Dual Causal Inference: Integrating Backdoor Adjustment and Instrumental Variable Learning for Medical VQA

Medical Visual Question Answering (MedVQA) aims to generate clinically reliable answers conditioned on complex medical images and questions. However, existing methods often overfit to superficial cross-modal correlations, neglecting the intrinsic biases embedded in multimodal medical data. Consequently, models become vulnerable to cross-modal confounding effects, severely hindering their ability to provide trustworthy diagnostic reasoning. To address this limitation, we propose a novel Dual Causal Inference (DCI) framework for MedVQA. To the best of our knowledge, DCI is the first unified architecture that integrates Backdoor Adjustment (BDA) and Instrumental Variable (IV) learning to jointly tackle both observable and unobserved confounders. Specifically, we formulate a Structural Causal Model (SCM) where observable cross-modal biases (e.g., frequent visual and textual co-occurrences) are mitigated via BDA, while unobserved confounders are compensated using an IV learned from a shared latent space. To guarantee the validity of the IV, we design mutual information constraints that maximize its dependence on the fused multimodal representations while minimizing its associations with the unobserved confounders and target answers. Through this dual mechanism, DCI extracts deconfounded representations that capture genuine causal relationships. Extensive experiments on four benchmark datasets, SLAKE, SLAKE-CP, VQA-RAD, and PathVQA, demonstrate that our method consistently outperforms existing approaches, particularly in out-of-distribution (OOD) generalization. Furthermore, qualitative analyses confirm that DCI significantly enhances the interpretability and robustness of cross-modal reasoning by explicitly disentangling true causal effects from spurious cross-modal shortcuts.

Modeling Higher-Order Brain Interactions via a Multi-View Information Bottleneck Framework for fMRI-based Psychiatric Diagnosis

Resting-state functional magnetic resonance imaging (fMRI) has emerged as a cornerstone for psychiatric diagnosis, yet most approaches rely on pairwise brain cortical or sub-cortical connectivities that overlooks higher-order interactions (HOIs) central to complex brain dynamics. While hypergraph methods encode HOIs through predefined hyperedges, their construction typically relies on heuristic similarity metrics and does not explicitly characterize whether interactions are synergy- or redundancy-dominated. In this paper, we introduce $O$-information, a signed measure that characterizes the informational nature of HOIs, and integrate third- and fourth-order $O$-information into a unified multi-view information bottleneck framework for fMRI-based psychiatric diagnosis. To enable scalable $O$-information estimation, we further develop two independent acceleration strategies: a Gaussian analytical approximation and a randomized matrix-based Rényi entropy estimator, achieving over a 30-fold computational speedup compared with conventional estimators. Our tri-view architecture systematically fuses pairwise, triadic, and tetradic brain interactions, capturing comprehensive brain connectivity while explicitly penalizing redundancy. Extensive evaluation across four benchmark datasets (REST-meta-MDD, ABIDE, UCLA, ADNI) demonstrates consistent improvements, outperforming 11 baseline methods including state-of-the-art graph neural network (GNN) and hypergraph based approaches. Moreover, our method reveals interpretable region-level synergy-redundancy patterns which are not explicitly characterized by conventional hypergraph formulations.

NTIRE 2026 The 3rd Restore Any Image Model (RAIM) Challenge: Professional Image Quality Assessment (Track 1)

In this paper, we present an overview of the NTIRE 2026 challenge on the 3rd Restore Any Image Model in the Wild, specifically focusing on Track 1: Professional Image Quality Assessment. Conventional Image Quality Assessment (IQA) typically relies on scalar scores. By compressing complex visual characteristics into a single number, these methods fundamentally struggle to distinguish subtle differences among uniformly high-quality images. Furthermore, they fail to articulate why one image is superior, lacking the reasoning capabilities required to provide guidance for vision tasks. To bridge this gap, recent advancements in Multimodal Large Language Models (MLLMs) offer a promising paradigm. Inspired by this potential, our challenge establishes a novel benchmark exploring the ability of MLLMs to mimic human expert cognition in evaluating high-quality image pairs. Participants were tasked with overcoming critical bottlenecks in professional scenarios, centering on two primary objectives: (1) Comparative Quality Selection: reliably identifying the visually superior image within a high-quality pair; and (2) Interpretative Reasoning: generating grounded, expert-level explanations that detail the rationale behind the selection. In total, the challenge attracted nearly 200 registrations and over 2,500 submissions. The top-performing methods significantly advanced the state of the art in professional IQA. The challenge dataset is available at https://github.com/narthchin/RAIM-PIQA, and the official homepage is accessible at https://www.codabench.org/competitions/12789/.

