AdCare-VLM: Leveraging Large Vision Language Model (LVLM) to Monitor Long-Term Medication Adherence and Care

Chronic diseases, including diabetes, hypertension, asthma, HIV-AIDS, epilepsy, and tuberculosis, necessitate rigorous adherence to medication to avert disease progression, manage symptoms, and decrease mortality rates. Adherence is frequently undermined by factors including patient behavior, caregiver support, elevated medical costs, and insufficient healthcare infrastructure. We propose AdCare-VLM, a specialized Video-LLaVA-based multimodal large vision language model (LVLM) aimed at visual question answering (VQA) concerning medication adherence through patient videos. We employ a private dataset comprising 806 custom-annotated tuberculosis (TB) medication monitoring videos, which have been labeled by clinical experts, to fine-tune the model for adherence pattern detection. We present LLM-TB-VQA, a detailed medical adherence VQA dataset that encompasses positive, negative, and ambiguous adherence cases. Our method identifies correlations between visual features, such as the clear visibility of the patient's face, medication, water intake, and the act of ingestion, and their associated medical concepts in captions. This facilitates the integration of aligned visual-linguistic representations and improves multimodal interactions. Experimental results indicate that our method surpasses parameter-efficient fine-tuning (PEFT) enabled VLM models, such as LLaVA-V1.5 and Chat-UniVi, with absolute improvements ranging from 3.1% to 3.54% across pre-trained, regular, and low-rank adaptation (LoRA) configurations. Comprehensive ablation studies and attention map visualizations substantiate our approach, enhancing interpretability.

Task-Specific Knowledge Distillation from the Vision Foundation Model for Enhanced Medical Image Segmentation

Large-scale pre-trained models, such as Vision Foundation Models (VFMs), have demonstrated impressive performance across various downstream tasks by transferring generalized knowledge, especially when target data is limited. However, their high computational cost and the domain gap between natural and medical images limit their practical application in medical segmentation tasks. Motivated by this, we pose the following important question: "How can we effectively utilize the knowledge of large pre-trained VFMs to train a small, task-specific model for medical image segmentation when training data is limited?" To address this problem, we propose a novel and generalizable task-specific knowledge distillation framework. Our method fine-tunes the VFM on the target segmentation task to capture task-specific features before distilling the knowledge to smaller models, leveraging Low-Rank Adaptation (LoRA) to reduce the computational cost of fine-tuning. Additionally, we incorporate synthetic data generated by diffusion models to augment the transfer set, enhancing model performance in data-limited scenarios. Experimental results across five medical image datasets demonstrate that our method consistently outperforms task-agnostic knowledge distillation and self-supervised pretraining approaches like MoCo v3 and Masked Autoencoders (MAE). For example, on the KidneyUS dataset, our method achieved a 28% higher Dice score than task-agnostic KD using 80 labeled samples for fine-tuning. On the CHAOS dataset, it achieved an 11% improvement over MAE with 100 labeled samples. These results underscore the potential of task-specific knowledge distillation to train accurate, efficient models for medical image segmentation in data-constrained settings.

Speculative Decoding for Multi-Sample Inference

We propose a novel speculative decoding method tailored for multi-sample reasoning scenarios, such as self-consistency and Best-of-N sampling. Our method exploits the intrinsic consensus of parallel generation paths to synthesize high-quality draft tokens without requiring auxiliary models or external databases. By dynamically analyzing structural patterns across parallel reasoning paths through a probabilistic aggregation mechanism, it identifies consensus token sequences that align with the decoding distribution. Evaluations on mathematical reasoning benchmarks demonstrate a substantial improvement in draft acceptance rates over baselines, while reducing the latency in draft token construction. This work establishes a paradigm shift for efficient multi-sample inference, enabling seamless integration of speculative decoding with sampling-based reasoning techniques.

