Daily Papers

We present Pre-trained Machine Reader (PMR), a novel method for retrofitting pre-trained masked language models (MLMs) to pre-trained machine reading comprehension (MRC) models without acquiring labeled data. PMR can resolve the discrepancy between model pre-training and downstream fine-tuning of existing MLMs. To build the proposed PMR, we constructed a large volume of general-purpose and high-quality MRC-style training data by using Wikipedia hyperlinks and designed a Wiki Anchor Extraction task to guide the MRC-style pre-training. Apart from its simplicity, PMR effectively solves extraction tasks, such as Extractive Question Answering and Named Entity Recognition. PMR shows tremendous improvements over existing approaches, especially in low-resource scenarios. When applied to the sequence classification task in the MRC formulation, PMR enables the extraction of high-quality rationales to explain the classification process, thereby providing greater prediction explainability. PMR also has the potential to serve as a unified model for tackling various extraction and classification tasks in the MRC formulation.

The integration of large language models (LLMs) into medical practice holds transformative potential, yet their real-world clinical utility remains limited by critical alignment challenges: (1) a disconnect between static evaluation benchmarks and dynamic clinical cognitive needs, (2) difficulties in adapting to evolving, multi-source medical standards, and (3) the inability of conventional reward models to capture nuanced, multi-dimensional medical quality criteria. To address these gaps, we propose MR-RML (Multidimensional Rubric-oriented Reward Model Learning) via GPRC (Geometric Projection Reference Constraints), a novel alignment framework that integrates medical standards into a structured "Dimensions-Scenarios-Disciplines" matrix to guide data generation and model optimization. MR-RML introduces three core innovations: (1) a "Dimensions-Scenarios-Disciplines" medical standard system that embeds domain standards into the full training pipeline; (2) an independent multi-dimensional reward model that decomposes evaluation criteria, shifting from real-time rubric-based scoring to internalized reward modeling for improved consistency and cost-efficiency; (3) geometric projection reference constraints that transform medical cognitive logic into mathematical regularization, aligning scoring gradients with clinical reasoning and enabling synthetic data-driven training. Through extensive evaluations on the authoritative medical benchmark Healthbench, our method yields substantial performance gains over the base LLM Qwen-32B (45% on the full subset and 85% on Hard subset, respectively). It achieves a SOTA among open-source LLMs with scores of 62.7 (full subset) and 44.7 (hard subset), while also outperforming the majority of closed-source models.

Magnetization transfer contrast magnetic resonance fingerprinting (MTC-MRF) is a novel quantitative imaging technique that simultaneously measures several tissue parameters of semisolid macromolecule and free bulk water. In this study, we propose an Only-Train-Once MR fingerprinting (OTOM) framework that estimates the free bulk water and MTC tissue parameters from MR fingerprints regardless of MRF schedule, thereby avoiding time-consuming process such as generation of training dataset and network training according to each MRF schedule. A recurrent neural network is designed to cope with two types of variants of MRF schedules: 1) various lengths and 2) various patterns. Experiments on digital phantoms and in vivo data demonstrate that our approach can achieve accurate quantification for the water and MTC parameters with multiple MRF schedules. Moreover, the proposed method is in excellent agreement with the conventional deep learning and fitting methods. The flexible OTOM framework could be an efficient tissue quantification tool for various MRF protocols.

Learned representations are a central component in modern ML systems, serving a multitude of downstream tasks. When training such representations, it is often the case that computational and statistical constraints for each downstream task are unknown. In this context rigid, fixed capacity representations can be either over or under-accommodating to the task at hand. This leads us to ask: can we design a flexible representation that can adapt to multiple downstream tasks with varying computational resources? Our main contribution is Matryoshka Representation Learning (MRL) which encodes information at different granularities and allows a single embedding to adapt to the computational constraints of downstream tasks. MRL minimally modifies existing representation learning pipelines and imposes no additional cost during inference and deployment. MRL learns coarse-to-fine representations that are at least as accurate and rich as independently trained low-dimensional representations. The flexibility within the learned Matryoshka Representations offer: (a) up to 14x smaller embedding size for ImageNet-1K classification at the same level of accuracy; (b) up to 14x real-world speed-ups for large-scale retrieval on ImageNet-1K and 4K; and (c) up to 2% accuracy improvements for long-tail few-shot classification, all while being as robust as the original representations. Finally, we show that MRL extends seamlessly to web-scale datasets (ImageNet, JFT) across various modalities -- vision (ViT, ResNet), vision + language (ALIGN) and language (BERT). MRL code and pretrained models are open-sourced at https://github.com/RAIVNLab/MRL.

Training models to effectively use test-time compute is crucial for improving the reasoning performance of LLMs. Current methods mostly do so via fine-tuning on search traces or running RL with 0/1 outcome reward, but do these approaches efficiently utilize test-time compute? Would these approaches continue to scale as the budget improves? In this paper, we try to answer these questions. We formalize the problem of optimizing test-time compute as a meta-reinforcement learning (RL) problem, which provides a principled perspective on spending test-time compute. This perspective enables us to view the long output stream from the LLM as consisting of several episodes run at test time and leads us to use a notion of cumulative regret over output tokens as a way to measure the efficacy of test-time compute. Akin to how RL algorithms can best tradeoff exploration and exploitation over training, minimizing cumulative regret would also provide the best balance between exploration and exploitation in the token stream. While we show that state-of-the-art models do not minimize regret, one can do so by maximizing a dense reward bonus in conjunction with the outcome 0/1 reward RL. This bonus is the ''progress'' made by each subsequent block in the output stream, quantified by the change in the likelihood of eventual success. Using these insights, we develop Meta Reinforcement Fine-Tuning, or MRT, a new class of fine-tuning methods for optimizing test-time compute. MRT leads to a 2-3x relative gain in performance and roughly a 1.5x gain in token efficiency for math reasoning compared to outcome-reward RL.

This paper introduces MR-Search, an in-context meta reinforcement learning (RL) formulation for agentic search with self-reflection. Instead of optimizing a policy within a single independent episode with sparse rewards, MR-Search trains a policy that conditions on past episodes and adapts its search strategy across episodes. MR-Search learns to learn a search strategy with self-reflection, allowing search agents to improve in-context exploration at test-time. Specifically, MR-Search performs cross-episode exploration by generating explicit self-reflections after each episode and leveraging them as additional context to guide subsequent attempts, thereby promoting more effective exploration during test-time. We further introduce a multi-turn RL algorithm that estimates a dense relative advantage at the turn level, enabling fine-grained credit assignment on each episode. Empirical results across various benchmarks demonstrate the advantages of MR-Search over baselines based RL, showing strong generalization and relative improvements of 9.2% to 19.3% across eight benchmarks. Our code and data are available at https://github.com/tengxiao1/MR-Search.

A crucial component of many deep learning applications (such as FAQ and RAG) is dense retrieval, in which embedding models are used to convert raw text to numerical vectors and then get the most similar text by MIPS (Maximum Inner Product Search). Some text embedding benchmarks (e.g. MTEB, BEIR, and AIR-Bench) have been established to evaluate embedding models accurately. Thanks to these benchmarks, we can use SOTA models; however, the deployment and application of these models in industry were hampered by their large vector dimensions and numerous parameters. To alleviate this problem, 1) we present a distillation technique that can enable a smaller student model to achieve good performance. 2) Inspired by MRL we present a training approach of reducing the vector dimensions based on its own vectors or its teacher vectors. 3) We do simple yet effective alignment training between images and text to make our model a multimodal encoder. We trained Stella and Jasper models using the technologies above and achieved high scores on the MTEB leaderboard. We release the model and data at Hugging Face Hub (https://huggingface.co/infgrad/jasper_en_vision_language_v1) and the training logs are at https://api.wandb.ai/links/dunnzhang0/z8jqoqpb.

Recent advances in multimodal reward modeling have been largely driven by a paradigm shift from discriminative to generative approaches. Building on this progress, recent studies have further employed reinforcement learning from verifiable rewards (RLVR) to enhance multimodal reward models (MRMs). Despite their success, RLVR-based training typically relies on labeled multimodal preference data, which are costly and labor-intensive to obtain, making it difficult to scale MRM training. To overcome this limitation, we propose a Multi-Stage Reinforcement Learning (MSRL) approach, which can achieve scalable RL for MRMs with limited multimodal data. MSRL replaces the conventional RLVR-based training paradigm by first learning a generalizable reward reasoning capability from large-scale textual preference data, and then progressively transferring this capability to multimodal tasks through caption-based and fully multimodal reinforcement-learning stages. Furthermore, we introduce a cross-modal knowledge distillation approach to improve preference generalization within MSRL. Extensive experiments demonstrate that MSRL effectively scales the RLVR-based training of generative MRMs and substantially improves their performance across both visual understanding and visual generation tasks (e.g., from 66.6% to 75.9% on VL-RewardBench and from 70.2% to 75.7% on GenAI-Bench), without requiring additional multimodal preference annotations. Our code is available at: https://github.com/wangclnlp/MSRL.

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.

Medical reasoning models (MRMs) achieve superior performance on medical benchmarks compared to medical LLMs; however, high accuracy alone is insufficient for practical deployment. One of such requirements for real-world application is robustness to varying output constraints. Specifically, posing the same medical question while requesting different answer formats should not affect the underlying correctness of the response. We investigate this phenomenon in this paper, focusing on MRMs. To quantify this behavior, we propose the metric answer-format robustness: the ability to reliably generate correct outputs across varying specified formats. We examine three representative formats: multiple-choice, open-ended question-answering, and ranked lists. Across 15 proprietary and open-weight models, we observe substantial variation in format robustness (35-100%). Furthermore, we conduct controlled fine-tuning experiments on a shared backbone with matched training data to isolate the effects of the fine-tuning paradigm. We find that supervised fine-tuning yields more stable behavior across formats, whereas reinforcement fine-tuning often exhibits higher cross-format brittleness, with the degree of instability strongly dependent on reward design. Overall, answer-format robustness in MRMs is trainable yet brittle and requires careful evaluation for practical medical use.

Test-time scaling has been shown to substantially improve large language models' (LLMs) mathematical reasoning. However, for a large portion of mathematical corpora, especially theorem proving, RLVR's scalability is limited: intermediate reasoning is crucial, while final answers are difficult to directly and reliably verify. Meanwhile, token-level SFT often degenerates into rote memorization rather than inducing longer chains of thought. Inspired by BERT's self-supervised tasks, we propose MR-RLVR (Masked-and-Reordered RLVR), which constructs process-level self-supervised rewards via "masked-then-fill" and "step reordering" to extract learnable signals from intermediate reasoning. Our training pipeline comprises two stages: we first perform self-supervised training on sampled mathematical calculation and proof data; we then conduct RLVR fine-tuning on mathematical calculation datasets where only outcomes are verifiable. We implement MR-RLVR on Qwen2.5-3B and DeepSeek-R1-Distill-Qwen-1.5B, and evaluate on AIME24, AIME25, AMC23, and MATH500. Under a fixed sampling and decoding budget, MR-RLVR achieves average relative gains over the original RLVR of +9.86% Pass@1, +5.27% Pass@5, and +4.00% Pass@8. These results indicate that incorporating process-aware self-supervised signals can effectively enhance RLVR's scalability and performance in only outcome-verifiable settings.

Multimodal magnetic resonance imaging (MRI) constitutes the first line of investigation for clinicians in the care of brain tumors, providing crucial insights for surgery planning, treatment monitoring, and biomarker identification. Pre-training on large datasets have been shown to help models learn transferable representations and adapt with minimal labeled data. This behavior is especially valuable in medical imaging, where annotations are often scarce. However, applying this paradigm to multimodal medical data introduces a challenge: most existing approaches assume that all imaging modalities are available during both pre-training and fine-tuning. In practice, missing modalities often occur due to acquisition issues, specialist unavailability, or specific experimental designs on small in-house datasets. Consequently, a common approach involves training a separate model for each desired modality combination, making the process both resource-intensive and impractical for clinical use. Therefore, we introduce BM-MAE, a masked image modeling pre-training strategy tailored for multimodal MRI data. The same pre-trained model seamlessly adapts to any combination of available modalities, extracting rich representations that capture both intra- and inter-modal information. This allows fine-tuning on any subset of modalities without requiring architectural changes, while still benefiting from a model pre-trained on the full set of modalities. Extensive experiments show that the proposed pre-training strategy outperforms or remains competitive with baselines that require separate pre-training for each modality subset, while substantially surpassing training from scratch on several downstream tasks. Additionally, it can quickly and efficiently reconstruct missing modalities, highlighting its practical value. Code and trained models are available at: https://github.com/Lucas-rbnt/BM-MAE

The rehearsal strategy is widely used to alleviate the catastrophic forgetting problem in class incremental learning (CIL) by preserving limited exemplars from previous tasks. With imbalanced sample numbers between old and new classes, the classifier learning can be biased. Existing CIL methods exploit the long-tailed (LT) recognition techniques, e.g., the adjusted losses and the data re-sampling methods, to handle the data imbalance issue within each increment task. In this work, the dynamic nature of data imbalance in CIL is shown and a novel Dynamic Residual Classifier (DRC) is proposed to handle this challenging scenario. Specifically, DRC is built upon a recent advance residual classifier with the branch layer merging to handle the model-growing problem. Moreover, DRC is compatible with different CIL pipelines and substantially improves them. Combining DRC with the model adaptation and fusion (MAF) pipeline, this method achieves state-of-the-art results on both the conventional CIL and the LT-CIL benchmarks. Extensive experiments are also conducted for a detailed analysis. The code is publicly available.

Despite the strong performance of large language models (LLMs) across a wide range of tasks, they still have reliability issues. Previous studies indicate that strong LLMs like GPT-4-turbo excel in evaluating the reliability of responses from LLMs, but face efficiency and local deployment issues. Thus, to enable weak LLMs to effectively assess the reliability of LLM responses, we propose a novel cross-query-comparison-based method called Meta Ranking (MR). Unlike previous few-shot methods that solely based on in-context learning capabilities in LLMs, MR assesses reliability by pairwisely ranking the target query-response pair with multiple reference query-response pairs. We found that MR is highly effective in error detection for LLM responses, where weak LLMs, such as Phi-2, could surpass strong baselines like GPT-3.5-turbo, requiring only five reference samples and significantly improving efficiency. We further demonstrate that MR can enhance strong LLMs' performance in two practical applications: model cascading and instruction tuning. In model cascading, we combine open- and closed-source LLMs to achieve performance comparable to GPT-4-turbo with lower costs. In instruction tuning, we use MR for iterative training data filtering, significantly reducing data processing time and enabling LLaMA-7B and Phi-2 to surpass Alpaca-13B with fewer training tokens. These results underscore the high potential of MR in both efficiency and effectiveness.

