SAGE: Sustainable Agent-Guided Expert-tuning for Culturally Attuned Translation in Low-Resource Southeast Asia

The vision of an inclusive World Wide Web is impeded by a severe linguistic divide, particularly for communities in low-resource regions of Southeast Asia. While large language models (LLMs) offer a potential solution for translation, their deployment in data-poor contexts faces a dual challenge: the scarcity of high-quality, culturally relevant data and the prohibitive energy costs of training on massive, noisy web corpora. To resolve the tension between digital inclusion and environmental sustainability, we introduce Sustainable Agent-Guided Expert-tuning (SAGE). This framework pioneers an energy-aware paradigm that prioritizes the "right data" over "big data". Instead of carbon-intensive training on unfiltered datasets, SAGE employs a reinforcement learning (RL) agent, optimized via Group Relative Policy Optimization (GRPO), to autonomously curate a compact training set. The agent utilizes a semantic reward signal derived from a small, expert-constructed set of community dialogues to filter out noise and cultural misalignment. We then efficiently fine-tune open-source LLMs on this curated data using Low-Rank Adaptation (LoRA). We applied SAGE to translation tasks between English and seven low-resource languages (LRLs) in Southeast Asia. Our approach establishes new state-of-the-art performance on BLEU-4 and COMET-22 metrics, effectively capturing local linguistic nuances. Crucially, SAGE surpasses baselines trained on full datasets while reducing data usage by 97.1% and training energy consumption by 95.2%. By delivering high-performance models with a minimal environmental footprint, SAGE offers a scalable and responsible pathway to bridge the digital divide in the Global South.

VGS-Decoding: Visual Grounding Score Guided Decoding for Hallucination Mitigation in Medical VLMs

Medical Vision-Language Models (VLMs) often hallucinate by generating responses based on language priors rather than visual evidence, posing risks in clinical applications. We propose Visual Grounding Score Guided Decoding (VGS-Decoding), a training-free method to mitigate hallucinations during inference. Our key insight is that hallucinated tokens maintain or increase their probability when visual information is degraded, while visually grounded tokens decrease in probability. We introduce the Visual Grounding Score (VGS), which measures each token's visual dependency by comparing distributions from original and distorted images. During decoding, we reweight probabilities by amplifying visually grounded tokens while suppressing hallucinations. Unlike fixed-weight contrastive methods, VGS-Decoding provides per-token adaptive control. Experiments on MIMIC-Diff-VQA and VQA-RAD across LLaVA-Med, CheXagent, and MedGemma demonstrate consistent improvements, with up to +9.12% overall gain and $+8.98\%$ in open-ended recall, while introducing only $2\times$ inference overhead and no additional training, making it practical for clinical deployment. Upon acceptance, code will be released publicly to facilitate reproducibility.

TuLaBM: Tumor-Biased Latent Bridge Matching for Contrast-Enhanced MRI Synthesis

Contrast-enhanced magnetic resonance imaging (CE-MRI) plays a crucial role in brain tumor assessment; however, its acquisition requires gadolinium-based contrast agents (GBCAs), which increase costs and raise safety concerns. Consequently, synthesizing CE-MRI from non-contrast MRI (NC-MRI) has emerged as a promising alternative. Early Generative Adversarial Network (GAN)-based approaches suffered from instability and mode collapse, while diffusion models, despite impressive synthesis quality, remain computationally expensive and often fail to faithfully reproduce critical tumor contrast patterns. To address these limitations, we propose Tumor-Biased Latent Bridge Matching (TuLaBM), which formulates NC-to-CE MRI translation as Brownian bridge transport between source and target distributions in a learned latent space, enabling efficient training and inference. To enhance tumor-region fidelity, we introduce a Tumor-Biased Attention Mechanism (TuBAM) that amplifies tumor-relevant latent features during bridge evolution, along with a boundary-aware loss that constrains tumor interfaces to improve margin sharpness. While bridge matching has been explored for medical image translation in pixel space, our latent formulation substantially reduces computational cost and inference time. Experiments on BraTS2023-GLI (BraSyn) and Cleveland Clinic (in-house) liver MRI dataset show that TuLaBM consistently outperforms state-of-the-art baselines on both whole-image and tumor-region metrics, generalizes effectively to unseen liver MRI data in zero-shot and fine-tuned settings, and achieves inference times under 0.097 seconds per image.

