See Fair, Speak Truth: Equitable Attention Improves Grounding and Reduces Hallucination in Vision-Language Alignment

Multimodal large language models (MLLMs) frequently hallucinate objects that are absent from the visual input, often because attention during decoding is disproportionately drawn to visually dominant or frequently occurring content. We observe that this inequity in attention allocation is a root cause of object hallucination: when rare, small, or contextually peripheral objects receive insufficient attention, the model fails to ground its generation in the full visual scene. We argue that every object in an image, regardless of its size, frequency or visual salience, deserves equal representational opportunity during decoding. To this end, we propose DOP-OBC, a training-free and architecture-agnostic decoding strategy built on the principle of equitable attention. Two complementary object-aware signals work in tandem: a Dominant Object Penalty (DOP) that softly suppresses attention over-concentration on visually dominant regions, and an Outlier Boost Coefficient (OBC) that amplifies attention toward rare yet confidently detected objects. These signals are injected as per-row logit modulations within the causal attention mask, requiring no weight updates and preserving autoregressive decoding properties. Extensive experiments across image and video MLLMs demonstrate consistent reductions in object hallucination on CHAIR and POPE benchmarks, alongside improvements in GPT-4o assessed captioning quality across correctness, consistency, detail, context and temporal dimensions. DOP-OBC establishes that fairness in attention allocation is not merely a design principle but a practical and effective path toward more faithful multimodal generation.

Beyond the Global Scores: Fine-Grained Token Grounding as a Robust Detector of LVLM Hallucinations

Large vision-language models (LVLMs) achieve strong performance on visual reasoning tasks but remain highly susceptible to hallucination. Existing detection methods predominantly rely on coarse, whole-image measures of how an object token relates to the input image. This global strategy is limited: hallucinated tokens may exhibit weak but widely scattered correlations across many local regions, which aggregate into deceptively high overall relevance, thus evading the current global hallucination detectors. We begin with a simple yet critical observation: a faithful object token must be strongly grounded in a specific image region. Building on this insight, we introduce a patch-level hallucination detection framework that examines fine-grained token-level interactions across model layers. Our analysis uncovers two characteristic signatures of hallucinated tokens: (i) they yield diffuse, non-localized attention patterns, in contrast to the compact, well-focused attention seen in faithful tokens; and (ii) they fail to exhibit meaningful semantic alignment with any visual region. Guided by these findings, we develop a lightweight and interpretable detection method that leverages patch-level statistical features, combined with hidden-layer representations. Our approach achieves up to 90% accuracy in token-level hallucination detection, demonstrating the superiority of fine-grained structural analysis for detecting hallucinations.

MedObvious: Exposing the Medical Moravec's Paradox in VLMs via Clinical Triage

Vision Language Models (VLMs) are increasingly used for tasks like medical report generation and visual question answering. However, fluent diagnostic text does not guarantee safe visual understanding. In clinical practice, interpretation begins with pre-diagnostic sanity checks: verifying that the input is valid to read (correct modality and anatomy, plausible viewpoint and orientation, and no obvious integrity violations). Existing benchmarks largely assume this step is solved, and therefore miss a critical failure mode: a model can produce plausible narratives even when the input is inconsistent or invalid. We introduce MedObvious, a 1,880-task benchmark that isolates input validation as a set-level consistency capability over small multi-panel image sets: the model must identify whether any panel violates expected coherence. MedObvious spans five progressive tiers, from basic orientation/modality mismatches to clinically motivated anatomy/viewpoint verification and triage-style cues, and includes five evaluation formats to test robustness across interfaces. Evaluating 17 different VLMs, we find that sanity checking remains unreliable: several models hallucinate anomalies on normal (negative-control) inputs, performance degrades when scaling to larger image sets, and measured accuracy varies substantially between multiple-choice and open-ended settings. These results show that pre-diagnostic verification remains unsolved for medical VLMs and should be treated as a distinct, safety-critical capability before deployment.