Multimodal Reward Models (MRMs) play a crucial role in enhancing the performance of Multimodal Large Language Models (MLLMs). While recent advancements have primarily focused on improving the model structure and training data of MRMs, there has been limited exploration into the effectiveness of long-term reasoning capabilities for reward modeling and how to activate these capabilities in MRMs. In this paper, we explore how Reinforcement Learning (RL) can be used to improve reward modeling. Specifically, we reformulate the reward modeling problem as a rule-based RL task. However, we observe that directly applying existing RL algorithms, such as Reinforce++, to reward modeling often leads to training instability or even collapse due to the inherent limitations of these algorithms. To address this issue, we propose the StableReinforce algorithm, which refines the training loss, advantage estimation strategy, and reward design of existing RL methods. These refinements result in more stable training dynamics and superior performance. To facilitate MRM training, we collect 200K preference data from diverse datasets. Our reward model, R1-Reward, trained using the StableReinforce algorithm on this dataset, significantly improves performance on multimodal reward modeling benchmarks. Compared to previous SOTA models, R1-Reward achieves a 8.4% improvement on the VL Reward-Bench and a 14.3% improvement on the Multimodal Reward Bench. Moreover, with more inference compute, R1-Reward's performance is further enhanced, highlighting the potential of RL algorithms in optimizing MRMs.

We present Gazal-R1, a 32-billion-parameter language model that achieves state-of-the-art performance in medical reasoning while providing transparent, step-by-step explanations for clinical decision-making. Built upon Qwen3 32B, our model demonstrates that strategic training can enable mid-sized models to outperform significantly larger counterparts in specialized domains. We developed a novel two-stage training pipeline: first, supervised fine-tuning on a carefully curated dataset of 107,033 synthetic medical reasoning examples that teaches structured clinical thinking, enhanced by advanced parameter-efficient techniques including Weight-Decomposed Low-Rank Adaptation (DoRA) and Rank-Stabilized LoRA (rsLoRA); second, reinforcement learning using Group Relative Policy Optimization (GRPO) with a sophisticated multi-component reward system that refines accuracy, format adherence, and reasoning quality. Gazal-R1 achieves exceptional performance across medical benchmarks, scoring 87.1% on MedQA, 81.6% on MMLU Pro (Medical), and 79.6% on PubMedQA, surpassing models up to 12x larger. Beyond its strong empirical results, this work provides detailed insights into the challenges of training reasoning-capable models in specialized domains, including issues with reward hacking, training instability, and the fundamental tension between factual recall and detailed reasoning. Our methodology offers a reproducible framework for developing high-capability, domain-specific language models that balance performance, efficiency, and explainability.

The rapid advancement of Multimodal Large Language Models (MLLMs) has made aligning them with human preferences a critical challenge. Reward Models (RMs) are a core technology for achieving this goal, but a systematic guide for building state-of-the-art Multimodal Reward Models (MRMs) is currently lacking in both academia and industry. Through exhaustive experimental analysis, this paper aims to provide a clear ``recipe'' for constructing high-performance MRMs. We systematically investigate every crucial component in the MRM development pipeline, including reward modeling paradigms (e.g., Naive-RM, Critic-based RM, and Generative RM), reward head architecture, training strategies, data curation (covering over ten multimodal and text-only preference datasets), backbone model and model scale, and ensemble methods. Based on these experimental insights, we introduce BaseReward, a powerful and efficient baseline for multimodal reward modeling. BaseReward adopts a simple yet effective architecture, built upon a {Qwen2.5-VL} backbone, featuring an optimized two-layer reward head, and is trained on a carefully curated mixture of high-quality multimodal and text-only preference data. Our results show that BaseReward establishes a new SOTA on major benchmarks such as MM-RLHF-Reward Bench, VL-Reward Bench, and Multimodal Reward Bench, outperforming previous models. Furthermore, to validate its practical utility beyond static benchmarks, we integrate BaseReward into a real-world reinforcement learning pipeline, successfully enhancing an MLLM's performance across various perception, reasoning, and conversational tasks. This work not only delivers a top-tier MRM but, more importantly, provides the community with a clear, empirically-backed guide for developing robust reward models for the next generation of MLLMs.

During surgical training, real-time feedback from trainers to trainees is important for preventing errors and enhancing long-term skill acquisition. Accurately predicting the effectiveness of this feedback, specifically whether it leads to a change in trainee behavior, is crucial for developing methods for improving surgical training and education. However, relying on human annotations to assess feedback effectiveness is laborious and prone to biases, underscoring the need for an automated, scalable, and objective method. Creating such an automated system poses challenges, as it requires an understanding of both the verbal feedback delivered by the trainer and the visual context of the real-time surgical scene. To address this, we propose a method that integrates information from transcribed verbal feedback and corresponding surgical video to predict feedback effectiveness. Our findings show that both transcribed feedback and surgical video are individually predictive of trainee behavior changes, and their combination achieves an AUROC of 0.70+/-0.02, improving prediction accuracy by up to 6.6%. Additionally, we introduce self-supervised fine-tuning as a strategy for enhancing surgical video representation learning, which is scalable and further enhances prediction performance. Our results demonstrate the potential of multi-modal learning to advance the automated assessment of surgical feedback.

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

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

Automated radiology report generation from 3D computed tomography (CT) volumes is challenging due to extreme sequence lengths, severe class imbalance, and the tendency of large language models (LLMs) to ignore visual tokens in favor of linguistic priors. We present Ker-VLJEPA-3B, a four-phase curriculum learning framework for free-text report generation from thoracic CT volumes. A phased training curriculum progressively adapts a Llama 3.2 3B decoder to ground its output in visual features from a frozen, self-supervised encoder. Our visual backbone (LeJEPA ViT-Large) is trained via self-supervised joint-embedding prediction on unlabeled CTs, without text supervision. Unlike contrastive models (CLIP, BiomedCLIP), this language-free backbone yields modality-pure representations. Vision-language alignment is deferred to the curriculum's bridge and generation phases. This modality-agnostic design can integrate any self-supervised encoder into an LLM without paired text during foundation training. Methodological innovations include: (1) zone-constrained cross-attention compressing slice embeddings into 32 spatially-grounded visual tokens; (2) PCA whitening of anisotropic LLM embeddings; (3) a positive-findings-only strategy eliminating posterior collapse; (4) warm bridge initialization transferring projection weights; and (5) selective cross-attention freezing with elastic weight consolidation to prevent catastrophic forgetting. Evaluated on the CT-RATE benchmark (2,984 validation volumes, 18 classes), Ker-VLJEPA-3B achieves a macro F1 of 0.429, surpassing the state-of-the-art (U-VLM, macro F1 = 0.414) by 3.6%, and reaching 0.448 (+8.2%) with threshold optimization. Ablation studies confirm 56.6% of generation quality derives from patient-specific visual content. Code and weights are available.

Automatic medical report generation (MRG), which possesses significant research value as it can aid radiologists in clinical diagnosis and report composition, has garnered increasing attention. Despite recent progress, generating accurate reports remains arduous due to the requirement for precise clinical comprehension and disease diagnosis inference. Furthermore, owing to the limited accessibility of medical data and the imbalanced distribution of diseases, the underrepresentation of rare diseases in training data makes large-scale medical visual language models (LVLMs) prone to hallucinations, such as omissions or fabrications, severely undermining diagnostic performance and further intensifying the challenges for MRG in practice. In this study, to effectively mitigate hallucinations in medical report generation, we propose a chain-of-medical-thought approach (CoMT), which intends to imitate the cognitive process of human doctors by decomposing diagnostic procedures. The radiological features with different importance are structured into fine-grained medical thought chains to enhance the inferential ability during diagnosis, thereby alleviating hallucination problems and enhancing the diagnostic accuracy of MRG. The code and dataset have been released at https://github.com/FRENKIE-CHIANG/CoMT.

Quantification of real-time informal feedback delivered by an experienced surgeon to a trainee during surgery is important for skill improvements in surgical training. Such feedback in the live operating room is inherently multimodal, consisting of verbal conversations (e.g., questions and answers) as well as non-verbal elements (e.g., through visual cues like pointing to anatomic elements). In this work, we leverage a clinically-validated five-category classification of surgical feedback: "Anatomic", "Technical", "Procedural", "Praise" and "Visual Aid". We then develop a multi-label machine learning model to classify these five categories of surgical feedback from inputs of text, audio, and video modalities. The ultimate goal of our work is to help automate the annotation of real-time contextual surgical feedback at scale. Our automated classification of surgical feedback achieves AUCs ranging from 71.5 to 77.6 with the fusion improving performance by 3.1%. We also show that high-quality manual transcriptions of feedback audio from experts improve AUCs to between 76.5 and 96.2, which demonstrates a clear path toward future improvements. Empirically, we find that the Staged training strategy, with first pre-training each modality separately and then training them jointly, is more effective than training different modalities altogether. We also present intuitive findings on the importance of modalities for different feedback categories. This work offers an important first look at the feasibility of automated classification of real-world live surgical feedback based on text, audio, and video modalities.

Multimodal Retrieval-Augmented Generation (MRAG) has shown promise in mitigating hallucinations in Multimodal Large Language Models (MLLMs) by incorporating external knowledge during generation. Existing MRAG methods typically adopt a static retrieval pipeline that fetches relevant information from multiple Knowledge Bases (KBs), followed by a refinement step. However, these approaches overlook the reasoning and planning capabilities of MLLMs to dynamically determine how to interact with different KBs during the reasoning process. To address this limitation, we propose R1-Router, a novel MRAG framework that learns to decide when and where to retrieve knowledge based on the evolving reasoning state. Specifically, R1-Router can generate follow-up queries according to the current reasoning step, routing these intermediate queries to the most suitable KB, and integrating external knowledge into a coherent reasoning trajectory to answer the original query. Furthermore, we introduce Step-wise Group Relative Policy Optimization (Step-GRPO), a tailored reinforcement learning algorithm that assigns step-specific rewards to optimize the reasoning behavior of MLLMs. Experimental results on various open-domain QA benchmarks across multiple modalities demonstrate that R1-Router outperforms baseline models by over 7%. Further analysis shows that R1-Router can adaptively and effectively leverage diverse KBs, reducing unnecessary retrievals and improving both efficiency and accuracy.

Recent advances in large language models (LLMs) have demonstrated exceptional performance in various natural language processing (NLP) tasks. However, their effective application in the medical domain is hampered by a lack of medical domain knowledge. In this study, we present SA-MDKIF, a scalable and adaptable framework that aims to inject medical knowledge into general-purpose LLMs through instruction tuning, thereby enabling adaptability for various downstream tasks. SA-MDKIF consists of two stages: skill training and skill adaptation. In the first stage, we define 12 basic medical skills and use AdaLoRA to train these skills based on uniformly formatted instructional datasets that we have constructed. In the next stage, we train the skill router using task-specific downstream data and use this router to integrate the acquired skills with LLMs during inference. Experimental results on 9 different medical tasks show that SA-MDKIF improves performance by 10-20% compared to the original LLMs. Notably, this improvement is particularly pronounced for unseen medical tasks, showing an improvement of up to 30%.

Recent advances in reinforcement learning with verifiable, rule-based rewards have greatly enhanced the reasoning capabilities and out-of-distribution generalization of VLMs/LLMs, obviating the need for manually crafted reasoning chains. Despite these promising developments in the general domain, their translation to medical imaging remains limited. Current medical reinforcement fine-tuning (RFT) methods predominantly focus on close-ended VQA, thereby restricting the model's ability to engage in world knowledge retrieval and flexible task adaptation. More critically, these methods fall short of addressing the critical clinical demand for open-ended, reasoning-intensive decision-making. To bridge this gap, we introduce MedCCO, the first multimodal reinforcement learning framework tailored for medical VQA that unifies close-ended and open-ended data within a curriculum-driven RFT paradigm. Specifically, MedCCO is initially fine-tuned on a diverse set of close-ended medical VQA tasks to establish domain-grounded reasoning capabilities, and is then progressively adapted to open-ended tasks to foster deeper knowledge enhancement and clinical interpretability. We validate MedCCO across eight challenging medical VQA benchmarks, spanning both close-ended and open-ended settings. Experimental results show that MedCCO consistently enhances performance and generalization, achieving a 11.4\% accuracy gain across three in-domain tasks, and a 5.7\% improvement on five out-of-domain benchmarks. These findings highlight the promise of curriculum-guided RL in advancing robust, clinically-relevant reasoning in medical multimodal language models.

We introduce MrBERT, a family of 150M-300M parameter encoders built on the ModernBERT architecture and pre-trained on 35 languages and code. Through targeted adaptation, this model family achieves state-of-the-art results on Catalan- and Spanish-specific tasks, while establishing robust performance across specialized biomedical and legal domains. To bridge the gap between research and production, we incorporate Matryoshka Representation Learning (MRL), enabling flexible vector sizing that significantly reduces inference and storage costs. Ultimately, the MrBERT family demonstrates that modern encoder architectures can be optimized for both localized linguistic excellence and efficient, high-stakes domain specialization. We open source the complete model family on Huggingface.

