MedHorizon: Towards Long-context Medical Video Understanding in the Wild

Medical multimodal large language models (MLLMs) have advanced image understanding and short-video analysis, but real clinical review often requires full-procedure video understanding. Unlike general long videos, medical procedures contain highly redundant anatomical views, while decisive evidence is temporally sparse, spatially subtle, and context dependent. Existing benchmarks often assume this evidence has already been localized through images, short clips, or pre-segmented videos, leaving the retrieval-before-reasoning problem under-tested. We introduce MedHorizon, an in-the-wild benchmark for long-context medical video understanding. MedHorizon preserves 759 hours of full-length clinical procedures and provides 1,253 evidence-grounded multiple-choice questionsthat jointly evaluate sparse evidence understanding and multi-hop clinical reasoning. Its evidence is extremely sparse, with only 0.166% evidence frames on average, requiring models to search noisy procedural streams before interpreting and aggregating findings. We evaluate representative general-domain, medical-domain, and long-video MLLMs. The best model reaches only 41.1% accuracy, showing that current systems remain far from robust full-procedure understanding. Further analysis yields four key findings: performance does not scale reliably with more frames, evidence retrieval and clinical interpretation remain primary bottlenecks; these bottlenecks are rooted in weak procedural reasoning and attention drift under redundancy, and generic sampling methods only partially balances local detail with global coverage. MedHorizon provides a rigorous testbed for MLLMs that retrieve sparse evidence and reason over complete clinical workflows.

Divide-then-Diagnose: Weaving Clinician-Inspired Contexts for Ultra-Long Capsule Endoscopy Videos

Capsule endoscopy (CE) enables non-invasive gastrointestinal screening, but current CE research remains largely limited to frame-level classification and detection, leaving video-level analysis underexplored. To bridge this gap, we introduce and formally define a new task, diagnosis-driven CE video summarization, which requires extracting key evidence frames that covers clinically meaningful findings and making accurate diagnoses from those evidence frames. This setting is challenging because diagnostically relevant events are extremely sparse and can be overwhelmed by tens of thousands of redundant normal frames, while individual observations are often ambiguous due to motion blur, debris, specular highlights, and rapid viewpoint changes. To facilitate research in this direction, we introduce VideoCAP, the first CE dataset with diagnosis-driven annotations derived from real clinical reports. VideoCAP comprises 240 full-length videos and provides realistic supervision for both key evidence frame extraction and diagnosis. To address this task, we further propose DiCE, a clinician-inspired framework that mirrors the standard CE reading workflow. DiCE first performs efficient candidate screening over the raw video, then uses a Context Weaver to organize candidates into coherent diagnostic contexts that preserve distinct lesion events, and an Evidence Converger to aggregate multi-frame evidence within each context into robust clip-level judgments. Experiments show that DiCE consistently outperforms state-of-the-art methods, producing concise and clinically reliable diagnostic summaries. These results highlight diagnosis-driven contextual reasoning as a promising paradigm for ultra-long CE video summarization.

Beyond Language: Grounding Referring Expressions with Hand Pointing in Egocentric Vision

Traditional Visual Grounding (VG) predominantly relies on textual descriptions to localize objects, a paradigm that inherently struggles with linguistic ambiguity and often ignores non-verbal deictic cues prevalent in real-world interactions. In natural egocentric engagements, hand-pointing combined with speech forms the most intuitive referring mechanism. To bridge this gap, we introduce EgoPoint-Ground, the first large-scale multimodal dataset dedicated to egocentric deictic visual grounding. Comprising over \textbf{15k} interactive samples in complex scenes, the dataset provides rich, multi-grained annotations including hand-target bounding box pairs and dense semantic captions. We establish a comprehensive benchmark for hand-pointing referring expression resolution, evaluating a wide spectrum of mainstream Multimodal Large Language Models (MLLMs) and state-of-the-art VG architectures. Furthermore, we propose SV-CoT, a novel baseline framework that reformulates grounding as a structured inference process, synergizing gestural and linguistic cues through a Visual Chain-of-Thought paradigm. Extensive experiments demonstrate that SV-CoT achieves an $\textbf{11.7\%}$ absolute improvement over existing methods, effectively mitigating semantic ambiguity and advancing the capability of agents to comprehend multimodal physical intents. The dataset and code will be made publicly available.

