Aligning Medical Conversational AI through Online Reinforcement Learning with Information-Theoretic Rewards

We present Information Gain Fine-Tuning (IGFT), a novel approach for training medical conversational AI to conduct effective patient interviews and generate comprehensive History of Present Illness (HPI) without requiring pre-collected human conversations. IGFT combines online Group Relative Policy Optimization (GRPO) with information-theoretic rewards, enabling models to learn from self-generated conversations with simulated patients. Unlike existing approaches that rely on expensive expert-annotated conversations or static datasets, our online RL framework allows models to discover effective questioning strategies through exploration. Our key innovation is an information gain reward function that tracks which clinical entities such as symptoms, temporal patterns, and medical history, are revealed during conversation. Each question's reward is computed based on its expected information gain combined with GPT-4o-mini quality assessments across dimensions including clinical relevance, patient engagement, and specificity. This hybrid approach ensures models learn to ask targeted, clinically appropriate questions that efficiently gather diagnostic information. We fine-tune two models using LoRA: Llama-3.1-8B-Instruct and DeepSeek-R1-Distill-Qwen-7B (a reasoning-optimized model). Training exclusively on Avey data containing concise HPIs, we evaluate generalization to MIMIC data with longer, more elaborate HPIs. DeepSeek-R1-Distill-Qwen-7B (IGFT) achieves F1 scores of 0.408 on Avey (10.9% improvement over base) and 0.289 on MIMIC (12.9% improvement), while Llama-3.1-8B-Instruct (IGFT) reaches 0.384 and 0.336 respectively. Both models outperform OpenAI's model on MIMIC and surpass medical domain-specific baselines like HuatuoGPT and UltraMedical, which were optimized for single-turn medical QA rather than multi-turn conversations.

PUNCH: Physics-informed Uncertainty-aware Network for Coronary Hemodynamics

Coronary microvascular dysfunction (CMD) affects millions worldwide yet remains underdiagnosed because gold-standard physiological measurements are invasive and variably reproducible. We introduce a non-invasive, uncertainty-aware framework for estimating coronary flow reserve (CFR) directly from standard angiography. The system integrates physics-informed neural networks with variational inference to infer coronary blood flow from first-principles models of contrast transport, without requiring ground-truth flow measurements. The pipeline runs in approximately three minutes per patient on a single GPU, with no population-level training. Using 1{,}000 synthetic spatiotemporal intensity maps (kymographs) with controlled noise and artifacts, the framework reliably identifies degraded data and outputs appropriately inflated uncertainty estimates, showing strong correspondence between predictive uncertainty and error (Pearson $r = 0.997$, Spearman $ρ= 0.998$). Clinical validation in 12 patients shows strong agreement between PUNCH-derived CFR and invasive bolus thermodilution (Pearson $r = 0.90$, $p = 6.3 \times 10^{-5}$). We focus on the LAD, the artery most commonly assessed in routine CMD testing. Probabilistic CFR estimates have confidence intervals narrower than the variability of repeated invasive measurements. By transforming routine angiography into quantitative, uncertainty-aware assessment, this approach enables scalable, safer, and more reproducible evaluation of coronary microvascular function. Because standard angiography is widely available globally, the framework could expand access to CMD diagnosis and establish a new paradigm for physics-informed, patient-specific inference from clinical imaging.

RubricHub: A Comprehensive and Highly Discriminative Rubric Dataset via Automated Coarse-to-Fine Generation

Reinforcement Learning with Verifiable Rewards (RLVR) has driven substantial progress in reasoning-intensive domains like mathematics. However, optimizing open-ended generation remains challenging due to the lack of ground truth. While rubric-based evaluation offers a structured proxy for verification, existing methods suffer from scalability bottlenecks and coarse criteria, resulting in a supervision ceiling effect. To address this, we propose an automated Coarse-to-Fine Rubric Generation framework. By synergizing principle-guided synthesis, multi-model aggregation, and difficulty evolution, our approach produces comprehensive and highly discriminative criteria capable of capturing the subtle nuances. Based on this framework, we introduce RubricHub, a large-scale ($\sim$110k) and multi-domain dataset. We validate its utility through a two-stage post-training pipeline comprising Rubric-based Rejection Sampling Fine-Tuning (RuFT) and Reinforcement Learning (RuRL). Experimental results demonstrate that RubricHub unlocks significant performance gains: our post-trained Qwen3-14B achieves state-of-the-art (SOTA) results on HealthBench (69.3), surpassing proprietary frontier models such as GPT-5. The code and data will be released soon.