Semantic Prior Distillation with Vision Foundation Model for Enhanced Rapid Bone Scintigraphy Image Restoration

Rapid bone scintigraphy is an essential tool for diagnosing skeletal diseases and tumor metastasis in pediatric patients, as it reduces scan time and minimizes patient discomfort. However, rapid scans often result in poor image quality, potentially affecting diagnosis due to reduced resolution and detail, which make it challenging to identify and evaluate finer anatomical structures. To address this issue, we propose the first application of SAM-based semantic priors for medical image restoration, leveraging the Segment Anything Model (SAM) to enhance rapid bone scintigraphy images in pediatric populations. Our method comprises two cascaded networks, $f^{IR1}$ and $f^{IR2}$, augmented by three key modules: a Semantic Prior Integration (SPI) module, a Semantic Knowledge Distillation (SKD) module, and a Semantic Consistency Module (SCM). The SPI and SKD modules incorporate domain-specific semantic information from a fine-tuned SAM, while the SCM maintains consistent semantic feature representation throughout the cascaded networks. In addition, we will release a novel Rapid Bone Scintigraphy dataset called RBS, the first dataset dedicated to rapid bone scintigraphy image restoration in pediatric patients. RBS consists of 137 pediatric patients aged between 0.5 and 16 years who underwent both standard and rapid bone scans. The dataset includes scans performed at 20 cm/min (standard) and 40 cm/min (rapid), representing a $2\times$ acceleration. We conducted extensive experiments on both the publicly available endoscopic dataset and RBS. The results demonstrate that our method outperforms all existing methods across various metrics, including PSNR, SSIM, FID, and LPIPS.

Revisiting Self-Consistency from Dynamic Distributional Alignment Perspective on Answer Aggregation

Self-consistency improves reasoning by aggregating diverse stochastic samples, yet the dynamics behind its efficacy remain underexplored. We reframe self-consistency as a dynamic distributional alignment problem, revealing that decoding temperature not only governs sampling randomness but also actively shapes the latent answer distribution. Given that high temperatures require prohibitively large sample sizes to stabilize, while low temperatures risk amplifying biases, we propose a confidence-driven mechanism that dynamically calibrates temperature: sharpening the sampling distribution under uncertainty to align with high-probability modes, and promoting exploration when confidence is high. Experiments on mathematical reasoning tasks show this approach outperforms fixed-diversity baselines under limited samples, improving both average and best-case performance across varying initial temperatures without additional data or modules. This establishes self-consistency as a synchronization challenge between sampling dynamics and evolving answer distributions.

Vision Foundation Models in Medical Image Analysis: Advances and Challenges

The rapid development of Vision Foundation Models (VFMs), particularly Vision Transformers (ViT) and Segment Anything Model (SAM), has sparked significant advances in the field of medical image analysis. These models have demonstrated exceptional capabilities in capturing long-range dependencies and achieving high generalization in segmentation tasks. However, adapting these large models to medical image analysis presents several challenges, including domain differences between medical and natural images, the need for efficient model adaptation strategies, and the limitations of small-scale medical datasets. This paper reviews the state-of-the-art research on the adaptation of VFMs to medical image segmentation, focusing on the challenges of domain adaptation, model compression, and federated learning. We discuss the latest developments in adapter-based improvements, knowledge distillation techniques, and multi-scale contextual feature modeling, and propose future directions to overcome these bottlenecks. Our analysis highlights the potential of VFMs, along with emerging methodologies such as federated learning and model compression, to revolutionize medical image analysis and enhance clinical applications. The goal of this work is to provide a comprehensive overview of current approaches and suggest key areas for future research that can drive the next wave of innovation in medical image segmentation.

