Med-R2: An Adversarial Benchmark for Evidence-Grounded Reasoning in Medical VLMs

Vision-language models have demonstrated impressive capabilities in general medical visual question answering, yet due to limited interpretability, it remains unclear whether their predictions reflect evidence-grounded clinical reasoning or reliance on spurious priors. We introduce Med-R2 Bench, a hierarchical benchmark aligned with the clinical workflow to evaluate adversarial robustness with visual grounding. We design stepwise QA tasks to assess whether reasoning chains are strictly grounded in visual evidence across the four clinical stages, and employ adversarial perturbations to test robustness against misleading cues. Med-R2 comprises 42,432 images, 31 task categories, and 110,406 QA pairs. Evaluation across 14 VLMs reveals a sequential performance degradation along the four-stage clinical workflow. Adversarial experiments show that models rely heavily on correct prompts to guess answers. Even when provided with explicit visual cues, the models struggle to accurately align textual descriptions. Finally, we demonstrate stepwise fine-tuning using our hierarchical data significantly improves reasoning robustness, highlighting its potential to drive future improvements in evidence-based medical AI.

How Far Are Video Models from True Multimodal Reasoning?

Despite remarkable progress toward general-purpose video models, a critical question remains unanswered: how far are these models from achieving true multimodal reasoning? Existing benchmarks fail to address this question rigorously, as they remain constrained by straightforward task designs and fragmented evaluation metrics that neglect complex multimodal reasoning. To bridge this gap, we introduce CLVG-Bench, an evaluation framework designed to probe video models' zero-shot reasoning capabilities via Context Learning in Video Generation. CLVG-Bench comprises more than 1,000 high-quality, manually annotated metadata across 6 categories and 47 subcategories, covering complex scenarios including physical simulation, logical reasoning, and interactive contexts. To enable rigorous and scalable assessment, we further propose an Adaptive Video Evaluator (AVE) that aligns with human expert perception using minimal annotations, delivering interpretable textual feedback across diverse video context tasks. Extensive experiments reveal a striking answer to our central question: while state-of-the-art (SOTA) video models, such as Seedance 2.0, demonstrate competence on certain understanding and reasoning subtasks, they fall substantially short with logically grounded and interactive generation tasks (achieving success rates <25% and ~0%, respectively), exposing multimodal reasoning and physical grounding as critical bottlenecks. By systematically quantifying these limitations, the proposed method provides actionable feedbacks and a clear roadmap toward truly robust, general-purpose video models. CLVG-Bench and code are released here.

PBE-UNet: A light weight Progressive Boundary-Enhanced U-Net with Scale-Aware Aggregation for Ultrasound Image Segmentation

Accurate lesion segmentation in ultrasound images is essential for preventive screening and clinical diagnosis, yet remains challenging due to low contrast, blurry boundaries, and significant scale variations. Although existing deep learning-based methods have achieved remarkable performance, these methods still struggle with scale variations and indistinct tumor boundaries. To address these challenges, we propose a progressive boundary enhanced U-Net (PBE-UNet). Specially, we first introduce a scale-aware aggregation module (SAAM) that dynamically adjusts its receptive field to capture robust multi-scale contextual information. Then, we propose a boundary-guided feature enhancement (BGFE) module to enhance the feature representations. We find that there are large gaps between the narrow boundary and the wide segmentation error areas. Unlike existing methods that treat boundaries as static masks, the BGFE module progressively expands the narrow boundary prediction into broader spatial attention maps. Thus, broader spatial attention maps could effectively cover the wider segmentation error regions and enhance the model's focus on these challenging areas. We conduct expensive experiments on four benchmark ultrasound datasets, BUSI, Dataset B, TN3K, and BP. The experimental results how that our proposed PBE-UNet outperforms state-of-the-art ultrasound image segmentation methods. The code is at https://github.com/cruelMouth/PBE-UNet.

