PACT: Learning Diverse Diagnostic Strategies via Privileged Synthesis and Branch Consensus

Clinical diagnosis requires flexible use of multiple reasoning paradigms under incomplete patient information. Existing LLM-based medical agents show strong medical reasoning ability, but single-paradigm or naively mixed dialogue supervision makes these paradigms difficult to learn without interference. We propose \textbf{PACT} (Periodic Anchor Consensus Training), a framework that couples supervised multi-paradigm dialogue synthesis with consensus-based Branch training. At the data level, \textbf{DPS} (Doctor-Patient-Supervisor) uses complete electronic medical records (EMRs) for quality control while keeping the doctor agent restricted to patient-visible information. This produces validated dialogues under four diagnostic reasoning paradigms without leaking hidden clinical answers. At the training level, PACT trains one paradigm-specific LoRA Branch per paradigm and periodically aggregates Branches into a shared Anchor through sign consensus. We further construct a dynamic multi-turn Chinese medical diagnosis benchmark for interactive consultation. Experiments show that PACT achieves state-of-the-art performance among compared proprietary, medical-specialized, and task-adapted baselines on diagnostic outcome and consultation-process metrics.

MolE-RAG: Molecular Structure-Enhanced Retrieval-Augmented Generation for Chemistry

Large language models (LLMs) have shown promise for molecular property prediction, but their ability to reason over chemical structures remains limited, as molecular representations such as SMILES differ substantially from the natural language on which LLMs are primarily trained. To bridge this semantic and chemical knowledge gap, we propose MolE-RAG, a training-free, molecule-centric retrieval-augmented generation framework for LLM-based molecular property prediction. MolE-RAG augments each prediction with three complementary sources of inference-time context: retrieved chemistry literature, molecule-specific information including compound synonyms, identifiers, functional group annotations, and physicochemical descriptors, and structurally similar molecules retrieved from the training set. We evaluate MolE-RAG across nine molecular property prediction tasks using proprietary, chemistry-specialized, and open-source LLMs. Across general-purpose LLMs, MolE-RAG improves ROC-AUC by up to 28 percentage points on classification tasks and reduces regression RMSE by up to 67% relative to a SMILES-only baseline. We further find that the utility of each context source varies across models and tasks, with different models benefiting most from textual retrieval, molecular context, or structural retrieval. These results suggest that molecule-centric retrieval can improve LLM-based molecular property prediction without model fine-tuning while providing a flexible framework for integrating heterogeneous chemical knowledge at inference time.

PatchWorld: Gradient-Free Optimization of Executable World Models

Text-agent environments are typically modeled as partially observable Markov decision processes (POMDPs), assuming that the simulator's latent state and transition dynamics are hidden from the agent. Yet little work has examined whether executable code can be induced to serve as a world model for prediction and planning under partial observability. We introduce PatchWorld, a gradient-free framework that turns offline trajectories into executable Python world models through counterexample-guided code repair. Instead of predicting the next observation with a black-box model, PatchWorld induces symbolic belief-state programs whose action updates can be inspected, replayed, and locally patched. Across seven AgentGym environments, PatchWorld-Simple achieves the highest code-based planning score among evaluated methods, reaching 76.4\% macro success in live one-step lookahead while invoking no LLM calls inside the world-model prediction module itself. We further find that a human-specified residual-memory bias improves surface observation fidelity but weakens decision utility. This exposes a tradeoff in executable world models, since improving observation fidelity can come at the expense of action-discriminative dynamics, and vice versa. Code is available at https://github.com/HKBU-KnowComp/PatchWorld.

Revisiting ML Training under Fully Homomorphic Encryption: Convergence Guarantees, Differential Privacy, and Efficient Algorithms

We present the first theoretical convergence analysis of machine learning training under fully homomorphic encryption (FHE), combined with a differentially private (DP) training algorithm tailored to encrypted computation. Our approach improves computational efficiency over standard differentially private gradient descent (DP-GD) while achieving comparable utility. In particular, we prove convergence of approximate gradient descent using polynomial approximations of activation and loss functions, which are required for FHE compatibility. To preserve privacy in downstream tasks, we integrate differential privacy without relying on costly per-sample gradient clipping, enabling scalable encrypted learning. We also provide data-independent hyperparameter selection and theoretically grounded strategies for polynomial approximation which can be of independent interest. Together, these contributions advance the feasibility of efficient, private, and secure machine learning on sensitive data.

