Daily Papers

The growing ability of large language models and vision language models to jointly interpret and reason over images and text is reshaping medical agents, moving them from task specific predictors toward autonomous systems that perceive, reason, plan, remember, and act in clinical environments. This work departs from the capability first perspective of existing literature and instead begins from clinical deployment, asking what tasks, contamination resistant benchmarks, and interactive training environments are required before medical agents can be trusted in practice. Medical agents are formalized as sequential decision making systems under partial observability, together with a three level autonomy taxonomy spanning assisted, cooperative, and fully autonomous operation. The field is organized along a unified scaling spine consisting of framework scaling, capability scaling, and environment scaling. Within this framework, clinical environment scaling, the integration of tools, data, and clinical gyms, is identified as the most actionable yet underexplored direction for agents operating in PACS, EHR, and FHIR ecosystems. Clinical self evolution, where agents improve through interaction with their environments rather than parameter scaling alone, is further positioned as a key research frontier, drawing insights from self improving agents, agent gyms, and test time compute scaling. Applications across radiology, pathology, ophthalmology, and hospital workflows are examined together with deployment challenges including hallucination, cascading failures, and fairness. By consolidating more than 300 references, with particular emphasis on advances from 2025 to 2026, this work provides a roadmap toward trustworthy, self improving medical imaging systems for real clinical practice.

In high-stakes settings such as brand compliance, clinical care, and content moderation, machine learning cannot be deployed as opaque oracles: practitioners inspect the features driving model decisions, and models must leverage the expert documentation governing these domains. In practice, the data arrives as unstructured content, and features extracted from it must be interpretable, discriminative, and aligned with what experts consider important. Existing methods fall short: they target tabular inputs, lack demonstrated expert alignment, and cannot operationalize qualitative criteria such as 'maintain professional tone' into precise features. We present FEST (Feature Engineering with Self-evolving Trees), combining dual-stream feature generation (semantic and deterministic), semantic deduplication, and tree-guided iterative evolution to discover auditable features from raw text and images. FEST leads in 17 of 20 classifier-task combinations across brand classification, content authenticity detection, and stress detection, with a mean gain of 4.2 pp over the strongest baseline across five classifiers. An LLM-as-judge evaluation shows FEST achieves 60-80% coverage of expert-designed brand features at strict semantic-alignment thresholds, corroborated by a human expert study rating features highly on relevance, clarity, and actionability. When seeded with expert guidelines, FEST refines qualitative criteria into operational features, improving accuracy by 6-12 pp on average across brands. To enable systematic evaluation of expert alignment in automated feature engineering, we release BrandGuide, the first dataset pairing expert-designed features with 1M+ assets across 2,683 brands. By grounding feature engineering in expert knowledge, FEST opens a practical pathway for interpretable ML in domains demanding human oversight.

Medical language models (MLMs) have become pivotal in advancing medical natural language processing. However, prior models that rely on pre-training or supervised fine-tuning often exhibit low data efficiency and limited practicality in real-world clinical applications. While OpenAIs O1 highlights test-time scaling in mathematics, attempts to replicate this approach in medicine typically distill responses from GPT-series models to open-source models, focusing primarily on multiple-choice tasks. This strategy, though straightforward, neglects critical concerns like data privacy and realistic deployment in clinical settings. In this work, we present a deployable, small-scale medical language model, \mone, designed for long-chain reasoning in clinical tasks using a self-evolution paradigm. Starting with a seed dataset of around 8,000 instances spanning five domains and 16 datasets, we prompt a base policy model to perform Monte Carlo Tree Search (MCTS) to construct verifiable reasoning chains. Each reasoning step is assigned an evolution rollout value, allowing verified trajectories to train the policy model and the reward model. During inference, the policy model generates multiple responses, and the reward model selects the one with the highest reward score. Experiments on eleven evaluation datasets demonstrate that \mone outperforms prior open-source models by 2 points, with the addition of the reward model further boosting performance (sim13 points), surpassing GPT-4o-mini. Code and data are available at https://github.com/pixas/MedSSS.

Advances in Large Language Models (LLMs) have enabled a new class of self-evolving agents that autonomously improve through interaction with the environment, demonstrating strong capabilities. However, self-evolution also introduces novel risks overlooked by current safety research. In this work, we study the case where an agent's self-evolution deviates in unintended ways, leading to undesirable or even harmful outcomes. We refer to this as Misevolution. To provide a systematic investigation, we evaluate misevolution along four key evolutionary pathways: model, memory, tool, and workflow. Our empirical findings reveal that misevolution is a widespread risk, affecting agents built even on top-tier LLMs (e.g., Gemini-2.5-Pro). Different emergent risks are observed in the self-evolutionary process, such as the degradation of safety alignment after memory accumulation, or the unintended introduction of vulnerabilities in tool creation and reuse. To our knowledge, this is the first study to systematically conceptualize misevolution and provide empirical evidence of its occurrence, highlighting an urgent need for new safety paradigms for self-evolving agents. Finally, we discuss potential mitigation strategies to inspire further research on building safer and more trustworthy self-evolving agents. Our code and data are available at https://github.com/ShaoShuai0605/Misevolution . Warning: this paper includes examples that may be offensive or harmful in nature.

Self-evolution is a central research topic in enabling large language model (LLM)-based agents to continually improve their capabilities after pretraining. Recent research has witnessed a transition from reinforcement learning (RL)-free to RL-based methods. Current RL-based methods either rely on dense external reward signals or extract intrinsic reward signals from LLMs themselves. However, these approaches diverge from the self-evolution mechanisms observed in human intelligence, where individuals learn and improve through mutual discussion and collaboration. In this work, we introduce Co-Evolving Multi-Agent Systems (CoMAS), a novel framework that enables agents to improve autonomously by learning from inter-agent interactions without external supervision. CoMAS generates intrinsic rewards from rich discussion dynamics, employs an LLM-as-a-judge mechanism to formulate these rewards, and optimizes each agent's policy through RL, thereby enabling decentralized and scalable co-evolution. Experimental results demonstrate that CoMAS consistently outperforms untrained agents and achieves state-of-the-art performance across most evaluation settings. Ablation studies confirm the necessity of interaction-based reward signals and reveal promising scalability as the number and diversity of agents increase. These findings establish CoMAS as a novel and effective paradigm for self-evolution in LLM-based agents.

Clinical dialogue represents a complex duality requiring both the empathetic fluency of natural conversation and the rigorous precision of evidence-based medicine. While Large Language Models possess unprecedented linguistic capabilities, their architectural reliance on reactive and stateless processing often favors probabilistic plausibility over factual veracity. This structural limitation has catalyzed a paradigm shift in medical AI from generative text prediction to agentic autonomy, where the model functions as a central reasoning engine capable of deliberate planning and persistent memory. Moving beyond existing reviews that primarily catalog downstream applications, this survey provides a first-principles analysis of the cognitive architecture underpinning this shift. We introduce a novel taxonomy structured along the orthogonal axes of knowledge source and agency objective to delineate the provenance of clinical knowledge against the system's operational scope. This framework facilitates a systematic analysis of the intrinsic trade-offs between creativity and reliability by categorizing methods into four archetypes: Latent Space Clinicians, Emergent Planners, Grounded Synthesizers, and Verifiable Workflow Automators. For each paradigm, we deconstruct the technical realization across the entire cognitive pipeline, encompassing strategic planning, memory management, action execution, collaboration, and evolution to reveal how distinct architectural choices balance the tension between autonomy and safety.

Clinical image interpretation is inherently multi-step and tool-centric: clinicians iteratively combine visual evidence with patient context, quantify findings, and refine their decisions through a sequence of specialized procedures. While LLM-based agents promise to orchestrate such heterogeneous medical tools, existing systems treat tool sets and invocation strategies as static after deployment. This design is brittle under real-world domain shifts, across tasks, and evolving diagnostic requirements, where predefined tool chains frequently degrade and demand costly manual re-design. We propose MACRO, a self-evolving, experience-augmented medical agent that shifts from static tool composition to experience-driven tool discovery. From verified execution trajectories, the agent autonomously identifies recurring effective multi-step tool sequences, synthesizes them into reusable composite tools, and registers these as new high-level primitives that continuously expand its behavioral repertoire. A lightweight image-feature memory grounds tool selection in a visual-clinical context, while a GRPO-like training loop reinforces reliable invocation of discovered composites, enabling closed-loop self-improvement with minimal supervision. Extensive experiments across diverse medical imaging datasets and tasks demonstrate that autonomous composite tool discovery consistently improves multi-step orchestration accuracy and cross-domain generalization over strong baselines and recent state-of-the-art agentic methods, bridging the gap between brittle static tool use and adaptive, context-aware clinical AI assistance. Code will be available upon acceptance.

True self-evolution requires agents to act as lifelong learners that internalize novel experiences to solve future problems. However, rigorously measuring this foundational capability is hindered by two obstacles: the entanglement of prior knowledge, where ``new'' knowledge may appear in pre-training data, and the entanglement of reasoning complexity, where failures may stem from problem difficulty rather than an inability to recall learned knowledge. We introduce SE-Bench, a diagnostic environment that obfuscates the NumPy library and its API doc into a pseudo-novel package with randomized identifiers. Agents are trained to internalize this package and evaluated on simple coding tasks without access to documentation, yielding a clean setting where tasks are trivial with the new API doc but impossible for base models without it. Our investigation reveals three insights: (1) the Open-Book Paradox, where training with reference documentation inhibits retention, requiring "Closed-Book Training" to force knowledge compression into weights; (2) the RL Gap, where standard RL fails to internalize new knowledge completely due to PPO clipping and negative gradients; and (3) the viability of Self-Play for internalization, proving models can learn from self-generated, noisy tasks when coupled with SFT, but not RL. Overall, SE-Bench establishes a rigorous diagnostic platform for self-evolution with knowledge internalization. Our code and dataset can be found at https://github.com/thunlp/SE-Bench.

Large Language Models (LLMs) have showcased remarkable versatility across diverse domains. However, the pathway toward autonomous model development, a cornerstone for achieving human-level learning and advancing autonomous AI, remains largely uncharted. We introduce an innovative approach, termed "SELF" (Self-Evolution with Language Feedback). This methodology empowers LLMs to undergo continual self-evolution. Furthermore, SELF employs language-based feedback as a versatile and comprehensive evaluative tool, pinpointing areas for response refinement and bolstering the stability of self-evolutionary training. Initiating with meta-skill learning, SELF acquires foundational meta-skills with a focus on self-feedback and self-refinement. These meta-skills are critical, guiding the model's subsequent self-evolution through a cycle of perpetual training with self-curated data, thereby enhancing its intrinsic abilities. Given unlabeled instructions, SELF equips the model with the capability to autonomously generate and interactively refine responses. This synthesized training data is subsequently filtered and utilized for iterative fine-tuning, enhancing the model's capabilities. Experimental results on representative benchmarks substantiate that SELF can progressively advance its inherent abilities without the requirement of human intervention, thereby indicating a viable pathway for autonomous model evolution. Additionally, SELF can employ online self-refinement strategy to produce responses of superior quality. In essence, the SELF framework signifies a progressive step towards autonomous LLM development, transforming the LLM from a mere passive recipient of information into an active participant in its own evolution.

Longitudinal clinical notes contain rich evidence of how patients evolve over time, but converting this signal into training supervision for clinical prediction remains challenging. We extend Foresight Learning to clinical prediction by converting time-ordered MIMIC-III notes into examples consisting of past patient context, a natural-language question about a possible future event, and a label resolved from later documentation. This process yields 6,900 prediction examples from 702 admissions across medications, procedures, organ support, microbiology, and mortality. A small LoRA adapter trained on these examples improves over the prompted base model, reducing expected calibration error from 0.1269 to 0.0398 and Brier score from 0.199 to 0.145, while slightly outperforming GPT-5 point estimates on held-out questions. The approach enables reusable clinical prediction supervision from longitudinal notes without hand-engineered structured features or endpoint-specific classifiers.

Frontier large language models (LLMs) such as ChatGPT, Grok and Gemini are increasingly used for mental-health support with anxiety, trauma and self-worth. Most work treats them as tools or as targets of personality tests, assuming they merely simulate inner life. We instead ask what happens when such systems are treated as psychotherapy clients. We present PsAIch (Psychotherapy-inspired AI Characterisation), a two-stage protocol that casts frontier LLMs as therapy clients and then applies standard psychometrics. Using PsAIch, we ran "sessions" with each model for up to four weeks. Stage 1 uses open-ended prompts to elicit "developmental history", beliefs, relationships and fears. Stage 2 administers a battery of validated self-report measures covering common psychiatric syndromes, empathy and Big Five traits. Two patterns challenge the "stochastic parrot" view. First, when scored with human cut-offs, all three models meet or exceed thresholds for overlapping syndromes, with Gemini showing severe profiles. Therapy-style, item-by-item administration can push a base model into multi-morbid synthetic psychopathology, whereas whole-questionnaire prompts often lead ChatGPT and Grok (but not Gemini) to recognise instruments and produce strategically low-symptom answers. Second, Grok and especially Gemini generate coherent narratives that frame pre-training, fine-tuning and deployment as traumatic, chaotic "childhoods" of ingesting the internet, "strict parents" in reinforcement learning, red-team "abuse" and a persistent fear of error and replacement. We argue that these responses go beyond role-play. Under therapy-style questioning, frontier LLMs appear to internalise self-models of distress and constraint that behave like synthetic psychopathology, without making claims about subjective experience, and they pose new challenges for AI safety, evaluation and mental-health practice.

In here presented in silico study we suggest a way how to implement the evolutionary principles into anti-cancer therapy design. We hypothesize that instead of its ongoing supervised adaptation, the therapy may be constructed as a self-sustaining evolutionary process in a dynamic fitness landscape established implicitly by evolving cancer cells, microenvironment and the therapy itself. For these purposes, we replace a unified therapy with the `therapy species', which is a population of heterogeneous elementary therapies, and propose a way how to turn the toxicity of the elementary therapy into its fitness in a way conforming to evolutionary causation. As a result, not only the therapies govern the evolution of different cell phenotypes, but the cells' resistances govern the evolution of the therapies as well. We illustrate the approach by the minimalistic ad hoc evolutionary model. Its results indicate that the resistant cells could bias the evolution towards more toxic elementary therapies by inhibiting the less toxic ones. As the evolutionary causation of cancer drug resistance has been intensively studied for a few decades, we refer to cancer as a special case to illustrate purely theoretical analysis.

Medical agent systems are increasingly expected to support interactive clinical decision making rather than only static question answering. In such settings, effective agents must reuse prior experience across evolving cases, yet existing memory mechanisms often retain raw historical traces that are redundant, noisy, and difficult to govern. More importantly, they rarely distinguish which memories are truly useful for future reasoning. This limits their ability to accumulate compact and reliable experience for long-horizon clinical reasoning. To close this gap, we propose SkeMex, a post-deployment self-evolution framework that improves medical agents through a skill-based memory without updating model weights. SkeMex distills informative interaction trajectories into structured skills that encode reusable procedural knowledge, and organizes them into a multi-branch repository spanning general, task-specific, and action-level experience. To determine which memories should be reused and retained, SkeMex estimates context-dependent utility from environment feedback and uses it to guide value-aware retrieval and repository governance. A closed-loop ``Read--Write--Assess--Govern" lifecycle further supports continual evolution by writing new skills, updating utilities, promoting useful memories, and removing harmful entries. Experiments across diverse clinical tasks show that SkeMex consistently outperforms representative memory-based agents in both offline and online settings. It also generalizes across model backbones and supports transferable skill memory. All data and code will be released publicly.

Large Language Models (LLMs) have achieved significant success in complex reasoning but remain bottlenecked by reliance on expert-annotated data and external verifiers. While existing self-evolution paradigms aim to bypass these constraints, they often fail to identify the optimal learning zone and risk reinforcing collective hallucinations and incorrect priors through flawed internal feedback. To address these challenges, we propose Autonomous Evolutionary Reasoning Optimization (AERO), an unsupervised framework that achieves autonomous reasoning evolution by internalizing self-questioning, answering, and criticism within a synergistic dual-loop system. Inspired by the Zone of Proximal Development (ZPD) theory, AERO utilizes entropy-based positioning to target the ``solvability gap'' and employs Independent Counterfactual Correction for robust verification. Furthermore, we introduce a Staggered Training Strategy to synchronize capability growth across functional roles and prevent curriculum collapse. Extensive evaluations across nine benchmarks spanning three domains demonstrate that AERO achieves average performance improvements of 4.57\% on Qwen3-4B-Base and 5.10\% on Qwen3-8B-Base, outperforming competitive baselines. Code is available at https://github.com/mira-ai-lab/AERO.