Scaling Video Pretraining for Surgical Foundation Models

Surgical video understanding is essential for computer-assisted interventions, yet existing surgical foundation models remain constrained by limited data scale, procedural diversity, and inconsistent evaluation, often lacking a reproducible training pipeline. We propose SurgRec, a scalable and reproducible pretraining recipe for surgical video understanding, instantiated with two variants: SurgRec-MAE and SurgRec-JEPA. We curate a large multi-source corpus of 10,535 videos and 214.5M frames spanning endoscopy, laparoscopy, cataract, and robotic surgery. Building on this corpus, we develop a unified pretraining pipeline with balanced sampling and standardize a reproducible benchmark across 16 downstream datasets and four clinical domains with consistent data splits. Across extensive comparisons against SSL baselines and vision-language models, SurgRec consistently achieves superior performance across downstream datasets. In contrast, VLMs prove unreliable for fine-grained temporal recognition, exhibiting both performance gaps and sensitivity to prompt phrasing. Our work provides a reproducible, scalable foundation for the community to build more general surgical video models. All code, models, and data will be publicly released.

HICT: High-precision 3D CBCT reconstruction from a single X-ray

Accurate 3D dental imaging is vital for diagnosis and treatment planning, yet CBCT's high radiation dose and cost limit its accessibility. Reconstructing 3D volumes from a single low-dose panoramic X-ray is a promising alternative but remains challenging due to geometric inconsistencies and limited accuracy. We propose HiCT, a two-stage framework that first generates geometrically consistent multi-view projections from a single panoramic image using a video diffusion model, and then reconstructs high-fidelity CBCT from the projections using a ray-based dynamic attention network and an X-ray sampling strategy. To support this, we built XCT, a large-scale dataset combining public CBCT data with 500 paired PX-CBCT cases. Extensive experiments show that HiCT achieves state-of-the-art performance, delivering accurate and geometrically consistent reconstructions for clinical use.

Optimsyn: Influence-Guided Rubrics Optimization for Synthetic Data Generation

Large language models (LLMs) achieve strong downstream performance largely due to abundant supervised fine-tuning (SFT) data. However, high-quality SFT data in knowledge-intensive domains such as humanities, social sciences, medicine, law, and finance is scarce because expert curation is expensive, privacy constraints are strict, and label consistency is hard to ensure. Recent work uses synthetic data, typically by prompting a generator over domain documents and filtering outputs with handcrafted rubrics. Yet rubric design is expert-dependent, transfers poorly across domains, and is often optimized through a brittle heuristic loop of writing rubrics, synthesizing data, training, inspecting results, and manually guessing revisions. This process lacks reliable quantitative feedback about how a rubric affects downstream performance. We propose evaluating synthetic data by its training utility on the target model and using this signal to guide data generation. Inspired by influence estimation, we adopt an optimizer-aware estimator that uses gradient information to quantify each synthetic sample's contribution to a target model's objective on specific tasks. Our analysis shows that even when synthetic and real samples are close in embedding space, their influence on learning can differ substantially. Based on this insight, we propose an optimization-based framework that adapts rubrics using target-model feedback. We provide lightweight guiding text and use a rubric-specialized model to generate task-conditioned rubrics. Influence score is used as the reward to optimize the rubric generator with reinforcement learning. Experiments across domains, target models, and data generators show consistent improvements and strong generalization without task-specific tuning.

AgentSwing: Adaptive Parallel Context Management Routing for Long-Horizon Web Agents

As large language models (LLMs) evolve into autonomous agents for long-horizon information-seeking, managing finite context capacity has become a critical bottleneck. Existing context management methods typically commit to a single fixed strategy throughout the entire trajectory. Such static designs may work well in some states, but they cannot adapt as the usefulness and reliability of the accumulated context evolve during long-horizon search. To formalize this challenge, we introduce a probabilistic framework that characterizes long-horizon success through two complementary dimensions: search efficiency and terminal precision. Building on this perspective, we propose AgentSwing, a state-aware adaptive parallel context management routing framework. At each trigger point, AgentSwing expands multiple context-managed branches in parallel and uses lookahead routing to select the most promising continuation. Experiments across diverse benchmarks and agent backbones show that AgentSwing consistently outperforms strong static context management methods, often matching or exceeding their performance with up to $3\times$ fewer interaction turns while also improving the ultimate performance ceiling of long-horizon web agents. Beyond the empirical gains, the proposed probabilistic framework provides a principled lens for analyzing and designing future context management strategies for long-horizon agents.

