Re-mixing Embeddings for Patient Augmentation in Data Scarce Multiple Instance Learning

Data scarcity is a major bottleneck in medical Multiple Instance Learning (MIL), especially for rare diseases or expensive modalities. We introduce a statistically grounded patient augmentation approach that generates realistic patients directly in embedding space. Using Gaussian Mixture Models as a probabilistic clustering approach on pooled instance embeddings from all patients, our method learns disease-specific "recipes"-statistical distributions of instances across unsupervised clusters. New patients are then generated by sampling embeddings from clusters based on learned recipes. Unlike existing methods that require examples from all categories, our method can generate patients offline by re-mixing pooled embeddings. Generated patients are further selected based on uncertainty quantification to improve MIL performance. We evaluate our method across three clinically relevant scarcity scenarios: (i) cross-dataset transfer, where an entirely missing "healthy" class is generated using statistics from an external cohort; (ii) low-data regimes, where class sizes are extremely limited; and (iii) small-cohort non-image tasks, including single-cell RNA-seq and flow cytometry. Across all experiments, our method improves performance over baseline, often outperforming other bag-mixing strategies. Notably, in the missing-class scenario, a performance comparable to full-dataset training is achieved, demonstrating its potential for rare disease diagnostic and privacy-preserving patient augmentation. The code is available at https://github.com/marrlab/RECIPE

From Point Estimates to Distributions: GMM Pooling for MIL in Preterm Birth Prediction

Preterm birth (PTB) prediction can enable targeted surveillance and timely intervention, yet most ultrasound-based models use a single selected transvaginal ultrasound (TVUS) frame per patient despite routine exams acquiring multiple cervical images. We formulate PTB prediction as a multiple instance learning (MIL) problem, representing each patient as a variable-sized bag of TVUS images with a single outcome label. To move beyond standard MIL aggregators that collapse a bag into a point estimate, we propose a Gaussian Mixture Model (GMM) pooling, which summarizes all images in a bag into a fixed-length representation by modeling their feature distribution. This design captures intra-patient variability. We evaluate the method on a private clinical cohort and on a public lymph node metastasis benchmark. For PTB prediction, GMM pooling improves over the instance-based model PR-AUC from 0.44 to 0.56. On the lymph node benchmark, it achieves state-of-the-art performance with 0.91 F1-score and 0.89 ROC-AUC for classification and 0.18 MAE for regression. The code is publicly available at https://github.com/HussainAlasmawi/GMM_Pooling.

Brain-Adapter: A Dual-Stream Vision-Language MIL Framework for Comprehensive 3D CT Diagnosis of Acute Intracranial Pathologies

Automated diagnosis of 3D brain CT scans is essential for critical care, yet it remains challenging due to the heavy reliance on manual annotations and the limited semantic understanding of conventional models. While 2D foundation vision-language models (VLMs) have shown remarkable generalization, effectively transferring their representational power to 3D volumes remains an open problem. In this paper, we propose Brain-Adapter, a novel dual-stream multiple instance learning (MIL) framework that leverages pre-trained 2D biomedical VLMs and raw diagnostic reports for robust scan-level multi-label classification. Specifically, we introduce a Text-Conditioned Attention (TCA) mechanism, utilizing raw diagnostic sentences as semantic queries to dynamically align visual cues with specific disease concepts. Concurrently, a parallel visual MIL stream captures global scan characteristics, supervised by structured labels extracted via a Large Language Model (LLM). To ensure representation coherence, a consistency constraint enforces synergy between the two streams. During inference, an Uncertainty-Aware Refinement (UAR) module dynamically calibrates and fuses these dual-stream predictions to resolve ambiguous cases. Extensive experiments demonstrate that our method significantly outperforms state-of-the-art 3D models and standard MIL approaches. By eliminating the reliance on dense annotations, Brain-Adapter provides a highly scalable and clinically viable solution for 3D acute intracranial pathology analysis.

