Evaluating Multi-Turn Multimodal Diagnostic Reasoning on Challenging Real-World Clinical Cases

Clinical diagnostic evaluation should not only assess whether models can provide correct diagnoses, but also reflect the realities of clinical practice, including progressive disclosure of multimodal information, dynamic updating of diagnostic hypotheses, and continuous refinement of clinical reasoning. However, existing evaluations of multimodal large language models (MLLMs) typically rely on single-turn or isolated tasks, making it difficult to fully capture the complexity of real-world clinical diagnosis. To bridge this gap, we developed ClinMM-Bench, the largest multi-turn multimodal clinical diagnostic evaluation benchmark to date. ClinMM-Bench contains 1,089 challenging real-world clinical cases and 3,760 medical images across eight specialties. We systematically evaluated 15 representative MLLMs using a two-level evaluation framework that assessed both diagnostic accuracy and diagnostic reasoning quality. Results showed that proprietary models achieved the highest overall diagnostic accuracy, but the proportion of completely correct diagnoses remained limited across all models. In terms of diagnostic reasoning quality, current models can identify plausible diagnostic directions but still have considerable limitations in generating reliable diagnostic reasoning. Error analysis further identified five representative failure modes: information synthesis failure, knowledge mapping error, perception error, premature closure, and visual hallucination.

Finding H. pylori in the Fine Print: Evidence-Linked Multi-Agent Case Finding from Gastric Biopsy Reports

Data from Singapore indicated that about 31% of the population had evidence of Helicobacter pylori infection. Persistent H. pylori infection is associated with chronic active gastritis and peptic ulcer disease, and its eradication is key to gastric cancer prevention. However, evidence supporting \textit{H. pylori} positivity and H. pylori-associated gastritis may be distributed across heterogeneous coded and free-text report fields and may require contextual interpretation of assertion and negation, limiting keyword search, and making manual review difficult to scale. We conducted a retrospective pilot evaluation of the Nimblemind Multi-Agent System (nMAS), a field-name-driven, evidence-linked extraction workflow, using 54 de-identified gastric biopsy pathology reports from a large healthcare system in Singapore. Four clinician-scoped binary fields were evaluated: gastric/stomach biopsy, biopsy status, H. pylori positivity, and H. pylori-associated gastritis. Across 216 feature-case decisions, nMAS correctly classified 213, corresponding to 98.61% overall accuracy. A separately implemented UMA-style MiniMax M2.5 comparator produced similar aggregate and per-field classification metrics. Although predictive performance was similar, nMAS maintained unified report-level outputs with supporting source sentences; the demonstrated contribution is therefore workflow integration and traceability rather than predictive superiority. Under an illustrative, unmeasured scenario, reviewing 1,000 reports at five minutes per manual review versus five seconds per evidence-linked verification would reduce review time from 83.3 to 1.4 staff-hours, corresponding to 81.9 staff-hours and about USD~6,100 in potential staff-time value. Larger multi-institutional studies should evaluate evidence-span correctness, clinician verification time, and generalizability.

FAF-CD: Frequency-Aware Fusion for Change Detection under Imperfect Multimodal Remote Sensing

Remote sensing change detection for real-world monitoring often relies on imperfect heterogeneous observations, where pre- and post-event images may be asynchronous, cross-sensor, or affected by illumination, seasonal, and modality shifts. This setting is especially challenging for EO-SAR disaster mapping, where nuisance variation can resemble structural damage. We propose FAF-CD, a frequency-aware hybrid framework with a DINOv3-pretrained ConvNeXt encoder and a linear-complexity VMamba-based decoder. Its rectification-aware tri-branch fusion module combines deformable spatial alignment with Fourier and Haar-wavelet comparisons, using adaptive gating to aggregate complementary cues across scales. On BRIGHT validation, a matched heterogeneous EO-SAR adaptation improves clean and perturbed tc-mIoU/tc-mAP over NeXt2Former-CD. FAF-CD also generalizes to binary optical CD, achieving 0.924 cF1 on LEVIR-CD and 0.955 cF1 on WHU-CD, and obtains the best average perturbed cIoU/cF1 on both binary datasets among M-CD and NeXt2Former-CD under pseudo-change-aligned stress tests. It further reduces cost by approximately 24 GFLOPs relative to NeXt2Former-CD while maintaining or improving accuracy.