Ran Score: a LLM-based Evaluation Score for Radiology Report Generation

Chest X-ray report generation and automated evaluation are limited by poor recognition of low-prevalence abnormalities and inadequate handling of clinically important language, including negation and ambiguity. We develop a clinician-guided framework combining human expertise and large language models for multi-label finding extraction from free-text chest X-ray reports and use it to define Ran Score, a finding-level metric for report evaluation. Using three non-overlapping MIMIC-CXR-EN cohorts from a public chest X-ray dataset and an independent ChestX-CN validation cohort, we optimize prompts, establish radiologist-derived reference labels and evaluate report generation models. The optimized framework improves the macro-averaged score from 0.753 to 0.956 on the MIMIC-CXR-EN development cohort, exceeds the CheXbert benchmark by 15.7 percentage points on directly comparable labels, and shows robust generalization on the ChestX-CN validation cohort. Here we show that clinician-guided prompt optimization improves agreement with a radiologist-derived reference standard and that Ran Score enables finding-level evaluation of report fidelity, particularly for low-prevalence abnormalities.

How to Utilize Complementary Vision-Text Information for 2D Structure Understanding

LLMs typically linearize 2D tables into 1D sequences to fit their autoregressive architecture, which weakens row-column adjacency and other layout cues. In contrast, purely visual encoders can capture spatial cues, yet often struggle to preserve exact cell text. Our analysis reveals that these two modalities provide highly distinct information to LLMs and exhibit strong complementarity. However, direct concatenation and other fusion methods yield limited gains and frequently introduce cross-modal interference. To address this issue, we propose DiVA-Former, a lightweight architecture designed to effectively integrate vision and text information. DiVA-Former leverages visual tokens as dynamic queries to distill long textual sequences into digest vectors, thereby effectively exploiting complementary vision--text information. Evaluated across 13 table benchmarks, DiVA-Former improves upon the pure-text baseline by 23.9\% and achieves consistent gains over existing baselines using visual inputs, textual inputs, or a combination of both.

EyeWorld: A Generative World Model of Ocular State and Dynamics

Ophthalmic decision-making depends on subtle lesion-scale cues interpreted across multimodal imaging and over time, yet most medical foundation models remain static and degrade under modality and acquisition shifts. Here we introduce EyeWorld, a generative world model that conceptualizes the eye as a partially observed dynamical system grounded in clinical imaging. EyeWorld learns an observation-stable latent ocular state shared across modalities, unifying fine-grained parsing, structure-preserving cross-modality translation and quality-robust enhancement within a single framework. Longitudinal supervision further enables time-conditioned state transitions, supporting forecasting of clinically meaningful progression while preserving stable anatomy. By moving from static representation learning to explicit dynamical modeling, EyeWorld provides a unified approach to robust multimodal interpretation and prognosis-oriented simulation in medicine.

Enhancing Cross-View UAV Geolocalization via LVLM-Driven Relational Modeling

The primary objective of cross-view UAV geolocalization is to identify the exact spatial coordinates of drone-captured imagery by aligning it with extensive, geo-referenced satellite databases. Current approaches typically extract features independently from each perspective and rely on basic heuristics to compute similarity, thereby failing to explicitly capture the essential interactions between different views. To address this limitation, we introduce a novel, plug-and-play ranking architecture designed to explicitly perform joint relational modeling for improved UAV-to-satellite image matching. By harnessing the capabilities of a Large Vision-Language Model (LVLM), our framework effectively learns the deep visual-semantic correlations linking UAV and satellite imagery. Furthermore, we present a novel relational-aware loss function to optimize the training phase. By employing soft labels, this loss provides fine-grained supervision that avoids overly penalizing near-positive matches, ultimately boosting both the model's discriminative power and training stability. Comprehensive evaluations across various baseline architectures and standard benchmarks reveal that the proposed method substantially boosts the retrieval accuracy of existing models, yielding superior performance even under highly demanding conditions.

