Latent reasoning enables reasoning over continuous hidden states rather than explicit tokens, avoiding the language bottleneck and inference overhead of chain-of-thought for medical VQA. However, existing methods suffer from modality collapse, insufficient visual supervision, and train-inference mismatch. Moreover, their opaque latent states offer no interpretability, which is critical in clinical applications. We propose VITAL, a latent-space reasoning framework for medical MLLMs with visual-semantic dual supervision: an auxiliary text decoder reconstructs reasoning chains from latent states, while a visual projector regresses ROI features from a frozen, independent medical vision encoder. Both modules are discarded at inference with zero overhead, yet can be re-attached post-hoc for dual interpretability, providing textual and visual explanations of the reasoning process without sacrificing efficiency. We construct a 61K dataset spanning 9 imaging modalities, exceeding prior medical visual latent reasoning datasets by an order of magnitude. Experiments on 7 benchmarks show that VITAL consistently and substantially outperforms the backbone, all latent reasoning baselines, and medical MLLMs trained on far larger data, achieving state-of-the-art results competitive with trillion-parameter proprietary models.

Hybrid cooling systems that combine wet and dry cooling have drawn growing attention, as they can leverage ambient air temperature to enable broader regional deployment while mitigating water consumption. However, hybrid cooling remains insufficiently explored because the water associated with power generation is often overlooked. Moreover, distributing water is also challenging when water is scarce. In this paper, we present WaterSplit, a water-aware optimization framework that minimizes the water footprint to enable sustainable datacenter operations with hybrid cooling under limited water budgets.

Recent medical MLLMs have made significant progress in generating step by step textual reasoning chains. However, they still struggle with complex clinical tasks that necessitate dynamic and iterative focusing on fine-grained visual regions. To close this gap, we introduce Ophiuchus, a versatile, tool-augmented framework that equips an MLLM to (i) decide when fine-grained visual evidence is needed, (ii) determine where to probe and ground within the medical image, and (iii) seamlessly weave the relevant sub-image content back into an interleaved, multimodal chain of thought for precise segmentation and diagnosis. Ophiuchus moves beyond mere tool-calling by tightly fusing the MLLM’s inherent grounding and reasoning capabilities with external tools, enabling more accurate and trustworthy decisions. The core of our method is a three-stage training strategy: cold-start SFT for basic tool selection; self-reflection fine-tuning to strengthen decision revision; and agentic tool reinforcement learning to elicit sophisticated, expert-like diagnostic behaviors. Extensive experiments show that Ophiuchus consistently outperforms both closed-source and open-source SOTA methods across diverse medical benchmarks, including VQA, detection, and reasoning-based segmentation.

Reliable medical image understanding requires models to connect clinical language and visual reasoning with pixel-level grounding. Yet medical vision-language models often lack precise localization, whereas medical segmenters typically rely on explicit target categories or precise spatial prompts. This divide is reinforced by a supervision mismatch: segmentation datasets provide precise masks but little language supervision, whereas medical vision-language data rarely pair language with dense spatial annotations. To address this gap, we present MedPixel, a unified medical pixel-language model built around a shared language--mask interface. To provide scalable supervision, we introduce MedPLG-440K, comprising approximately 440K pixel-language task samples constructed through a clinically motivated synthesis process without external LLM annotation. MedPixel is trained with joint multi-task supervised fine-tuning followed by Pixel-Level Preference Optimization, which uses ground-truth masks as offline verifiers to derive response preferences from mask quality. MedPixel supports a broad spectrum of tasks spanning explicit grounding, implicit reasoning, spatial interaction, grounded explanation, and medical VQA. Across this task spectrum, MedPixel achieves strong performance in both pixel-level prediction and response generation, together with effective zero-shot transfer to external grounding benchmarks and robustness to imperfect spatial prompts. Code and model checkpoints will be released at https://github.com/yhy-whu/Medpixel.

