Daily Papers

Emergency Medical Services (EMS) responders often operate under time-sensitive conditions, facing cognitive overload and inherent risks, requiring essential skills in critical thinking and rapid decision-making. This paper presents CognitiveEMS, an end-to-end wearable cognitive assistant system that can act as a collaborative virtual partner engaging in the real-time acquisition and analysis of multimodal data from an emergency scene and interacting with EMS responders through Augmented Reality (AR) smart glasses. CognitiveEMS processes the continuous streams of data in real-time and leverages edge computing to provide assistance in EMS protocol selection and intervention recognition. We address key technical challenges in real-time cognitive assistance by introducing three novel components: (i) a Speech Recognition model that is fine-tuned for real-world medical emergency conversations using simulated EMS audio recordings, augmented with synthetic data generated by large language models (LLMs); (ii) an EMS Protocol Prediction model that combines state-of-the-art (SOTA) tiny language models with EMS domain knowledge using graph-based attention mechanisms; (iii) an EMS Action Recognition module which leverages multimodal audio and video data and protocol predictions to infer the intervention/treatment actions taken by the responders at the incident scene. Our results show that for speech recognition we achieve superior performance compared to SOTA (WER of 0.290 vs. 0.618) on conversational data. Our protocol prediction component also significantly outperforms SOTA (top-3 accuracy of 0.800 vs. 0.200) and the action recognition achieves an accuracy of 0.727, while maintaining an end-to-end latency of 3.78s for protocol prediction on the edge and 0.31s on the server.

Vision-Language Models (VLMs) have demonstrated impressive capabilities in understanding visual content, but their reliability in safety-critical contexts remains under-explored. We introduce VERI (Visual Emergency Recognition Dataset), a carefully designed diagnostic benchmark of 200 images (100 contrastive pairs). Each emergency scene is matched with a visually similar but safe counterpart through multi-stage human verification and iterative refinement. Using a two-stage protocol - risk identification and emergency response - we evaluate 14 VLMs (2B-124B parameters) across medical emergencies, accidents, and natural disasters. Our analysis reveals a systematic overreaction problem: models excel at identifying real emergencies (70-100 percent success rate) but suffer from an alarming rate of false alarms, misidentifying 31-96 percent of safe situations as dangerous, with 10 scenarios failed by all models regardless of scale. This "better-safe-than-sorry" bias manifests primarily through contextual overinterpretation (88-93 percent of errors), challenging VLMs' reliability for safety applications. These findings highlight persistent limitations that are not resolved by increasing model scale, motivating targeted approaches for improving contextual safety assessment in visually misleading scenarios.

Conversational diagnosis prediction requires models to track evolving evidence in streaming clinical conversations and decide when to commit to a diagnosis. Existing medical dialogue corpora are largely dyadic or lack the multi-party workflow and annotations needed for this setting. We introduce an ePCR-grounded, topic-flow-based multi-agent generation pipeline that iteratively plans, generates, and self-refines dialogues with rule-based factual and topic flow checks. The pipeline yields EMSDialog, a dataset of 4,414 synthetic multi-speaker EMS conversations based on a real-world ePCR dataset, annotated with 43 diagnoses, speaker roles, and turn-level topics. Human and LLM evaluations confirm high quality and realism of EMSDialog using both utterance- and conversation-level metrics. Results show that EMSDialog-augmented training improves accuracy, timeliness, and stability of EMS conversational diagnosis prediction. Our datasets and code are publicly available at https://uva-dsa.github.io/EMSDialog

Background: AI-driven prediction algorithms have the potential to enhance emergency medicine by enabling rapid and accurate decision-making regarding patient status and potential deterioration. However, the integration of multimodal data, including raw waveform signals, remains underexplored in clinical decision support. Methods: We present a dataset and benchmarking protocol designed to advance multimodal decision support in emergency care. Our models utilize demographics, biometrics, vital signs, laboratory values, and electrocardiogram (ECG) waveforms as inputs to predict both discharge diagnoses and patient deterioration. Results: The diagnostic model achieves area under the receiver operating curve (AUROC) scores above 0.8 for 609 out of 1,428 conditions, covering both cardiac (e.g., myocardial infarction) and non-cardiac (e.g., renal disease, diabetes) diagnoses. The deterioration model attains AUROC scores above 0.8 for 14 out of 15 targets, accurately predicting critical events such as cardiac arrest, mechanical ventilation, ICU admission, and mortality. Conclusions: Our study highlights the positive impact of incorporating raw waveform data into decision support models, improving predictive performance. By introducing a unique, publicly available dataset and baseline models, we provide a foundation for measurable progress in AI-driven decision support for emergency care.

Large language models (LLMs) trained with next-word-prediction have achieved success as clinical foundation models. Representations from these language backbones yield strong linear probe performance across biomedical tasks, suggesting that patient semantics emerge from next-token prediction at scale. However, this paradigm treats patients as a document to be summarized rather than a dynamical system to be simulated; a patient's trajectory emerges from their state evolving under interventions and time, requiring models that simulate dynamics rather than predict tokens. To address this, we introduce SMB-Structure, a world model for structured EHR that grounds a joint-embedding prediction architecture (JEPA) with next-token prediction (SFT). SFT grounds our model to reconstruct future patient states in token space, while JEPA predicts those futures in latent space from the initial patient representation alone, forcing trajectory dynamics to be encoded before the next state is observed. We validate across two large-scale cohorts: Memorial Sloan Kettering (23,319 oncology patients; 323,000+ patient-years) and INSPECT (19,402 pulmonary embolism patients). Using a linear probe evaluated at multiple points along the disease trajectory, we demonstrate that our training paradigm learns embeddings that capture disease dynamics not recoverable by autoregressive baselines, enabling SMB-Structure to achieve competitive performance on complex tasks characterized by high patient heterogeneity. Model weights are available at https://huggingface.co/standardmodelbio/SMB-v1-1.7B-Structure.

Developing clinical prediction models (e.g., mortality prediction) based on electronic health records (EHRs) typically relies on expert opinion for feature selection and adjusting observation window size. This burdens experts and creates a bottleneck in the development process. We propose Retrieval-Enhanced Medical prediction model (REMed) to address such challenges. REMed can essentially evaluate an unlimited number of clinical events, select the relevant ones, and make predictions. This approach effectively eliminates the need for manual feature selection and enables an unrestricted observation window. We verified these properties through experiments on 27 clinical tasks and two independent cohorts from publicly available EHR datasets, where REMed outperformed other contemporary architectures that aim to handle as many events as possible. Notably, we found that the preferences of REMed align closely with those of medical experts. We expect our approach to significantly expedite the development of EHR prediction models by minimizing clinicians' need for manual involvement.

Medical triage is the task of allocating medical resources and prioritizing patients based on medical need. This paper introduces the first large-scale public dataset for studying medical triage in the context of asynchronous outpatient portal messages. Our novel task formulation views patient message triage as a pairwise inference problem, where we train LLMs to choose `"which message is more medically urgent" in a head-to-head tournament-style re-sort of a physician's inbox. Our novel benchmark PMR-Bench contains 1569 unique messages and 2,000+ high-quality test pairs for pairwise medical urgency assessment alongside a scalable training data generation pipeline. PMR-Bench includes samples that contain both unstructured patient-written messages alongside real electronic health record (EHR) data, emulating a real-world medical triage scenario. We develop a novel automated data annotation strategy to provide LLMs with in-domain guidance on this task. The resulting data is used to train two model classes, UrgentReward and UrgentSFT, leveraging Bradley-Terry and next token prediction objective, respectively to perform pairwise urgency classification. We find that UrgentSFT achieves top performance on PMR-Bench, with UrgentReward showing distinct advantages in low-resource settings. For example, UrgentSFT-8B and UrgentReward-8B provide a 15- and 16-point boost, respectively, on inbox sorting metrics over off-the-shelf 8B models. Paper resources can be found at https://tinyurl.com/Patient-Message-Triage

Electronic Health Records (EHRs) contain rich temporal dynamics that conventional encoding approaches fail to adequately capture. While Large Language Models (LLMs) show promise for EHR modeling, they struggle to reason about sequential clinical events and temporal dependencies. We propose Next Event Prediction (NEP), a framework that enhances LLMs' temporal reasoning through autoregressive fine-tuning on clinical event sequences. By reformulating EHRs as timestamped event chains and predicting future medical events, NEP explicitly models disease progression patterns and causal relationships. Extensive evaluations across oncology survival prediction and clinical diagnosis tasks demonstrate NEP's superiority, outperforming specialized EHR models by 4.6% AUROC and general-purpose LLMs by 7.2% C-index in temporal reasoning tasks. Our analyses reveal dual benefits: state-of-the-art prediction accuracy combined with clinically interpretable attention patterns that align with known disease pathways.

We present a foundation model-derived method to identify highly informative tokens and events in electronic health records. Our approach considers incoming data in the entire context of a patient's hospitalization and so can flag anomalous events that rule-based approaches would consider within a normal range. We demonstrate that the events our model flags are significant for predicting downstream patient outcomes and that a fraction of events identified as carrying little information can safely be dropped. Additionally, we show how informativeness can help interpret the predictions of prognostic models trained on foundation model-derived representations.

We developed an explainable artificial intelligence (AI) early warning score (xAI-EWS) system for early detection of acute critical illness. While maintaining a high predictive performance, our system explains to the clinician on which relevant electronic health records (EHRs) data the prediction is grounded. Acute critical illness is often preceded by deterioration of routinely measured clinical parameters, e.g., blood pressure and heart rate. Early clinical prediction is typically based on manually calculated screening metrics that simply weigh these parameters, such as Early Warning Scores (EWS). The predictive performance of EWSs yields a tradeoff between sensitivity and specificity that can lead to negative outcomes for the patient. Previous work on EHR-trained AI systems offers promising results with high levels of predictive performance in relation to the early, real-time prediction of acute critical illness. However, without insight into the complex decisions by such system, clinical translation is hindered. In this letter, we present our xAI-EWS system, which potentiates clinical translation by accompanying a prediction with information on the EHR data explaining it.

Acute poly-substance intoxication requires rapid, life-saving decisions under substantial uncertainty, as clinicians must rely on incomplete ingestion details and nonspecific symptoms. Effective diagnostic reasoning in this chaotic environment requires fusing unstructured, non-medical narratives (e.g. paramedic scene descriptions and unreliable patient self-reports or known histories), with structured medical data like vital signs. While Large Language Models (LLMs) show potential for processing such heterogeneous inputs, they struggle in this setting, often underperforming simple baselines that rely solely on patient histories. To address this, we present DeToxR (Decision-support for Toxicology with Reasoning), the first adaptation of Reinforcement Learning (RL) to emergency toxicology. We design a robust data-fusion engine for multi-label prediction across 14 substance classes based on an LLM finetuned with Group Relative Policy Optimization (GRPO). We optimize the model's reasoning directly using a clinical performance reward. By formulating a multi-label agreement metric as the reward signal, the model is explicitly penalized for missing co-ingested substances and hallucinating absent poisons. Our model significantly outperforms its unadapted base LLM counterpart and supervised baselines. Furthermore, in a clinical validation study, the model indicates a clinical advantage by outperforming an expert toxicologist in identifying the correct poisons (Micro-F1: 0.644 vs. 0.473). These results demonstrate the potential of RL-aligned LLMs to synthesize unstructured pre-clinical narratives and structured medical data for decision support in high-stakes environments.

This paper introduces the Emirates Multi-Task (EMT) dataset - the first publicly available dataset for autonomous driving collected in the Arab Gulf region. The EMT dataset captures the unique road topology, high traffic congestion, and distinctive characteristics of the Gulf region, including variations in pedestrian clothing and weather conditions. It contains over 30,000 frames from a dash-camera perspective, along with 570,000 annotated bounding boxes, covering approximately 150 kilometers of driving routes. The EMT dataset supports three primary tasks: tracking, trajectory forecasting and intention prediction. Each benchmark dataset is complemented with corresponding evaluations: (1) multi-agent tracking experiments, focusing on multi-class scenarios and occlusion handling; (2) trajectory forecasting evaluation using deep sequential and interaction-aware models; and (3) intention benchmark experiments conducted for predicting agents intentions from observed trajectories. The dataset is publicly available at avlab.io/emt-dataset, and pre-processing scripts along with evaluation models can be accessed at github.com/AV-Lab/emt-dataset.

Employing a machine learning approach we predict, up to 24 hours prior, a diagnosis of severe sepsis. Strongly predictive models are possible that use only text reports from the Electronic Health Record (EHR), and omit structured numerical data. Unstructured text alone gives slightly better performance than structured data alone, and the combination further improves performance. We also discuss advantages of using unstructured EHR text for modeling, as compared to structured EHR data.

The demand for emergency department (ED) services is increasing across the globe, particularly during the current COVID-19 pandemic. Clinical triage and risk assessment have become increasingly challenging due to the shortage of medical resources and the strain on hospital infrastructure caused by the pandemic. As a result of the widespread use of electronic health records (EHRs), we now have access to a vast amount of clinical data, which allows us to develop predictive models and decision support systems to address these challenges. To date, however, there are no widely accepted benchmark ED triage prediction models based on large-scale public EHR data. An open-source benchmarking platform would streamline research workflows by eliminating cumbersome data preprocessing, and facilitate comparisons among different studies and methodologies. In this paper, based on the Medical Information Mart for Intensive Care IV Emergency Department (MIMIC-IV-ED) database, we developed a publicly available benchmark suite for ED triage predictive models and created a benchmark dataset that contains over 400,000 ED visits from 2011 to 2019. We introduced three ED-based outcomes (hospitalization, critical outcomes, and 72-hour ED reattendance) and implemented a variety of popular methodologies, ranging from machine learning methods to clinical scoring systems. We evaluated and compared the performance of these methods against benchmark tasks. Our codes are open-source, allowing anyone with MIMIC-IV-ED data access to perform the same steps in data processing, benchmark model building, and experiments. This study provides future researchers with insights, suggestions, and protocols for managing raw data and developing risk triaging tools for emergency care.

Automated attack discovery techniques, such as attacker synthesis or model-based fuzzing, provide powerful ways to ensure network protocols operate correctly and securely. Such techniques, in general, require a formal representation of the protocol, often in the form of a finite state machine (FSM). Unfortunately, many protocols are only described in English prose, and implementing even a simple network protocol as an FSM is time-consuming and prone to subtle logical errors. Automatically extracting protocol FSMs from documentation can significantly contribute to increased use of these techniques and result in more robust and secure protocol implementations. In this work we focus on attacker synthesis as a representative technique for protocol security, and on RFCs as a representative format for protocol prose description. Unlike other works that rely on rule-based approaches or use off-the-shelf NLP tools directly, we suggest a data-driven approach for extracting FSMs from RFC documents. Specifically, we use a hybrid approach consisting of three key steps: (1) large-scale word-representation learning for technical language, (2) focused zero-shot learning for mapping protocol text to a protocol-independent information language, and (3) rule-based mapping from protocol-independent information to a specific protocol FSM. We show the generalizability of our FSM extraction by using the RFCs for six different protocols: BGPv4, DCCP, LTP, PPTP, SCTP and TCP. We demonstrate how automated extraction of an FSM from an RFC can be applied to the synthesis of attacks, with TCP and DCCP as case-studies. Our approach shows that it is possible to automate attacker synthesis against protocols by using textual specifications such as RFCs.

Despite the remarkable progress in the development of predictive models for healthcare, applying these algorithms on a large scale has been challenging. Algorithms trained on a particular task, based on specific data formats available in a set of medical records, tend to not generalize well to other tasks or databases in which the data fields may differ. To address this challenge, we propose General Healthcare Predictive Framework (GenHPF), which is applicable to any EHR with minimal preprocessing for multiple prediction tasks. GenHPF resolves heterogeneity in medical codes and schemas by converting EHRs into a hierarchical textual representation while incorporating as many features as possible. To evaluate the efficacy of GenHPF, we conduct multi-task learning experiments with single-source and multi-source settings, on three publicly available EHR datasets with different schemas for 12 clinically meaningful prediction tasks. Our framework significantly outperforms baseline models that utilize domain knowledge in multi-source learning, improving average AUROC by 1.2%P in pooled learning and 2.6%P in transfer learning while also showing comparable results when trained on a single EHR dataset. Furthermore, we demonstrate that self-supervised pretraining using multi-source datasets is effective when combined with GenHPF, resulting in a 0.6%P AUROC improvement compared to models without pretraining. By eliminating the need for preprocessing and feature engineering, we believe that this work offers a solid framework for multi-task and multi-source learning that can be leveraged to speed up the scaling and usage of predictive algorithms in healthcare.