QCAgent: An agentic framework for quality-controllable pathology report generation from whole slide image

Recent methods for pathology report generation from whole-slide image (WSI) are capable of producing slide-level diagnostic descriptions but fail to ground fine-grained statements in localized visual evidence. Furthermore, they lack control over which diagnostic details to include and how to verify them. Inspired by emerging agentic analysis paradigms and the diagnostic workflow of pathologists,who selectively examine multiple fields of view, we propose QCAgent, an agentic framework for quality-controllable WSI report generation. The core innovations of this framework are as follows: (i) it incorporates a customized critique mechanism guided by a user-defined checklist specifying required diagnostic details and constraints; (ii) it re-identifies informative regions in the WSI based on the critique feedback and text-patch semantic retrieval, a process that iteratively enriches and reconciles the report. Experiments demonstrate that by making report requirements explicitly prompt-defined, constraint-aware, and verifiable through evidence-grounded refinement, QCAgent enables controllable generation of clinically meaningful and high-coverage pathology reports from WSI.

AlgBench: To What Extent Do Large Reasoning Models Understand Algorithms?

Reasoning ability has become a central focus in the advancement of Large Reasoning Models (LRMs). Although notable progress has been achieved on several reasoning benchmarks such as MATH500 and LiveCodeBench, existing benchmarks for algorithmic reasoning remain limited, failing to answer a critical question: Do LRMs truly master algorithmic reasoning? To answer this question, we propose AlgBench, an expert-curated benchmark that evaluates LRMs under an algorithm-centric paradigm. AlgBench consists of over 3,000 original problems spanning 27 algorithms, constructed by ACM algorithmic experts and organized under a comprehensive taxonomy, including Euclidean-structured, non-Euclidean-structured, non-optimized, local-optimized, global-optimized, and heuristic-optimized categories. Empirical evaluations on leading LRMs (e.g., Gemini-3-Pro, DeepSeek-v3.2-Speciale and GPT-o3) reveal substantial performance heterogeneity: while models perform well on non-optimized tasks (up to 92%), accuracy drops sharply to around 49% on globally optimized algorithms such as dynamic programming. Further analysis uncovers \textbf{strategic over-shifts}, wherein models prematurely abandon correct algorithmic designs due to necessary low-entropy tokens. These findings expose fundamental limitations of problem-centric reinforcement learning and highlight the necessity of an algorithm-centric training paradigm for robust algorithmic reasoning.

Understanding What Is Not Said:Referring Remote Sensing Image Segmentation with Scarce Expressions

Referring Remote Sensing Image Segmentation (RRSIS) aims to segment instances in remote sensing images according to referring expressions. Unlike Referring Image Segmentation on general images, acquiring high-quality referring expressions in the remote sensing domain is particularly challenging due to the prevalence of small, densely distributed objects and complex backgrounds. This paper introduces a new learning paradigm, Weakly Referring Expression Learning (WREL) for RRSIS, which leverages abundant class names as weakly referring expressions together with a small set of accurate ones to enable efficient training under limited annotation conditions. Furthermore, we provide a theoretical analysis showing that mixed-referring training yields a provable upper bound on the performance gap relative to training with fully annotated referring expressions, thereby establishing the validity of this new setting. We also propose LRB-WREL, which integrates a Learnable Reference Bank (LRB) to refine weakly referring expressions through sample-specific prompt embeddings that enrich coarse class-name inputs. Combined with a teacher-student optimization framework using dynamically scheduled EMA updates, LRB-WREL stabilizes training and enhances cross-modal generalization under noisy weakly referring supervision. Extensive experiments on our newly constructed benchmark with varying weakly referring data ratios validate both the theoretical insights and the practical effectiveness of WREL and LRB-WREL, demonstrating that they can approach or even surpass models trained with fully annotated referring expressions.