique to two real-world applications, i.e., history-augmented personalized diagnosis and medical privacy protection. Codes and model is available at \href{https://github.com/tianyuan168326/All-in-One-MedReID-Pytorch}{https://github.com/tianyuan168326/All-in-One-MedReID-Pytorch}.

Mengliang He, Jiayi Zeng, Yankai Jiang et al.

While large language models (LLMs) show promise in code generation, existing benchmarks neglect the flowchart-based code generation. To promote further research on flowchart-based code generation, this work presents Flow2Code, a novel benchmark for flowchart-based code generation evaluation. The evaluation dataset spans 15 programming languages and includes 5,622 code segments paired with 16,866 flowcharts of three types: code, UML, and pseudocode. Extensive experiments with 13 multimodal LLMs reveal that current LLMs can not generate code based on flowcharts perfectly. Besides, experiment results show that the supervised fine-tuning technique contributes greatly to the models' performance. We publicly release our code and datasets at https://github.com/hml-github/Flow2Code.

Kaitao Chen, Mianxin Liu, Daoming Zong et al.

Complex medical decision-making involves cooperative workflows operated by different clinicians. Designing AI multi-agent systems can expedite and augment human-level clinical decision-making. Existing multi-agent researches primarily focus on language-only tasks, yet their extension to multimodal scenarios remains challenging. A blind combination of diverse vision-language models (VLMs) can amplify an erroneous outcome interpretation. VLMs in general are less capable in instruction following and importantly self-reflection, compared to large language models (LLMs) of comparable sizes. This disparity largely constrains VLMs' ability in cooperative workflows. In this study, we propose MedOrch, a mediator-guided multi-agent collaboration framework for medical multimodal decision-making. MedOrch employs an LLM-based mediator agent that enables multiple VLM-based expert agents to exchange and reflect on their outputs towards collaboration. We utilize multiple open-source general-purpose and domain-specific VLMs instead of costly GPT-series models, revealing the strength of heterogeneous models. We show that the collaboration within distinct VLM-based agents can surpass the capabilities of any individual agent. We validate our approach on five medical vision question answering benchmarks, demonstrating superior collaboration performance without model training. Our findings underscore the value of mediator-guided multi-agent collaboration in advancing medical multimodal intelligence.

Haoran Sun, Yankai Jiang, Zhenyu Tang et al.

The foundation of reproducible science lies in protocols that are precise, logically ordered, and executable. The autonomous generation of these protocols through natural language queries could greatly improve the efficiency of the reproduction process. However, current leading large language models (LLMs) often generate incomplete or inconsistent protocols, limiting their utility. To address this limitation, we first introduce SciRecipe, a large-scale dataset of over 12K structured protocols spanning 27 biological subfields and encompassing both comprehension and problem-solving tasks. To further improve protocol generation, we propose the "Sketch-and-Fill" paradigm, which separates analysis, structuring, and expression to ensure each step is explicit and verifiable. Complementing this, the structured component-based reward mechanism evaluates step granularity, action order, and semantic fidelity, aligning model optimization with experimental reliability. Building on these components, we develop Thoth, trained through a staged Knowledge-to-Action process that progresses from knowledge acquisition to operational reasoning and ultimately to robust, executable protocol generation. Across multiple benchmarks, Thoth consistently surpasses both proprietary and open-source LLMs, achieving significant improvements in step alignment, logical sequencing, and semantic accuracy. Our approach paves the way for reliable scientific assistants that bridge knowledge with experimental execution. All data, code, and models will be released publicly.

Haoyu Yang, Yuxiang Cai, Jintao Chen et al.

3D medical image segmentation is vital for clinical diagnosis and treatment but is challenged by high-dimensional data and complex spatial dependencies. Traditional single-modality networks, such as CNNs and Transformers, are often limited by computational inefficiency and constrained contextual modeling in 3D settings. We introduce a novel multimodal framework that leverages Mamba and Kolmogorov-Arnold Networks (KAN) as an efficient backbone for long-sequence modeling. Our approach features three key innovations: First, an EGSC (Enhanced Gated Spatial Convolution) module captures spatial information when unfolding 3D images into 1D sequences. Second, we extend Group-Rational KAN (GR-KAN), a Kolmogorov-Arnold Networks variant with rational basis functions, into 3D-Group-Rational KAN (3D-GR-KAN) for 3D medical imaging - its first application in this domain - enabling superior feature representation tailored to volumetric data. Third, a dual-branch text-driven strategy leverages CLIP's text embeddings: one branch swaps one-hot labels for semantic vectors to preserve inter-organ semantic relationships, while the other aligns images with detailed organ descriptions to enhance semantic alignment. Experiments on the Medical Segmentation Decathlon (MSD) and KiTS23 datasets show our method achieving state-of-the-art performance, surpassing existing approaches in accuracy and efficiency. This work highlights the power of combining advanced sequence modeling, extended network architectures, and vision-language synergy to push forward 3D medical image segmentation, delivering a scalable solution for clinical use. The source code is openly available at https://github.com/yhy-whu/TK-Mamba.