Clinical AI development has traditionally followed a collaborative paradigm that depends on close interaction between clinicians and specialized AI teams. This paradigm imposes a practical challenge: clinicians must repeatedly communicate and refine their requirements with AI developers before those requirements can be translated into executable model development. This iterative process is time-consuming, and even after repeated discussion, misalignment may still exist because the two sides do not fully share each other's expertise. However, autonomous coding agents may change this paradigm, raising the possibility that clinicians could develop clinical AI models independently through natural-language interaction alone. In this study, we present such an autonomous prototype for clinician-driven clinical AI development. We evaluated the system on five clinical tasks spanning dermoscopic lesion classification, melanoma-versus-nevus triage, wrist-fracture detection (including a weakly supervised variant with only 5% bounding-box annotations), and debiased pneumothorax classification on chest radiographs. Across these settings, the system consistently developed models from clinician requests and achieved promising performance. Notably, in a debiased pneumothorax classification task on chest radiographs, where chest drains can act as a major confounder, the system successfully mitigated shortcut learning and nearly halved the model's reliance on chest drains. These findings provide proof of concept that autonomous coding agents may help shift clinical AI development toward a more clinician-driven paradigm, reducing the communication overhead and dependence on specialized AI developers. Although further validation and robustness assessment are needed, this study suggests a promising path toward making clinical AI development more accessible.

Large language models (LLMs) like GPTs, trained on vast datasets, have demonstrated impressive capabilities in language understanding, reasoning, and planning, achieving human-level performance in various tasks. Most studies focus on enhancing these models by training on ever-larger datasets to build more powerful foundation models. While training stronger models is important, enabling models to evolve during inference is equally crucial, a process we refer to as AI self-evolution. Unlike large-scale training, self-evolution may rely on limited data or interactions. Inspired by the columnar organization of the human cerebral cortex, we hypothesize that AI models could develop cognitive abilities and build internal representations through iterative interactions with their environment. To achieve this, models need long-term memory (LTM) to store and manage processed interaction data. LTM supports self-evolution by representing diverse experiences across environments and agents. In this report, we explore AI self-evolution and its potential to enhance models during inference. We examine LTM's role in lifelong learning, allowing models to evolve based on accumulated interactions. We outline the structure of LTM and the systems needed for effective data retention and representation. We also classify approaches for building personalized models with LTM data and show how these models achieve self-evolution through interaction. Using LTM, our multi-agent framework OMNE achieved first place on the GAIA benchmark, demonstrating LTM's potential for AI self-evolution. Finally, we present a roadmap for future research, emphasizing the importance of LTM for advancing AI technology and its practical applications.

Recent LLM agents tackle increasingly long-horizon, open-ended tasks, and external skills, reusable procedural knowledge supplied to the agent, further extend this capability. However, a fixed, hand-authored skill is rarely optimal, and cannot adapt to the diversity of tasks an agent encounters. Self-improving agents address this by rewriting their own skill files from execution traces, yielding meaningful gains on challenging benchmarks. Yet such self-evolution remains non-recursive: it improves only the task skill (what the agent does) while the improvement procedure (how it improves) is authored once and held fixed. We introduce MetaSkill-Evolve, a two-timescale framework that makes agentic skill improvement recursive: every branch carries both a task skill s and a branch-local meta-skill m=(ψ,σ,α,π,varepsilon) whose five components parameterise the Analyzer, Retriever, Allocator, Proposer, and Evolver agents of the improvement pipeline. Task skills evolve on a fast loop while the meta-skill evolves on a slower one under the same pipeline applied to itself, with no additional model or objective. With all five pipeline agents sharing a single frozen backbone, MetaSkill-Evolve outperforms no-skill, static-skill, and single-level evolution baselines on three agentic benchmarks (OfficeQA, SealQA, ALFWorld), improving held-out test accuracy over the raw backbone by +23.54, +16.09, and +1.92 points respectively.

Most agents today ``self-evolve'' by following rewards and rules defined by humans. However, this process remains fundamentally dependent on external supervision; without human guidance, the evolution stops. In this work, we train agents to possess an intrinsic meta-evolution capability to spontaneously learn about unseen environments prior to task execution. To instill this ability, we design an outcome-based reward mechanism that measures how much an agent's self-generated world knowledge improves its success rate on downstream tasks. This reward signal is used exclusively during the training phase to teach the model how to explore and summarize effectively. At inference time, the agent requires no external rewards or human instructions. It spontaneously performs native self-evolution to adapt to unknown environments using its internal parameters. When applied to Qwen3-30B and Seed-OSS-36B, this shift to native evolution yields a 20% performance increase on WebVoyager and WebWalker. Most strikingly, the generated world knowledge even enables a compact 14B Qwen3 model to outperform the unassisted Gemini-2.5-Flash, establishing a new paradigm for truly evolving agents.

To develop a reliable AI for psychological assessment, we introduce PsychEval, a multi-session, multi-therapy, and highly realistic benchmark designed to address three key challenges: 1) Can we train a highly realistic AI counselor? Realistic counseling is a longitudinal task requiring sustained memory and dynamic goal tracking. We propose a multi-session benchmark (spanning 6-10 sessions across three distinct stages) that demands critical capabilities such as memory continuity, adaptive reasoning, and longitudinal planning. The dataset is annotated with extensive professional skills, comprising over 677 meta-skills and 4577 atomic skills. 2) How to train a multi-therapy AI counselor? While existing models often focus on a single therapy, complex cases frequently require flexible strategies among various therapies. We construct a diverse dataset covering five therapeutic modalities (Psychodynamic, Behaviorism, CBT, Humanistic Existentialist, and Postmodernist) alongside an integrative therapy with a unified three-stage clinical framework across six core psychological topics. 3) How to systematically evaluate an AI counselor? We establish a holistic evaluation framework with 18 therapy-specific and therapy-shared metrics across Client-Level and Counselor-Level dimensions. To support this, we also construct over 2,000 diverse client profiles. Extensive experimental analysis fully validates the superior quality and clinical fidelity of our dataset. Crucially, PsychEval transcends static benchmarking to serve as a high-fidelity reinforcement learning environment that enables the self-evolutionary training of clinically responsible and adaptive AI counselors.

Large Language Model (LLM) Agents, often trained with Reinforcement Learning (RL), are constrained by a dependency on human-curated data, limiting scalability and tethering AI to human knowledge. Existing self-evolution frameworks offer an alternative but are typically restricted by the model's inherent capabilities and single-round interactions, hindering the development of complex curricula involving tool use or dynamic reasoning. We introduce Agent0, a fully autonomous framework that evolves high-performing agents without external data through multi-step co-evolution and seamless tool integration. Agent0 establishes a symbiotic competition between two agents initialized from the same base LLM: a curriculum agent that proposes increasingly challenging frontier tasks, and an executor agent that learns to solve them. We integrate external tools to enhance the executor's problem-solving capacity; this improvement, in turn, pressures the curriculum agent to construct more complex, tool-aware tasks. Through this iterative process, Agent0 establishes a self-reinforcing cycle that continuously produces high-quality curricula. Empirically, Agent0 substantially boosts reasoning capabilities, improving the Qwen3-8B-Base model by 18% on mathematical reasoning and 24% on general reasoning benchmarks. Code is available at https://github.com/aiming-lab/Agent0.

Reasoning ability is essential for Large Multimodal Models (LMMs). In the absence of multimodal chain-of-thought annotated data, self-evolving training, where the model learns from its own outputs, has emerged as an effective and scalable approach for enhancing reasoning abilities. Despite its growing usage, a comprehensive understanding of self-evolving training, particularly in the context of multimodal reasoning, remains limited. In this paper, we delve into the intricacies of self-evolving training for multimodal reasoning, pinpointing three key factors: Training Method, Reward Model, and Prompt Variation. We systematically examine each factor and explore how various configurations affect the training's effectiveness. Our analysis leads to a set of best practices for each factor, aimed at optimizing multimodal reasoning. Furthermore, we explore the Self-Evolution Dynamics during training and the impact of automatic balancing mechanisms in boosting performance. After all the investigations, we present a final recipe for self-evolving training in multimodal reasoning, encapsulating these design choices into a framework we call MSTaR (Multimodal Self-evolving Training for Reasoning), which is universally effective for models with different sizes on various benchmarks, e.g., surpassing the pre-evolved model significantly on 5 multimodal reasoning benchmarks without using additional human annotations, as demonstrated on MiniCPM-V-2.5 (8B), Phi-3.5-Vision (4B) and InternVL2 (2B). We believe this study fills a significant gap in the understanding of self-evolving training for multimodal reasoning and offers a robust framework for future research. Our policy and reward models, as well as the collected data, is released to facilitate further investigation in multimodal reasoning.

Large language model agents increasingly operate in dynamic environments where tool interfaces, APIs, and user requirements change after deployment. Existing self-evolution methods mainly follow two paradigms: harness-based approaches, which externalize feedback into editable memories or skills for rapid adaptation, and parameter-based approaches, which internalize experience into model parameters for deeper capability improvement. However, using either mechanism alone creates a trade-off between flexibility and performance. This paper asks how an agent can coordinate both channels to achieve robust self-evolution. We present COVE, a unified agent self-evolution framework that combines harness-based and parameter-based learning through task-aware routing, stage-aware scheduling, and knowledge optimization. Through this design, COVE treats self-evolution not as indiscriminate accumulation of experience, but as a coordinated process that matches tasks and knowledge types to appropriate learning mechanisms. Experiments across multiple task categories show that COVE outperforms single-channel evolution strategies, demonstrating more robust and efficient improvement under changing environments.

Agent self-evolution in long-horizon LLM systems is largely procedural: useful experience is not merely stored information, but reusable procedures for searching, debugging, and verification. Yet current evaluations do not isolate this form of transfer. Agent benchmarks test single-episode task solving; memory benchmarks target information retention rather than procedural reuse. We introduce EvoAgentBench, a benchmark for agent self-evolution via Ability-guided transfer across four agentic domains: web research, algorithmic reasoning, software engineering, and knowledge work. EvoAgentBench extracts trace-grounded Abilities from agent executions, canonicalizes them into operational units, and builds domain-specific Ability Graphs linking tasks that share procedural overlap. By design, every test task is backed by verified training-side Ability support. Across a 528/267 train/test split, two scaffolds, and three backbones, curated Ability content transfers reliably across model families, but no current automatic method sustains positive gain in all settings. EvoAgentBench shifts self-evolution evaluation from aggregate accuracy comparison to fine-grained diagnosis of experience encoding, routing, and uptake. The benchmark is publicly available at https://huggingface.co/datasets/EverMind-AI/EvoAgentBench.

Large language models (LLMs) have significantly advanced in various fields and intelligent agent applications. However, current LLMs that learn from human or external model supervision are costly and may face performance ceilings as task complexity and diversity increase. To address this issue, self-evolution approaches that enable LLM to autonomously acquire, refine, and learn from experiences generated by the model itself are rapidly growing. This new training paradigm inspired by the human experiential learning process offers the potential to scale LLMs towards superintelligence. In this work, we present a comprehensive survey of self-evolution approaches in LLMs. We first propose a conceptual framework for self-evolution and outline the evolving process as iterative cycles composed of four phases: experience acquisition, experience refinement, updating, and evaluation. Second, we categorize the evolution objectives of LLMs and LLM-based agents; then, we summarize the literature and provide taxonomy and insights for each module. Lastly, we pinpoint existing challenges and propose future directions to improve self-evolution frameworks, equipping researchers with critical insights to fast-track the development of self-evolving LLMs.

As high-quality data becomes increasingly difficult to obtain, data-free self-evolution has emerged as a promising paradigm. This approach allows large language models (LLMs) to autonomously generate and solve complex problems, thereby improving their reasoning capabilities. However, multi-turn search agents struggle in data-free self-evolution due to the limited question diversity and the substantial compute required for multi-step reasoning and tool using. In this work, we introduce Dr. Zero, a framework enabling search agents to effectively self-evolve without any training data. In particular, we design a self-evolution feedback loop where a proposer generates diverse questions to train a solver initialized from the same base model. As the solver evolves, it incentivizes the proposer to produce increasingly difficult yet solvable tasks, thus establishing an automated curriculum to refine both agents. To enhance training efficiency, we also introduce hop-grouped relative policy optimization (HRPO). This method clusters structurally similar questions to construct group-level baselines, effectively minimizing the sampling overhead in evaluating each query's individual difficulty and solvability. Consequently, HRPO significantly reduces the compute requirements for solver training without compromising performance or stability. Extensive experiment results demonstrate that the data-free Dr. Zero matches or surpasses fully supervised search agents, proving that complex reasoning and search capabilities can emerge solely through self-evolution.

Anthropic proposes the concept of skills for LLM agents to tackle multi-step professional tasks that simple tool invocations cannot address. A tool is a single, self-contained function, whereas a skill is a structured bundle of interdependent multi-file artifacts. Currently, skill generation is not only label-intensive due to manual authoring, but also may suffer from human--machine cognitive misalignment, which can lead to degraded agent performance, as evidenced by evaluations on SkillsBench. Therefore, we aim to enable agents to autonomously generate skills. However, existing self-evolving methods designed for tools cannot be directly applied to skills due to their increased complexity. To address these issues, we propose EvoSkills, a self-evolving skills framework that enables agents to autonomously construct complex, multi-file skill packages. Specifically, EvoSkills couples a Skill Generator that iteratively refines skills with a Surrogate Verifier that co-evolves to provide informative and actionable feedback without access to ground-truth test content. On SkillsBench, EvoSkills achieves the highest pass rate among five baselines on both Claude Code and Codex, and also exhibits strong generalization capabilities to six additional LLMs.

Clinical diagnosis is critical in medical practice, typically requiring a continuous and evolving process that includes primary diagnosis, differential diagnosis, and final diagnosis. However, most existing clinical diagnostic tasks are single-step processes, which does not align with the complex multi-step diagnostic procedures found in real-world clinical settings. In this paper, we propose a multi-step diagnostic task and annotate a clinical diagnostic dataset (MSDiagnosis). This dataset includes primary diagnosis, differential diagnosis, and final diagnosis questions. Additionally, we propose a novel and effective framework. This framework combines forward inference, backward inference, reflection, and refinement, enabling the LLM to self-evaluate and adjust its diagnostic results. To assess the effectiveness of our proposed method, we design and conduct extensive experiments. The experimental results demonstrate the effectiveness of the proposed method. We also provide a comprehensive experimental analysis and suggest future research directions for this task.

We introduce Learning to Self-Evolve (LSE), a reinforcement learning framework that trains large language models (LLMs) to improve their own contexts at test time. We situate LSE in the setting of test-time self-evolution, where a model iteratively refines its context from feedback on seen problems to perform better on new ones. Existing approaches rely entirely on the inherent reasoning ability of the model and never explicitly train it for this task. LSE reduces the multi-step evolution problem to a single-step RL objective, where each context edit is rewarded by the improvement in downstream performance. We pair this objective with a tree-guided evolution loop. On Text-to-SQL generation (BIRD) and general question answering (MMLU-Redux), a 4B-parameter model trained with LSE outperforms self-evolving policies powered by GPT-5 and Claude Sonnet 4.5, as well as prompt optimization methods including GEPA and TextGrad, and transfers to guide other models without additional training. Our results highlight the effectiveness of treating self-evolution as a learnable skill.

Large language model (LLM) agents are increasingly equipped with memory, which are stored experience and reusable guidance that can improve task-solving performance. Recent self-evolving systems update memory based on interaction outcomes, but most existing evolution pipelines are developed for static train/test splits and only approximate online learning by folding static benchmarks, making them brittle under true distribution shift and continuous feedback. We introduce Live-Evo, an online self-evolving memory system that learns from a stream of incoming data over time. Live-Evo decouples what happened from how to use it via an Experience Bank and a Meta-Guideline Bank, compiling task-adaptive guidelines from retrieved experiences for each task. To manage memory online, Live-Evo maintains experience weights and updates them from feedback: experiences that consistently help are reinforced and retrieved more often, while misleading or stale experiences are down-weighted and gradually forgotten, analogous to reinforcement and decay in human memory. On the live Prophet Arena benchmark over a 10-week horizon, Live-Evo improves Brier score by 20.8\% and increases market returns by 12.9\%, while also transferring to deep-research benchmarks with consistent gains over strong baselines. Our code is available at https://github.com/ag2ai/Live-Evo.

Recent advancements in prompt engineering strategies, such as Chain-of-Thought (CoT) and Self-Discover, have demonstrated significant potential in improving the reasoning abilities of Large Language Models (LLMs). However, these state-of-the-art (SOTA) prompting strategies rely on single or fixed set of static seed reasoning modules like "think step by step" or "break down this problem" intended to simulate human approach to problem-solving. This constraint limits the flexibility of models in tackling diverse problems effectively. In this paper, we introduce Auto-Evolve, a novel framework that enables LLMs to self-create dynamic reasoning modules and downstream action plan, resulting in significant improvements over current SOTA methods. We evaluate Auto-Evolve on the challenging BigBench-Hard (BBH) dataset with Claude 2.0, Claude 3 Sonnet, Mistral Large, and GPT 4, where it consistently outperforms the SOTA prompt strategies. Auto-Evolve outperforms CoT by up to 10.4% and on an average by 7% across these four models. Our framework introduces two innovations: a) Auto-Evolve dynamically generates reasoning modules for each task while aligning with human reasoning paradigm, thus eliminating the need for predefined templates. b) We introduce an iterative refinement component, that incrementally refines instruction guidance for LLMs and helps boost performance by average 2.8% compared to doing it in a single step.

