RareLens: Towards End-to-End Rare Disease Care via Aligning Divergent Large Language Model Reasoning

Rare diseases collectively affect an estimated 3.5% to 5.9% of the population, yet more than 70% of patients are misdiagnosed and many endure years of evaluation before a diagnosis is reached, because early presentations are nonspecific and relevant expertise is scarce and unevenly distributed. Artificial intelligence could provide support, but existing systems address isolated stages of care, overwhelmingly diagnosis. They typically depend on the results of downstream investigations, and they treat the variability between models as noise to be eliminated. Here we present RareLens, a system that supports clinical decision-making across the entire rare disease trajectory by exploiting this variability. When heterogeneous large language models evaluate the same case, they generate divergent but complementary reasoning, which RareLens aligns and calibrates into a single convergent, actionable decision at each stage. Four coordinated modules perform primary-visit risk screening, diagnosis, treatment planning and prognosis. Developed and evaluated on RareBench, a real-world dataset of 157,525 cases spanning all 33 Orphanet categories and more than 7,000 conditions, RareLens outperformed every frontier model tested, including GPT-5, DeepSeek-R1, Claude-3.7-Sonnet and Gemini-2.5-Pro, at each stage. It achieved an area under the curve of 0.917 for screening and top-1 accuracies of 65.5% and 89.8% for diagnosis and treatment. In an external study spanning 1,287 cases and 23 physicians, autonomous RareLens and physicians assisted by RareLens both substantially outperformed unaided physicians. These findings indicate that aligning divergent model reasoning, rather than scaling a single model, offers a generalizable strategy for high-uncertainty clinical decision-making.

HIVE: Understanding Post-Hallucination Reasoning in Vision Language Models

Hallucinations in vision language models (VLMs) are commonly treated as semantic errors, yet they often arise from partial or ambiguous visual evidence. Prior work mainly focuses on detecting or suppressing hallucinations at generation time, leaving the subsequent reasoning stage largely unexplored. In this work, we study Post Hallucination Reasoning (PHR), the stage in which hallucinated semantics enter the model's inference context and influence downstream predictions. To systematically investigate PHR, we introduce HIVE, Hallucination Inference and Verification Engine, an evaluation infrastructure that enables controlled comparisons between faithful and hallucinated captions. Across nine tasks and nine models, we observe structured modality dependent patterns: hallucinated captions often improve accuracy on vision language tasks, while text only tasks exhibit limited or unstable effects. Further analyses show that hallucinated cues broaden semantic coverage and reshape reasoning dynamics while preserving stable inference. These findings highlight that hallucinated semantics may influence downstream reasoning once they enter the model's inference context. Understanding this post hallucination stage is important for improving the reliability and interpretability of multimodal reasoning systems. Code is publicly available at https://github.com/hefengcs/HIVE.

NeuroCogMap Reveals Cognitive Organization of Large Language Models

Understanding how complex cognitive functions are organized within artificial systems is central to interpreting large language models (LLMs) and relating them to biological cognition. Yet although LLMs exhibit broad cognitive-like behaviours, it remains unclear whether their internal representations form reproducible functional systems that explain behaviour, failure and links to human cognition. Here we present NeuroCogMap, a cognitive neuroscience-inspired framework that organizes internal features of LLMs into functional parcels and links them to interpretable functions, cognitive capabilities and a cognitive hierarchy. These parcels form a stable and semantically coherent organization that is partly conserved across models and functionally linked to model outputs. Within this organization, major LLM failures, including hallucination, bias, refusal failure and sycophancy, correspond to distinct disruptions in representational and behavioural-control systems, yielding internal signatures for mechanism-guided detection and targeted intervention. Beyond model behaviour, NeuroCogMap improves prediction of human cortical responses during naturalistic language comprehension, with the strongest correspondence in higher-order association cortex. At the cognitive level, its internal signatures expose latent strategies that guide refinements of classical models of human decision-making. Together, these findings establish NeuroCogMap as a system-level framework for mapping functional organization in artificial systems and for relating this organization to human cortical function and cognitive behaviour.