Yankai Jiang, Peng Zhang, Donglin Yang et al.

We explore Generalizable Tumor Segmentation, aiming to train a single model for zero-shot tumor segmentation across diverse anatomical regions. Existing methods face limitations related to segmentation quality, scalability, and the range of applicable imaging modalities. In this paper, we uncover the potential of the internal representations within frozen medical foundation diffusion models as highly efficient zero-shot learners for tumor segmentation by introducing a novel framework named DiffuGTS. DiffuGTS creates anomaly-aware open-vocabulary attention maps based on text prompts to enable generalizable anomaly segmentation without being restricted by a predefined training category list. To further improve and refine anomaly segmentation masks, DiffuGTS leverages the diffusion model, transforming pathological regions into high-quality pseudo-healthy counterparts through latent space inpainting, and applies a novel pixel-level and feature-level residual learning approach, resulting in segmentation masks with significantly enhanced quality and generalization. Comprehensive experiments on four datasets and seven tumor categories demonstrate the superior performance of our method, surpassing current state-of-the-art models across multiple zero-shot settings. Codes are available at https://github.com/Yankai96/DiffuGTS.

Yihao Liu, Xu Cao, Tingting Chen et al.

Healthcare systems worldwide face persistent challenges in efficiency, accessibility, and personalization. Powered by modern AI technologies such as multimodal large language models and world models, Embodied AI (EmAI) represents a transformative frontier, offering enhanced autonomy and the ability to interact with the physical world to address these challenges. As an interdisciplinary and rapidly evolving research domain, "EmAI in healthcare" spans diverse fields such as algorithms, robotics, and biomedicine. This complexity underscores the importance of timely reviews and analyses to track advancements, address challenges, and foster cross-disciplinary collaboration. In this paper, we provide a comprehensive overview of the "brain" of EmAI for healthcare, wherein we introduce foundational AI algorithms for perception, actuation, planning, and memory, and focus on presenting the healthcare applications spanning clinical interventions, daily care & companionship, infrastructure support, and biomedical research. Despite its promise, the development of EmAI for healthcare is hindered by critical challenges such as safety concerns, gaps between simulation platforms and real-world applications, the absence of standardized benchmarks, and uneven progress across interdisciplinary domains. We discuss the technical barriers and explore ethical considerations, offering a forward-looking perspective on the future of EmAI in healthcare. A hierarchical framework of intelligent levels for EmAI systems is also introduced to guide further development. By providing systematic insights, this work aims to inspire innovation and practical applications, paving the way for a new era of intelligent, patient-centered healthcare.

Yankai Jiang, Zhongzhen Huang, Rongzhao Zhang et al.

The long-tailed distribution problem in medical image analysis reflects a high prevalence of common conditions and a low prevalence of rare ones, which poses a significant challenge in developing a unified model capable of identifying rare or novel tumor categories not encountered during training. In this paper, we propose a new zero-shot pan-tumor segmentation framework (ZePT) based on query-disentangling and self-prompting to segment unseen tumor categories beyond the training set. ZePT disentangles the object queries into two subsets and trains them in two stages. Initially, it learns a set of fundamental queries for organ segmentation through an object-aware feature grouping strategy, which gathers organ-level visual features. Subsequently, it refines the other set of advanced queries that focus on the auto-generated visual prompts for unseen tumor segmentation. Moreover, we introduce query-knowledge alignment at the feature level to enhance each query's discriminative representation and generalizability. Extensive experiments on various tumor segmentation tasks demonstrate the performance superiority of ZePT, which surpasses the previous counterparts and evidence the promising ability for zero-shot tumor segmentation in real-world settings.

Shizhan Gong, Yankai Jiang, Qi Dou et al.