Recent research on medical MLLMs has gradually shifted its focus from image-level understanding to fine-grained, pixel-level comprehension. Although segmentation serves as the foundation for pixel-level understanding, existing approaches face two major challenges. First, they introduce implicit segmentation tokens and require simultaneous fine-tuning of both the MLLM and external pixel decoders, which increases the risk of catastrophic forgetting and limits generalization to out-of-domain scenarios. Second, most methods rely on single-pass reasoning and lack the capability to iteratively refine segmentation results, leading to suboptimal performance. To overcome these limitations, we propose IBISAgent—a novel agentic MLLM that reformulates segmentation as a vision-centric, multi-step decision-making process. IBISAgent enables MLLMs to generate interleaved reasoning and text-based click actions, invoke segmentation tools, and produce high-quality masks without architectural modifications. By iteratively performing multi-step visual reasoning on masked image features, IBISAgent naturally supports mask refinement and promotes the development of pixel-level visual reasoning capabilities. We further design a two-stage training framework consisting of cold-start supervised fine-tuning and agentic reinforcement learning with tailored, fine-grained rewards, enhancing the model’s robustness in complex medical referring and reasoning segmentation tasks. Extensive experiments demonstrate that IBISAgent consistently outperforms both closed-source and open-source SOTA methods. All datasets, code, and trained models will be released publicly.

Large language models(LLMs) increasingly match expert performance on licensing examinations, yet routine clinical use remains limited because governance requires auditable reasoning, safety and ethics alignment, and resilience to adversarial misuse. Here we present SafeMed-R1, trained with a traceable Clinical Trust Signals(CTS) pipeline that links each reasoning instance to clinician rubric scores and edit histories, and aligned through safety and ethics supervision and red team stress testing. SafeMed-R1 attains a macro-averaged accuracy of 79.6

Radiology reports describe clinical observations but do not specify executable segmentation targets. They may contain present, negated, prior,uncertain, or irrelevant findings, while multiple valid abnormalities may coexist. Existing segmentation methods largely bypass this ambiguity by receiving a target identity or spatial prompt before inference, which acts as a hidden target oracle. We study report-grounded abnormality segmentation, where a model must determine target eligibility, cardinality, and finding-to-mask correspondence directly from an unfiltered report before delineating the corresponding regions. We propose EliSeg, an atcor–verify–revise framework that integrates target construction with mask generation. A grammar-constrained Actor proposes target slots and masks, an independent text-only Verifier reconstructs the eligible finding inventory, and Revision selectively re-executes the shared Actor when their target structures disagree. EliSeg requires no predefined target identity, finding prompt, point, or bounding box. Experiments on MIMIC-CXR-ILS show that EliSeg consistently outperforms direct segmentation methods and extract-then-segment cascades across findings, while effectively suppressing masks for ineligible report mentions. Ablation studies confirm the complementary roles of verification and revision, and evaluation on CheXlocalize demonstrates effective transfer of the EliSeg to an external dataset.Code is available at https://github.com/Maybach-dream/EliSeg.

The carbon and water footprint of large-scale computing systems poses serious environmental sustainability risks. In this study, we discover that, unfortunately, carbon and water sustainability are at odds with each other - and, optimizing one alone hurts the other. Toward that goal, we introduce, WaterWise, a novel job scheduler for parallel workloads that intelligently co-optimizes carbon and water footprint to improve the sustainability of geographically distributed data centers.

We explore Generalizable Tumor Segmentation, aiming to train a single model for zero-shot tumor segmentation across diverse anatomical regions. Existing methods face limitations related to segmentation quality, scalability, and the range of applicable imaging modalities. In this paper, we uncover the potential of the internal representations within frozen medical foundation diffusion models as highly efficient zero-shot learners for tumor segmentation by introducing a novel framework named DiffuGTS. DiffuGTS creates anomaly-aware open-vocabulary attention maps based on text prompts to enable generalizable anomaly segmentation without being restricted by a predefined training category list. To further improve and refine anomaly segmentation masks, DiffuGTS leverages the diffusion model, transforming pathological regions into high-quality pseudo-healthy counterparts through latent space inpainting, and applies a novel pixel-level and feature-level residual learning approach, resulting in segmentation masks with significantly enhanced quality and generalization. Comprehensive experiments on four datasets and seven tumor categories demonstrate the superior performance of our method, surpassing current state-of-the-art models across multiple zero-shot settings. Codes are available at https://github.com/Yankai96/DiffuGTS.

Medical image re-identification (MedReID) is underexplored so far, despite its critical applications in personalized healthcare and privacy protection. In this paper, we introduce a thorough benchmark and a unified model for this problem. First, to handle various medical modalities, we propose a novel Continuous Modality-based Parameter Adapter (ComPA). ComPA condenses medical content into a continuous modality representation and dynamically adjusts the modality-agnostic model with modalityspecific parameters at runtime. This allows a single model to adaptively learn and process diverse modality data. Furthermore, we integrate medical priors into our model by aligning it with a bag of pre-trained medical foundation models, in terms of the differential features. Compared to single-image feature, modeling the inter-image difference better fits the re-identification problem, which involves discriminating multiple images. We evaluate the proposed model against 25 foundation models and 8 large multimodal language models across 11 image datasets, demonstrating consistently superior performance. Additionally, we deploy the proposed MedReID technique to two realworld applications, i.e., history-augmented personalized diagnosis and medical privacy protection. Codes and model is available at https://github.com/tianyuan168326/All-inOne-MedReID-Pytorch.

