Talk Before You Retrieve: Agent-Led Discussions for Better RAG in Medical QA

Medical question answering (QA) is a reasoning-intensive task that remains challenging for large language models (LLMs) due to hallucinations and outdated domain knowledge. Retrieval-Augmented Generation (RAG) provides a promising post-training solution by leveraging external knowledge. However, existing medical RAG systems suffer from two key limitations: (1) a lack of modeling for human-like reasoning behaviors during information retrieval, and (2) reliance on suboptimal medical corpora, which often results in the retrieval of irrelevant or noisy snippets. To overcome these challenges, we propose Discuss-RAG, a plug-and-play module designed to enhance the medical QA RAG system through collaborative agent-based reasoning. Our method introduces a summarizer agent that orchestrates a team of medical experts to emulate multi-turn brainstorming, thereby improving the relevance of retrieved content. Additionally, a decision-making agent evaluates the retrieved snippets before their final integration. Experimental results on four benchmark medical QA datasets show that Discuss-RAG consistently outperforms MedRAG, especially significantly improving answer accuracy by up to 16.67% on BioASQ and 12.20% on PubMedQA. The code is available at: https://github.com/LLM-VLM-GSL/Discuss-RAG.

A BERT-Style Self-Supervised Learning CNN for Disease Identification from Retinal Images

In the field of medical imaging, the advent of deep learning, especially the application of convolutional neural networks (CNNs) has revolutionized the analysis and interpretation of medical images. Nevertheless, deep learning methods usually rely on large amounts of labeled data. In medical imaging research, the acquisition of high-quality labels is both expensive and difficult. The introduction of Vision Transformers (ViT) and self-supervised learning provides a pre-training strategy that utilizes abundant unlabeled data, effectively alleviating the label acquisition challenge while broadening the breadth of data utilization. However, ViT's high computational density and substantial demand for computing power, coupled with the lack of localization characteristics of its operations on image patches, limit its efficiency and applicability in many application scenarios. In this study, we employ nn-MobileNet, a lightweight CNN framework, to implement a BERT-style self-supervised learning approach. We pre-train the network on the unlabeled retinal fundus images from the UK Biobank to improve downstream application performance. We validate the results of the pre-trained model on Alzheimer's disease (AD), Parkinson's disease (PD), and various retinal diseases identification. The results show that our approach can significantly improve performance in the downstream tasks. In summary, this study combines the benefits of CNNs with the capabilities of advanced self-supervised learning in handling large-scale unlabeled data, demonstrating the potential of CNNs in the presence of label scarcity.

How Effective Can Dropout Be in Multiple Instance Learning ?

Multiple Instance Learning (MIL) is a popular weakly-supervised method for various applications, with a particular interest in histological whole slide image (WSI) classification. Due to the gigapixel resolution of WSI, applications of MIL in WSI typically necessitate a two-stage training scheme: first, extract features from the pre-trained backbone and then perform MIL aggregation. However, it is well-known that this suboptimal training scheme suffers from "noisy" feature embeddings from the backbone and inherent weak supervision, hindering MIL from learning rich and generalizable features. However, the most commonly used technique (i.e., dropout) for mitigating this issue has yet to be explored in MIL. In this paper, we empirically explore how effective the dropout can be in MIL. Interestingly, we observe that dropping the top-k most important instances within a bag leads to better performance and generalization even under noise attack. Based on this key observation, we propose a novel MIL-specific dropout method, termed MIL-Dropout, which systematically determines which instances to drop. Experiments on five MIL benchmark datasets and two WSI datasets demonstrate that MIL-Dropout boosts the performance of current MIL methods with a negligible computational cost. The code is available at https://github.com/ChongQingNoSubway/MILDropout.

Enhancing 3T BOLD fMRI SNR using Unpaired 7T Data with Schrödinger Bridge Diffusion

High spatial and temporal resolution, coupled with a strong signal-to-noise ratio (SNR), has made BOLD 7 Tesla fMRI an invaluable tool for understanding how the brain processes visual stimuli. However, the limited availability of 7T MRI systems means that most research relies on 3T MRI systems, which offer lower spatial and temporal resolution and SNR. This naturally raises the question: Can we enhance the spatiotemporal resolution and SNR of 3T BOLD fMRI data to approximate 7T quality? In this study, we propose a novel framework that aligns 7T and 3T fMRI data from different subjects and datasets in a shared parametric domain. We then apply an unpaired Brain Disk Schr\"odinger Bridge diffusion model to enhance the spatiotemporal resolution and SNR of the 3T data. Our approach addresses the challenge of limited 7T data by improving the 3T scan quality. We demonstrate its effectiveness by testing it on two distinct fMRI retinotopy datasets (one 7T and one 3T), as well as synthetic data. The results show that our method significantly improves the SNR and goodness-of-fit of the population receptive field (pRF) model in the enhanced 3T data, making it comparable to 7T quality. The codes will be available at Github.

