Mind the Tool Failures: Achieving Synergistic Tool Gains for Medical Agents

Medical AI agents increasingly use external tools for diagnosis, treatment recommendation, and evidence retrieval, yet most existing approaches assume that task-appropriate tools are reliable within their intended scope. This assumption is fragile in real clinical settings, where even relevant tools may fail on challenging instances and lead to unsafe downstream decisions. To address this issue, we study medical tool use under imperfect-tool settings to correct failure instances missed by individual tools. Instance-dependent failure patterns create a gap between the best fixed single tool and an ideal instance-wise selector, which we refer to as the Single-Oracle risk gap. The core challenge is that conventional task-level tool selection cannot realize this gap, as it is inherently bounded by the performance of the best single tool. Motivated by this observation, we therefore account for instance-level heterogeneity and formulate tool use as an instance-level selection problem. Particularly, we propose a GRPO-based reinforcement learning framework with rewards for probabilistic risk minimization and disagreement-aware synergy learning, which promotes instance-level correction of erroneous tool consensus. Furthermore, an entropy-guided sampling strategy is adopted to upweight high-disagreement instances, which provide stronger signals for learning instance-specific tool synergy. These two components complement each other in mitigating instance-level heterogeneity and improving tool synergy. Experiments on two tasks and seven medical benchmarks show that our method consistently achieves robust and stable improvements over a broad range of baselines, highlighting the importance of synergy-aware tool use for reliable medical agentic systems.

Beyond Instance-Level Self-Supervision in 3D Multi-Modal Medical Imaging

Self-supervised pre-training methods in medical imaging typically treat each individual as an isolated instance, learning representations through augmentation-based objectives or masked reconstruction. They often do not adequately capitalize on a key characteristic of physiological features: anatomical structures maintain consistent spatial relationships across individuals (instances), such as the thalamus being medial to the basal ganglia, regardless of variations in brain size, shape, or pathology. We propose leveraging this cross-instance topological consistency as a supervisory signal. The challenge arises from the inherent variability in medical imaging, which can differ significantly across instances and modalities. To tackle this, we focus on two alignment regimes. (i) Intra-instance: with pixel-level correspondences available, a cross-modal triplet objective explicitly preserves local neighborhood topology. (ii) Inter-instance: without such supervision, we derive pseudo-correspondences to control partial neighborhood alignment and prevent topology collapse across modalities. We validate our approach across 7 downstream multi-modal tasks, achieving average improvements of 1.1% and 5.94% in segmentation and classification tasks, respectively, and demonstrating significantly better robustness when modalities are missing at test time.

Project Imaging-X: A Survey of 1000+ Open-Access Medical Imaging Datasets for Foundation Model Development

Foundation models have demonstrated remarkable success across diverse domains and tasks, primarily due to the thrive of large-scale, diverse, and high-quality datasets. However, in the field of medical imaging, the curation and assembling of such medical datasets are highly challenging due to the reliance on clinical expertise and strict ethical and privacy constraints, resulting in a scarcity of large-scale unified medical datasets and hindering the development of powerful medical foundation models. In this work, we present the largest survey to date of medical image datasets, covering over 1,000 open-access datasets with a systematic catalog of their modalities, tasks, anatomies, annotations, limitations, and potential for integration. Our analysis exposes a landscape that is modest in scale, fragmented across narrowly scoped tasks, and unevenly distributed across organs and modalities, which in turn limits the utility of existing medical image datasets for developing versatile and robust medical foundation models. To turn fragmentation into scale, we propose a metadata-driven fusion paradigm (MDFP) that integrates public datasets with shared modalities or tasks, thereby transforming multiple small data silos into larger, more coherent resources. Building on MDFP, we release an interactive discovery portal that enables end-to-end, automated medical image dataset integration, and compile all surveyed datasets into a unified, structured table that clearly summarizes their key characteristics and provides reference links, offering the community an accessible and comprehensive repository. By charting the current terrain and offering a principled path to dataset consolidation, our survey provides a practical roadmap for scaling medical imaging corpora, supporting faster data discovery, more principled dataset creation, and more capable medical foundation models.

