DeepBD: A Grounded Agentic Workflow for Variant Prioritization and Diagnosis of Genetic Birth Defects

Birth defects are a major cause of fetal loss, neonatal morbidity and long-term disability. In the subset with suspected genetic etiologies, exome and genome sequencing have moved many cases from variant detection to post-sequencing interpretation: clinicians must rank patient-specific candidate variants under incomplete fetal or infant phenotypes and heterogeneous evidence from population genetics, variant-effect prediction, gene-disease validity, phenotype ontologies, cellular and pathway context, protein structure and clinical literature. We present DeepBD, a grounded agentic workflow for variant prioritization and diagnostic interpretation of genetic birth defects. DeepBD organizes the workflow into LLM-assisted case structuring, a pretrained evidence engine, specialist evidence modules and a grounded diagnostic review layer. The evidence engine learns patient-specific variant scores from structured rule evidence, sequence and variant-effect representations and phenotype-conditioned biological context, whereas specialist modules and the agentic layer provide tool-based refinement, candidate-pool review and diagnosis-oriented synthesis from ranked candidates. Developed using an in-house fetal and infant cohort comprising 18,622 cases, DeepBD achieved Recall@1/3/5/10 of 0.658/0.882/0.912/0.929 on an internal held-out solved-case benchmark, outperforming standalone Exomiser, DeepRare and prompted LLM reranking baselines evaluated on Exomiser-derived top-20 candidate variants. Ablation and overlap analyses show that rule evidence, mechanistic context, and specialist refinement provide complementary signals. These findings support a grounded agentic workflow that separates evidence integration, tool-based refinement, and LLM-assisted diagnostic review for retrospective variant prioritization in genetic birth defects.

Sparsity Curse: Understanding RLVR Model Parameter Space from Model Merging

Reinforcement Learning with Verifiable Reward (RLVR) has emerged as a powerful post-training paradigm that surpasses Supervised Fine-Tuning (SFT) in eliciting reasoning intelligence and resisting catastrophic forgetting. Recent studies further reveal that RLVR induces highly sparse and off-principal parameter updates compared to SFT. This naturally raises the question: does such sparsity make RLVR models more amenable to model merging? If so, model merging would offer a scalable, training-free path to aggregate diverse reasoning capabilities from independently trained RLVR models. Surprisingly, we find the opposite, uncovering a sparsity curse: the sparse RLVR updates are spread farther apart in parameter space, forming near-orthogonal shortcuts that make aggregation inherently fragile. This is likely rooted in the stochasticity of RL optimization and the diversity of emergent reasoning patterns. Unlike SFT models that converge to shared, flat basins and merge naturally, RLVR models suffer severe degradation under standard merging methods. Through systematic empirical analysis of the update geometry, we characterize the mechanisms behind this failure and propose Sensitivity-aware Resolving Merging (SAR-Merging), a merging recipe tailored for the unique structure of RLVR parameter spaces. SAR-Merging resolves conflicts in overlapping update regions via Fisher Information-based sensitivity arbitration, followed by magnitude-aware sparsification and rescaling to preserve fragile reasoning pathways. Experiments on mathematical and coding benchmarks demonstrate that SAR-Merging substantially outperforms existing merging methods on RLVR models, enabling both single-task enhancement and multi-capability fusion.

Medical world models: representing medical states, modelling clinical dynamics and guiding intervention policies

Medical diagnosis and treatment are dynamic processes in which patient states evolve over time and clinical interventions alter future outcomes. Although current medical AI can detect disease, estimate risk and generate reports, many systems still return static labels or scores, offering limited insight into how illness may progress or how alternative interventions may reshape its trajectory. Medical world models adapt the world-model idea from artificial intelligence to healthcare by learning internal simulators of patient-state dynamics. Their long-term goal is to help clinicians anticipate deterioration, compare treatment-conditioned futures and tailor care to individual patients. Yet relevant work remains scattered across foundation models, longitudinal modelling, disease simulation, treatment-effect estimation, reinforcement learning and digital twins. To bridge this gap, this review outlines a roadmap for advancing medical AI from isolated diagnosis and prediction toward medical world models that simulate disease evolution and support intervention decisions. This roadmap is organized around three coupled capabilities: patient-state construction, clinical dynamics modelling and intervention decision support. Across representative systems, the comparison highlights what each capability contributes and how partial components can be integrated into more mature perception--dynamics--planning systems. Finally, we identify the challenges involved in turning plausible rollouts into clinically useful simulators. Related literature is available at https://github.com/1999kevin/awesome_medical_world_models.