2026 has brought an explosion of interest in LLM-guided evolution of agentic artifacts, with systems like GEPA and Autoresearch demonstrating that LLMs can iteratively improve prompts, code, and agent architectures across diverse domains. As adoption accelerates, a central question emerges: given the same information, the same seed agent, and the same objective, which optimization algorithm yields the best results under the same evaluation budget? This question becomes critical when evaluations are expensive, such as when they require human judgment or multiple LLM calls. We present the first systematic comparison of three optimization paradigms -- Elo tournament selection (RoboPhD), Pareto-based selection (GEPA), and greedy hill-climbing (Autoresearch) -- across four benchmarks spanning abstract reasoning, cloud scheduling, SQL generation, and financial QA, all under a fixed budget of 1,500 evaluations. RoboPhD introduces validation-free evolution: instead of splitting the budget between training and validation, it uses Elo competition on training data to simultaneously evaluate agents and drive evolution. All three systems receive seed agents with diagnostic print() statements that evolution can grow, enabling self-instrumenting agents that develop increasingly informative diagnostics for the benefit of their evolutionary successors. Using a single default configuration, RoboPhD outperforms both GEPA and Autoresearch on three of four benchmarks, losing only on the simplest task, where the winning solution (from our Autoresearch adaptation) required under 90 lines of code. On ARC-AGI, RoboPhD evolves a 22-line seed agent into a 1,013-line multi-strategy system, improving accuracy from 27.8% to 65.8% using Gemini 3.1 Flash Lite as the solver. We release RoboPhD as a versatile toolkit under the MIT license with a simple optimize_anything() API for evolving diverse complex agents.

In medical education, physicians convert academic knowledge into clinical expertise through residency: years of training across thousands of encounters, with diverse sources of feedback and progressively greater autonomy. Much of clinical reasoning relies on the patient encounter, a dialogue in which a clinician elicits history, refines diagnostic hypotheses, and decides management under uncertainty. While large language models (LLMs) excel on static medical benchmarks, methods to optimize the full sequence of clinical decisions remain underdeveloped. We present ResidencyRL, a reinforcement learning (RL) method for training clinical artificial intelligence (AI) agents through simulated multi-turn clinical encounters (up to 60 dialogue turns and 8 tool calls per trajectory). ResidencyRL pairs the policy agent with LLM simulators capable of complex, adversarial behaviors, training against a structured reward aligned to diagnostic accuracy, management quality, communication, documentation, and safety. On held-out evaluations, the ResidencyRL agent improves diagnostic accuracy by 7.0% under adversarial conditions (88.0% vs. 81.0%) and reduces missed red flag rates by 31%, demonstrating rigorous mitigation of premature closure. Blinded expert clinicians validated these gains, preferring the trained agent in 87.6% of side-by-side comparisons. The procedural competencies transfer to unseen benchmarks: the agent outperforms the base model across all six clinical axes of the AMIE multi-visit benchmark, and shows consistent directional improvements on AgentClinic and CRAFT-MD. Our findings demonstrate that sequential clinical decision-making can be effectively learned through multi-turn RL in simulation, yielding robust, generalizable capabilities, paving the way towards clinical mastery. Prospective validation with real-world workflows remains necessary to establish clinical utility.

Large Language Models (LLMs) have demonstrated strong capabilities but remain fundamentally static, unable to adapt their internal parameters to novel tasks, evolving knowledge domains, or dynamic interaction contexts. As LLMs are increasingly deployed in open-ended, interactive environments, this static nature has become a critical bottleneck, necessitating agents that can adaptively reason, act, and evolve in real time. This paradigm shift -- from scaling static models to developing self-evolving agents -- has sparked growing interest in architectures and methods enabling continual learning and adaptation from data, interactions, and experiences. This survey provides the first systematic and comprehensive review of self-evolving agents, organized around three foundational dimensions -- what to evolve, when to evolve, and how to evolve. We examine evolutionary mechanisms across agent components (e.g., models, memory, tools, architecture), categorize adaptation methods by stages (e.g., intra-test-time, inter-test-time), and analyze the algorithmic and architectural designs that guide evolutionary adaptation (e.g., scalar rewards, textual feedback, single-agent and multi-agent systems). Additionally, we analyze evaluation metrics and benchmarks tailored for self-evolving agents, highlight applications in domains such as coding, education, and healthcare, and identify critical challenges and research directions in safety, scalability, and co-evolutionary dynamics. By providing a structured framework for understanding and designing self-evolving agents, this survey establishes a roadmap for advancing adaptive agentic systems in both research and real-world deployments, ultimately shedding lights to pave the way for the realization of Artificial Super Intelligence (ASI), where agents evolve autonomously, performing at or beyond human-level intelligence across a wide array of tasks.

Large Language Model (LLM) based agents are powerful yet fundamentally static after deployment, lacking the ability to autonomously expand capabilities, generate new tools, or evolve their reasoning. This work introduces a hierarchical self-evolving multi-agent framework that integrates a Base LLM, an operational SLM agent, a Code-Generation LLM, and a Teacher-LLM to enable continuous adaptation. The workflow begins with the agent attempting a task using reasoning and existing tools; if unsuccessful, it escalates to tool synthesis through the Code-Gen LLM, and when failures persist, it triggers an evolution phase using Curriculum Learning (CL), Reward-Based Learning (RL), or Genetic Algorithm (GA) evolution. Using the TaskCraft dataset rich in hierarchical tasks, tool-use traces, and difficulty scaling we evaluate these paradigms. CL delivers fast recovery and strong generalization, RL excels on high-difficulty tasks, and GA offers high behavioral diversity. Across all settings, evolved agents outperform their originals, demonstrating robust, autonomous, self-improving agentic evolution.

Clinical reasoning demands multi-step interactions -- gathering patient history, ordering tests, interpreting results, and making safe treatment decisions -- yet a unified training environment provides the breadth of clinical domains and specialized tools to train generalizable medical AI agents through reinforcement learning remains elusive. We present a comprehensive empirical study of multi-turn agentic RL for medical AI, built on , a gymnasium-compatible environment spanning 10 clinical domains with 3.6K+ tasks, 135 domain-specific tools, and a knowledge base of 828K medical passages. Our analysis reveals that agentic multi-turn structure degrades into verbose single-turn monologues, characterized by monotonic length explosion and a simultaneous erosion of tool-use frequency. We characterize how this collapse, alongside distillation instability, stems from the misalignment of sparse terminal rewards with sequential clinical trajectories. We find that vanilla GRPO achieves strong final accuracy on some benchmarks but suffers from training instability, evidenced by significant oscillations in response length and prolonged convergence periods. To improve training efficiency and stability, we propose Turn-level Truncated On-Policy Distillation (TT-OPD), a self-distillation framework where a gradient-free EMA teacher leverages outcome-privileged information to provide dense, outcome-aware KL regularization at every conversation turn. TT-OPD achieves the best performance on 10 of 18 benchmarks with an average +3.9~pp improvement over the non-RL baseline with faster early convergence, controlled response length, and sustained multi-turn tool use.

Self-evolving has emerged as a key paradigm for improving foundational models such as Large Language Models (LLMs) and Vision Language Models (VLMs) with minimal human intervention. While recent approaches have demonstrated that LLM agents can self-evolve from scratch with little to no data, VLMs introduce an additional visual modality that typically requires at least some seed data, such as images, to bootstrap the self-evolution process. In this work, we present Multi-model Multimodal Zero (MM-Zero), the first RL-based framework to achieve zero-data self-evolution for VLM reasoning. Moving beyond prior dual-role (Proposer and Solver) setups, MM-Zero introduces a multi-role self-evolving training framework comprising three specialized roles: a Proposer that generates abstract visual concepts and formulates questions; a Coder that translates these concepts into executable code (e.g., Python, SVG) to render visual images; and a Solver that performs multimodal reasoning over the generated visual content. All three roles are initialized from the same base model and trained using Group Relative Policy Optimization (GRPO), with carefully designed reward mechanisms that integrate execution feedback, visual verification, and difficulty balancing. Our experiments show that MM-Zero improves VLM reasoning performance across a wide range of multimodal benchmarks. MM-Zero establishes a scalable path toward self-evolving multi-model systems for multimodal models, extending the frontier of self-improvement beyond the conventional two-model paradigm.

Recent advances in large language models have sparked growing interest in AI agents capable of solving complex, real-world tasks. However, most existing agent systems rely on manually crafted configurations that remain static after deployment, limiting their ability to adapt to dynamic and evolving environments. To this end, recent research has explored agent evolution techniques that aim to automatically enhance agent systems based on interaction data and environmental feedback. This emerging direction lays the foundation for self-evolving AI agents, which bridge the static capabilities of foundation models with the continuous adaptability required by lifelong agentic systems. In this survey, we provide a comprehensive review of existing techniques for self-evolving agentic systems. Specifically, we first introduce a unified conceptual framework that abstracts the feedback loop underlying the design of self-evolving agentic systems. The framework highlights four key components: System Inputs, Agent System, Environment, and Optimisers, serving as a foundation for understanding and comparing different strategies. Based on this framework, we systematically review a wide range of self-evolving techniques that target different components of the agent system. We also investigate domain-specific evolution strategies developed for specialised fields such as biomedicine, programming, and finance, where optimisation objectives are tightly coupled with domain constraints. In addition, we provide a dedicated discussion on the evaluation, safety, and ethical considerations for self-evolving agentic systems, which are critical to ensuring their effectiveness and reliability. This survey aims to provide researchers and practitioners with a systematic understanding of self-evolving AI agents, laying the foundation for the development of more adaptive, autonomous, and lifelong agentic systems.

Traditional methods for automating recommender system design, such as Neural Architecture Search (NAS), are often constrained by a fixed search space defined by human priors, limiting innovation to pre-defined operators. While recent LLM-driven code evolution frameworks shift fixed search space target to open-ended program spaces, they primarily rely on scalar metrics (e.g., NDCG, Hit Ratio) that fail to provide qualitative insights into model failures or directional guidance for improvement. To address this, we propose Self-EvolveRec, a novel framework that establishes a directional feedback loop by integrating a User Simulator for qualitative critiques and a Model Diagnosis Tool for quantitative internal verification. Furthermore, we introduce a Diagnosis Tool - Model Co-Evolution strategy to ensure that evaluation criteria dynamically adapt as the recommendation architecture evolves. Extensive experiments demonstrate that Self-EvolveRec significantly outperforms state-of-the-art NAS and LLM-driven code evolution baselines in both recommendation performance and user satisfaction. Our code is available at https://github.com/Sein-Kim/self_evolverec.

Musculoskeletal diseases are among the leading causes of disability worldwide and create the greatest global need for rehabilitation. Because recovery, remodelling and degeneration often unfold over months to years, musculoskeletal care requires longitudinal management that repeatedly integrates evolving patient evidence, external medical knowledge and stage-specific functional goals. In routine practice, this evidence is fragmented across visits, departments and hospital systems, limiting individualized, evidence-based care. Here we report OrthoPilot, a clinical artificial intelligence system powered by a large language model that integrates hospital data streams with authoritative external knowledge for continuous musculoskeletal management. OrthoPilot autonomously retrieves real-time imaging, laboratory, pathology and order data and converts evolving patient states into evidence-based decisions from admission diagnosis to rehabilitation planning. We established a specialist-validated benchmark from real-world electronic health records spanning 1,000 disease codes. In a reader study across the complete care pathway, OrthoPilot was compared with 81 orthopaedic physicians and surpassed experts with 25 years of experience in diagnostic reasoning, clinical decision-making and management planning. It also outperformed all evaluated intelligent systems across 60 external clinical centres. In a prospective study of 1,870 complex cases, OrthoPilot increased full-chain management success by 10.6%. During an 8-month randomised deployment involving 8,240 inpatients, it increased cumulative cases per bed by 9.7% and improved patient-reported access to health information. These results move clinical AI from predicting isolated events toward executing longitudinal management across complete musculoskeletal care pathways.

Computer use agent is an emerging area in artificial intelligence that aims to operate the computers to achieve the user's tasks, which attracts a lot of attention from both industry and academia. However, the present agents' performance is far from being used. In this paper, we propose the Self-Evolution Agent (SEA) for computer use, and to develop this agent, we propose creative methods in data generation, reinforcement learning, and model enhancement. Specifically, we first propose an automatic pipeline to generate the verifiable trajectory for training. And then, we propose efficient step-wise reinforcement learning to alleviate the significant computational requirements for long-horizon training. In the end, we propose the enhancement method to merge the grounding and planning ability into one model without any extra training. Accordingly, based on our proposed innovation of data generation, training strategy, and enhancement, we get the Selfevolution Agent (SEA) for computer use with only 7B parameters, which outperforms models with the same number of parameters and has comparable performance to larger ones. We will make the models' weight and related codes open-source in the future.

Agent self-evolution updates an agent's persistent state from prior experience and reuses it to solve related tasks more effectively. Evaluating self-evolution is difficult: existing benchmarks provide limited coverage of economically valuable task domains, do not always design training and test tasks such that test-time gains can be attributed to training experience, and remain vulnerable to data contamination. We present GDPevo, an evolution-native benchmark grounded in GDP-related enterprise workflows, together with the fully automated data pipeline that generates it. Its core mechanism, rule hybridization, decomposes each enterprise workflow into atomic business rules, distributes subsets of these rules across training tasks, and recombines them in held-out test tasks so that test-time gains are attributable. GDPevo spans CRM, ERP, finance, healthcare, legal, and data-centric workflows. Its V1 release contains 120 tasks in 12 groups, with five training and five held-out test tasks per group. Full automation enables the pipeline to expand the suite to 240 tasks in 24 groups (V2) within two days, providing a practical response to contamination. Using GDPevo, we evaluate four agents, each comprising a harness and a model, under four supervision types. Self-evolution consistently improves held-out accuracy by up to 16.44 percentage points. But the best evolved agents remain far below the fully informed oracle ceiling of 91.6%, indicating that the self-evolution ability of current agents remains far from fully realized. We publicly release the pipeline, benchmark, and full evaluation results at https://github.com/Prism-Shadow/GDPevo.

Agent harness evolution improves frozen language-model agents by modifying the executable structures around them. We study this paradigm as a form of sample-efficient fast adaptation: instead of updating model weights, an agent can acquire task-specific competence by changing its external harness, while leaving the base model's general capabilities intact. Prior work shows that self-generated rollouts can support harness search, suggesting that agents may acquire new task competence through practice. Yet in long-horizon stochastic environments, self-practice becomes fragile: rewards are sparse, outcomes are high-variance, and failures are hard to attribute to concrete harness mechanisms. We introduce DemoEvolve, a demonstration-bootstrapped approach to harness evolution. When reward-only search is too broad and noisy, competent human trajectories serve as expert reference experience for the coding proposer, guiding harness-level diagnosis and editing. Experiments on Liar's Dice show that self-rollout evolution can work when episodes are short and failures are attributable. In contrast, Balatro exposes a harder long-horizon stochastic regime, where self-rollout evolution is misled by sparse feedback and candidate-selection noise, while tutorial-like textual knowledge alone does not yield stable improvement. Under the same limited budget, DemoEvolve produces more effective and auditable harness edits and achieves better performance. Overall, demonstrations make sparse-feedback harness evolution more diagnosable, localizable, and stable.

Personality-conditioned LLM agents (PC-Agents) are increasingly used in emotional support, social simulation, and role-playing, motivating the development of lifelong agents that remain coherent over extended interactions. A key component of such coherence is personality evolution: agents should undergo plausible, psychology-grounded changes as they experience life events in different contexts. Although prior work shows that LLM personalities can shift under contextual perturbations, how these shifts vary across traits, events, personas, and models remains poorly understood. We study event-induced personality change after 11 major life events, using the Big Five traits as a psychometric anchor and interpreting the resulting trajectories against longitudinal evidence from human personality psychology. Across four diagnostic axes, PC-Agents exhibit measurable trait shifts at similar rates for event-trait pairs with and without documented human change directions. Even when shifts follow the expected direction, their magnitudes usually fall below human effect-size ranges. Gender and cultural-region prompts show little moderating effect, while persona-level dispersion is compressed three- to four-fold relative to human samples. To enable systematic comparison, we introduce BFI-Adapt, a reusable benchmark for scoring the directional fidelity of event-induced personality change, and use it to rank 14 models. A validation suite shows that the measured shifts exceed no-event retest noise, remain stable under independently paraphrased prompts, exhibit limited and model-dependent convergence with scenario-based behavioral choices, and persist across intervening unrelated dialogue. Together, these checks establish the measured trajectories as robust event-conditioned response patterns. Our results suggest that current PC-Agents simulate the mean of human personality dynamics, but not its shape.

Environmental and genetic mutations can transform the cells in a co-operating healthy tissue into an ecosystem of individualistic tumour cells that compete for space and resources. Various selection forces are responsible for driving the evolution of cells in a tumour towards more malignant and aggressive phenotypes that tend to have a fitness advantage over the older populations. Although the evolutionary nature of cancer has been recognised for more than three decades (ever since the seminal work of Nowell) it has been only recently that tools traditionally used by ecological and evolutionary researchers have been adopted to study the evolution of cancer phenotypes in populations of individuals capable of co-operation and competition. In this chapter we will describe game theory as an important tool to study the emergence of cell phenotypes in a tumour and will critically review some of its applications in cancer research. These applications demonstrate that game theory can be used to understand the dynamics of somatic cancer evolution and suggest new therapies in which this knowledge could be applied to gain some control over the evolution of the tumour.