Vision-language models, such as CLIP, have achieved significant success in aligning visual and textual representations, becoming essential components of many multi-modal large language models (MLLMs) like LLaVA and OpenFlamingo. However, numerous studies have identified CLIP's limited fine-grained perception as a critical drawback, leading to substantial failures in downstream MLLMs. In contrast, vision-centric foundation models like DINOv2 demonstrate remarkable capabilities in capturing fine details from images. In this work, we propose a novel kernel-based method to align CLIP's visual representation with that of DINOv2, ensuring that the resulting embeddings maintain compatibility with text embeddings while enhancing perceptual capabilities. Our alignment objective is designed for efficient stochastic optimization. Following this image-only alignment fine-tuning, the visual encoder retains compatibility with the frozen text encoder and exhibits significant improvements in zero-shot object recognition, fine-grained spatial reasoning, and localization. By integrating the aligned visual encoder, downstream MLLMs also demonstrate enhanced performance.

Wenhui Lei, Hanyu Chen, Zitian Zhang et al.

AI-assisted imaging made substantial advances in tumor diagnosis and management. However, a major barrier to developing robust oncology foundation models is the scarcity of large-scale, high-quality annotated datasets, which are limited by privacy restrictions and the high cost of manual labeling. To address this gap, we present PASTA, a pan-tumor radiology foundation model built on PASTA-Gen, a synthetic data framework that generated 30,000 3D CT scans with pixel-level lesion masks and structured reports of tumors across ten organ systems. Leveraging this resource, PASTA achieves state-of-the-art performance on 45 of 46 oncology tasks, including non-contrast CT tumor screening, lesion segmentation, structured reporting, tumor staging, survival prediction, and MRI-modality transfer. To assess clinical applicability, we developed PASTA-AID, a clinical decision support system, and ran a retrospective simulated clinical trial across two scenarios. For pan-tumor screening on plain CT with fixed reading time, PASTA-AID increased radiologists' throughput by 11.1-25.1% and improved sensitivity by 17.0-31.4% and precision by 10.5-24.9%; additionally, in a diagnosis-aid workflow, it reduced segmentation time by up to 78.2% and reporting time by up to 36.5%. Beyond gains in accuracy and efficiency, PASTA-AID narrowed the expertise gap, enabling less-experienced radiologists to approach expert-level performance. Together, this work establishes an end-to-end, synthetic data-driven pipeline spanning data generation, model development, and clinical validation, thereby demonstrating substantial potential for pan-tumor research and clinical translation.

Yankai Jiang, Wenhui Lei, Xiaofan Zhang et al.

Recent advancements in medical vision-language pre-training models have driven significant progress in zero-shot disease recognition. However, transferring image-level knowledge to pixel-level tasks, such as lesion segmentation in 3D CT scans, remains a critical challenge. Due to the complexity and variability of pathological visual characteristics, existing methods struggle to align fine-grained lesion features not encountered during training with disease-related textual representations. In this paper, we present Malenia, a novel multi-scale lesion-level mask-attribute alignment framework, specifically designed for 3D zero-shot lesion segmentation. Malenia improves the compatibility between mask representations and their associated elemental attributes, explicitly linking the visual features of unseen lesions with the extensible knowledge learned from previously seen ones. Furthermore, we design a Cross-Modal Knowledge Injection module to enhance both visual and textual features with mutually beneficial information, effectively guiding the generation of segmentation results. Comprehensive experiments across three datasets and 12 lesion categories validate the superior performance of Malenia.

Kaitao Chen, Shaohao Rui, Yankai Jiang et al.

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

Yuan Tian, Shuo Wang, Rongzhao Zhang et al.

Medical imaging has significantly advanced computer-aided diagnosis, yet its re-identification (ReID) risks raise critical privacy concerns, calling for de-identification (DeID) techniques. Unfortunately, existing DeID methods neither particularly preserve medical semantics, nor are flexibly adjustable towards different privacy levels. To address these issues, we propose a divide-and-conquer framework comprising two steps: (1) Identity-Blocking, which blocks varying proportions of identity-related regions, to achieve different privacy levels; and (2) Medical-Semantics-Compensation, which leverages pre-trained Medical Foundation Models (MFMs) to extract medical semantic features to compensate the blocked regions. Moreover, recognizing that features from MFMs may still contain residual identity information, we introduce a Minimum Description Length principle-based feature decoupling strategy, to effectively decouple and discard such identity components. Extensive evaluations against existing approaches across seven datasets and three downstream tasks, demonstrates our state-of-the-art performance.

Yuan Tian, Min Zhou, Yitong Chen et al.

Patient face images provide a convenient mean for evaluating eye diseases, while also raising privacy concerns. Here, we introduce ROFI, a deep learning-based privacy protection framework for ophthalmology. Using weakly supervised learning and neural identity translation, ROFI anonymizes facial features while retaining disease features (over 98\% accuracy, $κ> 0.90$). It achieves 100\% diagnostic sensitivity and high agreement ($κ> 0.90$) across eleven eye diseases in three cohorts, anonymizing over 95\% of images. ROFI works with AI systems, maintaining original diagnoses ($κ> 0.80$), and supports secure image reversal (over 98\% similarity), enabling audits and long-term care. These results show ROFI's effectiveness of protecting patient privacy in the digital medicine era.