Dual-Adaptive SAM3: Hierarchical Routing over Low-Rank Expert Layers for Parameter-Efficient Medical Image Segmentation

The Segment Anything Model with Concepts (SAM3) heralds a new paradigm for open-vocabulary segmentation through natural language interaction, offering significant potential for medical image analysis. However, effectively adapting such a powerful vision-language model to the diverse and nuanced domain of medical imaging remains a key challenge. Naive fine-tuning is parameter-inefficient, while standard Mixture-of-Experts (MoE) methods introduce prohibitive computational overhead, limiting their clinical applicability. To address this, we propose Dual-Adaptive SAM3 (DA-SAM3), a novel framework that achieves both high segmentation accuracy and extreme parameter efficiency via a dual-adaptive specialization mechanism. Our first adaptation is task-aware: a Dynamic Expert Router (DER) that sparsely activates the most relevant experts by jointly reasoning about the visual input and the textual concept prompt, mimicking a clinical consultation process. Our second adaptation is parameter-aware: a Decomposed Parameterized Experts (DPE) design that represents each expert as a shared frozen base (inherited from the pretrained SAM3) and a lightweight trainable low-rank delta, reducing MoE parameter overhead by over 80\%. Extensive experiments on multiple public medical segmentation benchmarks demonstrate that Dual-Adaptive SAM3 not only matches or exceeds the accuracy of fully fine-tuned SAM3 and standard MoE baselines, but also achieves a notable 5\% gain over current state-of-the-art methods, with interpretable results validating its effectiveness. The code is available at: https://github.com/Reconsider80/DA-SAM3.

Joint Medical Image Enhancement and Segmentation with Diffusion-based Symbiotic Information Interaction

Image quality is critical for accurate medical diagnosis. However, MRI, CT, and ultrasound images are often of low resolution and quality due to cost constraints, complicating the visualization of key anatomical structures and lesions. While such limitations are common in practice, traditional methods treat image enhancement as a separate preprocessing step, failing to fully leverage its potential synergy with image segmentation. To address this, we propose DiSIINet (Diffusion-based Symbiotic Information Interaction Network), which is built on the principle that enhancement and segmentation should mutually reinforce each other in a unified model. Based on Denoising Diffusion Implicit Models (DDIM), DiSIINet integrates an enhancement branch and a segmentation branch. These branches interact through a novel Symbiotic Information Interaction (SII) module, which facilitates dynamic, feature-level information exchange via cross-attention during the reverse diffusion process. This design enables both tasks to iteratively improve each other. The DDIM backbone ensures high-quality output and efficient inference through deterministic sampling. Experiments on multi-modal medical datasets (MRI, CT, ultrasound) show that DiSIINet achieves significant performance improvements compared to sequential or independent enhancement and segmentation approaches. The code is available at: https://github.com/Reconsider80/DiSIINet.

Synergistic Perception-Reasoning Governance: Grounding Medical MLLMs with Verifiable Anatomical Evidence

Multimodal large language models (MLLMs) show strong promise for clinical VQA and radiology report generation, yet inference-time hallucinations still undermine trustworthy use: models can produce fluent conclusions that conflict with imaging evidence. Existing mitigation strategies typically rely on additional training, external retrieval/knowledge bases, or multi-stage post-hoc verification, which increases cost and pipeline complexity and often generalizes poorly across models and tasks.To address this, we propose a holistic, training-free evidence-injection framework that systematically mitigates hallucinations through dual-side evidence injection. By leveraging ROI priors acquired using MedSAM in our implementation, we recalibrate the visual perception trajectory via ROI-guided activation modulation while anchoring the textual reasoning trajectory by mapping anatomical coordinates into discrete semantic tokens as verifiable external memory. Then we introduce a task-aware dynamic router to select modality-specific interventions based on task semantics, balancing perceptual grounding and linguistic fluency. We conduct systematic evaluations on 2 tasks and 5 datasets using \texttt{LLaVA-1.5-7B}, \texttt{LLaVA-Med-1.5-7B}, \texttt{Qwen3-VL-8B/32B}, and \texttt{InternVL-3.5-8B/38B}. Controlled ablations and visualizations further validate the framework, which consistently outperforms baselines across medical benchmarks, improving close-ended accuracy by up to $\sim\mathbf{6}\%\uparrow$ and reducing open-ended hallucinations by $\sim\mathbf{35}\%\downarrow$. The code has been made available on GitHub: \href{https://github.com/Henry991115/SPRG}{\textcolor{blue}{https://github.com/Henry991115/SPRG}}.

