SCALPEL: Semantic Cross-modal Alignment via LLM-Powered Encoder Learning for Medical Vision-Language Representation

Vision-language pre-training (VLP) serves as a cornerstone for medical multimodal representation learning. However, existing medical VLP frameworks are often constrained by the limited context windows and shallow representational capacities of lightweight text encoders when processing lengthy, terminology-dense clinical reports. While integrating medical large language models (LLMs) offers unprecedented clinical reasoning capabilities, it introduces three major bottlenecks: (i) the anisotropic representational collapse of generative LLMs under standard contrastive objectives, (ii) the prohibitive memory overhead of joint end-to-end training with large batch sizes, and (iii) the medical hallucinations induced by vanilla contrastive losses that ignore fine-grained anatomical laterality and negation modifiers. To address these challenges, we propose \textbf{SCALPEL}, a \textbf{S}emantic \textbf{C}ross-modal \textbf{A}lignment framework via \textbf{L}LM-\textbf{P}owered \textbf{E}ncoder \textbf{L}earning. First, Clinical Report Contrastive fine-tuning converts a generative LLM into an isotropic encoder via domain-specific clinical text adaptation. Second, an asymmetric alignment strategy leverages offline feature caching to enable efficient training. Critically, we formulate an Anatomy-Negation Aware Objective that explicitly penalizes mismatched image-text pairs involving laterality confusion or false negations. Extensive experiments across MIMIC-CXR, CheXpert, and IU X-Ray benchmarks demonstrate that SCALPEL achieves state-of-the-art performance in cross-modal retrieval, zero-shot disease classification and medical visual question answering.

Towards Dual-Brain Minimal Sufficient Representation for Vision-Language Navigation

Vision-and-Language Navigation in continuous environments (VLN-CE) requires an agent to ground language in egocentric observations and plan in unseen scenes. Although recent multimodal large models and world-model-based methods have improved navigation, they often preserve excessive task-irrelevant detail, weakening generalization and increasing computational burden. We propose BrainNav, a navigation framework grounded in the Principle of Minimal Sufficiency. BrainNav consists of three components: a Logical Anchor Model that implements instruction-aware selective perception to suppress environmental noise, a Minimalist Constraint Alignment module that serves as a compact cross-modal bottleneck, efficiently synchronizing discrete linguistic intent with continuous latent dynamics while filtering out redundant information, and a Compression World Model that predicts action-conditioned states within a condensed, low-rank latent space. These modules align semantic intent with spatial perception, enhancing the agent's robustness and efficiency in complex tasks. Experiments show that BrainNav improves over prior SOTA by 2.0 % / 1.0 in SR/SPL on R2R-CE val-unseen and 0.94 % / 0.78 on RxR-CE val-unseen. These results indicate that minimally sufficient world representations provide an effective foundation for robust VLN.