AURORA: Adaptive Unified Representation for Robust Ultrasound Analysis

Ultrasound images vary widely across scanners, operators, and anatomical targets, which often causes models trained in one setting to generalize poorly to new hospitals and clinical conditions. The Foundation Model Challenge for Ultrasound Image Analysis (FMC-UIA) reflects this difficulty by requiring a single model to handle multiple tasks, including segmentation, detection, classification, and landmark regression across diverse organs and datasets. We propose a unified multi-task framework based on a transformer visual encoder from the Qwen3-VL family. Intermediate token features are projected into spatial feature maps and fused using a lightweight multi-scale feature pyramid, enabling both pixel-level predictions and global reasoning within a shared representation. Each task is handled by a small task-specific prediction head, while training uses task-aware sampling and selective loss balancing to manage heterogeneous supervision and reduce task imbalance. Our method is designed to be simple to optimize and adaptable across a wide range of ultrasound analysis tasks. The performance improved from 67% to 85% on the validation set and achieved an average score of 81.84% on the official test set across all tasks. The code is publicly available at: https://github.com/saitejalekkala33/FMCUIA-ISBI.git

ClinCoT: Clinical-Aware Visual Chain-of-Thought for Medical Vision Language Models

Medical Vision-Language Models have shown promising potential in clinical decision support, yet they remain prone to factual hallucinations due to insufficient grounding in localized pathological evidence. Existing medical alignment methods primarily operate at the response level through preference optimization, improving output correctness but leaving intermediate reasoning weakly connected to visual regions. Although chain-of-thought (CoT) enhances multimodal reasoning, it remains largely text-centric, limiting effective integration of clinical visual cues. To address this gap, we propose ClinCoT, a clinical-aware visual chain-of-thought framework that transforms preference optimization from response-level correction to visual-driven reasoning. We introduce an automatic data generation pipeline that constructs clinically grounded preference pairs through reasoning with hypotheses-driven region proposals. Multiple Med-LLMs evaluators rank and assign scores to each response, and these rankings serve as supervision to train the target model. We further introduce a scoring-based margin-aware optimization strategy that incorporates both preference ranking and score difference to refine region-level reasoning trajectories. To maintain alignment as the model's policy evolves during training, we adopt an iterative learning scheme that dynamically regenerates preference data. Extensive experiments on three medical VQA and report generation benchmarks demonstrate that ClinCoT consistently improves factual grounding and achieves superior performance compared with existing preference-based alignment methods.

CMSA-Net: Causal Multi-scale Aggregation with Adaptive Multi-source Reference for Video Polyp Segmentation

Video polyp segmentation (VPS) is an important task in computer-aided colonoscopy, as it helps doctors accurately locate and track polyps during examinations. However, VPS remains challenging because polyps often look similar to surrounding mucosa, leading to weak semantic discrimination. In addition, large changes in polyp position and scale across video frames make stable and accurate segmentation difficult. To address these challenges, we propose a robust VPS framework named CMSA-Net. The proposed network introduces a Causal Multi-scale Aggregation (CMA) module to effectively gather semantic information from multiple historical frames at different scales. By using causal attention, CMA ensures that temporal feature propagation follows strict time order, which helps reduce noise and improve feature reliability. Furthermore, we design a Dynamic Multi-source Reference (DMR) strategy that adaptively selects informative and reliable reference frames based on semantic separability and prediction confidence. This strategy provides strong multi-frame guidance while keeping the model efficient for real-time inference. Extensive experiments on the SUN-SEG dataset demonstrate that CMSA-Net achieves state-of-the-art performance, offering a favorable balance between segmentation accuracy and real-time clinical applicability.