CTIS-QA: Clinical Template-Informed Slide-level Question Answering for Pathology

In this paper, we introduce a clinical diagnosis template-based pipeline to systematically collect and structure pathological information. In collaboration with pathologists and guided by the the College of American Pathologists (CAP) Cancer Protocols, we design a Clinical Pathology Report Template (CPRT) that ensures comprehensive and standardized extraction of diagnostic elements from pathology reports. We validate the effectiveness of our pipeline on TCGA-BRCA. First, we extract pathological features from reports using CPRT. These features are then used to build CTIS-Align, a dataset of 80k slide-description pairs from 804 WSIs for vision-language alignment training, and CTIS-Bench, a rigorously curated VQA benchmark comprising 977 WSIs and 14,879 question-answer pairs. CTIS-Bench emphasizes clinically grounded, closed-ended questions (e.g., tumor grade, receptor status) that reflect real diagnostic workflows, minimize non-visual reasoning, and require genuine slide understanding. We further propose CTIS-QA, a Slide-level Question Answering model, featuring a dual-stream architecture that mimics pathologists' diagnostic approach. One stream captures global slide-level context via clustering-based feature aggregation, while the other focuses on salient local regions through attention-guided patch perception module. Extensive experiments on WSI-VQA, CTIS-Bench, and slide-level diagnostic tasks show that CTIS-QA consistently outperforms existing state-of-the-art models across multiple metrics. Code and data are available at https://github.com/HLSvois/CTIS-QA.

NextFlow: Unified Sequential Modeling Activates Multimodal Understanding and Generation

We present NextFlow, a unified decoder-only autoregressive transformer trained on 6 trillion interleaved text-image discrete tokens. By leveraging a unified vision representation within a unified autoregressive architecture, NextFlow natively activates multimodal understanding and generation capabilities, unlocking abilities of image editing, interleaved content and video generation. Motivated by the distinct nature of modalities - where text is strictly sequential and images are inherently hierarchical - we retain next-token prediction for text but adopt next-scale prediction for visual generation. This departs from traditional raster-scan methods, enabling the generation of 1024x1024 images in just 5 seconds - orders of magnitude faster than comparable AR models. We address the instabilities of multi-scale generation through a robust training recipe. Furthermore, we introduce a prefix-tuning strategy for reinforcement learning. Experiments demonstrate that NextFlow achieves state-of-the-art performance among unified models and rivals specialized diffusion baselines in visual quality.

DrivingGen: A Comprehensive Benchmark for Generative Video World Models in Autonomous Driving

Video generation models, as one form of world models, have emerged as one of the most exciting frontiers in AI, promising agents the ability to imagine the future by modeling the temporal evolution of complex scenes. In autonomous driving, this vision gives rise to driving world models: generative simulators that imagine ego and agent futures, enabling scalable simulation, safe testing of corner cases, and rich synthetic data generation. Yet, despite fast-growing research activity, the field lacks a rigorous benchmark to measure progress and guide priorities. Existing evaluations remain limited: generic video metrics overlook safety-critical imaging factors; trajectory plausibility is rarely quantified; temporal and agent-level consistency is neglected; and controllability with respect to ego conditioning is ignored. Moreover, current datasets fail to cover the diversity of conditions required for real-world deployment. To address these gaps, we present DrivingGen, the first comprehensive benchmark for generative driving world models. DrivingGen combines a diverse evaluation dataset curated from both driving datasets and internet-scale video sources, spanning varied weather, time of day, geographic regions, and complex maneuvers, with a suite of new metrics that jointly assess visual realism, trajectory plausibility, temporal coherence, and controllability. Benchmarking 14 state-of-the-art models reveals clear trade-offs: general models look better but break physics, while driving-specific ones capture motion realistically but lag in visual quality. DrivingGen offers a unified evaluation framework to foster reliable, controllable, and deployable driving world models, enabling scalable simulation, planning, and data-driven decision-making.

Explainability-Guided Defense: Attribution-Aware Model Refinement Against Adversarial Data Attacks

The growing reliance on deep learning models in safety-critical domains such as healthcare and autonomous navigation underscores the need for defenses that are both robust to adversarial perturbations and transparent in their decision-making. In this paper, we identify a connection between interpretability and robustness that can be directly leveraged during training. Specifically, we observe that spurious, unstable, or semantically irrelevant features identified through Local Interpretable Model-Agnostic Explanations (LIME) contribute disproportionately to adversarial vulnerability. Building on this insight, we introduce an attribution-guided refinement framework that transforms LIME from a passive diagnostic into an active training signal. Our method systematically suppresses spurious features using feature masking, sensitivity-aware regularization, and adversarial augmentation in a closed-loop refinement pipeline. This approach does not require additional datasets or model architectures and integrates seamlessly into standard adversarial training. Theoretically, we derive an attribution-aware lower bound on adversarial distortion that formalizes the link between explanation alignment and robustness. Empirical evaluations on CIFAR-10, CIFAR-10-C, and CIFAR-100 demonstrate substantial improvements in adversarial robustness and out-of-distribution generalization.

