SearcharxivSearch

arXiv subjects

Qingyu Chen

Publications and source records attributed to Qingyu Chen.

At least 19 recordsLinked to original sources

HealMed: Multilingual Evaluation of Large Language Models in Medicine

We present HealMed, an expert-reviewed benchmark for multilingual evaluation of large language models in medicine. HealMed contains 1,000 examples in each of nine languages, drawn from nine datasets and covering three task formats: MCQA, NLI and open-ended QA. The benchmark was developed over two years by 23 physicians and medical experts based across nine countries and regions. Each translation was evaluated and revised by two experts fluent in English and the corresponding target language. On HealMed, performance declined most in low-resource languages, although the size of the gap varied markedly across languages and models. The strongest proprietary models were the most stable across languages, whereas many open-source and medically specialized models showed larger and less consistent gaps. Medical specialization alone did not ensure multilingual robustness. Furthermore, expert revision could either raise or lower measured performance, indicating that translation quality materially affects cross-language evaluation results.

cs.CL

verdi: retrieval is not transfer for continual world model optimization

Foundation world models have made remarkable progress in planning, simulation, and embodied intelligence. However, optimizing a pretrained world model toward a user-specified objective remains difficult: each campaign typically rediscovers optimization strategies from scratch, and the resulting knowledge rarely transfers to the next model. Existing research agents automate the optimization loop but treat successful strategies as directly reusable recipes, without principled safeguards for when transfer is appropriate. We argue instead that retrieval is not transfer: a strategy validated on one model is at best an optimization hypothesis for another, and becomes transferable knowledge only after target-side experimental valida- tion. Guided by this principle, we propose VERDI , a continual framework for evidence-licensed world model optimization. VERDI characterizes each world model through shared inference-time probes to construct an Optimization Fin- gerprint, retrieves relevant prior experience as ranked hypotheses, and validates every candidate under a frozen target-side verifier before admitting it as reusable evidence; contradictions among nearby fingerprints further trigger probe evolution, continually refining the diagnostic representation itself. Experiments on Ctrl-World, the Cosmos family, and RoboCoin show that VERDI reduces search cost by 68%, GPU cost by 69%, and negative transfer from 0.34 to 0.06, while predicting transfer outcomes with 83% sign accuracy.

cs.AI

A safety-oriented hypothetico-deductive framework for AI-assisted differential diagnosis

Diagnostic error is a major threat to patient safety, yet current large language model (LLM) systems often treat diagnosis as a one-shot prediction task, lacking safeguards against missed high-risk alternatives or rigorous verification of their reasoning. Here, we present AegisDx, a safety-oriented framework for hypothetico-deductive clinical reasoning. AegisDx coordinates specialized LLM components through role-specific contracts, structured intermediate outputs, evidence-retrieval interfaces, and verification gates to generate broad differential diagnoses, enforce explicit screening for dangerous "must-not-miss" conditions, verify reasoning against grounded medical evidence, and structure actionable next steps. We evaluated AegisDx across three layers. On literature-derived case reports from NEJM and JAMA, with GPT-oss-120B as the shared backbone, Top-3 diagnostic accuracy was 59.9% versus 52.1% for the standalone LLM on JAMA cases and 62.7% versus 51.4% on NEJM cases. On cases from Annals of Emergency Medicine, Top-3 accuracy was 85.7% versus 68.6%; against physician-consensus must-not-miss diagnosis sets, AegisDx captured at least one such condition among its top three diagnoses in 78.0% of cases versus 52.0%. In a blinded physician evaluation of 43 real-world emergency department notes from the Yale New Haven Health System compared against GPT-5, AegisDx improved the physician-rated composite safety score from 4.31 to 4.55 on a 5-point scale (adjusted p = 2.1x10^-4), with qualitative gains in must-not-miss identification and reasoning safety. Our findings suggest that engineering diagnostic AI as a safety-oriented reasoning framework, rather than optimizing raw predictive accuracy alone, can provide a safer, more transparent, and clinically meaningful layer of bedside decision support for acute care workflows.

cs.AI

MedPMC: A Systematic Framework for Scaling High-Fidelity Medical Multimodal Data for Foundation Models

