Coupled Graph--Policy Distillation for Personalized Medication Safety in Older Adults with Multimorbidity

Large language model (LLM) agents can support medication review between clinical visits, but safe choices for older adults with multimorbidity depend on conditions, medications, and geriatric risks that users may omit. We introduce ATLAS, a coupled graph--policy distillation framework for patient-adaptive medication safety. ATLAS structures guideline evidence as a medication-safety graph. Targeted questions update the patient state and distill relevant relations into a patient-specific medication conflict graph (PMCG). A risk-first multi-agent policy uses the PMCG to screen contraindications, assess cautions and monitoring needs, identify safer alternatives, and verify the final medication plan. We also introduce GeriMedBench, an interactive benchmark that tests safety-critical information acquisition and evidence-based decision revision. Across a European non-interactive multimorbidity benchmark, an Asian interactive multimorbidity benchmark, and an Asian non-interactive cross-guideline benchmark, ATLAS achieves the strongest complete-decision performance among the compared systems. On the European non-interactive multimorbidity benchmark, it exceeds the strongest proprietary LLM baseline by 53.73 points in Strict Success Rate and 14.63 points in overall safety reasoning score (OSRS), with no unsafe recommendations under the automated evaluator. A blinded clinician evaluation gives ATLAS higher mean ratings across all five criteria and flags potentially unsafe recommendations in one ATLAS case and two Gemini cases.

JustLLMGRPO: Radiographic Control for Chest X-Ray Generation

Text-conditioned chest X-ray generation aims to synthesize realistic radiographs that faithfully depict specified findings. Existing work has primarily improved quality by updating image generators, implicitly treating prompts as fixed after CXR-domain adaptation. We show that this generator-centric view leaves a substantial optimization dimension underexplored. With a CXR-adapted Sana generator frozen, one-pass reformulation by an unmodified LLM reduces RadDINO-FID from 54.225 to 27.572. Prompt analysis shows that the LLM suppresses temporal comparisons, uncertainty, and other non-renderable report content while emphasizing visible radiographic findings. However, unconstrained reformulation reduces BioViL-T alignment with source prompts from 0.695 to 0.609. We therefore introduce JustLLMGRPO, which applies standard Group Relative Policy Optimization (GRPO) only to the LLM prompt policy while keeping Sana frozen. Group-relative radiology-aware image feedback retains visual focus while preserving source-prompt alignment. On CheXGenBench, JustLLMGRPO reduces RadDINO-FID to 26.780, a 50.6% improvement over direct prompting, while maintaining alignment (0.696 versus 0.695). It also achieves state-of-the-art distribution coverage and downstream classification utility. These results show that substantial performance can remain latent in how radiographic information is expressed to an adapted generator. Code is publicly available at https://github.com/pxcai/JustLLMGRPO.

Decoding Children's Gait Behavior

We introduce a new problem domain for human action recognition: the fine-grained analysis of children's gait behaviors from standard RGB video. We specifically target the ambulatory patterns of children aged 3-17 years. Such behaviors arise naturally in the diagnosis and treatment of several critical developmental and neuromuscular disorders, such as cerebral palsy and hemiplegia. Despite their clinical value, current 3D sensor-based gait analysis systems are expensive, intrusive, and often impractical for young subjects. To address this, we introduce a new dataset comprising over 1,100 high-frame-rate (60 FPS) video sequences from 110 subjects, accompanied by synchronized, anonymized pose sequences. In each session, the child performs a 5-second "walk-around" task, capturing the gait cycle from multiple viewpoints. Crucially, we demonstrate that current state-of-the-art approaches, including gait foundation models and Multimodal Large Language Models (MLLMs), fail to effectively resolve these clinical nuances. We identify the key technical challenges in analyzing these erratic and subtle motor patterns and describe a unified end-to-end framework for decoding fundamental components of pediatric gait. Through comprehensive experimental results, we demonstrate the potential of this dataset to drive novel research questions and establish a rigorous baseline for automated child gait assessment.

Can Broad Biomedical Knowledge be Contextualized into Scenario-Grounded Propositions?