Redefining Quality Criteria and Distance-Aware Score Modeling for Image Editing Assessment

Recent advances in image editing have heightened the need for reliable Image Editing Quality Assessment (IEQA). Unlike traditional methods, IEQA requires complex reasoning over multimodal inputs and multi-dimensional assessments. Existing MLLM-based approaches often rely on human heuristic prompting, leading to two key limitations: rigid metric prompting and distance-agnostic score modeling. These issues hinder alignment with implicit human criteria and fail to capture the continuous structure of score spaces. To address this, we propose Define-and-Score Image Editing Quality Assessment (DS-IEQA), a unified framework that jointly learns evaluation criteria and score representations. Specifically, we introduce Feedback-Driven Metric Prompt Optimization (FDMPO) to automatically refine metric definitions via probabilistic feedback. Furthermore, we propose Token-Decoupled Distance Regression Loss (TDRL), which decouples numerical tokens from language modeling to explicitly model score continuity through expected distance minimization. Extensive experiments show our method's superior performance; it ranks 4th in the 2026 NTIRE X-AIGC Quality Assessment Track 2 without any additional training data.

Unlabeled Cross-Center Automatic Analysis for TAAD: An Integrated Framework from Segmentation to Clinical Features

Type A Aortic Dissection (TAAD) is a life-threatening cardiovascular emergency that demands rapid and precise preoperative evaluation. While key anatomical and pathological features are decisive for surgical planning, current research focuses predominantly on improving segmentation accuracy, leaving the reliable, quantitative extraction of clinically actionable features largely under-explored. Furthermore, constructing comprehensive TAAD datasets requires labor-intensive, expert level pixel-wise annotations, which is impractical for most clinical institutions. Due to significant domain shift, models trained on a single center dataset also suffer from severe performance degradation during cross-institutional deployment. This study addresses a clinically critical challenge: the accurate extraction of key TAAD clinical features during cross-institutional deployment in the total absence of target-domain annotations. To this end, we propose an unsupervised domain adaptation (UDA)-driven framework for the automated extraction of TAAD clinical features. The framework leverages limited source-domain labels while effectively adapting to unlabeled data from target domains. Tailored for real-world emergency workflows, our framework aims to achieve stable cross-institutional multi-class segmentation, reliable and quantifiable clinical feature extraction, and practical deployability independent of high-cost annotations. Extensive experiments demonstrate that our method significantly improves cross-domain segmentation performance compared to existing state-of-the-art approaches. More importantly, a reader study involving multiple cardiovascular surgeons confirms that the automatically extracted clinical features provide meaningful assistance for preoperative assessment, highlighting the practical utility of the proposed end-to-end segmentation-to-feature pipeline.

Learning to Trim: End-to-End Causal Graph Pruning with Dynamic Anatomical Feature Banks for Medical VQA

Medical Visual Question Answering (MedVQA) models often exhibit limited generalization due to reliance on dataset-specific correlations, such as recurring anatomical patterns or question-type regularities, rather than genuine diagnostic evidence. Existing causal approaches are typically implemented as static adjustments or post-hoc corrections. To address this issue, we propose a Learnable Causal Trimming (LCT) framework that integrates causal pruning into end-to-end optimization. We introduce a Dynamic Anatomical Feature Bank (DAFB), updated via a momentum mechanism, to capture global prototypes of frequent anatomical and linguistic patterns, serving as an approximation of dataset-level regularities. We further design a differentiable trimming module that estimates the dependency between instance-level representations and the global feature bank. Features highly correlated with global prototypes are softly suppressed, while instance-specific evidence is emphasized. This learnable mechanism encourages the model to prioritize causal signals over spurious correlations adaptively. Experiments on VQA-RAD, SLAKE, SLAKE-CP and PathVQA demonstrate that LCT consistently improves robustness and generalization over existing debiasing strategies.

Implicit Patterns in LLM-Based Binary Analysis

Binary vulnerability analysis is increasingly performed by LLM-based agents in an iterative, multi-pass manner, with the model as the core decision-maker. However, how such systems organize exploration over hundreds of reasoning steps remains poorly understood, due to limited context windows and implicit token-level behaviors. We present the first large-scale, trace-level study showing that multi-pass LLM reasoning gives rise to structured, token-level implicit patterns. Analyzing 521 binaries with 99,563 reasoning steps, we identify four dominant patterns: early pruning, path-dependent lock-in, targeted backtracking, and knowledge-guided prioritization that emerge implicitly from reasoning traces. These token-level implicit patterns serve as an abstraction of LLM reasoning: instead of explicit control-flow or predefined heuristics, exploration is organized through implicit decisions regulating path selection, commitment, and revision. Our analysis shows these patterns form a stable, structured system with distinct temporal roles and measurable characteristics. Our results provide the first systematic characterization of LLM-driven binary analysis and a foundation for more reliable analysis systems.

