Evidence-Grounded AI for Musculoskeletal Care

Musculoskeletal diseases are among the leading causes of disability worldwide and create the greatest global need for rehabilitation. Because recovery, remodelling and degeneration often unfold over months to years, musculoskeletal care requires longitudinal management that repeatedly integrates evolving patient evidence, external medical knowledge and stage-specific functional goals. In routine practice, this evidence is fragmented across visits, departments and hospital systems, limiting individualized, evidence-based care. Here we report OrthoPilot, a clinical artificial intelligence system powered by a large language model that integrates hospital data streams with authoritative external knowledge for continuous musculoskeletal management. OrthoPilot autonomously retrieves real-time imaging, laboratory, pathology and order data and converts evolving patient states into evidence-based decisions from admission diagnosis to rehabilitation planning. We established a specialist-validated benchmark from real-world electronic health records spanning 1,000 disease codes. In a reader study across the complete care pathway, OrthoPilot was compared with 81 orthopaedic physicians and surpassed experts with 25 years of experience in diagnostic reasoning, clinical decision-making and management planning. It also outperformed all evaluated intelligent systems across 60 external clinical centres. In a prospective study of 1,870 complex cases, OrthoPilot increased full-chain management success by 10.6%. During an 8-month randomised deployment involving 8,240 inpatients, it increased cumulative cases per bed by 9.7% and improved patient-reported access to health information. These results move clinical AI from predicting isolated events toward executing longitudinal management across complete musculoskeletal care pathways.

Verifiable User Simulation for Search and Recommendation Systems

Large-language-model (LLM) based user simulation is increasingly adopted for evaluating search engines, recommender systems, and retrieval-augmented generation pipelines, yet most simulators remain opaque: it is difficult to determine why a simulated user made a particular choice or whether that choice is consistent with the intended user profile. Compounding this, recent research shows that LLMs can produce biased or discriminatory responses depending on user background characteristics such as language, education level, and cultural context, raising concerns about the equitable treatment of minority and disadvantaged groups. This half-day, in-person tutorial introduces a proposed design-and-audit framework that treats a user simulator as a verifiable engineering artefact composed of seven auditable components - structured Persona, task-aware Contract, matched human-vs-agent Execution, auditable Trace, persona-aligned Verification, structured Feedback, and a Refinement loop that updates personas and contracts. Through two hands-on mini-labs on recommendation-list evaluation and search-query formulation, participants will inspect simulator behaviour end-to-end, distinguish diagnostic discrepancy analysis from statistical validation, and apply checks for fidelity, credibility, and demographic bias. The tutorial targets information retrieval and recommender systems researchers and practitioners interested in user behaviour simulation and responsible AI.

Bridging Brain and Semantics: A Hierarchical Framework for Semantically Enhanced fMRI-to-Video Reconstruction

Reconstructing dynamic visual experiences as videos from functional magnetic resonance imaging (fMRI) is pivotal for advancing the understanding of neural processes. However, current fMRI-to-video reconstruction methods are hindered by a semantic gap between noisy fMRI signals and the rich content of videos, stemming from a reliance on incomplete semantic embeddings that neither capture video-specific cues (e.g., actions) nor integrate prior knowledge. To this end, we draw inspiration from the dual-pathway processing mechanism in human brain and introduce CineNeuron, a novel hierarchical framework for semantically enhanced video reconstruction from fMRI signals with two synergistic stages. First, a bottom-up semantic enrichment stage maps fMRI signals to a rich embedding space that comprehensively captures textual semantics, image contents, action concepts, and object categories. Second, a top-down memory integration stage utilizes the proposed Mixture-of-Memories method to dynamically select relevant "memories" from previously seen data and fuse them with the fMRI embedding to refine the video reconstruction. Extensive experimental results on two fMRI-to-video benchmarks demonstrate that CineNeuron surpasses state-of-the-art methods across various metrics.

Task-Aware Automated User Profile Generation for Recommendation Simulation Using Large Language Models

Large Language Model (LLM)-based agent simulation has emerged as a promising approach to meet the increasing demand for real-time and rigorous evaluation in modern recommender systems. A typical LLM-driven simulation framework comprises three essential components: the profile module, memory module, and action module. However, existing studies have primarily concentrated on enhancing the memory and action modules, with limited attention to profile generation, which plays a pivotal role in ensuring realistic agent behaviours and aligning simulated interactions with real user dynamics. Moreover, the scarcity of datasets specifically designed for recommendation simulations has led to heavy reliance on manually crafted profiles, significantly limiting the scalability and generalisability of simulation frameworks across different datasets. To address these challenges, this work proposes an Automated Profile Generation Framework for Recommendation Simulation, APG4RecSim, that constructs realistic, coherent, and robust user profiles with minimal supervision. Extensive experiments on three benchmark datasets demonstrate that APG4RecSim achieves the best overall performance on discrimination, ranking, and rating tasks, improving ranking quality by up to 7% in nDCG@10 and reducing rating distribution divergence by 8% in JSD compared to existing profile-generation baselines. Beyond overall performance gains, our results show that profiles generated by APG4RecSim are resilient to popularity- and position-induced biases and maintain stable performance across datasets and different LLMs.