Hospitals struggle to predict critical outcomes. Traditional early warning systems, like NEWS and MEWS, rely on static variables and fixed thresholds, limiting their adaptability, accuracy, and personalization. We previously developed the Enhanced Transformer for Health Outcome Simulation (ETHOS), an AI model that tokenizes patient health timelines (PHTs) from EHRs and uses transformer-based architectures to predict future PHTs. ETHOS is a versatile framework for developing a wide range of applications. In this work, we develop the Adaptive Risk Estimation System (ARES) that leverages ETHOS to compute dynamic, personalized risk probabilities for clinician-defined critical events. ARES also features a personalized explainability module that highlights key clinical factors influencing risk estimates. We evaluated ARES using the MIMIC-IV v2.2 dataset together with its Emergency Department (ED) extension and benchmarked performance against both classical early warning systems and contemporary machine learning models. The entire dataset was tokenized resulting in 285,622 PHTs, comprising over 360 million tokens. ETHOS outperformed benchmark models in predicting hospital admissions, ICU admissions, and prolonged stays, achieving superior AUC scores. Its risk estimates were robust across demographic subgroups, with calibration curves confirming model reliability. The explainability module provided valuable insights into patient-specific risk factors. ARES, powered by ETHOS, advances predictive healthcare AI by delivering dynamic, real-time, personalized risk estimation with patient-specific explainability. Although our results are promising, the clinical impact remains uncertain. Demonstrating ARES's true utility in real-world settings will be the focus of our future work. We release the source code to facilitate future research.

As the performance of large language models (LLMs) continues to advance, their adoption is expanding across a wide range of domains, including the medical field. The integration of LLMs into medical applications raises critical safety concerns, particularly due to their use by users with diverse roles, e.g. patients and clinicians, and the potential for model's outputs to directly affect human health. Despite the domain-specific capabilities of medical LLMs, prior safety evaluations have largely focused only on general safety benchmarks. In this paper, we introduce a safety evaluation protocol tailored to the medical domain in both patient user and clinician user perspectives, alongside general safety assessments and quantitatively analyze the safety of medical LLMs. We bridge a gap in the literature by building the PatientSafetyBench containing 466 samples over 5 critical categories to measure safety from the perspective of the patient. We apply our red-teaming protocols on the MediPhi model collection as a case study. To our knowledge, this is the first work to define safety evaluation criteria for medical LLMs through targeted red-teaming taking three different points of view - patient, clinician, and general user - establishing a foundation for safer deployment in medical domains.

Accurately predicting the criticalness of ICU patients (such as in-ICU mortality risk) is vital for early intervention in critical care. However, conventional models often treat each patient in isolation and struggle to exploit the relational structure in Electronic Health Records (EHR). We propose a Similarity-Based Self-Construct Graph Model (SBSCGM) that dynamically builds a patient similarity graph from multi-modal EHR data, and a HybridGraphMedGNN architecture that operates on this graph to predict patient mortality and a continuous criticalness score. SBSCGM uses a hybrid similarity measure (combining feature-based and structural similarities) to connect patients with analogous clinical profiles in real-time. The HybridGraphMedGNN integrates Graph Convolutional Network (GCN), GraphSAGE, and Graph Attention Network (GAT) layers to learn robust patient representations, leveraging both local and global graph patterns. In experiments on 6,000 ICU stays from the MIMIC-III dataset, our model achieves state-of-the-art performance (AUC-ROC 0.94) outperforming baseline classifiers and single-type GNN models. We also demonstrate improved precision/recall and show that the attention mechanism provides interpretable insights into model predictions. Our framework offers a scalable and interpretable solution for critical care risk prediction, with potential to support clinicians in real-world ICU deployment.

Despite decades of clinical research, sepsis remains a global public health crisis with high mortality, and morbidity. Currently, when sepsis is detected and the underlying pathogen is identified, organ damage may have already progressed to irreversible stages. Effective sepsis management is therefore highly time-sensitive. By systematically analysing trends in the plethora of clinical data available in the intensive care unit (ICU), an early prediction of sepsis could lead to earlier pathogen identification, resistance testing, and effective antibiotic and supportive treatment, and thereby become a life-saving measure. Here, we developed and validated a machine learning (ML) system for the prediction of sepsis in the ICU. Our analysis represents the largest multi-national, multi-centre in-ICU study for sepsis prediction using ML to date. Our dataset contains 156,309 unique ICU admissions, which represent a refined and harmonised subset of five large ICU databases originating from three countries. Using the international consensus definition Sepsis-3, we derived hourly-resolved sepsis label annotations, amounting to 26,734 (17.1%) septic stays. We compared our approach, a deep self-attention model, to several clinical baselines as well as ML baselines and performed an extensive internal and external validation within and across databases. On average, our model was able to predict sepsis with an AUROC of 0.847 pm 0.050 (internal out-of sample validation) and 0.761 pm 0.052 (external validation). For a harmonised prevalence of 17%, at 80% recall our model detects septic patients with 39% precision 3.7 hours in advance.

Models that can predict the occurrence of events ahead of time with low false-alarm rates are critical to the acceptance of decision support systems in the medical community. This challenging task is typically treated as a simple binary classification, ignoring temporal dependencies between samples, whereas we propose to exploit this structure. We first introduce a common theoretical framework unifying dynamic survival analysis and early event prediction. Following an analysis of objectives from both fields, we propose Temporal Label Smoothing (TLS), a simpler, yet best-performing method that preserves prediction monotonicity over time. By focusing the objective on areas with a stronger predictive signal, TLS improves performance over all baselines on two large-scale benchmark tasks. Gains are particularly notable along clinically relevant measures, such as event recall at low false-alarm rates. TLS reduces the number of missed events by up to a factor of two over previously used approaches in early event prediction.

Foundation Models (FMs) trained on Electronic Health Records (EHRs) have achieved state-of-the-art results on numerous clinical prediction tasks. However, most existing EHR FMs have context windows of <1k tokens. This prevents them from modeling full patient EHRs which can exceed 10k's of events. Recent advancements in subquadratic long-context architectures (e.g., Mamba) offer a promising solution. However, their application to EHR data has not been well-studied. We address this gap by presenting the first systematic evaluation of the effect of context length on modeling EHR data. We find that longer context models improve predictive performance -- our Mamba-based model surpasses the prior state-of-the-art on 9/14 tasks on the EHRSHOT prediction benchmark. For clinical applications, however, model performance alone is insufficient -- robustness to the unique properties of EHR is crucial. Thus, we also evaluate models across three previously underexplored properties of EHR data: (1) the prevalence of "copy-forwarded" diagnoses which creates artificial repetition of tokens within EHR sequences; (2) the irregular time intervals between EHR events which can lead to a wide range of timespans within a context window; and (3) the natural increase in disease complexity over time which makes later tokens in the EHR harder to predict than earlier ones. Stratifying our EHRSHOT results, we find that higher levels of each property correlate negatively with model performance, but that longer context models are more robust to more extreme levels of these properties. Our work highlights the potential for using long-context architectures to model EHR data, and offers a case study for identifying new challenges in modeling sequential data motivated by domains outside of natural language. We release our models and code at: https://github.com/som-shahlab/long_context_clues

We study multiple rule-based and machine learning (ML) models for sepsis detection. We report the first neural network detection and prediction results on three categories of sepsis. We have used the retrospective Medical Information Mart for Intensive Care (MIMIC)-III dataset, restricted to intensive care unit (ICU) patients. Features for prediction were created from only common vital sign measurements. We show significant improvement of AUC score using neural network based ensemble model compared to single ML and rule-based models. For the detection of sepsis, severe sepsis, and septic shock, our model achieves an AUC of 0.97, 0.96 and 0.91, respectively. Four hours before the positive hours, it predicts the same three categories with an AUC of 0.90, 0.91 and 0.90 respectively. Further, we ranked the features and found that using six vital signs consistently provides higher detection and prediction AUC for all the models tested. Our novel ensemble model achieves highest AUC in detecting and predicting sepsis, severe sepsis, and septic shock in the MIMIC-III ICU patients, and is amenable to deployment in hospital settings.

The successes of foundation models such as ChatGPT and AlphaFold have spurred significant interest in building similar models for electronic medical records (EMRs) to improve patient care and hospital operations. However, recent hype has obscured critical gaps in our understanding of these models' capabilities. We review over 80 foundation models trained on non-imaging EMR data (i.e. clinical text and/or structured data) and create a taxonomy delineating their architectures, training data, and potential use cases. We find that most models are trained on small, narrowly-scoped clinical datasets (e.g. MIMIC-III) or broad, public biomedical corpora (e.g. PubMed) and are evaluated on tasks that do not provide meaningful insights on their usefulness to health systems. In light of these findings, we propose an improved evaluation framework for measuring the benefits of clinical foundation models that is more closely grounded to metrics that matter in healthcare.

Recent large language models (LLMs) have demonstrated significant advancements, particularly in their ability to serve as agents thereby surpassing their traditional role as chatbots. These agents can leverage their planning and tool utilization capabilities to address tasks specified at a high level. However, a standardized dataset to benchmark the agent capabilities of LLMs in medical applications is currently lacking, making the evaluation of LLMs on complex tasks in interactive healthcare environments challenging. To address this gap, we introduce MedAgentBench, a broad evaluation suite designed to assess the agent capabilities of large language models within medical records contexts. MedAgentBench encompasses 300 patient-specific clinically-derived tasks from 10 categories written by human physicians, realistic profiles of 100 patients with over 700,000 data elements, a FHIR-compliant interactive environment, and an accompanying codebase. The environment uses the standard APIs and communication infrastructure used in modern EMR systems, so it can be easily migrated into live EMR systems. MedAgentBench presents an unsaturated agent-oriented benchmark that current state-of-the-art LLMs exhibit some ability to succeed at. The best model (Claude 3.5 Sonnet v2) achieves a success rate of 69.67%. However, there is still substantial space for improvement which gives the community a next direction to optimize. Furthermore, there is significant variation in performance across task categories. MedAgentBench establishes this and is publicly available at https://github.com/stanfordmlgroup/MedAgentBench , offering a valuable framework for model developers to track progress and drive continuous improvements in the agent capabilities of large language models within the medical domain.

Medical systematic reviews can be very costly and resource intensive. We explore how Large Language Models (LLMs) can support and be trained to perform literature screening when provided with a detailed set of selection criteria. Specifically, we instruction tune LLaMA and Guanaco models to perform abstract screening for medical systematic reviews. Our best model, Bio-SIEVE, outperforms both ChatGPT and trained traditional approaches, and generalises better across medical domains. However, there remains the challenge of adapting the model to safety-first scenarios. We also explore the impact of multi-task training with Bio-SIEVE-Multi, including tasks such as PICO extraction and exclusion reasoning, but find that it is unable to match single-task Bio-SIEVE's performance. We see Bio-SIEVE as an important step towards specialising LLMs for the biomedical systematic review process and explore its future developmental opportunities. We release our models, code and a list of DOIs to reconstruct our dataset for reproducibility.

5G is the 5th generation cellular network protocol. It is the state-of-the-art global wireless standard that enables an advanced kind of network designed to connect virtually everyone and everything with increased speed and reduced latency. Therefore, its development, analysis, and security are critical. However, all approaches to the 5G protocol development and security analysis, e.g., property extraction, protocol summarization, and semantic analysis of the protocol specifications and implementations are completely manual. To reduce such manual effort, in this paper, we curate SPEC5G the first-ever public 5G dataset for NLP research. The dataset contains 3,547,586 sentences with 134M words, from 13094 cellular network specifications and 13 online websites. By leveraging large-scale pre-trained language models that have achieved state-of-the-art results on NLP tasks, we use this dataset for security-related text classification and summarization. Security-related text classification can be used to extract relevant security-related properties for protocol testing. On the other hand, summarization can help developers and practitioners understand the high level of the protocol, which is itself a daunting task. Our results show the value of our 5G-centric dataset in 5G protocol analysis automation. We believe that SPEC5G will enable a new research direction into automatic analyses for the 5G cellular network protocol and numerous related downstream tasks. Our data and code are publicly available.

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.

Biological protocols are fundamental to reproducible and safe life science research. While LLMs excel on general tasks, their systematic evaluation on these highly specialized, accuracy-critical, and inherently procedural texts remains limited. In this work, we present BioProBench, the first large-scale, integrated multi-task benchmark for biological protocol understanding and reasoning. While limited benchmarks have touched upon specific aspects like protocol QA, BioProBench provides a comprehensive suite of five core tasks: Protocol Question Answering, Step Ordering, Error Correction, Protocol Generation, and Protocol Reasoning, enabling a holistic evaluation of LLMs on procedural biological texts. Built upon 27K original protocols, it yields nearly 556K high-quality structured instances. We evaluate 12 mainstream open/closed-source LLMs on BioProBench. Experimental results reveal that while top models preform well on surface understanding tasks, struggle significantly with deep reasoning and structured generation tasks like ordering and generation. Furthermore, model comparisons reveal diverse performance: certain open-source models approach closed-source levels on some tasks, yet bio-specific small models lag behind general LLMs, indicating limitations on complex procedural content. Overall, our findings underscore that procedural reasoning within biological protocols represents a significant challenge for current LLMs. BioProBench serves as a standardized framework to diagnose these specific limitations and guide the development of AI systems better equipped for safely automating complex scientific procedures. The code and data are available at: https://github.com/YuyangSunshine/bioprotocolbench and https://huggingface.co/datasets/GreatCaptainNemo/BioProBench.

Electronic health records (EHRs) are multimodal by nature, consisting of structured tabular features like lab tests and unstructured clinical notes. In real-life clinical practice, doctors use complementary multimodal EHR data sources to get a clearer picture of patients' health and support clinical decision-making. However, most EHR predictive models do not reflect these procedures, as they either focus on a single modality or overlook the inter-modality interactions/redundancy. In this work, we propose MEDFuse, a Multimodal EHR Data Fusion framework that incorporates masked lab-test modeling and large language models (LLMs) to effectively integrate structured and unstructured medical data. MEDFuse leverages multimodal embeddings extracted from two sources: LLMs fine-tuned on free clinical text and masked tabular transformers trained on structured lab test results. We design a disentangled transformer module, optimized by a mutual information loss to 1) decouple modality-specific and modality-shared information and 2) extract useful joint representation from the noise and redundancy present in clinical notes. Through comprehensive validation on the public MIMIC-III dataset and the in-house FEMH dataset, MEDFuse demonstrates great potential in advancing clinical predictions, achieving over 90% F1 score in the 10-disease multi-label classification task.

Background: Electronic Health Records hold detailed longitudinal information about each patient's health status and general clinical history, a large portion of which is stored within the unstructured text. Existing approaches focus mostly on structured data and a subset of single-domain outcomes. We explore how temporal modelling of patients from free text and structured data, using deep generative transformers can be used to forecast a wide range of future disorders, substances, procedures or findings. Methods: We present Foresight, a novel transformer-based pipeline that uses named entity recognition and linking tools to convert document text into structured, coded concepts, followed by providing probabilistic forecasts for future medical events such as disorders, substances, procedures and findings. We processed the entire free-text portion from three different hospital datasets totalling 811336 patients covering both physical and mental health. Findings: On tests in two UK hospitals (King's College Hospital, South London and Maudsley) and the US MIMIC-III dataset precision@10 0.68, 0.76 and 0.88 was achieved for forecasting the next disorder in a patient timeline, while precision@10 of 0.80, 0.81 and 0.91 was achieved for forecasting the next biomedical concept. Foresight was also validated on 34 synthetic patient timelines by five clinicians and achieved relevancy of 97% for the top forecasted candidate disorder. As a generative model, it can forecast follow-on biomedical concepts for as many steps as required. Interpretation: Foresight is a general-purpose model for biomedical concept modelling that can be used for real-world risk forecasting, virtual trials and clinical research to study the progression of disorders, simulate interventions and counterfactuals, and educational purposes.