Medicine is inherently multimodal, requiring clinicians to synthesize information across diverse data streams. Yet the development of multimodal foundation models is constrained by limited access to large-scale, high-quality clinical data. Although PubMed Central (PMC) offers a complementary source of expert-authored image-text data, existing PMC-derived resources remain limited in fidelity, reproducibility, and clinical validation. We introduce MedPMC, an automated, continuously updatable framework that transforms permissively licensed literature into high-fidelity infrastructure for medical multimodal models. Applied to 6.1 million PMC articles, MedPMC curated 11 million medical image-text pairs. Component evaluations showed strong performance for initial screening (F1 = 93.2), multi-panel figure detection (F1 = 96.5), figure separation (mAP = 89.8), caption separation and alignment (F1 = 81.4; ROUGE-L = 85.3), and medical figure classification (F1 = 96.5). Manual review by five annotators, three with medical training, found 95.3% of MedPMC images medically relevant, versus 19.7% in a prior PMC-derived dataset. Across 26 benchmarks spanning 11 specialties, a MedPMC-trained CLIP-style model improved average zero-shot AUC by 7.1 percentage points over the strongest architecture-matched biomedical CLIP baseline despite using fewer than half as many image-text pairs. As the vision encoder in a multimodal large language model, it improved medical visual question-answering by 1.9 and 16.9 percentage points across two benchmarks. In 10,524 Yale New Haven Health System dermatology photographs, it improved morphology-to-image retrieval Recall@5 by 11.7 percentage points. These findings show that high-fidelity literature curation strengthens medical multimodal foundation models across benchmark and clinical settings. We publicly release the framework, corpus, benchmarks, and pretrained models.

cs.CV

Benchmarking AI Agents for Addressing Scientific Challenges Across Scales

AI agents are increasingly being developed to accelerate scientific discovery, yet their practical capabilities in real research settings remain poorly understood. Existing benchmarks for AI agents rarely capture the complexity, heterogeneity, and extended reasoning required by scientific work, whereas benchmarks for scientific tasks often reduce research to static, direct problems and provide limited support for interactive evaluation. Here, we introduce SciAgentArena, a systematic benchmark for evaluating AI agents in real-world scientific research scenarios drawn from emerging needs across multiple domains. SciAgentArena comprises approximately 200 tasks with stepwise verification and an interactive, agent-agnostic environment for assessing diverse AI agents. Using this benchmark, we find that current agents can contribute effectively to well-specified data-analysis workflows, particularly when the task structure and evaluation criteria are clear. However, their performance remains uneven across scientific contexts: agents struggle to generate genuinely novel insights, sustain self-directed exploration, and formulate robust solutions for open-ended research questions. We further characterize common failure modes across agents and identify opportunities for improving their reliability, autonomy, and scientific reasoning. Together, SciAgentArena provides a practical framework for measuring progress in AI agents for science and for guiding the design of future agents capable of addressing complex scientific challenges. Full codes, tasks, and datasets can be accessed via this link: https://sciagentarena.github.io/.

cs.AI

TimeSRL: Generalizable Time-Series Behavioral Modeling via Semantic RL-Tuned LLMs -- A Case Study in Mental Health

Longitudinal passive sensing enables continuous health prediction, yet models often fail under cross-dataset distribution shifts. Traditional ML overfits cohort-specific artifacts, while Large Language Models (LLMs) struggle to reason reliably over long, heterogeneous time-series. We introduce TimeSRL, a two-stage LLM framework that routes predictions through an explicit semantic bottleneck. The model first abstracts raw signals into high-level natural language, then predicts behavioral outcomes from these abstractions alone. This forces the model to reason over semantic concepts that we argue generalize better than raw numbers. We optimize this process end-to-end using Group Relative Policy Optimization (GRPO) with Reinforcement Learning from Verifiable Rewards (RLVR), learning outcome-aligned abstractions without gold intermediate annotations. Instantiated on mental-health prediction, TimeSRL achieves state-of-the-art performance on a benchmark designed to stress-test cross-cohort generalization under a rigorous leave-one-dataset-out (LOSO) protocol, reducing mean absolute error (MAE) over strong non-LLM ML and LLM baselines by 3.1--10.1% and 9.5--44.1% for anxiety, and 3.2--9.6% and 27.4--57.6% for depression (all $p$s<0.05). TimeSRL significantly outperforms prior methods in cross-benchmark transfer across different sensing pipelines, rivaling its own within-domain performance without target-domain fine-tuning. These results demonstrate that semantic abstractions are reusable and point to a new direction for generalizable behavior modeling via RL-tuned LLMs.

cs.LG

Does Synthetic Layered Design Data Benefit Layered Design Decomposition?

