Clinical diagnosis is inherently sequential: clinicians escalate from cheap to costly tests only when additional evidence is expected to resolve diagnostic uncertainty. We present ActiveMedAgent, a framework that brings this cost-aware sequential logic to multimodal medical AI. Given a frozen, API-accessed vision-language model, ActiveMedAgent probability distributions over candidate diagnoses induced each acquisition by its per-step diagnostic utility minus cost. A lightweight MLP controller is then trained offline on these scored trajectories, learning when to request additional evidence and when to commit. Across three commonly used benchmarks, trajectory-based policy learning consistently outperforms both unguided acquisition and full-modality baselines. Notably, we identify an information overload effect. In 175 cases, the agent produces a correct diagnosis with fewer channels while the full-modality baseline fails, showing that learning what to omit can be as important as learning what to acquire

Post-training LLMs with Reinforcement Learning, specifically Group Relative Policy Optimization (GRPO), has emerged as a paradigm for enhancing mathematical reasoning. However, standard GRPO relies on scalar correctness rewards that are often non-injective with respect to semantic content: distinct reasoning paths receive identical rewards. This leads to a Diversity-Quality Inconsistency, where the policy collapses into a narrow set of dominant modes while ignoring equally valid but structurally novel strategies.To bridge this gap, we propose Diversity-aware Reward Adjustment (DRA), a theoretically grounded framework that calibrates the reward signal using the semantic density of sampled groups. By leveraging Submodular Mutual Information (SMI), DRA implements an Inverse Propensity Scoring (IPS) mechanism that effectively de-biases the gradient estimation. This creates a repulsive force against redundancy, driving the policy to achieve better coverage of the high-reward landscape.Our method is plug-and-play and integrates seamlessly with GRPO variants. Empirical evaluations on five math benchmarks demonstrate that DRA-GRPO consistently outperforms strong baselines, achieving an average accuracy of 58.2% on DeepSeek-R1-Distill-Qwen-1.5B with only 7,000 training samples and 55 cost, highlighting the critical role of diversity calibration in data-efficient alignment.

Although Large Audio-Language Models (LALMs) deliver state-of-the-art (SOTA) performance, they frequently suffer from hallucinations, e.g., generating text not grounded in the audio input. We analyze these grounding failures and identify a distinct taxonomy: Event Omission, False Event Identity, Temporal Relation Error, and Quantitative Temporal Error. To address this, we introduce the AHA (Audio Hallucination Alignment) framework. By leveraging counterfactual hard negative mining, our pipeline constructs a high-quality preference dataset that forces models to distinguish strict acoustic evidence from linguistically plausible fabrications. Additionally, we establish AHA-Eval, a diagnostic benchmark designed to rigorously test these fine-grained reasoning capabilities. We apply this data to align Qwen2.5-Omni. The resulting model, Qwen-Audio-AHA, achieves a 13.7% improvement on AHA-Eval. Crucially, this benefit generalizes beyond our diagnostic set. Our model shows substantial gains on public benchmarks, including 1.3% on MMAU-Test and 1.6% on MMAR, outperforming latest SOTA methods.

Multimodal large language models (MLLMs) have shown strong performance in perception and question-answering, but many clinical decisions require reasoning across observations collected over time rather than from a single input. We study this problem in longitudinal modeling, where evidence evolves across visits. We introduce LUMINA (LongitUdinal MultImodal reasoNing Agent), a single-agent framework that incrementally builds an auditable evidence state before making predictions. Instead of predicting directly from all observations, LUMINA organizes current evidence, compares observations across prior visits, maintains longitudinal memory, optionally retrieves relevant cross-subject summaries, and verifies whether the accumulated evidence supports the final decision. We evaluate LUMINA on two subject-level benchmarks: Alzheimer’s disease classification and 36-month progression forecasting from observed visit prefixes. Across nine MLLM backbones, LUMINA consistently outperforms MLLM baselines and an adapted medical reasoning agent, achieving 13.8%–18.5% relative balanced accuracy gains on classification and 16.8%–24.8% gains on progression forecasting over the strongest non-agent baseline. Additional evaluations preserve the same method ordering on Parkinsonian-state classification and breast cancer treatment-response prediction.

Lifelong editing of LLMs requires storing thousands of edits after acquisition. A widely used family of approaches attaches one LoRA adapter per edit, which preserves behavior but grows linearly in storage. To address this challenge, we propose LadderEdit, a method that compresses each LoRA adapter after it is acquired. Each edit is first stored at low rank as a cheap sketch. We then check whether this sketch still satisfies the rewrite, generalization, and locality contract on probe prompts. Edits that pass keep the sketch; those that fail are promoted to a higher rank along a ladder until the contract is met. Because every edit retains some representation, coverage is maintained, and only hard edits consume more rank. Across ZsRE, CounterFact, and WikiBigEdit benchmarks on LLaMA-3-8B, Mistral-7B, and Qwen2.5-7B, LadderEdit tracks exact LoRA storage at 5.2× less memory and remains effective at 50,000 sequential edits.