Clinical Cognition Alignment for Gastrointestinal Diagnosis with Multimodal LLMs

Multimodal Large Language Models (MLLMs) have demonstrated remarkable potential in medical image analysis. However, their application in gastrointestinal endoscopy is currently hindered by two critical limitations: the misalignment between general model reasoning and standardized clinical cognitive pathways, and the lack of causal association between visual features and diagnostic outcomes. In this paper, we propose a novel Clinical-Cognitive-Aligned (CogAlign) framework to address these challenges. First, we endow the model with rigorous clinical analytical capabilities by constructing the hierarchical clinical cognition dataset and employing Supervised Fine-Tuning (SFT). Unlike conventional approaches, this strategy internalizes the hierarchical diagnostic logic of experts, ranging from anatomical localization and morphological evaluation to microvascular analysis, directly into the model. Second, to eliminate visual bias, we provide a theoretical analysis demonstrating that standard supervised tuning inevitably converges to spurious background correlations. Guided by this insight, we propose a counterfactual-driven reinforcement learning strategy to enforce causal rectification. By generating counterfactual normal samples via lesion masking and optimizing through clinical-cognition-centric rewards, we constrain the model to strictly ground its diagnosis in causal lesion features. Extensive experiments demonstrate that our approach achieves State-of-the-Art (SoTA) performance across multiple benchmarks, significantly enhancing diagnostic accuracy in complex clinical scenarios. All source code and datasets will be made publicly available.

LADR: Locality-Aware Dynamic Rescue for Efficient Text-to-Image Generation with Diffusion Large Language Models

Discrete Diffusion Language Models have emerged as a compelling paradigm for unified multimodal generation, yet their deployment is hindered by high inference latency arising from iterative decoding. Existing acceleration strategies often require expensive re-training or fail to leverage the 2D spatial redundancy inherent in visual data. To address this, we propose Locality-Aware Dynamic Rescue (LADR), a training-free method that expedites inference by exploiting the spatial Markov property of images. LADR prioritizes the recovery of tokens at the ''generation frontier'', regions spatially adjacent to observed pixels, thereby maximizing information gain. Specifically, our method integrates morphological neighbor identification to locate candidate tokens, employs a risk-bounded filtering mechanism to prevent error propagation, and utilizes manifold-consistent inverse scheduling to align the diffusion trajectory with the accelerated mask density. Extensive experiments on four text-to-image generation benchmarks demonstrate that our LADR achieves an approximate 4 x speedup over standard baselines. Remarkably, it maintains or even enhances generative fidelity, particularly in spatial reasoning tasks, offering a state-of-the-art trade-off between efficiency and quality.

HanMoVLM: Large Vision-Language Models for Professional Artistic Painting Evaluation

While Large Vision-Language Models (VLMs) demonstrate impressive general visual capabilities, they remain artistically blind and unable to offer professional evaluation of artworks within specific artistic domains like human experts. To bridge this gap, we transform VLMs into experts capable of professional-grade painting evaluation in the Chinese Artistic Domain, which is more abstract and demands extensive artistic training for evaluation. We introduce HanMo-Bench, a new dataset that features authentic auction-grade masterpieces and AI-generated works, grounded in real-world market valuations. To realize the rigorous judgment, we propose the HanMoVLM and construct a Chain-of-Thought (CoT) validated by experts. This CoT guides the model to perform expert-level reasoning: from content identification and Region of Interest (RoI) localization to professional evaluation, guided by both theme-specific evaluation and typical three-tier evaluation in Chinese paintings. Furthermore, we design a reward function to refine the reasoning process of the HanMoVLM to improve the accuracy. We demonstrate that HanMoVLM can serve as a critical backbone for Test-time Scaling in image generation. By acting as a high-quality verifier, HanMoVLM enables generative models to select the most artistically superior outputs from multiple candidates. Experimental results and human studies confirm that the proposed HanMoVLM effectively bridges the gap, achieving a high consistency with professional experts and significantly improving the quality of Chinese Painting generation.