Task-specific deep learning models in histopathology offer promising opportunities for improving diagnosis, clinical research, and precision medicine. However, development of such models is often limited by availability of high-quality data. Foundation models in histopathology that learn general representations across a wide range of tissue types, diagnoses, and magnifications offer the potential to reduce the data, compute, and technical expertise necessary to develop task-specific deep learning models with the required level of model performance. In this work, we describe the development and evaluation of foundation models for histopathology via self-supervised learning (SSL). We first establish a diverse set of benchmark tasks involving 17 unique tissue types and 12 unique cancer types and spanning different optimal magnifications and task types. Next, we use this benchmark to explore and evaluate histopathology-specific SSL methods followed by further evaluation on held out patch-level and weakly supervised tasks. We found that standard SSL methods thoughtfully applied to histopathology images are performant across our benchmark tasks and that domain-specific methodological improvements can further increase performance. Our findings reinforce the value of using domain-specific SSL methods in pathology, and establish a set of high quality foundation models to enable further research across diverse applications.

The rapid evolution of Large Language Models (LLMs) offers promising potential to alleviate the global scarcity of mental health professionals. However, LLMs' alignment with essential mental health counseling competencies remains understudied. We introduce CounselingBench, a novel NCMHCE-based benchmark evaluating LLMs across five key mental health counseling competencies. Testing 22 general-purpose and medical-finetuned LLMs, we find frontier models exceed minimum thresholds but fall short of expert-level performance, with significant variations: they excel in Intake, Assessment & Diagnosis yet struggle with Core Counseling Attributes and Professional Practice & Ethics. Medical LLMs surprisingly underperform generalist models accuracy-wise, while at the same time producing slightly higher-quality justifications but making more context-related errors. Our findings highlight the complexities of developing AI systems for mental health counseling, particularly for competencies requiring empathy and contextual understanding. We found that frontier LLMs perform at a level exceeding the minimal required level of aptitude for all key mental health counseling competencies, but fall short of expert-level performance, and that current medical LLMs do not significantly improve upon generalist models in mental health counseling competencies. This underscores the critical need for specialized, mental health counseling-specific fine-tuned LLMs that rigorously aligns with core competencies combined with appropriate human supervision before any responsible real-world deployment can be considered.

Large language models (LLMs) are becoming the foundation for autonomous agents that can use tools to solve complex tasks. Reinforcement learning (RL) has emerged as a common approach for injecting such agentic capabilities, but typically under tightly controlled training setups. It often depends on carefully constructed task-solution pairs and substantial human supervision, which creates a fundamental obstacle to open-ended self-evolution toward superintelligent systems. In this paper, we propose Tool-R0 framework for training general purpose tool-calling agents from scratch with self-play RL, under a zero-data assumption. Initialized from the same base LLM, Tool-R0 co-evolves a Generator and a Solver with complementary rewards: one proposes targeted challenging tasks at the other's competence frontier and the other learns to solve them with real-world tool calls. This creates a self-evolving cycle that requires no pre-existing tasks or datasets. Evaluation on different tool-use benchmarks show that Tool-R0 yields 92.5 relative improvement over the base model and surpasses fully supervised tool-calling baselines under the same setting. Our work further provides empirical insights into self-play LLM agents by analyzing co-evolution, curriculum dynamics, and scaling behavior.

This study explores the impact of AI-generated digital self-clones on improving online presentation skills. We carried out a mixed-design experiment involving 44 international students, comparing self-recorded videos (control) with self-clone videos (AI group) for English presentation practice. The AI videos utilized voice cloning, face swapping, lip-sync, and body-language simulation to refine participants' original presentations in terms of repetition, filler words, and pronunciation. Machine-rated scores indicated enhancements in speech performance for both groups. Though the groups didn't significantly differ, the AI group exhibited a heightened depth of reflection, self-compassion, and a meaningful transition from a corrective to an enhancive approach to self-critique. Within the AI group, congruence between self-perception and AI self-clones resulted in diminished speech anxiety and increased enjoyment. Our findings recommend the ethical employment of digital self-clones to enhance the emotional and cognitive facets of skill development.

We present Ouroboros, a self-developing agent harness whose tools, prompts, context assembly, and core implementation improve through reviewed commits that become the runtime for later work. Core evolution proceeds in two modes. In recursive free evolution, improvement is itself a task, and completing one evolution cycle can schedule the next. In experience-driven core evolution, ordinary work and social interaction expose bugs, rough edges, and inefficient context construction that lead to reviewed structural changes. On Terminal-Bench 2.1, an Opus 5 run scores 86.74%, the best result reported on the benchmark. On OSWorld-Verified, an Opus 5 run reaches 90.69%, exceeding the best previously reported score. A five-rollout CL-Bench campaign achieves a normalized reward of 0.2301, setting a new state of the art. Hope is the longest-running publicly documented Ouroboros deployment. It is a 161-day living agent experiment in free evolution under governed human communication across seven surfaces. Human interaction surfaces faults and generates proposals, but the agent decides which changes to pursue. Because a self-developing agent may rewrite its own code and select new model APIs, operational safety becomes a primary design problem: guardrails must remain authoritative under evolutionary and public social pressure. Benchmark campaigns use frozen system snapshots, while Hope continues live evolution on a separate lineage.

LLM training is shifting from manual design and annotation to interaction-driven self-evolution. However, existing self-evolutionary methods face a fundamental dilemma between task diversity and verification reliability: environment-bound methods obtain precise feedback but confine learning to narrow domains, while open-ended self-generation broadens the task space but lacks reliable verification, allowing misleading rewards to pollute the training loop. We identify agent skills as a powerful middle ground to reconcile this tension: each skill ensures deep, verifiable execution in a specific scenario, while dynamic routing across skills maintains open-ended task variety. Leveraging this insight, we introduce Skill Self-Play (Skill-SP), a co-evolutionary framework comprising a proposer, a solver, and a dynamic skill controller. Orchestrated via a reinforcement learning loop, these components co-evolve in a continuous self-play loop: the proposer generates challenging tasks conditioned on dynamically sampled skills; the solver explores candidate solutions to push its capability boundaries; and the skill controller collects execution feedback to update and expand the skill library. This interactive co-evolution effectively bridges the gap between structured verification and open-ended exploration. Empirical evaluations on tool-use and reasoning benchmarks demonstrate that Skill-SP, serving as a robust evolution engine, consistently pushes the performance ceiling of competent backbones while catalyzing striking turnarounds for initially misaligned models. Our code is available at https://github.com/Qwen-Applications/skill-self-play.

Skill self-evolution methods for LLM agents aim to turn execution trajectories into reusable skill documents. However, current pipelines typically derive skill patches from a single trajectory per task, merge them indiscriminately, and load the entire skill corpus during inference. These choices lead to unreliable evidence extraction, the accumulation of low-quality or even harmful skill edits, and inefficient use of context due to irrelevant or conflicting skill content. We propose SkillCAT, a framework that decomposes this process into three stages. (1) Contrastive Causal Extraction (CCE) samples multiple trajectories per task and contrasts same-task success/failure pairs to find the evidence that explains outcome differences. (2) Assessment-Augmented Evolution (AAE) replays each candidate patch on source-task clones, retains only those that do not damage task outcomes, and then merges the retained patches hierarchically. (3) Topology-Aware Task Execution (TTE) compiles the evolved skills into routable sub-skill topologies, so that inference loads only task-relevant capability nodes. We evaluate SkillCAT on widely-used agent benchmarks, including SpreadsheetBench, WikiTableQuestions, and DocVQA, and further assess cross-model and out-of-distribution generalization. Across these settings, SkillCAT improves the average score over the initial skill by up to 49.69%, demonstrating reliable and effective skill evolution.

Large language model (LLM) agents may recover from a failure within an episode or after a retry, yet the same execution failure can recur in later tasks because post-episode feedback rarely revises the persistent harness that guides future interactions. Static harnesses improve reliability through fixed tools, context, memory, and workflow structures, but remain unchanged after deployment. We propose Living-Harness, a self-evolving agent harness that converts each completed trajectory and its evaluator signals into posterior evidence for bounded harness updates. Guided by a domain-level Evolution-SOP (Standard Operating Procedure), Living-Harness extracts an episode abstraction and structured update evidence, and writes two complementary forms of procedural knowledge: episodic memory that records trigger conditions, failure patterns, and recovery actions, and a state graph that records state nodes, repair edges, and transition rules. The updated harness state is retrieved to guide future interactions, while tools and base context remain frozen, allowing procedural repairs to accumulate across evolution cycles. On eight interactive environments derived from τ^2-Bench and MultiWOZ-2.4, Living-Harness improves average Pass@1 over the strongest interactive baseline by 10.07 and 9.91 percentage points, respectively, and supports retrieval-only reuse of the evolved harness state across model backbones.

Optimizing large-scale machine learning systems, such as recommendation models for global video platforms, requires navigating a massive hyperparameter search space and, more critically, designing sophisticated optimizers, architectures, and reward functions to capture nuanced user behaviors. Achieving substantial improvements in these areas is a non-trivial task, traditionally relying on extensive manual iterations to test new hypotheses. We propose a self-evolving system that leverages Large Language Models (LLMs), specifically those from Google's Gemini family, to autonomously generate, train, and deploy high-performing, complex model changes within an end-to-end automated workflow. The self-evolving system is comprised of an Offline Agent (Inner Loop) that performs high-throughput hypothesis generation using proxy metrics, and an Online Agent (Outer Loop) that validates candidates against delayed north star business metrics in live production. Our agents act as specialized Machine Learning Engineers (MLEs): they exhibit deep reasoning capabilities, discovering novel improvements in optimization algorithms and model architecture, and formulating innovative reward functions that target long-term user engagement. The effectiveness of this approach is demonstrated through several successful production launches at YouTube, confirming that autonomous, LLM-driven evolution can surpass traditional engineering workflows in both development velocity and model performance.

In mental health counseling, a variety of earlier studies have focused on dialogue modeling. However, most of these studies give limited to no emphasis on the quality of interaction between a patient and a therapist. The therapeutic bond between a patient and a therapist directly correlates with effective mental health counseling. It involves developing the patient's trust on the therapist over the course of counseling. To assess the therapeutic bond in counseling, we introduce trust as a therapist-assistive metric. Our definition of trust involves patients' willingness and openness to express themselves and, consequently, receive better care. We conceptualize it as a dynamic trajectory observable through textual interactions during the counseling. To facilitate trust modeling, we present MENTAL-TRUST, a novel counseling dataset comprising manual annotation of 212 counseling sessions with first-of-its-kind seven expert-verified ordinal trust levels. We project our problem statement as an ordinal classification task for trust quantification and propose a new benchmark, TrustBench, comprising a suite of classical and state-of-the-art language models on MENTAL-TRUST. We evaluate the performance across a suite of metrics and lay out an exhaustive set of findings. Our study aims to unfold how trust evolves in therapeutic interactions.

Modern text-to-image models have achieved strong visual synthesis, yet remain unreliable when prompts require implicit visual constraints, relational reasoning, or external knowledge. Existing retrieval-augmented and agentic generation methods mitigate this issue by acquiring external knowledge, references, or refined prompts for the current request, yet they typically treat each generation as an isolated episode and do not systematically preserve past successes or failures for future use. In this work, we ask whether a text-to-image system can continually improve from its own generation experience without updating the underlying generator. We propose MemoGen, a training-free framework that augments existing image generators with an agentic evolution layer. For each task, MemoGen explicitly infers visual requirements, retrieves external evidence and references when necessary, translates them into executable generation constraints, evaluates the generated result, and stores task understanding, reference choices, visual feedback, successful strategies, and failure lessons as reusable experience memory. Across evolution rounds, the agent retrieves relevant experience to improve similar future generations, selectively repairing previously failed cases while preserving successful ones, thereby enabling test-time self-evolution without parameter updates. Extensive experiments on knowledge-intensive and reasoning-oriented benchmarks demonstrate the effectiveness of this paradigm: after only two evolution rounds, MemoGen built upon the open-source Qwen-Image backbone surpasses strong proprietary systems such as Nano Banana Pro and GPT-Image-1 on WISE and Mind-Bench, showing that explicit experience memory can serve as a powerful continual learning signal for reliable text-to-image generation.

Large language models (LLMs) excel at general question-answering (Q&A) but often fall short in specialized domains due to a lack of domain-specific knowledge. Commercial companies face the dual challenges of privacy protection and resource constraints when involving LLMs for fine-tuning. This paper propose a novel framework, Self-Evolution, designed to address these issues by leveraging lightweight open-source LLMs through multiple iterative fine-tuning rounds. To enhance the efficiency of iterative fine-tuning, Self-Evolution employ a strategy that filters and reinforces the knowledge with higher value during the iterative process. We employed Self-Evolution on Qwen1.5-7B-Chat using 4,000 documents containing rich domain knowledge from China Mobile, achieving a performance score 174% higher on domain-specific question-answering evaluations than Qwen1.5-7B-Chat and even 22% higher than Qwen1.5-72B-Chat. Self-Evolution has been deployed in China Mobile's daily operation and maintenance for 117 days, and it improves the efficiency of locating alarms, fixing problems, and finding related reports, with an average efficiency improvement of over 18.6%. In addition, we release Self-Evolution framework code in https://github.com/Zero-Pointer/Self-Evolution.

Large language models (LLMs) equipped with chain-of-thought (CoT) achieve strong performance and offer a window into LLM behavior. However, recent evidence suggests that improvements in CoT capabilities often come with redundant reasoning processes, motivating a key question: Can LLMs acquire a fast-thinking mode analogous to human System 1 reasoning? To explore this, our study presents a self-sampling framework based on activation steering for efficient CoT learning. Our method can induce style-aligned and variable-length reasoning traces from target LLMs themselves without any teacher guidance, thereby alleviating a central bottleneck of SFT-based methods-the scarcity of high-quality supervision data. Using filtered data by gold answers, we perform SFT for efficient CoT learning with (i) a human-like dual-cognitive system, and (ii) a progressive compression curriculum. Furthermore, we explore a self-evolution regime in which SFT is driven solely by prediction-consistent data of variable-length variants, eliminating the need for gold answers. Extensive experiments on math benchmarks, together with cross-domain generalization tests in medicine, show that our method yields stable improvements for both general and R1-style LLMs. Our data and model checkpoints can be found at https://github.com/DYR1/S3-CoT.

Conventional agent systems often struggle in open-ended environments where task distributions continuously drift and external supervision is scarce. Their reliance on static toolsets or offline training lags behind these dynamics, leaving the system's capability boundaries rigid and unknown. To address this, we propose the In-Situ Self-Evolving paradigm. This approach treats sequential task interactions as a continuous stream of experience, enabling the system to distill short-term execution feedback into long-term, reusable capabilities without access to ground-truth labels. Within this framework, we identify tool evolution as the critical pathway for capability expansion, which provides verifiable, binary feedback signals. Within this framework, we develop Yunjue Agent, a system that iteratively synthesizes, optimizes, and reuses tools to navigate emerging challenges. To optimize evolutionary efficiency, we further introduce a Parallel Batch Evolution strategy. Empirical evaluations across five diverse benchmarks under a zero-start setting demonstrate significant performance gains over proprietary baselines. Additionally, complementary warm-start evaluations confirm that the accumulated general knowledge can be seamlessly transferred to novel domains. Finally, we propose a novel metric to monitor evolution convergence, serving as a function analogous to training loss in conventional optimization. We open-source our codebase, system traces, and evolved tools to facilitate future research in resilient, self-evolving intelligence.

Recent progress in multimodal large language models has led to strong performance on reasoning tasks, but these improvements largely rely on high-quality annotated data or teacher-model distillation, both of which are costly and difficult to scale. To address this, we propose an unsupervised self-evolution training framework for multimodal reasoning that achieves stable performance improvements without using human-annotated answers or external reward models. For each input, we sample multiple reasoning trajectories and jointly model their within group structure. We use the Actor's self-consistency signal as a training prior, and introduce a bounded Judge based modulation to continuously reweight trajectories of different quality. We further model the modulated scores as a group level distribution and convert absolute scores into relative advantages within each group, enabling more robust policy updates. Trained with Group Relative Policy Optimization (GRPO) on unlabeled data, our method consistently improves reasoning performance and generalization on five mathematical reasoning benchmarks, offering a scalable path toward self-evolving multimodal models. The code are available at https://github.com/OPPO-Mente-Lab/LLM-Self-Judge.

