The Inference Report

Multimodal large language models (MLLMs) hold immense potential to revolutionize clinical practice, yet deploying them in the medical domain is fundamentally a vision-centric challenge: models must absorb knowledge from heterogeneous 2D and 3D medical images, and evaluation protocols must align with radiologists' clinical practice and provide an accurate, fine-grained and factualness-driven assessment. In this paper, we introduce ClinFusion, a vision-centric MLLM designed for holistic medical understanding that systematically addresses these limitations. We propose a compositional and cascaded vision encoder architecture featuring a Cascade Spatial-Aware Locality Fusion operator that unifies diverse 2D and native 3D medical image understanding within a fused encoder. We further introduce a vision-grounded evaluation framework, including MedIF-Bench for instruction-following assessment and a region-of-interest-grounded method for clinically aligned and factualness-driven report generation evaluation. We show that ClinFusion sets a new state-of-the-art across a comprehensive suite of 2D and 3D multimodal medical benchmarks---spanning visual question answering, report generation, and instruction following---as well as textual medical tasks, outperforming leading open-source medical MLLMs (\textit{e.g.}, Hulu-Med, Lingshu) on 20 out of 24 benchmarks and demonstrating multimodal capabilities better than powerful proprietary models such as GPT-5.2 and Gemini-3-Flash on 13 out of 16 benchmarks, and can be further augmented with agentic tool use for retrieval-augmented and tool-assisted clinical workflows. A blinded evaluation by board-certified radiologists confirms that ClinFusion produces the highest-ranked reports, and validates our RoI-grounded metric as achieving the strongest correlation with expert judgment among all automatic evaluation metrics examined.

Dynamic applications, including optimal-transport Flow Matching, repeatedly solve related entropic optimal transport problems, yet conventional distributed Sinkhorn processes frames sequentially and synchronizes after every iteration. We present TemporalSinkhorn, a parallel-in-time executor that batches future candidates and their repairs without making output accuracy speculative. A centered, row-sharded certificate accepts only a deterministic safe prefix. The remaining candidates share packed Sinkhorn updates; an online projective forgetting rate places audit milestones, while a posteriori residual checks recover from every depth underestimate. Prediction can therefore change work placement but cannot authorize an inaccurate output. On 4 A100 GPUs, a 60-run, five-seed grid at n = 2048 shows that forgetting-guided milestones reduce wall time by 1.15x-1.47x relative to auditing every packed iteration in five statistically resolved regime cells. Against a sequential soft c-transform warm start, temporal execution is 1.42x-3.55x faster across six synthetic streams, with zero marginal-tolerance violations. On Flow Matching minibatch streams, temporal execution is 3.054x-3.632x faster than sequential carry at n = 2048, with no tolerance violations. A separate fixed-kernel test on an RTX 4060 Laptop GPU gives a 4.315x geometric-mean speedup. These are complementary deployment studies rather than a controlled hardware comparison. End-to-end Flow Matching integration, optimized-solver comparisons, and multi-node validation remain open.

Motivated by learning from heterogeneous and overlapping data providers, we study a stylized model of distribution learning from restricted conditional samples. The goal is to learn an unknown distribution $p$ on a finite domain $[n]$. The learner is given a fixed family of queryable sets $\mathscr{S} \subseteq 2^{[n]}$, and each query to $S \in \mathscr{S}$ returns an independent sample from the conditional distribution $p(\cdot \mid S)$. Learnability is governed by the co-occurrence graph associated with $\mathscr{S}$: two domain elements are adjacent if they appear together in some queryable set. Pointwise consistency is achievable when this graph is connected on the target support. PAC learning requires more: it is possible when the co-occurrence graph is complete. The optimal sample complexity of PAC learning ranges from nearly linear to quadratic. Every query family with complete co-occurrence graph admits sample complexity $\widetilde O(n^2/ε^2)$, and this bound is tight in the worst case. On the other hand, if $[n]$ is queryable then ordinary sampling improves the bound to $Θ(n/ε^2)$, and this cannot be improved further even if every set is queryable. More generally, we identify hierarchical comparabilityas a sufficient structural condition on $\mathscr S$ under which the optimal complexity is nearly linear, $\widetilde Θ(n/ε^2)$, with pairwise query families as a canonical example. Finally, the full range of polynomial rates between linear and quadratic is attainable: for every $α\in (1,2)$, there exists a query family with optimal PAC rate $\widetilde Θ(n^α/ε^2)$.

On-policy distillation (OPD) adapts diffusion models by querying a teacher along trajectories generated by the current student, but how it should behave under classifier-free guidance (CFG), a default component of modern diffusion systems, remains poorly understood. Existing OPD methods naturally extend velocity matching to the CFG-composed prediction, directly matching teacher and student guided velocities. We show that this objective is under-identified at the branch level: positive- and negative-branch errors can compensate in the guided prediction. Through two contrasting cases, we find that naive matching remains effective under shared negative conditioning, where both branch errors decrease jointly. When the model's native CFG schema retains privileged information in the teacher's negative branch that is unavailable to the student, however, this joint reduction breaks down and the composed objective induces antagonistic branch-error dynamics, reducing the positive-branch error while increasing the negative-branch error. We term this failure mode Negative Branch Asymmetry (NBA). To address NBA, we introduce Positive--Direction Matching (PDM), a branch-aware OPD objective that separately constrains the positive prediction and the CFG conditional direction. We apply PDM to dense-to-sparse video control, where naive guided matching is highly sensitive to inference guidance scales, while branch-aware supervision enables more robust and effective knowledge transfer.

Computer vision models have become highly effective for medical applications, yet their black-box nature continues to undermine clinician trust. In clinical workflows, chest X-ray classifiers are increasingly paired with Vision-Language Models (VLMs) to generate natural-language explanations. However, these systems add linguistic fluency without addressing the underlying opacity of the visual model. With the emergence of Kolmogorov-Arnold Networks (KANs), whose spline-based components provide inherently interpretable functional units, we investigate whether this architectural transparency can be leveraged to produce more trustworthy textual explanations. We introduce KANEx, the first ever framework that leverages the symbolic transparency of KANs to ground VLM reasoning. This interpretability also made it possible to design KAN-Map, a novel heatmap generation method derived directly from KAN models rather than gradient approximations. We feed these grounded contexts into downstream VLMs for enhanced explainability. Benchmarked on the MIMIC-CXR dataset, we demonstrate that KAN-based architectures with ResNet/ViT baselines demonstrate improved semantic similarity while producing significantly more faithful saliency maps. KAN architectures improve visual localization and downstream reasoning quality by 10%. Our findings suggest that grounding linguistic explanations and visual attributions in mathematically interpretable units is a necessary step toward trustworthy medical AI.

The Deep Galerkin Method (DGM) and Physics Informed Neural Networks (PINNs) have become widely-used methods for solving partial differential equations (PDEs) in the rapidly growing field of scientific machine learning. In these methods, a neural network is trained to approximate the PDE solution by using (stochastic) gradient descent to minimize the PDE residual of the neural network. Due to the non-convexity of the PDE residual objective function, the trained neural network may, in principle, only converge to a local minimizer of the objective function (which would not be a solution of the PDE). Therefore, there is a longstanding question regarding the mathematical foundations of these algorithms, and it is highly valuable to establish that the trained neural network will converge to the PDE solution. For a class of semi-linear PDEs (nonlinear in the solution and its first derivative), we prove that neural networks trained with gradient descent to minimize the PDE residual objective function will converge to the PDE solution.