Dynamic Decision Learning: Test-Time Evolution for Abnormality Grounding in Rare Diseases

Clinical abnormality grounding for rare diseases is often hindered by data scarcity, making supervised fine-tuning impractical and single-pass inference highly unstable. We propose Dynamic Decision Learning (DDL), a framework that enables frozen large vision-language models (LVLMs) to refine their decisions across both language and visual spaces by optimizing instructions and consolidating predictions under visual perturbations. This process improves localization quality and produces a consensus-based reliability score that quantifies model confidence. Results on brain imaging benchmarks, including a rare-disease dataset with 281 pathology types across models ranging from 3B to 72B parameters, show that DDL improves mAP@75 by up to 105% on rare-disease cases and outperforms adaptation baselines and supervised fine-tuning. Furthermore, DDL demonstrates stronger calibration between reliability scores and localization accuracy under severe distribution shifts and increasing task difficulty. Code is available at: https://lijunrio.github.io/DDL/

Evo-MedAgent: Beyond One-Shot Diagnosis with Agents That Remember, Reflect, and Improve

Tool-augmented large language model (LLM) agents can orchestrate specialist classifiers, segmentation models, and visual question-answering modules to interpret chest X-rays. However, these agents still solve each case in isolation: they fail to accumulate experience across cases, correct recurrent reasoning mistakes, or adapt their tool-use behavior without expensive reinforcement learning. While a radiologist naturally improves with every case, current agents remain static. In this work, we propose Evo-MedAgent, a self-evolving memory module that equips a medical agent with the capacity for inter-case learning at test time. Our memory comprises three complementary stores: (1)~\emph{Retrospective Clinical Episodes} that retrieve problem-solving experiences from similar past cases, (2)~an \emph{Adaptive Procedural Heuristics} bank curating priority-tagged diagnostic rules that evolves via reflection, much like a physician refining their internal criteria, and (3)~a \emph{Tool Reliability Controller} that tracks per-tool trustworthiness. On ChestAgentBench, Evo-MedAgent raises multiple-choice question (MCQ) accuracy from 0.68 to 0.79 on GPT-5-mini, and from 0.76 to 0.87 on Gemini-3 Flash. With a strong base model, evolving memory improves performance more effectively than orchestrating external tools on qualitative diagnostic tasks. Because Evo-MedAgent requires no training, its per-case overhead is bounded by one additional retrieval pass and a single reflection call, making it deployable on top of any frozen model.

MedOpenClaw: Auditable Medical Imaging Agents Reasoning over Uncurated Full Studies

Currently, evaluating vision-language models (VLMs) in medical imaging tasks oversimplifies clinical reality by relying on pre-selected 2D images that demand significant manual labor to curate. This setup misses the core challenge of realworld diagnostics: a true clinical agent must actively navigate full 3D volumes across multiple sequences or modalities to gather evidence and ultimately support a final decision. To address this, we propose MEDOPENCLAW, an auditable runtime designed to let VLMs operate dynamically within standard medical tools or viewers (e.g., 3D Slicer). On top of this runtime, we introduce MEDFLOWBENCH, a full-study medical imaging benchmark covering multi-sequence brain MRI and lung CT/PET. It systematically evaluates medical agentic capabilities across viewer-only, tool-use, and open-method tracks. Initial results reveal a critical insight: while state-of-the-art LLMs/VLMs (e.g., Gemini 3.1 Pro and GPT-5.4) can successfully navigate the viewer to solve basic study-level tasks, their performance paradoxically degrades when given access to professional support tools due to a lack of precise spatial grounding. By bridging the gap between static-image perception and interactive clinical workflows, MEDOPENCLAW and MEDFLOWBENCH establish a reproducible foundation for developing auditable, full-study medical imaging agents.