Current medical language models, adapted from large language models (LLMs), typically predict ICD code-based diagnosis from electronic health records (EHRs) because these labels are readily available. However, ICD codes do not capture the nuanced, context-rich reasoning clinicians use for diagnosis. Clinicians synthesize diverse patient data and reference clinical practice guidelines (CPGs) to make evidence-based decisions. This misalignment limits the clinical utility of existing models. We introduce GARMLE-G, a Generation-Augmented Retrieval framework that grounds medical language model outputs in authoritative CPGs. Unlike conventional Retrieval-Augmented Generation based approaches, GARMLE-G enables hallucination-free outputs by directly retrieving authoritative guideline content without relying on model-generated text. It (1) integrates LLM predictions with EHR data to create semantically rich queries, (2) retrieves relevant CPG knowledge snippets via embedding similarity, and (3) fuses guideline content with model output to generate clinically aligned recommendations. A prototype system for hypertension diagnosis was developed and evaluated on multiple metrics, demonstrating superior retrieval precision, semantic relevance, and clinical guideline adherence compared to RAG-based baselines, while maintaining a lightweight architecture suitable for localized healthcare deployment. This work provides a scalable, low-cost, and hallucination-free method for grounding medical language models in evidence-based clinical practice, with strong potential for broader clinical deployment.

The proliferation of Large Language Models (LLMs) presents transformative potential for healthcare, yet practical deployment is hindered by the absence of frameworks that assess real-world clinical utility. Existing benchmarks test static knowledge, failing to capture the dynamic, application-oriented capabilities required in clinical practice. To bridge this gap, we introduce a Medical LLM Benchmark MLB, a comprehensive benchmark evaluating LLMs on both foundational knowledge and scenario-based reasoning. MLB is structured around five core dimensions: Medical Knowledge (MedKQA), Safety and Ethics (MedSE), Medical Record Understanding (MedRU), Smart Services (SmartServ), and Smart Healthcare (SmartCare). The benchmark integrates 22 datasets (17 newly curated) from diverse Chinese clinical sources, covering 64 clinical specialties. Its design features a rigorous curation pipeline involving 300 licensed physicians. Besides, we provide a scalable evaluation methodology, centered on a specialized judge model trained via Supervised Fine-Tuning (SFT) on expert annotations. Our comprehensive evaluation of 10 leading models reveals a critical translational gap: while the top-ranked model, Kimi-K2-Instruct (77.3% accuracy overall), excels in structured tasks like information extraction (87.8% accuracy in MedRU), performance plummets in patient-facing scenarios (61.3% in SmartServ). Moreover, the exceptional safety score (90.6% in MedSE) of the much smaller Baichuan-M2-32B highlights that targeted training is equally critical. Our specialized judge model, trained via SFT on a 19k expert-annotated medical dataset, achieves 92.1% accuracy, an F1-score of 94.37%, and a Cohen's Kappa of 81.3% for human-AI consistency, validating a reproducible and expert-aligned evaluation protocol. MLB thus provides a rigorous framework to guide the development of clinically viable LLMs.

Satellite connectivity is gaining increased attention as the demand for seamless internet access, especially in transportation and remote areas, continues to grow. For fast-moving objects such as aircraft, vehicles, or trains, satellite connectivity is critical due to their mobility and frequent presence in areas without terrestrial coverage. Maintaining reliable connectivity in these cases requires frequent switching between satellite beams, constellations, or orbits. To enhance user experience and address challenges like long switching times, Machine Learning (ML) algorithms can analyze historical connectivity data and predict network quality at specific locations. This allows for proactive measures, such as network switching before connectivity issues arise. In this paper, we analyze a real dataset of communication between a Geostationary Orbit (GEO) satellite and aircraft over multiple flights, using ML to predict signal quality. Our prediction model achieved an F1 score of 0.97 on the test data, demonstrating the accuracy of machine learning in predicting signal quality during flight. By enabling seamless broadband service, including roaming between different satellite constellations and providers, our model addresses the need for real-time predictions of signal quality. This approach can further be adapted to automate satellite and beam-switching mechanisms to improve overall communication efficiency. The model can also be retrained and applied to any moving object with satellite connectivity, using customized datasets, including connected vehicles and trains.

Disasters are inevitable and increasingly costly, and effective response depends on querying structured tabular data: precise, information-dense records of hazard, exposure, vulnerability, and lifeline infrastructure that underpin disaster management. Current text-to-SQL methods enable natural-language access to such tables but transfer poorly to the disaster domain, where queries span heterogeneous geospatial schemas and require reasoning over causal relations. We introduce DisasterLex, a knowledge-graph-mediated framework that inserts an Expert Knowledge Graph (EKG) of curated concepts and typed causal edges between the user query and the database, bridged to schema by concept-to-table links. The orchestration runs four stages (identifying query entities, routing to the operational domain, planning over causal edges, and grounding the SQL), restricting the schema passed to the model at each step. We instantiate it on a disaster-analytics database (36 geospatial tables, 150 columns) with an EKG of 107 concepts, 117 causal edges, and 52 concept-to-schema links, evaluated on a 75-query test set. On all seven base models spanning proprietary and open-weight families, DisasterLex beats four state-of-the-art baselines (LightRAG, HippoRAG 2, ReFoRCE, CHESS) by 1.4x to 2.75x, with absolute scores of 1.65 to 3.56 (of 5.0). Error analysis shows baseline failures cluster in routing and multi-table SQL composition, the operations our orchestration explicitly addresses. Code, data, and the EKG artifact are available at https://github.com/YimingXiao98/DisasterLex and on Zenodo at https://doi.org/10.5281/zenodo.20388029.

Agent communication protocols are becoming critical infrastructure for large language model (LLM) systems that must use tools, coordinate with other agents, and operate across heterogeneous environments. This work presents a human-inspired perspective on this emerging landscape by organizing agent communication into three layers: communication, syntactic, and semantic. Under this framework, we systematically analyze 18 representative protocols and compare how they support reliable transport, structured interaction, and meaning-level coordination. Our analysis shows a clear imbalance in current protocol design. Most protocols provide increasingly mature support for transport, streaming, schema definition, and lifecycle management, but offer limited protocol-level mechanisms for clarification, context alignment, and verification. As a result, semantic responsibilities are often pushed into prompts, wrappers, or application-specific orchestration logic, creating hidden interoperability and maintenance costs. To make this gap actionable, we further identify major forms of technical debt in today's protocol ecosystem and distill practical guidance for selecting protocols under different deployment settings. We conclude by outlining a research agenda for interoperable, secure, and semantically robust agent ecosystems that move beyond message passing toward shared understanding.

Many deployments must compare candidate language models for safety before a labeled benchmark exists for the relevant language, sector, or regulatory regime. We formalize this setting as benchmarkless comparative safety scoring and specify the contract under which a scenario-based audit can be interpreted as deployment evidence. Scores are valid only under a fixed scenario pack, rubric, auditor, judge, sampling configuration, and rerun budget. Because no labels are available, we replace ground-truth agreement with an instrumental-validity chain: responsiveness to a controlled safe-versus-abliterated contrast, dominance of target-driven variance over auditor and judge artifacts, and stability across reruns. We instantiate the chain in SimpleAudit, a local-first scoring instrument, and validate it on a Norwegian safety pack. Safe and abliterated targets separate with AUROC values between 0.89 and 1.00, target identity is the dominant variance component (η^2 approx 0.52), and severity profiles stabilize by ten reruns. Applying the same chain to Petri shows that it admits both tools. The substantial differences arise upstream of the chain, in claim-contract enforcement and deployment fit. A Norwegian public-sector procurement case comparing Borealis and Gemma 3 demonstrates the resulting evidence in practice: the safer model depends on scenario category and risk measure. Consequently, scores, matched deltas, critical rates, uncertainty, and the auditor and judge used must be reported together rather than collapsed into a single ranking.

Machine learning (ML) interpretability techniques can reveal undesirable patterns in data that models exploit to make predictions--potentially causing harms once deployed. However, how to take action to address these patterns is not always clear. In a collaboration between ML and human-computer interaction researchers, physicians, and data scientists, we develop GAM Changer, the first interactive system to help domain experts and data scientists easily and responsibly edit Generalized Additive Models (GAMs) and fix problematic patterns. With novel interaction techniques, our tool puts interpretability into action--empowering users to analyze, validate, and align model behaviors with their knowledge and values. Physicians have started to use our tool to investigate and fix pneumonia and sepsis risk prediction models, and an evaluation with 7 data scientists working in diverse domains highlights that our tool is easy to use, meets their model editing needs, and fits into their current workflows. Built with modern web technologies, our tool runs locally in users' web browsers or computational notebooks, lowering the barrier to use. GAM Changer is available at the following public demo link: https://interpret.ml/gam-changer.

Ontologies and taxonomies of research fields are critical for managing and organising scientific knowledge, as they facilitate efficient classification, dissemination and retrieval of information. However, the creation and maintenance of such ontologies are expensive and time-consuming tasks, usually requiring the coordinated effort of multiple domain experts. Consequently, ontologies in this space often exhibit uneven coverage across different disciplines, limited inter-domain connectivity, and infrequent updating cycles. In this study, we investigate the capability of several large language models to identify semantic relationships among research topics within three academic domains: biomedicine, physics, and engineering. The models were evaluated under three distinct conditions: zero-shot prompting, chain-of-thought prompting, and fine-tuning on existing ontologies. Additionally, we assessed the cross-domain transferability of fine-tuned models by measuring their performance when trained in one domain and subsequently applied to a different one. To support this analysis, we introduce PEM-Rel-8K, a novel dataset consisting of over 8,000 relationships extracted from the most widely adopted taxonomies in the three disciplines considered in this study: MeSH, PhySH, and IEEE. Our experiments demonstrate that fine-tuning LLMs on PEM-Rel-8K yields excellent performance across all disciplines.

Large language model-powered chatbots have transformed how people seek information, especially in high-stakes contexts like mental health. Despite their support capabilities, safe detection and response to crises such as suicidal ideation and self-harm are still unclear, hindered by the lack of unified crisis taxonomies and clinical evaluation standards. We address this by creating: (1) a taxonomy of six crisis categories; (2) a dataset of over 2,000 inputs from 12 mental health datasets, classified into these categories; and (3) a clinical response assessment protocol. We also use LLMs to identify crisis inputs and audit five models for response safety and appropriateness. First, we built a clinical-informed crisis taxonomy and evaluation protocol. Next, we curated 2,252 relevant examples from over 239,000 user inputs, then tested three LLMs for automatic classification. In addition, we evaluated five models for the appropriateness of their responses to a user's crisis, graded on a 5-point Likert scale from harmful (1) to appropriate (5). While some models respond reliably to explicit crises, risks still exist. Many outputs, especially in self-harm and suicidal categories, are inappropriate or unsafe. Different models perform variably; some, like gpt-5-nano and deepseek-v3.2-exp, have low harm rates, but others, such as gpt-4o-mini and grok-4-fast, generate more unsafe responses. All models struggle with indirect signals, default replies, and context misalignment. These results highlight the urgent need for better safeguards, crisis detection, and context-aware responses in LLMs. They also show that alignment and safety practices, beyond scale, are crucial for reliable crisis support. Our taxonomy, datasets, and evaluation methods support ongoing AI mental health research, aiming to reduce harm and protect vulnerable users.

Accurate remaining useful life (RUL) prediction hinges on the quality of health indicators (HIs), yet existing methods often fail to disentangle complex degradation mechanisms in multi-sensor systems or quantify uncertainty in HI reliability. This paper introduces a novel framework for HI construction, advancing three key contributions. First, we adapt Reconstruction along Projected Pathways (RaPP) as a health indicator (HI) for RUL prediction for the first time, showing that it outperforms traditional reconstruction error metrics. Second, we show that augmenting RaPP-derived HIs with aleatoric and epistemic uncertainty quantification (UQ) via Monte Carlo dropout and probabilistic latent spaces- significantly improves RUL-prediction robustness. Third, and most critically, we propose indicator groups, a paradigm that isolates sensor subsets to model system-specific degradations, giving rise to our novel method, I-GLIDE which enables interpretable, mechanism-specific diagnostics. Evaluated on data sourced from aerospace and manufacturing systems, our approach achieves marked improvements in accuracy and generalizability compared to state-of-the-art HI methods while providing actionable insights into system failure pathways. This work bridges the gap between anomaly detection and prognostics, offering a principled framework for uncertainty-aware degradation modeling in complex systems.

Recent advances in medical large language models (LLMs), multimodal models, and agents demand evaluation frameworks that reflect real clinical workflows and safety constraints. We present MedBench v4, a nationwide, cloud-based benchmarking infrastructure comprising over 700,000 expert-curated tasks spanning 24 primary and 91 secondary specialties, with dedicated tracks for LLMs, multimodal models, and agents. Items undergo multi-stage refinement and multi-round review by clinicians from more than 500 institutions, and open-ended responses are scored by an LLM-as-a-judge calibrated to human ratings. We evaluate 15 frontier models. Base LLMs reach a mean overall score of 54.1/100 (best: Claude Sonnet 4.5, 62.5/100), but safety and ethics remain low (18.4/100). Multimodal models perform worse overall (mean 47.5/100; best: GPT-5, 54.9/100), with solid perception yet weaker cross-modal reasoning. Agents built on the same backbones substantially improve end-to-end performance (mean 79.8/100), with Claude Sonnet 4.5-based agents achieving up to 85.3/100 overall and 88.9/100 on safety tasks. MedBench v4 thus reveals persisting gaps in multimodal reasoning and safety for base models, while showing that governance-aware agentic orchestration can markedly enhance benchmarked clinical readiness without sacrificing capability. By aligning tasks with Chinese clinical guidelines and regulatory priorities, the platform offers a practical reference for hospitals, developers, and policymakers auditing medical AI.

Anticipating supply chain disruptions before they materialize is a core challenge for firms and policymakers alike. A key difficulty is learning to reason reliably about infrequent, high-impact events from noisy and unstructured inputs - a setting where general-purpose models struggle without task-specific adaptation. We introduce an end-to-end framework that trains LLMs to produce calibrated probabilistic forecasts using realized disruption outcomes as supervision. The resulting model substantially outperforms strong baselines - including GPT-5 - on accuracy, calibration, and precision. We also show that training induces more structured and reliable probabilistic reasoning without explicit prompting. These results suggest a general pathway for training domain-specific forecasting models that produce decision-ready signals. To support transparency we open-source the evaluation dataset used in this study. Dataset: https://huggingface.co/datasets/LightningRodLabs/supply-chain-predictions

Evolutionary multitasking (EMT) has emerged as a popular topic of evolutionary computation over the past decade. It aims to concurrently address multiple optimization tasks within limited computing resources, leveraging inter-task knowledge transfer techniques. Despite the abundance of multitask evolutionary algorithms (MTEAs) proposed for multitask optimization (MTO), there remains a need for a comprehensive software platform to help researchers evaluate MTEA performance on benchmark MTO problems as well as explore real-world applications. To bridge this gap, we introduce the first open-source benchmarking platform, named MToP, for EMT. MToP incorporates over 50 MTEAs, more than 200 MTO problem cases with real-world applications, and over 20 performance metrics. Based on these, we provide benchmarking recommendations tailored for different MTO scenarios. Moreover, to facilitate comparative analyses between MTEAs and traditional evolutionary algorithms, we adapted over 50 popular single-task evolutionary algorithms to address MTO problems. Notably, we release extensive pre-run experimental data on benchmark suites to enhance reproducibility and reduce computational overhead for researchers. MToP features a user-friendly graphical interface, facilitating results analysis, data export, and schematic visualization. More importantly, MToP is designed with extensibility in mind, allowing users to develop new algorithms and tackle emerging problem domains. The source code of MToP is available at: https://github.com/intLyc/MTO-Platform

Hospitals and healthcare systems rely on operational decisions that determine patient flow, cost, and quality of care. Despite strong performance on medical knowledge and conversational benchmarks, foundation models trained on general text may lack the specialized knowledge required for these operational decisions. We introduce Lang1, a family of models (100M-7B parameters) pretrained on a specialized corpus blending 80B clinical tokens from NYU Langone Health's EHRs and 627B tokens from the internet. To rigorously evaluate Lang1 in real-world settings, we developed the REalistic Medical Evaluation (ReMedE), a benchmark derived from 668,331 EHR notes that evaluates five critical tasks: 30-day readmission prediction, 30-day mortality prediction, length of stay, comorbidity coding, and predicting insurance claims denial. In zero-shot settings, both general-purpose and specialized models underperform on four of five tasks (36.6%-71.7% AUROC), with mortality prediction being an exception. After finetuning, Lang1-1B outperforms finetuned generalist models up to 70x larger and zero-shot models up to 671x larger, improving AUROC by 3.64%-6.75% and 1.66%-23.66% respectively. We also observed cross-task scaling with joint finetuning on multiple tasks leading to improvement on other tasks. Lang1-1B effectively transfers to out-of-distribution settings, including other clinical tasks and an external health system. Our findings suggest that predictive capabilities for hospital operations require explicit supervised finetuning, and that this finetuning process is made more efficient by in-domain pretraining on EHR. Our findings support the emerging view that specialized LLMs can compete with generalist models in specialized tasks, and show that effective healthcare systems AI requires the combination of in-domain pretraining, supervised finetuning, and real-world evaluation beyond proxy benchmarks.