Learning Transferable Temporal Primitives for Video Reasoning via Synthetic Videos

The transition from image to video understanding requires vision-language models (VLMs) to shift from recognizing static patterns to reasoning over temporal dynamics such as motion trajectories, speed changes, and state transitions. Yet current post-training methods fall short due to two critical limitations: (1) existing datasets often lack temporal-centricity, where answers can be inferred from isolated keyframes rather than requiring holistic temporal integration; and (2) training data generated by proprietary models contains systematic errors in fundamental temporal perception, such as confusing motion directions or misjudging speeds. We introduce SynRL, a post-training framework that teaches models temporal primitives, the fundamental building blocks of temporal understanding including direction, speed, and state tracking. Our key insight is that these abstract primitives, learned from programmatically generated synthetic videos, transfer effectively to real-world scenarios. We decompose temporal understanding into short-term perceptual primitives (speed, direction) and long-term cognitive primitives, constructing 7.7K CoT and 7K RL samples with ground-truth frame-level annotations through code-based video generation. Despite training on simple geometric shapes, SynRL achieves substantial improvements across 15 benchmarks spanning temporal grounding, complex reasoning, and general video understanding. Remarkably, our 7.7K synthetic CoT samples outperform Video-R1 with 165K real-world samples. We attribute this to fundamental temporal skills, such as tracking frame by frame changes and comparing velocity, that transfer effectively from abstract synthetic patterns to complex real-world scenarios. This establishes a new paradigm for video post-training: video temporal learning through carefully designed synthetic data provides a more cost efficient scaling path.

IOSVLM: A 3D Vision-Language Model for Unified Dental Diagnosis from Intraoral Scans

3D intraoral scans (IOS) are increasingly adopted in routine dentistry due to abundant geometric evidence, and unified multi-disease diagnosis is desirable for clinical documentation and communication. While recent works introduce dental vision-language models (VLMs) to enable unified diagnosis and report generation on 2D images or multi-view images rendered from IOS, they do not fully leverage native 3D geometry. Such work is necessary and also challenging, due to: (i) heterogeneous scan forms and the complex IOS topology, (ii) multi-disease co-occurrence with class imbalance and fine-grained morphological ambiguity, (iii) limited paired 3D IOS-text data. Thus, we present IOSVLM, an end-to-end 3D VLM that represents scans as point clouds and follows a 3D encoder-projector-LLM design for unified diagnosis and generative visual question-answering (VQA), together with IOSVQA, a large-scale multi-source IOS diagnosis VQA dataset comprising 19,002 cases and 249,055 VQA pairs over 23 oral diseases and heterogeneous scan types. To address the distribution gap between color-free IOS data and color-dependent 3D pre-training, we propose a geometry-to-chromatic proxy that stabilizes fine-grained geometric perception and cross-modal alignment. A two-stage curriculum training strategy further enhances robustness. IOSVLM consistently outperforms strong baselines, achieving gains of at least +9.58% macro accuracy and +1.46% macro F1, indicating the effectiveness of direct 3D geometry modeling for IOS-based diagnosis.

Bridging the Skill Gap in Clinical CBCT Interpretation with CBCTRepD

Generative AI has advanced rapidly in medical report generation; however, its application to oral and maxillofacial CBCT reporting remains limited, largely because of the scarcity of high-quality paired CBCT-report data and the intrinsic complexity of volumetric CBCT interpretation. To address this, we introduce CBCTRepD, a bilingual oral and maxillofacial CBCT report-generation system designed for integration into routine radiologist-AI co-authoring workflows. We curated a large-scale, high-quality paired CBCT-report dataset comprising approximately 7,408 studies, covering 55 oral disease entities across diverse acquisition settings, and used it to develop the system. We further established a clinically grounded, multi-level evaluation framework that assesses both direct AI-generated drafts and radiologist-edited collaboration reports using automatic metrics together with radiologist- and clinician-centered evaluation. Using this framework, we show that CBCTRepD achieves superior report-generation performance and produces drafts with writing quality and standardization comparable to those of intermediate radiologists. More importantly, in radiologist-AI collaboration, CBCTRepD provides consistent and clinically meaningful benefits across experience levels: it helps novice radiologists improve toward intermediate-level reporting, enables intermediate radiologists to approach senior-level performance, and even assists senior radiologists by reducing omission-related errors, including clinically important missed lesions. By improving report structure, reducing omissions, and promoting attention to co-existing lesions across anatomical regions, CBCTRepD shows strong and reliable potential as a practical assistant for real-world CBCT reporting across multi-level care settings.