Lang Qin, Zijian Gan, Xu Cao et al.

Computational drug repurposing for rare diseases is especially challenging when no prior associations exist between drugs and target diseases. Therefore, knowledge graph completion and message-passing GNNs have little reliable signal to learn and propagate, resulting in poor performance. We present RareAgent, a self-evolving multi-agent system that reframes this task from passive pattern recognition to active evidence-seeking reasoning. RareAgent organizes task-specific adversarial debates in which agents dynamically construct evidence graphs from diverse perspectives to support, refute, or entail hypotheses. The reasoning strategies are analyzed post hoc in a self-evolutionary loop, producing textual feedback that refines agent policies, while successful reasoning paths are distilled into transferable heuristics to accelerate future investigations. Comprehensive evaluations reveal that RareAgent improves the indication AUPRC by 18.1% over reasoning baselines and provides a transparent reasoning chain consistent with clinical evidence.

Chenyu Zhou, Xiaoming Shi, Hui Qiu et al.

E-commerce agents contribute greatly to helping users complete their e-commerce needs. To promote further research and application of e-commerce agents, benchmarking frameworks are introduced for evaluating LLM agents in the e-commerce domain. Despite the progress, current benchmarks lack evaluating agents' capability to handle mixed-type e-commerce dialogue and complex domain rules. To address the issue, this work first introduces a novel corpus, termed Mix-ECom, which is constructed based on real-world customer-service dialogues with post-processing to remove user privacy and add CoT process. Specifically, Mix-ECom contains 4,799 samples with multiply dialogue types in each e-commerce dialogue, covering four dialogue types (QA, recommendation, task-oriented dialogue, and chit-chat), three e-commerce task types (pre-sales, logistics, after-sales), and 82 e-commerce rules. Furthermore, this work build baselines on Mix-Ecom and propose a dynamic framework to further improve the performance. Results show that current e-commerce agents lack sufficient capabilities to handle e-commerce dialogues, due to the hallucination cased by complex domain rules. The dataset will be publicly available.

Zhongzhen Huang, Yankai Jiang, Rongzhao Zhang et al.

Existing promptable segmentation methods in the medical imaging field primarily consider either textual or visual prompts to segment relevant objects, yet they often fall short when addressing anomalies in medical images, like tumors, which may vary greatly in shape, size, and appearance. Recognizing the complexity of medical scenarios and the limitations of textual or visual prompts, we propose a novel dual-prompt schema that leverages the complementary strengths of visual and textual prompts for segmenting various organs and tumors. Specifically, we introduce CAT, an innovative model that Coordinates Anatomical prompts derived from 3D cropped images with Textual prompts enriched by medical domain knowledge. The model architecture adopts a general query-based design, where prompt queries facilitate segmentation queries for mask prediction. To synergize two types of prompts within a unified framework, we implement a ShareRefiner, which refines both segmentation and prompt queries while disentangling the two types of prompts. Trained on a consortium of 10 public CT datasets, CAT demonstrates superior performance in multiple segmentation tasks. Further validation on a specialized in-house dataset reveals the remarkable capacity of segmenting tumors across multiple cancer stages. This approach confirms that coordinating multimodal prompts is a promising avenue for addressing complex scenarios in the medical domain.

Baolin Li, Yankai Jiang, Vijay Gadepally et al.

The rapid advancement of Generative Artificial Intelligence (GenAI) across diverse sectors raises significant environmental concerns, notably the carbon emissions from their cloud and high performance computing (HPC) infrastructure. This paper presents Sprout, an innovative framework designed to address these concerns by reducing the carbon footprint of generative Large Language Model (LLM) inference services. Sprout leverages the innovative concept of "generation directives" to guide the autoregressive generation process, thereby enhancing carbon efficiency. Our proposed method meticulously balances the need for ecological sustainability with the demand for high-quality generation outcomes. Employing a directive optimizer for the strategic assignment of generation directives to user prompts and an original offline quality evaluator, Sprout demonstrates a significant reduction in carbon emissions by over 40% in real-world evaluations using the Llama2 LLM and global electricity grid data. This research marks a critical step toward aligning AI technology with sustainable practices, highlighting the potential for mitigating environmental impacts in the rapidly expanding domain of generative artificial intelligence.