Visual commissions require image agents to integrate heterogeneous source materials, preserve requirements across dependent stages, and produce coordinated deliverables. Existing evaluations examine specific capabilities and execution settings, leaving end-to-end commission completion less understood. We introduce Visual Commission Bench (VCB), comprising 600 tasks across 12 categories and three complementary tiers, from capability-focused tasks to complete commissions. VCB uses 5,039 requirement checks and separate visual quality ratings to assess content correctness, visual realization, constraint preservation, and delivery completeness without prescribing an internal workflow. We present V-Protocol, a reference agent that dynamically composes reusable task, cognitive, and expression modules at inference time. Task modules organize delivery, cognitive modules derive content, and expression modules guide visual realization. The modules exchange structured intermediate artifacts, while a shared execution harness tracks artifact revisions and dependencies, manages tool execution, and checks completion. With the same controller and image generator as the agent baselines, V-Protocol achieves 69.0\% strict task success on VCB, compared with 42.0\% for SCOPE. On Mind-Bench, strict accuracy increases from 39.2\% to 45.4\%.
Pneumonia changes across respiration, inflammation, and organ function, while the measurements that describe it arrive at different times and are often incomplete. We introduce PULMOWORLD, a world model for longitudinal pneumonia dynamics that connects asynchronous state estimation, recursive simulation, and evidence-constrained planning. History-aware filtering separates state propagation from observation-driven correction, so a measurement updates the shared belief only when it is observed. That belief supports recursive forecasts of clinical values and modality representations, and summaries of future prognosis. Cap-MBRL searches imagined continuations inside an authorized action set and replaces a frozen fallback only when a candidate meets the risk budget and a predicted-cost margin. On the pneumonia cohort MASS, recursive forecasts are competitive with task-trained sequence models, and simulated future states retain prognostic information. Trained separately on public MIMIC-IV-CXR chest radiographs and clinical trajectories, this model improves prognostic discrimination over latest-value fusion in development and is competitive on long-horizon error on the locked pneumonia panel. In five known-mechanism MASS-Syn environments, Cap-MBRL lowers selection regret relative to direct fallback execution.