Advanced Multimodal Large Language Models (MLLMs) struggle with recent Knowledge-based VQA tasks, such as INFOSEEK and Encyclopedic-VQA, due to their limited and frozen knowledge scope, often leading to ambiguous and inaccurate responses. Thus, multimodal Retrieval-Augmented Generation (mRAG) is naturally introduced to provide MLLMs with comprehensive and up-to-date knowledge, effectively expanding the knowledge scope. However, current mRAG methods have inherent drawbacks, including: 1) Performing retrieval even when external knowledge is not needed. 2) Lacking of identification of evidence that supports the query. 3) Increasing model complexity due to additional information filtering modules or rules. To address these shortcomings, we propose a novel generalized framework called multimodal Retrieval-Reflection-Augmented Generation (mR^2AG), which achieves adaptive retrieval and useful information localization to enable answers through two easy-to-implement reflection operations, preventing high model complexity. In mR^2AG, Retrieval-Reflection is designed to distinguish different user queries and avoids redundant retrieval calls, and Relevance-Reflection is introduced to guide the MLLM in locating beneficial evidence of the retrieved content and generating answers accordingly. In addition, mR^2AG can be integrated into any well-trained MLLM with efficient fine-tuning on the proposed mR^2AG Instruction-Tuning dataset (mR^2AG-IT). mR^2AG significantly outperforms state-of-the-art MLLMs (e.g., GPT-4v/o) and RAG-based MLLMs on INFOSEEK and Encyclopedic-VQA, while maintaining the exceptional capabilities of base MLLMs across a wide range of Visual-dependent tasks.

In this work, we develop an open-source surgical simulation environment that includes a realistic model obtained by MRI-scanning a physical phantom, for the purpose of training and evaluating a Learning from Demonstration (LfD) algorithm for autonomous suturing. The LfD algorithm utilizes Dynamic Movement Primitives (DMP) and Locally Weighted Regression (LWR), but focuses on the needle trajectory, rather than the instruments, to obtain better generality with respect to needle grasps. We conduct a user study to collect multiple suturing demonstrations and perform a comprehensive analysis of the ability of the LfD algorithm to generalize from a demonstration at one location in one phantom to different locations in the same phantom and to a different phantom. Our results indicate good generalization, on the order of 91.5%, when learning from more experienced subjects, indicating the need to integrate skill assessment in the future.

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.

Multilingual text recognition (MLTR) systems typically focus on a fixed set of languages, which makes it difficult to handle newly added languages or adapt to ever-changing data distribution. In this paper, we propose the Incremental MLTR (IMLTR) task in the context of incremental learning (IL), where different languages are introduced in batches. IMLTR is particularly challenging due to rehearsal-imbalance, which refers to the uneven distribution of sample characters in the rehearsal set, used to retain a small amount of old data as past memories. To address this issue, we propose a Multiplexed Routing Network (MRN). MRN trains a recognizer for each language that is currently seen. Subsequently, a language domain predictor is learned based on the rehearsal set to weigh the recognizers. Since the recognizers are derived from the original data, MRN effectively reduces the reliance on older data and better fights against catastrophic forgetting, the core issue in IL. We extensively evaluate MRN on MLT17 and MLT19 datasets. It outperforms existing general-purpose IL methods by large margins, with average accuracy improvements ranging from 10.3% to 35.8% under different settings. Code is available at https://github.com/simplify23/MRN.

Multimodal document retrieval systems enable information access across text, images, and layouts, benefiting various domains like document-based question answering, report analysis, and interactive content summarization. Rerankers improve retrieval precision by reordering retrieved candidates. However, current multimodal reranking methods remain underexplored, with significant room for improvement in both training strategies and overall effectiveness. Moreover, the lack of explicit reasoning makes it difficult to analyze and optimize these methods further. In this paper, We propose MM-R5, a MultiModal Reasoning-Enhanced ReRanker via Reinforcement Learning for Document Retrieval, aiming to provide a more effective and reliable solution for multimodal reranking tasks. MM-R5 is trained in two stages: supervised fine-tuning (SFT) and reinforcement learning (RL). In the SFT stage, we focus on improving instruction-following and guiding the model to generate complete and high-quality reasoning chains. To support this, we introduce a novel data construction strategy that produces rich, high-quality reasoning data. In the RL stage, we design a task-specific reward framework, including a reranking reward tailored for multimodal candidates and a composite template-based reward to further refine reasoning quality. We conduct extensive experiments on MMDocIR, a challenging public benchmark spanning multiple domains. MM-R5 achieves state-of-the-art performance on most metrics and delivers comparable results to much larger models on the remaining ones. Moreover, compared to the best retrieval-only method, MM-R5 improves recall@1 by over 4%. These results validate the effectiveness of our reasoning-enhanced training pipeline.

Cardiac magnetic resonance (CMR) is a key investigation in clinical cardiovascular medicine and has been used extensively in population research. However, extracting clinically important measurements such as ejection fraction for diagnosing cardiovascular diseases remains time-consuming and subjective. We developed CineMA, a foundation AI model automating these tasks with limited labels. CineMA is a self-supervised autoencoder model trained on 74,916 cine CMR studies to reconstruct images from masked inputs. After fine-tuning, it was evaluated across eight datasets on 23 tasks from four categories: ventricle and myocardium segmentation, left and right ventricle ejection fraction calculation, disease detection and classification, and landmark localisation. CineMA is the first foundation model for cine CMR to match or outperform convolutional neural networks (CNNs). CineMA demonstrated greater label efficiency than CNNs, achieving comparable or better performance with fewer annotations. This reduces the burden of clinician labelling and supports replacing task-specific training with fine-tuning foundation models in future cardiac imaging applications. Models and code for pre-training and fine-tuning are available at https://github.com/mathpluscode/CineMA, democratising access to high-performance models that otherwise require substantial computational resources, promoting reproducibility and accelerating clinical translation.

We introduce a full-stack framework that scales up reasoning in vision-language models (VLMs) to long videos, leveraging reinforcement learning. We address the unique challenges of long video reasoning by integrating three critical components: (1) a large-scale dataset, LongVideo-Reason, comprising 52K long video QA pairs with high-quality reasoning annotations across diverse domains such as sports, games, and vlogs; (2) a two-stage training pipeline that extends VLMs with chain-of-thought supervised fine-tuning (CoT-SFT) and reinforcement learning (RL); and (3) a training infrastructure for long video RL, named Multi-modal Reinforcement Sequence Parallelism (MR-SP), which incorporates sequence parallelism and a vLLM-based engine tailored for long video, using cached video embeddings for efficient rollout and prefilling. In experiments, LongVILA-R1-7B achieves strong performance on long video QA benchmarks such as VideoMME. It also outperforms Video-R1-7B and even matches Gemini-1.5-Pro across temporal reasoning, goal and purpose reasoning, spatial reasoning, and plot reasoning on our LongVideo-Reason-eval benchmark. Notably, our MR-SP system achieves up to 2.1x speedup on long video RL training. LongVILA-R1 demonstrates consistent performance gains as the number of input video frames scales. LongVILA-R1 marks a firm step towards long video reasoning in VLMs. In addition, we release our training system for public availability that supports RL training on various modalities (video, text, and audio), various models (VILA and Qwen series), and even image and video generation models. On a single A100 node (8 GPUs), it supports RL training on hour-long videos (e.g., 3,600 frames / around 256k tokens).

Reinforcement Learning with Verifiable Rewards (RLVR) has become a key paradigm to improve the reasoning capabilities of Multimodal Large Language Models (MLLMs). However, prevalent group-based algorithms such as GRPO require multi-rollout sampling for each prompt. While more efficient single-rollout variants have recently been explored in text-only settings, we find that they suffer from severe instability in multimodal contexts, often leading to training collapse. To address this training efficiency-stability trade-off, we introduce MSSR (Multimodal Stabilized Single-Rollout), a group-free RLVR framework that achieves both stable optimization and effective multimodal reasoning performance. MSSR achieves this via an entropy-based advantage-shaping mechanism that adaptively regularizes advantage magnitudes, preventing collapse and maintaining training stability. While such mechanisms have been used in group-based RLVR, we show that in the multimodal single-rollout setting they are not merely beneficial but essential for stability. In in-distribution evaluations, MSSR demonstrates superior training compute efficiency, achieving similar validation accuracy to the group-based baseline with half the training steps. When trained for the same number of steps, MSSR's performance surpasses the group-based baseline and shows consistent generalization improvements across five diverse reasoning-intensive benchmarks. Together, these results demonstrate that MSSR enables stable, compute-efficient, and effective RLVR for complex multimodal reasoning tasks.

Reinforcement learning (RL) has been widely used in training large language models~(LLMs) for preventing unexpected outputs, \eg reducing harmfulness and errors. However, existing RL methods mostly adopt the instance-level reward, which is unable to provide fine-grained supervision for complex reasoning tasks, and can not focus on the few key tokens that lead to the incorrectness. To address it, we propose a new RL method named RLMEC that incorporates a generative model as the reward model, which is trained by the erroneous solution rewriting task under the minimum editing constraint, and can produce token-level rewards for RL training. Based on the generative reward model, we design the token-level RL objective for training and an imitation-based regularization for stabilizing RL process. And the both objectives focus on the learning of the key tokens for the erroneous solution, reducing the effect of other unimportant tokens. The experiment results on mathematical tasks and question-answering tasks have demonstrated the effectiveness of our approach. Our code and data are available at https://github.com/RUCAIBox/RLMEC.

Machine Learning as a Service (MLaaS) is often provided as a pay-per-query, black-box system to clients. Such a black-box approach not only hinders open replication, validation, and interpretation of model results, but also makes it harder for white-hat researchers to identify vulnerabilities in the MLaaS systems. Model extraction is a promising technique to address these challenges by reverse-engineering black-box models. Since training data is typically unavailable for MLaaS models, this paper focuses on the realistic version of it: data-free model extraction. We propose a data-free model extraction approach, CaBaGe, to achieve higher model extraction accuracy with a small number of queries. Our innovations include (1) a novel experience replay for focusing on difficult training samples; (2) an ensemble of generators for steadily producing diverse synthetic data; and (3) a selective filtering process for querying the victim model with harder, more balanced samples. In addition, we create a more realistic setting, for the first time, where the attacker has no knowledge of the number of classes in the victim training data, and create a solution to learn the number of classes on the fly. Our evaluation shows that CaBaGe outperforms existing techniques on seven datasets -- MNIST, FMNIST, SVHN, CIFAR-10, CIFAR-100, ImageNet-subset, and Tiny ImageNet -- with an accuracy improvement of the extracted models by up to 43.13%. Furthermore, the number of queries required to extract a clone model matching the final accuracy of prior work is reduced by up to 75.7%.

Multiple Instance Learning (MIL) is a cornerstone approach in computational pathology (CPath) for generating clinically meaningful slide-level embeddings from gigapixel tissue images. However, MIL often struggles with small, weakly supervised clinical datasets. In contrast to fields such as NLP and conventional computer vision, where transfer learning is widely used to address data scarcity, the transferability of MIL models remains poorly understood. In this study, we systematically evaluate the transfer learning capabilities of pretrained MIL models by assessing 11 models across 21 pretraining tasks for morphological and molecular subtype prediction. Our results show that pretrained MIL models, even when trained on different organs than the target task, consistently outperform models trained from scratch. Moreover, pretraining on pancancer datasets enables strong generalization across organs and tasks, outperforming slide foundation models while using substantially less pretraining data. These findings highlight the robust adaptability of MIL models and demonstrate the benefits of leveraging transfer learning to boost performance in CPath. Lastly, we provide a resource which standardizes the implementation of MIL models and collection of pretrained model weights on popular CPath tasks, available at https://github.com/mahmoodlab/MIL-Lab

In multi-agent reinforcement learning, the behaviors that agents learn in a single Markov Game (MG) are typically confined to the given agent number. Every single MG induced by varying the population may possess distinct optimal joint strategies and game-specific knowledge, which are modeled independently in modern multi-agent reinforcement learning algorithms. In this work, our focus is on creating agents that can generalize across population-varying MGs. Instead of learning a unimodal policy, each agent learns a policy set comprising effective strategies across a variety of games. To achieve this, we propose Meta Representations for Agents (MRA) that explicitly models the game-common and game-specific strategic knowledge. By representing the policy sets with multi-modal latent policies, the game-common strategic knowledge and diverse strategic modes are discovered through an iterative optimization procedure. We prove that by approximately maximizing the resulting constrained mutual information objective, the policies can reach Nash Equilibrium in every evaluation MG when the latent space is sufficiently large. When deploying MRA in practical settings with limited latent space sizes, fast adaptation can be achieved by leveraging the first-order gradient information. Extensive experiments demonstrate the effectiveness of MRA in improving training performance and generalization ability in challenging evaluation games.

The accelerated adoption of digital pathology and advances in deep learning have enabled the development of powerful models for various pathology tasks across a diverse array of diseases and patient cohorts. However, model training is often difficult due to label scarcity in the medical domain and the model's usage is limited by the specific task and disease for which it is trained. Additionally, most models in histopathology leverage only image data, a stark contrast to how humans teach each other and reason about histopathologic entities. We introduce CONtrastive learning from Captions for Histopathology (CONCH), a visual-language foundation model developed using diverse sources of histopathology images, biomedical text, and notably over 1.17 million image-caption pairs via task-agnostic pretraining. Evaluated on a suite of 13 diverse benchmarks, CONCH can be transferred to a wide range of downstream tasks involving either or both histopathology images and text, achieving state-of-the-art performance on histology image classification, segmentation, captioning, text-to-image and image-to-text retrieval. CONCH represents a substantial leap over concurrent visual-language pretrained systems for histopathology, with the potential to directly facilitate a wide array of machine learning-based workflows requiring minimal or no further supervised fine-tuning.

Large language models (LLMs) have recently shown strong potential in audio-visual speech recognition (AVSR), but their high computational demands and sensitivity to token granularity limit their practicality in resource-constrained settings. Token compression methods can reduce inference cost, but they require fixing a compression rate in advance and produce a single fixed-length output, offering no flexibility to balance information density and efficiency at inference time. Matryoshka representation learning (MRL) addresses this by enabling a single model to operate across multiple token granularities, allowing compression rates to be adjusted dynamically. However, current MRL-based methods treat each scale independently during training, limiting cross-scale generalization, robustness at high compression, and interpretability. To overcome these limitations, we propose MoME (Mixture of Matryoshka Experts), a novel framework that integrates sparse Mixture-of-Experts (MoE) into MRL-based LLMs for AVSR. MoME augments a frozen LLM with top-k routed and shared experts, allowing dynamic capacity allocation across scales and modalities. A shared router promotes consistent expert activation across granularities, enabling compressed sequences to benefit from representations learned at lower compression. Experiments on LRS2 and LRS3 demonstrate that MoME achieves state-of-the-art performance across AVSR, ASR, and VSR tasks, while requiring significantly fewer parameters and maintaining robustness under noise. MoME unifies the adaptability of MRL with the efficiency of MoE, offering a scalable and interpretable solution for resource-aware speech recognition.

