XrayClaw: Cooperative-Competitive Multi-Agent Alignment for Trustworthy Chest X-ray Diagnosis

Chest X-ray (CXR) interpretation is a fundamental yet complex clinical task that increasingly relies on artificial intelligence for automation. However, traditional monolithic models often lack the nuanced reasoning required for trustworthy diagnosis, frequently leading to logical inconsistencies and diagnostic hallucinations. While multi-agent systems offer a potential solution by simulating collaborative consultations, existing frameworks remain susceptible to consensus-based errors when instantiated by a single underlying model. This paper introduces XrayClaw, a novel framework that operationalizes multi-agent alignment through a sophisticated cooperative-competitive architecture. XrayClaw integrates four specialized cooperative agents to simulate a systematic clinical workflow, alongside a competitive agent that serves as an independent auditor. To reconcile these distinct diagnostic pathways, we propose Competitive Preference Optimization, a learning objective that penalizes illogical reasoning by enforcing mutual verification between analytical and holistic interpretations. Extensive empirical evaluations on the MS-CXR-T, MIMIC-CXR, and CheXbench benchmarks demonstrate that XrayClaw achieves state-of-the-art performance in diagnostic accuracy, clinical reasoning fidelity, and zero-shot domain generalization. Our results indicate that XrayClaw effectively mitigates cumulative hallucinations and enhances the overall reliability of automated CXR diagnosis, establishing a new paradigm for trustworthy medical imaging analysis.

Multimodal Model for Computational Pathology:Representation Learning and Image Compression

Whole slide imaging (WSI) has transformed digital pathology by enabling computational analysis of gigapixel histopathology images. Recent foundation model advances have accelerated progress in computational pathology, facilitating joint reasoning across pathology images, clinical reports, and structured data. Despite this progress, challenges remain: the extreme resolution of WSIs creates computational hurdles for visual learning; limited expert annotations constrain supervised approaches; integrating multimodal information while preserving biological interpretability remains difficult; and the opacity of modeling ultra-long visual sequences hinders clinical transparency. This review comprehensively surveys recent advances in multimodal computational pathology. We systematically analyze four research directions: (1) self-supervised representation learning and structure-aware token compression for WSIs; (2) multimodal data generation and augmentation; (3) parameter-efficient adaptation and reasoning-enhanced few-shot learning; and (4) multi-agent collaborative reasoning for trustworthy diagnosis. We specifically examine how token compression enables cross-scale modeling and how multi-agent mechanisms simulate a pathologist's "Chain of Thought" across magnifications to achieve uncertainty-aware evidence fusion. Finally, we discuss open challenges and argue that future progress depends on unified multimodal frameworks integrating high-resolution visual data with clinical and biomedical knowledge to support interpretable and safe AI-assisted diagnosis.

From Snapshots to Symphonies: The Evolution of Protein Prediction from Static Structures to Generative Dynamics and Multimodal Interactions

The protein folding problem has been fundamentally transformed by artificial intelligence, evolving from static structure prediction toward the modeling of dynamic conformational ensembles and complex biomolecular interactions. This review systematically examines the paradigm shift in AI driven protein science across five interconnected dimensions: unified multimodal representations that integrate sequences, geometries, and textual knowledge; refinement of static prediction through MSA free architectures and all atom complex modeling; generative frameworks, including diffusion models and flow matching, that capture conformational distributions consistent with thermodynamic ensembles; prediction of heterogeneous interactions spanning protein ligand, protein nucleic acid, and protein protein complexes; and functional inference of fitness landscapes, mutational effects, and text guided property prediction. We critically analyze current bottlenecks, including data distribution biases, limited mechanistic interpretability, and the disconnect between geometric metrics and biophysical reality, while identifying future directions toward physically consistent generative models, multimodal foundation architectures, and experimental closed loop systems. This methodological transformation marks artificial intelligence's transition from a structural analysis tool into a universal simulator capable of understanding and ultimately rewriting the dynamic language of life.

ZeroSense:How Vision matters in Long Context Compression

Recent visual-text compression (VTC) methods, typified by DeepSeek-OCR, report impressive high token compression ratios for long-context modeling tasks by leveraging text-to-image rendering. However, existing evaluation protocols heavily rely on downstream task performance. Such evaluation metrics fail to accurately measure text preservation due to the strong inherent linguistic priors of Multimodal Large Language Models (MLLMs). In this work, we introduce a new evaluation framework that decouples MLLMs' capabilities to faithfully assess VTC quality. Within this framework, we further introduce the ZeroSense Benchmark to ensure low semantic correlation of testing samples. By eliminating contextual dependencies, our benchmark guarantees that the evaluation results are purely reflective of VTC quality, unaffected by the semantic inference capabilities of downstream models. Extensive experiments across multiple datasets demonstrate that VTC quality and downstream task accuracy diverge significantly, highlighting the necessity of our decoupled evaluation framework.

TC-SSA: Token Compression via Semantic Slot Aggregation for Gigapixel Pathology Reasoning

The application of large vision-language models to computational pathology holds great promise for diagnostic assistants but faces a critical computational bottleneck: the gigapixel scale of Whole Slide Images (WSIs). A single WSI typically contains over 105 patches, creating sequence lengths that exceed the constraints of standard Transformer architectures. Existing solutions often resort to spatial sampling, which risks discarding diagnostically critical evidence. To address this, we propose TC-SSA (Token Compression via Semantic Slot Aggregation), a learnable token compression framework that aggregates patch features into a fixed number of semantic slots. A gated routing module assigns patches to slots using sparse Top-2 routing, followed by weighted aggregation, enabling global slide coverage under a strict token budget. The resulting representation retains diagnostically relevant information while reducing the number of visual tokens to 1.7% of the original sequence. On the SlideBench(TCGA), our model achieves 78.34% overall accuracy and 77.14% on the diagnosis subset, outperforming sampling-based baselines under comparable token budgets. The method also generalizes to MIL classification, reaching AUC of 95.83% on TCGA-BRCA, 98.27% on TCGA-NSCLC and 79.80% on PANDA. These results suggest that learnable semantic aggregation provides an effective trade-off between efficiency and diagnostic performance for gigapixel pathology reasoning.