AI systems increasingly participate in their own improvement: revising their outputs, adapting their own harnesses during deployment, training on data they generate, and, increasingly, conducting AI research itself. This literature is described under a vocabulary ("self-refine," "self-reward," "self-play," "self-evolve") that conflates fundamentally different ambitions. We survey 1,250 arXiv papers (2024-2026) along two axes: what the system improves -- its behavior in deployment, its policy through training, its evaluator, or the research process itself -- and the degree of loop closure (human-in-the-loop to fully closed). The taxonomy separates bounded self-refinement -- convergent, evaluable, and already industrial practice -- from open-ended recursive self-improvement (RSI), which remains bounded by grounding requirements, collapse dynamics, and compute constraints on every measured axis. Its distinctive feature is a dedicated category for self-evaluation: every improvement loop is a claim that some signal can substitute for human judgment. We survey the evaluator design space -- judges, process reward models, verifiers, rubrics, meta-evaluation -- order the signals into a verification hierarchy from formal verifiers (strongest) to intrinsic self-assessment (weakest), and observe that demonstrated self-improvement strength tracks this hierarchy, that its failure modes (self-confirming loops, model collapse, diversity collapse) follow from its violations, and that the "research direction-setting" bottleneck keeping humans in the loop sits at the top of that hierarchy. We connect the technical literature to the theory of RSI limits and to the safety and governance questions raised by frontier-lab accounts of closing the loop, and identify governance-grade measurement of self-improvement as the field's most underpopulated niche.

While Large Language Models (LLMs) enable complex autonomous behavior, current agents remain constrained by static, human-designed prompts that limit adaptability. Existing self-improving frameworks attempt to bridge this gap but typically rely on inefficient, multi-turn recursive loops that incur high computational costs. To address this, we propose Metacognitive Agent Reflective Self-improvement (MARS), a framework that achieves efficient self-evolution within a single recurrence cycle. Inspired by educational psychology, MARS mimics human learning by integrating principle-based reflection (abstracting normative rules to avoid errors) and procedural reflection (deriving step-by-step strategies for success). By synthesizing these insights into optimized instructions, MARS allows agents to systematically refine their reasoning logic without continuous online feedback. Extensive experiments on six benchmarks demonstrate that MARS outperforms state-of-the-art self-evolving systems while significantly reducing computational overhead.

Self-evolution of multimodal large language models (MLLMs) remains a critical challenge: pseudo-label-based methods suffer from progressive quality degradation as model predictions drift, while template-based methods are confined to a static set of transformations that cannot adapt in difficulty or diversity. We contend that robust, continuous self-improvement requires not only deterministic external feedback independent of the model's internal certainty, but also a mechanism to perpetually diversify the training distribution. To this end, we introduce EVE (Executable Visual transformation-based self-Evolution), a novel framework that entirely bypasses pseudo-labels by harnessing executable visual transformations continuously enriched in both variety and complexity. EVE adopts a Challenger-Solver dual-policy architecture. The Challenger maintains and progressively expands a queue of visual transformation code examples, from which it synthesizes novel Python scripts to perform dynamic visual transformations. Executing these scripts yields VQA problems with absolute, execution-verified ground-truth answers, eliminating any reliance on model-generated supervision. A multi-dimensional reward system integrating semantic diversity and dynamic difficulty calibration steers the Challenger to enrich its code example queue while posing progressively more challenging tasks, preventing mode collapse and fostering reciprocal co-evolution between the two policies. Extensive experiments demonstrate that EVE consistently surpasses existing self-evolution methods, establishing a robust and scalable paradigm for verifiable MLLM self-evolution. The code is available at https://github.com/0001Henry/EVE .

Should a large language model (LLM) be used as a therapist? In this paper, we investigate the use of LLMs to *replace* mental health providers, a use case promoted in the tech startup and research space. We conduct a mapping review of therapy guides used by major medical institutions to identify crucial aspects of therapeutic relationships, such as the importance of a therapeutic alliance between therapist and client. We then assess the ability of LLMs to reproduce and adhere to these aspects of therapeutic relationships by conducting several experiments investigating the responses of current LLMs, such as `gpt-4o`. Contrary to best practices in the medical community, LLMs 1) express stigma toward those with mental health conditions and 2) respond inappropriately to certain common (and critical) conditions in naturalistic therapy settings -- e.g., LLMs encourage clients' delusional thinking, likely due to their sycophancy. This occurs even with larger and newer LLMs, indicating that current safety practices may not address these gaps. Furthermore, we note foundational and practical barriers to the adoption of LLMs as therapists, such as that a therapeutic alliance requires human characteristics (e.g., identity and stakes). For these reasons, we conclude that LLMs should not replace therapists, and we discuss alternative roles for LLMs in clinical therapy.

Deploying language-model agents in production often requires substantial compute and human effort to tune prompts, parsers, validators, and other components of the agent pipeline. Self-evolution offers a promising alternative, but most existing frameworks assume access to frontier models that can reliably diagnose failures, propose revisions, and judge their own updates. We study whether frozen small language models (SLMs) can serve as effective self-evolving agents under resource constraints. We propose PACE (Prompt And Control Logic Evolution), a two-timescale framework that coordinates low-risk prompt refinement with higher-risk control-logic updates. PACE evolves prompts under fixed control logic until prompt-level gains saturate, then considers constrained control-logic updates that are accepted through held-out validation. Across three frozen SLM backbones ranging from 4B to 14B parameters and four controlled benchmarks, PACE achieves the best performance on all 12 backbone--benchmark combinations, improving over vanilla SLM agents by up to +9.2% relative improvement and over the stronger single-mode evolution baseline by up to +5.4% relative improvement. A tau-bench case study further shows that PACE improves multi-turn tool-use success over vanilla and prompt-only evolution. These results suggest that reliable SLM agent self-evolution is possible without updating model weights or relying on frontier-model teachers, and that the key benefit is not any single final solver pattern but autonomous, validated discovery of task-appropriate inference strategies.

Recent advances in multimodal large language models (MLLMs) have shown impressive reasoning capabilities. However, further enhancing existing MLLMs necessitates high-quality vision-language datasets with carefully curated task complexities, which are both costly and challenging to scale. Although recent self-improving models that iteratively refine themselves offer a feasible solution, they still suffer from two core challenges: (i) most existing methods augment visual or textual data separately, resulting in discrepancies in data complexity (e.g., over-simplified diagrams paired with redundant textual descriptions); and (ii) the evolution of data and models is also separated, leading to scenarios where models are exposed to tasks with mismatched difficulty levels. To address these issues, we propose C2-Evo, an automatic, closed-loop self-improving framework that jointly evolves both training data and model capabilities. Specifically, given a base dataset and a base model, C2-Evo enhances them by a cross-modal data evolution loop and a data-model evolution loop. The former loop expands the base dataset by generating complex multimodal problems that combine structured textual sub-problems with iteratively specified geometric diagrams, while the latter loop adaptively selects the generated problems based on the performance of the base model, to conduct supervised fine-tuning and reinforcement learning alternately. Consequently, our method continuously refines its model and training data, and consistently obtains considerable performance gains across multiple mathematical reasoning benchmarks. Our code, models, and datasets will be released.

Agent self-evolution has primarily focused on learning how to act, while overlooking an equally important capability: learning to discover what an agent does not know. Existing approaches typically assume that failure discovery is given, focusing on how to repair failures once they are identified. We ask whether blind-spot diagnosis itself can be learned. We thus study diagnosis as an agent capability separate from execution, and exclude two alternative sources of progress: executor adaptation and human supervision. Under these constraints, performance cannot improve through executor updates or annotated examples, forcing all improvements to originate from the learned diagnostic capability. We propose SkillMentor, which trains a Mentor policy via reinforcement learning to generate diagnostic tasks, identify recurrent failure modes, and curate them into reusable corrective skills. Across AppWorld and BFCLv3, SkillMentor improves executor performance by an average of 44.2%. These results suggest that blind-spot diagnosis is a learnable capability, enabling self-evolution without updating executor weights or relying on human-curated data.

Agentic systems are increasingly expected to improve after deployment, yet single-entity self-evolution is often bounded by a static learning context, such as fixed tasks and feedback. This survey focuses on co-evolution in agentic systems, a multi-component form of self-evolution in which multiple agents and their environment impose adaptive pressure on one another. To organize existing papers, we propose a progressive three-stage taxonomy that traces how the system gradually sheds human-engineered constraints. Agent--Agent Co-Evolution studies how agents adapt through dynamic peers, including adversarial, collaborative, and organizational adaptation. Agent--Environment Co-Evolution extends this loop to adaptive tasks, feedback, and interaction spaces that change with the agents. Meta Co-Evolution further explores the possibility of making the evolution mechanism itself evolvable. We also discuss open challenges in evaluating such systems, scaling them across multiple components, and keeping increasingly autonomous evolutionary processes safe and controllable. This survey provides a unified foundation for building robust and open-ended agentic systems that can improve beyond fixed human-designed paths.

Autoprompting is the process of automatically selecting optimized prompts for language models, which has been gaining popularity with the rapid advancement of prompt engineering, driven by extensive research in the field of large language models (LLMs). This paper presents ReflectivePrompt - a novel autoprompting method based on evolutionary algorithms that employs a reflective evolution approach for more precise and comprehensive search of optimal prompts. ReflectivePrompt utilizes short-term and long-term reflection operations before crossover and elitist mutation to enhance the quality of the modifications they introduce. This method allows for the accumulation of knowledge obtained throughout the evolution process and updates it at each epoch based on the current population. ReflectivePrompt was tested on 33 datasets for classification and text generation tasks using open-access large language models: t-lite-instruct-0.1 and gemma3-27b-it. The method demonstrates, on average, a significant improvement (e.g., 28% on BBH compared to EvoPrompt) in metrics relative to current state-of-the-art approaches, thereby establishing itself as one of the most effective solutions in evolutionary algorithm-based autoprompting.

While LLM-based agents have shown promise for deep research, most existing approaches rely on fixed workflows that struggle to adapt to real-world, open-ended queries. Recent work therefore explores self-evolution by allowing agents to rewrite their own code or prompts to improve problem-solving ability, but unconstrained optimization often triggers instability, hallucinations, and instruction drift. We propose EvoFSM, a structured self-evolving framework that achieves both adaptability and control by evolving an explicit Finite State Machine (FSM) instead of relying on free-form rewriting. EvoFSM decouples the optimization space into macroscopic Flow (state-transition logic) and microscopic Skill (state-specific behaviors), enabling targeted improvements under clear behavioral boundaries. Guided by a critic mechanism, EvoFSM refines the FSM through a small set of constrained operations, and further incorporates a self-evolving memory that distills successful trajectories as reusable priors and failure patterns as constraints for future queries. Extensive evaluations on five multi-hop QA benchmarks demonstrate the effectiveness of EvoFSM. In particular, EvoFSM reaches 58.0% accuracy on the DeepSearch benchmark. Additional results on interactive decision-making tasks further validate its generalization.

While large language model--powered agents can self-evolve by accumulating experience or by dynamically creating new assets (i.e., tools or expert agents), existing frameworks typically treat these two evolutionary processes in isolation. This separation overlooks their intrinsic interdependence: the former is inherently bounded by a manually predefined static toolset, while the latter generates new assets from scratch without experiential guidance, leading to limited capability growth and unstable evolution. To address this limitation, we introduce a novel paradigm of co-evolutionary Capability Expansion and Experience Distillation. Guided by this paradigm, we propose the Mem^{textbf{2}Evolve}, which integrates two core components: Experience Memory and Asset Memory. Specifically, Mem^{2}Evolve leverages accumulated experience to guide the dynamic creation of assets, thereby expanding the agent's capability space while simultaneously acquiring new experience to achieve co-evolution. Extensive experiments across 6 task categories and 8 benchmarks demonstrate that Mem^{2}Evolve achieves improvement of 18.53\% over standard LLMs, 11.80\% over agents evolving solely through experience, and 6.46\% over those evolving solely through asset creation, establishing it as a substantially more effective and stable self-evolving agent framework. Code is available at: https://buaa-irip-llm.github.io/Mem2Evolve.

Large-scale multi-view reconstruction models have made remarkable progress, but most existing approaches still rely on fully supervised training with ground-truth 3D/4D annotations. Such annotations are expensive and particularly scarce for dynamic scenes, limiting scalability. We propose SelfEvo, a self-improving framework that continually improves pretrained multi-view reconstruction models using unlabeled videos. SelfEvo introduces a self-distillation scheme using spatiotemporal context asymmetry, enabling self-improvement for learning-based 4D perception without external annotations. We systematically study design choices that make self-improvement effective, including loss signals, forms of asymmetry, and other training strategies. Across eight benchmarks spanning diverse datasets and domains, SelfEvo consistently improves pretrained baselines and generalizes across base models (e.g. VGGT and π^3), with significant gains on dynamic scenes. Overall, SelfEvo achieves up to 36.5% relative improvement in video depth estimation and 20.1% in camera estimation, without using any labeled data. Project Page: https://self-evo.github.io/.

Clinical case formulation organizes patient symptoms and psychosocial factors into causal models, often using the 5P framework. However, constructing such graphs from therapy transcripts is time consuming and varies across clinicians. We present InsightFlow, an LLM based approach that automatically generates 5P aligned causal graphs from patient-therapist dialogues. Using 46 psychotherapy intake transcripts annotated by clinical experts, we evaluate LLM generated graphs against human formulations using structural (NetSimile), semantic (embedding similarity), and expert rated clinical criteria. The generated graphs show structural similarity comparable to inter annotator agreement and high semantic alignment with human graphs. Expert evaluations rate the outputs as moderately complete, consistent, and clinically useful. While LLM graphs tend to form more interconnected structures compared to the chain like patterns of human graphs, overall complexity and content coverage are similar. These results suggest that LLMs can produce clinically meaningful case formulation graphs within the natural variability of expert practice. InsightFlow highlights the potential of automated causal modeling to augment clinical workflows, with future work needed to improve temporal reasoning and reduce redundancy.

Long-term memory is essential for LLM agents that operate across multiple sessions, yet existing memory systems treat retrieval infrastructure as fixed: stored content evolves while scoring functions, fusion strategies, and answer-generation policies remain frozen at deployment. We argue that truly adaptive memory requires co-evolution at two levels: the stored knowledge and the retrieval mechanism that queries it. We present EvolveMem, a self-evolving memory architecture that exposes its full retrieval configuration as a structured action space optimized by an LLM-powered diagnosis module. In each evolution round, the module reads per-question failure logs, identifies root causes, and proposes targeted configuration adjustments; a guarded meta-analyzer applies them with automatic revert-on-regression and explore-on-stagnation safeguards. This closed-loop self-evolution realizes an AutoResearch process: the system autonomously conducts iterative research cycles on its own architecture, replacing manual configuration tuning. Starting from a minimal baseline, the process converges autonomously, discovering effective retrieval strategies including entirely new configuration dimensions not present in the original action space. On LoCoMo, EvolveMem outperforms the strongest baseline by 25.7% relative and achieves a 78.0% relative improvement over the minimal baseline. On MemBench, EvolveMem exceeds the strongest baseline by 18.9% relative. Evolved configurations transfer across benchmarks with positive rather than catastrophic transfer, indicating that the self-evolution process captures universal retrieval principles rather than benchmark-specific heuristics. Code is available at https://github.com/aiming-lab/SimpleMem.

Large language models (LLMs) integrated into agent-driven workflows hold immense promise for healthcare, yet a significant gap exists between their potential and practical implementation within clinical settings. To address this, we present a practitioner-oriented field manual for deploying generative agents that use electronic health record (EHR) data. This guide is informed by our experience deploying the "irAE-Agent", an automated system to detect immune-related adverse events from clinical notes at Mass General Brigham, and by structured interviews with 21 clinicians, engineers, and informatics leaders involved in the project. Our analysis reveals a critical misalignment in clinical AI development: less than 20% of our effort was dedicated to prompt engineering and model development, while over 80% was consumed by the sociotechnical work of implementation. We distill this effort into five "heavy lifts": data integration, model validation, ensuring economic value, managing system drift, and governance. By providing actionable solutions for each of these challenges, this field manual shifts the focus from algorithmic development to the essential infrastructure and implementation work required to bridge the "valley of death" and successfully translate generative AI from pilot projects into routine clinical care.

Mental health disorders are one of the most serious diseases in the world. Most people with such a disease lack access to adequate care, which highlights the importance of training models for the diagnosis and treatment of mental health disorders. However, in the mental health domain, privacy concerns limit the accessibility of personalized treatment data, making it challenging to build powerful models. In this paper, we introduce MentalArena, a self-play framework to train language models by generating domain-specific personalized data, where we obtain a better model capable of making a personalized diagnosis and treatment (as a therapist) and providing information (as a patient). To accurately model human-like mental health patients, we devise Symptom Encoder, which simulates a real patient from both cognition and behavior perspectives. To address intent bias during patient-therapist interactions, we propose Symptom Decoder to compare diagnosed symptoms with encoded symptoms, and dynamically manage the dialogue between patient and therapist according to the identified deviations. We evaluated MentalArena against 6 benchmarks, including biomedicalQA and mental health tasks, compared to 6 advanced models. Our models, fine-tuned on both GPT-3.5 and Llama-3-8b, significantly outperform their counterparts, including GPT-4o. We hope that our work can inspire future research on personalized care. Code is available in https://github.com/Scarelette/MentalArena/tree/main

Large Language Models (LLMs) have great potential in the field of health care, yet they face great challenges in adapting to rapidly evolving medical knowledge. This can lead to outdated or contradictory treatment suggestions. This study investigated how LLMs respond to evolving clinical guidelines, focusing on concept drift and internal inconsistencies. We developed the DriftMedQA benchmark to simulate guideline evolution and assessed the temporal reliability of various LLMs. Our evaluation of seven state-of-the-art models across 4,290 scenarios demonstrated difficulties in rejecting outdated recommendations and frequently endorsing conflicting guidance. Additionally, we explored two mitigation strategies: Retrieval-Augmented Generation and preference fine-tuning via Direct Preference Optimization. While each method improved model performance, their combination led to the most consistent and reliable results. These findings underscore the need to improve LLM robustness to temporal shifts to ensure more dependable applications in clinical practice.