MetaWorld-X: Hierarchical World Modeling via VLM-Orchestrated Experts for Humanoid Loco-Manipulation

Learning natural, stable, and compositionally generalizable whole-body control policies for humanoid robots performing simultaneous locomotion and manipulation (loco-manipulation) remains a fundamental challenge in robotics. Existing reinforcement learning approaches typically rely on a single monolithic policy to acquire multiple skills, which often leads to cross-skill gradient interference and motion pattern conflicts in high-degree-of-freedom systems. As a result, generated behaviors frequently exhibit unnatural movements, limited stability, and poor generalization to complex task compositions. To address these limitations, we propose MetaWorld-X, a hierarchical world model framework for humanoid control. Guided by a divide-and-conquer principle, our method decomposes complex control problems into a set of specialized expert policies (Specialized Expert Policies, SEP). Each expert is trained under human motion priors through imitation-constrained reinforcement learning, introducing biomechanically consistent inductive biases that ensure natural and physically plausible motion generation. Building upon this foundation, we further develop an Intelligent Routing Mechanism (IRM) supervised by a Vision-Language Model (VLM), enabling semantic-driven expert composition. The VLM-guided router dynamically integrates expert policies according to high-level task semantics, facilitating compositional generalization and adaptive execution in multi-stage loco-manipulation tasks.

KCoEvo: A Knowledge Graph Augmented Framework for Evolutionary Code Generation

Code evolution is inevitable in modern software development. Changes to third-party APIs frequently break existing code and complicate maintenance, posing practical challenges for developers. While large language models (LLMs) have shown promise in code generation, they struggle to reason without a structured representation of these evolving relationships, often leading them to produce outdated APIs or invalid outputs. In this work, we propose a knowledge graph-augmented framework that decomposes the migration task into two synergistic stages: evolution path retrieval and path-informed code generation. Our approach constructs static and dynamic API graphs to model intra-version structures and cross-version transitions, enabling structured reasoning over API evolution. Both modules are trained with synthetic supervision automatically derived from real-world API diffs, ensuring scalability and minimal human effort. Extensive experiments across single-package and multi-package benchmarks demonstrate that our framework significantly improves migration accuracy, controllability, and execution success over standard LLM baselines. The source code and datasets are available at: https://github.com/kangjz1203/KCoEvo.

CARD: Towards Conditional Design of Multi-agent Topological Structures

Large language model (LLM)-based multi-agent systems have shown strong capabilities in tasks such as code generation and collaborative reasoning. However, the effectiveness and robustness of these systems critically depend on their communication topology, which is often fixed or statically learned, ignoring real-world dynamics such as model upgrades, API (or tool) changes, or knowledge source variability. To address this limitation, we propose CARD (Conditional Agentic Graph Designer), a conditional graph-generation framework that instantiates AMACP, a protocol for adaptive multi-agent communication. CARD explicitly incorporates dynamic environmental signals into graph construction, enabling topology adaptation at both training and runtime. Through a conditional variational graph encoder and environment-aware optimization, CARD produces communication structures that are both effective and resilient to shifts in model capability or resource availability. Empirical results on HumanEval, MATH, and MMLU demonstrate that CARD consistently outperforms static and prompt-based baselines, achieving higher accuracy and robustness across diverse conditions. The source code is available at: https://github.com/Warma10032/CARD.

Disco: Densely-overlapping Cell Instance Segmentation via Adjacency-aware Collaborative Coloring

Accurate cell instance segmentation is foundational for digital pathology analysis. Existing methods based on contour detection and distance mapping still face significant challenges in processing complex and dense cellular regions. Graph coloring-based methods provide a new paradigm for this task, yet the effectiveness of this paradigm in real-world scenarios with dense overlaps and complex topologies has not been verified. Addressing this issue, we release a large-scale dataset GBC-FS 2025, which contains highly complex and dense sub-cellular nuclear arrangements. We conduct the first systematic analysis of the chromatic properties of cell adjacency graphs across four diverse datasets and reveal an important discovery: most real-world cell graphs are non-bipartite, with a high prevalence of odd-length cycles (predominantly triangles). This makes simple 2-coloring theory insufficient for handling complex tissues, while higher-chromaticity models would cause representational redundancy and optimization difficulties. Building on this observation of complex real-world contexts, we propose Disco (Densely-overlapping Cell Instance Segmentation via Adjacency-aware COllaborative Coloring), an adjacency-aware framework based on the "divide and conquer" principle. It uniquely combines a data-driven topological labeling strategy with a constrained deep learning system to resolve complex adjacency conflicts. First, "Explicit Marking" strategy transforms the topological challenge into a learnable classification task by recursively decomposing the cell graph and isolating a "conflict set." Second, "Implicit Disambiguation" mechanism resolves ambiguities in conflict regions by enforcing feature dissimilarity between different instances, enabling the model to learn separable feature representations.