Condition Errors Refinement in Autoregressive Image Generation with Diffusion Loss

Recent studies have explored autoregressive models for image generation, with promising results, and have combined diffusion models with autoregressive frameworks to optimize image generation via diffusion losses. In this study, we present a theoretical analysis of diffusion and autoregressive models with diffusion loss, highlighting the latter's advantages. We present a theoretical comparison of conditional diffusion and autoregressive diffusion with diffusion loss, demonstrating that patch denoising optimization in autoregressive models effectively mitigates condition errors and leads to a stable condition distribution. Our analysis also reveals that autoregressive condition generation refines the condition, causing the condition error influence to decay exponentially. In addition, we introduce a novel condition refinement approach based on Optimal Transport (OT) theory to address ``condition inconsistency''. We theoretically demonstrate that formulating condition refinement as a Wasserstein Gradient Flow ensures convergence toward the ideal condition distribution, effectively mitigating condition inconsistency. Experiments demonstrate the superiority of our method over diffusion and autoregressive models with diffusion loss methods.

From Human Intention to Action Prediction: A Comprehensive Benchmark for Intention-driven End-to-End Autonomous Driving

Current end-to-end autonomous driving systems operate at a level of intelligence akin to following simple steering commands. However, achieving genuinely intelligent autonomy requires a paradigm shift: moving from merely executing low-level instructions to understanding and fulfilling high-level, abstract human intentions. This leap from a command-follower to an intention-fulfiller, as illustrated in our conceptual framework, is hindered by a fundamental challenge: the absence of a standardized benchmark to measure and drive progress on this complex task. To address this critical gap, we introduce Intention-Drive, the first comprehensive benchmark designed to evaluate the ability to translate high-level human intent into safe and precise driving actions. Intention-Drive features two core contributions: (1) a new dataset of complex scenarios paired with corresponding natural language intentions, and (2) a novel evaluation protocol centered on the Intent Success Rate (ISR), which assesses the semantic fulfillment of the human's goal beyond simple geometric accuracy. Through an extensive evaluation of a spectrum of baseline models on Intention-Drive, we reveal a significant performance deficit, showing that the baseline model struggle to achieve the comprehensive scene and intention understanding required for this advanced task.

RVLF: A Reinforcing Vision-Language Framework for Gloss-Free Sign Language Translation

Gloss-free sign language translation (SLT) is hindered by two key challenges: **inadequate sign representation** that fails to capture nuanced visual cues, and **sentence-level semantic misalignment** in current LLM-based methods, which limits translation quality. To address these issues, we propose a three-stage **r**einforcing **v**ision-**l**anguage **f**ramework (**RVLF**). We build a large vision-language model (LVLM) specifically designed for sign language, and then combine it with reinforcement learning (RL) to adaptively enhance translation performance. First, for a sufficient representation of sign language, RVLF introduces an effective semantic representation learning mechanism that fuses skeleton-based motion cues with semantically rich visual features extracted via DINOv2, followed by instruction tuning to obtain a strong SLT-SFT baseline. Then, to improve sentence-level semantic misalignment, we introduce a GRPO-based optimization strategy that fine-tunes the SLT-SFT model with a reward function combining translation fidelity (BLEU) and sentence completeness (ROUGE), yielding the optimized model termed SLT-GRPO. Our conceptually simple framework yields substantial gains under the gloss-free SLT setting without pre-training on any external large-scale sign language datasets, improving BLEU-4 scores by +5.1, +1.11, +1.4, and +1.61 on the CSL-Daily, PHOENIX-2014T, How2Sign, and OpenASL datasets, respectively. To the best of our knowledge, this is the first work to incorporate GRPO into SLT. Extensive experiments and ablation studies validate the effectiveness of GRPO-based optimization in enhancing both translation quality and semantic consistency.

Sim4Seg: Boosting Multimodal Multi-disease Medical Diagnosis Segmentation with Region-Aware Vision-Language Similarity Masks

Despite significant progress in pixel-level medical image analysis, existing medical image segmentation models rarely explore medical segmentation and diagnosis tasks jointly. However, it is crucial for patients that models can provide explainable diagnoses along with medical segmentation results. In this paper, we introduce a medical vision-language task named Medical Diagnosis Segmentation (MDS), which aims to understand clinical queries for medical images and generate the corresponding segmentation masks as well as diagnostic results. To facilitate this task, we first present the Multimodal Multi-disease Medical Diagnosis Segmentation (M3DS) dataset, containing diverse multimodal multi-disease medical images paired with their corresponding segmentation masks and diagnosis chain-of-thought, created via an automated diagnosis chain-of-thought generation pipeline. Moreover, we propose Sim4Seg, a novel framework that improves the performance of diagnosis segmentation by taking advantage of the Region-Aware Vision-Language Similarity to Mask (RVLS2M) module. To improve overall performance, we investigate a test-time scaling strategy for MDS tasks. Experimental results demonstrate that our method outperforms the baselines in both segmentation and diagnosis.

