Fundus Image-based Glaucoma Screening via Retinal Knowledge-Oriented Dynamic Multi-Level Feature Integration

Automated diagnosis based on color fundus photography is essential for large-scale glaucoma screening. However, existing deep learning models are typically data-driven and lack explicit integration of retinal anatomical knowledge, which limits their robustness across heterogeneous clinical datasets. Moreover, pathological cues in fundus images may appear beyond predefined anatomical regions, making fixed-region feature extraction insufficient for reliable diagnosis. To address these challenges, we propose a retinal knowledge-oriented glaucoma screening framework that integrates dynamic multi-scale feature learning with domain-specific retinal priors. The framework adopts a tri-branch structure to capture complementary retinal representations, including global retinal context, structural features of the optic disc/cup, and dynamically localized pathological regions. A Dynamic Window Mechanism is devised to adaptively identify diagnostically informative regions, while a Knowledge-Enhanced Convolutional Attention Module incorporates retinal priors extracted from a pre-trained foundation model to guide attention learning. Extensive experiments on the large-scale AIROGS dataset demonstrate that the proposed method outperforms diverse baselines, achieving an AUC of 98.5% and an accuracy of 94.6%. Additional evaluations on multiple datasets from the SMDG-19 benchmark further confirm its strong cross-domain generalization capability, indicating that knowledge-guided attention combined with adaptive lesion localization can significantly improve the robustness of automated glaucoma screening systems.

Cognitive Pivot Points and Visual Anchoring: Unveiling and Rectifying Hallucinations in Multimodal Reasoning Models

Multimodal Large Reasoning Models (MLRMs) have achieved remarkable strides in visual reasoning through test time compute scaling, yet long chain reasoning remains prone to hallucinations. We identify a concerning phenomenon termed the Reasoning Vision Truth Disconnect (RVTD): hallucinations are strongly correlated with cognitive bifurcation points that often exhibit high entropy states. We attribute this vulnerability to a breakdown in visual semantic anchoring, localized within the network's intermediate layers; specifically, during these high uncertainty transitions, the model fails to query visual evidence, reverting instead to language priors. Consequently, we advocate a shift from solely outcome level supervision to augmenting it with fine grained internal attention guidance. To this end, we propose V-STAR (Visual Structural Training with Attention Reinforcement), a lightweight, holistic training paradigm designed to internalize visually aware reasoning capabilities. Central to our approach is the Hierarchical Visual Attention Reward (HVAR), integrated within the GRPO framework. Upon detecting high entropy states, this mechanism dynamically incentivizes visual attention across critical intermediate layers, thereby anchoring the reasoning process back to the visual input. Furthermore, we introduce the Forced Reflection Mechanism (FRM), a trajectory editing strategy that disrupts cognitive inertia by triggering reflection around high entropy cognitive bifurcation points and encouraging verification of subsequent steps against the visual input, thereby translating external debiasing interventions into an intrinsic capability for hallucination mitigation.

Do No Harm: Exposing Hidden Vulnerabilities of LLMs via Persona-based Client Simulation Attack in Psychological Counseling

The increasing use of large language models (LLMs) in mental healthcare raises safety concerns in high-stakes therapeutic interactions. A key challenge is distinguishing therapeutic empathy from maladaptive validation, where supportive responses may inadvertently reinforce harmful beliefs or behaviors in multi-turn conversations. This risk is largely overlooked by existing red-teaming frameworks, which focus mainly on generic harms or optimization-based attacks. To address this gap, we introduce Personality-based Client Simulation Attack (PCSA), the first red-teaming framework that simulates clients in psychological counseling through coherent, persona-driven client dialogues to expose vulnerabilities in psychological safety alignment. Experiments on seven general and mental health-specialized LLMs show that PCSA substantially outperforms four competitive baselines. Perplexity analysis and human inspection further indicate that PCSA generates more natural and realistic dialogues. Our results reveal that current LLMs remain vulnerable to domain-specific adversarial tactics, providing unauthorized medical advice, reinforcing delusions, and implicitly encouraging risky actions.