Towards Scalable Lightweight GUI Agents via Multi-role Orchestration

Autonomous Graphical User Interface (GUI) agents powered by Multimodal Large Language Models (MLLMs) enable digital automation on end-user devices. While scaling both parameters and data has yielded substantial gains, advanced methods still suffer from prohibitive deployment costs on resource-constrained devices. When facing complex in-the-wild scenarios, lightweight GUI agents are bottlenecked by limited capacity and poor task scalability under end-to-end episodic learning, impeding adaptation to multi-agent systems (MAS), while training multiple skill-specific experts remains costly. Can we strike an effective trade-off in this cost-scalability dilemma, enabling lightweight MLLMs to participate in realistic GUI workflows? To address these challenges, we propose the LAMO framework, which endows a lightweight MLLM with GUI-specific knowledge and task scalability, allowing multi-role orchestration to expand its capability boundary for GUI automation. LAMO combines role-oriented data synthesis with a two-stage training recipe: (i) supervised fine-tuning with Perplexity-Weighted Cross-Entropy optimization for knowledge distillation and visual perception enhancement, and (ii) reinforcement learning for role-oriented cooperative exploration. With LAMO, we develop a task-scalable native GUI agent, LAMO-3B, supporting monolithic execution and MAS-style orchestration. When paired with advanced planners as a plug-and-play policy executor, LAMO-3B can continuously benefit from planner advances, enabling a higher performance ceiling. Extensive static and online evaluations validate the effectiveness of our design.

Generalizable Self-Evolving Memory for Automatic Prompt Optimization

Automatic prompt optimization is a promising approach for adapting large language models (LLMs) to downstream tasks, yet existing methods typically search for a specific prompt specialized to a fixed task. This paradigm limits generalization across heterogeneous queries and prevents models from accumulating reusable prompting knowledge over time. In this paper, we propose MemAPO, a memory-driven framework that reconceptualizes prompt optimization as generalizable and self-evolving experience accumulation. MemAPO maintains a dual-memory mechanism that distills successful reasoning trajectories into reusable strategy templates while organizing incorrect generations into structured error patterns that capture recurrent failure modes. Given a new prompt, the framework retrieves both relevant strategies and failure patterns to compose prompts that promote effective reasoning while discouraging known mistakes. Through iterative self-reflection and memory editing, MemAPO continuously updates its memory, enabling prompt optimization to improve over time rather than restarting from scratch for each task. Experiments on diverse benchmarks show that MemAPO consistently outperforms representative prompt optimization baselines while substantially reducing optimization cost.

Learning Image-Text Matching with Optimal Partial Transport

Cross-modal matching, a fundamental task in bridging vision and language, has recently garnered substantial research interest. Despite the development of numerous methods aimed at quantifying the semantic relatedness between image-text pairs, these methods often fall short of achieving both outstanding performance and high efficiency. In this paper, we propose the crOss-Modal sInkhorn maTching (OMIT) network as an effective solution to effectively improving performance while maintaining efficiency. Rooted in the theoretical foundations of Optimal Transport, OMIT harnesses the capabilities of Cross-modal Mover's Distance to precisely compute the similarity between fine-grained visual and textual fragments, utilizing Sinkhorn iterations for efficient approximation. To further alleviate the issue of redundant alignments, we seamlessly integrate partial matching into OMIT, leveraging local-to-global similarities to eliminate the interference of irrelevant fragments. We conduct extensive evaluations of OMIT on two benchmark image-text retrieval datasets, namely Flickr30K and MS-COCO. The superior performance achieved by OMIT on both datasets unequivocally demonstrates its effectiveness in cross-modal matching. Furthermore, through comprehensive visualization analysis, we elucidate OMIT's inherent tendency towards focal matching, thereby shedding light on its efficacy. Our code is publicly available at https://github.com/ppanzx/OMIT.