TheraMind: A Strategic and Adaptive Agent for Longitudinal Psychological Counseling

Large language models (LLMs) in psychological counseling have attracted increasing attention. However, existing approaches often lack emotional understanding, adaptive strategies, and the use of therapeutic methods across multiple sessions with long-term memory, leaving them far from real clinical practice. To address these critical gaps, we introduce TheraMind, a strategic and adaptive agent for longitudinal psychological counseling. The cornerstone of TheraMind is a novel dual-loop architecture that decouples the complex counseling process into an Intra-Session Loop for tactical dialogue management and a Cross-Session Loop for strategic therapeutic planning. The Intra-Session Loop perceives the patient's emotional state to dynamically select response strategies while leveraging cross-session memory to ensure continuity. Crucially, the Cross-Session Loop empowers the agent with long-term adaptability by evaluating the efficacy of the applied therapy after each session and adjusting the method for subsequent interactions. We validate our approach in a high-fidelity simulation environment grounded in real clinical cases. Extensive evaluations show that TheraMind outperforms other methods, especially on multi-session metrics like Coherence, Flexibility, and Therapeutic Attunement, validating the effectiveness of its dual-loop design in emulating strategic, adaptive, and longitudinal therapeutic behavior. The code is publicly available at https://0mwwm0.github.io/TheraMind/.

Semantic Causality-Aware Vision-Based 3D Occupancy Prediction

Vision-based 3D semantic occupancy prediction is a critical task in 3D vision that integrates volumetric 3D reconstruction with semantic understanding. Existing methods, however, often rely on modular pipelines. These modules are typically optimized independently or use pre-configured inputs, leading to cascading errors. In this paper, we address this limitation by designing a novel causal loss that enables holistic, end-to-end supervision of the modular 2D-to-3D transformation pipeline. Grounded in the principle of 2D-to-3D semantic causality, this loss regulates the gradient flow from 3D voxel representations back to the 2D features. Consequently, it renders the entire pipeline differentiable, unifying the learning process and making previously non-trainable components fully learnable. Building on this principle, we propose the Semantic Causality-Aware 2D-to-3D Transformation, which comprises three components guided by our causal loss: Channel-Grouped Lifting for adaptive semantic mapping, Learnable Camera Offsets for enhanced robustness against camera perturbations, and Normalized Convolution for effective feature propagation. Extensive experiments demonstrate that our method achieves state-of-the-art performance on the Occ3D benchmark, demonstrating significant robustness to camera perturbations and improved 2D-to-3D semantic consistency.

MAM: Modular Multi-Agent Framework for Multi-Modal Medical Diagnosis via Role-Specialized Collaboration

Recent advancements in medical Large Language Models (LLMs) have showcased their powerful reasoning and diagnostic capabilities. Despite their success, current unified multimodal medical LLMs face limitations in knowledge update costs, comprehensiveness, and flexibility. To address these challenges, we introduce the Modular Multi-Agent Framework for Multi-Modal Medical Diagnosis (MAM). Inspired by our empirical findings highlighting the benefits of role assignment and diagnostic discernment in LLMs, MAM decomposes the medical diagnostic process into specialized roles: a General Practitioner, Specialist Team, Radiologist, Medical Assistant, and Director, each embodied by an LLM-based agent. This modular and collaborative framework enables efficient knowledge updates and leverages existing medical LLMs and knowledge bases. Extensive experimental evaluations conducted on a wide range of publicly accessible multimodal medical datasets, incorporating text, image, audio, and video modalities, demonstrate that MAM consistently surpasses the performance of modality-specific LLMs. Notably, MAM achieves significant performance improvements ranging from 18% to 365% compared to baseline models. Our code is released at https://github.com/yczhou001/MAM.