Medical imaging has significantly advanced computer-aided diagnosis, yet its re-identification (ReID) risks raise critical privacy concerns, calling for de-identification (DeID) techniques. Unfortunately, existing DeID methods neither particularly preserve medical semantics, nor are flexibly adjustable towards different privacy levels. To address these issues, we propose a divide-and-conquer framework comprising two steps: (1) Identity-Blocking, which blocks varying proportions of identity-related regions, to achieve different privacy levels; and (2) Medical-Semantics-Compensation, which leverages pre-trained Medical Foundation Models (MFMs) to extract medical semantic features to compensate the blocked regions. Moreover, recognizing that features from MFMs may still contain residual identity information, we introduce a Minimum Description Length principle-based feature decoupling strategy, to effectively decouple and discard such identity components. Extensive evaluations against existing approaches across seven datasets and three downstream tasks, demonstrates our state-of-the-art performance.

Fluorinated compounds, commonly known as forever chemicals, play a critical role in semiconductor fabrication steps such as lithography, etching, and chamber cleaning. They exhibit global warming potentials thousands of times higher than carbon dioxide and persist in the atmosphere for millennia. Yet, sustainability efforts in computer systems have primarily focused on carbon emissions alone. We introduce ForgetMeNot, a modeling tool that quantifies fluorinated compound emissions across different steps of the semiconductor manufacturing pipeline. We validate its accuracy using real-world fab data and demonstrate its utility for emission-aware hardware design. ForgetMeNot reveals how different chip characteristics affect fluorinated compound emissions, and helps datacenter operators select low-emission hardware configurations. By integrating fluorinated compound emissions into hardware manufacturing decisions, ForgetMeNot presents a more complete sustainability framework for computing systems.

AI-assisted imaging made substantial advances in tumor diagnosis and management. However, a major barrier to developing robust oncology foundation models is the scarcity of large-scale, high-quality annotated datasets, which are limited by privacy restrictions and the high cost of manual labeling. To address this gap, we present PASTA, a pan-tumor radiology foundation model built on PASTA-Gen, a synthetic data framework that generated 30,000 3D CT scans with pixel-level lesion masks and structured reports of tumors across ten organ systems. Leveraging this resource, PASTA achieves state-of-the-art performance on 45 of 46 oncology tasks, including non-contrast CT tumor screening, lesion segmentation, structured reporting, tumor staging, survival prediction, and MRI-modality transfer. To assess clinical applicability, we developed PASTA-AID, a clinical decision support system, and ran a retrospective simulated clinical trial across two scenarios. For pan-tumor screening on plain CT with fixed reading time, PASTA-AID increased radiologists' throughput by 11.1-25.1

Rising computational demands have made cloud datacenters' water footprint a critical concern. We demonstrate how different water footprint accounting methodologies - incorporating operational, manufacturing, and decommissioning water consumption, impact measurements and highlight the need for methodology standardization for water-aware operations. Our analysis reveals opportunities for water-aware scheduling in datacenters by considering regional water variations and lifecycle impacts.

3D medical image segmentation is important for clinical diagnosis and treatment but faces challenges from high-dimensional data and complex spatial dependencies. Traditional single-modality networks, such as CNNs and Transformers, are often limited by computational inefficiency and constrained contextual modeling in 3D settings. To alleviate these limitations, we propose TK-Mamba, a multimodal framework that fuses the linear-time Mamba with Kolmogorov-Arnold Networks (KAN) to form an efficient hybrid backbone. Our approach is characterized by two primary technical contributions. Firstly, we introduce the novel 3D-Group-Rational KAN (3D-GR-KAN), which marks the first application of KAN in 3D medical imaging, providing a superior and computationally efficient nonlinear feature transformation crucial for complex volumetric structures. Secondly, we devise a dual-branch text-driven strategy using Pubmedclip's embeddings. This strategy significantly enhances segmentation robustness and accuracy by simultaneously capturing inter-organ semantic relationships to mitigate label inconsistencies and aligning image features with anatomical texts. By combining this advanced backbone and vision-language knowledge, TK-Mamba offers a unified and scalable solution for both multi-organ and tumor segmentation. Experiments on multiple datasets demonstrate that our framework achieves state-of-the-art performance in both organ and tumor segmentation tasks, surpassing existing methods in both accuracy and efficiency. Our code is publicly available at https://github.com/yhy-whu/TK-Mamba

The carbon footprint of networking poses a significant environmental concern. In this paper, we show how transmission latency-focused traditional routing can be sub-optimal in terms of carbon footprint. Based on the dynamic factors that affect a network's carbon footprint and transmission latency, we design a carbon-aware routing solution. We evaluate our solution on real backbone Internet topologies to show that there is an opportunity to minimize the network's carbon emissions with only modest latency penalties.