MedGuideX: Internalizing Decision Logic from Executable Guidelines into Large Language Models for Clinical Reasoning

Clinical practice guidelines (CPGs) encode evidence-based decision logic that clinicians apply by evaluating patient variables, conditional criteria, and recommendation rules. However, existing methods often use CPGs as free-text training data or retrieval sources, underutilizing their procedural decision structure. To better exploit this structure, we introduce a guideline-derived training pipeline that transforms CPG recommendations into executable clinical decision logic and uses it to generate factual and counterfactual question-answering data. Theses data teach models both guideline-supported decisions and how decisions change under different patient conditions. Post-training a medical LLM on the generated data yields MedGuideX. Across four clinical reasoning benchmarks, MedGuideX achieves a 10.28% relative improvement in average accuracy. Physician evaluation further shows that MedGuideX better recovers clinician authored reasoning steps and produces physician-preferred rationales in faithfulness, validity, completeness, and clarity. Overall, our results show that executable decision logic from CPGs can be transformed into scalable supervision for building reliable medical LLMs.

MedConceal: A Benchmark for Clinical Hidden-Concern Reasoning Under Partial Observability

Patient-clinician communication is an asymmetric-information problem: patients often do not disclose fears, misconceptions, or practical barriers unless clinicians elicit them skillfully. Effective medical dialogue therefore requires reasoning under partial observability: clinicians must elicit latent concerns, confirm them through interaction, and respond in ways that guide patients toward appropriate care. However, existing medical dialogue benchmarks largely sidestep this challenge by exposing hidden patient state, collapsing elicitation into extraction, or evaluating responses without modeling what remains hidden. We present MedConceal, a benchmark with an interactive patient simulator for evaluating hidden-concern reasoning in medical dialogue, comprising 300 curated cases and 600 clinician-LLM interactions. Built from clinician-answered online health discussions, each case pairing clinician-visible context with simulator-internal hidden concerns derived from prior literature and structured using an expert-developed taxonomy. The simulator withholds these concerns from the dialogue agent, tracks whether they have been revealed and addressed via theory-grounded turn-level communication signals, and is clinician-reviewed for clinical plausibility. This enables process-aware evaluation of both task success and the interaction process that leads to it. We study two abilities: confirmation, surfacing hidden concerns through multi-turn dialogue, and intervention, addressing the primary concern and guiding the patient toward a target plan. Results show that no single system dominates: frontier models lead on different confirmation metrics, while human clinicians (N=159) remain strongest on intervention success. Together, these results identify hidden-concern reasoning under partial observability as a key unresolved challenge for medical dialogue systems.

Joint Optimization of Reasoning and Dual-Memory for Self-Learning Diagnostic Agent

Clinical expertise improves not only by acquiring medical knowledge, but by accumulating experience that yields reusable diagnostic patterns. Recent LLMs-based diagnostic agents have shown promising progress in clinical reasoning for decision support. However, most approaches treat cases independently, limiting experience reuse and continual adaptation. We propose SEA, a self-learning diagnostic agent with cognitively inspired dual-memory module. We design a reinforcement training framework tailored to our designed agent for joint optimization of reasoning and memory management. We evaluate SEA in two complementary settings. On standard evaluation with MedCaseReasoning dataset, SEA achieves 92.46% accuracy, outperforming the strongest baseline by +19.6%, demonstrating the benefit of jointly optimizing reasoning and memory. On the long-horizon with ER-Reason dataset, SEA attains the best final accuracy (0.7214) and the largest improvement (+0.35 Acc@100), while baseline methods show limited or unstable gains. Expert evaluation further indicates that rules consolidated from SEA show strong clinical correctness, usefulness and trust, suggesting that the induced rules in dual-memory module are reliable and practically meaningful. Overall, SEA improves both diagnostic reasoning ability and continual learning by effectively transforming experience into reusable knowledge.