USS: Unified Spatial-Semantic Prompts for Embodied Visual Tracking with Latent Dynamics Learning

Embodied Visual Tracking (EVT) requires an agent to continuously follow a specified target while actively moving through dynamic environments. However, prevailing EVT paradigms predominantly rely on language-based target indication. While language is expressive and convenient, cluttered scenes often contain multiple objects that satisfy the same semantic description, leading to ambiguous target grounding. We therefore propose a paradigm shift, reframing target indication in EVT from text-only specification to unified spatial-semantic prompting. Based on this paradigm, we introduce Unified Spatial-Semantic Prompts for Embodied Visual Tracking with Latent Dynamics Learning, USS, an end-to-end embodied tracking framework that supports text, point, bounding box, and mask prompts within a unified architecture. USS encodes heterogeneous prompts with modality-specific encoders, fuses prompt tokens with visual features through hybrid attention, and decodes compact prompt-conditioned representations into egocentric waypoints. To further improve temporal robustness, USS incorporates a latent world model that predicts future representations through self-supervised alignment. Real-robot experiments demonstrate that explicit spatial target cues yield higher success rates than text-only prompts, particularly in scenarios involving similar distractors and longer-horizon tracking where maintaining instance-level target identity is critical. In the simulation benchmark, USS also achieves state-of-the-art performance among non-MLLM-based methods and competitive results against recent MLLM-based approaches with faster inference speed. Our findings reveal that spatial-semantic prompting provides a more precise and flexible target indication interface for embodied visual tracking. Project site: https://arescheah.github.io/uss-project-page/.

BiPACE: Bisimulation-Guided Policy Optimization with Action Counterfactual Estimation for LLM Agents

Stepwise group-based RL is an attractive way to train long-horizon LLM agents without a learned critic: it reuses multiple sampled rollouts to estimate local advantages. Its weakness is less visible but more fundamental: every group-relative estimator assumes that the steps it compares are equivalent for credit assignment. We show that current agentic variants violate this assumption through a state-action credit mismatch. The observation-hash partition is overly fine on the state side, creating singleton groups with zero step-level signal, while a single within-group mean is too coarse on the action side, mixing state-value estimation with action-specific credit. We introduce BiPACE (Bisimulation-Guided Policy Optimization with Action Counterfactual Estimation), a drop-in advantage estimator that fixes both sides without adding a critic, auxiliary loss, or extra rollouts. BiGPO clusters steps by cosine distance in the actor's own hidden-state geometry, an empirical policy-induced proxy for bisimulation that substantially lowers the singleton rate left by observation hashing. PACE then recenters returns within each behavioral cluster using action-conditioned peer baselines; its Q-style instance estimates a local Q(s,a)-V(s) nonparametrically. On ALFWorld/Qwen2.5-7B, BiPACE_Q raises overall validation success from GiGPO's 90.8 to $97.1\pm0.9$ over three seeds, and crosses the 95% threshold on every seed, which GiGPO never does within the same budget. On Qwen2.5-1.5B it reaches $93.5\pm1.2$ versus GiGPO's 86.7, and on WebShop and TextCraft it improves over GRPO and GiGPO at both model scales. The measured BiPACE-specific overhead is 11.3% of a single training-step wall time. Yet it changes the estimator's comparison unit from surface identity to approximate behavioral equivalence plus action-side counterfactuals. The code is available at https://github.com/TianxiangZhao/BiPACE.

GeoRouteNet: Geometry-Enhanced Non-Autoregressive Neural Solver for the Traveling Salesman Problem

The traveling salesman problem (TSP) is a canonical NP-hard combinatorial optimization benchmark that tests the representational capacity and generalization of neural solvers. While non-autoregressive (NAR) approaches offer parallel inference, they often lack sufficient geometric inductive bias and stable training signals, leading to degraded performance under cross-scale and cross-distribution shifts. We propose GeoRouteNet, a geometry-enhanced NAR neural solver for Euclidean TSP. On the model side, GeoRouteNet incorporates centered node features, learnable radial distance basis functions, distance-aware graph attention with explicit edge messaging, LayerNorm-SwiGLU feed-forward blocks, and cross-layer attentive residual mixing. On the training side, we design multi-candidate self-comparison reinforcement learning (MCS-RL), which samples multiple candidate tours per instance, constructs adaptive baselines from greedy and peer candidates, and adds winner-candidate guidance with annealed entropy regularization. On 10,000 random TSP50 instances, GeoRouteNet achieves a 0.32% optimality gap under Beam-1000 decoding. On TSP100, the gap is 1.26%. On 27 stratified TSPLIB EUC_2D instances, the overall gap drops from 17.12% (NAR4TSP reproduction) to 3.60%, while batch inference throughput substantially exceeds that of Concorde and LKH3. Ablation studies confirm that geometric structure enhancement and multi-candidate training are complementary: structure improvements dominate cross-distribution gains, while MCS-RL further stabilizes solution quality when paired with a strong geometric encoder.