Evaluation using Large Language Model (LLM) judges has been widely adopted in English and shown to be effective for automatic evaluation. However, their performance does not generalize well to non-English settings, and it remains unclear what constitutes effective multilingual training for such judges. In this paper, we introduce mR3, a massively multilingual, rubric-agnostic reward reasoning model trained on 72 languages, achieving the broadest language coverage in reward modeling to date. We present a comprehensive study of data and curriculum selection for training to identify effective strategies and data sources for building high-quality reward models, including the integration of target-language reasoning datasets. Our approach attains state-of-the-art performance on multilingual reward model benchmarks, surpassing much larger models (i.e., GPT-OSS-120B) while being up to 9x smaller, and its effectiveness is further confirmed through extensive ablation studies. Our models, data, and code are available as open source at https://github.com/rubricreward/mr3.

Lack of large expert annotated MR datasets makes training deep learning models difficult. Therefore, a cross-modality (MR-CT) deep learning segmentation approach that augments training data using pseudo MR images produced by transforming expert-segmented CT images was developed. Eighty-One T2-weighted MRI scans from 28 patients with non-small cell lung cancers were analyzed. Cross-modality prior encoding the transformation of CT to pseudo MR images resembling T2w MRI was learned as a generative adversarial deep learning model. This model augmented training data arising from 6 expert-segmented T2w MR patient scans with 377 pseudo MRI from non-small cell lung cancer CT patient scans with obtained from the Cancer Imaging Archive. A two-dimensional Unet implemented with batch normalization was trained to segment the tumors from T2w MRI. This method was benchmarked against (a) standard data augmentation and two state-of-the art cross-modality pseudo MR-based augmentation and (b) two segmentation networks. Segmentation accuracy was computed using Dice similarity coefficient (DSC), Hausdroff distance metrics, and volume ratio. The proposed approach produced the lowest statistical variability in the intensity distribution between pseudo and T2w MR images measured as Kullback-Leibler divergence of 0.069. This method produced the highest segmentation accuracy with a DSC of 0.75 and the lowest Hausdroff distance on the test dataset. This approach produced highly similar estimations of tumor growth as an expert (P = 0.37). A novel deep learning MR segmentation was developed that overcomes the limitation of learning robust models from small datasets by leveraging learned cross-modality priors to augment training. The results show the feasibility of the approach and the corresponding improvement over the state-of-the-art methods.

Multimodal Process Reward Models (MPRMs) are central to step-level supervision for visual reasoning in MLLMs. Training MPRMs typically requires large-scale Monte Carlo (MC)-annotated corpora, incurring substantial training cost. This paper studies the data efficiency for MPRM training.Our preliminary experiments reveal that MPRM training quickly saturates under random subsampling of the training data, indicating substantial redundancy within existing MC-annotated corpora.To explain this, we formalize a theoretical framework and reveal that informative gradient updates depend on two factors: label mixtures of positive/negative steps and label reliability (average MC scores of positive steps). Guided by these insights, we propose the Balanced-Information Score (BIS), which prioritizes both mixture and reliability based on existing MC signals at the rollout level, without incurring any additional cost. Across two backbones (InternVL2.5-8B and Qwen2.5-VL-7B) on VisualProcessBench, BIS-selected subsets consistently match and even surpass the full-data performance at small fractions. Notably, the BIS subset reaches full-data performance using only 10% of the training data, improving over random subsampling by a relative 4.1%.

In recent years, automated radiology report generation has experienced significant growth. This paper introduces MRScore, an automatic evaluation metric tailored for radiology report generation by leveraging Large Language Models (LLMs). Conventional NLG (natural language generation) metrics like BLEU are inadequate for accurately assessing the generated radiology reports, as systematically demonstrated by our observations within this paper. To address this challenge, we collaborated with radiologists to develop a framework that guides LLMs for radiology report evaluation, ensuring alignment with human analysis. Our framework includes two key components: i) utilizing GPT to generate large amounts of training data, i.e., reports with different qualities, and ii) pairing GPT-generated reports as accepted and rejected samples and training LLMs to produce MRScore as the model reward. Our experiments demonstrate MRScore's higher correlation with human judgments and superior performance in model selection compared to traditional metrics. Our code and datasets will be available on GitHub.

General-purpose LLM judges capable of human-level evaluation provide not only a scalable and accurate way of evaluating instruction-following LLMs but also new avenues for supervising and improving their performance. One promising way of leveraging LLM judges for supervision is through Minimum Bayes Risk (MBR) decoding, which uses a reference-based evaluator to select a high-quality output from amongst a set of candidate outputs. In the first part of this work, we explore using MBR decoding as a method for improving the test-time performance of instruction-following LLMs. We find that MBR decoding with reference-based LLM judges substantially improves over greedy decoding, best-of-N decoding with reference-free judges and MBR decoding with lexical and embedding-based metrics on AlpacaEval and MT-Bench. These gains are consistent across LLMs with up to 70B parameters, demonstrating that smaller LLM judges can be used to supervise much larger LLMs. Then, seeking to retain the improvements from MBR decoding while mitigating additional test-time costs, we explore iterative self-training on MBR-decoded outputs. We find that self-training using Direct Preference Optimisation leads to significant performance gains, such that the self-trained models with greedy decoding generally match and sometimes exceed the performance of their base models with MBR decoding.

Medical phrase grounding is crucial for identifying relevant regions in medical images based on phrase queries, facilitating accurate image analysis and diagnosis. However, current methods rely on manual extraction of key phrases from medical reports, reducing efficiency and increasing the workload for clinicians. Additionally, the lack of model confidence estimation limits clinical trust and usability. In this paper, we introduce a novel task called Medical Report Grounding (MRG), which aims to directly identify diagnostic phrases and their corresponding grounding boxes from medical reports in an end-to-end manner. To address this challenge, we propose uMedGround, a robust and reliable framework that leverages a multimodal large language model to predict diagnostic phrases by embedding a unique token, <BOX>, into the vocabulary to enhance detection capabilities. A vision encoder-decoder processes the embedded token and input image to generate grounding boxes. Critically, uMedGround incorporates an uncertainty-aware prediction model, significantly improving the robustness and reliability of grounding predictions. Experimental results demonstrate that uMedGround outperforms state-of-the-art medical phrase grounding methods and fine-tuned large visual-language models, validating its effectiveness and reliability. This study represents a pioneering exploration of the MRG task, marking the first-ever endeavor in this domain. Additionally, we demonstrate the applicability of uMedGround in medical visual question answering and class-based localization tasks, where it highlights visual evidence aligned with key diagnostic phrases, supporting clinicians in interpreting various types of textual inputs, including free-text reports, visual question answering queries, and class labels.

Radiology report generation (RRG) has attracted significant attention due to its potential to reduce the workload of radiologists. Current RRG approaches are still unsatisfactory against clinical standards. This paper introduces a novel RRG method, LM-RRG, that integrates large models (LMs) with clinical quality reinforcement learning to generate accurate and comprehensive chest X-ray radiology reports. Our method first designs a large language model driven feature extractor to analyze and interpret different regions of the chest X-ray image, emphasizing specific regions with medical significance. Next, based on the large model's decoder, we develop a multimodal report generator that leverages multimodal prompts from visual features and textual instruction to produce the radiology report in an auto-regressive way. Finally, to better reflect the clinical significant and insignificant errors that radiologists would normally assign in the report, we introduce a novel clinical quality reinforcement learning strategy. It utilizes the radiology report clinical quality (RadCliQ) metric as a reward function in the learning process. Extensive experiments on the MIMIC-CXR and IU-Xray datasets demonstrate the superiority of our method over the state of the art.

Multimodal reward models (MRMs) play a crucial role in the training, inference, and evaluation of Large Vision Language Models (LVLMs) by assessing response quality. However, existing benchmarks for evaluating MRMs in the video domain suffer from a limited number and diversity of questions, a lack of comprehensive evaluation dimensions, and inadequate evaluation of diverse types of MRMs. To address these gaps, we introduce VideoRewardBench, the first comprehensive benchmark covering four core aspects of video understanding: perception, knowledge, reasoning, and safety. Through our AI-assisted data pipeline, we curate a high-quality preference dataset of 1,563 annotated samples, including 1,482 unique videos and 1,559 distinct questions--15 times the number found in the most question-rich prior benchmark. Each sample is a triplet consisting of a video-text prompt, a chosen response, and a rejected response. We also conduct a comprehensive evaluation across 28 multimodal reward models spanning three categories: generative, discriminative, and semi-scalar. Results show that even the top-performing model GPT-4o achieves only 57.0% overall accuracy, and the state-of-the-art open-source model Qwen2.5-VL-72B reaches merely 53.3%. Our analysis further reveals three key insights: (i) MRMs trained with reinforcement learning (RL) do not necessarily exhibit stronger cross-modal generalization than those trained without RL; (ii) except for discriminative MRMs, other types of MRMs across varying model capacities can benefit from inference-time scaling; and (iii) variations in input video frame count have different effects on different types of MRMs. We believe VideoRewardBench offers a challenging and valuable benchmark for advancing the evaluation and development of MRMs in the video domain.

Many large-scale systems rely on high-quality deep representations (embeddings) to facilitate tasks like retrieval, search, and generative modeling. Matryoshka Representation Learning (MRL) recently emerged as a solution for adaptive embedding lengths, but it requires full model retraining and suffers from noticeable performance degradations at short lengths. In this paper, we show that sparse coding offers a compelling alternative for achieving adaptive representation with minimal overhead and higher fidelity. We propose Contrastive Sparse Representation (CSR), a method that sparsifies pre-trained embeddings into a high-dimensional but selectively activated feature space. By leveraging lightweight autoencoding and task-aware contrastive objectives, CSR preserves semantic quality while allowing flexible, cost-effective inference at different sparsity levels. Extensive experiments on image, text, and multimodal benchmarks demonstrate that CSR consistently outperforms MRL in terms of both accuracy and retrieval speed-often by large margins-while also cutting training time to a fraction of that required by MRL. Our results establish sparse coding as a powerful paradigm for adaptive representation learning in real-world applications where efficiency and fidelity are both paramount. Code is available at https://github.com/neilwen987/CSR_Adaptive_Rep

Mitotic figure (MF) detection in histopathology images is challenging due to large variations in slide scanners, staining protocols, tissue types, and the presence of artifacts. This paper presents a collection of training techniques - a bag of tricks - that enable robust, real-time MF detection across diverse domains. We build on the efficient RTMDet single stage object detector to achieve high inference speed suitable for clinical deployment. Our method addresses scanner variability and tumor heterogeneity via extensive multi-domain training data, balanced sampling, and careful augmentation. Additionally, we employ targeted, hard negative mining on necrotic and debris tissue to reduce false positives. In a grouped 5-fold cross-validation across multiple MF datasets, our model achieves an F1 score between 0.78 and 0.84. On the preliminary test set of the MItosis DOmain Generalization (MIDOG) 2025 challenge, our single-stage RTMDet-S based approach reaches an F1 of 0.81, outperforming larger models and demonstrating adaptability to new, unfamiliar domains. The proposed solution offers a practical trade-off between accuracy and speed, making it attractive for real-world clinical adoption.

We propose Score-of-Mixture Training (SMT), a novel framework for training one-step generative models by minimizing a class of divergences called the alpha-skew Jensen-Shannon divergence. At its core, SMT estimates the score of mixture distributions between real and fake samples across multiple noise levels. Similar to consistency models, our approach supports both training from scratch (SMT) and distillation using a pretrained diffusion model, which we call Score-of-Mixture Distillation (SMD). It is simple to implement, requires minimal hyperparameter tuning, and ensures stable training. Experiments on CIFAR-10 and ImageNet 64x64 show that SMT/SMD are competitive with and can even outperform existing methods.

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.

Deep learning has shown strong performance in musculoskeletal imaging, but prior work has largely targeted conditions where diagnosis is relatively straightforward. More challenging problems remain underexplored, such as detecting Bankart lesions (anterior-inferior glenoid labral tears) on standard MRIs. These lesions are difficult to diagnose due to subtle imaging features, often necessitating invasive MRI arthrograms (MRAs). We introduce ScopeMRI, the first publicly available, expert-annotated dataset for shoulder pathologies, and present a deep learning framework for Bankart lesion detection on both standard MRIs and MRAs. ScopeMRI contains shoulder MRIs from patients who underwent arthroscopy, providing ground-truth labels from intraoperative findings, the diagnostic gold standard. Separate models were trained for MRIs and MRAs using CNN- and transformer-based architectures, with predictions ensembled across multiple imaging planes. Our models achieved radiologist-level performance, with accuracy on standard MRIs surpassing radiologists interpreting MRAs. External validation on independent hospital data demonstrated initial generalizability across imaging protocols. By releasing ScopeMRI and a modular codebase for training and evaluation, we aim to accelerate research in musculoskeletal imaging and foster development of datasets and models that address clinically challenging diagnostic tasks.

Segmenting stroke lesions in Magnetic Resonance Imaging (MRI) is challenging due to diverse clinical imaging domains, with existing models struggling to generalise across different MRI acquisition parameters and sequences. In this work, we propose two novel physics-constrained approaches using synthetic quantitative MRI (qMRI) images to enhance the robustness and generalisability of segmentation models. We trained a qMRI estimation model to predict qMRI maps from MPRAGE images, which were used to simulate diverse MRI sequences for segmentation training. A second approach built upon prior work in synthetic data for stroke lesion segmentation, generating qMRI maps from a dataset of tissue labels. The proposed approaches improved over the baseline nnUNet on a variety of out-of-distribution datasets, with the second approach outperforming the prior synthetic data method.

Reinforcement Learning with Verifiable Rewards (RLVR) has emerged as a prevailing paradigm for enhancing reasoning in Multimodal Large Language Models (MLLMs). However, relying solely on outcome supervision risks reward hacking, where models learn spurious reasoning patterns to satisfy final answer checks. While recent rubric-based approaches offer fine-grained supervision signals, they suffer from high computational costs of instance-level generation and inefficient training dynamics caused by treating all rubrics as equally learnable. In this paper, we propose Stratified Rubric-based Curriculum Learning (RuCL), a novel framework that reformulates curriculum learning by shifting the focus from data selection to reward design. RuCL generates generalized rubrics for broad applicability and stratifies them based on the model's competence. By dynamically adjusting rubric weights during training, RuCL guides the model from mastering foundational perception to tackling advanced logical reasoning. Extensive experiments on various visual reasoning benchmarks show that RuCL yields a remarkable +7.83% average improvement over the Qwen2.5-VL-7B model, achieving a state-of-the-art accuracy of 60.06%.