MedProbeBench: Systematic Benchmarking at Deep Evidence Integration for Expert-level Medical Guideline

Recent advances in deep research systems enable large language models to retrieve, synthesize, and reason over large-scale external knowledge. In medicine, developing clinical guidelines critically depends on such deep evidence integration. However, existing benchmarks fail to evaluate this capability in realistic workflows requiring multi-step evidence integration and expert-level judgment. To address this gap, we introduce MedProbeBench, the first benchmark leveraging high-quality clinical guidelines as expert-level references. Medical guidelines, with their rigorous standards in neutrality and verifiability, represent the pinnacle of medical expertise and pose substantial challenges for deep research agents. For evaluation, we propose MedProbe-Eval, a comprehensive evaluation framework featuring: (1) Holistic Rubrics with 1,200+ task-adaptive rubric criteria for comprehensive quality assessment, and (2) Fine-grained Evidence Verification for rigorous validation of evidence precision, grounded in 5,130+ atomic claims. Evaluation of 17 LLMs and deep research agents reveals critical gaps in evidence integration and guideline generation, underscoring the substantial distance between current capabilities and expert-level clinical guideline development. Project: https://github.com/uni-medical/MedProbeBench

MMRareBench: A Rare-Disease Multimodal and Multi-Image Medical Benchmark

Multimodal large language models (MLLMs) have advanced clinical tasks for common conditions, but their performance on rare diseases remains largely untested. In rare-disease scenarios, clinicians often lack prior clinical knowledge, forcing them to rely strictly on case-level evidence for clinical judgments. Existing benchmarks predominantly evaluate common-condition, single-image settings, leaving multimodal and multi-image evidence integration under rare-disease data scarcity systematically unevaluated. We introduce MMRareBench, to our knowledge the first rare-disease benchmark jointly evaluating multimodal and multi-image clinical capability across four workflow-aligned tracks: diagnosis, treatment planning, cross-image evidence alignment, and examination suggestion. The benchmark comprises 1,756 question-answer pairs with 7,958 associated medical images curated from PMC case reports, with Orphanet-anchored ontology alignment, track-specific leakage control, evidence-grounded annotations, and a two-level evaluation protocol. A systematic evaluation of 23 MLLMs reveals fragmented capability profiles and universally low treatment-planning performance, with medical-domain models trailing general-purpose MLLMs substantially on multi-image tracks despite competitive diagnostic scores. These patterns are consistent with a capacity dilution effect: medical fine-tuning can narrow the diagnostic gap but may erode the compositional multi-image capability that rare-disease evidence integration demands.

PHASOR: Anatomy- and Phase-Consistent Volumetric Diffusion for CT Virtual Contrast Enhancement

Contrast-enhanced computed tomography (CECT) is pivotal for highlighting tissue perfusion and vascularity, yet its clinical ubiquity is impeded by the invasive nature of contrast agents and radiation risks. While virtual contrast enhancement (VCE) offers an alternative to synthesizing CECT from non-contrast CT (NCCT), existing methods struggle with anatomical heterogeneity and spatial misalignment, leading to inconsistent enhancement patterns and incorrect details. This paper introduces PHASOR, a volumetric diffusion framework for high-fidelity CT VCE. By treating CT volumes as coherent sequences, we leverage a video diffusion model to enhance structural coherence and volumetric accuracy. To ensure anatomy-phase consistent synthesis, we introduce two complementary modules. First, anatomy-routed mixture-of-experts (AR-MoE) anchors distinct enhancement patterns to anatomical semantics, with organ-specific memory to capture salient details. Second, intensity-phase aware representation alignment (IP-REPA) highlights intricate contrast signals while mitigating the impact of imperfect spatial alignment. Extensive experiments across three datasets demonstrate that PHASOR significantly outperforms state-of-the-art methods in both synthesis quality and enhancement accuracy.

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.

MedQ-Engine: A Closed-Loop Data Engine for Evolving MLLMs in Medical Image Quality Assessment

Medical image quality assessment (Med-IQA) is a prerequisite for clinical AI deployment, yet multimodal large language models (MLLMs) still fall substantially short of human experts, particularly when required to provide descriptive assessments with clinical reasoning beyond simple quality scores. However, improving them is hindered by the high cost of acquiring descriptive annotations and by the inability of one-time data collection to adapt to the model's evolving weaknesses. To address these challenges, we propose MedQ-Engine, a closed-loop data engine that iteratively evaluates the model to discover failure prototypes via data-driven clustering, explores a million-scale image pool using these prototypes as retrieval anchors with progressive human-in-the-loop annotation, and evolves through quality-assured fine-tuning, forming a self-improving cycle. Models are evaluated on complementary perception and description tasks. An entropy-guided routing mechanism triages annotations to minimize labeling cost. Experiments across five medical imaging modalities show that MedQ-Engine elevates an 8B-parameter model to surpass GPT-4o by over 13% and narrow the gap with human experts to only 4.34%, using only 10K annotations with more than 4x sample efficiency over random sampling.

MedQ-UNI: Toward Unified Medical Image Quality Assessment and Restoration via Vision-Language Modeling

Existing medical image restoration (Med-IR) methods are typically modality-specific or degradation-specific, failing to generalize across the heterogeneous degradations encountered in clinical practice. We argue this limitation stems from the isolation of Med-IR from medical image quality assessment (Med-IQA), as restoration models without explicit quality understanding struggle to adapt to diverse degradation types across modalities. To address these challenges, we propose MedQ-UNI, a unified vision-language model that follows an assess-then-restore paradigm, explicitly leveraging Med-IQA to guide Med-IR across arbitrary modalities and degradation types. MedQ-UNI adopts a multimodal autoregressive dual-expert architecture with shared attention: a quality assessment expert first identifies degradation issues through structured natural language descriptions, and a restoration expert then conditions on these descriptions to perform targeted image restoration. To support this paradigm, we construct a large-scale dataset of approximately 50K paired samples spanning three imaging modalities and five restoration tasks, each annotated with structured quality descriptions for joint Med-IQA and Med-IR training, along with a 2K-sample benchmark for evaluation. Extensive experiments demonstrate that a single MedQ-UNI model, without any task-specific adaptation, achieves state-of-the-art restoration performance across all tasks while generating superior descriptions, confirming that explicit quality understanding meaningfully improves restoration fidelity and interpretability.