M3Net: A Macro-to-Meso-to-Micro Clinical-inspired Hierarchical 3D Network for Pulmonary Nodule Classification

The accurate classification of benign and malignant pulmonary nodules in CT scans is critical for early lung cancer screening, yet remains challenging due to the multi-scale and heterogeneous nature of pulmonary nodules. While deep learning offers potential for auxiliary diagnosis, most existing models act as "black boxes", lacking the transparency and explainability required for trustworthy clinical integration. To address this issue, we propose M3Net, a novel 3D network for pulmonary nodule classification inspired by the hierarchical diagnostic workflow of radiologists, which integrates multi-scale contextual information from fine-grained structures to global anatomical relationships. Our framework constructs a progressive multi-scale input, from fine-grained nodule structures to local semantics and global spatial relationships. M3Net employs scale-specific encoders and ensures cross-scale semantic consistency through latent space projection and mutual information maximization. Extensive experiments on the public LIDC-IDRI dataset and a self-collected clinical dataset (USTC-FHLN) demonstrate that our method achieves state-of-the-art performance, with accuracies of 86.96% and 84.24% respectively, outperforming the best baseline by 3.26% and 2.17%. The results validate that M3Net provides a more robust and clinically relevant solution for pulmonary nodule classification. The code is available at https://github.com/jylEcho/M3-Net.

PathMem: Toward Cognition-Aligned Memory Transformation for Pathology MLLMs

Computational pathology demands both visual pattern recognition and dynamic integration of structured domain knowledge, including taxonomy, grading criteria, and clinical evidence. In practice, diagnostic reasoning requires linking morphological evidence with formal diagnostic and grading criteria. Although multimodal large language models (MLLMs) demonstrate strong vision language reasoning capabilities, they lack explicit mechanisms for structured knowledge integration and interpretable memory control. As a result, existing models struggle to consistently incorporate pathology-specific diagnostic standards during reasoning. Inspired by the hierarchical memory process of human pathologists, we propose PathMem, a memory-centric multimodal framework for pathology MLLMs. PathMem organizes structured pathology knowledge as a long-term memory (LTM) and introduces a Memory Transformer that models the dynamic transition from LTM to working memory (WM) through multimodal memory activation and context-aware knowledge grounding, enabling context-aware memory refinement for downstream reasoning. PathMem achieves SOTA performance across benchmarks, improving WSI-Bench report generation (12.8% WSI-Precision, 10.1% WSI-Relevance) and open-ended diagnosis by 9.7% and 8.9% over prior WSI-based models.

HG-Lane: High-Fidelity Generation of Lane Scenes under Adverse Weather and Lighting Conditions without Re-annotation

Lane detection is a crucial task in autonomous driving, as it helps ensure the safe operation of vehicles. However, existing datasets such as CULane and TuSimple contain relatively limited data under extreme weather conditions, including rain, snow, and fog. As a result, detection models trained on these datasets often become unreliable in such environments, which may lead to serious safety-critical failures on the road. To address this issue, we propose HG-Lane, a High-fidelity Generation framework for Lane Scenes under adverse weather and lighting conditions without requiring re-annotation. Based on this framework, we further construct a benchmark that includes adverse weather and lighting scenarios, containing 30,000 images. Experimental results demonstrate that our method consistently and significantly improves the performance of existing lane detection networks. For example, using the state-of-the-art CLRNet, the overall mF1 score on our benchmark increases by 20.87 percent. The F1@50 score for the overall, normal, snow, rain, fog, night, and dusk categories increases by 19.75 percent, 8.63 percent, 38.8 percent, 14.96 percent, 26.84 percent, 21.5 percent, and 12.04 percent, respectively. The code and dataset are available at: https://github.com/zdc233/HG-Lane.

Granulon: Awakening Pixel-Level Visual Encoders with Adaptive Multi-Granularity Semantics for MLLM

Recent advances in multimodal large language models largely rely on CLIP-based visual encoders, which emphasize global semantic alignment but struggle with fine-grained visual understanding. In contrast, DINOv3 provides strong pixel-level perception yet lacks coarse-grained semantic abstraction, leading to limited multi-granularity reasoning. To address this gap, we propose Granulon, a novel DINOv3-based MLLM with adaptive granularity augmentation. Granulon introduces a text-conditioned granularity Controller that dynamically adjusts the visual abstraction level according to the semantic scope of the textual input, and an Adaptive Token Aggregation module that performs granularity-guided pooling and relation-aware clustering to produce compact, semantically rich visual tokens. This design enables unified "pixel-to-fine-to-coarse" reasoning within a single forward pass. Extensive and interpretable experiments demonstrate that Granulon improves accuracy by ~30% and reduces hallucination by ~20%, outperforming all visual encoders under identical settings.