arXiv:2602.13666v1 Announce Type: cross Abstract: In complex clinical decision-making, clinicians must often track a variety of competing metrics defined by aim (ideal) and limit (strict) thresholds. Sifting through these high-dimensional tradeoffs to infer the optimal patient-specific strategy is cognitively demanding and historically prone to variability. In this paper, we address this challenge within the context of High-Dose-Rate (HDR) brachytherapy for cervical cancer, where planning requires strictly managing radiation hot spots while balancing tumor coverage against organ sparing. We present ALMo (Aim-Limit-defined Multi-Objective system), an interactive decision support system designed to infer and operationalize clinician intent. ALMo employs a novel optimization framework that minimizes manual input through automated parameter setup and enables flexible control over toxicity risks. Crucially, the system allows clinicians to navigate the Pareto surface of dosimetric tradeoffs by directly manipulating intuitive aim and limit values. In a retrospective evaluation of 25 clinical cases, ALMo generated treatment plans that consistently met or exceeded manual planning quality, with 65% of cases demonstrating dosimetric improvements. Furthermore, the system significantly enhanced efficiency, reducing average planning time to approximately 17 minutes, compared to the conventional 30-60 minutes. While validated in brachytherapy, ALMo demonstrates a generalized framework for streamlining interaction in multi-criteria clinical decision-making.

arXiv:2601.20802v2 Announce Type: replace-cross Abstract: Large language models are increasingly post-trained with reinforcement learning in verifiable domains such as code and math. Yet, current methods for reinforcement learning with verifiable rewards (RLVR) learn only from a scalar outcome reward per attempt, creating a severe credit-assignment bottleneck. Many verifiable environments actually provide rich textual feedback, such as runtime errors or judge evaluations, that explain why an attempt failed. We formalize this setting as reinforcement learning with rich feedback and introduce Self-Distillation Policy Optimization (SDPO), which converts tokenized feedback into a dense learning signal without any external teacher or explicit reward model. SDPO treats the current model conditioned on feedback as a self-teacher and distills its feedback-informed next-token predictions back into the policy. In this way, SDPO leverages the model's ability to retrospectively identify its own mistakes in-context. Across scientific reasoning, tool use, and competitive programming on LiveCodeBench v6, SDPO improves sample efficiency and final accuracy over strong RLVR baselines. Notably, SDPO also outperforms baselines in standard RLVR environments that only return scalar feedback by using successful rollouts as implicit feedback for failed attempts. Finally, applying SDPO to individual questions at test time accelerates discovery on difficult binary-reward tasks, achieving the same discovery probability as best-of-k sampling or multi-turn conversations with 3x fewer attempts.