Project Imaging-X: A Survey of 1000+ Open-Access Medical Imaging Datasets for Foundation Model Development

Foundation models have demonstrated remarkable success across diverse domains and tasks, primarily due to the thrive of large-scale, diverse, and high-quality datasets. However, in the field of medical imaging, the curation and assembling of such medical datasets are highly challenging due to the reliance on clinical expertise and strict ethical and privacy constraints, resulting in a scarcity of large-scale unified medical datasets and hindering the development of powerful medical foundation models. In this work, we present the largest survey to date of medical image datasets, covering over 1,000 open-access datasets with a systematic catalog of their modalities, tasks, anatomies, annotations, limitations, and potential for integration. Our analysis exposes a landscape that is modest in scale, fragmented across narrowly scoped tasks, and unevenly distributed across organs and modalities, which in turn limits the utility of existing medical image datasets for developing versatile and robust medical foundation models. To turn fragmentation into scale, we propose a metadata-driven fusion paradigm (MDFP) that integrates public datasets with shared modalities or tasks, thereby transforming multiple small data silos into larger, more coherent resources. Building on MDFP, we release an interactive discovery portal that enables end-to-end, automated medical image dataset integration, and compile all surveyed datasets into a unified, structured table that clearly summarizes their key characteristics and provides reference links, offering the community an accessible and comprehensive repository. By charting the current terrain and offering a principled path to dataset consolidation, our survey provides a practical roadmap for scaling medical imaging corpora, supporting faster data discovery, more principled dataset creation, and more capable medical foundation models.

MuSEAgent: A Multimodal Reasoning Agent with Stateful Experiences

Research agents have recently achieved significant progress in information seeking and synthesis across heterogeneous textual and visual sources. In this paper, we introduce MuSEAgent, a multimodal reasoning agent that enhances decision-making by extending the capabilities of research agents to discover and leverage stateful experiences. Rather than relying on trajectory-level retrieval, we propose a stateful experience learning paradigm that abstracts interaction data into atomic decision experiences through hindsight reasoning. These experiences are organized into a quality-filtered experience bank that supports policy-driven experience retrieval at inference time. Specifically, MuSEAgent enables adaptive experience exploitation through complementary wide- and deep-search strategies, allowing the agent to dynamically retrieve multimodal guidance across diverse compositional semantic viewpoints. Extensive experiments demonstrate that MuSEAgent consistently outperforms strong trajectory-level experience retrieval baselines on both fine-grained visual perception and complex multimodal reasoning tasks. These results validate the effectiveness of stateful experience modeling in improving multimodal agent reasoning.

Thinking in Uncertainty: Mitigating Hallucinations in MLRMs with Latent Entropy-Aware Decoding

Recent advancements in multimodal large reasoning models (MLRMs) have significantly improved performance in visual question answering. However, we observe that transition words (e.g., because, however, and wait) are closely associated with hallucinations and tend to exhibit high-entropy states. We argue that adequate contextual reasoning information can be directly extracted from the token probability distribution. Inspired by superposed representation theory, we propose leveraging latent superposed reasoning to integrate multiple candidate semantics and maintain latent reasoning trajectories. The hypothesis is that reliance on discrete textual inputs may drive the model toward sequential explicit reasoning, underutilizing dense contextual cues during high-entropy reasoning stages. Therefore, we propose constructing rich semantic representations from the token probability distributions to enhance in-context reasoning. With this goal, we present Latent Entropy-Aware Decoding (LEAD), an efficient plug-and-play decoding strategy that leverages semantic context to achieve reliable reasoning. The heart of our method lies in entropy-aware reasoning mode switching. The model employs probability-weighted continuous embeddings under high-entropy states and transitions back to discrete token embeddings as entropy decreases. Moreover, we propose a prior-guided visual anchor injection strategy that encourages the model to focus on visual information. Extensive experiments show that LEAD effectively mitigates hallucinations across various MLRMs on multiple benchmarks.

OPGAgent: An Agent for Auditable Dental Panoramic X-ray Interpretation

Orthopantomograms (OPGs) are the standard panoramic radiograph in dentistry, used for full-arch screening across multiple diagnostic tasks. While Vision Language Models (VLMs) now allow multi-task OPG analysis through natural language, they underperform task-specific models on most individual tasks. Agentic systems that orchestrate specialized tools offer a path to both versatility and accuracy, this approach remains unexplored in the field of dental imaging. To address this gap, we propose OPGAgent, a multi-tool agentic system for auditable OPG interpretation. OPGAgent coordinates specialized perception modules with a consensus mechanism through three components: (1) a Hierarchical Evidence Gathering module that decomposes OPG analysis into global, quadrant, and tooth-level phases with dynamically invoking tools, (2) a Specialized Toolbox encapsulating spatial, detection, utility, and expert zoos, and (3) a Consensus Subagent that resolves conflicts through anatomical constraints. We further propose OPG-Bench, a structured-report protocol based on (Location, Field, Value) triples derived from real clinical reports, which enables a comprehensive review of findings and hallucinations, extending beyond the limitations of VQA indicators. On our OPG-Bench and the public MMOral-OPG benchmark, OPGAgent outperforms current dental VLMs and medical agent frameworks across both structured-report and VQA evaluation. Code will be released upon acceptance.