DeLo: Dual Decomposed Low-Rank Experts Collaboration for Continual Missing Modality Learning

Adapting Large Multimodal Models (LMMs) to real-world scenarios poses the dual challenges of learning from sequential data streams while handling frequent modality incompleteness, a task known as Continual Missing Modality Learning (CMML). However, existing works on CMML have predominantly relied on prompt tuning, a technique that struggles with this task due to cross-task interference between its learnable prompts in their shared embedding space. A naive application of Low-Rank Adaptation (LoRA) with modality-shared module will also suffer modality interference from competing gradients. To this end, we propose DeLo, the first framework to leverage a novel dual-decomposed low-rank expert architecture for CMML. Specifically, this architecture resolves modality interference through decomposed LoRA expert, dynamically composing LoRA update matrix with rank-one factors from disentangled modality-specific factor pools. Embedded within a task-partitioned framework that structurally prevents catastrophic forgetting, this expert system is supported by two key mechanisms: a Cross-Modal Guided Routing strategy to handle incomplete data and a Task-Key Memory for efficient, task-agnostic inference. Extensive experiments on established CMML benchmarks demonstrate that our method significantly outperforms state-of-the-art approaches. This highlights the value of a principled, architecturally-aware LoRA design for real-world multimodal challenges.

ClinCoT: Clinical-Aware Visual Chain-of-Thought for Medical Vision Language Models

Medical Vision-Language Models have shown promising potential in clinical decision support, yet they remain prone to factual hallucinations due to insufficient grounding in localized pathological evidence. Existing medical alignment methods primarily operate at the response level through preference optimization, improving output correctness but leaving intermediate reasoning weakly connected to visual regions. Although chain-of-thought (CoT) enhances multimodal reasoning, it remains largely text-centric, limiting effective integration of clinical visual cues. To address this gap, we propose ClinCoT, a clinical-aware visual chain-of-thought framework that transforms preference optimization from response-level correction to visual-driven reasoning. We introduce an automatic data generation pipeline that constructs clinically grounded preference pairs through reasoning with hypotheses-driven region proposals. Multiple Med-LLMs evaluators rank and assign scores to each response, and these rankings serve as supervision to train the target model. We further introduce a scoring-based margin-aware optimization strategy that incorporates both preference ranking and score difference to refine region-level reasoning trajectories. To maintain alignment as the model's policy evolves during training, we adopt an iterative learning scheme that dynamically regenerates preference data. Extensive experiments on three medical VQA and report generation benchmarks demonstrate that ClinCoT consistently improves factual grounding and achieves superior performance compared with existing preference-based alignment methods.

CMSA-Net: Causal Multi-scale Aggregation with Adaptive Multi-source Reference for Video Polyp Segmentation

Video polyp segmentation (VPS) is an important task in computer-aided colonoscopy, as it helps doctors accurately locate and track polyps during examinations. However, VPS remains challenging because polyps often look similar to surrounding mucosa, leading to weak semantic discrimination. In addition, large changes in polyp position and scale across video frames make stable and accurate segmentation difficult. To address these challenges, we propose a robust VPS framework named CMSA-Net. The proposed network introduces a Causal Multi-scale Aggregation (CMA) module to effectively gather semantic information from multiple historical frames at different scales. By using causal attention, CMA ensures that temporal feature propagation follows strict time order, which helps reduce noise and improve feature reliability. Furthermore, we design a Dynamic Multi-source Reference (DMR) strategy that adaptively selects informative and reliable reference frames based on semantic separability and prediction confidence. This strategy provides strong multi-frame guidance while keeping the model efficient for real-time inference. Extensive experiments on the SUN-SEG dataset demonstrate that CMSA-Net achieves state-of-the-art performance, offering a favorable balance between segmentation accuracy and real-time clinical applicability.

Mitigating Preference Leakage via Strict Estimator Separation for Normative Generative Ranking

In Generative Information Retrieval (GenIR), the bottleneck has shifted from generation to the selection of candidates, particularly for normative criteria such as cultural relevance. Current LLM-as-a-Judge evaluations often suffer from circularity and preference leakage, where overlapping supervision and evaluation models inflate performance. We address this by formalising cultural relevance as a within-query ranking task and introducing a leakage-free two-judge framework that strictly separates supervision (Judge B) from evaluation (Judge A). On a new benchmark of 33,052 (NGR-33k) culturally grounded stories, we find that while classical baselines yield only modest gains, a dense bi-encoder distilled from a Judge-B-supervised Cross-Encoder is highly effective. Although the Cross-Encoder provides a strong supervision signal for distillation, the distilled BGE-M3 model substantially outperforms it under leakage-free Judge~A evaluation. We validate our framework on the human-curated Moral Stories dataset, showing strong alignment with human norms. Our results demonstrate that rigorous evaluator separation is a prerequisite for credible GenIR evaluation, proving that subtle cultural preferences can be distilled into efficient rankers without leakage.