Understanding and Defending VLM Jailbreaks via Jailbreak-Related Representation Shift

Large vision-language models (VLMs) often exhibit weakened safety alignment with the integration of the visual modality. Even when text prompts contain explicit harmful intent, adding an image can substantially increase jailbreak success rates. In this paper, we observe that VLMs can clearly distinguish benign inputs from harmful ones in their representation space. Moreover, even among harmful inputs, jailbreak samples form a distinct internal state that is separable from refusal samples. These observations suggest that jailbreaks do not arise from a failure to recognize harmful intent. Instead, the visual modality shifts representations toward a specific jailbreak state, thereby leading to a failure to trigger refusal. To quantify this transition, we identify a jailbreak direction and define the jailbreak-related shift as the component of the image-induced representation shift along this direction. Our analysis shows that the jailbreak-related shift reliably characterizes jailbreak behavior, providing a unified explanation for diverse jailbreak scenarios. Finally, we propose a defense method that enhances VLM safety by removing the jailbreak-related shift (JRS-Rem) at inference time. Experiments show that JRS-Rem provides strong defense across multiple scenarios while preserving performance on benign tasks.

Fairness-Aware Beamforming for Polarimetric ISAC Systems with Polarization-Reconfigurable Antennas

Polarization diversity offers significant flexibility for enhancing integrated sensing and communications (ISAC). However, conventional dual-polarized arrays typically require dedicated radio-frequency (RF) chains for each polarization branch, leading to prohibitive hardware costs. To address this, polarization-reconfigurable (PR) antennas have emerged as a cost-effective alternative, enabling polarization flexibility with reduced hardware complexity by driving two polarization branches with a single RF chain. In this paper, we investigate fairness-aware beamforming for ISAC systems equipped with PR antennas. Specifically, we jointly optimize the transmit beamforming and PR control coefficients to maximize the minimum signal-to-interference-plus-noise ratio (SINR) for communication users and the minimum signal-to-clutter-plus-noise ratio (SCNR) for sensing targets. The resulting problem is highly nonconvex and nonsmooth due to the strong coupling among optimization variables in the max-min objective, as well as the nonconvex spherical constraints imposed by the PR antennas. To tackle this, we derive an equivalent smooth reformulation by introducing auxiliary variables and transforming the minimum operators into inequality constraints. Subsequently, we develop an exact-penalty product Riemannian manifold gradient descent (EP-PRMGD) algorithm, which integrates an exact penalty method with Riemannian optimization to guarantee convergence to a Karush-Kuhn-Tucker (KKT) point. Numerical results demonstrate that the proposed PR-enabled ISAC scheme achieves performance comparable to dual-polarized architectures while utilizing only half the RF chains, thereby validating its effectiveness in balancing fairness and hardware efficiency.

Evaluating GPT-5 as a Multimodal Clinical Reasoner: A Landscape Commentary

The transition from task-specific artificial intelligence toward general-purpose foundation models raises fundamental questions about their capacity to support the integrated reasoning required in clinical medicine, where diagnosis demands synthesis of ambiguous patient narratives, laboratory data, and multimodal imaging. This landscape commentary provides the first controlled, cross-sectional evaluation of the GPT-5 family (GPT-5, GPT-5 Mini, GPT-5 Nano) against its predecessor GPT-4o across a diverse spectrum of clinically grounded tasks, including medical education examinations, text-based reasoning benchmarks, and visual question-answering in neuroradiology, digital pathology, and mammography using a standardized zero-shot chain-of-thought protocol. GPT-5 demonstrated substantial gains in expert-level textual reasoning, with absolute improvements exceeding 25 percentage-points on MedXpertQA. When tasked with multimodal synthesis, GPT-5 effectively leveraged this enhanced reasoning capacity to ground uncertain clinical narratives in concrete imaging evidence, achieving state-of-the-art or competitive performance across most VQA benchmarks and outperforming GPT-4o by margins of 10-40% in mammography tasks requiring fine-grained lesion characterization. However, performance remained moderate in neuroradiology (44% macro-average accuracy) and lagged behind domain-specific models in mammography, where specialized systems exceed 80% accuracy compared to GPT-5's 52-64%. These findings indicate that while GPT-5 represents a meaningful advance toward integrated multimodal clinical reasoning, mirroring the clinician's cognitive process of biasing uncertain information with objective findings, generalist models are not yet substitutes for purpose-built systems in highly specialized, perception-critical tasks.