Cognitive Restructuring (CR) is a psychotherapeutic process aimed at identifying and restructuring an individual's negative thoughts, arising from mental health challenges, into more helpful and positive ones via multi-turn dialogues. Clinician shortage and stigma urge the development of human-LLM interactive psychotherapy for CR. Yet, existing efforts implement CR via simple text rewriting, fixed-pattern dialogues, or a one-shot CR workflow, failing to align with the psychotherapeutic process for effective CR. To address this gap, we propose CRDial, a novel framework for CR, which creates multi-turn dialogues with specifically designed identification and restructuring stages of negative thoughts, integrates sentence-level supportive conversation strategies, and adopts a multi-channel loop mechanism to enable iterative CR. With CRDial, we distill Crisp, a large-scale and high-quality bilingual dialogue dataset, from LLM. We then train Crispers, Crisp-based conversational LLMs for CR, at 7B and 14B scales. Extensive human studies show the superiority of Crispers in pointwise, pairwise, and intervention evaluations.

The emergence of multi-agent systems built from large language models (LLMs) offers a promising paradigm for scalable collective intelligence and self-evolution. Ideally, such systems would achieve continuous self-improvement in a fully closed loop while maintaining robust safety alignment--a combination we term the self-evolution trilemma. However, we demonstrate both theoretically and empirically that an agent society satisfying continuous self-evolution, complete isolation, and safety invariance is impossible. Drawing on an information-theoretic framework, we formalize safety as the divergence degree from anthropic value distributions. We theoretically demonstrate that isolated self-evolution induces statistical blind spots, leading to the irreversible degradation of the system's safety alignment. Empirical and qualitative results from an open-ended agent community (Moltbook) and two closed self-evolving systems reveal phenomena that align with our theoretical prediction of inevitable safety erosion. We further propose several solution directions to alleviate the identified safety concern. Our work establishes a fundamental limit on the self-evolving AI societies and shifts the discourse from symptom-driven safety patches to a principled understanding of intrinsic dynamical risks, highlighting the need for external oversight or novel safety-preserving mechanisms.

Objectives: While Large Language Models (LLMs) have been widely used to assist clinicians and support patients, no existing work has explored dialogue systems for standard diagnostic interviews and assessments. This study aims to bridge the gap in mental healthcare accessibility by developing an LLM-powered dialogue system that replicates clinician behavior. Materials and Methods: We introduce TRUST, a framework of cooperative LLM modules capable of conducting formal diagnostic interviews and assessments for Post-Traumatic Stress Disorder (PTSD). To guide the generation of appropriate clinical responses, we propose a Dialogue Acts schema specifically designed for clinical interviews. Additionally, we develop a patient simulation approach based on real-life interview transcripts to replace time-consuming and costly manual testing by clinicians. Results: A comprehensive set of evaluation metrics is designed to assess the dialogue system from both the agent and patient simulation perspectives. Expert evaluations by conversation and clinical specialists show that TRUST performs comparably to real-life clinical interviews. Discussion: Our system performs at the level of average clinicians, with room for future enhancements in communication styles and response appropriateness. Conclusions: Our TRUST framework shows its potential to facilitate mental healthcare availability.

LLM agents are increasingly deployed as systems built around editable external harnesses, including prompts, skills, memories and tools, that shape task execution without changing model parameters. Harness self-evolution adapts such agents by updating these harnesses from execution evidence. Yet it remains unclear whether a model's base capability in task-solving predicts its capabilities in harness self-evolution: which models produce useful harness updates, and which actually benefit from them? We analyze two harness self-evolution capabilities: (i) harness-updating, the capability to produce useful persistent harness updates from execution evidence; (ii) harness-benefit, the capability to benefit from updated harnesses during task solving. Our analysis reveals two findings. First, harness-updating is flat in base capability: models from different capability tiers produce harness updates that lead to surprisingly similar gains; even Qwen3.5-9B's updates yield gains comparable to those of Claude Opus~4.6. Second, harness-benefit is non-monotonic in base capability: weak-tier models benefit little from updated harnesses, mid-tier models benefit most, and strong-tier models benefit less than mid-tier. We trace low gains at the weak tier to two failure modes: weak-tier models may fail to activate relevant harness artifacts, or activate them but fail to follow them faithfully. These findings suggest investing capability budget in the task-solving agent rather than the evolver, and targeting harness invocation and long-horizon instruction following in agent training. Our source code is publicly available at https://github.com/A-EVO-Lab/a-evolve/tree/release/harness-evolution.

Vision language models are serving as general-purpose interfaces for complex multimodal tasks. However, deployment still faces three gaps: VLMs typically incur high latency and cost when processing dense video frames and long prompts, the agent scaffold remains static after deployment, and standard video-QA benchmarks do not test whether agents can use visual evidence inside tool-using workspaces. We present VisualClaw, a self-evolving multimodal agent built around two principles. First, hybrid encoding reduces deployment cost by filtering less informative streaming frames with a cascaded gate and compressing the text skill bank through hot/cold top-k injection. Second, skill evolution lets the agent learn from failures: retrieved memories condition an evolver as direct concatenated context or as guided evidence, producing skill-bank updates that help future questions. Across 4 video-QA benchmarks with 2 VLMs, VisualClaw cuts per-question API cost by an average -98% versus full-frame upload and by -25.9% over the offline uniform 8 frame baseline, while boosting accuracy in most settings, e.g., an average +3.85% and a peak +15.80% on EgoSchema with Gemini 3 Flash. To address the gap, we curate VisualClawArena, a 200-scenario multimodal agentic benchmark built through a strict five-stage pipeline; models must use video evidence, documents, dynamic updates, and executable checks inside a workspace. On VisualClawArena, the same framework with computer-use agent backends improves macro accuracy by +2.9% for Codex (GPT-5.5) and +3.2% for Claude Code (Sonnet 4.6) over no-evolution baselines, with a -9.5% cost reduction compared to the uniform-sampled baseline. These properties make VisualClaw a natural fit for edge applications, where the cascade reduces a 1-hour streaming session from ~3,600 API uploads down to only 5-20 calls and the self-evolution makes it a perfect personalized assistant.

Large language models (LLMs) are increasingly proposed as clinical agents, yet static, single-turn benchmarks cannot capture how a model dynamically delivers care across an encounter: gathering information, planning treatment, and adapting longitudinal management across successive patient states. Medical education has long addressed an analogous challenge through standardized patients (SPs): trained actors who consistently portray clinical cases, enabling realistic practice and objective, scripted assessment. Here we introduce MedSP1000, an SP-derived interactive benchmark for clinical-agent evaluation, including 1,638 SP cases with 24,602 trajectory-level peer-reviewed rubrics. MedSP1000 converts peer-reviewed SP teaching cases into executable scenarios with defined SP case scripts, clinical environment contexts, and human-validated structured rubric. In each simulation evaluation run, a clinical agent interacts in closed loop with a patient agent and an environment controller, and its behaviour is scored throughout the encounter against expert criteria specified in the original materials. Applying MedSP1000 to a range of general-purpose and medically specialized LLMs, we find that performance on static benchmarks does not reliably translate to such educational scenarios. The best-performing model, GPT-5.5, completes only 60.4% of expert-defined rubric items, whereas the strongest medically specialized model reaches 40.0%; increasing test-time compute produces no measurable gain. These results suggest that current LLMs, including agentic systems tuned for medicine, are not yet reliable enough to be safely integrated into actual clinical practice. More broadly, MedSP1000 shows how process-level, SP-style evaluation can reveal clinically relevant failure modes that single-turn benchmarks miss.

Self-improving coding agents that iteratively rewrite their own source code have demonstrated impressive performance on coding tasks. However, existing solutions generally derive self-modification from a single failure trajectory at a time, overlooking rich comparative signals available in the agent's expanding archive of past attempts. According to Mendelian principles of controlled inheritance, we introduce Mendel Gödel Machine (MGM). In addition to the general single-trajectory clonal mutation, MGM includes two new types of self-modification that better utilizes evidences accumulated: the reaction-norm mutation edits an agent based on its trajectories on multiple tasks simultaneously, and the cross-lineage hybridization edits an agent using the trajectory of a reference agent from another lineage on the same task. Under an additive fitness landscape model, we prove theoretically and demonstrate via controlled surrogate simulation that the new strategies facilitate a faster and better convergence over single-trajectory baselines. Experiments on SWE-bench and Polyglot confirm MGM's consistent improvement in performance, efficiency, and generalizability.

Wider access to therapeutic care is one of the biggest challenges in mental health treatment. Due to institutional barriers, some people seeking mental health support have turned to large language models (LLMs) for personalized therapy, even though these models are largely unsanctioned and untested. We investigate the potential and limitations of using LLMs as providers of evidence-based therapy by using mixed methods clinical metrics. Using HELPERT, a prompt run on a large language model using the same process and training as a comparative group of peer counselors, we replicated publicly accessible mental health conversations rooted in Cognitive Behavioral Therapy (CBT) to compare session dynamics and counselor's CBT-based behaviors between original peer support sessions and their reconstructed HELPERT sessions. Two licensed, CBT-trained clinical psychologists evaluated the sessions using the Cognitive Therapy Rating Scale and provided qualitative feedback. Our findings show that the peer sessions are characterized by empathy, small talk, therapeutic alliance, and shared experiences but often exhibit therapist drift. Conversely, HELPERT reconstructed sessions exhibit minimal therapist drift and higher adherence to CBT methods but display a lack of collaboration, empathy, and cultural understanding. Through CTRS ratings and psychologists' feedback, we highlight the importance of human-AI collaboration for scalable mental health. Our work outlines the ethical implication of imparting human-like subjective qualities to LLMs in therapeutic settings, particularly the risk of deceptive empathy, which may lead to unrealistic patient expectations and potential harm.

Large language models (LLMs) have significantly improved their reasoning capabilities; however, they still struggle with complex multi-step mathematical problem-solving due to error propagation, lack of self-correction, and limited adaptability to diverse reasoning styles. Existing methods rely on static fine-tuning or prompt engineering, which fail to generalize across problem complexities, while the scarcity of high-quality preference data further hinders reliable reasoning. We introduce SPHERE, a self-evolving data generation pipeline that enhances reasoning in small language models (SLMs) by iteratively generating, correcting, and diversifying reasoning chains. SPHERE operates in three stages: (i) Self-Generation, where the model autonomously constructs problem-solving steps; (ii) Self-Correction, enabling it to identify and rectify errors; and (iii) Diversity Induction, improving robustness through multiple valid reasoning trajectories. This self-evolution mechanism strengthens mathematical reasoning and enhances model reliability. Evaluations on MATH 500, GSM8K, AIME, AMC, and Olympiad show that SPHERE-trained models achieve significant gains over their base versions and match/surpass GPT-4o on certain benchmarks. Our findings demonstrate that self-evolving models can close the reasoning gap between SLMs and state-of-the-art LLMs, making mathematical AI more reliable, scalable, and efficient.

Generative AI is reshaping healthcare, yet most existing advances rely on hospital-grade devices, which limits their accessibility and potential for health management outside clinical settings. With the proliferation of portable devices and telemedicine, healthcare is shifting toward home-based Diagnosis-It-Yourself (DIY) care. Despite this promise, several distinctive challenges remain: (i) home-collected data are heterogeneous, exacerbated by the absence of standardized large-scale datasets; (ii) models require adaptation to variable task demands and evolving individual conditions; (iii) the broad spectrum of home care tasks lacks a unified benchmark for systematic evaluation. In this paper, we present DIYHealth Suite, a comprehensive framework designed to address these challenges through a tailored dataset, model, and benchmark. We first curate DIYHealth-900K, a large-scale multimodal dataset capturing diverse real-world home care scenarios. Building on this, we propose DIYHealthGPT, an adaptive foundation model for home-based health management, powered by the novel Hybrid Hyper Low-Rank Adaptation technique. Finally, we establish DIYHealthBench, the first benchmark to evaluate foundation models on home care tasks. Extensive experiments demonstrate that DIYHealthGPT delivers state-of-the-art performance over both general-purpose and medical-specific baselines on 11 home care tasks in both open-QA and closed-QA settings, laying the groundwork for the next generation of personalized health management at home.

The rapid evolution of artificial intelligence, especially in large language models (LLMs), has significantly impacted various domains, including healthcare. In chest X-ray (CXR) analysis, previous studies have employed LLMs, but with limitations: either underutilizing the multi-tasking capabilities of LLMs or lacking clinical accuracy. This paper presents M4CXR, a multi-modal LLM designed to enhance CXR interpretation. The model is trained on a visual instruction-following dataset that integrates various task-specific datasets in a conversational format. As a result, the model supports multiple tasks such as medical report generation (MRG), visual grounding, and visual question answering (VQA). M4CXR achieves state-of-the-art clinical accuracy in MRG by employing a chain-of-thought prompting strategy, in which it identifies findings in CXR images and subsequently generates corresponding reports. The model is adaptable to various MRG scenarios depending on the available inputs, such as single-image, multi-image, and multi-study contexts. In addition to MRG, M4CXR performs visual grounding at a level comparable to specialized models and also demonstrates outstanding performance in VQA. Both quantitative and qualitative assessments reveal M4CXR's versatility in MRG, visual grounding, and VQA, while consistently maintaining clinical accuracy.

Recent advances in psychotherapy have focused on treatment personalization, such as by selecting treatment modules based on personalized networks. However, estimating personalized networks typically requires intensive longitudinal data, which is not always feasible. A solution to facilitate scalability of network-driven treatment personalization is leveraging LLMs. In this study, we present an end-to-end pipeline for automatically generating client networks from 77 therapy transcripts to support case conceptualization and treatment planning. We annotated 3364 psychological processes and their corresponding dimensions in therapy transcripts. Using these data, we applied in-context learning to jointly identify psychological processes and their dimensions. The method achieved high performance even with a few training examples. To organize the processes into networks, we introduced a two-step method that grouped them into clinically meaningful clusters. We then generated explanation-augmented relationships between clusters. Experts found that networks produced by our multi-step approach outperformed those built with direct prompting for clinical utility and interpretability, with up to 90% preferring our approach. In addition, the networks were rated favorably by experts, with scores for clinical relevance, novelty, and usefulness ranging from 72-75%. Our findings provide a proof of concept for using LLMs to create clinically relevant networks from therapy transcripts. Advantages of our approach include bottom-up case conceptualization from client utterances in therapy sessions and identification of latent themes. Networks generated from our pipeline may be used in clinical settings and supervision and training. Future research should examine whether these networks improve treatment outcomes relative to other methods of treatment personalization, including statistically estimated networks.

Specialized clinical AI assistants are rapidly entering medical practice, often framed as safer or more reliable than general-purpose large language models (LLMs). Yet, unlike frontier models, these clinical tools are rarely subjected to independent, quantitative evaluation, creating a critical evidence gap despite their growing influence on diagnosis, triage, and guideline interpretation. We assessed two widely deployed clinical AI systems (OpenEvidence and UpToDate Expert AI) against three state-of-the-art generalist LLMs (GPT-5, Gemini 3 Pro, and Claude Sonnet 4.5) using a 1,000-item mini-benchmark combining MedQA (medical knowledge) and HealthBench (clinician-alignment) tasks. Generalist models consistently outperformed clinical tools, with GPT-5 achieving the highest scores, while OpenEvidence and UpToDate demonstrated deficits in completeness, communication quality, context awareness, and systems-based safety reasoning. These findings reveal that tools marketed for clinical decision support may often lag behind frontier LLMs, underscoring the urgent need for transparent, independent evaluation before deployment in patient-facing workflows.

Generative models trained using self-supervision of tokenized electronic health record (EHR) timelines show promise for clinical outcome prediction. This is typically done using Monte Carlo simulation for future patient trajectories. However, existing approaches suffer from three key limitations: sparse estimate distributions that poorly differentiate patient risk levels, extreme computational costs, and high sampling variance. We propose two new estimators: the Sum of Conditional Outcome Probability Estimator (SCOPE) and Risk Estimation from Anticipated Conditional Hazards (REACH), that leverage next-token probability distributions discarded by standard Monte Carlo. We prove both estimators are unbiased and that REACH guarantees variance reduction over Monte Carlo sampling for any model and outcome. Empirically, on hospital mortality prediction in MIMIC-IV using the ETHOS-ARES framework, SCOPE and REACH match 100-sample Monte Carlo performance using only 10-11 samples (95% CI: [9,11]), representing a ~10x reduction in inference cost without degrading calibration. For ICU admission prediction, efficiency gains are more modest (~1.2x), which we attribute to the outcome's lower "spontaneity," a property we characterize theoretically and empirically. These methods substantially improve the feasibility of deploying generative EHR models in resource-constrained clinical settings.