Prompt-OT: An Optimal Transport Regularization Paradigm for Knowledge Preservation in Vision-Language Model Adaptation

Vision-language models (VLMs) such as CLIP demonstrate strong performance but struggle when adapted to downstream tasks. Prompt learning has emerged as an efficient and effective strategy to adapt VLMs while preserving their pre-trained knowledge. However, existing methods still lead to overfitting and degrade zero-shot generalization. To address this challenge, we propose an optimal transport (OT)-guided prompt learning framework that mitigates forgetting by preserving the structural consistency of feature distributions between pre-trained and fine-tuned models. Unlike conventional point-wise constraints, OT naturally captures cross-instance relationships and expands the feasible parameter space for prompt tuning, allowing a better trade-off between adaptation and generalization. Our approach enforces joint constraints on both vision and text representations, ensuring a holistic feature alignment. Extensive experiments on benchmark datasets demonstrate that our simple yet effective method can outperform existing prompt learning strategies in base-to-novel generalization, cross-dataset evaluation, and domain generalization without additional augmentation or ensemble techniques. The code is available at https://github.com/ChongQingNoSubway/Prompt-OT

RetinalGPT: A Retinal Clinical Preference Conversational Assistant Powered by Large Vision-Language Models

Recently, Multimodal Large Language Models (MLLMs) have gained significant attention for their remarkable ability to process and analyze non-textual data, such as images, videos, and audio. Notably, several adaptations of general-domain MLLMs to the medical field have been explored, including LLaVA-Med. However, these medical adaptations remain insufficiently advanced in understanding and interpreting retinal images. In contrast, medical experts emphasize the importance of quantitative analyses for disease detection and interpretation. This underscores a gap between general-domain and medical-domain MLLMs: while general-domain MLLMs excel in broad applications, they lack the specialized knowledge necessary for precise diagnostic and interpretative tasks in the medical field. To address these challenges, we introduce \textit{RetinalGPT}, a multimodal conversational assistant for clinically preferred quantitative analysis of retinal images. Specifically, we achieve this by compiling a large retinal image dataset, developing a novel data pipeline, and employing customized visual instruction tuning to enhance both retinal analysis and enrich medical knowledge. In particular, RetinalGPT outperforms MLLM in the generic domain by a large margin in the diagnosis of retinal diseases in 8 benchmark retinal datasets. Beyond disease diagnosis, RetinalGPT features quantitative analyses and lesion localization, representing a pioneering step in leveraging LLMs for an interpretable and end-to-end clinical research framework. The code is available at https://github.com/Retinal-Research/RetinalGPT

EyeBench: A Call for More Rigorous Evaluation of Retinal Image Enhancement

Over the past decade, generative models have achieved significant success in enhancement fundus images.However, the evaluation of these models still presents a considerable challenge. A comprehensive evaluation benchmark for fundus image enhancement is indispensable for three main reasons: 1) The existing denoising metrics (e.g., PSNR, SSIM) are hardly to extend to downstream real-world clinical research (e.g., Vessel morphology consistency). 2) There is a lack of comprehensive evaluation for both paired and unpaired enhancement methods, along with the need for expert protocols to accurately assess clinical value. 3) An ideal evaluation system should provide insights to inform future developments of fundus image enhancement. To this end, we propose a novel comprehensive benchmark, EyeBench, to provide insights that align enhancement models with clinical needs, offering a foundation for future work to improve the clinical relevance and applicability of generative models for fundus image enhancement. EyeBench has three appealing properties: 1) multi-dimensional clinical alignment downstream evaluation: In addition to evaluating the enhancement task, we provide several clinically significant downstream tasks for fundus images, including vessel segmentation, DR grading, denoising generalization, and lesion segmentation. 2) Medical expert-guided evaluation design: We introduce a novel dataset that promote comprehensive and fair comparisons between paired and unpaired methods and includes a manual evaluation protocol by medical experts. 3) Valuable insights: Our benchmark study provides a comprehensive and rigorous evaluation of existing methods across different downstream tasks, assisting medical experts in making informed choices. Additionally, we offer further analysis of the challenges faced by existing methods. The code is available at \url{https://github.com/Retinal-Research/EyeBench}