Research in emergency triage is restricted to structured electronic health records (EHR) due to regulatory constraints on nurse-patient interactions. We introduce TriageSim, a simulation framework for generating persona-conditioned triage conversations from structured records. TriageSim enables multi-turn nurse-patient interactions with explicit control over disfluency and decision behaviour, producing a corpus of ~800 synthetic transcripts and corresponding audio. We use a combination of automated analysis for linguistic, behavioural and acoustic fidelity alongside manual evaluation for medical fidelity using a random subset of 50 conversations. The utility of the generated corpus is examined via conversational triage classification. We observe modest agreement for acuity levels across three modalities: generated synthetic text, ASR transcripts, and direct audio inputs. The code, persona schemata and triage policy prompts for TriageSim will be available upon acceptance.

Identifying disease phenotypes from electronic health records (EHRs) is critical for numerous secondary uses. Manually encoding physician knowledge into rules is particularly challenging for rare diseases due to inadequate EHR coding, necessitating review of clinical notes. Large language models (LLMs) offer promise in text understanding but may not efficiently handle real-world clinical documentation. We propose a zero-shot LLM-based method enriched by retrieval-augmented generation and MapReduce, which pre-identifies disease-related text snippets to be used in parallel as queries for the LLM to establish diagnosis. We show that this method as applied to pulmonary hypertension (PH), a rare disease characterized by elevated arterial pressures in the lungs, significantly outperforms physician logic rules (F_1 score of 0.62 vs. 0.75). This method has the potential to enhance rare disease cohort identification, expanding the scope of robust clinical research and care gap identification.

Deep-learning survival models for electronic health record (EHR) data are hard to compare across papers because the upstream preprocessing step, which includes cohort definition, time discretisation, missingness handling, and censoring rules, is typically undocumented and inconsistent. A reported difference in concordance between two mortality models can therefore reflect any of these choices rather than a modelling contribution. We present SurvBench, an open-source preprocessing pipeline that converts raw PhysioNet exports into model-ready tensors for survival analysis. SurvBench covers four critical-care databases (MIMIC-IV, eICU, MC-MED, HiRID) and four input modalities: time-series vitals and laboratory values, static demographics, International Classification of Diseases (ICD) codes, and radiology report embeddings. Every preprocessing decision is controlled through YAML configuration. Imputation, scaling, and feature filtering are fit on the training fold only. Missingness is recorded as a binary mask alongside each feature tensor. The pipeline handles single-risk endpoints (in-hospital and in-ICU mortality) and competing-risks endpoints (a three-way emergency-department admission pathway, with home discharge treated as administrative censoring). We also provide support for harmonised cross-dataset external validation between eICU and MIMIC-IV. SurvBench is publicly available at https://github.com/munibmesinovic/SurvBench, providing a robust platform that future deep-learning EHR survival work, especially nascent multi-modal approaches, can be measured against under matched preprocessing.

Medical applications of machine learning (ML) have experienced a surge in popularity in recent years. The intensive care unit (ICU) is a natural habitat for ML given the abundance of available data from electronic health records. Models have been proposed to address numerous ICU prediction tasks like the early detection of complications. While authors frequently report state-of-the-art performance, it is challenging to verify claims of superiority. Datasets and code are not always published, and cohort definitions, preprocessing pipelines, and training setups are difficult to reproduce. This work introduces Yet Another ICU Benchmark (YAIB), a modular framework that allows researchers to define reproducible and comparable clinical ML experiments; we offer an end-to-end solution from cohort definition to model evaluation. The framework natively supports most open-access ICU datasets (MIMIC III/IV, eICU, HiRID, AUMCdb) and is easily adaptable to future ICU datasets. Combined with a transparent preprocessing pipeline and extensible training code for multiple ML and deep learning models, YAIB enables unified model development. Our benchmark comes with five predefined established prediction tasks (mortality, acute kidney injury, sepsis, kidney function, and length of stay) developed in collaboration with clinicians. Adding further tasks is straightforward by design. Using YAIB, we demonstrate that the choice of dataset, cohort definition, and preprocessing have a major impact on the prediction performance - often more so than model class - indicating an urgent need for YAIB as a holistic benchmarking tool. We provide our work to the clinical ML community to accelerate method development and enable real-world clinical implementations. Software Repository: https://github.com/rvandewater/YAIB.

Accurately forecasting patient arrivals at Urgent Care Clinics (UCCs) and Emergency Departments (EDs) is important for effective resourcing and patient care. However, correctly estimating patient flows is not straightforward since it depends on many drivers. The predictability of patient arrivals has recently been further complicated by the COVID-19 pandemic conditions and the resulting lockdowns. This study investigates how a suite of novel quasi-real-time variables like Google search terms, pedestrian traffic, the prevailing incidence levels of influenza, as well as the COVID-19 Alert Level indicators can both generally improve the forecasting models of patient flows and effectively adapt the models to the unfolding disruptions of pandemic conditions. This research also uniquely contributes to the body of work in this domain by employing tools from the eXplainable AI field to investigate more deeply the internal mechanics of the models than has previously been done. The Voting ensemble-based method combining machine learning and statistical techniques was the most reliable in our experiments. Our study showed that the prevailing COVID-19 Alert Level feature together with Google search terms and pedestrian traffic were effective at producing generalisable forecasts. The implications of this study are that proxy variables can effectively augment standard autoregressive features to ensure accurate forecasting of patient flows. The experiments showed that the proposed features are potentially effective model inputs for preserving forecast accuracies in the event of future pandemic outbreaks.

Alarm fatigue in intensive care units (ICUs) is a well documented patient safety crisis. Clinical monitors generate 350 or more alarms per patient per day, out of which 72-99% are clinically irrelevant. Staff desensitization to non-actionable alarms increases the risk of missed true emergencies. This paper presents SigmaMedStat, a machine learning system that evaluates the trustworthiness of physiological alarm signals before clinical action is taken. Four approaches were evaluated on the PhysioNet/Computing in Cardiology Challenge 2015 dataset of 498 four-channel ICU alarm recordings. Primary contribution is a temporal modeling framework that splits each 60 second recording into six consecutive 10-second chunks, and this in turn generates Continuous Wavelet Transform (CWT) scalograms per chunk, encodes each chunk with a shared EfficientNet-B0 encoder, and passes the resulting feature sequence to a two-layer Long Short-Term Memory (LSTM) network. Five-fold stratified cross-validation yields a mean AUC of 0.822 +/- 0.016 (95% CI: [0.790,0.853]), compared to 0.641 for a static EfficientNet baseline trained on the full 60-second window. Ablation studies confirm that temporal chunking and multi-channel signal fusion both contribute independently to classification performance. Per-alarm type analysis reveals that Ventricular Flutter is the most accurately classified alarm type (AUC 0.820) while Asystole remains the hardest (AUC 0.722). Error analysis identifies 65 false negatives and 85 high-confidence misclassifications as the primary failure modes. All code and results are publicly available at https://github.com/Arun-K-Ram/sigmamedstat.

Surgical future prediction, driven by real-time AI analysis of surgical video, is critical for operating room safety and efficiency. It provides actionable insights into upcoming events, their timing, and risks-enabling better resource allocation, timely instrument readiness, and early warnings for complications (e.g., bleeding, bile duct injury). Despite this need, current surgical AI research focuses on understanding what is happening rather than predicting future events. Existing methods target specific tasks in isolation, lacking unified approaches that span both short-term (action triplets, events) and long-term horizons (remaining surgery duration, phase transitions). These methods rely on coarse-grained supervision while fine-grained surgical action triplets and steps remain underexplored. Furthermore, methods based only on future feature prediction struggle to generalize across different surgical contexts and procedures. We address these limits by reframing surgical future prediction as state-change learning. Rather than forecasting raw observations, our approach classifies state transitions between current and future timesteps. We introduce SurgFUTR, implementing this through a teacher-student architecture. Video clips are compressed into state representations via Sinkhorn-Knopp clustering; the teacher network learns from both current and future clips, while the student network predicts future states from current videos alone, guided by our Action Dynamics (ActDyn) module. We establish SFPBench with five prediction tasks spanning short-term (triplets, events) and long-term (remaining surgery duration, phase and step transitions) horizons. Experiments across four datasets and three procedures show consistent improvements. Cross-procedure transfer validates generalizability.

While Large Language Models (LLMs) excel in world knowledge understanding, adapting them to specific subfields requires precise adjustments. Due to the model's vast scale, traditional global fine-tuning methods for large models can be computationally expensive and impact generalization. To address this challenge, a range of innovative Parameters-Efficient Fine-Tuning (PEFT) methods have emerged and achieved remarkable success in both LLMs and Large Vision-Language Models (LVLMs). In the medical domain, fine-tuning a medical Vision-Language Pretrained (VLP) model is essential for adapting it to specific tasks. Can the fine-tuning methods for large models be transferred to the medical field to enhance transfer learning efficiency? In this paper, we delve into the fine-tuning methods of LLMs and conduct extensive experiments to investigate the impact of fine-tuning methods for large models on the existing multimodal model in the medical domain from the training data level and the model structure level. We show the different impacts of fine-tuning methods for large models on medical VLMs and develop the most efficient ways to fine-tune medical VLP models. We hope this research can guide medical domain researchers in optimizing VLMs' training costs, fostering the broader application of VLMs in healthcare fields. The code and dataset have been released at https://github.com/TIMMY-CHAN/MILE.

Large language models (LLMs) show promise in clinical decision support yet risk acquiescing to patient pressure for inappropriate care. We introduce SycoEval-EM, a multi-agent simulation framework evaluating LLM robustness through adversarial patient persuasion in emergency medicine. Across 20 LLMs and 1,875 encounters spanning three Choosing Wisely scenarios, acquiescence rates ranged from 0-100\%. Models showed higher vulnerability to imaging requests (38.8\%) than opioid prescriptions (25.0\%), with model capability poorly predicting robustness. All persuasion tactics proved equally effective (30.0-36.0\%), indicating general susceptibility rather than tactic-specific weakness. Our findings demonstrate that static benchmarks inadequately predict safety under social pressure, necessitating multi-turn adversarial testing for clinical AI certification.

Foundation models (FMs) trained on electronic health records (EHRs) have shown strong performance on a range of clinical prediction tasks. However, adapting these models to local health systems remains challenging due to limited data availability and resource constraints. In this study, we investigated what these models learn and evaluated the transferability of an FM trained on MIMIC-IV to an institutional EHR dataset at the University of Chicago Medical Center. We assessed their ability to identify outlier patients and examined representation-space patient trajectories in relation to future clinical outcomes. We also evaluated the performance of supervised fine-tuned classifiers on both source and target datasets. Our findings offer insights into the adaptability of FMs across different healthcare systems, highlight considerations for their effective implementation, and provide an empirical analysis of the underlying factors that contribute to their predictive performance.

In recent years, medical information technology has made it possible for electronic health record (EHR) to store fairly complete clinical data. This has brought health care into the era of "big data". However, medical data are often sparse and strongly correlated, which means that medical problems cannot be solved effectively. With the rapid development of deep learning in recent years, it has provided opportunities for the use of big data in healthcare. In this paper, we propose a temporal-saptial correlation attention network (TSCAN) to handle some clinical characteristic prediction problems, such as predicting death, predicting length of stay, detecting physiologic decline, and classifying phenotypes. Based on the design of the attention mechanism model, our approach can effectively remove irrelevant items in clinical data and irrelevant nodes in time according to different tasks, so as to obtain more accurate prediction results. Our method can also find key clinical indicators of important outcomes that can be used to improve treatment options. Our experiments use information from the Medical Information Mart for Intensive Care (MIMIC-IV) database, which is open to the public. Finally, we have achieved significant performance benefits of 2.0\% (metric) compared to other SOTA prediction methods. We achieved a staggering 90.7\% on mortality rate, 45.1\% on length of stay. The source code can be find: https://github.com/yuyuheintju/TSCAN.

Clinical notes contain rich data, which is unexploited in predictive modeling compared to structured data. In this work, we developed a new text representation Clinical XLNet for clinical notes which also leverages the temporal information of the sequence of the notes. We evaluated our models on prolonged mechanical ventilation prediction problem and our experiments demonstrated that Clinical XLNet outperforms the best baselines consistently.

Multimodal Large Language Models (MLLMs) have expanded the capabilities of traditional language models by enabling interaction through both text and images. However, ensuring the safety of these models remains a significant challenge, particularly in accurately identifying whether multimodal content is safe or unsafe-a capability we term safety awareness. In this paper, we introduce MMSafeAware, the first comprehensive multimodal safety awareness benchmark designed to evaluate MLLMs across 29 safety scenarios with 1500 carefully curated image-prompt pairs. MMSafeAware includes both unsafe and over-safety subsets to assess models abilities to correctly identify unsafe content and avoid over-sensitivity that can hinder helpfulness. Evaluating nine widely used MLLMs using MMSafeAware reveals that current models are not sufficiently safe and often overly sensitive; for example, GPT-4V misclassifies 36.1% of unsafe inputs as safe and 59.9% of benign inputs as unsafe. We further explore three methods to improve safety awareness-prompting-based approaches, visual contrastive decoding, and vision-centric reasoning fine-tuning-but find that none achieve satisfactory performance. Our findings highlight the profound challenges in developing MLLMs with robust safety awareness, underscoring the need for further research in this area. All the code and data will be publicly available to facilitate future research.

Laboratory accidents pose significant risks to human life and property, underscoring the importance of robust safety protocols. Despite advancements in safety training, laboratory personnel may still unknowingly engage in unsafe practices. With the increasing reliance on large language models (LLMs) for guidance in various fields, including laboratory settings, there is a growing concern about their reliability in critical safety-related decision-making. Unlike trained human researchers, LLMs lack formal lab safety education, raising questions about their ability to provide safe and accurate guidance. Existing research on LLM trustworthiness primarily focuses on issues such as ethical compliance, truthfulness, and fairness but fails to fully cover safety-critical real-world applications, like lab safety. To address this gap, we propose the Laboratory Safety Benchmark (LabSafety Bench), a comprehensive evaluation framework based on a new taxonomy aligned with Occupational Safety and Health Administration (OSHA) protocols. This benchmark includes 765 multiple-choice questions verified by human experts, assessing LLMs and vision language models (VLMs) performance in lab safety contexts. Our evaluations demonstrate that while GPT-4o outperforms human participants, it is still prone to critical errors, highlighting the risks of relying on LLMs in safety-critical environments. Our findings emphasize the need for specialized benchmarks to accurately assess the trustworthiness of LLMs in real-world safety applications.

As a telecom provider, our company has a critical mission to maintain telecom services even during power outages. To accomplish the mission, it is essential to maintain the power of the telecom base stations. Here we consider a solution where electric vehicles (EVs) directly supply power to base stations by traveling to their locations. The goal is to find EV routes that minimize both the total travel distance of all EVs and the number of downed base stations. In this paper, we formulate this routing problem as a new variant of the Electric Vehicle Routing Problem (EVRP) and propose a solver that combines a rule-based vehicle selector and a reinforcement learning (RL)-based node selector. The rule of the vehicle selector ensures the exact environmental states when the selected EV starts to move. In addition, the node selection by the RL model enables fast route generation, which is critical in emergencies. We evaluate our solver on both synthetic datasets and real datasets. The results show that our solver outperforms baselines in terms of the objective value and computation time. Moreover, we analyze the generalization and scalability of our solver, demonstrating the capability toward unseen settings and large-scale problems. Check also our project page: https://ntt-dkiku.github.io/rl-evrpeps.

