When Vision Misleads, Let Location Speak: A Worldwide Image Geo-Localization Method via Location Attention Mechanism and Large Multimodal Models

Worldwide image geo-localization aims to determine the capture location of an image on a global scale. Existing methods often mislocalize images by matching them to visually similar scenes from different geographic regions, which limits reliability in practical applications. To address this issue, we propose TransGeoCLIP, a novel retrieval-based framework that integrates a location attention mechanism and large multimodal models (LMMs). Using the Transformer encoder with location attention to encode GPS coordinates, TransGeoCLIP can effectively distinguish geographic features among visually similar images. The framework consists of two stages: 1) Retrieval database construction, which employs Transformers equipped with location attention mechanisms to encode labeled GPS coordinates and enhance location semantics, subsequently enables joint image-text-GPS embedding through CLIP; 2) Retrieval-augmented inference, which leverages LMMs to infer the final image location prediction from retrieved database results. Extensive experimental results on diverse datasets, including IM2GPS, IM2GPS3k, YFCC4k, and YFCC26k, demonstrate that TransGeoCLIP significantly enhances localization performance for visually similar images. Particularly, street-level localization accuracy (within 1 km error) is substantially improved, surpassing state-of-the-art methods by 1.5%, 1.07%, 7.18%, and 9.75% on these benchmarks, respectively.

Agents' Last Exam

Recent AI systems have achieved strong results on a wide range of benchmarks, yet these gains have not translated into economically meaningful deployment across many professional domains. We argue that this gap is largely an evaluation problem: widely used benchmarks lack sustained performance measurement on real and economically valuable workflows. This paper introduces Agents' Last Exam (ALE), a benchmark designed to evaluate AI agents on long-horizon, economically valuable, real-world tasks with verifiable outcomes. Developed in collaboration with 250+ industry experts, ALE covers non-physical industries defined with reference to O*NET / SOC 2018 (the U.S. federal occupational taxonomy). It is organized around a task taxonomy with 55 subfields grouped into 13 industry clusters covering 1K+ tasks. Current results show that the hardest tier remains far from saturated: across mainstream harness and backbone configurations, the average full pass rate is 2.6%. ALE is designed as a living benchmark: its task pool grows continuously as new workflows and industries are onboarded. More broadly, ALE is intended not merely as another leaderboard, but as an instrument for closing the gap between benchmark success and GDP-relevant impact.

ClinEnv: An Interactive Multi-Stage Long Horizon EHR Environment for Agents

Clinical practice is not the selection of an answer from enumerated options: a physician gathers heterogeneous information incrementally and commits to sequential, irreversible decisions under uncertainty. Static benchmarks cannot probe and existing interactive medical benchmarks each compromise on at least one of them. We present ClinEnv, an interactive benchmark that evaluates LLMs as attending physicians over real inpatient admissions under a paradigm we term Longitudinal Inpatient Simulation. Each case is automatically constructed into an ordered sequence of decision stages; at every stage the model must actively query four specialized agents before committing to medications, procedures, and diagnoses. ClinEnv scores both what the model decides, through deterministic ontology-grounded matching, and how it gathers information. Across seven models, the strongest reaches only 0.31 decision F1, and outcome quality is sharply decoupled from process quality. Difficulty concentrates in management decisions and later stages, where models recover discharge diagnoses far more reliably than management actions (0.51 vs. 0.17 F1) and continue to issue redundant queries as cases progress. ClinEnv makes this information-acquisition gap, invisible to outcome-only evaluation, directly measurable.

DualGeo: A Dual-View Framework for Worldwide Image Geo-localization

Worldwide image geo-localization aims to infer the geographic location of an image captured anywhere on Earth, spanning street, city, regional, national, and continental scales. Existing methods rely on visual features that are sensitive to environmental variations (e.g., lighting, season, and weather) and lack effective post-processing to filter outlier candidates, limiting localization accuracy. To address these limitations, we propose DualGeo, a two-stage framework for worldwide image geo-localization. First, it establishes a geo-representational foundation by fusing image and semantic segmentation features via bidirectional cross-attention. The fused features are then aligned with GPS coordinates through dual-view contrastive learning to build a global retrieval database. Second, it performs geo-cognitive refinement by re-ranking retrieved candidates using geographic clustering. It then feeds them into large multimodal models (LMMs) for final coordinate prediction. Experiments on IM2GPS, IM2GPS3k, and YFCC4k show that DualGeo outperforms state-of-the-art methods, improving street-level (<1 km) and city-level (<25 km) localization accuracy by 3.6%-16.58% and 1.29%-8.77%, respectively. Our code and datasets are available : https://github.com/CJ310177/DualGeo.