IQuest-Coder-V1 Technical Report

In this report, we introduce the IQuest-Coder-V1 series-(7B/14B/40B/40B-Loop), a new family of code large language models (LLMs). Moving beyond static code representations, we propose the code-flow multi-stage training paradigm, which captures the dynamic evolution of software logic through different phases of the pipeline. Our models are developed through the evolutionary pipeline, starting with the initial pre-training consisting of code facts, repository, and completion data. Following that, we implement a specialized mid-training stage that integrates reasoning and agentic trajectories in 32k-context and repository-scale in 128k-context to forge deep logical foundations. The models are then finalized with post-training of specialized coding capabilities, which is bifurcated into two specialized paths: the thinking path (utilizing reasoning-driven RL) and the instruct path (optimized for general assistance). IQuest-Coder-V1 achieves state-of-the-art performance among competitive models across critical dimensions of code intelligence: agentic software engineering, competitive programming, and complex tool use. To address deployment constraints, the IQuest-Coder-V1-Loop variant introduces a recurrent mechanism designed to optimize the trade-off between model capacity and deployment footprint, offering an architecturally enhanced path for efficacy-efficiency trade-off. We believe the release of the IQuest-Coder-V1 series, including the complete white-box chain of checkpoints from pre-training bases to the final thinking and instruction models, will advance research in autonomous code intelligence and real-world agentic systems.

CogDoc: Towards Unified thinking in Documents

Current document reasoning paradigms are constrained by a fundamental trade-off between scalability (processing long-context documents) and fidelity (capturing fine-grained, multimodal details). To bridge this gap, we propose CogDoc, a unified coarse-to-fine thinking framework that mimics human cognitive processes: a low-resolution "Fast Reading" phase for scalable information localization,followed by a high-resolution "Focused Thinking" phase for deep reasoning. We conduct a rigorous investigation into post-training strategies for the unified thinking framework, demonstrating that a Direct Reinforcement Learning (RL) approach outperforms RL with Supervised Fine-Tuning (SFT) initialization. Specifically, we find that direct RL avoids the "policy conflict" observed in SFT. Empirically, our 7B model achieves state-of-the-art performance within its parameter class, notably surpassing significantly larger proprietary models (e.g., GPT-4o) on challenging, visually rich document benchmarks.

Emergent Hierarchical Reasoning in LLMs through Reinforcement Learning

Reinforcement Learning (RL) has proven highly effective at enhancing the complex reasoning abilities of Large Language Models (LLMs), yet underlying mechanisms driving this success remain largely opaque. Our analysis reveals that puzzling phenomena like ``aha moments", ``length-scaling'' and entropy dynamics are not disparate occurrences but hallmarks of an emergent reasoning hierarchy, akin to the separation of high-level strategic planning from low-level procedural execution in human cognition. We uncover a compelling two-phase dynamic: initially, a model is constrained by procedural correctness and must improve its low-level skills. The learning bottleneck then decisively shifts, with performance gains being driven by the exploration and mastery of high-level strategic planning. This insight exposes a core inefficiency in prevailing RL algorithms like GRPO, which apply optimization pressure agnostically and dilute the learning signal across all tokens. To address this, we propose HIerarchy-Aware Credit Assignment (HICRA), an algorithm that concentrates optimization efforts on high-impact planning tokens. HICRA significantly outperforms strong baselines, demonstrating that focusing on this strategic bottleneck is key to unlocking advanced reasoning. Furthermore, we validate semantic entropy as a superior compass for measuring strategic exploration over misleading metrics such as token-level entropy.

Knowledge to Sight: Reasoning over Visual Attributes via Knowledge Decomposition for Abnormality Grounding

In this work, we address the problem of grounding abnormalities in medical images, where the goal is to localize clinical findings based on textual descriptions. While generalist Vision-Language Models (VLMs) excel in natural grounding tasks, they often struggle in the medical domain due to rare, compositional, and domain-specific terms that are poorly aligned with visual patterns. Specialized medical VLMs address this challenge via large-scale domain pretraining, but at the cost of substantial annotation and computational resources. To overcome these limitations, we propose \textbf{Knowledge to Sight (K2Sight)}, a framework that introduces structured semantic supervision by decomposing clinical concepts into interpretable visual attributes, such as shape, density, and anatomical location. These attributes are distilled from domain ontologies and encoded into concise instruction-style prompts, which guide region-text alignment during training. Unlike conventional report-level supervision, our approach explicitly bridges domain knowledge and spatial structure, enabling data-efficient training of compact models. We train compact models with 0.23B and 2B parameters using only 1.5\% of the data required by state-of-the-art medical VLMs. Despite their small size and limited training data, these models achieve performance on par with or better than 7B+ medical VLMs, with up to 9.82\% improvement in $mAP_{50}$. Code and models: \href{https://lijunrio.github.io/K2Sight/}{\textcolor{SOTAPink}{https://lijunrio.github.io/K2Sight/}}.