Biomedical discovery often requires connecting broad biomedical knowledge with specific experimental or clinical data. Background knowledge suggests relevant mechanisms but is usually too general to map directly onto dataset variables, while data-driven patterns can be dataset-specific and hard to interpret mechanistically. We study this missing link as knowledge contextualization: transforming broad biomedical knowledge into evidence-supported, scenario-grounded propositions that domain experts can inspect, replay, and validate. We propose SCENE, a bi-level multi-agent framework that treats knowledge contextualization as iterative search. The upper level converts broad knowledge into search directions and grounds them in the dataset schema. The lower level executes these directions through multi-objective optimization to identify concrete propositions that balance evidential strength and data support. Feedback between the two levels progressively refines the search. We evaluate SCENE in two settings: discovering patient subgroups with heterogeneous treatment benefits in clinical trial scenarios, and identifying context-specific biological responses in LINCS L1000 studies. In clinical trials, SCENE discovers specific, well-supported subgroups and outperforms existing baselines. In L1000 studies, SCENE identifies perturbational contexts with strong target-response matching and high positive rates. These results show that SCENE bridges broad knowledge and scenario-specific evidence, producing traceable, inspectable hypotheses for follow-up validation.

Don't Retrain, Just Reuse: Recovering Dual-Target Molecules from Single-Target Diffusion Models

Designing a single molecule that modulates two targets is a promising strategy for polypharmacology, but it remains substantially harder than standard single-target generation because one candidate must satisfy two binding requirements while preserving drug-likeness and synthesizability. Existing dual-target generative methods typically introduce dual-target capability by either retraining the generator or intervening in the diffusion process during sampling. The former can be costly and difficult to stabilize when dual-target supervision is sparse, while the latter may be sensitive to denoising-time target balancing and competing update directions. These limitations motivate a generator-preserving alternative that keeps the pretrained prior intact: can dual-target candidates instead be recovered from the input space of a frozen single-target diffusion model, without modifying its parameters or denoising dynamics? We formulate this task as a constrained multi-objective optimization problem and propose REUSE, a hierarchical evolutionary input-space search framework that combines pair-conditioned exploration with structured multi-stage selection to enforce dual-target affinity, chemical quality, and diversity. Experiments show that, compared with methods that modify the diffusion process, REUSE consistently improves dual-target affinity and balance, achieving a 20.9-percentage-point gain in Dual High Affinity over the strongest prior baseline while maintaining competitive molecular quality.

CoRE: Concept-Reasoning Expansion for Continual Brain Lesion Segmentation

Accurate brain lesion segmentation in MRI is vital for effective clinical diagnosis and treatment planning. Due to high annotation costs and strict data privacy regulations, universal models require employing Continual Learning (CL) to adapt to evolving clinical tasks without losing previously acquired knowledge. However, existing CL paradigms often suffer from capacity limits or redundant parameter growth, and even advanced dynamic methods rely mostly on image-perception strategies that struggle to handle the substantial pathological and multimodal heterogeneity inherent in brain imaging. To address this issue, we propose Concept-Reasoning Expansion (CoRE) framework, which establishes a joint decision-making mechanism by integrating visual features with structured concepts. Through the alignment of image tokens with a hierarchical concept library, CoRE simulates clinical reasoning to guide both interpretable expert routing and demand-based model growth. This collaborative process ensures model evolution is grounded in clinical priors, preventing redundant parameter expansion while maximizing knowledge reuse. Extensive evaluations across 12 sequential brain lesion MRI tasks demonstrate that CoRE achieves state-of-the-art performance and provides a high knowledge starting point for efficient future adaptation. Its superior few-shot transferability and clinical interpretability further validate its effectiveness in managing non-stationary clinical data streams. Our code will be released soon.

Med-Scout: Curing MLLMs' Geometric Blindness in Medical Perception via Geometry-Aware RL Post-Training

Despite recent Multimodal Large Language Models (MLLMs)' linguistic prowess in medical diagnosis, we find even state-of-the-art MLLMs suffer from a critical perceptual deficit: geometric blindness. This failure to ground outputs in objective geometric constraints leads to plausible yet factually incorrect hallucinations, rooted in training paradigms that prioritize linguistic fluency over geometric fidelity. This paper introduces Med-Scout, a novel framework that "cures" this blindness via Reinforcement Learning (RL) that leverages the intrinsic geometric logic latent within unlabeled medical images. Instead of relying on costly expert annotations, Med-Scout derives verifiable supervision signals through three strategic proxy tasks: Hierarchical Scale Localization, Topological Jigsaw Reconstruction, and Anomaly Consistency Detection. To rigorously quantify this deficit, we present Med-Scout-Bench, a new benchmark specifically designed to evaluate geometric perception. Extensive evaluations show that Med-Scout significantly mitigates geometric blindness, outperforming leading proprietary and open-source MLLMs by over 40% on our benchmark. Furthermore, this enhanced geometric perception generalizes to broader medical understanding, achieving superior results on radiological and comprehensive medical VQA tasks.