Masked Image Contrastive Learning for Efficient Visual Conceptual Pre-training

This paper proposes a scalable and straightforward pre-training paradigm for efficient visual conceptual representation called masked image contrastive learning (MiCL). Our MiCL approach is simple: we randomly mask patches to generate different views within an image and contrast them among a mini-batch of images. The core idea behind MiCL consists of two designs. First, masked tokens have the potential to significantly diminish the conceptual redundancy inherent in images, and create distinct views with substantial fine-grained differences on the semantic concept level instead of the instance level. Second, contrastive learning is adept at extracting high-level semantic conceptual features during the pre-training, circumventing the high-frequency interference and additional costs associated with image reconstruction. Importantly, MiCL learns highly semantic conceptual representations efficiently without relying on hand-crafted data augmentations or additional auxiliary modules. Empirically, MiCL demonstrates high scalability with Vision Transformers, as the ViT-L/16 can complete pre-training in 133 hours using only 4 A100 GPUs, achieving 85.8% accuracy in downstream fine-tuning tasks.

A foundation model for generalizable disease diagnosis in chest X-ray images

Medical artificial intelligence (AI) is revolutionizing the interpretation of chest X-ray (CXR) images by providing robust tools for disease diagnosis. However, the effectiveness of these AI models is often limited by their reliance on large amounts of task-specific labeled data and their inability to generalize across diverse clinical settings. To address these challenges, we introduce CXRBase, a foundational model designed to learn versatile representations from unlabelled CXR images, facilitating efficient adaptation to various clinical tasks. CXRBase is initially trained on a substantial dataset of 1.04 million unlabelled CXR images using self-supervised learning methods. This approach allows the model to discern meaningful patterns without the need for explicit labels. After this initial phase, CXRBase is fine-tuned with labeled data to enhance its performance in disease detection, enabling accurate classification of chest diseases. CXRBase provides a generalizable solution to improve model performance and alleviate the annotation workload of experts to enable broad clinical AI applications from chest imaging.

MedViLaM: A multimodal large language model with advanced generalizability and explainability for medical data understanding and generation

Medicine is inherently multimodal and multitask, with diverse data modalities spanning text, imaging. However, most models in medical field are unimodal single tasks and lack good generalizability and explainability. In this study, we introduce MedViLaM, a unified vision-language model towards a generalist model for medical data that can flexibly encode and interpret various forms of medical data, including clinical language and imaging, all using the same set of model weights. To facilitate the creation of such multi-task model, we have curated MultiMedBench, a comprehensive pretaining dataset and benchmark consisting of several distinct tasks, i.e., continuous question-answering, multi-label disease classification, disease localization, generation and summarization of radiology reports. MedViLaM demonstrates strong performance across all MultiMedBench tasks, frequently outpacing other generalist models by a significant margin. Additionally, we present instances of zero-shot generalization to new medical concepts and tasks, effective transfer learning across different tasks, and the emergence of zero-shot medical reasoning.

ViLaM: A Vision-Language Model with Enhanced Visual Grounding and Generalization Capability

Vision-language models have revolutionized human-computer interaction and shown significant progress in multi-modal tasks. However, applying these models to complex visual tasks like medical image analysis remains challenging. In this study, we propose ViLaM, a unified Vision-Language transformer model that integrates instruction tuning predicated on a large language model. This approach enables us to optimally utilize the knowledge and reasoning capacities of large pre-trained language models for an array of tasks encompassing both language and vision. We employ frozen pre-trained encoders to encode and align both image and text features, enabling ViLaM to handle a variety of visual tasks following textual instructions. Besides, we've designed cycle training for referring expressions to address the need for high-quality, paired referring expression datasets for training large models in terms of both quantity and quality. We evaluated ViLaM's exceptional performance on public general datasets and further confirmed its generalizability on medical datasets. Importantly, we've observed the model's impressive zero-shot learning ability, indicating the potential future application of ViLaM in the medical field.

Learning A Multi-Task Transformer Via Unified And Customized Instruction Tuning For Chest Radiograph Interpretation

The emergence of multi-modal deep learning models has made significant impacts on clinical applications in the last decade. However, the majority of models are limited to single-tasking, without considering disease diagnosis is indeed a multi-task procedure. Here, we demonstrate a unified transformer model specifically designed for multi-modal clinical tasks by incorporating customized instruction tuning. We first compose a multi-task training dataset comprising 13.4 million instruction and ground-truth pairs (with approximately one million radiographs) for the customized tuning, involving both image- and pixel-level tasks. Thus, we can unify the various vision-intensive tasks in a single training framework with homogeneous model inputs and outputs to increase clinical interpretability in one reading. Finally, we demonstrate the overall superior performance of our model compared to prior arts on various chest X-ray benchmarks across multi-tasks in both direct inference and finetuning settings. Three radiologists further evaluate the generated reports against the recorded ones, which also exhibit the enhanced explainability of our multi-task model.