DoAtlas-1: A Causal Compilation Paradigm for Clinical AI

Medical foundation models generate narrative explanations but cannot quantify intervention effects, detect evidence conflicts, or validate literature claims, limiting clinical auditability. We propose causal compilation, a paradigm that transforms medical evidence from narrative text into executable code. The paradigm standardizes heterogeneous research evidence into structured estimand objects, each explicitly specifying intervention contrast, effect scale, time horizon, and target population, supporting six executable causal queries: do-calculus, counterfactual reasoning, temporal trajectories, heterogeneous effects, mechanistic decomposition, and joint interventions. We instantiate this paradigm in DoAtlas-1, compiling 1,445 effect kernels from 754 studies through effect standardization, conflict-aware graph construction, and real-world validation (Human Phenotype Project, 10,000 participants). The system achieves 98.5% canonicalization accuracy and 80.5% query executability. This paradigm shifts medical AI from text generation to executable, auditable, and verifiable causal reasoning.

MedViz: An Agent-based, Visual-guided Research Assistant for Navigating Biomedical Literature

Biomedical researchers face increasing challenges in navigating millions of publications in diverse domains. Traditional search engines typically return articles as ranked text lists, offering little support for global exploration or in-depth analysis. Although recent advances in generative AI and large language models have shown promise in tasks such as summarization, extraction, and question answering, their dialog-based implementations are poorly integrated with literature search workflows. To address this gap, we introduce MedViz, a visual analytics system that integrates multiple AI agents with interactive visualization to support the exploration of the large-scale biomedical literature. MedViz combines a semantic map of millions of articles with agent-driven functions for querying, summarizing, and hypothesis generation, allowing researchers to iteratively refine questions, identify trends, and uncover hidden connections. By bridging intelligent agents with interactive visualization, MedViz transforms biomedical literature search into a dynamic, exploratory process that accelerates knowledge discovery.

Robust Atypical Mitosis Classification with DenseNet121: Stain-Aware Augmentation and Hybrid Loss for Domain Generalization

Atypical mitotic figures are important biomarkers of tumor aggressiveness in histopathology, yet reliable recognition remains challenging due to severe class imbalance and variability across imaging domains. We present a DenseNet-121-based framework tailored for atypical mitosis classification in the MIDOG 2025 (Track 2) setting. Our method integrates stain-aware augmentation (Macenko), geometric and intensity transformations, and imbalance-aware learning via weighted sampling with a hybrid objective combining class-weighted binary cross-entropy and focal loss. Trained end-to-end with AdamW and evaluated across multiple independent domains, the model demonstrates strong generalization under scanner and staining shifts, achieving balanced accuracy 85.0%, AUROC 0.927, sensitivity 89.2%, and specificity 80.9% on the official test set. These results indicate that combining DenseNet-121 with stain-aware augmentation and imbalance-adaptive objectives yields a robust, domain-generalizable framework for atypical mitosis classification suitable for real-world computational pathology workflows.

A Knowledge-driven Adaptive Collaboration of LLMs for Enhancing Medical Decision-making

Medical decision-making often involves integrating knowledge from multiple clinical specialties, typically achieved through multidisciplinary teams. Inspired by this collaborative process, recent work has leveraged large language models (LLMs) in multi-agent collaboration frameworks to emulate expert teamwork. While these approaches improve reasoning through agent interaction, they are limited by static, pre-assigned roles, which hinder adaptability and dynamic knowledge integration. To address these limitations, we propose KAMAC, a Knowledge-driven Adaptive Multi-Agent Collaboration framework that enables LLM agents to dynamically form and expand expert teams based on the evolving diagnostic context. KAMAC begins with one or more expert agents and then conducts a knowledge-driven discussion to identify and fill knowledge gaps by recruiting additional specialists as needed. This supports flexible, scalable collaboration in complex clinical scenarios, with decisions finalized through reviewing updated agent comments. Experiments on two real-world medical benchmarks demonstrate that KAMAC significantly outperforms both single-agent and advanced multi-agent methods, particularly in complex clinical scenarios (i.e., cancer prognosis) requiring dynamic, cross-specialty expertise. Our code is publicly available at: https://github.com/XiaoXiao-Woo/KAMAC.