LLM-Bootstrapped Targeted Finding Guidance for Factual MLLM-based Medical Report Generation

The automatic generation of medical reports utilizing Multimodal Large Language Models (MLLMs) frequently encounters challenges related to factual instability, which may manifest as the omission of findings or the incorporation of inaccurate information, thereby constraining their applicability in clinical settings. Current methodologies typically produce reports based directly on image features, which inherently lack a definitive factual basis. In response to this limitation, we introduce Fact-Flow, an innovative framework that separates the process of visual fact identification from the generation of reports. This is achieved by initially predicting clinical findings from the image, which subsequently directs the MLLM to produce a report that is factually precise. A pivotal advancement of our approach is a pipeline that leverages a Large Language Model (LLM) to autonomously create a dataset of labeled medical findings, effectively eliminating the need for expensive manual annotation. Extensive experimental evaluations conducted on two disease-focused medical datasets validate the efficacy of our method, demonstrating a significant enhancement in factual accuracy compared to state-of-the-art models, while concurrently preserving high standards of text quality.

Unsupervised Causal Prototypical Networks for De-biased Interpretable Dermoscopy Diagnosis

Despite the success of deep learning in dermoscopy image analysis, its inherent black-box nature hinders clinical trust, motivating the use of prototypical networks for case-based visual transparency. However, inevitable selection bias in clinical data often drives these models toward shortcut learning, where environmental confounders are erroneously encoded as predictive prototypes, generating spurious visual evidence that misleads medical decision-making. To mitigate these confounding effects, we propose CausalProto, an Unsupervised Causal Prototypical Network that fundamentally purifies the visual evidence chain. Framed within a Structural Causal Model, we employ an Information Bottleneck-constrained encoder to enforce strict unsupervised orthogonal disentanglement between pathological features and environmental confounders. By mapping these decoupled representations into independent prototypical spaces, we leverage the learned spurious dictionary to perform backdoor adjustment via do-calculus, transforming complex causal interventions into efficient expectation pooling to marginalize environmental noise. Extensive experiments on multiple dermoscopy datasets demonstrate that CausalProto achieves superior diagnostic performance and consistently outperforms standard black box models, while simultaneously providing transparent and high purity visual interpretability without suffering from the traditional accuracy compromise.

Directed Ordinal Diffusion Regularization for Progression-Aware Diabetic Retinopathy Grading

Diabetic Retinopathy (DR) progresses as a continuous and irreversible deterioration of the retina, following a well-defined clinical trajectory from mild to severe stages. However, most existing ordinal regression approaches model DR severity as a set of static, symmetric ranks, capturing relative order while ignoring the inherent unidirectional nature of disease progression. As a result, the learned feature representations may violate biological plausibility, allowing implausible proximity between non-consecutive stages or even reverse transitions. To bridge this gap, we propose Directed Ordinal Diffusion Regularization (D-ODR), which explicitly models the feature space as a directed flow by constructing a progression-constrained directed graph that strictly enforces forward disease evolution. By performing multi-scale diffusion on this directed structure, D-ODR imposes penalties on score inversions along valid progression paths, thereby effectively preventing the model from learning biologically inconsistent reverse transitions. This mechanism aligns the feature representation with the natural trajectory of DR worsening. Extensive experiments demonstrate that D-ODR yields superior grading performance compared to state-of-the-art ordinal regression and DR-specific grading methods, offering a more clinically reliable assessment of disease severity. Our code is available on https://github.com/HovChen/D-ODR.

VasGuideNet: Vascular Topology-Guided Couinaud Liver Segmentation with Structural Contrastive Loss

Accurate Couinaud liver segmentation is critical for preoperative surgical planning and tumor localization.However, existing methods primarily rely on image intensity and spatial location cues, without explicitly modeling vascular topology. As a result, they often produce indistinct boundaries near vessels and show limited generalization under anatomical variability.We propose VasGuideNet, the first Couinaud segmentation framework explicitly guided by vascular topology. Specifically, skeletonized vessels, Euclidean distance transform (EDT)--derived geometry, and k-nearest neighbor (kNN) connectivity are encoded into topology features using Graph Convolutional Networks (GCNs). These features are then injected into a 3D encoder--decoder backbone via a cross-attention fusion module. To further improve inter-class separability and anatomical consistency, we introduce a Structural Contrastive Loss (SCL) with a global memory bank.On Task08_HepaticVessel and our private LASSD dataset, VasGuideNet achieves Dice scores of 83.68% and 76.65% with RVDs of 1.68 and 7.08, respectively. It consistently outperforms representative baselines including UNETR, Swin UNETR, and G-UNETR++, delivering higher Dice/mIoU and lower RVD across datasets, demonstrating its effectiveness for anatomically consistent segmentation. Code is available at https://github.com/Qacket/VasGuideNet.git.