CIPHER: Causal Intervention Pathways for Healthcare Equity and Robustness

Deep learning models for medical diagnosis frequently exhibit substantial performance disparities across sensitive subgroups (e.g., race, sex), even when average accuracy is high. While generative data augmentation offers a route to mitigate this, existing strategies are suboptimal; they typically address only one or two dependency channels between sensitive attributes and image features. We formalize the medical image formation process via a structural causal model, revealing that sensitive attributes actually influence image content through four distinct pathways-a structural complexity neglected by prior works. Based on this insight, we introduce CIPHER (Causal Intervention Pathways for Healthcare Equity and Robustness), a framework designed to systematically intervene on all four causal paths. To achieve this, CIPHER utilizes a diffusion backbone equipped with classifier-free guidance and null-text inversion. This technical design enables the faithful reconstruction of patient-specific anatomy while allowing for the precise, editable synthesis of counterfactuals required to break sensitive dependency chains. We tested CIPHER using chest X-ray and dermoscopy benchmarks across both standard and shifted data distributions. By employing a multi-pathway intervention strategy, our model reduced worst-group disparities by an average of 35.8% compared to disease-conditioned synthesis baselines, while also improving total diagnostic accuracy

Enhancing Brain MRI Anomaly Detection and Reasoning with ROI Rethink and Synthetic Data

Medical vision-language models typically generate diagnoses through single-pass inference without indicating which image regions support their conclusions. This lack of spatial grounding limits clinical utility: outputs cannot be audited, and models may hallucinate findings on normal scans. We present BrReMark (Brain Rethink via ROI Marking), a framework that introduces explicit region marking into brain MRI diagnosis. The model first generates hypotheses about potential abnormalities and grounds them through explicit bounding box marking, then verifies conclusions by re-examining the marked evidence. Training combines supervised fine-tuning on structured reasoning trajectories with reinforcement learning using a composite reward over localization accuracy and diagnostic reasoning. Furthermore, we integrate a domain randomization-based pathology synthesis augmentation strategy to improve the model's generalizability to out-of-distribution (OOD) data. On internal benchmark, BrReMark improves mAP50 from 0.74% to 37.54% compared to the base model, while achieving 21.57% Clinical F1 and 45.26% diagnostic accuracy. On NOVA OOD benchmark, it also achieves competitive overall performance with a 45.7% reduction in false positives compared to the state-of-the-art, indicating reduced hallucination on rare pathologies. These findings suggest that explicit hypothesis-verification grounding is a practical path toward trustworthy open-ended brain MRI diagnosis across both in-distribution and OOD settings.

Perfect Demo Makes Poor Teacher: Learning Robust Alignment from Critical Motion Segments

Expert demonstrations are widely assumed to be the gold standard for robot imitation learning. Yet for fine-grained manipulation such as insertion, stacking, and alignment, we uncover a counterintuitive failure mode: fluent demonstrations can be poor teachers. A skilled teleoperator compresses the decisive moments of alignment and recovery into a brief temporal window, leaving the policy flooded with redundant free-space motion and starved of supervision exactly where precision determines success. We address this bottleneck at two levels. At the data level, slowing down near alignment and resampling critical segments both help, yet the gain comes mainly from broadening the coverage of recovery states the policy must learn, not from reweighting frames it already has. Such data-side fixes, however, leave the policy's per-frame view untouched: a single image still maps directly to an action, and the local motion that governs correction stays implicit. We therefore turn to the representation level and introduce STAIR (\textbf{S}patio-\textbf{T}emporal feature \textbf{A}s an \textbf{I}nterface for \textbf{R}obot learning), a compact dynamic feature that bridges the vision-language model and the action expert, distilling the short-horizon motion already recorded in each trajectory into dense, motion-aware supervision. Trained on fluent data alone, STAIR recovers most of the deliberate-demonstration gain ($50.0$ to $62.2\%$ overall, approaching the $64.4\%$ of deliberate demonstrations). These results call for a more pedagogical view of robot data, optimized for machine learnability rather than human efficiency alone.

