Daily Papers

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.

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

While Large Language Models (LLMs) have shown strong performance on clinical text understanding, they struggle with longitudinal prediction tasks such as dementia prognosis, which require reasoning over complex, non-monotonic symptom trajectories across multiple visits. Standard supervised training lacks explicit annotations for symptom evolution, while direct Reinforcement Learning (RL) is hindered by sparse binary rewards. To address this challenge, we introduce Dementia-R1, an RL-based framework for longitudinal dementia prognosis from unstructured clinical notes. Our approach adopts a Cold-Start RL strategy that pre-trains the model to predict verifiable clinical indices extracted from patient histories, enhancing the capability to reason about disease progression before determining the final clinical status. Extensive experiments demonstrate that Dementia-R1 achieves an F1 score of 77.03% on real-world unstructured clinical datasets. Notably, on the ADNI benchmark, our 7B model rivals GPT-4o, effectively capturing fluctuating cognitive trajectories. Code is available at https://anonymous.4open.science/r/dementiar1-CDB5

Objective: Using natural language processing (NLP) to find sentences that state treatment plans in a clinical note, would automate plan extraction and would further enable their use in tools that help providers and care managers. However, as in the most NLP tasks on clinical text, creating gold standard to train and test NLP models is tedious and expensive. Fortuitously, sometimes but not always clinical notes contain sections with a heading that identifies the section as a plan. Leveraging contents of such labeled sections as a noisy training data, we assessed accuracy of NLP models trained with the data. Methods: We used common variations of plan headings and rule-based heuristics to find plan sections with headings in clinical notes, and we extracted sentences from them and formed a noisy training data of plan sentences. We trained Support Vector Machine (SVM) and Convolutional Neural Network (CNN) models with the data. We measured accuracy of the trained models on the noisy dataset using ten-fold cross validation and separately on a set-aside manually annotated dataset. Results: About 13% of 117,730 clinical notes contained treatment plans sections with recognizable headings in the 1001 longitudinal patient records that were obtained from Cleveland Clinic under an IRB approval. We were able to extract and create a noisy training data of 13,492 plan sentences from the clinical notes. CNN achieved best F measures, 0.91 and 0.97 in the cross-validation and set-aside evaluation experiments respectively. SVM slightly underperformed with F measures of 0.89 and 0.96 in the same experiments. Conclusion: Our study showed that the training supervised learning models using noisy plan sentences was effective in identifying them in all clinical notes. More broadly, sections with informal headings in clinical notes can be a good source for generating effective training data.

Electronic Health Records (EHRs) hold immense potential for advancing healthcare, offering rich, longitudinal data that combines structured information with valuable insights from unstructured clinical notes. However, the unstructured nature of clinical text poses significant challenges for secondary applications. Traditional methods for structuring EHR free-text data, such as rule-based systems and multi-stage pipelines, are often limited by their time-consuming configurations and inability to adapt across clinical notes from diverse healthcare settings. Few systems provide a comprehensive attribute extraction for terminologies. While giant large language models (LLMs) like GPT-4 and LLaMA 405B excel at structuring tasks, they are slow, costly, and impractical for large-scale use. To overcome these limitations, we introduce GENIE, a Generative Note Information Extraction system that leverages LLMs to streamline the structuring of unstructured clinical text into usable data with standardized format. GENIE processes entire paragraphs in a single pass, extracting entities, assertion statuses, locations, modifiers, values, and purposes with high accuracy. Its unified, end-to-end approach simplifies workflows, reduces errors, and eliminates the need for extensive manual intervention. Using a robust data preparation pipeline and fine-tuned small scale LLMs, GENIE achieves competitive performance across multiple information extraction tasks, outperforming traditional tools like cTAKES and MetaMap and can handle extra attributes to be extracted. GENIE strongly enhances real-world applicability and scalability in healthcare systems. By open-sourcing the model and test data, we aim to encourage collaboration and drive further advancements in EHR structurization.

