MedHorizon: Towards Long-context Medical Video Understanding in the Wild

Medical multimodal large language models (MLLMs) have advanced image understanding and short-video analysis, but real clinical review often requires full-procedure video understanding. Unlike general long videos, medical procedures contain highly redundant anatomical views, while decisive evidence is temporally sparse, spatially subtle, and context dependent. Existing benchmarks often assume this evidence has already been localized through images, short clips, or pre-segmented videos, leaving the retrieval-before-reasoning problem under-tested. We introduce MedHorizon, an in-the-wild benchmark for long-context medical video understanding. MedHorizon preserves 759 hours of full-length clinical procedures and provides 1,253 evidence-grounded multiple-choice questionsthat jointly evaluate sparse evidence understanding and multi-hop clinical reasoning. Its evidence is extremely sparse, with only 0.166% evidence frames on average, requiring models to search noisy procedural streams before interpreting and aggregating findings. We evaluate representative general-domain, medical-domain, and long-video MLLMs. The best model reaches only 41.1% accuracy, showing that current systems remain far from robust full-procedure understanding. Further analysis yields four key findings: performance does not scale reliably with more frames, evidence retrieval and clinical interpretation remain primary bottlenecks; these bottlenecks are rooted in weak procedural reasoning and attention drift under redundancy, and generic sampling methods only partially balances local detail with global coverage. MedHorizon provides a rigorous testbed for MLLMs that retrieve sparse evidence and reason over complete clinical workflows.

Stop Rewarding Hallucinated Steps: Faithfulness-Aware Step-Level Reinforcement Learning for Small Reasoning Models

As large language models become smaller and more efficient, small reasoning models (SRMs) are crucial for enabling chain-of-thought (CoT) reasoning in resource-constrained settings. However, they are prone to faithfulness hallucinations, especially in intermediate reasoning steps. Existing mitigation methods based on online reinforcement learning rely on outcome-based rewards or coarse-grained CoT evaluation, which can inadvertently reinforce unfaithful reasoning when the final answer is correct. To address these limitations, we propose Faithfulness-Aware Step-Level Reinforcement Learning (FaithRL), introducing step-level supervision via explicit faithfulness rewards from a process reward model, together with an implicit truncated resampling strategy that generates contrastive signals from faithful prefixes. Experiments across multiple SRMs and Open-Book QA benchmarks demonstrate that FaithRL consistently reduces hallucinations in both the CoT and final answers, leading to more faithful and reliable reasoning. Code is available at https://github.com/Easy195/FaithRL.

Subgraph Aggregation for Out-of-Distribution Generalization on Graphs

Out-of-distribution (OOD) generalization in Graph Neural Networks (GNNs) has gained significant attention due to its critical importance in graph-based predictions in real-world scenarios. Existing methods primarily focus on extracting a single causal subgraph from the input graph to achieve generalizable predictions. However, relying on a single subgraph can lead to susceptibility to spurious correlations and is insufficient for learning invariant patterns behind graph data. Moreover, in many real-world applications, such as molecular property prediction, multiple critical subgraphs may influence the target label property. To address these challenges, we propose a novel framework, SubGraph Aggregation (SuGAr), designed to learn a diverse set of subgraphs that are crucial for OOD generalization on graphs. Specifically, SuGAr employs a tailored subgraph sampler and diversity regularizer to extract a diverse set of invariant subgraphs. These invariant subgraphs are then aggregated by averaging their representations, which enriches the subgraph signals and enhances coverage of the underlying causal structures, thereby improving OOD generalization. Extensive experiments on both synthetic and real-world datasets demonstrate that \ours outperforms state-of-the-art methods, achieving up to a 24% improvement in OOD generalization on graphs. To the best of our knowledge, this is the first work to study graph OOD generalization by learning multiple invariant subgraphs.