Context Distillation as Latent Memory Management

Context distillation compresses contextual information into model parameters, yet existing methods often ignore how multiple distilled latent memories should be stored, retrieved, and safely activated in non-oracle settings. We formulate context distillation as a latent memory management problem. We distill each context into an independent LoRA adapter, forming a modular memory bank that enables explicit memory selection. Given a query, our framework retrieves candidate memories, routes the query to the most suitable adapter, and uses a Self-Gating mechanism to decide whether latent memory should be activated. To improve efficiency, we further introduce cache sharing to reduce management overhead during inference. Experiments show that our method substantially outperforms baselines with retrieval, while Self-Gating improves robustness by deactivate unnecessary latent memories.

Defining Robust Ultrasound Quality Metrics via an Ultrasound Foundation Model

Clinicians lack a principled framework to quantify diagnostic utility in ultrasound reconstructions. Existing standards like PSNR and VGG-LPIPS are inadequate, failing to account for modality-specific physics or the structural nuances of acoustic imaging. We close this gap with a TinyUSFM-based evaluation framework featuring two distinct metrics: TinyUSFM-uLPIPS, a full-reference perceptual distance based on multi-layer token relations, and TinyUSFM-NRQ, a deployable no-reference quality score utilizing clean-manifold modeling and worst-region aggregation to detect localized harmful artifacts. We demonstrate that the presented metrics have four unique advantages: 1) Task-linked quality, where TinyUSFM-uLPIPS achieves superior calibration with semantic task damage, accurately reflecting Dice-score drops in segmentation where VGG-based metrics fail; 2) Cross-organ comparability, maintaining stable scoring scales and consistent severity rankings across diverse anatomical sites and domain-shifted data; 3) PSNR-consistent sensitivity, with TinyUSFM-NRQ providing a reliable quality score without ground-truth images that remains consistent with traditional fidelity benchmarks (i.e. PSNR); and 4) Clinical utility, improving the prediction of expert preference from 47.2$\%$ to 72.8$\%$ accuracy and producing super-resolution reconstructions preferred by sonographers. By integrating these advantages into a unified assessment and optimization loop, this work establishes a modality-aligned standard that finally bridges the gap between algorithmic performance and diagnostic utility. https://github.com/sextant-fable/US-Metrics

From Craft to Kernel: A Governance-First Execution Architecture and Semantic ISA for Agentic Computers

The transition of agentic AI from brittle prototypes to production systems is stalled by a pervasive crisis of craft. We suggest that the prevailing orchestration paradigm-delegating the system control loop to large language models and merely patching with heuristic guardrails-is the root cause of this fragility. Instead, we propose Arbiter-K, a Governance-First execution architecture that reconceptualizes the underlying model as a Probabilistic Processing Unit encapsulated by a deterministic, neuro-symbolic kernel. Arbiter-K implements a Semantic Instruction Set Architecture (ISA) to reify probabilistic messages into discrete instructions. This allows the kernel to maintain a Security Context Registry and construct an Instruction Dependency Graph at runtime, enabling active taint propagation based on the data-flow pedigree of each reasoning node. By leveraging this mechanism, Arbiter-K precisely interdicts unsafe trajectories at deterministic sinks (e.g., high-risk tool calls or unauthorized network egress) and enables autonomous execution correction and architectural rollback when security policies are triggered. Evaluations on OpenClaw and NanoBot demonstrate that Arbiter-K enforces security as a microarchitectural property, achieving 76% to 95% unsafe interception for a 92.79% absolute gain over native policies. The code is publicly available at https://github.com/cure-lab/ArbiterOS.

Fine-Grained Action Segmentation for Renorrhaphy in Robot-Assisted Partial Nephrectomy

Fine-grained action segmentation during renorrhaphy in robot-assisted partial nephrectomy requires frame-level recognition of visually similar suturing gestures with variable duration and substantial class imbalance. The SIA-RAPN benchmark defines this problem on 50 clinical videos acquired with the da Vinci Xi system and annotated with 12 frame-level labels. The benchmark compares four temporal models built on I3D features: MS-TCN++, AsFormer, TUT, and DiffAct. Evaluation uses balanced accuracy, edit score, segmental F1 at overlap thresholds of 10, 25, and 50, frame-wise accuracy, and frame-wise mean average precision. In addition to the primary evaluation across five released split configurations on SIA-RAPN, the benchmark reports cross-domain results on a separate single-port RAPN dataset. Across the strongest reported values over those five runs on the primary dataset, DiffAct achieves the highest F1, frame-wise accuracy, edit score, and frame mAP, while MS-TCN++ attains the highest balanced accuracy.