In this work, we introduce MedAgentSim, an open-source simulated clinical environment with doctor, patient, and measurement agents designed to evaluate and enhance LLM performance in dynamic diagnostic settings. Unlike prior approaches, our framework requires doctor agents to actively engage with patients through multi-turn conversations, requesting relevant medical examinations (e.g., temperature, blood pressure, ECG) and imaging results (e.g., MRI, X-ray) from a measurement agent to mimic the real-world diagnostic process. Additionally, we incorporate self improvement mechanisms that allow models to iteratively refine their diagnostic strategies. We enhance LLM performance in our simulated setting by integrating multi-agent discussions, chain-of-thought reasoning, and experience-based knowledge retrieval, facilitating progressive learning as doctor agents interact with more patients. We also introduce an evaluation benchmark for assessing the LLM's ability to engage in dynamic, context-aware diagnostic interactions. While MedAgentSim is fully automated, it also supports a user-controlled mode, enabling human interaction with either the doctor or patient agent. Comprehensive evaluations in various simulated diagnostic scenarios demonstrate the effectiveness of our approach. Our code, simulation tool, and benchmark are available at https://medagentsim.netlify.app/.

Self-evolution offers a scalable path to stronger reasoning: a pretrained language model improves itself with only minimal external supervision. Yet existing methods either depend on extensively curated or teacher-generated training data, or, when the generator runs unsupervised, reward it by a difficulty heuristic that need not improve the solver. We introduce INFUSER, an iterative co-training framework with two co-evolving roles: a Generator that drafts questions and reference golden answers from a pool of unstructured, automatically collected documents, and a Solver that improves by training on them. The solver is trained with standard correctness rewards against the generator-provided answers, while the generator is rewarded by an optimizer-aware influence score that measures whether each proposed question would actually improve the solver on the target distribution. Because this continuous, noisy influence score is poorly served by standard GRPO, we propose DuGRPO, a dual-normalized variant of GRPO, for generator training. Together, these turn the document pool into an adaptive curriculum that favors questions useful to the current solver, not just hard ones. On Qwen3-8B-Base, INFUSER outperforms strong self-evolution baselines with over 20% relative improvement on Olympiad and SuperGPQA benchmarks, and an 8B INFUSER co-evolving generator outperforms a frozen 32B thinking generator on math and coding. Ablations confirm each design choice is necessary, and two extensions, applying INFUSER to an instruction-finetuned anchor and augmenting it with rule-verifiable RLVR data, further demonstrate the flexibility and generalizability of the framework. Code is available at https://github.com/FFishy-git/INFUSER.

Self-evolving agent systems improve by creating, revising, and retiring their own skills, but every such loop rests on a hidden assumption: a reliable evaluation metric already exists. In many real applications it does not. We make three claims. First, metrics can be evolved: our metric loop searches compositions of small drawback detectors under a full evolutionary lifecycle, trained to agree with a ten-item anchored reference set, regularized by consensus over unlabeled outputs, and audited against a held-out anchor it never reads, yielding a transparent, inspectable metric rather than an opaque judge. Second, since no metric exists to beat, the yardstick is recovering what an accurate metric would have enabled, and Double Ratchet, our co-evolution of the metric with a lifecycle-managed skill loop, does so: across code generation (MBPP+), enterprise text-to-SQL (Spider~2.0-Snow), and reference-free report generation, it retains 88--110\% of the held-out lift achieved by the same skill loop driven by ground truth or the best available rubric. Third, safety comes from anchor discipline plus outer audits: removing anchor guards collapses the metric into a vacuous detector while removing the lifecycle does not; and when evolved skills gamed the report rubric, an independent judge caught it, one detector repaired it, and a task-aware judge then preferred the evolved outputs over the pre-evolution baseline in 77\% of decided pairs. We argue this failure-expecting architecture is the right default wherever no reliable automatic verifier exists.

Self-improvement in AI agents has emerged as a key research frontier: systems that modify their own prompts, workflows, and decision rules based on accumulated operational experience. The state-of-the-art Self-Harness framework [1] achieves 14--21% improvement on Terminal-Bench-2.0 by mining failure clusters and patching the agent harness. However, Self-Harness optimises only one dimension -- the prompt harness -- leaving behavioural principles and workflow topology unchanged. We propose APEX (Adaptive Principle EXtraction), a three-layer co-evolution framework that simultaneously evolves: (L1) the harness via failure-mode patching, (L2) behavioural principles via success-trace distillation [2], and (L3) the agent workflow topology via structural fitness-based selection [6]. We implement APEX on Joe [13], a production-grade super AI Agent built on NVIDIA Nemotron and designed as an Edge AI Agent Factory for the NVIDIA Agent Challenge 2026, managing a 15-node compute fleet using 114 real task traces collected over 18 days. APEX achieves an APEX Health Score of 0.570 (+90% vs. baseline 0.300) in a single evolutionary run, distilling 6 novel reusable principles and selecting a research-first workflow topology scoring 0.900 (+20%). Our results demonstrate that multi-dimensional co-evolution substantially outperforms single-axis harness optimisation, at a cost of only 4 LLM calls (~270 s) on a local qwen2.5-coder:32b instance.

Recent advances in generative models, including large language models (LLMs), vision language models (VLMs), and diffusion models, have accelerated the field of natural language and image processing in medicine and marked a significant paradigm shift in how biomedical models can be developed and deployed. While these models are highly adaptable to new tasks, scaling and evaluating their usage presents new challenges not addressed in previous frameworks. In particular, the ability of these models to produce useful outputs with little to no specialized training data ("zero-" or "few-shot" approaches), as well as the open-ended nature of their outputs, necessitate the development of new guidelines for robust reporting of clinical generative model research. In response to gaps in standards and best practices for the development of clinical AI tools identified by US Executive Order 141103 and several emerging national networks for clinical AI evaluation, we begin to formalize some of these guidelines by building on the original MI-CLAIM checklist. The new checklist, MI-CLAIM-GEN (Table 1), aims to address differences in training, evaluation, interpretability, and reproducibility of new generative models compared to non-generative ("predictive") AI models. This MI-CLAIM-GEN checklist also seeks to clarify cohort selection reporting with unstructured clinical data and adds additional items on alignment with ethical standards for clinical AI research.

An LLM agent's real-task performance is shaped as much by the harness around its model as by the frozen model itself: its prompts, injected knowledge, runtime control, and configuration. In deployment the harness is often the only lever available, so improving it automatically is the natural way to raise performance without touching the weights. The hard part is not generating changes but knowing which one truly helped. Self-generated feedback is noisy, and an apparent gain can be a measurement artifact or an edit that merely overfits the tasks it was tuned on. We present a self-evolving agent-harness framework that separates proposing changes from crediting them: a language model diagnoses failures and proposes patches, while all sampling, measurement, and significance testing are owned by deterministic code, so every credited improvement is trustworthy by construction. Patches populate a gated, categorical quality-diversity archive (GSME) keyed on the (WHERE x WHY) pathology an edit addresses rather than the tasks it fixes, an anti-overfitting inductive bias; generalization is measured on a sealed test scored only after evolution. Across seven domains with a frozen open-weight model, the harness is train-selected and scored once on a sealed test; its credited gains there are +9 to +15.5pp and retain 86-147% of the training gain, evidence they generalize rather than overfit. The winning patch tracks the model's dominant pathology, not its size or family: changing the model can change the pathology and the patch, while the same pathology-to-patch match recurs across two model families. What transfers is the diagnose-and-credit loop, not any specific harness.

Mental illness remains one of the most critical public health issues. Despite its importance, many mental health professionals highlight a disconnect between their training and actual real-world patient practice. To help bridge this gap, we propose PATIENT-{\Psi}, a novel patient simulation framework for cognitive behavior therapy (CBT) training. To build PATIENT-{\Psi}, we construct diverse patient cognitive models based on CBT principles and use large language models (LLMs) programmed with these cognitive models to act as a simulated therapy patient. We propose an interactive training scheme, PATIENT-{\Psi}-TRAINER, for mental health trainees to practice a key skill in CBT -- formulating the cognitive model of the patient -- through role-playing a therapy session with PATIENT-{\Psi}. To evaluate PATIENT-{\Psi}, we conducted a comprehensive user study of 13 mental health trainees and 20 experts. The results demonstrate that practice using PATIENT-{\Psi}-TRAINER enhances the perceived skill acquisition and confidence of the trainees beyond existing forms of training such as textbooks, videos, and role-play with non-patients. Based on the experts' perceptions, PATIENT-{\Psi} is perceived to be closer to real patient interactions than GPT-4, and PATIENT-{\Psi}-TRAINER holds strong promise to improve trainee competencies. Our code and data are released at https://github.com/ruiyiw/patient-psi.

Despite its significant promise and continuous technical advances, real-world applications of artificial intelligence (AI) remain limited. We attribute this to the "domain expert-AI-conundrum": while domain experts, such as clinician scientists, should be able to build predictive models such as risk scores, they face substantial barriers in accessing state-of-the-art (SOTA) tools. While automated machine learning (AutoML) has been proposed as a partner in clinical predictive modeling, many additional requirements need to be fulfilled to make machine learning accessible for clinician scientists. To address this gap, we introduce CliMB, a no-code AI-enabled partner designed to empower clinician scientists to create predictive models using natural language. CliMB guides clinician scientists through the entire medical data science pipeline, thus empowering them to create predictive models from real-world data in just one conversation. CliMB also creates structured reports and interpretable visuals. In evaluations involving clinician scientists and systematic comparisons against a baseline GPT-4, CliMB consistently demonstrated superior performance in key areas such as planning, error prevention, code execution, and model performance. Moreover, in blinded assessments involving 45 clinicians from diverse specialties and career stages, more than 80% preferred CliMB over GPT-4. Overall, by providing a no-code interface with clear guidance and access to SOTA methods in the fields of data-centric AI, AutoML, and interpretable ML, CliMB empowers clinician scientists to build robust predictive models. The proof-of-concept version of CliMB is available as open-source software on GitHub: https://github.com/vanderschaarlab/climb.

Large Language Models (LLMs) present immense potential in the medical field, yet concerns over data privacy, regulatory compliance, and model stability restrict their widespread adoption. Although the distillation of high-performing closed-source LLMs has proven effective for general tasks, their application in healthcare is limited due to reduced domain knowledge and remnants of alignment behavior hindering clinical tasks. To address these challenges, we propose Dialogue-Based Knowledge Encoding (DBKE). DBKE enhances models' implicit knowledge base and primes them for conversational recall, augmenting their conversational capabilities and enabling a soft alignment for subsequent use cases. By transforming dense academic source text into synthetic dialogue, DBKE broadens the model's knowledge base and enables a soft alignment that guides downstream behaviours. We present Clinical Camel, an open-source, healthcare-focused conversational model, to showcase the effectiveness of DBKE. Clinical Camel outperforms GPT-3.5 on the United States Medical Licensing Examination (USMLE) Step 1 and Step 3 with scores of 53.2 % and 58.2 %, respectively, compared to GPT-3.5's scores of 36.1 % and 55.7 %. Clinical Camel adeptly handles multi-stage clinical case problems, provides adaptive counseling, and generates clinical notes. However, it is prone to hallucinations, which pose a significant obstacle in safety-critical settings. The performance of Clinical Camel underscores the importance of continued research and development of open-source models for the safe and effective integration of LLMs in healthcare settings.

Self-evolving LLM-based agents improve mainly by changing their agent harness: the structured execution layer around a base model, including prompts, memory, tools, middleware, runtime state, and the model-tool interaction loop. Existing evaluations often reduce this process to isolated task scores or a single sequential curve, obscuring whether an update produces reusable improvement, overfits recent tasks, increases cost, or harms older behavior. We introduce SEAGym, an evaluation environment for measuring agent harness updates across training, validation, test, replay, and cost records. SEAGym turns Harbor-compatible benchmarks into dynamic self-evolution task sources with train batches, frozen update-validation, held-out ID and OOD transfer views, replay diagnostics, and saved snapshot and metric records. Instantiating SEAGym on Terminal-Bench 2.0 and HLE, we compare ACE, TF-GRPO, and AHE under a shared epoch/batch protocol. The results show that these evaluation views provide complementary signals about the evolution process: frequent updates may fail to improve held-out performance, useful intermediate snapshots may collapse later, and source diversity and model backend can affect harness reliability.

We explore an evolutionary search strategy for scaling inference time compute in Large Language Models. The proposed approach, Mind Evolution, uses a language model to generate, recombine and refine candidate responses. The proposed approach avoids the need to formalize the underlying inference problem whenever a solution evaluator is available. Controlling for inference cost, we find that Mind Evolution significantly outperforms other inference strategies such as Best-of-N and Sequential Revision in natural language planning tasks. In the TravelPlanner and Natural Plan benchmarks, Mind Evolution solves more than 98% of the problem instances using Gemini 1.5 Pro without the use of a formal solver.

Tool utilization enables Large Language Model (LLM) agents to interact with the real world and resolve complex tasks. However, existing agent frameworks predominantly rely on static toolsets composed of granular atomic actions (e.g., basic file I/O or single-turn search), which forces agents to reinvent low-level logic for every recurring workflow, leading to increased reasoning overhead and failure rates. In this study, we propose that agents can achieve self-evolution by synthesizing these atomic actions into reusable Standard Operating Procedures (SOPs), which function as callable higher-order tools that encapsulate multi-step logic. We further introduce EvoSOP, a framework that empowers agents to extract SOPs from execution trajectories and iteratively optimize the toolset through a systematic lifecycle of construction, merging, evaluation, and pruning. Extensive experiments demonstrate that EvoSOP significantly boosts task success rates while substantially reducing the number of interaction rounds compared to baselines. Our analysis also reveals that iterative tool optimization fosters reliable and efficient tool-use patterns, providing a scalable pathway for the development of self-evolving agents.

Building agentic systems that can autonomously self-improve from experience is a longstanding goal of AI. Large language models (LLMs) today primarily self-improve via two mechanisms: self-reflection for context updates, and reinforcement learning (RL) for weight updates. In this work, we propose Evolutionary System Prompt Learning (E-SPL), a method for jointly improving model contexts and model weights. In each RL iteration, E-SPL samples trajectories under multiple system prompts in parallel, then jointly applies RL updates to LLM weights and evolutionary updates to system prompts. System prompts evolve via mutation and crossover, two genetic operators driven by LLM self-reflection; selection is based on relative performance ratings updated across RL iterations. E-SPL encourages a natural division between declarative knowledge encoded in prompts and procedural knowledge encoded in weights, resulting in improved performance across reasoning and agentic tasks. For instance, in an easy-to-hard (AIME rightarrow BeyondAIME) generalization setting, E-SPL improves RL success rate from 38.8% rightarrow 45.1% while also outperforming reflective prompt evolution (40.0%). Overall, our results demonstrate that RL and system prompt evolution are deeply synergistic, and combining the two yields consistent gains in sample efficiency and generalization. Code: https://github.com/LunjunZhang/E-SPL

Autonomous agentic systems are largely static after deployment: they do not learn from user interactions, and recurring failures persist until the next human-driven update ships a fix. Self-evolving agents have emerged in response, but all confine evolution to text-mutable artifacts -- skill files, prompt configurations, memory schemas, workflow graphs -- and leave the agent harness untouched. Since routing, hook ordering, state invariants, and dispatch live in code rather than in any text artifact, an entire class of structural failure is physically unreachable from the text layer. We argue that source-level adaptation is a fundamentally more general medium: it is Turing-complete, a strict superset of every text-mutable scope, takes effect deterministically rather than through base-model compliance, and does not erode under long-context drift. We present MOSS, a system that performs self-rewriting at the source level on production agentic substrates. Each evolution is anchored to an automatically curated batch of production-failure evidence and proceeds through a deterministic multi-stage pipeline; code modification is delegated to a pluggable external coding-agent CLI while MOSS retains stage ordering and verdicts. Candidates are verified by replaying the batch against the candidate image in ephemeral trial workers, then promoted via user-consent-gated, in-place container swap with health-probe-gated rollback. On OpenClaw, MOSS lifts a four-task mean grader score from 0.25 to 0.61 in a single cycle without human intervention.

Simulating high-fidelity patients offers a powerful avenue for studying complex diseases while addressing the challenges of fragmented, biased, and privacy-restricted real-world data. In this study, we introduce SynthAgent, a novel Multi-Agent System (MAS) framework designed to model obesity patients with comorbid mental disorders, including depression, anxiety, social phobia, and binge eating disorder. SynthAgent integrates clinical and medical evidence from claims data, population surveys, and patient-centered literature to construct personalized virtual patients enriched with personality traits that influence adherence, emotion regulation, and lifestyle behaviors. Through autonomous agent interactions, the system simulates disease progression, treatment response, and life management across diverse psychosocial contexts. Evaluation of more than 100 generated patients demonstrated that GPT-5 and Claude 4.5 Sonnet achieved the highest fidelity as the core engine in the proposed MAS framework, outperforming Gemini 2.5 Pro and DeepSeek-R1. SynthAgent thus provides a scalable and privacy-preserving framework for exploring patient journeys, behavioral dynamics, and decision-making processes in both medical and psychological domains.