Recent advances in large language models have led to renewed interest in natural language processing in healthcare using the free text of clinical notes. One distinguishing characteristic of clinical notes is their long time span over multiple long documents. The unique structure of clinical notes creates a new design choice: when the context length for a language model predictor is limited, which part of clinical notes should we choose as the input? Existing studies either choose the inputs with domain knowledge or simply truncate them. We propose a framework to analyze the sections with high predictive power. Using MIMIC-III, we show that: 1) predictive power distribution is different between nursing notes and discharge notes and 2) combining different types of notes could improve performance when the context length is large. Our findings suggest that a carefully selected sampling function could enable more efficient information extraction from clinical notes.

The discharge summary is a one of critical documents in the patient journey, encompassing all events experienced during hospitalization, including multiple visits, medications, tests, surgery/procedures, and admissions/discharge. Providing a summary of the patient's progress is crucial, as it significantly influences future care and planning. Consequently, clinicians face the laborious and resource-intensive task of manually collecting, organizing, and combining all the necessary data for a discharge summary. Therefore, we propose "NOTE", which stands for "Notable generation Of patient Text summaries through an Efficient approach based on direct preference optimization". NOTE is based on Medical Information Mart for Intensive Care- III dataset and summarizes a single hospitalization of a patient. Patient events are sequentially combined and used to generate a discharge summary for each hospitalization. In the present circumstances, large language models' application programming interfaces (LLMs' APIs) are widely available, but importing and exporting medical data presents significant challenges due to privacy protection policies in healthcare institutions. Moreover, to ensure optimal performance, it is essential to implement a lightweight model for internal server or program within the hospital. Therefore, we utilized DPO and parameter efficient fine tuning (PEFT) techniques to apply a fine-tuning method that guarantees superior performance. To demonstrate the practical application of the developed NOTE, we provide a webpage-based demonstration software. In the future, we will aim to deploy the software available for actual use by clinicians in hospital. NOTE can be utilized to generate various summaries not only discharge summaries but also throughout a patient's journey, thereby alleviating the labor-intensive workload of clinicians and aiming for increased efficiency.

Iterative RAG for multi-hop question answering faces challenges with lengthy contexts and the buildup of irrelevant information. This hinders a model's capacity to process and reason over retrieved content and limits performance. While recent methods focus on compressing retrieved information, they are either restricted to single-round RAG, require finetuning or lack scalability in iterative RAG. To address these challenges, we propose Notes Writing, a method that generates concise and relevant notes from retrieved documents at each step, thereby reducing noise and retaining only essential information. This indirectly increases the effective context length of Large Language Models (LLMs), enabling them to reason and plan more effectively while processing larger volumes of input text. Notes Writing is framework agnostic and can be integrated with different iterative RAG methods. We demonstrate its effectiveness with three iterative RAG methods, across two models and four evaluation datasets. Notes writing yields an average improvement of 15.6 percentage points overall, with minimal increase in output tokens.

Daily progress notes are common types in the electronic health record (EHR) where healthcare providers document the patient's daily progress and treatment plans. The EHR is designed to document all the care provided to patients, but it also enables note bloat with extraneous information that distracts from the diagnoses and treatment plans. Applications of natural language processing (NLP) in the EHR is a growing field with the majority of methods in information extraction. Few tasks use NLP methods for downstream diagnostic decision support. We introduced the 2022 National NLP Clinical Challenge (N2C2) Track 3: Progress Note Understanding - Assessment and Plan Reasoning as one step towards a new suite of tasks. The Assessment and Plan Reasoning task focuses on the most critical components of progress notes, Assessment and Plan subsections where health problems and diagnoses are contained. The goal of the task was to develop and evaluate NLP systems that automatically predict causal relations between the overall status of the patient contained in the Assessment section and its relation to each component of the Plan section which contains the diagnoses and treatment plans. The goal of the task was to identify and prioritize diagnoses as the first steps in diagnostic decision support to find the most relevant information in long documents like daily progress notes. We present the results of 2022 n2c2 Track 3 and provide a description of the data, evaluation, participation and system performance.