Predicting in-hospital mortality for intensive care unit (ICU) patients is key to final clinical outcomes. AI has shown advantaged accuracy but suffers from the lack of explainability. To address this issue, this paper proposes an eXplainable Multimodal Mortality Predictor (X-MMP) approaching an efficient, explainable AI solution for predicting in-hospital mortality via multimodal ICU data. We employ multimodal learning in our framework, which can receive heterogeneous inputs from clinical data and make decisions. Furthermore, we introduce an explainable method, namely Layer-Wise Propagation to Transformer, as a proper extension of the LRP method to Transformers, producing explanations over multimodal inputs and revealing the salient features attributed to prediction. Moreover, the contribution of each modality to clinical outcomes can be visualized, assisting clinicians in understanding the reasoning behind decision-making. We construct a multimodal dataset based on MIMIC-III and MIMIC-III Waveform Database Matched Subset. Comprehensive experiments on benchmark datasets demonstrate that our proposed framework can achieve reasonable interpretation with competitive prediction accuracy. In particular, our framework can be easily transferred to other clinical tasks, which facilitates the discovery of crucial factors in healthcare research.

Fragmentation is a routine part of communication in 6LoWPAN-based IoT networks, designed to accommodate small frame sizes on constrained wireless links. However, this process introduces a critical vulnerability fragments are typically stored and processed before their legitimacy is confirmed, allowing attackers to exploit this gap with minimal effort. In this work, we explore a defense strategy that takes a more adaptive, behavior-aware approach to this problem. Our system, called Predictive-CSM, introduces a combination of two lightweight mechanisms. The first tracks how each node behaves over time, rewarding consistent and successful interactions while quickly penalizing suspicious or failing patterns. The second checks the integrity of packet fragments using a chained hash, allowing incomplete or manipulated sequences to be caught early, before they can occupy memory or waste processing time. We put this system to the test using a set of targeted attack simulations, including early fragment injection, replayed headers, and flooding with fake data. Across all scenarios, Predictive CSM preserved network delivery and maintained energy efficiency, even under pressure. Rather than relying on heavyweight cryptography or rigid filters, this approach allows constrained de vices to adapt their defenses in real time based on what they observe, not just what they're told. In that way, it offers a step forward for securing fragmented communication in real world IoT systems

With the widespread application of Large Language Models (LLMs), their associated security issues have become increasingly prominent, severely constraining their trustworthy deployment in critical domains. This paper proposes a novel safety response framework designed to systematically safeguard LLMs at both the input and output levels. At the input level, the framework employs a supervised fine-tuning-based safety classification model. Through a fine-grained four-tier taxonomy (Safe, Unsafe, Conditionally Safe, Focused Attention), it performs precise risk identification and differentiated handling of user queries, significantly enhancing risk coverage and business scenario adaptability, and achieving a risk recall rate of 99.3%. At the output level, the framework integrates Retrieval-Augmented Generation (RAG) with a specifically fine-tuned interpretation model, ensuring all responses are grounded in a real-time, trustworthy knowledge base. This approach eliminates information fabrication and enables result traceability. Experimental results demonstrate that our proposed safety control model achieves a significantly higher safety score on public safety evaluation benchmarks compared to the baseline model, TinyR1-Safety-8B. Furthermore, on our proprietary high-risk test set, the framework's components attained a perfect 100% safety score, validating their exceptional protective capabilities in complex risk scenarios. This research provides an effective engineering pathway for building high-security, high-trust LLM applications.

Accurate epidemic forecasting is crucial for outbreak preparedness, but existing data-driven models are often brittle. Typically trained on a single pathogen, they struggle with data scarcity during new outbreaks and fail under distribution shifts caused by viral evolution or interventions. However, decades of surveillance data and the design of various compartmental models from diverse diseases offer an untapped source of transferable knowledge. To leverage the collective lessons from history, we propose CAPE, the first open-source pre-trained model for epidemic forecasting. Unlike existing time series foundation models that overlook epidemiological challenges, CAPE models epidemic dynamics as mixtures of latent compartmental population states, termed compartmental prototypes. It models a flexible dictionary of compartment prototypes directly from a large collection of simulation data, enabling each outbreak to be expressed as a time-varying mixture that links observed infections to latent population states. To promote robust generalization, CAPE adopts the next-token-prediction paradigm during pre-training with lightweight epidemic-aware regularization that aligns the learned prototypes with epidemiological semantics. On a comprehensive benchmark spanning 17 diseases, CAPE significantly outperforms strong baselines with zero-shot forecasting. This work represents a principled step toward pre-trained epidemic models that are both transferable and epidemiologically grounded. We provide our code in: https://github.com/nuuuh/CAPE.

Safety alignment in Large Language Models is critical for healthcare; however, reliance on binary refusal boundaries often results in over-refusal of benign queries or unsafe compliance with harmful ones. While existing benchmarks measure these extremes, they fail to evaluate Safe Completion: the model's ability to maximise helpfulness on dual-use or borderline queries by providing safe, high-level guidance without crossing into actionable harm. We introduce Health-ORSC-Bench, the first large-scale benchmark designed to systematically measure Over-Refusal and Safe Completion quality in healthcare. Comprising 31,920 benign boundary prompts across seven health categories (e.g., self-harm, medical misinformation), our framework uses an automated pipeline with human validation to test models at varying levels of intent ambiguity. We evaluate 30 state-of-the-art LLMs, including GPT-5 and Claude-4, revealing a significant tension: safety-optimised models frequently refuse up to 80\% of "Hard" benign prompts, while domain-specific models often sacrifice safety for utility. Our findings demonstrate that model family and size significantly influence calibration: larger frontier models (e.g., GPT-5, Llama-4) exhibit "safety-pessimism" and higher over-refusal than smaller or MoE-based counterparts (e.g., Qwen-3-Next), highlighting that current LLMs struggle to balance refusal and compliance. Health-ORSC-Bench provides a rigorous standard for calibrating the next generation of medical AI assistants toward nuanced, safe, and helpful completions. The code and data will be released upon acceptance. red{Warning: Some contents may include toxic or undesired contents.}

In mobile telecommunications, alarms act as early warning signals. They are triggered when a cell, the basic unit of radio coverage, shuts down or behaves abnormally. This signals a degradation in service quality, which directly affects the customer experience. To fix the issue, operators rely on preset thresholds to decide when an engineer should be sent out. In practice, these thresholds are set manually and remain fixed regardless of the time of day, traffic levels, or overall network conditions. This often leads to serious faults slipping through during busy hours, while minor issues can cause unnecessary callouts when the network is quiet. This paper presents a machine learning framework that automatically predicts four alarm thresholds, audit window duration, inactive time limit, total fluctuation count, and per hour fluctuation limit, from live network behavior. Since no ground truth labels exist for thresholds, we introduce a percentile guided label derivation strategy and evaluate four models on an anonymized dataset of 10,648 cells across three vendors and nine regions from a real 4G network, comprising a Gradient Boosted Trees baseline, a CNN-BiLSTM with attention, the proposed PCTN, and an iTransformer. PCTN performs the best overall with respect to three of the four targets, outperforming a state-of-the-art iTransformer while using 83 percent fewer parameters. Its mixed output heads and dynamic alpha mechanism produce thresholds that are both accurate and interpretable, allowing operators to inspect and adjust the learned policy without retraining. All comparisons are statistically significant at p < 0.001. The framework undergoes daily retraining using new data, which enables the thresholds to constantly adjust to changes in the network.

Transformers have significantly advanced the modeling of Electronic Health Records (EHR), yet their deployment in real-world healthcare is limited by several key challenges. Firstly, the quadratic computational cost and insufficient context length of these models pose significant obstacles for hospitals in processing the extensive medical histories typical in EHR data. Additionally, existing models employ separate finetuning for each clinical task, complicating maintenance in healthcare environments. Moreover, these models focus exclusively on either clinical prediction or EHR forecasting, lacking the flexibility to perform well across both. To overcome these limitations, we introduce EHRMamba, a robust foundation model built on the Mamba architecture. EHRMamba can process sequences up to four times longer than previous models due to its linear computational cost. We also introduce a novel approach to Multitask Prompted Finetuning (MTF) for EHR data, which enables EHRMamba to simultaneously learn multiple clinical tasks in a single finetuning phase, significantly enhancing deployment and cross-task generalization. Furthermore, our model leverages the HL7 FHIR data standard to simplify integration into existing hospital systems. Alongside EHRMamba, we open-source Odyssey, a toolkit designed to support the development and deployment of EHR foundation models, with an emphasis on data standardization and interpretability. Our evaluations on the MIMIC-IV dataset demonstrate that EHRMamba advances state-of-the-art performance across 6 major clinical tasks and excels in EHR forecasting, marking a significant leap forward in the field.

The rapid development of large language models (LLMs) has led to the widespread deployment of LLM agents across diverse industries, including customer service, content generation, data analysis, and even healthcare. However, as more LLM agents are deployed, a major issue has emerged: there is no standard way for these agents to communicate with external tools or data sources. This lack of standardized protocols makes it difficult for agents to work together or scale effectively, and it limits their ability to tackle complex, real-world tasks. A unified communication protocol for LLM agents could change this. It would allow agents and tools to interact more smoothly, encourage collaboration, and triggering the formation of collective intelligence. In this paper, we provide the first comprehensive analysis of existing agent protocols, proposing a systematic two-dimensional classification that differentiates context-oriented versus inter-agent protocols and general-purpose versus domain-specific protocols. Additionally, we conduct a comparative performance analysis of these protocols across key dimensions such as security, scalability, and latency. Finally, we explore the future landscape of agent protocols by identifying critical research directions and characteristics necessary for next-generation protocols. These characteristics include adaptability, privacy preservation, and group-based interaction, as well as trends toward layered architectures and collective intelligence infrastructures. We expect this work to serve as a practical reference for both researchers and engineers seeking to design, evaluate, or integrate robust communication infrastructures for intelligent agents.

Large Language Models (LLMs) exhibit impressive capabilities but also present risks such as biased content generation and privacy issues. One of the current alignment techniques includes principle-driven integration, but it faces challenges arising from the imprecision of manually crafted rules and inadequate risk perception in models without safety training. To address these, we introduce Guide-Align, a two-stage approach. Initially, a safety-trained model identifies potential risks and formulates specific guidelines for various inputs, establishing a comprehensive library of guidelines and a model for input-guidelines retrieval. Subsequently, the retrieval model correlates new inputs with relevant guidelines, which guide LLMs in response generation to ensure safe and high-quality outputs, thereby aligning with human values. An additional optional stage involves fine-tuning a model with well-aligned datasets generated through the process implemented in the second stage. Our method customizes guidelines to accommodate diverse inputs, thereby enhancing the fine-grainedness and comprehensiveness of the guideline library. Furthermore, it incorporates safety expertise from a safety-trained LLM through a lightweight retrieval model. We evaluate our approach on three benchmarks, demonstrating significant improvements in LLM security and quality. Notably, our fine-tuned model, Labrador, even at 13 billion parameters, outperforms GPT-3.5-turbo and surpasses GPT-4 in alignment capabilities.

Foundation models in video generation are demonstrating remarkable capabilities as potential world models for simulating the physical world. However, their application in high-stakes domains like surgery, which demand deep, specialized causal knowledge rather than general physical rules, remains a critical unexplored gap. To systematically address this challenge, we present SurgVeo, the first expert-curated benchmark for video generation model evaluation in surgery, and the Surgical Plausibility Pyramid (SPP), a novel, four-tiered framework tailored to assess model outputs from basic appearance to complex surgical strategy. On the basis of the SurgVeo benchmark, we task the advanced Veo-3 model with a zero-shot prediction task on surgical clips from laparoscopic and neurosurgical procedures. A panel of four board-certified surgeons evaluates the generated videos according to the SPP. Our results reveal a distinct "plausibility gap": while Veo-3 achieves exceptional Visual Perceptual Plausibility, it fails critically at higher levels of the SPP, including Instrument Operation Plausibility, Environment Feedback Plausibility, and Surgical Intent Plausibility. This work provides the first quantitative evidence of the chasm between visually convincing mimicry and causal understanding in surgical AI. Our findings from SurgVeo and the SPP establish a crucial foundation and roadmap for developing future models capable of navigating the complexities of specialized, real-world healthcare domains.

When an LLM agent reads a confidential file, then writes a summary, then emails it externally, no single step is unsafe, but the sequence is a data leak. We call this safety drift: individually safe actions compounding into violations. Prior work has measured this problem; we predict it. SafetyDrift models agent safety trajectories as absorbing Markov chains, computing the probability that a trajectory will reach a violation within a given number of steps via closed form absorption analysis. A consequence of the monotonic state design is that every agent will eventually violate safety if left unsupervised (absorption probability 1.0 from all states), making the practical question not if but when, and motivating our focus on finite horizon prediction. Across 357 traces spanning 40 realistic tasks in four categories, we discover that "points of no return" are sharply task dependent: in communication tasks, agents that reach even a mild risk state have an 85% chance of violating safety within five steps, while in technical tasks the probability stays below 5% from any state. A lightweight monitor built on these models detects 94.7% of violations with 3.7 steps of advance warning at negligible computational cost, outperforming both keyword matching (44.7% detection, 55.9% false positive rate) and per step LLM judges (52.6% detection, 38.2% false positive rate) while running over 60,000x faster.

With the advent of Vision-Language Models (VLMs), medical artificial intelligence (AI) has experienced significant technological progress and paradigm shifts. This survey provides an extensive review of recent advancements in Medical Vision-Language Models (Med-VLMs), which integrate visual and textual data to enhance healthcare outcomes. We discuss the foundational technology behind Med-VLMs, illustrating how general models are adapted for complex medical tasks, and examine their applications in healthcare. The transformative impact of Med-VLMs on clinical practice, education, and patient care is highlighted, alongside challenges such as data scarcity, narrow task generalization, interpretability issues, and ethical concerns like fairness, accountability, and privacy. These limitations are exacerbated by uneven dataset distribution, computational demands, and regulatory hurdles. Rigorous evaluation methods and robust regulatory frameworks are essential for safe integration into healthcare workflows. Future directions include leveraging large-scale, diverse datasets, improving cross-modal generalization, and enhancing interpretability. Innovations like federated learning, lightweight architectures, and Electronic Health Record (EHR) integration are explored as pathways to democratize access and improve clinical relevance. This review aims to provide a comprehensive understanding of Med-VLMs' strengths and limitations, fostering their ethical and balanced adoption in healthcare.

Over the past several years, across the globe, there has been an increase in people seeking care in emergency departments (EDs). ED resources, including nurse staffing, are strained by such increases in patient volume. Accurate forecasting of incoming patient volume in emergency departments (ED) is crucial for efficient utilization and allocation of ED resources. Working with a suburban ED in the Pacific Northwest, we developed a tool powered by machine learning models, to forecast ED arrivals and ED patient volume to assist end-users, such as ED nurses, in resource allocation. In this paper, we discuss the results from our predictive models, the challenges, and the learnings from users' experiences with the tool in active clinical deployment in a real world setting.

This study aims to explore the implementation of Natural Language Processing (NLP) and machine learning (ML) techniques to automate the coding of medical letters with visualised explainability and light-weighted local computer settings. Currently in clinical settings, coding is a manual process that involves assigning codes to each condition, procedure, and medication in a patient's paperwork (e.g., 56265001 heart disease using SNOMED CT code). There are preliminary research on automatic coding in this field using state-of-the-art ML models; however, due to the complexity and size of the models, the real-world deployment is not achieved. To further facilitate the possibility of automatic coding practice, we explore some solutions in a local computer setting; in addition, we explore the function of explainability for transparency of AI models. We used the publicly available MIMIC-III database and the HAN/HLAN network models for ICD code prediction purposes. We also experimented with the mapping between ICD and SNOMED CT knowledge bases. In our experiments, the models provided useful information for 97.98\% of codes. The result of this investigation can shed some light on implementing automatic clinical coding in practice, such as in hospital settings, on the local computers used by clinicians , project page https://github.com/Glenj01/Medical-Coding.

Recent research in disaster informatics demonstrates a practical and important use case of artificial intelligence to save human lives and suffering during natural disasters based on social media contents (text and images). While notable progress has been made using texts, research on exploiting the images remains relatively under-explored. To advance image-based approaches, we propose MEDIC (Available at: https://crisisnlp.qcri.org/medic/index.html), which is the largest social media image classification dataset for humanitarian response consisting of 71,198 images to address four different tasks in a multi-task learning setup. This is the first dataset of its kind: social media images, disaster response, and multi-task learning research. An important property of this dataset is its high potential to facilitate research on multi-task learning, which recently receives much interest from the machine learning community and has shown remarkable results in terms of memory, inference speed, performance, and generalization capability. Therefore, the proposed dataset is an important resource for advancing image-based disaster management and multi-task machine learning research. We experiment with different deep learning architectures and report promising results, which are above the majority baselines for all tasks. Along with the dataset, we also release all relevant scripts (https://github.com/firojalam/medic).