PRPO: Aligning Process Reward with Outcome Reward in Policy Optimization

Policy optimization for large language models often suffers from sparse reward signals in multi-step reasoning tasks. Critic-free methods like GRPO assign a single normalized outcome reward to all tokens, providing limited guidance for intermediate reasoning . While Process Reward Models (PRMs) offer dense feedback, they risk premature collapse when used alone, as early low-reward tokens can drive policies toward truncated outputs. We introduce Process Relative Policy Optimization (PRPO), which combines outcome reliability with process-level guidance in a critic-free framework. PRPO segments reasoning sequences based on semantic clues, normalizes PRM scores into token-level advantages, and aligns their distribution with outcome advantages through location-parameter shift. On MATH500, PRPO improves Qwen2.5-Math-1.5B accuracy from 61.2% to 64.4% over GRPO using only eight rollouts and no value network, demonstrating efficient fine-grained credit assignment within critic-free optimization. Code is available at: https://github.com/SchumiDing/srpocode

Tracing the Heart's Pathways: ECG Representation Learning from a Cardiac Conduction Perspective

The multi-lead electrocardiogram (ECG) stands as a cornerstone of cardiac diagnosis. Recent strides in electrocardiogram self-supervised learning (eSSL) have brightened prospects for enhancing representation learning without relying on high-quality annotations. Yet earlier eSSL methods suffer a key limitation: they focus on consistent patterns across leads and beats, overlooking the inherent differences in heartbeats rooted in cardiac conduction processes, while subtle but significant variations carry unique physiological signatures. Moreover, representation learning for ECG analysis should align with ECG diagnostic guidelines, which progress from individual heartbeats to single leads and ultimately to lead combinations. This sequential logic, however, is often neglected when applying pre-trained models to downstream tasks. To address these gaps, we propose CLEAR-HUG, a two-stage framework designed to capture subtle variations in cardiac conduction across leads while adhering to ECG diagnostic guidelines. In the first stage, we introduce an eSSL model termed Conduction-LEAd Reconstructor (CLEAR), which captures both specific variations and general commonalities across heartbeats. Treating each heartbeat as a distinct entity, CLEAR employs a simple yet effective sparse attention mechanism to reconstruct signals without interference from other heartbeats. In the second stage, we implement a Hierarchical lead-Unified Group head (HUG) for disease diagnosis, mirroring clinical workflow. Experimental results across six tasks show a 6.84% improvement, validating the effectiveness of CLEAR-HUG. This highlights its ability to enhance representations of cardiac conduction and align patterns with expert diagnostic guidelines.

BiPETE: A Bi-Positional Embedding Transformer Encoder for Risk Assessment of Alcohol and Substance Use Disorder with Electronic Health Records

Transformer-based deep learning models have shown promise for disease risk prediction using electronic health records(EHRs), but modeling temporal dependencies remains a key challenge due to irregular visit intervals and lack of uniform structure. We propose a Bi-Positional Embedding Transformer Encoder or BiPETE for single-disease prediction, which integrates rotary positional embeddings to encode relative visit timing and sinusoidal embeddings to preserve visit order. Without relying on large-scale pretraining, BiPETE is trained on EHR data from two mental health cohorts-depressive disorder and post-traumatic stress disorder (PTSD)-to predict the risk of alcohol and substance use disorders (ASUD). BiPETE outperforms baseline models, improving the area under the precision-recall curve (AUPRC) by 34% and 50% in the depression and PTSD cohorts, respectively. An ablation study further confirms the effectiveness of the dual positional encoding strategy. We apply the Integrated Gradients method to interpret model predictions, identifying key clinical features associated with ASUD risk and protection, such as abnormal inflammatory, hematologic, and metabolic markers, as well as specific medications and comorbidities. Overall, these key clinical features identified by the attribution methods contribute to a deeper understanding of the risk assessment process and offer valuable clues for mitigating potential risks. In summary, our study presents a practical and interpretable framework for disease risk prediction using EHR data, which can achieve strong performance.