Benchmarking Multi-turn Medical Diagnosis: Hold, Lure, and Self-Correction

Large language models (LLMs) achieve high accuracy in medical diagnosis when all clinical information is provided in a single turn, yet how they behave under multi-turn evidence accumulation closer to real clinical reasoning remains unexplored. We introduce MINT (Medical Incremental N-Turn Benchmark), a high-fidelity, multi-turn medical diagnosis benchmark comprising 1,035 cases with clinically labeled evidence shards, controlled turn granularity, and information-preserving decomposition. Through systematic evaluation of 11 LLMs on MINT, we uncover three persistent behavioral patterns that significantly impact diagnostic decisions: (1) intent to answer, models rush to answer before sufficient evidence has been observed, with over 55% of answers committed within the first two turns; (2) self-correction, incorrect-to-correct answer revisions occur at up to 10.6 times the rate of correct-to-incorrect flips, revealing a latent capacity for self-correction that premature commitment forecloses; and (3) strong lures, clinically salient information such as laboratory results trigger premature answering even when models are explicitly instructed to wait. We translate these findings into clinically actionable guidance: deferring the diagnostic question to later turns reduces premature answering and improves accuracy at the first point of commitment by up to 62.6%, while reserving salient clinical evidence for later turns prevents a catastrophic accuracy drop of up to 23.3% caused by premature commitment. Our work provides both a controlled evaluation framework and concrete recommendations for improving the reliability of LLMs in multi-turn medical diagnosis.

Deep reflective reasoning in interdependence constrained structured data extraction from clinical notes for digital health

Extracting structured information from clinical notes requires navigating a dense web of interdependent variables where the value of one attribute logically constrains others. Existing Large Language Model (LLM)-based extraction pipelines often struggle to capture these dependencies, leading to clinically inconsistent outputs. We propose deep reflective reasoning, a large language model agent framework that iteratively self-critiques and revises structured outputs by checking consistency among variables, the input text, and retrieved domain knowledge, stopping when outputs converge. We extensively evaluate the proposed method in three diverse oncology applications: (1) On colorectal cancer synoptic reporting from gross descriptions (n=217), reflective reasoning improved average F1 across eight categorical synoptic variables from 0.828 to 0.911 and increased mean correct rate across four numeric variables from 0.806 to 0.895; (2) On Ewing sarcoma CD99 immunostaining pattern identification (n=200), the accuracy improved from 0.870 to 0.927; (3) On lung cancer tumor staging (n=100), tumor stage accuracy improved from 0.680 to 0.833 (pT: 0.842 -> 0.884; pN: 0.885 -> 0.948). The results demonstrate that deep reflective reasoning can systematically improve the reliability of LLM-based structured data extraction under interdependence constraints, enabling more consistent machine-operable clinical datasets and facilitating knowledge discovery with machine learning and data science towards digital health.