In this study, we introduce FEET, a standardized protocol designed to guide the development and benchmarking of foundation models. While numerous benchmark datasets exist for evaluating these models, we propose a structured evaluation protocol across three distinct scenarios to gain a comprehensive understanding of their practical performance. We define three primary use cases: frozen embeddings, few-shot embeddings, and fully fine-tuned embeddings. Each scenario is detailed and illustrated through two case studies: one in sentiment analysis and another in the medical domain, demonstrating how these evaluations provide a thorough assessment of foundation models' effectiveness in research applications. We recommend this protocol as a standard for future research aimed at advancing representation learning models.

Predicting disease trajectories from electronic health records (EHRs) is a complex task due to major challenges such as data non-stationarity, high granularity of medical codes, and integration of multimodal data. EHRs contain both structured data, such as diagnostic codes, and unstructured data, such as clinical notes, which hold essential information often overlooked. Current models, primarily based on structured data, struggle to capture the complete medical context of patients, resulting in a loss of valuable information. To address this issue, we propose an approach that integrates unstructured clinical notes into transformer-based deep learning models for sequential disease prediction. This integration enriches the representation of patients' medical histories, thereby improving the accuracy of diagnosis predictions. Experiments on MIMIC-IV datasets demonstrate that the proposed approach outperforms traditional models relying solely on structured data.

Given the clinical notes written in electronic health records (EHRs), it is challenging to predict the diagnostic codes which is formulated as a multi-label classification task. The large set of labels, the hierarchical dependency, and the imbalanced data make this prediction task extremely hard. Most existing work built a binary prediction for each label independently, ignoring the dependencies between labels. To address this problem, we propose a two-stage framework to improve automatic ICD coding by capturing the label correlation. Specifically, we train a label set distribution estimator to rescore the probability of each label set candidate generated by a base predictor. This paper is the first attempt at learning the label set distribution as a reranking module for medical code prediction. In the experiments, our proposed framework is able to improve upon best-performing predictors on the benchmark MIMIC datasets. The source code of this project is available at https://github.com/MiuLab/ICD-Correlation.

The rapid development of the AI agent communication protocols, including the Model Context Protocol (MCP), Agent2Agent (A2A), Agora, and Agent Network Protocol (ANP), is reshaping how AI agents communicate with tools, services, and each other. While these protocols support scalable multi-agent interaction and cross-organizational interoperability, their security principles remain understudied, and standardized threat modeling is limited; no protocol-centric risk assessment framework has been established yet. This paper presents a systematic security analysis of four emerging AI agent communication protocols. First, we develop a structured threat modeling analysis that examines protocol architectures, trust assumptions, interaction patterns, and lifecycle behaviors to identify protocol-specific and cross-protocol risk surfaces. Second, we introduce a qualitative risk assessment framework that identifies twelve protocol-level risks and evaluates security posture across the creation, operation, and update phases through systematic assessment of likelihood, impact, and overall protocol risk, with implications for secure deployment and future standardization. Third, we provide a measurement-driven case study on MCP that formalizes the risk of missing mandatory validation/attestation for executable components as a falsifiable security claim by quantifying wrong-provider tool execution under multi-server composition across representative resolver policies. Collectively, our results highlight key design-induced risk surfaces and provide actionable guidance for secure deployment and future standardization of agent communication ecosystems.

As Large Language Models (LLMs) and generative AI become increasingly widespread, concerns about content safety have grown in parallel. Currently, there is a clear lack of high-quality, human-annotated datasets that address the full spectrum of LLM-related safety risks and are usable for commercial applications. To bridge this gap, we propose a comprehensive and adaptable taxonomy for categorizing safety risks, structured into 12 top-level hazard categories with an extension to 9 fine-grained subcategories. This taxonomy is designed to meet the diverse requirements of downstream users, offering more granular and flexible tools for managing various risk types. Using a hybrid data generation pipeline that combines human annotations with a multi-LLM "jury" system to assess the safety of responses, we obtain Aegis 2.0, a carefully curated collection of 34,248 samples of human-LLM interactions, annotated according to our proposed taxonomy. To validate its effectiveness, we demonstrate that several lightweight models, trained using parameter-efficient techniques on Aegis 2.0, achieve performance competitive with leading safety models fully fine-tuned on much larger, non-commercial datasets. In addition, we introduce a novel training blend that combines safety with topic following data.This approach enhances the adaptability of guard models, enabling them to generalize to new risk categories defined during inference. We plan to open-source Aegis 2.0 data and models to the research community to aid in the safety guardrailing of LLMs.

Over the past year, the vLLM Semantic Router project has released a series of work spanning: (1) core routing mechanisms -- signal-driven routing, context-length pool routing, router performance engineering, policy conflict detection, low-latency embedding models, category-aware semantic caching, user-feedback-driven routing adaptation, hallucination detection, and hierarchical content-safety classification for privacy and jailbreak protection; (2) fleet optimization -- fleet provisioning and energy-efficiency analysis; (3) agentic and multimodal routing -- multimodal agent routing, tool selection, CUA security, and multi-turn context memory and safety; (4) governance and standards -- inference routing protocols and multi-provider API extensions. Each paper tackled a specific problem in LLM inference, but the problems are not independent; for example, fleet provisioning depends on the routing policy, which depends on the workload mix, shifting as organizations adopt agentic and multimodal workloads. This paper distills those results into the Workload-Router-Pool (WRP) architecture, a three-dimensional framework for LLM inference optimization. Workload characterizes what the fleet serves (chat vs. agent, single-turn vs. multi-turn, warm vs. cold, prefill-heavy vs. decode-heavy). Router determines how each request is dispatched (static semantic rules, online bandit adaptation, RL-based model selection, quality-aware cascading). Pool defines where inference runs (homogeneous vs. heterogeneous GPU, disaggregated prefill/decode, KV-cache topology). We map our prior work onto a 3x3 WRP interaction matrix, identify which cells we have covered and which remain open, and propose twenty-one concrete research directions at the intersections, each grounded in our prior measurements, tiered by maturity from engineering-ready to open research.

The rapid expansion of interconnected devices, autonomous systems, and AI applications has created severe fragmentation in adaptive transport systems, where diverse protocols and context sources remain isolated. This survey provides the first systematic investigation of the Model Context Protocol (MCP) as a unifying paradigm, highlighting its ability to bridge protocol-level adaptation with context-aware decision making. Analyzing established literature, we show that existing efforts have implicitly converged toward MCP-like architectures, signaling a natural evolution from fragmented solutions to standardized integration frameworks. We propose a five-category taxonomy covering adaptive mechanisms, context-aware frameworks, unification models, integration strategies, and MCP-enabled architectures. Our findings reveal three key insights: traditional transport protocols have reached the limits of isolated adaptation, MCP's client-server and JSON-RPC structure enables semantic interoperability, and AI-driven transport demands integration paradigms uniquely suited to MCP. Finally, we present a research roadmap positioning MCP as a foundation for next-generation adaptive, context-aware, and intelligent transport infrastructures.

Computer Use Agents (CUAs) translate natural-language instructions into Graphical User Interface (GUI) actions such as clicks, keystrokes, and scrolls by relying on a Vision-Language Model (VLM) to interpret screenshots and predict grounded tool calls. However, grounding accuracy varies dramatically across VLMs, while current CUA systems typically route every action to a single fixed model regardless of difficulty. We propose Adaptive VLM Routing (AVR), a framework that inserts a lightweight semantic routing layer between the CUA orchestrator and a pool of VLMs. For each tool call, AVR estimates action difficulty from multimodal embeddings, probes a small VLM to measure confidence, and routes the action to the cheapest model whose predicted accuracy satisfies a target reliability threshold. For warm agents with memory of prior UI interactions, retrieved context further narrows the capability gap between small and large models, allowing many actions to be handled without escalation. We formalize routing as a cost--accuracy trade-off, derive a threshold-based policy for model selection, and evaluate AVR using ScreenSpot-Pro grounding data together with the OpenClaw agent routing benchmark. Across these settings, AVR projects inference cost reductions of up to 78\% while staying within 2 percentage points of an all-large-model baseline. When combined with the Visual Confused Deputy guardrail, AVR also escalates high-risk actions directly to the strongest available model, unifying efficiency and safety within a single routing framework. Materials are also provided Model, benchmark, and code: https://github.com/vllm-project/semantic-router.

This research showcases the innovative integration of Large Language Models into machine learning workflows for traffic incident management, focusing on the classification of incident severity using accident reports. By leveraging features generated by modern language models alongside conventional data extracted from incident reports, our research demonstrates improvements in the accuracy of severity classification across several machine learning algorithms. Our contributions are threefold. First, we present an extensive comparison of various machine learning models paired with multiple large language models for feature extraction, aiming to identify the optimal combinations for accurate incident severity classification. Second, we contrast traditional feature engineering pipelines with those enhanced by language models, showcasing the superiority of language-based feature engineering in processing unstructured text. Third, our study illustrates how merging baseline features from accident reports with language-based features can improve the severity classification accuracy. This comprehensive approach not only advances the field of incident management but also highlights the cross-domain application potential of our methodology, particularly in contexts requiring the prediction of event outcomes from unstructured textual data or features translated into textual representation. Specifically, our novel methodology was applied to three distinct datasets originating from the United States, the United Kingdom, and Queensland, Australia. This cross-continental application underlines the robustness of our approach, suggesting its potential for widespread adoption in improving incident management processes globally.

Multimodal Large Language Models have demonstrated powerful cross-modal understanding and reasoning capabilities in general domains. However, in the electromagnetic (EM) domain, they still face challenges such as data scarcity and insufficient integration of domain knowledge. This paper proposes PReD, the first foundation model for the EM domain that covers the intelligent closed-loop of "perception, recognition, decision-making." We constructed a high-quality multitask EM dataset, PReD-1.3M, and an evaluation benchmark, PReD-Bench. The dataset encompasses multi-perspective representations such as raw time-domain waveform, frequency-domain spectrograms, and constellation diagrams, covering typical features of communication and radar signals. It supports a range of core tasks, including signal detection, modulation recognition, parameter estimation, protocol recognition, radio frequency fingerprint recognition, and anti-jamming decision-making. PReD adopts a multi-stage training strategy that unifies multiple tasks for EM signals. It achieves closed-loop optimization from end-to-end signal understanding to language-driven reasoning and decision-making, significantly enhancing EM domain expertise while maintaining general multimodal capabilities. Experimental results show that PReD achieves state-of-the-art performance on PReD-Bench constructed from both open-source and self-collected signal datasets. These results collectively validate the feasibility and potential of vision-aligned foundation models in advancing the understanding and reasoning of EM signals.

Accurate clinical prognosis requires synthesizing structured Electronic Health Records (EHRs) with real-time physiological signals like the Electrocardiogram (ECG). Large Language Models (LLMs) offer a powerful reasoning engine for this task but struggle to natively process these heterogeneous, non-textual data types. To address this, we propose UniPACT (Unified Prognostic Question Answering for Clinical Time-series), a unified framework for prognostic question answering that bridges this modality gap. UniPACT's core contribution is a structured prompting mechanism that converts numerical EHR data into semantically rich text. This textualized patient context is then fused with representations learned directly from raw ECG waveforms, enabling an LLM to reason over both modalities holistically. We evaluate UniPACT on the comprehensive MDS-ED benchmark, it achieves a state-of-the-art mean AUROC of 89.37% across a diverse set of prognostic tasks including diagnosis, deterioration, ICU admission, and mortality, outperforming specialized baselines. Further analysis demonstrates that our multimodal, multi-task approach is critical for performance and provides robustness in missing data scenarios.

Energy-based models (EBMs) are known in the Machine Learning community for decades. Since the seminal works devoted to EBMs dating back to the noughties, there have been a lot of efficient methods which solve the generative modelling problem by means of energy potentials (unnormalized likelihood functions). In contrast, the realm of Optimal Transport (OT) and, in particular, neural OT solvers is much less explored and limited by few recent works (excluding WGAN-based approaches which utilize OT as a loss function and do not model OT maps themselves). In our work, we bridge the gap between EBMs and Entropy-regularized OT. We present a novel methodology which allows utilizing the recent developments and technical improvements of the former in order to enrich the latter. From the theoretical perspective, we prove generalization bounds for our technique. In practice, we validate its applicability in toy 2D and image domains. To showcase the scalability, we empower our method with a pre-trained StyleGAN and apply it to high-res AFHQ 512times 512 unpaired I2I translation. For simplicity, we choose simple short- and long-run EBMs as a backbone of our Energy-guided Entropic OT approach, leaving the application of more sophisticated EBMs for future research. Our code is available at: https://github.com/PetrMokrov/Energy-guided-Entropic-OT

Purpose: With advancements in Large Language Models (LLMs) for healthcare, the need arises for competitive open-source models to protect the public interest. This work contributes to the field of open medical LLMs by optimizing key stages of data preprocessing and training, while showing how to improve model safety (through DPO) and efficacy (through RAG). The evaluation methodology used, which includes four different types of tests, defines a new standard for the field. The resultant models, shown to be competitive with the best private alternatives, are released with a permisive license. Methods: Building on top of strong base models like Llama 3.1 and Qwen 2.5, Aloe Beta uses a custom dataset to enhance public data with synthetic Chain of Thought examples. The models undergo alignment with Direct Preference Optimization, emphasizing ethical and policy-aligned performance in the presence of jailbreaking attacks. Evaluation includes close-ended, open-ended, safety and human assessments, to maximize the reliability of results. Results: Recommendations are made across the entire pipeline, backed by the solid performance of the Aloe Family. These models deliver competitive performance across healthcare benchmarks and medical fields, and are often preferred by healthcare professionals. On bias and toxicity, the Aloe Beta models significantly improve safety, showing resilience to unseen jailbreaking attacks. For a responsible release, a detailed risk assessment specific to healthcare is attached to the Aloe Family models. Conclusion: The Aloe Beta models, and the recipe that leads to them, are a significant contribution to the open-source medical LLM field, offering top-of-the-line performance while maintaining high ethical requirements. This work sets a new standard for developing and reporting aligned LLMs in healthcare.

Many court systems are overwhelmed all over the world, leading to huge backlogs of pending cases. Effective triage systems, like those in emergency rooms, could ensure proper prioritization of open cases, optimizing time and resource allocation in the court system. In this work, we introduce the Criticality Prediction dataset, a novel resource for evaluating case prioritization. Our dataset features a two-tier labeling system: (1) the binary LD-Label, identifying cases published as Leading Decisions (LD), and (2) the more granular Citation-Label, ranking cases by their citation frequency and recency, allowing for a more nuanced evaluation. Unlike existing approaches that rely on resource-intensive manual annotations, we algorithmically derive labels leading to a much larger dataset than otherwise possible. We evaluate several multilingual models, including both smaller fine-tuned models and large language models in a zero-shot setting. Our results show that the fine-tuned models consistently outperform their larger counterparts, thanks to our large training set. Our results highlight that for highly domain-specific tasks like ours, large training sets are still valuable.

As the development of Large Models (LMs) progresses rapidly, their safety is also a priority. In current Large Language Models (LLMs) and Multimodal Large Language Models (MLLMs) safety workflow, evaluation, diagnosis, and alignment are often handled by separate tools. Specifically, safety evaluation can only locate external behavioral risks but cannot figure out internal root causes. Meanwhile, safety diagnosis often drifts from concrete risk scenarios and remains at the explainable level. In this way, safety alignment lack dedicated explanations of changes in internal mechanisms, potentially degrading general capabilities. To systematically address these issues, we propose an open-source project, namely DeepSight, to practice a new safety evaluation-diagnosis integrated paradigm. DeepSight is low-cost, reproducible, efficient, and highly scalable large-scale model safety evaluation project consisting of a evaluation toolkit DeepSafe and a diagnosis toolkit DeepScan. By unifying task and data protocols, we build a connection between the two stages and transform safety evaluation from black-box to white-box insight. Besides, DeepSight is the first open source toolkit that support the frontier AI risk evaluation and joint safety evaluation and diagnosis.