In this work, we address the TrackRAD2025 challenge of real-time tumor tracking in cine-MRI sequences of the thoracic and abdominal regions under strong data scarcity constraints. Two complementary strategies were explored: (i) unsupervised registration with the IMPACT similarity metric and (ii) foundation model-based segmentation leveraging SAM 2.1 and its recent variants through prompt-based interaction. Due to the one-second runtime constraint, the SAM-based method was ultimately selected. The final configuration used SAM2.1 b+ with mask-based prompts from the first annotated slice, fine-tuned solely on the small labeled subset from TrackRAD2025. Training was configured to minimize overfitting, using 1024x1024 patches (batch size 1), standard augmentations, and a balanced Dice + IoU loss. A low uniform learning rate (0.0001) was applied to all modules (prompt encoder, decoder, Hiera backbone) to preserve generalization while adapting to annotator-specific styles. Training lasted 300 epochs (~12h on RTX A6000, 48GB). The same inference strategy was consistently applied across all anatomical sites and MRI field strengths. Test-time augmentation was considered but ultimately discarded due to negligible performance gains. The final model was selected based on the highest Dice Similarity Coefficient achieved on the validation set after fine-tuning. On the hidden test set, the model reached a Dice score of 0.8794, ranking 6th overall in the TrackRAD2025 challenge. These results highlight the strong potential of foundation models for accurate and real-time tumor tracking in MRI-guided radiotherapy.

Multimodal large language models (MLLMs) hold significant potential in medical applications, including disease diagnosis and clinical decision-making. However, these tasks require highly accurate, context-sensitive, and professionally aligned responses, making reliable reward models and judges critical. Despite their importance, medical reward models (MRMs) and judges remain underexplored, with no dedicated benchmarks addressing clinical requirements. Existing benchmarks focus on general MLLM capabilities or evaluate models as solvers, neglecting essential evaluation dimensions like diagnostic accuracy and clinical relevance. To address this, we introduce Med-RewardBench, the first benchmark specifically designed to evaluate MRMs and judges in medical scenarios. Med-RewardBench features a multimodal dataset spanning 13 organ systems and 8 clinical departments, with 1,026 expert-annotated cases. A rigorous three-step process ensures high-quality evaluation data across six clinically critical dimensions. We evaluate 32 state-of-the-art MLLMs, including open-source, proprietary, and medical-specific models, revealing substantial challenges in aligning outputs with expert judgment. Additionally, we develop baseline models that demonstrate substantial performance improvements through fine-tuning.

The transformer architecture and variants presented remarkable success across many machine learning tasks in recent years. This success is intrinsically related to the capability of handling long sequences and the presence of context-dependent weights from the attention mechanism. We argue that these capabilities suit the central role of a Meta-Reinforcement Learning algorithm. Indeed, a meta-RL agent needs to infer the task from a sequence of trajectories. Furthermore, it requires a fast adaptation strategy to adapt its policy for a new task -- which can be achieved using the self-attention mechanism. In this work, we present TrMRL (Transformers for Meta-Reinforcement Learning), a meta-RL agent that mimics the memory reinstatement mechanism using the transformer architecture. It associates the recent past of working memories to build an episodic memory recursively through the transformer layers. We show that the self-attention computes a consensus representation that minimizes the Bayes Risk at each layer and provides meaningful features to compute the best actions. We conducted experiments in high-dimensional continuous control environments for locomotion and dexterous manipulation. Results show that TrMRL presents comparable or superior asymptotic performance, sample efficiency, and out-of-distribution generalization compared to the baselines in these environments.

Medical coding is the task of assigning medical codes to clinical free-text documentation. Healthcare professionals manually assign such codes to track patient diagnoses and treatments. Automated medical coding can considerably alleviate this administrative burden. In this paper, we reproduce, compare, and analyze state-of-the-art automated medical coding machine learning models. We show that several models underperform due to weak configurations, poorly sampled train-test splits, and insufficient evaluation. In previous work, the macro F1 score has been calculated sub-optimally, and our correction doubles it. We contribute a revised model comparison using stratified sampling and identical experimental setups, including hyperparameters and decision boundary tuning. We analyze prediction errors to validate and falsify assumptions of previous works. The analysis confirms that all models struggle with rare codes, while long documents only have a negligible impact. Finally, we present the first comprehensive results on the newly released MIMIC-IV dataset using the reproduced models. We release our code, model parameters, and new MIMIC-III and MIMIC-IV training and evaluation pipelines to accommodate fair future comparisons.

This paper introduces Multi-Modal Retrieval-Augmented Generation (M^2RAG), a benchmark designed to evaluate the effectiveness of Multi-modal Large Language Models (MLLMs) in leveraging knowledge from multi-modal retrieval documents. The benchmark comprises four tasks: image captioning, multi-modal question answering, multi-modal fact verification, and image reranking. All tasks are set in an open-domain setting, requiring RAG models to retrieve query-relevant information from a multi-modal document collection and use it as input context for RAG modeling. To enhance the context utilization capabilities of MLLMs, we also introduce Multi-Modal Retrieval-Augmented Instruction Tuning (MM-RAIT), an instruction tuning method that optimizes MLLMs within multi-modal contexts. Our experiments show that MM-RAIT improves the performance of RAG systems by enabling them to effectively learn from multi-modal contexts. All data and code are available at https://github.com/NEUIR/M2RAG.

Identification of vessel structures of different sizes in biomedical images is crucial in the diagnosis of many neurodegenerative diseases. However, the sparsity of good-quality annotations of such images makes the task of vessel segmentation challenging. Deep learning offers an efficient way to segment vessels of different sizes by learning their high-level feature representations and the spatial continuity of such features across dimensions. Semi-supervised patch-based approaches have been effective in identifying small vessels of one to two voxels in diameter. This study focuses on improving the segmentation quality by considering the spatial correlation of the features using the Maximum Intensity Projection~(MIP) as an additional loss criterion. Two methods are proposed with the incorporation of MIPs of label segmentation on the single~(z-axis) and multiple perceivable axes of the 3D volume. The proposed MIP-based methods produce segmentations with improved vessel continuity, which is evident in visual examinations of ROIs. Patch-based training is improved by introducing an additional loss term, MIP loss, to penalise the predicted discontinuity of vessels. A training set of 14 volumes is selected from the StudyForrest dataset comprising of 18 7-Tesla 3D Time-of-Flight~(ToF) Magnetic Resonance Angiography (MRA) images. The generalisation performance of the method is evaluated using the other unseen volumes in the dataset. It is observed that the proposed method with multi-axes MIP loss produces better quality segmentations with a median Dice of 80.245 pm 0.129. Also, the method with single-axis MIP loss produces segmentations with a median Dice of 79.749 pm 0.109. Furthermore, a visual comparison of the ROIs in the predicted segmentation reveals a significant improvement in the continuity of the vessels when MIP loss is incorporated into training.

Techniques that learn improved representations via offline data or self-supervised objectives have shown impressive results in traditional reinforcement learning (RL). Nevertheless, it is unclear how improved representation learning can benefit reinforcement learning from human feedback (RLHF) on language models (LMs). In this work, we propose training reward models (RMs) in a contrastive, goal-conditioned fashion by increasing the representation similarity of future states along sampled preferred trajectories and decreasing the similarity along randomly sampled dispreferred trajectories. This objective significantly improves RM performance by up to 0.09 AUROC across challenging benchmarks, such as MATH and GSM8k. These findings extend to general alignment as well -- on the Helpful-Harmless dataset, we observe 2.3% increase in accuracy. Beyond improving reward model performance, we show this way of training RM representations enables improved steerability because it allows us to evaluate the likelihood of an action achieving a particular goal-state (e.g., whether a solution is correct or helpful). Leveraging this insight, we find that we can filter up to 55% of generated tokens during majority voting by discarding trajectories likely to end up in an "incorrect" state, which leads to significant cost savings. We additionally find that these representations can perform fine-grained control by conditioning on desired future goal-states. For example, we show that steering a Llama 3 model towards helpful generations with our approach improves helpfulness by 9.6% over a supervised-fine-tuning trained baseline. Similarly, steering the model towards complex generations improves complexity by 21.6% over the baseline. Overall, we find that training RMs in this contrastive, goal-conditioned fashion significantly improves performance and enables model steerability.

Recent progress in large language models (LLMs) has led to impressive performance on a range of tasks, yet advanced instruction following (IF)-especially for complex, multi-turn, and system-prompted instructions-remains a significant challenge. Rigorous evaluation and effective training for such capabilities are hindered by the lack of high-quality, human-annotated benchmarks and reliable, interpretable reward signals. In this work, we introduce AdvancedIF (we will release this benchmark soon), a comprehensive benchmark featuring over 1,600 prompts and expert-curated rubrics that assess LLMs ability to follow complex, multi-turn, and system-level instructions. We further propose RIFL (Rubric-based Instruction-Following Learning), a novel post-training pipeline that leverages rubric generation, a finetuned rubric verifier, and reward shaping to enable effective reinforcement learning for instruction following. Extensive experiments demonstrate that RIFL substantially improves the instruction-following abilities of LLMs, achieving a 6.7% absolute gain on AdvancedIF and strong results on public benchmarks. Our ablation studies confirm the effectiveness of each component in RIFL. This work establishes rubrics as a powerful tool for both training and evaluating advanced IF in LLMs, paving the way for more capable and reliable AI systems.

Reinforcement learning with AI feedback (RLAIF) is a popular paradigm for improving the instruction-following abilities of powerful pre-trained language models. RLAIF first performs supervised fine-tuning (SFT) using demonstrations from a teacher model and then further fine-tunes the model with reinforcement learning (RL), using feedback from a critic model. While recent popular open-source models have demonstrated substantial improvements in performance from the RL step, in this paper we question whether the complexity of this RL step is truly warranted for AI feedback. We show that the improvements of the RL step are virtually entirely due to the widespread practice of using a weaker teacher model (e.g. GPT-3.5) for SFT data collection than the critic (e.g., GPT-4) used for AI feedback generation. Specifically, we show that simple supervised fine-tuning with GPT-4 as the teacher outperforms existing RLAIF pipelines. More generally, we find that the gains from RLAIF vary substantially across base model families, test-time evaluation protocols, and critic models. Finally, we provide a mechanistic explanation for when SFT may outperform the full two-step RLAIF pipeline as well as suggestions for making RLAIF maximally useful in practice.

Reinforcement learning (RL) with verifiable rewards has recently catalyzed a wave of "MLLM-r1" approaches that bring RL to vision language models. Most representative paradigms begin with a cold start, typically employing supervised fine-tuning (SFT), to initialize the policy before RL. However, SFT-based cold start adopts the reasoning paradigm intertwined with task solution and output format, which may induce instruction-style overfitting, weakens out-of-distribution generalization, and ultimately affects downstream RL. We revisit the cold start along two views, its training method and data construction, and introduce the Generalization Factor (GF) coefficient to quantify the generalization capability under different methods. Our empirical study finds that preference-based training methods (e.g. DPO) generalizes better than SFT-based methods in cold start. Motivated by this, we propose SPECS-a Self-distilled, Preference-based Cold Start framework that decouples multimodal learning: (1) generates introspective preference data pairs via self-distillation, avoiding reliance on larger teachers or manual annotation; (2) performs preference-based training to learn, focusing on shallow, transferable surface-form criteria (format, structure, style) rather than memorizing content; and (3) hands off to RL with verifiable rewards for deep reasoning results. Experimental results across multiple multimodal benchmarks show that our decoupling learning framework yields consistent performance gains over strong baselines, improving MEGA-Bench by 4.1% and MathVista by 12.2%. Additional experiments indicate that SPECS contributes to reducing in-distribution "stuckness," improving exploration, stabilizing training, and raising the performance ceiling.

Reinforcement learning (RL) promises a framework for near-universal problem-solving. In practice however, RL algorithms are often tailored to specific benchmarks, relying on carefully tuned hyperparameters and algorithmic choices. Recently, powerful model-based RL methods have shown impressive general results across benchmarks but come at the cost of increased complexity and slow run times, limiting their broader applicability. In this paper, we attempt to find a unifying model-free deep RL algorithm that can address a diverse class of domains and problem settings. To achieve this, we leverage model-based representations that approximately linearize the value function, taking advantage of the denser task objectives used by model-based RL while avoiding the costs associated with planning or simulated trajectories. We evaluate our algorithm, MR.Q, on a variety of common RL benchmarks with a single set of hyperparameters and show a competitive performance against domain-specific and general baselines, providing a concrete step towards building general-purpose model-free deep RL algorithms.

In this paper, we explore FP8 low-bit data formats for efficient training of large language models (LLMs). Our key insight is that most variables, such as gradients and optimizer states, in LLM training can employ low-precision data formats without compromising model accuracy and requiring no changes to hyper-parameters. Specifically, we propose a new FP8 automatic mixed-precision framework for training LLMs. This framework offers three levels of FP8 utilization to streamline mixed-precision and distributed parallel training for LLMs. It gradually incorporates 8-bit gradients, optimizer states, and distributed learning in an incremental manner. Experiment results show that, during the training of GPT-175B model on H100 GPU platform, our FP8 mixed-precision training framework not only achieved a remarkable 42% reduction in real memory usage but also ran 64% faster than the widely adopted BF16 framework (i.e., Megatron-LM), surpassing the speed of Nvidia Transformer Engine by 17%. This largely reduces the training costs for large foundation models. Furthermore, our FP8 mixed-precision training methodology is generic. It can be seamlessly applied to other tasks such as LLM instruction tuning and reinforcement learning with human feedback, offering savings in fine-tuning expenses. Our FP8 low-precision training framework is open-sourced at {https://github.com/Azure/MS-AMP}{aka.ms/MS.AMP}.

