OpenRCA 2.0: From Outcome Labels to Causal Process Supervision

Root cause analysis (RCA) poses a holistic test of LLM agentic capabilities, such as long-context understanding, multi-step reasoning, and tool use. However, existing datasets suffer from a fundamental gap: they label only the root cause, not the propagation path connecting it to the observed symptom, which largely simplifies the task to naive pattern matching. To support rigorous evaluation, we introduce PAVE, a step-wise labeling protocol that leverages known interventions from fault injection to reconstruct causal propagation paths. The mechanism is forward verification: reasoning from cause to effect rather than inferring backward from symptoms. Applying PAVE yields OpenRCA 2.0 (500 instances), the first cross-system RCA benchmark with step-wise causal annotations for LLM agents. Across 11 frontier LLMs, recovering the exact root-cause set succeeds in only 20.7% of cases on average. To locate where this difficulty lies, we relax the criterion and find what we call the ungrounded diagnosis: agents identify at least one correct root-cause service in 76.0% of cases, but ground that service in a verified causal propagation path to the observed symptom in only 61.5%. Outcome-only evaluation hides this failure mode; step-wise causal ground truth is the missing piece for trustworthy LLM-based RCA agents.

DAMPER: A Dual-Stage Medical Report Generation Framework with Coarse-Grained MeSH Alignment and Fine-Grained Hypergraph Matching

Medical report generation is crucial for clinical diagnosis and patient management, summarizing diagnoses and recommendations based on medical imaging. However, existing work often overlook the clinical pipeline involved in report writing, where physicians typically conduct an initial quick review followed by a detailed examination. Moreover, current alignment methods may lead to misaligned relationships. To address these issues, we propose DAMPER, a dual-stage framework for medical report generation that mimics the clinical pipeline of report writing in two stages. In the first stage, a MeSH-Guided Coarse-Grained Alignment (MCG) stage that aligns chest X-ray (CXR) image features with medical subject headings (MeSH) features to generate a rough keyphrase representation of the overall impression. In the second stage, a Hypergraph-Enhanced Fine-Grained Alignment (HFG) stage that constructs hypergraphs for image patches and report annotations, modeling high-order relationships within each modality and performing hypergraph matching to capture semantic correlations between image regions and textual phrases. Finally,the coarse-grained visual features, generated MeSH representations, and visual hypergraph features are fed into a report decoder to produce the final medical report. Extensive experiments on public datasets demonstrate the effectiveness of DAMPER in generating comprehensive and accurate medical reports, outperforming state-of-the-art methods across various evaluation metrics.