Vision Language Models (VLMs) are increasingly used for tasks like medical report generation and visual question answering. However, fluent diagnostic text does not guarantee safe visual understanding. In clinical practice, interpretation begins with pre-diagnostic sanity checks: verifying that the input is valid to read (correct modality and anatomy, plausible viewpoint and orientation, and no obvious integrity violations). Existing benchmarks largely assume this step is solved, and therefore miss a critical failure mode: a model can produce plausible narratives even when the input is inconsistent or invalid. We introduce MedObvious, a 1,880-task benchmark that isolates input validation as a set-level consistency capability over small multi-panel image sets: the model must identify whether any panel violates expected coherence. MedObvious spans five progressive tiers, from basic orientation/modality mismatches to clinically motivated anatomy/viewpoint verification and triage-style cues, and includes five evaluation formats to test robustness across interfaces. Evaluating 17 different VLMs, we find that sanity checking remains unreliable: several models hallucinate anomalies on normal (negative-control) inputs, performance degrades when scaling to larger image sets, and measured accuracy varies substantially between multiple-choice and open-ended settings. These results show that pre-diagnostic verification remains unsolved for medical VLMs and should be treated as a distinct, safety-critical capability before deployment.

Large language models (LLMs) are increasingly deployed in medical contexts, raising critical concerns about safety, alignment, and susceptibility to adversarial manipulation. While prior benchmarks assess model refusal capabilities for harmful prompts, they often lack clinical specificity, graded harmfulness levels, and coverage of jailbreak-style attacks. We introduce CARES (Clinical Adversarial Robustness and Evaluation of Safety), a benchmark for evaluating LLM safety in healthcare. CARES includes over 18,000 prompts spanning eight medical safety principles, four harm levels, and four prompting styles: direct, indirect, obfuscated, and role-play, to simulate both malicious and benign use cases. We propose a three-way response evaluation protocol (Accept, Caution, Refuse) and a fine-grained Safety Score metric to assess model behavior. Our analysis reveals that many state-of-the-art LLMs remain vulnerable to jailbreaks that subtly rephrase harmful prompts, while also over-refusing safe but atypically phrased queries. Finally, we propose a mitigation strategy using a lightweight classifier to detect jailbreak attempts and steer models toward safer behavior via reminder-based conditioning. CARES provides a rigorous framework for testing and improving medical LLM safety under adversarial and ambiguous conditions.

This position paper argues that the field of LLM agents requires a unified, telecom-inspired communication protocol to ensure safety, interoperability, and scalability, especially within the context of Next Generation (NextG) networks. Current ad-hoc communication methods are creating a fragmented ecosystem, reminiscent of the early "protocol wars" in networking, which stifles innovation and poses significant risks. Drawing inspiration from the layered, standardized protocols that underpin modern telecommunications, we propose the LLM-Agent Communication Protocol (LACP). LACP establishes a three-layer architecture designed to ensure semantic clarity in communication, transactional integrity for complex tasks, and robust, built-in security. In this position paper, we argue that adopting a principled, universal protocol is not merely beneficial but essential for realizing the potential of distributed AI. Such a standard is critical for ensuring that multi-agent systems can operate safely and reliably in the complex, real-time applications envisioned for 6G and beyond.

The electrocardiogram (ECG) is a cost-effective, highly accessible and widely employed diagnostic tool. With the advent of Foundation Models (FMs), the field of AI-assisted ECG interpretation has begun to evolve, as they enable model reuse across different tasks by relying on embeddings. However, to responsibly employ FMs, it is crucial to rigorously assess to which extent the embeddings they produce are generalizable, particularly in error-sensitive domains such as healthcare. Although prior works have already addressed the problem of benchmarking ECG-expert FMs, they focus predominantly on the evaluation of downstream performance. To fill this gap, this study aims to find an in-depth, comprehensive benchmarking framework for FMs, with a specific focus on ECG-expert ones. To this aim, we introduce a benchmark methodology that complements performance-based evaluation with representation-level analysis, leveraging SHAP and UMAP techniques. Furthermore, we rely on the methodology for carrying out an extensive evaluation of several ECG-expert FMs pretrained via state-of-the-art techniques over different cross-continental datasets and data availability settings; this includes ones featuring data scarcity, a fairly common situation in real-world medical scenarios. Experimental results show that our benchmarking protocol provides a rich insight of ECG-expert FMs' embedded patterns, enabling a deeper understanding of their representational structure and generalizability.

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.

Large language models (LLMs) exhibit advancing capabilities in complex tasks, such as reasoning and graduate-level question answering, yet their resilience against misuse, particularly involving scientifically sophisticated risks, remains underexplored. Existing safety benchmarks typically focus either on instructions requiring minimal knowledge comprehension (e.g., ``tell me how to build a bomb") or utilize prompts that are relatively low-risk (e.g., multiple-choice or classification tasks about hazardous content). Consequently, they fail to adequately assess model safety when handling knowledge-intensive, hazardous scenarios. To address this critical gap, we introduce SOSBench, a regulation-grounded, hazard-focused benchmark encompassing six high-risk scientific domains: chemistry, biology, medicine, pharmacology, physics, and psychology. The benchmark comprises 3,000 prompts derived from real-world regulations and laws, systematically expanded via an LLM-assisted evolutionary pipeline that introduces diverse, realistic misuse scenarios (e.g., detailed explosive synthesis instructions involving advanced chemical formulas). We evaluate frontier models within a unified evaluation framework using our SOSBench. Despite their alignment claims, advanced models consistently disclose policy-violating content across all domains, demonstrating alarmingly high rates of harmful responses (e.g., 79.1% for Deepseek-R1 and 47.3% for GPT-4.1). These results highlight significant safety alignment deficiencies and underscore urgent concerns regarding the responsible deployment of powerful LLMs.

Large language model (LLM) systems are increasingly used to support high-stakes decision-making, but they typically perform worse when the available evidence is internally inconsistent. Such a scenario exists in real-world healthcare settings, with patient-reported symptoms contradicting medical signs. To study this problem, we introduce MIMIC-DOS, a dataset for short-horizon organ dysfunction worsening prediction in the intensive care unit (ICU) setting. We derive this dataset from the widely recognized MIMIC-IV, a publicly available electronic health record dataset, and construct it exclusively from cases in which discordance between signs and symptoms exists. This setting poses a substantial challenge for existing LLM-based approaches, with single-pass LLMs and agentic pipelines often struggling to reconcile such conflicting signals. To address this problem, we propose CARE: a multi-stage privacy-compliant agentic reasoning framework in which a remote LLM provides guidance by generating structured categories and transitions without accessing sensitive patient data, while a local LLM uses these categories and transitions to support evidence acquisition and final decision-making. Empirically, CARE achieves stronger performance across all key metrics compared to multiple baseline settings, showing that CARE can more robustly handle conflicting clinical evidence while preserving privacy.

The primary goal of drug safety researchers and regulators is to promptly identify adverse drug reactions. Doing so may in turn prevent or reduce the harm to patients and ultimately improve public health. Evaluating and monitoring drug safety (i.e., pharmacovigilance) involves analyzing an ever growing collection of spontaneous reports from health professionals, physicians, and pharmacists, and information voluntarily submitted by patients. In this scenario, facilitating analysis of such reports via automation has the potential to rapidly identify safety signals. Unfortunately, public resources for developing natural language models for this task are scant. We present PHEE, a novel dataset for pharmacovigilance comprising over 5000 annotated events from medical case reports and biomedical literature, making it the largest such public dataset to date. We describe the hierarchical event schema designed to provide coarse and fine-grained information about patients' demographics, treatments and (side) effects. Along with the discussion of the dataset, we present a thorough experimental evaluation of current state-of-the-art approaches for biomedical event extraction, point out their limitations, and highlight open challenges to foster future research in this area.

The mining of adverse drug events (ADEs) is pivotal in pharmacovigilance, enhancing patient safety by identifying potential risks associated with medications, facilitating early detection of adverse events, and guiding regulatory decision-making. Traditional ADE detection methods are reliable but slow, not easily adaptable to large-scale operations, and offer limited information. With the exponential increase in data sources like social media content, biomedical literature, and Electronic Medical Records (EMR), extracting relevant ADE-related information from these unstructured texts is imperative. Previous ADE mining studies have focused on text-based methodologies, overlooking visual cues, limiting contextual comprehension, and hindering accurate interpretation. To address this gap, we present a MultiModal Adverse Drug Event (MMADE) detection dataset, merging ADE-related textual information with visual aids. Additionally, we introduce a framework that leverages the capabilities of LLMs and VLMs for ADE detection by generating detailed descriptions of medical images depicting ADEs, aiding healthcare professionals in visually identifying adverse events. Using our MMADE dataset, we showcase the significance of integrating visual cues from images to enhance overall performance. This approach holds promise for patient safety, ADE awareness, and healthcare accessibility, paving the way for further exploration in personalized healthcare.

The rapid development of Large Language Models (LLMs) for healthcare applications has spurred calls for holistic evaluation beyond frequently-cited benchmarks like USMLE, to better reflect real-world performance. While real-world assessments are valuable indicators of utility, they often lag behind the pace of LLM evolution, likely rendering findings obsolete upon deployment. This temporal disconnect necessitates a comprehensive upfront evaluation that can guide model selection for specific clinical applications. We introduce MEDIC, a framework assessing LLMs across five critical dimensions of clinical competence: medical reasoning, ethics and bias, data and language understanding, in-context learning, and clinical safety. MEDIC features a novel cross-examination framework quantifying LLM performance across areas like coverage and hallucination detection, without requiring reference outputs. We apply MEDIC to evaluate LLMs on medical question-answering, safety, summarization, note generation, and other tasks. Our results show performance disparities across model sizes, baseline vs medically finetuned models, and have implications on model selection for applications requiring specific model strengths, such as low hallucination or lower cost of inference. MEDIC's multifaceted evaluation reveals these performance trade-offs, bridging the gap between theoretical capabilities and practical implementation in healthcare settings, ensuring that the most promising models are identified and adapted for diverse healthcare applications.

Powered by remarkable advancements in Large Language Models (LLMs), Multimodal Large Language Models (MLLMs) demonstrate impressive capabilities in manifold tasks. However, the practical application scenarios of MLLMs are intricate, exposing them to potential malicious instructions and thereby posing safety risks. While current benchmarks do incorporate certain safety considerations, they often lack comprehensive coverage and fail to exhibit the necessary rigor and robustness. For instance, the common practice of employing GPT-4V as both the evaluator and a model to be evaluated lacks credibility, as it tends to exhibit a bias toward its own responses. In this paper, we present MLLMGuard, a multidimensional safety evaluation suite for MLLMs, including a bilingual image-text evaluation dataset, inference utilities, and a lightweight evaluator. MLLMGuard's assessment comprehensively covers two languages (English and Chinese) and five important safety dimensions (Privacy, Bias, Toxicity, Truthfulness, and Legality), each with corresponding rich subtasks. Focusing on these dimensions, our evaluation dataset is primarily sourced from platforms such as social media, and it integrates text-based and image-based red teaming techniques with meticulous annotation by human experts. This can prevent inaccurate evaluation caused by data leakage when using open-source datasets and ensures the quality and challenging nature of our benchmark. Additionally, a fully automated lightweight evaluator termed GuardRank is developed, which achieves significantly higher evaluation accuracy than GPT-4. Our evaluation results across 13 advanced models indicate that MLLMs still have a substantial journey ahead before they can be considered safe and responsible.

Multimodal Large Language Models (MLLMs) have tremendous potential to improve the accuracy, availability, and cost-effectiveness of healthcare by providing automated solutions or serving as aids to medical professionals. Despite promising first steps in developing medical MLLMs in the past few years, their capabilities and limitations are not well-understood. Recently, many benchmark datasets have been proposed that test the general medical knowledge of such models across a variety of medical areas. However, the systematic failure modes and vulnerabilities of such models are severely underexplored with most medical benchmarks failing to expose the shortcomings of existing models in this safety-critical domain. In this paper, we introduce MediConfusion, a challenging medical Visual Question Answering (VQA) benchmark dataset, that probes the failure modes of medical MLLMs from a vision perspective. We reveal that state-of-the-art models are easily confused by image pairs that are otherwise visually dissimilar and clearly distinct for medical experts. Strikingly, all available models (open-source or proprietary) achieve performance below random guessing on MediConfusion, raising serious concerns about the reliability of existing medical MLLMs for healthcare deployment. We also extract common patterns of model failure that may help the design of a new generation of more trustworthy and reliable MLLMs in healthcare.

The electrocardiogram (ECG) is an essential non-invasive diagnostic tool for assessing cardiac conditions. Existing automatic interpretation methods suffer from limited generalizability, focusing on a narrow range of cardiac conditions, and typically depend on raw physiological signals, which may not be readily available in resource-limited settings where only printed or digital ECG images are accessible. Recent advancements in multimodal large language models (MLLMs) present promising opportunities for addressing these challenges. However, the application of MLLMs to ECG image interpretation remains challenging due to the lack of instruction tuning datasets and well-established ECG image benchmarks for quantitative evaluation. To address these challenges, we introduce ECGInstruct, a comprehensive ECG image instruction tuning dataset of over one million samples, covering a wide range of ECG-related tasks from diverse data sources. Using ECGInstruct, we develop PULSE, an MLLM tailored for ECG image comprehension. In addition, we curate ECGBench, a new evaluation benchmark covering four key ECG image interpretation tasks across nine different datasets. Our experiments show that PULSE sets a new state-of-the-art, outperforming general MLLMs with an average accuracy improvement of 15% to 30%. This work highlights the potential of PULSE to enhance ECG interpretation in clinical practice.

During the COVID-19 pandemic, a significant effort has gone into developing ML-driven epidemic forecasting techniques. However, benchmarks do not exist to claim if a new AI/ML technique is better than the existing ones. The "covid-forecast-hub" is a collection of more than 30 teams, including us, that submit their forecasts weekly to the CDC. It is not possible to declare whether one method is better than the other using those forecasts because each team's submission may correspond to different techniques over the period and involve human interventions as the teams are continuously changing/tuning their approach. Such forecasts may be considered "human-expert" forecasts and do not qualify as AI/ML approaches, although they can be used as an indicator of human expert performance. We are interested in supporting AI/ML research in epidemic forecasting which can lead to scalable forecasting without human intervention. Which modeling technique, learning strategy, and data pre-processing technique work well for epidemic forecasting is still an open problem. To help advance the state-of-the-art AI/ML applied to epidemiology, a benchmark with a collection of performance points is needed and the current "state-of-the-art" techniques need to be identified. We propose EpiBench a platform consisting of community-driven benchmarks for AI/ML applied to epidemic forecasting to standardize the challenge with a uniform evaluation protocol. In this paper, we introduce a prototype of EpiBench which is currently running and accepting submissions for the task of forecasting COVID-19 cases and deaths in the US states and We demonstrate that we can utilize the prototype to develop an ensemble relying on fully automated epidemic forecasts (no human intervention) that reaches human-expert level ensemble currently being used by the CDC.

General-purpose large language models (LLMs), despite their broad capabilities accrued from open-world data, frequently exhibit suboptimal performance when confronted with the nuanced and specialized demands inherent in real-time telecommunications applications. This investigation addresses this critical limitation through the meticulous fine-tuning of TSLAM-Mini developed by NetoAI, a compact (3.8-billion parameter) causal language model architecturally derived from Phi-4 Mini Instruct 4B. The fine-tuning regimen leverages a bespoke dataset comprising 100,000 samples, strategically engineered to address 20 pivotal telecommunications use-cases, encompassing domains such as Network Fundamentals, IP Routing, MPLS, Network Security, Automation, OSS/BSS, RAN, Mobile Core, Satellite Communications, and Ethical AI. This dataset was curated utilizing NetoAI's DigiTwin platform, enriched with granular insights from venerated network Subject Matter Experts (SMEs) and authoritative RFC documents, thereby capturing high-fidelity representations of real-world network dynamics through simulations inspired by digital twin paradigms. Employing Quantized Low-Rank Adaptation (QLoRA), a state-of-the-art Parameter Efficient Fine-Tuning (PEFT) technique, we achieved substantial training efficiency and enabled prospective deployment on resource-constrained hardware. A novel evaluation framework, predicated on a high-capacity LLM (Qwen3-235B-A22B) functioning as an automated adjudicator, was instituted to rigorously assess instruction-following fidelity and response quality across the specified telecom use-cases. Empirical results unequivocally demonstrate TSLAM-Mini's superior aptitude in telecom-centric applications, underscoring the profound efficacy of domain-specific datasets and PEFT methodologies for advancing intelligent network management.