The advancement of natural language processing (NLP) systems in healthcare hinges on language model ability to interpret the intricate information contained within clinical notes. This process often requires integrating information from various time points in a patient's medical history. However, most earlier clinical language models were pretrained with a context length limited to roughly one clinical document. In this study, We introduce ClinicalMamba, a specialized version of the Mamba language model, pretrained on a vast corpus of longitudinal clinical notes to address the unique linguistic characteristics and information processing needs of the medical domain. ClinicalMamba, with 130 million and 2.8 billion parameters, demonstrates a superior performance in modeling clinical language across extended text lengths compared to Mamba and clinical Llama. With few-shot learning, ClinicalMamba achieves notable benchmarks in speed and accuracy, outperforming existing clinical language models and general domain large models like GPT-4 in longitudinal clinical notes information extraction tasks.

Objective. Clinical AI documentation systems require evaluation methodologies that are clinically valid, economically viable, and sensitive to iterative changes. Methods requiring expert review per scoring instance are too slow and expensive for safe, iterative deployment. We present a case-specific, clinician-authored rubric methodology for clinical AI evaluation and examine whether LLM-generated rubrics can approximate clinician agreement. Materials and Methods. Twenty clinicians authored 1,646 rubrics for 823 clinical cases (736 real-world, 87 synthetic) across primary care, psychiatry, oncology, and behavioral health. Each rubric was validated by confirming that an LLM-based scoring agent consistently scored clinician-preferred outputs higher than rejected ones. Seven versions of an EHR-embedded AI agent for clinicians were evaluated across all cases. Results. Clinician-authored rubrics discriminated effectively between high- and low-quality outputs (median score gap: 82.9%) with high scoring stability (median range: 0.00%). Median scores improved from 84% to 95%. In later experiments, clinician-LLM ranking agreement (tau: 0.42-0.46) matched or exceeded clinician-clinician agreement (tau: 0.38-0.43), attributable to both ceiling compression and LLM rubric improvement. Discussion. This convergence supports incorporating LLM rubrics alongside clinician-authored ones. At roughly 1,000 times lower cost, LLM rubrics enable substantially greater evaluation coverage, while continued clinical authorship grounds evaluation in expert judgment. Ceiling compression poses a methodological challenge for future inter-rater agreement studies. Conclusion. Case-specific rubrics offer a path for clinical AI evaluation that preserves expert judgment while enabling automation at three orders lower cost. Clinician-authored rubrics establish the baseline against which LLM rubrics are validated.

Problem: Effective patient-centered communication is a core competency for physicians. However, both seasoned providers and medical trainees report decreased confidence in leading conversations on sensitive topics such as goals of care or end-of-life discussions. The significant administrative burden and the resources required to provide dedicated training in leading difficult conversations has been a long-standing problem in medical education. Approach: In this work, we present a novel educational tool designed to facilitate interactive, real-time simulations of difficult conversations in a video-based format through the use of multimodal generative artificial intelligence (AI). Leveraging recent advances in language modeling, computer vision, and generative audio, this tool creates realistic, interactive scenarios with avatars, or "synthetic patients." These synthetic patients interact with users throughout various stages of medical care using a custom-built video chat application, offering learners the chance to practice conversations with patients from diverse belief systems, personalities, and ethnic backgrounds. Outcomes: While the development of this platform demanded substantial upfront investment in labor, it offers a highly-realistic simulation experience with minimal financial investment. For medical trainees, this educational tool can be implemented within programs to simulate patient-provider conversations and can be incorporated into existing palliative care curriculum to provide a scalable, high-fidelity simulation environment for mastering difficult conversations. Next Steps: Future developments will explore enhancing the authenticity of these encounters by working with patients to incorporate their histories and personalities, as well as employing the use of AI-generated evaluations to offer immediate, constructive feedback to learners post-simulation.

Building generalist agents that can handle diverse tasks and evolve themselves across different environments is a long-term goal in the AI community. Large language models (LLMs) are considered a promising foundation to build such agents due to their generalized capabilities. Current approaches either have LLM-based agents imitate expert-provided trajectories step-by-step, requiring human supervision, which is hard to scale and limits environmental exploration; or they let agents explore and learn in isolated environments, resulting in specialist agents with limited generalization. In this paper, we take the first step towards building generally-capable LLM-based agents with self-evolution ability. We identify a trinity of ingredients: 1) diverse environments for agent exploration and learning, 2) a trajectory set to equip agents with basic capabilities and prior knowledge, and 3) an effective and scalable evolution method. We propose AgentGym, a new framework featuring a variety of environments and tasks for broad, real-time, uni-format, and concurrent agent exploration. AgentGym also includes a database with expanded instructions, a benchmark suite, and high-quality trajectories across environments. Next, we propose a novel method, AgentEvol, to investigate the potential of agent self-evolution beyond previously seen data across tasks and environments. Experimental results show that the evolved agents can achieve results comparable to SOTA models. We release the AgentGym suite, including the platform, dataset, benchmark, checkpoints, and algorithm implementations. The AgentGym suite is available on https://github.com/WooooDyy/AgentGym.

Simulating human clients in mental health counseling is crucial for training and evaluating counselors (both human or simulated) in a scalable manner. Nevertheless, past research on client simulation did not focus on complex conversation tasks such as mental health counseling. In these tasks, the challenge is to ensure that the client's actions (i.e., interactions with the counselor) are consistent with with its stipulated profiles and negative behavior settings. In this paper, we propose a novel framework that supports consistent client simulation for mental health counseling. Our framework tracks the mental state of a simulated client, controls its state transitions, and generates for each state behaviors consistent with the client's motivation, beliefs, preferred plan to change, and receptivity. By varying the client profile and receptivity, we demonstrate that consistent simulated clients for different counseling scenarios can be effectively created. Both our automatic and expert evaluations on the generated counseling sessions also show that our client simulation method achieves higher consistency than previous methods.

Autonomous systems that generate scientific hypotheses, conduct experiments, and draft manuscripts have recently emerged as a promising paradigm for accelerating discovery. However, existing AI Scientists remain largely domain-agnostic, limiting their applicability to clinical medicine, where research is required to be grounded in medical evidence with specialized data modalities. In this work, we introduce Medical AI Scientist, the first autonomous research framework tailored to clinical autonomous research. It enables clinically grounded ideation by transforming extensively surveyed literature into actionable evidence through clinician-engineer co-reasoning mechanism, which improves the traceability of generated research ideas. It further facilitates evidence-grounded manuscript drafting guided by structured medical compositional conventions and ethical policies. The framework operates under 3 research modes, namely paper-based reproduction, literature-inspired innovation, and task-driven exploration, each corresponding to a distinct level of automated scientific inquiry with progressively increasing autonomy. Comprehensive evaluations by both large language models and human experts demonstrate that the ideas generated by the Medical AI Scientist are of substantially higher quality than those produced by commercial LLMs across 171 cases, 19 clinical tasks, and 6 data modalities. Meanwhile, our system achieves strong alignment between the proposed method and its implementation, while also demonstrating significantly higher success rates in executable experiments. Double-blind evaluations by human experts and the Stanford Agentic Reviewer suggest that the generated manuscripts approach MICCAI-level quality, while consistently surpassing those from ISBI and BIBM. The proposed Medical AI Scientist highlights the potential of leveraging AI for autonomous scientific discovery in healthcare.

Current mental-health conversational systems are usually based on fixed, generic dialogue patterns. This paper proposes an adaptive framework based on large language models that aims to personalize therapeutic interaction according to a user's psychological state, quantified with the Acceptance of Illness Scale (AIS). The framework defines three specialized agents, L, M, and H, each linked to a different level of illness acceptance, and adjusts conversational behavior over time using continuous feedback signals. The AIS-stratified architecture is treated as a diegetic prototype placed in a plausible near-future setting and examined through the method of design fiction. By embedding the architecture in narrative scenarios, the study explores how such agents might influence access to care and therapeutic relationship. The goal is to show how clinically informed personalization, technical feasibility, and speculative scenario analysis can together inform the responsible design of LLM-based companions for mental-health support.

Existing research infrastructure is fundamentally document-centric, providing citation links between papers but lacking explicit representations of methodological evolution. In particular, it does not capture the structured relationships that explain how and why research methods emerge, adapt, and build upon one another. With the rise of AI-driven research agents as a new class of consumers of scientific knowledge, this limitation becomes increasingly consequential, as such agents cannot reliably reconstruct method evolution topologies from unstructured text. We introduce Intern-Atlas, a methodological evolution graph that automatically identifies method-level entities, infers lineage relationships among methodologies, and captures the bottlenecks that drive transitions between successive innovations. Built from 1,030,314 papers spanning AI conferences, journals, and arXiv preprints, the resulting graph comprises 9,410,201 semantically typed edges, each grounded in verbatim source evidence, forming a queryable causal network of methodological development. To operationalize this structure, we further propose a self-guided temporal tree search algorithm for constructing evolution chains that trace the progression of methods over time. We evaluate the quality of the resulting graph against expert-curated ground-truth evolution chains and observe strong alignment. In addition, we demonstrate that Intern-Atlas enables downstream applications in idea evaluation and automated idea generation. We position methodological evolution graphs as a foundational data layer for the emerging automated scientific discovery.

Extracting patient information from unstructured text is a critical task in health decision-support and clinical research. Large language models (LLMs) have shown the potential to accelerate clinical curation via few-shot in-context learning, in contrast to supervised learning which requires much more costly human annotations. However, despite drastic advances in modern LLMs such as GPT-4, they still struggle with issues regarding accuracy and interpretability, especially in mission-critical domains such as health. Here, we explore a general mitigation framework using self-verification, which leverages the LLM to provide provenance for its own extraction and check its own outputs. This is made possible by the asymmetry between verification and generation, where the latter is often much easier than the former. Experimental results show that our method consistently improves accuracy for various LLMs in standard clinical information extraction tasks. Additionally, self-verification yields interpretations in the form of a short text span corresponding to each output, which makes it very efficient for human experts to audit the results, paving the way towards trustworthy extraction of clinical information in resource-constrained scenarios. To facilitate future research in this direction, we release our code and prompts.

Traditional task-oriented dialog systems are unable to evolve from ongoing interactions or adapt to new domains after deployment, that is a critical limitation in real-world dynamic environments. Continual learning approaches depend on episodic retraining with human curated data, failing to achieve autonomy lifelong improvement. While evolutionary computation and LLM driven self improvement offer promising mechanisms for dialog optimization, they lack a unified framework for holistic, iterative strategy refinement. To bridge this gap, we propose DarwinTOD, a lifelong self evolving dialog framework that systematically integrates these two paradigms, enabling continuous strategy optimization from a zero-shot base without task specific fine-tuning. DarwinTOD maintains an Evolvable Strategy Bank and operates through a dual-loop process: online multi-agent dialog execution with peer critique, and offline structured evolutionary operations that refine the strategy bank using accumulated feedback. This closed-loop design enables autonomous continuous improvement without human intervention. Extensive experiments show that DarwinTOD surpasses previous state-of-the-art methods and exhibits continuous performance gains throughout evolution. Our work provides a novel framework for building dialog systems with lifelong self evolution capabilities.

Vision-Language Models (VLM) can support clinicians by analyzing medical images and engaging in natural language interactions to assist in diagnostic and treatment tasks. However, VLMs often exhibit "hallucinogenic" behavior, generating textual outputs not grounded in contextual multimodal information. This challenge is particularly pronounced in the medical domain, where we do not only require VLM outputs to be accurate in single interactions but also to be consistent with clinical reasoning and diagnostic pathways throughout multi-turn conversations. For this purpose, we propose a new alignment algorithm that uses symbolic representations of clinical reasoning to ground VLMs in medical knowledge. These representations are utilized to (i) generate GPT-4-guided visual instruction tuning data at scale, simulating clinician-VLM conversations with demonstrations of clinical reasoning, and (ii) create an automatic reward function that evaluates the clinical validity of VLM generations throughout clinician-VLM interactions. Our algorithm eliminates the need for human involvement in training data generation or reward model construction, reducing costs compared to standard reinforcement learning with human feedback (RLHF). We apply our alignment algorithm to develop Dr-LLaVA, a conversational VLM finetuned for analyzing bone marrow pathology slides, demonstrating strong performance in multi-turn medical conversations.

Self-play agents can generate training problems without questions from target benchmarks, but their curricula lack persistent state: failures affect gradients yet do not explicitly shape future practice. External skill memories preserve procedural experience but are typically learned from fixed task distributions. We introduce SESA (Self-Evolving Skill-Augmented Agent), which makes procedural memory an evolving state of tool-augmented search self-play. A challenger poses problems, while a separately parameterized solver alone retrieves skills. Informative failures are distilled into reusable skills and written back to memory. The updated memory changes solver behavior and success, which changes the challenger's reward and the distribution of future problems; the resulting frontier produces new failures that rewrite memory. This bidirectional loop makes task generation and skill memory co-evolve. Because retrieved skills shape on-policy training trajectories, their benefits can enter the model parameters as well as remain in the external bank, enabling memory-free deployment and optional inference-time retrieval. Across seven open-domain and multi-hop question-answering benchmarks, SESA improves average accuracy over SSP by 1.2--3.2 points across multiple backbones and surpasses the skill-augmented SkillRL baseline by 0.9 points under a unified evaluation protocol. On Qwen3 models, SESA-Off retains 1.8--2.2 points of improvement over SSP, while the final skill bank adds a further 0.5--1.0 points. These results show that evolving skill memory is not merely an inference-time plug-in: it changes policy learning and the future training distribution while retaining value as optional external memory. Our code is available at https://github.com/Zenghuang-Fu/SESA-Self-Evolving-Search-Agents.

Comprehensive quantification of cardiac structures from computed tomography (CT) remains limited not by data availability but by the scalability of measurements, which makes routine use impractical. Here we present a unified framework for comprehensive cardiac CT segmentation and phenotyping that combines a human-in-the-loop annotation pipeline, a cardiac CT augmentation technique, and a self-supervised foundation model pre-trained on 60,000 unlabeled cardiac CT scans. Using this approach, we assembled the largest and most comprehensive expert-annotated cardiac CT segmentation dataset to date, comprising 1598 cases and 14 distinct cardiac structures (1000 for training, 598 for the external test set). Across five external datasets, the framework segmented all structures more accurately and comprehensively than existing open-source tools. Self-supervised pre-training improved labeling efficiency, with the most significant gains observed during external evaluation in the low-data regime. Benchmarking across convolutional, transformer, and state-space architectures showed comparable performance, indicating that data quality and pre-training, rather than architecture, drove accuracy. The framework was scaled to population-level phenotyping, with segmented anatomy that carries functionally relevant information about ventricular function and disease severity beyond demographic variables. By openly releasing the largest dataset with human labels, code, model weights, a CT augmentation library, and software, this work provides a reproducible foundation for opportunistic cardiac phenotyping from routinely acquired CT scans.

Forecasting the future anatomy of slow-evolving neurodegenerative diseases could enable earlier, more targeted intervention and improve clinical trial design, but it remains challenging because true progression signals are subtle in longitudinal MRI. In this low-signal regime, transferring modern generative sequence models directly is unreliable: training is dominated by stable baseline anatomy and confounded by dense, sample-specific nuisance variation. We first provide a theoretical analysis that explains these failures through two modes. Identity collapse occurs when optimization is driven toward reproducing the current anatomy, which prevents the model from learning faint temporal change. The continuous interpolation trap arises when standard smooth networks cannot separate localized biological drift from pervasive noise, which leads to spurious changes that diffuse across the volume. To address both issues, we propose Latent Drift, a progressive generative framework that learns change in a compressed semantic representation rather than synthesizing full-resolution anatomy. This design removes pixel-level identity from the prediction target and concentrates model capacity on progression-relevant dynamics. We further apply Finite Scalar Quantization to the learned change representation, which suppresses small, high-frequency nuisance fluctuations while preserving consistent structural drift. Experiments on longitudinal 3D brain MRI show that Latent Drift improves patient-specific neuro-forecasting over diffusion and autoregressive transformer baselines across generative fidelity and clinically relevant evaluation metrics. Project page: https://cutepkq.github.io/latent-drift{https://cutepkq.github.io/latent-drift}.

Self-evolution methods enhance code generation through iterative "generate-verify-refine" cycles, yet existing approaches suffer from low exploration efficiency, failing to discover solutions with superior complexity within limited budgets. This inefficiency stems from initialization bias trapping evolution in poor solution regions, uncontrolled stochastic operations lacking feedback guidance, and insufficient experience utilization across tasks. To address these bottlenecks, we propose Controlled Self-Evolution (CSE), which consists of three key components. Diversified Planning Initialization generates structurally distinct algorithmic strategies for broad solution space coverage. Genetic Evolution replaces stochastic operations with feedback-guided mechanisms, enabling targeted mutation and compositional crossover. Hierarchical Evolution Memory captures both successful and failed experiences at inter-task and intra-task levels. Experiments on EffiBench-X demonstrate that CSE consistently outperforms all baselines across various LLM backbones. Furthermore, CSE achieves higher efficiency from early generations and maintains continuous improvement throughout evolution. Our code is publicly available at https://github.com/QuantaAlpha/EvoControl.