KindSleep: Knowledge-Informed Diagnosis of Obstructive Sleep Apnea from Oximetry

Obstructive sleep apnea (OSA) is a sleep disorder that affects nearly one billion people globally and significantly elevates cardiovascular risk. Traditional diagnosis through polysomnography is resource-intensive and limits widespread access, creating a critical need for accurate and efficient alternatives. In this paper, we introduce KindSleep, a deep learning framework that integrates clinical knowledge with single-channel patient-specific oximetry signals and clinical data for precise OSA diagnosis. KindSleep first learns to identify clinically interpretable concepts, such as desaturation indices and respiratory disturbance events, directly from raw oximetry signals. It then fuses these AI-derived concepts with multimodal clinical data to estimate the Apnea-Hypopnea Index (AHI). We evaluate KindSleep on three large, independent datasets from the National Sleep Research Resource (SHHS, CFS, MrOS; total n = 9,815). KindSleep demonstrates excellent performance in estimating AHI scores (R2 = 0.917, ICC = 0.957) and consistently outperforms existing approaches in classifying OSA severity, achieving weighted F1-scores from 0.827 to 0.941 across diverse populations. By grounding its predictions in a layer of clinically meaningful concepts, KindSleep provides a more transparent and trustworthy diagnostic tool for sleep medicine practices.

Scaling Medical Reasoning Verification via Tool-Integrated Reinforcement Learning

Large language models have achieved strong performance on medical reasoning benchmarks, yet their deployment in clinical settings demands rigorous verification to ensure factual accuracy. While reward models offer a scalable approach for reasoning trace verification, existing methods face two limitations: they produce only scalar reward values without explicit justification, and they rely on single-pass retrieval that precludes adaptive knowledge access as verification unfolds. We introduce $\method$, an agentic framework that addresses these limitations by training medical reasoning verifiers to iteratively query external medical corpora during evaluation. Our approach combines tool-augmented verification with an iterative reinforcement learning paradigm that requires only trace-level supervision, alongside an adaptive curriculum mechanism that dynamically adjusts training data distribution. Across four medical reasoning benchmarks, $\method$ achieves substantial gains over existing methods, improving MedQA accuracy by 23.5% and MedXpertQA by 32.0% relative to the base generator in particular. Crucially, $\method$ demonstrates an $\mathbf{8\times}$ reduction in sampling budget requirement compared to prior reward model baselines. These findings establish that grounding verification in dynamically retrieved evidence offers a principled path toward more reliable medical reasoning systems.

LLM-as-RNN: A Recurrent Language Model for Memory Updates and Sequence Prediction

Large language models are strong sequence predictors, yet standard inference relies on immutable context histories. After making an error at generation step t, the model lacks an updatable memory mechanism that improves predictions for step t+1. We propose LLM-as-RNN, an inference-only framework that turns a frozen LLM into a recurrent predictor by representing its hidden state as natural-language memory. This state, implemented as a structured system-prompt summary, is updated at each timestep via feedback-driven text rewrites, enabling learning without parameter updates. Under a fixed token budget, LLM-as-RNN corrects errors and retains task-relevant patterns, effectively performing online learning through language. We evaluate the method on three sequential benchmarks in healthcare, meteorology, and finance across Llama, Gemma, and GPT model families. LLM-as-RNN significantly outperforms zero-shot, full-history, and MemPrompt baselines, improving predictive accuracy by 6.5% on average, while producing interpretable, human-readable learning traces absent in standard context accumulation.

MEDVISTAGYM: A Scalable Training Environment for Thinking with Medical Images via Tool-Integrated Reinforcement Learning

Vision language models (VLMs) achieve strong performance on general image understanding but struggle to think with medical images, especially when performing multi-step reasoning through iterative visual interaction. Medical VLMs often rely on static visual embeddings and single-pass inference, preventing models from re-examining, verifying, or refining visual evidence during reasoning. While tool-integrated reasoning offers a promising path forward, open-source VLMs lack the training infrastructure to learn effective tool selection, invocation, and coordination in multi-modal medical reasoning. We introduce MedVistaGym, a scalable and interactive training environment that incentivizes tool-integrated visual reasoning for medical image analysis. MedVistaGym equips VLMs to determine when and which tools to invoke, localize task-relevant image regions, and integrate single or multiple sub-image evidence into interleaved multimodal reasoning within a unified, executable interface for agentic training. Using MedVistaGym, we train MedVistaGym-R1 to interleave tool use with agentic reasoning through trajectory sampling and end-to-end reinforcement learning. Across six medical VQA benchmarks, MedVistaGym-R1-8B exceeds comparably sized tool-augmented baselines by 19.10% to 24.21%, demonstrating that structured agentic training--not tool access alone--unlocks effective tool-integrated reasoning for medical image analysis.