Recent advances in image generation have made it easy to produce high-quality images. However, these outputs are inherently flattened, entangling foreground elements, background, and text within a fixed canvas. As a result, flexible post-generation editing remains challenging, revealing a clear last-mile gap toward practical usability. Existing approaches either rely on scarce proprietary layered assets or construct partially synthetic data from limited structural priors. However, both strategies face fundamental challenges in scalability. In this work, we investigate whether pure synthetic layered data can improve graphic design decomposition. We make the assumption that, in graphic design, effective decomposition does not require modeling inter-layer dependencies as precisely as in natural-image composition, since design elements are often intentionally arranged as modular and semantically separable components. Concretely, we conduct a data-centric study based on CLD baseline, which is a state-of-the-art layer decomposition framework. Based on the baseline, we construct our own synthetic dataset, SynLayers, generate textual supervision using vision language models, and automate inference inputs with VLM-predicted bounding boxes. Our study reveals three key findings: (1) even training with purely synthetic data can outperform non-scalable alternatives such as the widely used PrismLayersPro dataset, demonstrating its viability as a scalable and effective substitute; (2) performance consistently improves with increased training data scale, while gains begin to saturate at around 50K samples; and (3) synthetic data enables balanced control over layer-count distributions, avoiding the layer-count imbalance commonly observed in real-world datasets. We hope this data-centric study encourages broader adoption of synthetic data as a practical foundation for layered design editing systems.

cs.CV

Large Language Models Lack Temporal Awareness of Medical Knowledge

The existing methods for evaluating the medical knowledge of Large Language Models (LLMs) are largely based on atemporal examination-style benchmarks, while in reality, medical knowledge is inherently dynamic and continuously evolves as new evidence emerges and treatments are approved. Consequently, evaluating medical knowledge without a temporal context may provide an incomplete assessment of whether LLMs can accurately reason about time-specific medical knowledge. Moreover, most medical data are historical, requiring the models not only to recall the correct knowledge, but also to know when that knowledge is correct. To bridge the gap, we built TempoMed-Bench, the first-of-its-kind benchmark for evaluating the temporal awareness of the LLMs in the medical domain through evolving guideline knowledge. Based on the TempoMed-Bench, our evaluation analysis first reveals that LLMs lack temporal awareness in medical knowledge through the key findings: (1) model performance on up-to-date medical knowledge exhibits a gradual linear decline over time rather than a sharp knowledge-cutoff behavior, suggesting that parametric medical knowledge is not strictly bounded by knowledge cutoffs; (2) LLMs consistently struggle more with recalling outdated historical medical knowledge than with up-to-date recommendations: accuracy of historical knowledge is only 25.37%-53.89% of up-to-date knowledge, indicating potential knowledge forgetting effects during training; and (3) LLMs often exhibit temporally inconsistent behaviors, where predictions fluctuate irregularly across neighboring years. We also show that the temporal awareness problem is a challenge that cannot be easily solved when integrated with agentic search tools (-3.15%-14.14%). This work highlights an important yet underexplored challenge and motivates future research on developing LLMs that can better encode time-specific medical knowledge.

cs.LG

Resolving the bias-precision paradox with stochastic causal representation learning for personalized medicine

Estimating individualized treatment effects from longitudinal observational data is central to data-driven medicine, yet existing methods face a fundamental limitation: reducing confounding bias often suppresses clinically informative heterogeneity, degrading patient-specific predictions. Here, we identify this tension as a bias-precision paradox in causal representation learning and introduce sampling-based maximum mean discrepancy (sMMD), a stochastic alignment strategy that replaces global adversarial balancing with subset-level matching. We instantiate this approach in a framework for counterfactual outcome prediction with attribution-grounded interpretability. Across two large-scale ICU cohorts (n = 27,783), our framework improves accuracy under distribution shift, reducing error by up to 11.5% and substantially increasing recall in high-risk tasks. Mechanistic analyses show that sMMD selectively preserves clinically decisive variables. In human-AI evaluation, our method outperforms clinicians-in-training and large language models, and improves clinician accuracy by 14.7% while reducing decision time, enabling interpretable, real-time clinical decision support.

cs.AI

OphMAE: Bridging Volumetric and Planar Imaging with a Foundation Model for Adaptive Ophthalmological Diagnosis