DoAtlas-1: A Causal Compilation Paradigm for Clinical AI

Medical foundation models generate narrative explanations but cannot quantify intervention effects, detect evidence conflicts, or validate literature claims, limiting clinical auditability. We propose causal compilation, a paradigm that transforms medical evidence from narrative text into executable code. The paradigm standardizes heterogeneous research evidence into structured estimand objects, each explicitly specifying intervention contrast, effect scale, time horizon, and target population, supporting six executable causal queries: do-calculus, counterfactual reasoning, temporal trajectories, heterogeneous effects, mechanistic decomposition, and joint interventions. We instantiate this paradigm in DoAtlas-1, compiling 1,445 effect kernels from 754 studies through effect standardization, conflict-aware graph construction, and real-world validation (Human Phenotype Project, 10,000 participants). The system achieves 98.5% canonicalization accuracy and 80.5% query executability. This paradigm shifts medical AI from text generation to executable, auditable, and verifiable causal reasoning.

LATA: Laplacian-Assisted Transductive Adaptation for Conformal Uncertainty in Medical VLMs

Medical vision-language models (VLMs) are strong zero-shot recognizers for medical imaging, but their reliability under domain shift hinges on calibrated uncertainty with guarantees. Split conformal prediction (SCP) offers finite-sample coverage, yet prediction sets often become large (low efficiency) and class-wise coverage unbalanced-high class-conditioned coverage gap (CCV), especially in few-shot, imbalanced regimes; moreover, naively adapting to calibration labels breaks exchangeability and voids guarantees. We propose \texttt{\textbf{LATA}} (Laplacian-Assisted Transductive Adaptation), a \textit{training- and label-free} refinement that operates on the joint calibration and test pool by smoothing zero-shot probabilities over an image-image k-NN graph using a small number of CCCP mean-field updates, preserving SCP validity via a deterministic transform. We further introduce a \textit{failure-aware} conformal score that plugs into the vision-language uncertainty (ViLU) framework, providing instance-level difficulty and label plausibility to improve prediction set efficiency and class-wise balance at fixed coverage. \texttt{\textbf{LATA}} is black-box (no VLM updates), compute-light (windowed transduction, no backprop), and includes an optional prior knob that can run strictly label-free or, if desired, in a label-informed variant using calibration marginals once. Across \textbf{three} medical VLMs and \textbf{nine} downstream tasks, \texttt{\textbf{LATA}} consistently reduces set size and CCV while matching or tightening target coverage, outperforming prior transductive baselines and narrowing the gap to label-using methods, while using far less compute. Comprehensive ablations and qualitative analyses show that \texttt{\textbf{LATA}} sharpens zero-shot predictions without compromising exchangeability.

MedMO: Grounding and Understanding Multimodal Large Language Model for Medical Images

Multimodal large language models (MLLMs) have rapidly advanced, yet their adoption in medicine remains limited by gaps in domain coverage, modality alignment, and grounded reasoning. In this work, we introduce MedMO, a medical foundation model built upon a generalized MLLM architecture and trained exclusively on large-scale, domain-specific data. MedMO follows a multi-stage training recipe: (i) cross-modal pretraining to align heterogeneous visual encoders with a medical language backbone; (ii) instruction tuning on multi-task supervision that spans captioning, VQA, report generation, retrieval, and grounded disease localization with bounding boxes; and (iii) reinforcement learning with verifiable rewards that combine factuality checks with a box-level GIoU reward to strengthen spatial grounding and step-by-step reasoning in complex clinical scenarios. MedMO consistently outperforms strong open-source medical MLLMs across multiple modalities and tasks. On VQA benchmarks, MedMO achieves an average accuracy improvement of +13.7% over the baseline and performs within 1.9% of the SOTA Fleming-VL. For text-based QA, it attains +6.9% over the baseline and +14.5% over Fleming-VL. In medical report generation, MedMO delivers significant gains in both semantic and clinical accuracy. Moreover, it exhibits strong grounding capability, achieving an IoU improvement of +40.4 over the baseline and +37.0% over Fleming-VL, underscoring its robust spatial reasoning and localization performance. Evaluations across radiology, ophthalmology, and pathology-microscopy confirm MedMO's broad cross-modality generalization. We release two versions of MedMO: 4B and 8B. Project is available at https://genmilab.github.io/MedMO-Page