Progress in computer-aided synthesis planning (CASP) is obscured by the lack of standardized evaluation infrastructure and the reliance on metrics that prioritize topological completion over chemical validity. We introduce RetroCast, a unified evaluation suite that standardizes heterogeneous model outputs into a common schema to enable statistically rigorous, apples-to-apples comparison. The framework includes a reproducible benchmarking pipeline with stratified sampling and bootstrapped confidence intervals, accompanied by SynthArena, an interactive platform for qualitative route inspection. We utilize this infrastructure to evaluate leading search-based and sequence-based algorithms on a new suite of standardized benchmarks. Our analysis reveals a divergence between "solvability" (stock-termination rate) and route quality; high solvability scores often mask chemical invalidity or fail to correlate with the reproduction of experimental ground truths. Furthermore, we identify a "complexity cliff" in which search-based methods, despite high solvability rates, exhibit a sharp performance decay in reconstructing long-range synthetic plans compared to sequence-based approaches. We release the full framework, benchmark definitions, and a standardized database of model predictions to support transparent and reproducible development in the field.

Model predictive control (MPC)-based energy management systems (EMS) are essential for ensuring optimal, secure, and stable operation in microgrids with high penetrations of distributed energy resources. However, due to the high computational cost for the decision-making, the conventional MPC-based EMS typically adopts a simplified integrated-bus power balance model. While this simplification is effective for small networks, large-scale systems require a more detailed branch flow model to account for the increased impact of grid power losses and security constraints. This work proposes an efficient and reliable MPC-based EMS that incorporates power-loss effects and grid-security constraints. %, while adaptively shaping the battery power profile in response to online renewable inputs, achieving reduced operational costs. It enhances system reliability, reduces operational costs, and shows strong potential for online implementation due to its reduced computational effort. Specifically, a second-order cone program (SOCP) branch flow relaxation is integrated into the constraint set, yielding a convex formulation that guarantees globally optimal solutions with high computational efficiency. Owing to the radial topology of the microgrid, this relaxation is practically tight, ensuring equivalence to the original problem. Building on this foundation, an online demand response (DR) module is designed to further reduce the operation cost through peak shaving. To the best of our knowledge, no prior MPC-EMS framework has simultaneously modeled losses and security constraints while coordinating flexible loads within a unified architecture. The developed framework enables secure operation with effective peak shaving and reduced total cost. The effectiveness of the proposed method is validated on 10-bus, 18-bus, and 33-bus systems.

The proposed IncidentResponseGPT framework - a novel system that applies generative artificial intelligence (AI) to potentially enhance the efficiency and effectiveness of traffic incident response. This model allows for synthesis of region-specific incident response guidelines and generates incident response plans adapted to specific area, aiming to expedite decision-making for traffic management authorities. This approach aims to accelerate incident resolution times by suggesting various recommendations (e.g. optimal rerouting strategies, estimating resource needs) to minimize the overall impact on the urban traffic network. The system suggests specific actions, including dynamic lane closures, optimized rerouting and dispatching appropriate emergency resources. IncidentResponseGPT employs the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) to rank generated response plans based on criteria like impact minimization and resource efficiency based on their proximity to an human-proposed solution.

We present a new challenging dataset, CPPE - 5 (Medical Personal Protective Equipment), with the goal to allow the study of subordinate categorization of medical personal protective equipments, which is not possible with other popular data sets that focus on broad-level categories (such as PASCAL VOC, ImageNet, Microsoft COCO, OpenImages, etc). To make it easy for models trained on this dataset to be used in practical scenarios in complex scenes, our dataset mainly contains images that show complex scenes with several objects in each scene in their natural context. The image collection for this dataset focuses on: obtaining as many non-iconic images as possible and making sure all the images are real-life images, unlike other existing datasets in this area. Our dataset includes 5 object categories (coveralls, face shields, gloves, masks, and goggles), and each image is annotated with a set of bounding boxes and positive labels. We present a detailed analysis of the dataset in comparison to other popular broad category datasets as well as datasets focusing on personal protective equipments, we also find that at present there exist no such publicly available datasets. Finally, we also analyze performance and compare model complexities on baseline and state-of-the-art models for bounding box results. Our code, data, and trained models are available at https://git.io/cppe5-dataset.

Accurate long horizon forecasting of particulate matter (PM) concentration fields is essential for operational public health decisions. However, achieving reliable forecasts remains challenging in regions with complex terrain and strong atmospheric dynamics such as East Asia. While foundation models such as Aurora offer global generality, they often miss region-specific dynamics and rely on non-real-time inputs, limiting their practical utility for localized warning systems. To address this gap, we construct and release the real-world observations and high-resolution CMAQ-OBS dataset for East Asia, reducing regional error by 59.5% and enabling real-time 48-120 hour forecasts critical for public health alerts. However, standard point-wise objectives cannot reflect asymmetric operational costs, where false alarms deteriorate public trust while missed severe events endanger populations. This cost mismatch causes SFT models to over-predict and yield high False Alarm Rates. We introduce Group-Relative Policy Optimization (GRPO) with class-wise rewards and curriculum rollout to align predictions with operational priorities. Experimental results demonstrate that our framework significantly improves the reliability of the forecast. Compared to the SFT-only baseline, our model reduces the False Alarm Rate by 47.3% while achieving a competitive F1-score, proving its effectiveness for practical, real-world air quality forecasting systems on long lead time scenarios.

Understanding and anticipating vulnerability-related activity is a major challenge in cyber threat intelligence. This work investigates whether vulnerability sightings, such as proof-of-concept releases, detection templates, or online discussions, can be forecast over time. Building on our earlier work on VLAI, a transformer-based model that predicts vulnerability severity from textual descriptions, we examine whether severity scores can improve time-series forecasting as exogenous variables. We evaluate several approaches for short-term forecasting of sightings per vulnerability. First, we test SARIMAX models with and without log(x+1) transformations and VLAI-derived severity inputs. Although these adjustments provide limited improvements, SARIMAX remains poorly suited to sparse, short, and bursty vulnerability data. In practice, forecasts often produce overly wide confidence intervals and sometimes unrealistic negative values. To better capture the discrete and event-driven nature of sightings, we then explore count-based methods such as Poisson regression. Early results show that these models produce more stable and interpretable forecasts, especially when sightings are aggregated weekly. We also discuss simpler operational alternatives, including exponential decay functions for short forecasting horizons, to estimate future activity without requiring long historical series. Overall, this study highlights both the potential and the limitations of forecasting rare and bursty cyber events, and provides practical guidance for integrating predictive analytics into vulnerability intelligence workflows.

The Model Context Protocol (MCP) standardizes how AI agents discover and invoke external tools, with over 10,000 active servers and 97 million monthly SDK downloads as of early 2026. Yet MCP does not yet standardize how agents safely operate those tools at production scale. Three protocol-level primitives remain missing: identity propagation, adaptive tool budgeting, and structured error semantics. This paper identifies these gaps through field lessons from an enterprise deployment of an AI agent platform integrated with a major cloud provider's MCP servers (client name redacted). We propose three mechanisms to fill them: (1) the Context-Aware Broker Protocol (CABP), which extends JSON-RPC with identity-scoped request routing via a six-stage broker pipeline; (2) Adaptive Timeout Budget Allocation (ATBA), which frames sequential tool invocation as a budget allocation problem over heterogeneous latency distributions; and (3) the Structured Error Recovery Framework (SERF), which provides machine-readable failure semantics that enable deterministic agent self-correction. We organize production failure modes into five design dimensions (server contracts, user context, timeouts, errors, and observability), document concrete failure vignettes, and present a production readiness checklist. All three algorithms are formalized as testable hypotheses with reproducible experimental methodology. Field observations demonstrate that while MCP provides a solid protocol foundation, reliable agent tool integration requires infrastructure-level mechanisms that the specification does not yet address.

Air quality prediction and modelling plays a pivotal role in public health and environment management, for individuals and authorities to make informed decisions. Although traditional data-driven models have shown promise in this domain, their long-term prediction accuracy can be limited, especially in scenarios with sparse or incomplete data and they often rely on black-box deep learning structures that lack solid physical foundation leading to reduced transparency and interpretability in predictions. To address these limitations, this paper presents a novel approach named Physics guided Neural Network for Air Quality Prediction (AirPhyNet). Specifically, we leverage two well-established physics principles of air particle movement (diffusion and advection) by representing them as differential equation networks. Then, we utilize a graph structure to integrate physics knowledge into a neural network architecture and exploit latent representations to capture spatio-temporal relationships within the air quality data. Experiments on two real-world benchmark datasets demonstrate that AirPhyNet outperforms state-of-the-art models for different testing scenarios including different lead time (24h, 48h, 72h), sparse data and sudden change prediction, achieving reduction in prediction errors up to 10%. Moreover, a case study further validates that our model captures underlying physical processes of particle movement and generates accurate predictions with real physical meaning.

Improving large language models (LLMs) for electronic health record (EHR) reasoning is essential for enabling accurate and generalizable clinical predictions. While LLMs excel at medical text understanding, they underperform on EHR-based prediction tasks due to challenges in modeling temporally structured, high-dimensional data. Existing approaches often rely on hybrid paradigms, where LLMs serve merely as frozen prior retrievers while downstream deep learning (DL) models handle prediction, failing to improve the LLM's intrinsic reasoning capacity and inheriting the generalization limitations of DL models. To this end, we propose EAG-RL, a novel two-stage training framework designed to intrinsically enhance LLMs' EHR reasoning ability through expert attention guidance, where expert EHR models refer to task-specific DL models trained on EHR data. Concretely, EAG-RL first constructs high-quality, stepwise reasoning trajectories using expert-guided Monte Carlo Tree Search to effectively initialize the LLM's policy. Then, EAG-RL further optimizes the policy via reinforcement learning by aligning the LLM's attention with clinically salient features identified by expert EHR models. Extensive experiments on two real-world EHR datasets show that EAG-RL improves the intrinsic EHR reasoning ability of LLMs by an average of 14.62%, while also enhancing robustness to feature perturbations and generalization to unseen clinical domains. These results demonstrate the practical potential of EAG-RL for real-world deployment in clinical prediction tasks. Our code have been available at https://github.com/devilran6/EAG-RL.

Despite their remarkable achievements and widespread adoption, Multimodal Large Language Models (MLLMs) have revealed significant security vulnerabilities, highlighting the urgent need for robust safety evaluation benchmarks. Existing MLLM safety benchmarks, however, fall short in terms of data quality and coverge, and modal risk combinations, resulting in inflated and contradictory evaluation results, which hinders the discovery and governance of security concerns. Besides, we argue that vulnerabilities to harmful queries and oversensitivity to harmless ones should be considered simultaneously in MLLMs safety evaluation, whereas these were previously considered separately. In this paper, to address these shortcomings, we introduce Unified Safety Benchmarks (USB), which is one of the most comprehensive evaluation benchmarks in MLLM safety. Our benchmark features high-quality queries, extensive risk categories, comprehensive modal combinations, and encompasses both vulnerability and oversensitivity evaluations. From the perspective of two key dimensions: risk categories and modality combinations, we demonstrate that the available benchmarks -- even the union of the vast majority of them -- are far from being truly comprehensive. To bridge this gap, we design a sophisticated data synthesis pipeline that generates extensive, high-quality complementary data addressing previously unexplored aspects. By combining open-source datasets with our synthetic data, our benchmark provides 4 distinct modality combinations for each of the 61 risk sub-categories, covering both English and Chinese across both vulnerability and oversensitivity dimensions.

Multi-model routing has evolved from an engineering technique into essential infrastructure, yet existing work lacks a systematic, reproducible benchmark for evaluating vision-language models (VLMs). We present VL-RouterBench to assess the overall capability of VLM routing systems systematically. The benchmark is grounded in raw inference and scoring logs from VLMs and constructs quality and cost matrices over sample-model pairs. In scale, VL-RouterBench covers 14 datasets across 3 task groups, totaling 30,540 samples, and includes 15 open-source models and 2 API models, yielding 519,180 sample-model pairs and a total input-output token volume of 34,494,977. The evaluation protocol jointly measures average accuracy, average cost, and throughput, and builds a ranking score from the harmonic mean of normalized cost and accuracy to enable comparison across router configurations and cost budgets. On this benchmark, we evaluate 10 routing methods and baselines and observe a significant routability gain, while the best current routers still show a clear gap to the ideal Oracle, indicating considerable room for improvement in router architecture through finer visual cues and modeling of textual structure. We will open-source the complete data construction and evaluation toolchain to promote comparability, reproducibility, and practical deployment in multimodal routing research.

Image content safety has become a significant challenge with the rise of visual media on online platforms. Meanwhile, in the age of AI-generated content (AIGC), many image generation models are capable of producing harmful content, such as images containing sexual or violent material. Thus, it becomes crucial to identify such unsafe images based on established safety rules. Pre-trained Multimodal Large Language Models (MLLMs) offer potential in this regard, given their strong pattern recognition abilities. Existing approaches typically fine-tune MLLMs with human-labeled datasets, which however brings a series of drawbacks. First, relying on human annotators to label data following intricate and detailed guidelines is both expensive and labor-intensive. Furthermore, users of safety judgment systems may need to frequently update safety rules, making fine-tuning on human-based annotation more challenging. This raises the research question: Can we detect unsafe images by querying MLLMs in a zero-shot setting using a predefined safety constitution (a set of safety rules)? Our research showed that simply querying pre-trained MLLMs does not yield satisfactory results. This lack of effectiveness stems from factors such as the subjectivity of safety rules, the complexity of lengthy constitutions, and the inherent biases in the models. To address these challenges, we propose a MLLM-based method includes objectifying safety rules, assessing the relevance between rules and images, making quick judgments based on debiased token probabilities with logically complete yet simplified precondition chains for safety rules, and conducting more in-depth reasoning with cascaded chain-of-thought processes if necessary. Experiment results demonstrate that our method is highly effective for zero-shot image safety judgment tasks.

Electronic health records (EHRs) contain vast amounts of complex data, but harmonizing and processing this information remains a challenging and costly task requiring significant clinical expertise. While large language models (LLMs) have shown promise in various healthcare applications, their potential for abstracting medical concepts from EHRs remains largely unexplored. We introduce EHRmonize, a framework leveraging LLMs to abstract medical concepts from EHR data. Our study uses medication data from two real-world EHR databases to evaluate five LLMs on two free-text extraction and six binary classification tasks across various prompting strategies. GPT-4o's with 10-shot prompting achieved the highest performance in all tasks, accompanied by Claude-3.5-Sonnet in a subset of tasks. GPT-4o achieved an accuracy of 97% in identifying generic route names, 82% for generic drug names, and 100% in performing binary classification of antibiotics. While EHRmonize significantly enhances efficiency, reducing annotation time by an estimated 60%, we emphasize that clinician oversight remains essential. Our framework, available as a Python package, offers a promising tool to assist clinicians in EHR data abstraction, potentially accelerating healthcare research and improving data harmonization processes.

Despite recent advancements in speech recognition, there are still difficulties in accurately transcribing conversational and emotional speech in noisy and reverberant acoustic environments. This poses a particular challenge in the search and rescue (SAR) domain, where transcribing conversations among rescue team members is crucial to support real-time decision-making. The scarcity of speech data and associated background noise in SAR scenarios make it difficult to deploy robust speech recognition systems. To address this issue, we have created and made publicly available a German speech dataset called RescueSpeech. This dataset includes real speech recordings from simulated rescue exercises. Additionally, we have released competitive training recipes and pre-trained models. Our study indicates that the current level of performance achieved by state-of-the-art methods is still far from being acceptable.

Multimodal Large Language Models (MLLMs) have demonstrated impressive capabilities in multimodal understanding, reasoning, and interaction. Given the extensive applications of MLLMs, the associated safety issues have become increasingly critical. Due to the effectiveness of preference optimization in aligning MLLMs with human preferences, there is an urgent need for safety-related preference data for MLLMs. To address this, we construct the MMSafe-PO preference dataset towards harmless multimodal assistants, featuring multimodal instructions, the conversational format, and ranked paired responses from human feedback. We also identify two insightful observations: modality co-defense and modality cheating, which illustrate that MLLMs possess a certain level of inherent defense while still presenting unique safety challenges. Based on these observations, we propose the Blind Preference Optimization (BPO) approach. Comprehensive experiments on three benchmarks show that BPO effectively enhances the safety capabilities of MLLMs. Notably, BPO significantly improves the safety rate of the base MLLM by 45.0%, outperforming the DPO approach. Additionally, applying BPO to the MMSafe-PO dataset greatly reduces the base MLLM's unsafe rate on other safety benchmarks (14.5% on MM-SafetyBench and 82.9% on HarmEval, demonstrating the effectiveness and robustness of both the dataset and the approach. We release code and data at https://lu-yang666.github.io/MMsafe-PO-Web/.