DiffHLS: Differential Learning for High-Level Synthesis QoR Prediction with GNNs and LLM Code Embeddings

High-Level Synthesis (HLS) compiles C/C++ into RTL, but exploring pragma-driven optimization choices remains expensive because each design point requires time-consuming synthesis. We propose \textbf{\DiffHLS}, a differential learning framework for HLS Quality-of-Result (QoR) prediction that learns from kernel--design pairs: a kernel baseline and a pragma-inserted design variant. \DiffHLS~encodes kernel and design intermediate-representation graphs with dedicated graph neural network (GNN) branches, and augments the delta pathway with code embeddings from a pretrained code large language model (LLM). Instead of regressing absolute targets directly, we jointly predict the kernel baseline and the design-induced delta, and compose them to obtain the design prediction. On PolyBench, \DiffHLS~attains lower average MAPE than GNN baselines under four GNN backbones, and LLM code embeddings consistently improve over a GNN-only ablation. We further validate scalability on the ForgeHLS dataset.

EchoAgent: Towards Reliable Echocardiography Interpretation with "Eyes","Hands" and "Minds"

Reliable interpretation of echocardiography (Echo) is crucial for assessing cardiac function, which demands clinicians to synchronously orchestrate multiple capabilities, including visual observation (eyes), manual measurement (hands), and expert knowledge learning and reasoning (minds). While current task-specific deep-learning approaches and multimodal large language models have demonstrated promise in assisting Echo analysis through automated segmentation or reasoning, they remain focused on restricted skills, i.e., eyes-hands or eyes-minds, thereby limiting clinical reliability and utility. To address these issues, we propose EchoAgent, an agentic system tailored for end-to-end Echo interpretation, which achieves a fully coordinated eyes-hands-minds workflow that learns, observes, operates, and reasons like a cardiac sonographer. First, we introduce an expertise-driven cognition engine where our agent can automatically assimilate credible Echo guidelines into a structured knowledge base, thus constructing an Echo-customized mind. Second, we devise a hierarchical collaboration toolkit to endow EchoAgent with eyes-hands, which can automatically parse Echo video streams, identify cardiac views, perform anatomical segmentation, and quantitative measurement. Third, we integrate the perceived multimodal evidence with the exclusive knowledge base into an orchestrated reasoning hub to conduct explainable inferences. We evaluate EchoAgent on CAMUS and MIMIC-EchoQA datasets, which cover 48 distinct echocardiographic views spanning 14 cardiac anatomical regions. Experimental results show that EchoAgent achieves optimal performance across diverse structure analyses, yielding overall accuracy of up to 80.00%. Importantly, EchoAgent empowers a single system with abilities to learn, observe, operate and reason like an echocardiologist, which holds great promise for reliable Echo interpretation.

ColoDiff: Integrating Dynamic Consistency With Content Awareness for Colonoscopy Video Generation

Colonoscopy video generation delivers dynamic, information-rich data critical for diagnosing intestinal diseases, particularly in data-scarce scenarios. High-quality video generation demands temporal consistency and precise control over clinical attributes, but faces challenges from irregular intestinal structures, diverse disease representations, and various imaging modalities. To this end, we propose ColoDiff, a diffusion-based framework that generates dynamic-consistent and content-aware colonoscopy videos, aiming to alleviate data shortage and assist clinical analysis. At the inter-frame level, our TimeStream module decouples temporal dependency from video sequences through a cross-frame tokenization mechanism, enabling intricate dynamic modeling despite irregular intestinal structures. At the intra-frame level, our Content-Aware module incorporates noise-injected embeddings and learnable prototypes to realize precise control over clinical attributes, breaking through the coarse guidance of diffusion models. Additionally, ColoDiff employs a non-Markovian sampling strategy that cuts steps by over 90% for real-time generation. ColoDiff is evaluated across three public datasets and one hospital database, based on both generation metrics and downstream tasks including disease diagnosis, modality discrimination, bowel preparation scoring, and lesion segmentation. Extensive experiments show ColoDiff generates videos with smooth transitions and rich dynamics. ColoDiff presents an effort in controllable colonoscopy video generation, revealing the potential of synthetic videos in complementing authentic representation and mitigating data scarcity in clinical settings.