The advent of foundation models has heralded a new era in medical artificial intelligence (AI), enabling the extraction of generalizable representations from large-scale unlabeled datasets. However, current ophthalmic AI paradigms are predominantly constrained to single-modality inference, thereby creating a dissonance with clinical practice where diagnosis relies on the synthesis of complementary imaging modalities. Furthermore, the deployment of high-performance AI in resource-limited settings is frequently impeded by the unavailability of advanced three-dimensional imaging hardware. Here, we present the Ophthalmic multimodal Masked Autoencoder (OphMAE), a multi-imaging foundation model engineered to synergize the volumetric depth of 3D Optical Coherence Tomography (OCT) with the planar context of 2D en face OCT. By implementing a novel cross-modal fusion architecture and a unique adaptive inference mechanism, OphMAE was pre-trained on a massive dataset with of 183,875 paired OCT images derived from 32,765 patients. In a rigorous benchmark encompassing 17 diverse diagnostic tasks with 48,340 paired OCT images from 8,191 patients, the model demonstrated state-of-the-art performance, achieving an Area Under the Curve (AUC) of 96.9% for Age-related Macular Degeneration (AMD) and 97.2% for Diabetic Macular Edema (DME), consistently surpassing existing single-modal and multimodal foundation models. Crucially, OphMAE exhibits robust engineering adaptability: it maintains high diagnostic accuracy, such as 93.7\% AUC for AMD, even when restricted to single-modality 2D inputs, and demonstrates exceptional data efficiency by retaining 95.7% AUC with as few as 500 labeled samples. This work establishes a scalable and adaptable framework for ophthalmic AI, ensuring robust performance across different tasks.

cs.CV

Foundation Models to Unlock Real-World Evidence from Nationwide Medical Claims

Evidence derived from large-scale real-world data (RWD) is increasingly informing regulatory evaluation and healthcare decision-making. Administrative claims provide population-scale, longitudinal records of healthcare utilization, expenditure, and detailed coding of diagnoses, procedures, and medications, yet their potential as a substrate for healthcare foundation models remains largely unexplored. Here we present ReClaim, a generative transformer trained from scratch on 43.8 billion medical events from more than 200 million enrollees in the MarketScan claims data spanning 2008-2022. ReClaim models longitudinal trajectories across diagnoses, procedures, medications, and expenditure, and was scaled to 140 million, 700 million, and 1.7 billion parameters. Across over 1,000 disease-onset prediction tasks, ReClaim achieved a mean AUC of 75.6%, substantially outperforming disease-specific LightGBM (66.3%) and the transformer-based Delphi model (69.4%), with the largest gains for rare diseases. These advantages held across retrospective and prospective evaluations and in external validation on two independent datasets. Performance improved monotonically with scale, and post-training added 13.8 percentage points over pre-training alone. Beyond disease prediction, ReClaim captured financial outcomes and improved real-world evidence (RWE) analyses: for healthcare expenditure forecasting it increased explained variance from 0.28 to 0.37 relative to LightGBM, and in a target trial emulation it reduced systematic bias by 72% on average relative to Delphi. Together, these results establish administrative claims as a scalable substrate for healthcare foundation models and show that learned representations generalize across time periods and data sources, supporting disease surveillance, expenditure forecasting, and RWE generation.

cs.AI

Are Multimodal LLMs Ready for Clinical Dermatology? A Real-World Evaluation in Dermatology

Multimodal large language models (MLLMs) have demonstrated promise on publicly available dermatology benchmarks. However, benchmark performance may not generalize to real-world dermatologic decision-making. To quantify this benchmark-to-bedside gap, we evaluated four open-weight MLLMs (InternVL-Chat v1.5, LLaVA-Med v1.5, SkinGPT4 and MedGemma-4B-Instruct) and one commercial MLLM (GPT-4.1) across three publicly available dermatology datasets and a retrospective multi-site hospital-based dermatology consultation cohort comprising 5,811 cases and 46,405 clinical images. Models were evaluated on two clinically relevant tasks: differential diagnosis generation and severity-based triage. Diagnostic performance was modest on public datasets and declined substantially in the real-world cohort. On public benchmarks, top-3 diagnostic accuracy reached 26.55% for the best open-weight model and 42.25% for GPT-4.1. On real-world consultation cases using images alone, top-3 diagnostic accuracy fell to 1.50%-13.35% among open-weight models and 24.65% for GPT-4.1. Incorporating clinical context improved performance across all models, increasing top-3 diagnostic accuracy up to 28.75% among open-weight models and 38.93% for GPT-4.1. However, model outputs were highly sensitive to incomplete or erroneous consultation context. For severity-based triage, models achieved moderate sensitivity (above 60%), suggesting potential utility for screening but insufficient reliability for clinical deployment. These findings demonstrate that benchmark performance substantially overestimates the real-world clinical capability of current dermatology MLLMs.