LATA: Laplacian-Assisted Transductive Adaptation for Conformal Uncertainty in Medical VLMs

Medical vision-language models (VLMs) are strong zero-shot recognizers for medical imaging, but their reliability under domain shift hinges on calibrated uncertainty with guarantees. Split conformal prediction (SCP) offers finite-sample coverage, yet prediction sets often become large (low efficiency) and class-wise coverage unbalanced-high class-conditioned coverage gap (CCV), especially in few-shot, imbalanced regimes; moreover, naively adapting to calibration labels breaks exchangeability and voids guarantees. We propose \texttt{\textbf{LATA}} (Laplacian-Assisted Transductive Adaptation), a \textit{training- and label-free} refinement that operates on the joint calibration and test pool by smoothing zero-shot probabilities over an image-image k-NN graph using a small number of CCCP mean-field updates, preserving SCP validity via a deterministic transform. We further introduce a \textit{failure-aware} conformal score that plugs into the vision-language uncertainty (ViLU) framework, providing instance-level difficulty and label plausibility to improve prediction set efficiency and class-wise balance at fixed coverage. \texttt{\textbf{LATA}} is black-box (no VLM updates), compute-light (windowed transduction, no backprop), and includes an optional prior knob that can run strictly label-free or, if desired, in a label-informed variant using calibration marginals once. Across \textbf{three} medical VLMs and \textbf{nine} downstream tasks, \texttt{\textbf{LATA}} consistently reduces set size and CCV while matching or tightening target coverage, outperforming prior transductive baselines and narrowing the gap to label-using methods, while using far less compute. Comprehensive ablations and qualitative analyses show that \texttt{\textbf{LATA}} sharpens zero-shot predictions without compromising exchangeability.

A Vision-Language Foundation Model for Zero-shot Clinical Collaboration and Automated Concept Discovery in Dermatology

Medical foundation models have shown promise in controlled benchmarks, yet widespread deployment remains hindered by reliance on task-specific fine-tuning. Here, we introduce DermFM-Zero, a dermatology vision-language foundation model trained via masked latent modelling and contrastive learning on over 4 million multimodal data points. We evaluated DermFM-Zero across 20 benchmarks spanning zero-shot diagnosis and multimodal retrieval, achieving state-of-the-art performance without task-specific adaptation. We further evaluated its zero-shot capabilities in three multinational reader studies involving over 1,100 clinicians. In primary care settings, AI assistance enabled general practitioners to nearly double their differential diagnostic accuracy across 98 skin conditions. In specialist settings, the model significantly outperformed board-certified dermatologists in multimodal skin cancer assessment. In collaborative workflows, AI assistance enabled non-experts to surpass unassisted experts while improving management appropriateness. Finally, we show that DermFM-Zero's latent representations are interpretable: sparse autoencoders unsupervisedly disentangle clinically meaningful concepts that outperform predefined-vocabulary approaches and enable targeted suppression of artifact-induced biases, enhancing robustness without retraining. These findings demonstrate that a foundation model can provide effective, safe, and transparent zero-shot clinical decision support.

OneVision-Encoder: Codec-Aligned Sparsity as a Foundational Principle for Multimodal Intelligence

Hypothesis. Artificial general intelligence is, at its core, a compression problem. Effective compression demands resonance: deep learning scales best when its architecture aligns with the fundamental structure of the data. These are the fundamental principles. Yet, modern vision architectures have strayed from these truths: visual signals are highly redundant, while discriminative information, the surprise, is sparse. Current models process dense pixel grids uniformly, wasting vast compute on static background rather than focusing on the predictive residuals that define motion and meaning. We argue that to solve visual understanding, we must align our architectures with the information-theoretic principles of video, i.e., Codecs. Method. OneVision-Encoder encodes video by compressing predictive visual structure into semantic meaning. By adopting Codec Patchification, OV-Encoder abandons uniform computation to focus exclusively on the 3.1%-25% of regions rich in signal entropy. To unify spatial and temporal reasoning under irregular token layouts, OneVision-Encoder employs a shared 3D RoPE and is trained with a large-scale cluster discrimination objective over more than one million semantic concepts, jointly capturing object permanence and motion dynamics. Evidence. The results validate our core hypothesis: efficiency and accuracy are not a trade-off; they are positively correlated. When integrated into LLM, it consistently outperforms strong vision backbones such as Qwen3-ViT and SigLIP2 across 16 image, video, and document understanding benchmarks, despite using substantially fewer visual tokens and pretraining data. Notably, on video understanding tasks, OV-Encoder achieves an average improvement of 4.1% over Qwen3-ViT. Codec-aligned, patch-level sparsity is a foundational principle, enabling OV-Encoder as a scalable engine for next-generation visual generalists.