Beyond One-Size-Fits-All: Tailored Benchmarks for Efficient Evaluation

Evaluating models on large benchmarks is very resource-intensive, especially during the period of rapid model evolution. Existing efficient evaluation methods estimate the performance of target models by testing them only on a small and static coreset of the benchmark, which is derived from the publicly available evaluation results of source models. These methods rely on the assumption that target models have high prediction consistency with source models. However, we demonstrate that it doesn't generalize well in practice. To alleviate the inconsistency issue, we present TailoredBench, a method that conducts customized evaluation tailored to each target model. Specifically, a Global-coreset is first constructed as a probe to identify the most consistent source models for each target model with an adaptive source model selection strategy. Afterwards, a scalable K-Medoids clustering algorithm is proposed to extend the Global-coreset to a tailored Native-coreset for each target model. According to the predictions on Native-coresets, we obtain the performance of target models on the whole benchmark with a calibrated estimation strategy. Comprehensive experiments on 5 benchmarks across over 300 models demonstrate that compared to best performing baselines, TailoredBench achieves an average reduction of 31.4% in MAE of accuracy estimates under the same inference budgets, showcasing strong effectiveness and generalizability.

From Sub-Ability Diagnosis to Human-Aligned Generation: Bridging the Gap for Text Length Control via MARKERGEN

Despite the rapid progress of large language models (LLMs), their length-controllable text generation (LCTG) ability remains below expectations, posing a major limitation for practical applications. Existing methods mainly focus on end-to-end training to reinforce adherence to length constraints. However, the lack of decomposition and targeted enhancement of LCTG sub-abilities restricts further progress.To bridge this gap, we conduct a bottom-up decomposition of LCTG sub-abilities with human patterns as reference and perform a detailed error analysis.On this basis, we propose MarkerGen, a simple-yet-effective plug-and-play approach that:(1) mitigates LLM fundamental deficiencies via external tool integration;(2) conducts explicit length modeling with dynamically inserted markers;(3) employs a three-stage generation scheme to better align length constraints while maintaining content quality.Comprehensive experiments demonstrate that MarkerGen significantly improves LCTG across various settings, exhibiting outstanding effectiveness and generalizability.

UniCBE: An Uniformity-driven Comparing Based Evaluation Framework with Unified Multi-Objective Optimization

Human preference plays a significant role in measuring large language models and guiding them to align with human values. Unfortunately, current comparing-based evaluation (CBE) methods typically focus on a single optimization objective, failing to effectively utilize scarce yet valuable preference signals. To address this, we delve into key factors that can enhance the accuracy, convergence, and scalability of CBE: suppressing sampling bias, balancing descending process of uncertainty, and mitigating updating uncertainty. Following the derived guidelines, we propose UniCBE, a unified uniformity-driven CBE framework which simultaneously optimize these core objectives by constructing and integrating three decoupled sampling probability matrices, each designed to ensure uniformity in specific aspects. We further ablate the optimal tuple sampling and preference aggregation strategies to achieve efficient CBE. On the AlpacaEval benchmark, UniCBE saves over 17% of evaluation budgets while achieving a Pearson correlation with ground truth exceeding 0.995, demonstrating excellent accuracy and convergence. In scenarios where new models are continuously introduced, UniCBE can even save over 50% of evaluation costs, highlighting its improved scalability.

InsBank: Evolving Instruction Subset for Ongoing Alignment

Large language models (LLMs) typically undergo instruction tuning to enhance alignment. Recent studies emphasize that quality and diversity of instruction data are more crucial than quantity, highlighting the need to select diverse, high-quality subsets to reduce training costs. However, how to evolve these selected subsets alongside the development of new instruction data remains insufficiently explored. To achieve LLMs' ongoing alignment, we introduce Instruction Bank (InsBank), a continuously updated repository that integrates the latest valuable instruction data. We further propose Progressive Instruction Bank Evolution (PIBE), a novel framework designed to evolve InsBank effectively and efficiently over time. PIBE employs a gradual data selection strategy to maintain long-term efficiency, leveraging a representation-based diversity score to capture relationships between data points and retain historical information for comprehensive diversity evaluation. This also allows for flexible combination of diversity and quality scores during data selection and ranking. Extensive experiments demonstrate that PIBE significantly outperforms baselines in InsBank evolution and is able to extract budget-specific subsets, demonstrating its effectiveness and adaptability.