Reinforcement learning (RL) has proven effective for fine-tuning large language models (LLMs), significantly enhancing their reasoning abilities in domains such as mathematics and code generation. A crucial factor influencing RL fine-tuning success is the training curriculum: the order in which training problems are presented. While random curricula serve as common baselines, they remain suboptimal; manually designed curricula often rely heavily on heuristics, and online filtering methods can be computationally prohibitive. To address these limitations, we propose Self-Evolving Curriculum (SEC), an automatic curriculum learning method that learns a curriculum policy concurrently with the RL fine-tuning process. Our approach formulates curriculum selection as a non-stationary Multi-Armed Bandit problem, treating each problem category (e.g., difficulty level or problem type) as an individual arm. We leverage the absolute advantage from policy gradient methods as a proxy measure for immediate learning gain. At each training step, the curriculum policy selects categories to maximize this reward signal and is updated using the TD(0) method. Across three distinct reasoning domains: planning, inductive reasoning, and mathematics, our experiments demonstrate that SEC significantly improves models' reasoning capabilities, enabling better generalization to harder, out-of-distribution test problems. Additionally, our approach achieves better skill balance when fine-tuning simultaneously on multiple reasoning domains. These findings highlight SEC as a promising strategy for RL fine-tuning of LLMs.

Recent research has shown that training low-rank neural networks can effectively reduce the total number of trainable parameters without sacrificing predictive accuracy, resulting in end-to-end speedups. However, low-rank model training necessitates adjusting several additional factorization hyperparameters, such as the rank of the factorization at each layer. In this paper, we tackle this challenge by introducing Cuttlefish, an automated low-rank training approach that eliminates the need for tuning factorization hyperparameters. Cuttlefish leverages the observation that after a few epochs of full-rank training, the stable rank (i.e., an approximation of the true rank) of each layer stabilizes at a constant value. Cuttlefish switches from full-rank to low-rank training once the stable ranks of all layers have converged, setting the dimension of each factorization to its corresponding stable rank. Our results show that Cuttlefish generates models up to 5.6 times smaller than full-rank models, and attains up to a 1.2 times faster end-to-end training process while preserving comparable accuracy. Moreover, Cuttlefish outperforms state-of-the-art low-rank model training methods and other prominent baselines. The source code for our implementation can be found at: https://github.com/hwang595/Cuttlefish.

Recent progress in vision-language modeling for 3D medical imaging has been fueled by large-scale computed tomography (CT) corpora with paired free-text reports, stronger architectures, and powerful pretrained models. This has enabled applications such as automated report generation and text-conditioned 3D image synthesis. Yet, current approaches struggle with high-resolution, long-sequence volumes: contrastive pretraining often yields vision encoders that are misaligned with clinical language, and slice-wise tokenization blurs fine anatomy, reducing diagnostic performance on downstream tasks. We introduce BTB3D (Better Tokens for Better 3D), a causal convolutional encoder-decoder that unifies 2D and 3D training and inference while producing compact, frequency-aware volumetric tokens. A three-stage training curriculum enables (i) local reconstruction, (ii) overlapping-window tiling, and (iii) long-context decoder refinement, during which the model learns from short slice excerpts yet generalizes to scans exceeding 300 slices without additional memory overhead. BTB3D sets a new state-of-the-art on two key tasks: it improves BLEU scores and increases clinical F1 by 40% over CT2Rep, CT-CHAT, and Merlin for report generation; and it reduces FID by 75% and halves FVD compared to GenerateCT and MedSyn for text-to-CT synthesis, producing anatomically consistent 512*512*241 volumes. These results confirm that precise three-dimensional tokenization, rather than larger language backbones alone, is essential for scalable vision-language modeling in 3D medical imaging. The codebase is available at: https://github.com/ibrahimethemhamamci/BTB3D

Deep reinforcement learning (RL) is a powerful approach to complex decision making. However, one issue that limits its practical application is its brittleness, sometimes failing to train in the presence of small changes in the environment. Motivated by the success of zero-shot transfer-where pre-trained models perform well on related tasks-we consider the problem of selecting a good set of training tasks to maximize generalization performance across a range of tasks. Given the high cost of training, it is critical to select training tasks strategically, but not well understood how to do so. We hence introduce Model-Based Transfer Learning (MBTL), which layers on top of existing RL methods to effectively solve contextual RL problems. MBTL models the generalization performance in two parts: 1) the performance set point, modeled using Gaussian processes, and 2) performance loss (generalization gap), modeled as a linear function of contextual similarity. MBTL combines these two pieces of information within a Bayesian optimization (BO) framework to strategically select training tasks. We show theoretically that the method exhibits sublinear regret in the number of training tasks and discuss conditions to further tighten regret bounds. We experimentally validate our methods using urban traffic and standard continuous control benchmarks. The experimental results suggest that MBTL can achieve up to 50x improved sample efficiency compared with canonical independent training and multi-task training. Further experiments demonstrate the efficacy of BO and the insensitivity to the underlying RL algorithm and hyperparameters. This work lays the foundations for investigating explicit modeling of generalization, thereby enabling principled yet effective methods for contextual RL.

Breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) plays an important role in the screening and prognosis assessment of high-risk breast cancer. The segmentation of cancerous regions is essential useful for the subsequent analysis of breast MRI. To alleviate the annotation effort to train the segmentation networks, we propose a weakly-supervised strategy using extreme points as annotations for breast cancer segmentation. Without using any bells and whistles, our strategy focuses on fully exploiting the learning capability of the routine training procedure, i.e., the train - fine-tune - retrain process. The network first utilizes the pseudo-masks generated using the extreme points to train itself, by minimizing a contrastive loss, which encourages the network to learn more representative features for cancerous voxels. Then the trained network fine-tunes itself by using a similarity-aware propagation learning (SimPLe) strategy, which leverages feature similarity between unlabeled and positive voxels to propagate labels. Finally the network retrains itself by employing the pseudo-masks generated using previous fine-tuned network. The proposed method is evaluated on our collected DCE-MRI dataset containing 206 patients with biopsy-proven breast cancers. Experimental results demonstrate our method effectively fine-tunes the network by using the SimPLe strategy, and achieves a mean Dice value of 81%.

Current Large Language Models (LLMs) exhibit significant limitations, notably in structured, interpretable, and verifiable medical reasoning, alongside practical deployment challenges related to computational resources and data privacy. This report focused on the development of WiNGPT-3.0, the 32-billion parameter LLMs, engineered with the objective of enhancing its capacity for medical reasoning and exploring its potential for effective integration within healthcare IT infrastructures. The broader aim is to advance towards clinically applicable models. The approach involved a multi-stage training pipeline tailored for general, medical, and clinical reasoning. This pipeline incorporated supervised fine-tuning (SFT) and reinforcement learning (RL), leveraging curated Long Chain-of-Thought (CoT) datasets, auxiliary reward models, and an evidence-based diagnostic chain simulation. WiNGPT-3.0 demonstrated strong performance: specific model variants achieved scores of 66.6 on MedCalc and 87.1 on MedQA-USMLE. Furthermore, targeted training improved performance on a clinical reasoning task from a baseline score of 58.1 to 62.5. These findings suggest that reinforcement learning, even when applied with a limited dataset of only a few thousand examples, can enhance medical reasoning accuracy. Crucially, this demonstration of RL's efficacy with limited data and computation paves the way for more trustworthy and practically deployable LLMs within clinical workflows and health information infrastructures.

While state-of-the-art vision-language models (VLMs) have demonstrated remarkable capabilities in complex visual-text tasks, their success heavily relies on massive model scaling, limiting their practical deployment. Small-scale VLMs offer a more practical alternative but face significant challenges when trained with traditional supervised fine-tuning (SFT), particularly in two aspects: out-of-domain (OOD) generalization and reasoning abilities, which significantly lags behind the contemporary Large language models (LLMs). To address these challenges, we propose Curriculum Reinforcement Finetuning (Curr-ReFT), a novel post-training paradigm specifically designed for small-scale VLMs. Inspired by the success of reinforcement learning in LLMs, Curr-ReFT comprises two sequential stages: (1) Curriculum Reinforcement Learning, which ensures steady progression of model capabilities through difficulty-aware reward design, transitioning from basic visual perception to complex reasoning tasks; and (2) Rejected Sampling-based Self-improvement, which maintains the fundamental capabilities of VLMs through selective learning from high-quality multimodal and language examples. Extensive experiments demonstrate that models trained with Curr-ReFT paradigm achieve state-of-the-art performance across various visual tasks in both in-domain and out-of-domain settings. Moreover, our Curr-ReFT enhanced 3B model matches the performance of 32B-parameter models, demonstrating that efficient training paradigms can effectively bridge the gap between small and large models.

Reinforcement learning from verifiable rewards (RLVR) has recently gained attention for its ability to elicit self-evolved reasoning capabilitie from base language models without explicit reasoning supervisions, as demonstrated by DeepSeek-R1. While prior work on RLVR has primarily focused on mathematical and coding domains, its applicability to other tasks and domains remains unexplored. In this work, we investigate whether medical reasoning can emerge from RLVR. We introduce Med-RLVR as an initial study of RLVR in the medical domain leveraging medical multiple-choice question answering (MCQA) data as verifiable labels. Our results demonstrate that RLVR is not only effective for math and coding but also extends successfully to medical question answering. Notably, Med-RLVR achieves performance comparable to traditional supervised fine-tuning (SFT) on in-distribution tasks while significantly improving out-of-distribution generalization, with an 8-point accuracy gain. Further analysis of training dynamics reveals that, with no explicit reasoning supervision, reasoning emerges from the 3B-parameter base model. These findings underscore the potential of RLVR in domains beyond math and coding, opening new avenues for its application in knowledge-intensive fields such as medicine.

Multiparametric magnetic resonance imaging (mpMRI) has demonstrated promising results in prostate cancer (PCa) detection using deep convolutional neural networks (CNNs). Recently, transformers have achieved competitive performance compared to CNNs in computer vision. Large-scale transformers need abundant annotated data for training, which are difficult to obtain in medical imaging. Self-supervised learning can effectively leverage unlabeled data to extract useful semantic representations without annotation and its associated costs. This can improve model performance on downstream tasks with limited labelled data and increase generalizability. We introduce a novel end-to-end Cross-Shaped windows (CSwin) transformer UNet model, CSwin UNet, to detect clinically significant prostate cancer (csPCa) in prostate bi-parametric MR imaging (bpMRI) and demonstrate the effectiveness of our proposed self-supervised pre-training framework. Using a large prostate bpMRI dataset with 1500 patients, we first pre-train CSwin transformer using multi-task self-supervised learning to improve data-efficiency and network generalizability. We then finetuned using lesion annotations to perform csPCa detection. Five-fold cross validation shows that self-supervised CSwin UNet achieves 0.888 AUC and 0.545 Average Precision (AP), significantly outperforming four state-of-the-art models (Swin UNETR, DynUNet, Attention UNet, UNet). Using a separate bpMRI dataset with 158 patients, we evaluated our model robustness to external hold-out data. Self-supervised CSwin UNet achieves 0.79 AUC and 0.45 AP, still outperforming all other comparable methods and demonstrating generalization to a dataset shift.

Inspired by Curriculum Learning, we propose a consecutive (i.e., image-to-text-to-text) generation framework where we divide the problem of radiology report generation into two steps. Contrary to generating the full radiology report from the image at once, the model generates global concepts from the image in the first step and then reforms them into finer and coherent texts using a transformer architecture. We follow the transformer-based sequence-to-sequence paradigm at each step. We improve upon the state-of-the-art on two benchmark datasets.

Automated radiology report generation offers an effective solution to alleviate radiologists' workload. However, most existing methods focus primarily on single or fixed-view images to model current disease conditions, which limits diagnostic accuracy and overlooks disease progression. Although some approaches utilize longitudinal data to track disease progression, they still rely on single images to analyze current visits. To address these issues, we propose enhanced contrastive learning with Multi-view Longitudinal data to facilitate chest X-ray Report Generation, named MLRG. Specifically, we introduce a multi-view longitudinal contrastive learning method that integrates spatial information from current multi-view images and temporal information from longitudinal data. This method also utilizes the inherent spatiotemporal information of radiology reports to supervise the pre-training of visual and textual representations. Subsequently, we present a tokenized absence encoding technique to flexibly handle missing patient-specific prior knowledge, allowing the model to produce more accurate radiology reports based on available prior knowledge. Extensive experiments on MIMIC-CXR, MIMIC-ABN, and Two-view CXR datasets demonstrate that our MLRG outperforms recent state-of-the-art methods, achieving a 2.3% BLEU-4 improvement on MIMIC-CXR, a 5.5% F1 score improvement on MIMIC-ABN, and a 2.7% F1 RadGraph improvement on Two-view CXR.

We introduce Filter Like You Test (FLYT), a method for curating large-scale vision-language datasets that learns the usefulness of each data point as a pretraining example. FLYT trains a scoring model that learns to weigh each example using gradient signals from downstream tasks training sets. Using the same training methodology, we develop Mixing-FLYT (M-FLYT), which takes the per-example scores generated by different scoring methods and learns to unify them into a single score. Our training methodology naturally produces a distribution over the training examples, which we leverage through Soft Cap Sampling (SCS), a strategy for obtaining a filtered pretraining dataset from per-example probabilities that samples examples while preventing over-representation through a repetition penalty. Using all three methods, we achieve 40.1% ImageNet zero-shot accuracy on the DataComp medium scale filtering benchmark, a 1.9% absolute accuracy increase over all previous results and a 5.5% increase over results that -- like us -- use only public resources.

Masked Autoencoders (MAE) have been popular paradigms for large-scale vision representation pre-training. However, MAE solely reconstructs the low-level RGB signals after the decoder and lacks supervision upon high-level semantics for the encoder, thus suffering from sub-optimal learned representations and long pre-training epochs. To alleviate this, previous methods simply replace the pixel reconstruction targets of 75% masked tokens by encoded features from pre-trained image-image (DINO) or image-language (CLIP) contrastive learning. Different from those efforts, we propose to Mimic before Reconstruct for Masked Autoencoders, named as MR-MAE, which jointly learns high-level and low-level representations without interference during pre-training. For high-level semantics, MR-MAE employs a mimic loss over 25% visible tokens from the encoder to capture the pre-trained patterns encoded in CLIP and DINO. For low-level structures, we inherit the reconstruction loss in MAE to predict RGB pixel values for 75% masked tokens after the decoder. As MR-MAE applies high-level and low-level targets respectively at different partitions, the learning conflicts between them can be naturally overcome and contribute to superior visual representations for various downstream tasks. On ImageNet-1K, the MR-MAE base pre-trained for only 400 epochs achieves 85.8% top-1 accuracy after fine-tuning, surpassing the 1600-epoch MAE base by +2.2% and the previous state-of-the-art BEiT V2 base by +0.3%. Code and pre-trained models will be released at https://github.com/Alpha-VL/ConvMAE.