Sequence Complementor: Complementing Transformers For Time Series Forecasting with Learnable Sequences

Since its introduction, the transformer has shifted the development trajectory away from traditional models (e.g., RNN, MLP) in time series forecasting, which is attributed to its ability to capture global dependencies within temporal tokens. Follow-up studies have largely involved altering the tokenization and self-attention modules to better adapt Transformers for addressing special challenges like non-stationarity, channel-wise dependency, and variable correlation in time series. However, we found that the expressive capability of sequence representation is a key factor influencing Transformer performance in time forecasting after investigating several representative methods, where there is an almost linear relationship between sequence representation entropy and mean square error, with more diverse representations performing better. In this paper, we propose a novel attention mechanism with Sequence Complementors and prove feasible from an information theory perspective, where these learnable sequences are able to provide complementary information beyond current input to feed attention. We further enhance the Sequence Complementors via a diversification loss that is theoretically covered. The empirical evaluation of both long-term and short-term forecasting has confirmed its superiority over the recent state-of-the-art methods.

Multimodal Variational Autoencoder: a Barycentric View

Multiple signal modalities, such as vision and sounds, are naturally present in real-world phenomena. Recently, there has been growing interest in learning generative models, in particular variational autoencoder (VAE), to for multimodal representation learning especially in the case of missing modalities. The primary goal of these models is to learn a modality-invariant and modality-specific representation that characterizes information across multiple modalities. Previous attempts at multimodal VAEs approach this mainly through the lens of experts, aggregating unimodal inference distributions with a product of experts (PoE), a mixture of experts (MoE), or a combination of both. In this paper, we provide an alternative generic and theoretical formulation of multimodal VAE through the lens of barycenter. We first show that PoE and MoE are specific instances of barycenters, derived by minimizing the asymmetric weighted KL divergence to unimodal inference distributions. Our novel formulation extends these two barycenters to a more flexible choice by considering different types of divergences. In particular, we explore the Wasserstein barycenter defined by the 2-Wasserstein distance, which better preserves the geometry of unimodal distributions by capturing both modality-specific and modality-invariant representations compared to KL divergence. Empirical studies on three multimodal benchmarks demonstrated the effectiveness of the proposed method.

SMAC-Hard: Enabling Mixed Opponent Strategy Script and Self-play on SMAC

The availability of challenging simulation environments is pivotal for advancing the field of Multi-Agent Reinforcement Learning (MARL). In cooperative MARL settings, the StarCraft Multi-Agent Challenge (SMAC) has gained prominence as a benchmark for algorithms following centralized training with decentralized execution paradigm. However, with continual advancements in SMAC, many algorithms now exhibit near-optimal performance, complicating the evaluation of their true effectiveness. To alleviate this problem, in this work, we highlight a critical issue: the default opponent policy in these environments lacks sufficient diversity, leading MARL algorithms to overfit and exploit unintended vulnerabilities rather than learning robust strategies. To overcome these limitations, we propose SMAC-HARD, a novel benchmark designed to enhance training robustness and evaluation comprehensiveness. SMAC-HARD supports customizable opponent strategies, randomization of adversarial policies, and interfaces for MARL self-play, enabling agents to generalize to varying opponent behaviors and improve model stability. Furthermore, we introduce a black-box testing framework wherein agents are trained without exposure to the edited opponent scripts but are tested against these scripts to evaluate the policy coverage and adaptability of MARL algorithms. We conduct extensive evaluations of widely used and state-of-the-art algorithms on SMAC-HARD, revealing the substantial challenges posed by edited and mixed strategy opponents. Additionally, the black-box strategy tests illustrate the difficulty of transferring learned policies to unseen adversaries. We envision SMAC-HARD as a critical step toward benchmarking the next generation of MARL algorithms, fostering progress in self-play methods for multi-agent systems. Our code is available at https://github.com/devindeng94/smac-hard.