Improving Clinical Diagnosis with Counterfactual Multi-Agent Reasoning

Clinical diagnosis is a complex reasoning process in which clinicians gather evidence, form hypotheses, and test them against alternative explanations. In medical training, this reasoning is explicitly developed through counterfactual questioning--e.g., asking how a diagnosis would change if a key symptom were absent or altered--to strengthen differential diagnosis skills. As large language model (LLM)-based systems are increasingly used for diagnostic support, ensuring the interpretability of their recommendations becomes critical. However, most existing LLM-based diagnostic agents reason over fixed clinical evidence without explicitly testing how individual findings support or weaken competing diagnoses. In this work, we propose a counterfactual multi-agent diagnostic framework inspired by clinician training that makes hypothesis testing explicit and evidence-grounded. Our framework introduces counterfactual case editing to modify clinical findings and evaluate how these changes affect competing diagnoses. We further define the Counterfactual Probability Gap, a method that quantifies how strongly individual findings support a diagnosis by measuring confidence shifts under these edits. These counterfactual signals guide multi-round specialist discussions, enabling agents to challenge unsupported hypotheses, refine differential diagnoses, and produce more interpretable reasoning trajectories. Across three diagnostic benchmarks and seven LLMs, our method consistently improves diagnostic accuracy over prompting and prior multi-agent baselines, with the largest gains observed in complex and ambiguous cases. Human evaluation further indicates that our framework produces more clinically useful, reliable, and coherent reasoning. These results suggest that incorporating counterfactual evidence verification is an important step toward building reliable AI systems for clinical decision support.

AD-Copilot: A Vision-Language Assistant for Industrial Anomaly Detection via Visual In-context Comparison

Multimodal Large Language Models (MLLMs) have achieved impressive success in natural visual understanding, yet they consistently underperform in industrial anomaly detection (IAD). This is because MLLMs trained mostly on general web data differ significantly from industrial images. Moreover, they encode each image independently and can only compare images in the language space, making them insensitive to subtle visual differences that are key to IAD. To tackle these issues, we present AD-Copilot, an interactive MLLM specialized for IAD via visual in-context comparison. We first design a novel data curation pipeline to mine inspection knowledge from sparsely labeled industrial images and generate precise samples for captioning, VQA, and defect localization, yielding a large-scale multimodal dataset Chat-AD rich in semantic signals for IAD. On this foundation, AD-Copilot incorporates a novel Comparison Encoder that employs cross-attention between paired image features to enhance multi-image fine-grained perception, and is trained with a multi-stage strategy that incorporates domain knowledge and gradually enhances IAD skills. In addition, we introduce MMAD-BBox, an extended benchmark for anomaly localization with bounding-box-based evaluation. The experiments show that AD-Copilot achieves 82.3% accuracy on the MMAD benchmark, outperforming all other models without any data leakage. In the MMAD-BBox test, it achieves a maximum improvement of $3.35\times$ over the baseline. AD-Copilot also exhibits excellent generalization of its performance gains across other specialized and general-purpose benchmarks. Remarkably, AD-Copilot surpasses human expert-level performance on several IAD tasks, demonstrating its potential as a reliable assistant for real-world industrial inspection. All datasets and models will be released for the broader benefit of the community.

Multi-Head Low-Rank Attention

Long-context inference in large language models is bottlenecked by Key--Value (KV) cache loading during the decoding stage, where the sequential nature of generation requires repeatedly transferring the KV cache from off-chip High-Bandwidth Memory (HBM) to on-chip Static Random-Access Memory (SRAM) at each step. While Multi-Head Latent Attention (MLA) significantly reduces the total KV cache size, it suffers from a sharding bottleneck during distributed decoding via Tensor Parallelism (TP). Since its single latent head cannot be partitioned, each device is forced to redundantly load the complete KV cache for every token, consuming excessive memory traffic and diminishing TP benefits like weight sharding. In this work, we propose Multi-Head Low-Rank Attention (MLRA), which enables partitionable latent states for efficient 4-way TP decoding. Extensive experiments show that MLRA achieves state-of-the-art perplexity and downstream task performance, while also delivering a 2.8$\times$ decoding speedup over MLA. Code is available at https://github.com/SongtaoLiu0823/MLRA. Pretrained weights, along with the training and evaluation data, are available at https://huggingface.co/Soughing/MLRA.