LLMs Know When They Know, but Do Not Act on It: A Metacognitive Harness for Test-time Scaling

Large language models (LLMs) often expose useful signals of self-monitoring: before solving a problem, they can estimate whether they are likely to succeed, and after solving it, they can judge whether their answer is likely to be correct. However, these signals are typically measured or elicited in isolation, rather than used to control inference. In this work, we ask whether LLMs possess latent metacognitive ability that can be turned into effective test-time control. Inspired by the Nelson--Narens theory from cognitive psychology, we propose a metacognitive harness that separates monitoring from reasoning. For each problem, the model first reports a pre-solve feeling-of-knowing (FOK) signal; after each solve attempt, it reports a post-solve judgment-of-learning (JOL) signal. Rather than treating these signals as passive confidence estimates, the harness turns them into an explicit control interface for reasoning: it decides when to trust the current solution, when to retry with compact metacognitive feedback, and when to pass multiple attempts to a final aggregator. Across text, code, and multimodal reasoning benchmarks, our harness substantially improves a fixed Claude Sonnet-4.6 base model without parameter updates or benchmark-specific fine-tuning. On the evaluated public benchmark snapshots, it raises pooled accuracy from 48.3 to 56.9 and exceeds the strongest listed leaderboard entries on the three primary evaluation settings: HLE-Verified, LiveCodeBench v6, and R-Bench-V. These results suggest that strong LLMs may already possess useful metacognitive ability, but require an explicit control harness to act on it during reasoning.

A Benchmark Grocery Dataset of Realworld Point Clouds From Single View

Fine-grained grocery object recognition is an important computer vision problem with broad applications in automatic checkout, in-store robotic navigation, and assistive technologies for the visually impaired. Existing datasets on groceries are mainly 2D images. Models trained on these datasets are limited to learning features from the regular 2D grids. While portable 3D sensors such as Kinect were commonly available for mobile phones, sensors such as LiDAR and TrueDepth, have recently been integrated into mobile phones. Despite the availability of mobile 3D sensors, there are currently no dedicated real-world large-scale benchmark 3D datasets for grocery. In addition, existing 3D datasets lack fine-grained grocery categories and have limited training samples. Furthermore, collecting data by going around the object versus the traditional photo capture makes data collection cumbersome. Thus, we introduce a large-scale grocery dataset called 3DGrocery100. It constitutes 100 classes, with a total of 87,898 3D point clouds created from 10,755 RGB-D single-view images. We benchmark our dataset on six recent state-of-the-art 3D point cloud classification models. Additionally, we also benchmark the dataset on few-shot and continual learning point cloud classification tasks. Project Page: https://bigdatavision.org/3DGrocery100/.

Unsupervised Out-of-Distribution Detection with Diffusion Inpainting

Unsupervised out-of-distribution detection (OOD) seeks to identify out-of-domain data by learning only from unlabeled in-domain data. We present a novel approach for this task - Lift, Map, Detect (LMD) - that leverages recent advancement in diffusion models. Diffusion models are one type of generative models. At their core, they learn an iterative denoising process that gradually maps a noisy image closer to their training manifolds. LMD leverages this intuition for OOD detection. Specifically, LMD lifts an image off its original manifold by corrupting it, and maps it towards the in-domain manifold with a diffusion model. For an out-of-domain image, the mapped image would have a large distance away from its original manifold, and LMD would identify it as OOD accordingly. We show through extensive experiments that LMD achieves competitive performance across a broad variety of datasets.

A principled distributional approach to trajectory similarity measurement

Existing measures and representations for trajectories have two longstanding fundamental shortcomings, i.e., they are computationally expensive and they can not guarantee the `uniqueness' property of a distance function: dist(X,Y) = 0 if and only if X=Y, where $X$ and $Y$ are two trajectories. This paper proposes a simple yet powerful way to represent trajectories and measure the similarity between two trajectories using a distributional kernel to address these shortcomings. It is a principled approach based on kernel mean embedding which has a strong theoretical underpinning. It has three distinctive features in comparison with existing approaches. (1) A distributional kernel is used for the very first time for trajectory representation and similarity measurement. (2) It does not rely on point-to-point distances which are used in most existing distances for trajectories. (3) It requires no learning, unlike existing learning and deep learning approaches. We show the generality of this new approach in three applications: (a) trajectory anomaly detection, (b) anomalous sub-trajectory detection, and (c) trajectory pattern mining. We identify that the distributional kernel has (i) a unique data-dependent property and the above uniqueness property which are the key factors that lead to its superior task-specific performance; and (ii) runtime orders of magnitude faster than existing distance measures.