cs.CV

VOLMO: Versatile and Open Large Models for Ophthalmology

Vision impairment affects millions globally, and early detection is critical to preventing irreversible vision loss. Ophthalmology workflows require clinicians to integrate medical images, structured clinical data, and free-text notes to determine disease severity and management, which is time-consuming and burdensome. Recent multimodal large language models (MLLMs) show promise, but existing general and medical MLLMs perform poorly in ophthalmology, and few ophthalmology-specific MLLMs are openly available. We present VOLMO (Versatile and Open Large Models for Ophthalmology), a model-agnostic, data-open framework for developing ophthalmology-specific MLLMs. VOLMO includes three stages: ophthalmology knowledge pretraining on 86,965 image-text pairs from 26,569 articles across 82 journals; domain task fine-tuning on 26,929 annotated instances spanning 12 eye conditions for disease screening and severity classification; and multi-step clinical reasoning on 913 patient case reports for assessment, planning, and follow-up care. Using this framework, we trained a compact 2B-parameter MLLM and compared it with strong baselines, including InternVL-2B, LLaVA-Med-7B, MedGemma-4B, MedGemma-27B, and RETFound. We evaluated these models on image description generation, disease screening and staging classification, and assessment-and-management generation, with additional manual review by two healthcare professionals and external validation on three independent cohorts for age-related macular degeneration and diabetic retinopathy. Across settings, VOLMO-2B consistently outperformed baselines, achieving stronger image description performance, an average F1 of 87.4% across 12 eye conditions, and higher scores in external validation.

cs.CV

Deliberative multi-agent large language models improve clinical reasoning in ophthalmology

Large language models (LLMs) show potential for ophthalmic clinical reasoning, yet individual models risk introducing harm. We evaluated whether multi-agent LLM deliberative councils improve diagnostic performance and mitigate harm compared to individual LLMs. In a comparative cross-sectional study, we assessed 12 individual LLMs and three multi-agent councils on 100 ophthalmology clinical vignettes. Each council comprised four models assembled by type: proprietary flagship, proprietary fast, and open-source. Models independently answered a vignette, anonymously ranked one another's responses, and a designated chair synthesized all responses and peer reviews into a final answer. Councils consistently outperformed pooled individual models across all three tiers. Accuracy improved for proprietary flagship (95.0% vs 90.8%; risk difference [RD]: 4.25 [95% CI: 0.45, 8.05]), proprietary fast (96.0% vs 86.5%; RD: 9.50 [5.31, 13.59]), and open-source councils (91.0% vs 83.2%; RD: 7.75 [4.17, 11.33]). Harm rates declined for proprietary flagship (10.0% vs 22.5%; RD: -12.50 [-16.86, -8.14]), proprietary fast (16.0% vs 31.8%; RD: -15.75 [-21.49, -10.01]), and open-source councils (22.0% vs 38.5%; RD: -16.50 [-22.27, -10.73]). Coverage analysis revealed net positive gains for accuracy ({\Delta}Coverage: 4.4-9.8 percentage points) and safety ({\Delta}Coverage: 13.6-20.6), indicating councils recovered correct diagnoses and averted harm. Councils elevated correct diagnoses to higher rank positions; and produced more complete differentials and management plans (all P<.05). Harmful council responses showed reduced combined commission-and-omission errors and tended to be less severe. Structured deliberation via multi-agent LLM councils may enhance the reliability of LLM-assisted ophthalmic clinical reasoning.

cs.CY

FSVideo: Fast Speed Video Diffusion Model in a Highly-Compressed Latent Space

We introduce FSVideo, a fast speed transformer-based image-to-video (I2V) diffusion framework. We build our framework on the following key components: 1.) a new video autoencoder with highly-compressed latent space ($64\times64\times4$ spatial-temporal downsampling ratio), achieving competitive reconstruction quality; 2.) a diffusion transformer (DIT) architecture with a new layer memory design to enhance inter-layer information flow and context reuse within DIT, and 3.) a multi-resolution generation strategy via a few-step DIT upsampler to increase video fidelity. Our final model, which contains a 14B DIT base model and a 14B DIT upsampler, achieves competitive performance against other popular open-source models, while being an order of magnitude faster. We discuss our model design as well as training strategies in this report.