Stuttering Classification and Segmentation with Attention-Based Multiple Instance Learning

Stuttering detection and classification using deep learning methods has the potential to improve the process of stuttering severity assessment. Most stuttering classification datasets provide clip-level labels, making them unsuitable for fine-grained frame-level classification needed to determine the duration of individual stuttering dysfluencies. To overcome this challenge, we present a multiple instance neural network architecture based on fine-tuned wav2vec 2.0, WavLM and Whisper encoders. We apply instance- and embedding-based multiple instance learning approaches to train models on a clip-level dataset for both clip-level and frame-level stuttering classification tasks. Our results show a 23% improvement in frame-level F1 score and between 2% and 9% in clip-level F1 score, demonstrating the ability of our models to utilize clip-level data for frame-level segmentation.

QG-MIL: A Gated Transformer Aggregator for Domain-Agnostic Multiple Instance Learning in Medical Imaging

Attention-based Multiple Instance Learning aggregators in medical imaging are prone to attention concentration, producing overconfident and unstable predictions. We introduce QG-MIL, a gated transformer aggregator that addresses this through four synergistic architectural components: RMSNorm-based pre-normalization, per-head QK normalization, fine-grained attention output gating, and SwiGLU-style feed-forward modules. Together, these design choices stabilize training and distribute attention more uniformly across instances without auxiliary losses, masking, or multi-stage regularization. We evaluate QG-MIL across six benchmarks spanning whole-slide pathology and cell-level hematology, covering two fundamentally different MIL scales. The best-performing QG-MIL variants outperform leading baselines on all six benchmarks, with an average improvement of +6.1 mean macro F1 points. Attention overlays and attention mass analysis confirm more distributed instance weighting. Ablation studies show that while individual components can match the full model on specific datasets, the QG-MIL design provides the most consistent cross-domain performance and tightest variance when compared to selected baselines. We release a configurable implementation to support reproducibility at: https://github.com/unica-visual-intelligence-lab/QG-MIL

Embedded Polygon Symbolic Transfer Entropy (EPSTE): A Geometric Token and Deep Learning Approach to Estimating Transfer Entropy in Neuroimaging Time Series

Inferring directed interactions between neural systems from EEG and MEG remains challenging due to noise, nonstationarity, and the high sample complexity of information-theoretic estimators. Transfer Entropy (TE) provides a principled and model-free measure of directed information flow; however, its practical estimation is not stable in finite data regimes (particularly as embedding dimension increases). This work introduces Embedded Polygon Symbolic Transfer Entropy (EPSTE), a framework that reframes TE estimation as a learnable problem operating on structured symbolic representations of local temporal morphology rather than raw signal amplitudes. Neural time series are decomposed into sequences of geometric primitives derived from local triplets of samples encoding complementary aspects of waveform structure such as magnitude, curvature and directional change. These primitives are discretised into symbolic tokens, yielding a compact but expressive state space over which symbolic TE is estimated. A recurrent neural network with attention-based multiple-instance learning is trained to predict surrogate-validated TE values from bags of symbolic temporal windows. The method is evaluated on source-reconstructed MEG data parcellated using the AAL90 atlas and compared against a standard symbolic baseline using identical architectures and supervision. The results demonstrate that while local window-level predictions are noisy, aggregation across trials and channel pairs yields stable directed dependencies. At the pair level, EPSTE achieves near-perfect recovery of ground-truth directed structure and significantly lower absolute error than the baseline, indicating that representational geometry plays a critical role in enabling practical learnability of information-theoretic dependencies.

RaLMPH: Reliability-aware Learning for Multi-Pathologist Harmonization in Whole-Slide Image Classification

Multiple Instance Learning (MIL) is a standard paradigm for Whole-Slide Image (WSI) analysis and has achieved strong results in computational pathology. However, most MIL pipelines assume a single "gold" label per slide, which conflicts with clinical practice where substantial inter-pathologist variability is common. Existing multi-annotator learning and label-refinement methods typically estimate global annotator reliability or rely on single-instance assumptions, making them poorly suited to MIL and to localized diagnostic contexts where experts disagree. We propose RaLMPH (Reliability-aware Learning for Multi-Pathologist Harmonization), a MIL-based label reconciliation framework for WSIs annotated by multiple pathologists. RaLMPH introduces a reliability field that jointly models (i) local neighborhood structure in WSI feature space and (ii) expert uncertainty (entropy), enabling per-sample identification of trustworthy reference neighborhoods. Leveraging this field, RaLMPH performs sample-wise local annotator ranking to select reliable opinions per slide and applies an adaptive gating mechanism to fuse labels conditioned on local reliability. Experiments on a clinical WSI dataset with labels from six pathologists, as well as controlled simulated benchmarks, show that RaLMPH consistently outperforms existing approaches. Further analyses clarify how our reliability-aware mechanism improves label reconciliation and downstream MIL performance.