Recent advancements in medical vision-language pre-training models have driven significant progress in zero-shot disease recognition. However, transferring image-level knowledge to pixel-level tasks, such as lesion segmentation in 3D CT scans, remains a critical challenge. Due to the complexity and variability of pathological visual characteristics, existing methods struggle to align fine-grained lesion features not encountered during training with disease-related textual representations. In this paper, we present Malenia, a novel multi-scale lesion-level mask-attribute alignment framework, specifically designed for 3D zero-shot lesion segmentation. Malenia improves the compatibility between mask representations and their associated elemental attributes, explicitly linking the visual features of unseen lesions with the extensible knowledge learned from previously seen ones. Furthermore, we design a Cross-Modal Knowledge Injection module to enhance both visual and textual features with mutually beneficial information, effectively guiding the generation of segmentation results.Comprehensive experiments across three datasets and 12 lesion categories validate the superior performance of Malenia.

High-performance computing (HPC) systems are becoming increasingly water-intensive due to their reliance on water-based cooling and the energy used in power generation. However, the water footprint of HPC remains relatively underexplored-especially in contrast to the growing focus on carbon emissions. In this paper, we present ThirstyFLOPS - a comprehensive water footprint analysis framework for HPC systems. Our approach incorporates region-specific metrics, including Water Usage Effectiveness, Power Usage Effectiveness, and Energy Water Factor, to quantify water consumption using real-world data. Using four representative HPC systems - Marconi, Fugaku, Polaris, and Frontier - as examples, we provide implications for HPC system planning and management. We explore the impact of regional water scarcity and nuclear-based energy strategies on HPC sustainability. Our findings aim to advance the development of water-aware, environmentally responsible computing infrastructures.

The rapid rise of generative AI (GenAI) technologies has brought innovative video generation models like OpenAI's Sora to the forefront, but these advancements come with significant sustainability challenges due to their high carbon footprint. This paper presents a carbon-centric case study on video generation, providing the first systematic investigation into the environmental impact of this technology. By analyzing Open-Sora, an open-source text-to-video model inspired by OpenAI Sora, we identify the iterative diffusion denoising process as the primary source of carbon emissions. Our findings reveal that video generation applications are significantly more carbon-demanding than text-based GenAI models and that their carbon footprint is largely dictated by denoising step number, video resolution, and duration. To promote sustainability, we propose integrating carbon-aware credit systems and encouraging offline generation during high carbon intensity periods, offering a foundation for environmentally friendly practices in GenAI.

Healthcare systems worldwide face persistent challenges in efficiency, accessibility, and personalization. Powered by modern AI technologies such as multimodal large language models and world models, Embodied AI (EmAI) represents a transformative frontier, offering enhanced autonomy and the ability to interact with the physical world to address these challenges. As an interdisciplinary and rapidly evolving research domain, "EmAI in healthcare" spans diverse fields such as algorithms, robotics, and biomedicine. This complexity underscores the importance of timely reviews and analyses to track advancements, address challenges, and foster cross-disciplinary collaboration. In this paper, we provide a comprehensive overview of the "brain" of EmAI for healthcare, wherein we introduce foundational AI algorithms for perception, actuation, planning, and memory, and focus on presenting the healthcare applications spanning clinical interventions, daily care & companionship, infrastructure support, and biomedical research. Despite its promise, the development of EmAI for healthcare is hindered by critical challenges such as safety concerns, gaps between simulation platforms and real-world applications, the absence of standardized benchmarks, and uneven progress across interdisciplinary domains. We discuss the technical barriers and explore ethical considerations, offering a forward-looking perspective on the future of EmAI in healthcare. A hierarchical framework of intelligent levels for EmAI systems is also introduced to guide further development. By providing systematic insights, this work aims to inspire innovation and practical applications, paving the way for a new era of intelligent, patient-centered healthcare.