cs.CV

EHR-RAG: Bridging Long-Horizon Structured Electronic Health Records and Large Language Models via Enhanced Retrieval-Augmented Generation

Electronic Health Records (EHRs) provide rich longitudinal clinical evidence that is central to medical decision-making, motivating the use of retrieval-augmented generation (RAG) to ground large language model (LLM) predictions. However, long-horizon EHRs often exceed LLM context limits, and existing approaches commonly rely on truncation or vanilla retrieval strategies that discard clinically relevant events and temporal dependencies. To address these challenges, we propose EHR-RAG, a retrieval-augmented framework designed for accurate interpretation of long-horizon structured EHR data. EHR-RAG introduces three components tailored to longitudinal clinical prediction tasks: Event- and Time-Aware Hybrid EHR Retrieval to preserve clinical structure and temporal dynamics, Adaptive Iterative Retrieval to progressively refine queries in order to expand broad evidence coverage, and Dual-Path Evidence Retrieval and Reasoning to jointly retrieves and reasons over both factual and counterfactual evidence. Experiments across four long-horizon EHR prediction tasks show that EHR-RAG consistently outperforms the strongest LLM-based baselines, achieving an average Macro-F1 improvement of 10.76%. Overall, our work highlights the potential of retrieval-augmented LLMs to advance clinical prediction on structured EHR data in practice.

cs.AI

Toward Federated Large Language Models in Medicine: A Parameter-Efficient Framework for Privacy-Preserving, Multi-Institutional Adaptation

Large language models (LLMs) are increasingly adapted for medical applications, but most are trained using data from a single institution because privacy and governance constraints prevent multi-institutional data sharing. As a result, these models often generalize poorly across heterogeneous healthcare systems. We address this gap by introducing Fed-MedLoRA and Fed-MedLoRA+, a parameter-efficient federated framework for collaborative LLM adaptation across healthcare institutions. Fed-MedLoRA transmits only low-rank adapters rather than full model weights, reducing communication overhead. We also evaluate a privacy-preserving variant that applies Gaussian perturbation to transmitted adapter updates. Fed-MedLoRA+ further incorporates adaptive aggregation to better address cross-site heterogeneity in patient populations, annotation practices, and disease distributions. We evaluate the framework on clinical information extraction across five independent patient cohorts totaling 42,198 entities and 41,570 relations, and compare it with zero-shot and fine-tuned LLMs, domain-specific BERT models, and federated baselines. Across all settings, the proposed methods consistently improve extraction performance and generalize better to heterogeneous cohorts. In a real-world case study using clinical notes from the Yale New Haven Health System, the framework demonstrates strong performance under low-resource new-site deployment. These results suggest that federated, parameter-efficient LLM adaptation is feasible, scalable, and effective for multi-institutional clinical deployment.

cs.CL

OS-Marathon: Benchmarking Computer-Use Agents on Vast-Horizon, Repetitive Tasks

Vast-horizon, repetitive workflows are common in daily routines, e.g., processing expense reports from a stack of receipts, organising a collection of PDF annotations into structured notes, and are tedious for humans, with execution length scaling with the volume of data to process. They are, however, well-suited to autonomous agents, since their structured, recurring sub-workflows follow a logic that can be systematically learned. Yet no existing benchmark evaluates agents specifically on vast-horizon, repetitive capabilities, leaving the problem largely underexplored. To bridge this gap, we establish OS-Marathon, comprising 100 vast-horizon, repetitive tasks across 5 scenarios and 10 domains, on which our evaluation reveals that leading state-of-the-art (SOTA) CUAs struggle substantially. We further find that introducing a task orchestrator to decompose the workflow into per-instance subtasks fails to mitigate the challenge: errors accumulate and propagate across solver agents, indicating that naive decomposition is insufficient for these tasks. We then explore a cost-friendly personalisation strategy, i.e. GraphDemo, that adapts general agents to such tasks from a single human demonstration of the recurring sub-workflow logic. Extensive experiments show both the real-world challenge of vast-horizon, repetitive tasks and the improvement provided by human demonstration in this setting. Project website: https://os-marathon.github.io/.

cs.CV