OpenOneRec Technical Report

While the OneRec series has successfully unified the fragmented recommendation pipeline into an end-to-end generative framework, a significant gap remains between recommendation systems and general intelligence. Constrained by isolated data, they operate as domain specialists-proficient in pattern matching but lacking world knowledge, reasoning capabilities, and instruction following. This limitation is further compounded by the lack of a holistic benchmark to evaluate such integrated capabilities. To address this, our contributions are: 1) RecIF Bench & Open Data: We propose RecIF-Bench, a holistic benchmark covering 8 diverse tasks that thoroughly evaluate capabilities from fundamental prediction to complex reasoning. Concurrently, we release a massive training dataset comprising 96 million interactions from 160,000 users to facilitate reproducible research. 2) Framework & Scaling: To ensure full reproducibility, we open-source our comprehensive training pipeline, encompassing data processing, co-pretraining, and post-training. Leveraging this framework, we demonstrate that recommendation capabilities can scale predictably while mitigating catastrophic forgetting of general knowledge. 3) OneRec-Foundation: We release OneRec Foundation (1.7B and 8B), a family of models establishing new state-of-the-art (SOTA) results across all tasks in RecIF-Bench. Furthermore, when transferred to the Amazon benchmark, our models surpass the strongest baselines with an average 26.8% improvement in Recall@10 across 10 diverse datasets (Figure 1). This work marks a step towards building truly intelligent recommender systems. Nonetheless, realizing this vision presents significant technical and theoretical challenges, highlighting the need for broader research engagement in this promising direction.

Replay Failures as Successes: Sample-Efficient Reinforcement Learning for Instruction Following

Reinforcement Learning (RL) has shown promise for aligning Large Language Models (LLMs) to follow instructions with various constraints. Despite the encouraging results, RL improvement inevitably relies on sampling successful, high-quality responses; however, the initial model often struggles to generate responses that satisfy all constraints due to its limited capabilities, yielding sparse or indistinguishable rewards that impede learning. In this work, we propose Hindsight instruction Replay (HiR), a novel sample-efficient RL framework for complex instruction following tasks, which employs a select-then-rewrite strategy to replay failed attempts as successes based on the constraints that have been satisfied in hindsight. We perform RL on these replayed samples as well as the original ones, theoretically framing the objective as dual-preference learning at both the instruction- and response-level to enable efficient optimization using only a binary reward signal. Extensive experiments demonstrate that the proposed HiR yields promising results across different instruction following tasks, while requiring less computational budget. Our code and dataset is available at https://github.com/sastpg/HIR.

UCCL-EP: Portable Expert-Parallel Communication

Mixture-of-Experts (MoE) workloads rely on expert parallelism (EP) to achieve high GPU efficiency. State-of-the-art EP communication systems such as DeepEP demonstrate strong performance but exhibit poor portability across heterogeneous GPU and NIC platforms. The poor portability is rooted in architecture: GPU-initiated token-level RDMA communication requires tight vertical integration between GPUs and NICs, e.g., GPU writes to NIC driver/MMIO interfaces. We present UCCL-EP, a portable EP communication system that delivers DeepEP-level performance across heterogeneous GPU and NIC hardware. UCCL-EP replaces GPU-initiated RDMA with a high-throughput GPU-CPU control channel: compact token-routing commands are transferred to multithreaded CPU proxies, which then issue GPUDirect RDMA operations on behalf of GPUs. UCCL-EP further emulates various ordering semantics required by specialized EP communication modes using RDMA immediate data, enabling correctness on NICs that lack such ordering, e.g., AWS EFA. We implement UCCL-EP on NVIDIA and AMD GPUs with EFA and Broadcom NICs. On EFA, it outperforms the best existing EP solution by up to $2.1\times$ for dispatch and combine throughput. On NVIDIA-only platform, UCCL-EP achieves comparable performance to the original DeepEP. UCCL-EP also improves token throughput on SGLang by up to 40% on the NVIDIA+EFA platform, and improves DeepSeek-V3 training throughput over the AMD Primus/Megatron-LM framework by up to 45% on a 16-node AMD+Broadcom platform.