Step-Audio 2 Technical Report

This paper presents Step-Audio 2, an end-to-end multi-modal large language model designed for industry-strength audio understanding and speech conversation. By integrating a latent audio encoder and reasoning-centric reinforcement learning (RL), Step-Audio 2 achieves promising performance in automatic speech recognition (ASR) and audio understanding. To facilitate genuine end-to-end speech conversation, Step-Audio 2 incorporates the generation of discrete audio tokens into language modeling, significantly enhancing its responsiveness to paralinguistic information such as speaking styles and emotions. To effectively leverage the rich textual and acoustic knowledge in real-world data, Step-Audio 2 integrates retrieval-augmented generation (RAG) and is able to call external tools such as web search to mitigate hallucination and audio search to switch timbres. Trained on millions of hours of speech and audio data, Step-Audio 2 delivers intelligence and expressiveness across diverse conversational scenarios. Evaluation results demonstrate that Step-Audio 2 achieves state-of-the-art performance on various audio understanding and conversational benchmarks compared to other open-source and commercial solutions. Please visit https://github.com/stepfun-ai/Step-Audio2 for more information.

Dual form Complementary Masking for Domain-Adaptive Image Segmentation

Recent works have correlated Masked Image Modeling (MIM) with consistency regularization in Unsupervised Domain Adaptation (UDA). However, they merely treat masking as a special form of deformation on the input images and neglect the theoretical analysis, which leads to a superficial understanding of masked reconstruction and insufficient exploitation of its potential in enhancing feature extraction and representation learning. In this paper, we reframe masked reconstruction as a sparse signal reconstruction problem and theoretically prove that the dual form of complementary masks possesses superior capabilities in extracting domain-agnostic image features. Based on this compelling insight, we propose MaskTwins, a simple yet effective UDA framework that integrates masked reconstruction directly into the main training pipeline. MaskTwins uncovers intrinsic structural patterns that persist across disparate domains by enforcing consistency between predictions of images masked in complementary ways, enabling domain generalization in an end-to-end manner. Extensive experiments verify the superiority of MaskTwins over baseline methods in natural and biological image segmentation. These results demonstrate the significant advantages of MaskTwins in extracting domain-invariant features without the need for separate pre-training, offering a new paradigm for domain-adaptive segmentation.

Beyond Distillation: Pushing the Limits of Medical LLM Reasoning with Minimalist Rule-Based RL

Improving performance on complex tasks and enabling interpretable decision making in large language models (LLMs), especially for clinical applications, requires effective reasoning. Yet this remains challenging without supervised fine-tuning (SFT) on costly chain-of-thought (CoT) data distilled from closed-source models (e.g., GPT-4o). In this work, we present AlphaMed, the first medical LLM to show that reasoning capability can emerge purely through reinforcement learning (RL), using minimalist rule-based rewards on public multiple-choice QA datasets, without relying on SFT or distilled CoT data. AlphaMed achieves state-of-the-art results on six medical QA benchmarks, outperforming models trained with conventional SFT+RL pipelines. On challenging benchmarks (e.g., MedXpert), AlphaMed even surpasses larger or closed-source models such as DeepSeek-V3-671B and Claude-3.5-Sonnet. To understand the factors behind this success, we conduct a comprehensive data-centric analysis guided by three questions: (i) Can minimalist rule-based RL incentivize reasoning without distilled CoT supervision? (ii) How do dataset quantity and diversity impact reasoning? (iii) How does question difficulty shape the emergence and generalization of reasoning? Our findings show that dataset informativeness is a key driver of reasoning performance, and that minimalist RL on informative, multiple-choice QA data is effective at inducing reasoning without CoT supervision. We also observe divergent trends across benchmarks, underscoring limitations in current evaluation and the need for more challenging, reasoning-oriented medical QA benchmarks.