Large language model (LLM) agents extend generative models with reasoning, tool use, and persistent memory, thereby enabling the automation of complex tasks. In healthcare, such systems could support documentation, care coordination, and clinical decision making. Their reliable deployment in hospitals, however, remains constrained by safety risks, limited transparency, and inadequate mechanisms for handling longitudinal clinical context. Here we propose an architecture that adapts LLM agents to hospital environments. The design comprises four components: a restricted execution environment inspired by multi-user operating systems, a document-centric interaction model linking patient and clinician agents, a page-indexed memory architecture for longitudinal context management, and a curated library of composable medical skills. Implemented on top of OpenClaw, an open-source agent orchestration framework, this design provides the basis for an Agentic Operating System for Hospitals: a computing layer for coordinating clinical workflows while preserving safety, transparency, and auditability. To evaluate the memory component, we introduce manifest-guided retrieval for hierarchical navigation of longitudinal patient records. In a benchmark derived from the MIMIC-IV dataset (v2.2) comprising 100 de-identified patient records and 300 clinical queries stratified across three difficulty tiers (100 per tier), manifest-guided retrieval matched a metadata-filtered RAG baseline on overall recall (0.877 versus 0.876) while achieving 2.2x higher precision (0.779 versus 0.352) and retrieving fewer documents; on tier-3 longitudinal queries, manifest recall was 21% higher (0.846 versus 0.701), confirming that LLM-guided hierarchical navigation is most valuable when queries span multiple care episodes. These results outline a practical path toward hospital-scale agentic infrastructure.

Longitudinal analysis has great potential to reveal developmental trajectories and monitor disease progression in medical imaging. This process relies on consistent and robust joint 4D segmentation. Traditional techniques are dependent on the similarity of images over time and the use of subject-specific priors to reduce random variation and improve the robustness and sensitivity of the overall longitudinal analysis. This is however slow and computationally intensive as subject-specific templates need to be rebuilt every time. The focus of this work to accelerate this analysis with the use of deep learning. The proposed approach is based on deep CNNs and incorporates semantic segmentation and provides a longitudinal relationship for the same subject. The proposed approach is based on deep CNNs and incorporates semantic segmentation and provides a longitudinal relationship for the same subject. The state of art using 3D patches as inputs to modified Unet provides results around {0.91 pm 0.5} Dice and using multi-view atlas in CNNs provide around the same results. In this work, different models are explored, each offers better accuracy and fast results while increasing the segmentation quality. These methods are evaluated on 135 scans from the EADC-ADNI Harmonized Hippocampus Protocol. Proposed CNN based segmentation approaches demonstrate how 2D segmentation using prior slices can provide similar results to 3D segmentation while maintaining good continuity in the 3D dimension and improved speed. Just using 2D modified sagittal slices provide us a better Dice and longitudinal analysis for a given subject. For the ADNI dataset, using the simple UNet CNN technique gives us {0.84 pm 0.5} and while using modified CNN techniques on the same input yields {0.89 pm 0.5}. Rate of atrophy and RMS error are calculated for several test cases using various methods and analyzed.

Brain tissue segmentation is essential for neuroscience and clinical studies. However, segmentation on longitudinal data is challenging due to dynamic brain changes across the lifespan. Previous researches mainly focus on self-supervision with regularizations and will lose longitudinal generalization when fine-tuning on a specific age group. In this paper, we propose a dual meta-learning paradigm to learn longitudinally consistent representations and persist when fine-tuning. Specifically, we learn a plug-and-play feature extractor to extract longitudinal-consistent anatomical representations by meta-feature learning and a well-initialized task head for fine-tuning by meta-initialization learning. Besides, two class-aware regularizations are proposed to encourage longitudinal consistency. Experimental results on the iSeg2019 and ADNI datasets demonstrate the effectiveness of our method. Our code is available at https://github.com/ladderlab-xjtu/DuMeta.