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.

The rise of large language models (LLMs) has created a significant disparity: industrial research labs with their computational resources, expert teams, and advanced infrastructures, can effectively fine-tune LLMs, while individual developers and small organizations face barriers due to limited resources. In this paper, we aim to bridge this gap by presenting a comprehensive study on supervised fine-tuning of LLMs using instruction-tuning datasets spanning diverse knowledge domains and skills. We focus on small-sized LLMs (3B to 7B parameters) for their cost-efficiency and accessibility. We explore various training configurations and strategies across four open-source pre-trained models. We provide detailed documentation of these configurations, revealing findings that challenge several common training practices, including hyperparameter recommendations from TULU and phased training recommended by Orca. Key insights from our work include: (i) larger batch sizes paired with lower learning rates lead to improved model performance on benchmarks such as MMLU, MTBench, and Open LLM Leaderboard; (ii) early-stage training dynamics, such as lower gradient norms and higher loss values, are strong indicators of better final model performance, enabling early termination of sub-optimal runs and significant computational savings; (iii) through a thorough exploration of hyperparameters like warmup steps and learning rate schedules, we provide guidance for practitioners and find that certain simplifications do not compromise performance; and (iv) we observed no significant difference in performance between phased and stacked training strategies, but stacked training is simpler and more sample efficient. With these findings holding robustly across datasets and models, we hope this study serves as a guide for practitioners fine-tuning small LLMs and promotes a more inclusive environment for LLM research.

The success of the machine learning field has reliably depended on training on large datasets. While effective, this trend comes at an extraordinary cost. This is due to two deeply intertwined factors: the size of models and the size of datasets. While promising research efforts focus on reducing the size of models, the other half of the equation remains fairly mysterious. Indeed, it is surprising that the standard approach to training remains to iterate over and over, uniformly sampling the training dataset. In this paper we explore a series of alternative training paradigms that leverage insights from hard-data-mining and dropout, simple enough to implement and use that can become the new training standard. The proposed Progressive Data Dropout reduces the number of effective epochs to as little as 12.4% of the baseline. This savings actually do not come at any cost for accuracy. Surprisingly, the proposed method improves accuracy by up to 4.82%. Our approach requires no changes to model architecture or optimizer, and can be applied across standard training pipelines, thus posing an excellent opportunity for wide adoption. Code can be found here: https://github.com/bazyagami/LearningWithRevision

Current research on Multimodal Retrieval-Augmented Generation (MRAG) enables diverse multimodal inputs but remains limited to single-modality outputs, restricting expressive capacity and practical utility. In contrast, real-world applications often demand both multimodal inputs and multimodal outputs for effective communication and grounded reasoning. Motivated by the recent success of Reinforcement Learning (RL) in complex reasoning tasks for Large Language Models (LLMs), we adopt RL as a principled and effective paradigm to address the multi-step, outcome-driven challenges inherent in multimodal output generation. Here, we introduce M2IO-R1, a novel framework for Multimodal Retrieval-Augmented Multimodal Generation (MRAMG) that supports both multimodal inputs and outputs. Central to our framework is an RL-based inserter, Inserter-R1-3B, trained with Group Relative Policy Optimization to guide image selection and placement in a controllable and semantically aligned manner. Empirical results show that our lightweight 3B inserter achieves strong reasoning capabilities with significantly reduced latency, outperforming baselines in both quality and efficiency.

To build a French national electronic injury surveillance system based on emergency room visits, we aim to develop a coding system to classify their causes from clinical notes in free-text. Supervised learning techniques have shown good results in this area but require a large amount of expert annotated dataset which is time consuming and costly to obtain. We hypothesize that the Natural Language Processing Transformer model incorporating a generative self-supervised pre-training step can significantly reduce the required number of annotated samples for supervised fine-tuning. In this preliminary study, we test our hypothesis in the simplified problem of predicting whether a visit is the consequence of a traumatic event or not from free-text clinical notes. Using fully re-trained GPT-2 models (without OpenAI pre-trained weights), we assess the gain of applying a self-supervised pre-training phase with unlabeled notes prior to the supervised learning task. Results show that the number of data required to achieve a ginve level of performance (AUC>0.95) was reduced by a factor of 10 when applying pre-training. Namely, for 16 times more data, the fully-supervised model achieved an improvement <1% in AUC. To conclude, it is possible to adapt a multi-purpose neural language model such as the GPT-2 to create a powerful tool for classification of free-text notes with only a small number of labeled samples.

Cardiac Magnetic Resonance (CMR) imaging serves as the gold-standard for evaluating cardiac morphology and function. Typically, a multi-view CMR stack, covering short-axis (SA) and 2/3/4-chamber long-axis (LA) views, is acquired for a thorough cardiac assessment. However, efficiently streamlining the complex, high-dimensional 3D+T CMR data and distilling compact, coherent representation remains a challenge. In this work, we introduce a whole-heart self-supervised learning framework that utilizes masked imaging modeling to automatically uncover the correlations between spatial and temporal patches throughout the cardiac stacks. This process facilitates the generation of meaningful and well-clustered heart representations without relying on the traditionally required, and often costly, labeled data. The learned heart representation can be directly used for various downstream tasks. Furthermore, our method demonstrates remarkable robustness, ensuring consistent representations even when certain CMR planes are missing/flawed. We train our model on 14,000 unlabeled CMR data from UK BioBank and evaluate it on 1,000 annotated data. The proposed method demonstrates superior performance to baselines in tasks that demand comprehensive 3D+T cardiac information, e.g. cardiac phenotype (ejection fraction and ventricle volume) prediction and multi-plane/multi-frame CMR segmentation, highlighting its effectiveness in extracting comprehensive cardiac features that are both anatomically and pathologically relevant.

BACKGROUND: Radiology reports are typically written in a free-text format, making clinical information difficult to extract and use. Recently the adoption of structured reporting (SR) has been recommended by various medical societies thanks to the advantages it offers, e.g. standardization, completeness and information retrieval. We propose a pipeline to extract information from free-text radiology reports, that fits with the items of the reference SR registry proposed by a national society of interventional and medical radiology, focusing on CT staging of patients with lymphoma. METHODS: Our work aims to leverage the potential of Natural Language Processing (NLP) and Transformer-based models to deal with automatic SR registry filling. With the availability of 174 radiology reports, we investigate a rule-free generative Question Answering approach based on a domain-specific version of T5 (IT5). Two strategies (batch-truncation and ex-post combination) are implemented to comply with the model's context length limitations. Performance is evaluated in terms of strict accuracy, F1, and format accuracy, and compared with the widely used GPT-3.5 Large Language Model. A 5-point Likert scale questionnaire is used to collect human-expert feedback on the similarity between medical annotations and generated answers. RESULTS: The combination of fine-tuning and batch splitting allows IT5 to achieve notable results; it performs on par with GPT-3.5 albeit its size being a thousand times smaller in terms of parameters. Human-based assessment scores show a high correlation (Spearman's correlation coefficients>0.88, p-values<0.001) with AI performance metrics (F1) and confirm the superior ability of LLMs (i.e., GPT-3.5, 175B of parameters) in generating plausible human-like statements.

Generative reward models (also known as LLMs-as-judges), which use large language models (LLMs) to evaluate answer quality, are increasingly adopted in reinforcement learning with verifiable rewards (RLVR). They are often preferred over rigid rule-based metrics, especially for complex reasoning tasks involving free-form outputs. In this paradigm, an LLM is typically prompted to compare a candidate answer against a ground-truth reference and assign a binary reward indicating correctness. Despite the seeming simplicity of this comparison task, we find that generative reward models exhibit surprising vulnerabilities to superficial manipulations: non-word symbols (e.g., ":" or ".") or reasoning openers like "Thought process:" and "Let's solve this problem step by step." can often lead to false positive rewards. We demonstrate that this weakness is widespread across LLMs, datasets, and prompt formats, posing a serious threat for core algorithmic paradigms that rely on generative reward models, such as rejection sampling, preference optimization, and RLVR. To mitigate this issue, we introduce a simple yet effective data augmentation strategy and train a new generative reward model with substantially improved robustness. Our findings highlight the urgent need for more reliable LLM-based evaluation methods. We release our robust, general-domain reward model and its synthetic training data at https://huggingface.co/sarosavo/Master-RM and https://huggingface.co/datasets/sarosavo/Master-RM.

Reward modeling is essential for aligning large language models (LLMs) with human preferences, especially through reinforcement learning from human feedback (RLHF). To provide accurate reward signals, a reward model (RM) should stimulate deep thinking and conduct interpretable reasoning before assigning a score or a judgment. However, existing RMs either produce opaque scalar scores or directly generate the prediction of a preferred answer, making them struggle to integrate natural language critiques, thus lacking interpretability. Inspired by recent advances of long chain-of-thought (CoT) on reasoning-intensive tasks, we hypothesize and validate that integrating reasoning capabilities into reward modeling significantly enhances RM's interpretability and performance. In this work, we introduce a new class of generative reward models -- Reasoning Reward Models (ReasRMs) -- which formulate reward modeling as a reasoning task. We propose a reasoning-oriented training pipeline and train a family of ReasRMs, RM-R1. The training consists of two key stages: (1) distillation of high-quality reasoning chains and (2) reinforcement learning with verifiable rewards. RM-R1 improves LLM rollouts by self-generating reasoning traces or chat-specific rubrics and evaluating candidate responses against them. Empirically, our models achieve state-of-the-art or near state-of-the-art performance of generative RMs across multiple comprehensive reward model benchmarks, outperforming much larger open-weight models (e.g., Llama3.1-405B) and proprietary ones (e.g., GPT-4o) by up to 13.8%. Beyond final performance, we perform thorough empirical analysis to understand the key ingredients of successful ReasRM training. To facilitate future research, we release six ReasRM models along with code and data at https://github.com/RM-R1-UIUC/RM-R1.

This work introduces the first framework for reconstructing surgical dialogue from unstructured real-world recordings, which is crucial for characterizing teaching tasks. In surgical training, the formative verbal feedback that trainers provide to trainees during live surgeries is crucial for ensuring safety, correcting behavior immediately, and facilitating long-term skill acquisition. However, analyzing and quantifying this feedback is challenging due to its unstructured and specialized nature. Automated systems are essential to manage these complexities at scale, allowing for the creation of structured datasets that enhance feedback analysis and improve surgical education. Our framework integrates voice activity detection, speaker diarization, and automated speech recaognition, with a novel enhancement that 1) removes hallucinations (non-existent utterances generated during speech recognition fueled by noise in the operating room) and 2) separates speech from trainers and trainees using few-shot voice samples. These aspects are vital for reconstructing accurate surgical dialogues and understanding the roles of operating room participants. Using data from 33 real-world surgeries, we demonstrated the system's capability to reconstruct surgical teaching dialogues and detect feedback instances effectively (F1 score of 0.79+/-0.07). Moreover, our hallucination removal step improves feedback detection performance by ~14%. Evaluation on downstream clinically relevant tasks of predicting Behavioral Adjustment of trainees and classifying Technical feedback, showed performances comparable to manual annotations with F1 scores of 0.82+/0.03 and 0.81+/0.03 respectively. These results highlight the effectiveness of our framework in supporting clinically relevant tasks and improving over manual methods.

Recent advances in general medical AI have made significant strides, but existing models often lack the reasoning capabilities needed for complex medical decision-making. This paper presents GMAI-VL-R1, a multimodal medical reasoning model enhanced by reinforcement learning (RL) to improve its reasoning abilities. Through iterative training, GMAI-VL-R1 optimizes decision-making, significantly boosting diagnostic accuracy and clinical support. We also develop a reasoning data synthesis method, generating step-by-step reasoning data via rejection sampling, which further enhances the model's generalization. Experimental results show that after RL training, GMAI-VL-R1 excels in tasks such as medical image diagnosis and visual question answering. While the model demonstrates basic memorization with supervised fine-tuning, RL is crucial for true generalization. Our work establishes new evaluation benchmarks and paves the way for future advancements in medical reasoning models. Code, data, and model will be released at https://github.com/uni-medical/GMAI-VL-R1{this link}.

Diffusion language models, as a promising alternative to traditional autoregressive (AR) models, enable faster generation and richer conditioning on bidirectional context. However, they suffer from a key discrepancy between training and inference: during inference, MDLMs progressively reveal the structure of the generated sequence by producing fewer and fewer masked tokens, whereas this structure is ignored in training as tokens are masked at random. Although this discrepancy between training and inference can lead to suboptimal performance, it has been largely overlooked by previous works, leaving closing this gap between the two stages an open problem. To address this, we frame the problem of learning effective denoising trajectories as a sequential decision-making problem and use the resulting framework to apply reinforcement learning. We propose a novel Masked Diffusion Policy Optimization (MDPO) to exploit the Markov property diffusion possesses and explicitly train the model under the same progressive refining schedule used at inference. MDPO matches the performance of the previous state-of-the-art (SOTA) method with 60x fewer gradient updates, while achieving average improvements of 9.6% on MATH500 and 54.2% on Countdown over SOTA when trained within the same number of weight updates. Additionally, we improve the remasking strategy of MDLMs as a plug-in inference replacement to overcome the limitation that the model cannot refine tokens flexibly. This simple yet effective training-free strategy, what we refer to as RCR, consistently improves performance and yields additional gains when combined with MDPO. Our findings establish great potential for investigating the discrepancy between pre-training and inference of MDLMs. Code: https://github.com/autonomousvision/mdpo. Project Page: https://cli212.github.io/MDPO/.

Multiple Instance Learning (MIL) has emerged as a dominant paradigm to extract discriminative feature representations within Whole Slide Images (WSIs) in computational pathology. Despite driving notable progress, existing MIL approaches suffer from limitations in facilitating comprehensive and efficient interactions among instances, as well as challenges related to time-consuming computations and overfitting. In this paper, we incorporate the Selective Scan Space State Sequential Model (Mamba) in Multiple Instance Learning (MIL) for long sequence modeling with linear complexity, termed as MambaMIL. By inheriting the capability of vanilla Mamba, MambaMIL demonstrates the ability to comprehensively understand and perceive long sequences of instances. Furthermore, we propose the Sequence Reordering Mamba (SR-Mamba) aware of the order and distribution of instances, which exploits the inherent valuable information embedded within the long sequences. With the SR-Mamba as the core component, MambaMIL can effectively capture more discriminative features and mitigate the challenges associated with overfitting and high computational overhead. Extensive experiments on two public challenging tasks across nine diverse datasets demonstrate that our proposed framework performs favorably against state-of-the-art MIL methods. The code is released at https://github.com/isyangshu/MambaMIL.

We participated in the SynthRAD2025 challenge (Tasks 1 and 2) with a unified pipeline for synthetic CT (sCT) generation from MRI and CBCT, implemented using the KonfAI framework. Our model is a 2.5D U-Net++ with a ResNet-34 encoder, trained jointly across anatomical regions and fine-tuned per region. The loss function combined pixel-wise L1 loss with IMPACT-Synth, a perceptual loss derived from SAM and TotalSegmentator to enhance structural fidelity. Training was performed using AdamW (initial learning rate = 0.001, halved every 25k steps) on patch-based, normalized, body-masked inputs (320x320 for MRI, 256x256 for CBCT), with random flipping as the only augmentation. No post-processing was applied. Final predictions leveraged test-time augmentation and five-fold ensembling. The best model was selected based on validation MAE. Two registration strategies were evaluated: (i) Elastix with mutual information, consistent with the challenge pipeline, and (ii) IMPACT, a feature-based similarity metric leveraging pretrained segmentation networks. On the local test sets, IMPACT-based registration achieved more accurate and anatomically consistent alignments than mutual-information-based registration, resulting in improved sCT synthesis with lower MAE and more realistic anatomical structures. On the public validation set, however, models trained with Elastix-aligned data achieved higher scores, reflecting a registration bias favoring alignment strategies consistent with the evaluation pipeline. This highlights how registration errors can propagate into supervised learning, influencing both training and evaluation, and potentially inflating performance metrics at the expense of anatomical fidelity. By promoting anatomically consistent alignment, IMPACT helps mitigate this bias and supports the development of more robust and generalizable sCT synthesis models.

Recently, multi-expert methods have led to significant improvements in long-tail recognition (LTR). We summarize two aspects that need further enhancement to contribute to LTR boosting: (1) More diverse experts; (2) Lower model variance. However, the previous methods didn't handle them well. To this end, we propose More Diverse experts with Consistency Self-distillation (MDCS) to bridge the gap left by earlier methods. Our MDCS approach consists of two core components: Diversity Loss (DL) and Consistency Self-distillation (CS). In detail, DL promotes diversity among experts by controlling their focus on different categories. To reduce the model variance, we employ KL divergence to distill the richer knowledge of weakly augmented instances for the experts' self-distillation. In particular, we design Confident Instance Sampling (CIS) to select the correctly classified instances for CS to avoid biased/noisy knowledge. In the analysis and ablation study, we demonstrate that our method compared with previous work can effectively increase the diversity of experts, significantly reduce the variance of the model, and improve recognition accuracy. Moreover, the roles of our DL and CS are mutually reinforcing and coupled: the diversity of experts benefits from the CS, and the CS cannot achieve remarkable results without the DL. Experiments show our MDCS outperforms the state-of-the-art by 1% sim 2% on five popular long-tailed benchmarks, including CIFAR10-LT, CIFAR100-LT, ImageNet-LT, Places-LT, and iNaturalist 2018. The code is available at https://github.com/fistyee/MDCS.

Knowledge of the medical decision process, which can be modeled as medical decision trees (MDTs), is critical to build clinical decision support systems. However, the current MDT construction methods rely heavily on time-consuming and laborious manual annotation. In this work, we propose a novel task, Text2MDT, to explore the automatic extraction of MDTs from medical texts such as medical guidelines and textbooks. We normalize the form of the MDT and create an annotated Text-to-MDT dataset in Chinese with the participation of medical experts. We investigate two different methods for the Text2MDT tasks: (a) an end-to-end framework which only relies on a GPT style large language models (LLM) instruction tuning to generate all the node information and tree structures. (b) The pipeline framework which decomposes the Text2MDT task to three subtasks. Experiments on our Text2MDT dataset demonstrate that: (a) the end-to-end method basd on LLMs (7B parameters or larger) show promising results, and successfully outperform the pipeline methods. (b) The chain-of-thought (COT) prompting method Wei2022ChainOT can improve the performance of the fine-tuned LLMs on the Text2MDT test set. (c) the lightweight pipelined method based on encoder-based pretrained models can perform comparably with LLMs with model complexity two magnititudes smaller. Our Text2MDT dataset is open-sourced at https://tianchi.aliyun.com/dataset/95414, and the source codes are open-sourced at https://github.com/michael-wzhu/text2dt.

In medical scenarios, effectively retrieving external knowledge and leveraging it for rigorous logical reasoning is of significant importance. Despite their potential, existing work has predominantly focused on enhancing either retrieval or reasoning capabilities of the models in isolation, with little attention given to their joint optimization, which leads to limited coordination between the two processes. Additionally, current methods rely heavily on supervised fine-tuning (SFT), which can cause models to memorize existing problem-solving pathways, thereby restricting their generalization ability when confronted with novel problem contexts. Furthermore, while some studies have explored to improve retrieval-augmented reasoning in general domains via reinforcement learning, their reward function designs do not adequately capture the specific demands of the medical domain. To address these challenges, we introduce **Med-R^3**, a **Med**ical **R**etrieval-augmented **R**easoning framework driven by progressive **R**einforcement learning. In this framework, we first develop the model's ability to perform logical reasoning over medical problems. Subsequently, on the basis of this foundation, we adaptively optimize the retrieval capability to better align with the characteristics of knowledge corpus and external information utilization throughout the reasoning process. Finally, we conduct joint optimization of the model's retrieval and reasoning coordination. Extensive experiments indicate that **Med-R^3** could achieve state-of-the-art performances, with LLaMA3.1-8B-Instruct + Med-R^3 surpassing closed-sourced GPT-4o-mini by 3.93\% at a comparable parameter scale, while Qwen2.5-14B augmented with Med-R^3 shows a more substantial gain of 13.53\%.

Pretraining with large-scale 3D volumes has a potential for improving the segmentation performance on a target medical image dataset where the training images and annotations are limited. Due to the high cost of acquiring pixel-level segmentation annotations on the large-scale pretraining dataset, pretraining with unannotated images is highly desirable. In this work, we propose a novel self-supervised learning strategy named Volume Fusion (VF) for pretraining 3D segmentation models. It fuses several random patches from a foreground sub-volume to a background sub-volume based on a predefined set of discrete fusion coefficients, and forces the model to predict the fusion coefficient of each voxel, which is formulated as a self-supervised segmentation task without manual annotations. Additionally, we propose a novel network architecture based on parallel convolution and transformer blocks that is suitable to be transferred to different downstream segmentation tasks with various scales of organs and lesions. The proposed model was pretrained with 110k unannotated 3D CT volumes, and experiments with different downstream segmentation targets including head and neck organs, thoracic/abdominal organs showed that our pretrained model largely outperformed training from scratch and several state-of-the-art self-supervised training methods and segmentation models. The code and pretrained model are available at https://github.com/openmedlab/MIS-FM.

In this report, we introduce Piccolo2, an embedding model that surpasses other models in the comprehensive evaluation over 6 tasks on CMTEB benchmark, setting a new state-of-the-art. Piccolo2 primarily leverages an efficient multi-task hybrid loss training approach, effectively harnessing textual data and labels from diverse downstream tasks. In addition, Piccolo2 scales up the embedding dimension and uses MRL training to support more flexible vector dimensions. The latest information of piccolo models can be accessed via: https://huggingface.co/sensenova/

Effective approaches that can scale embedding model depth (i.e. layers) and embedding size allow for the creation of models that are highly scalable across different computational resources and task requirements. While the recently proposed 2D Matryoshka training approach can efficiently produce a single embedding model such that its sub-layers and sub-dimensions can measure text similarity, its effectiveness is significantly worse than if smaller models were trained separately. To address this issue, we propose Starbucks, a new training strategy for Matryoshka-like embedding models, which encompasses both the fine-tuning and pre-training phases. For the fine-tuning phase, we discover that, rather than sampling a random sub-layer and sub-dimensions for each training steps, providing a fixed list of layer-dimension pairs, from small size to large sizes, and computing the loss across all pairs significantly improves the effectiveness of 2D Matryoshka embedding models, bringing them on par with their separately trained counterparts. To further enhance performance, we introduce a new pre-training strategy, which applies masked autoencoder language modelling to sub-layers and sub-dimensions during pre-training, resulting in a stronger backbone for subsequent fine-tuning of the embedding model. Experimental results on both semantic text similarity and retrieval benchmarks demonstrate that the proposed pre-training and fine-tuning strategies significantly improved the effectiveness over 2D Matryoshka models, enabling Starbucks models to perform more efficiently and effectively than separately trained models.

Recent advances in medical vision language models guide the learning of visual representations; however, this form of supervision is constrained by the availability of paired image text data, raising the question of whether robust radiology encoders can be learned without relying on language supervision. In this work, we introduce RadJEPA, a self-supervised framework built on a Joint Embedding Predictive Architecture that learns without language supervision. Pre-trained solely on unlabeled chest X-ray images, the model learns to predict latent representations of masked image regions. This predictive objective differs fundamentally from both image text pre-training and DINO-style self-distillation: rather than aligning global representations across views or modalities, RadJEPA explicitly models latent-space prediction. We evaluate the learned encoder on disease classification, semantic segmentation, and report generation tasks. Across benchmarks, RadJEPA achieves performance exceeding state-of-the-art approaches, including Rad-DINO.

Objectives: We aim to dynamically retrieve informative demonstrations, enhancing in-context learning in multimodal large language models (MLLMs) for disease classification. Methods: We propose a Retrieval-Augmented In-Context Learning (RAICL) framework, which integrates retrieval-augmented generation (RAG) and in-context learning (ICL) to adaptively select demonstrations with similar disease patterns, enabling more effective ICL in MLLMs. Specifically, RAICL examines embeddings from diverse encoders, including ResNet, BERT, BioBERT, and ClinicalBERT, to retrieve appropriate demonstrations, and constructs conversational prompts optimized for ICL. We evaluated the framework on two real-world multi-modal datasets (TCGA and IU Chest X-ray), assessing its performance across multiple MLLMs (Qwen, Llava, Gemma), embedding strategies, similarity metrics, and varying numbers of demonstrations. Results: RAICL consistently improved classification performance. Accuracy increased from 0.7854 to 0.8368 on TCGA and from 0.7924 to 0.8658 on IU Chest X-ray. Multi-modal inputs outperformed single-modal ones, with text-only inputs being stronger than images alone. The richness of information embedded in each modality will determine which embedding model can be used to get better results. Few-shot experiments showed that increasing the number of retrieved examples further enhanced performance. Across different similarity metrics, Euclidean distance achieved the highest accuracy while cosine similarity yielded better macro-F1 scores. RAICL demonstrated consistent improvements across various MLLMs, confirming its robustness and versatility. Conclusions: RAICL provides an efficient and scalable approach to enhance in-context learning in MLLMs for multimodal disease classification.

Natural language could play an important role in developing generalist surgical models by providing a broad source of supervision from raw texts. This flexible form of supervision can enable the model's transferability across datasets and tasks as natural language can be used to reference learned visual concepts or describe new ones. In this work, we present HecVL, a novel hierarchical video-language pretraining approach for building a generalist surgical model. Specifically, we construct a hierarchical video-text paired dataset by pairing the surgical lecture video with three hierarchical levels of texts: at clip-level, atomic actions using transcribed audio texts; at phase-level, conceptual text summaries; and at video-level, overall abstract text of the surgical procedure. Then, we propose a novel fine-to-coarse contrastive learning framework that learns separate embedding spaces for the three video-text hierarchies using a single model. By disentangling embedding spaces of different hierarchical levels, the learned multi-modal representations encode short-term and long-term surgical concepts in the same model. Thanks to the injected textual semantics, we demonstrate that the HecVL approach can enable zero-shot surgical phase recognition without any human annotation. Furthermore, we show that the same HecVL model for surgical phase recognition can be transferred across different surgical procedures and medical centers. The code is available at https://github.com/CAMMA-public/SurgVLP

Reinforcement Learning (RL) has emerged as a popular training paradigm, particularly when paired with reasoning models. While effective, it primarily focuses on generating responses and lacks mechanisms to explicitly foster critique or reflection. Several recent studies, like Critique-Fine-Tuning (CFT) and Critique-Guided-Distillation (CGD) have shown the benefits of explicitly teaching LLMs how to critique. Motivated by them, we propose Critique Reinforcement Learning (CRL), where the model is tasked with generating a critique for a given (question, solution) pair. The reward is determined solely by whether the final judgment label c in {True, False} of the generated critique aligns with the ground-truth judgment c^*. Building on this point, we introduce Critique-Coder, which is trained on a hybrid of RL and CRL by substituting 20\% of the standard RL data with CRL data. We fine-tune multiple models (Critique-Coder) and evaluate them on different benchmarks to show their advantages over RL-only models. We show that Critique-Coder consistently outperforms RL-only baselines on all the evaluated benchmarks. Notably, our Critique-Coder-8B can reach over 60\% on LiveCodeBench (v5), outperforming other reasoning models like DeepCoder-14B and GPT-o1. Beyond code generation, Critique-Coder also demonstrates enhanced general reasoning abilities, as evidenced by its better performance on logic reasoning tasks from the BBEH dataset. This indicates that the application of CRL on coding datasets enhances general reasoning and critique abilities, which are transferable across a broad range of tasks. Hence, we believe that CRL works as a great complement to standard RL for LLM reasoning.