Researchers are usually interested in examining the impact of covariates when separating heterogeneous samples into latent classes that are more homogeneous. The majority of theoretical and empirical studies with such aims have focused on identifying covariates as predictors of class membership in the structural equation modeling framework. In other words, the covariates only indirectly affect the sample heterogeneity. However, the covariates' influence on between-individual differences can also be direct. This article presents a mixture model that investigates covariates to explain within-cluster and between-cluster heterogeneity simultaneously, known as a mixture-of-experts (MoE) model. This study aims to extend the MoE framework to investigate heterogeneity in nonlinear trajectories: to identify latent classes, covariates as predictors to clusters, and covariates that explain within-cluster differences in change patterns over time. Our simulation studies demonstrate that the proposed model generally estimates the parameters unbiasedly, precisely and exhibits appropriate empirical coverage for a nominal 95% confidence interval. This study also proposes implementing structural equation model forests to shrink the covariate space of the proposed mixture model. We illustrate how to select covariates and construct the proposed model with longitudinal mathematics achievement data. Additionally, we demonstrate that the proposed mixture model can be further extended in the structural equation modeling framework by allowing the covariates that have direct effects to be time-varying.

Under a unified operational definition, we define LLM memory as a persistent state written during pretraining, finetuning, or inference that can later be addressed and that stably influences outputs. We propose a four-part taxonomy (parametric, contextual, external, procedural/episodic) and a memory quadruple (location, persistence, write/access path, controllability). We link mechanism, evaluation, and governance via the chain write -> read -> inhibit/update. To avoid distorted comparisons across heterogeneous setups, we adopt a three-setting protocol (parametric only, offline retrieval, online retrieval) that decouples capability from information availability on the same data and timeline. On this basis we build a layered evaluation: parametric (closed-book recall, edit differential, memorization/privacy), contextual (position curves and the mid-sequence drop), external (answer correctness vs snippet attribution/faithfulness), and procedural/episodic (cross-session consistency and timeline replay, E MARS+). The framework integrates temporal governance and leakage auditing (freshness hits, outdated answers, refusal slices) and uncertainty reporting via inter-rater agreement plus paired tests with multiple-comparison correction. For updating and forgetting, we present DMM Gov: coordinating DAPT/TAPT, PEFT, model editing (ROME, MEND, MEMIT, SERAC), and RAG to form an auditable loop covering admission thresholds, rollout, monitoring, rollback, and change audits, with specs for timeliness, conflict handling, and long-horizon consistency. Finally, we give four testable propositions: minimum identifiability; a minimal evaluation card; causally constrained editing with verifiable forgetting; and when retrieval with small-window replay outperforms ultra-long-context reading. This yields a reproducible, comparable, and governable coordinate system for research and deployment.

Human organs constantly undergo anatomical changes due to a complex mix of short-term (e.g., heartbeat) and long-term (e.g., aging) factors. Evidently, prior knowledge of these factors will be beneficial when modeling their future state, i.e., via image generation. However, most of the medical image generation tasks only rely on the input from a single image, thus ignoring the sequential dependency even when longitudinal data is available. Sequence-aware deep generative models, where model input is a sequence of ordered and timestamped images, are still underexplored in the medical imaging domain that is featured by several unique challenges: 1) Sequences with various lengths; 2) Missing data or frame, and 3) High dimensionality. To this end, we propose a sequence-aware diffusion model (SADM) for the generation of longitudinal medical images. Recently, diffusion models have shown promising results in high-fidelity image generation. Our method extends this new technique by introducing a sequence-aware transformer as the conditional module in a diffusion model. The novel design enables learning longitudinal dependency even with missing data during training and allows autoregressive generation of a sequence of images during inference. Our extensive experiments on 3D longitudinal medical images demonstrate the effectiveness of SADM compared with baselines and alternative methods. The code is available at https://github.com/ubc-tea/SADM-Longitudinal-Medical-Image-Generation.

Video has become a popular media form for information sharing and consumption. However, taking notes while watching a video requires significant time and effort. To address this, we propose a novel interactive system, NoTeeline, for taking real-time, personalized notes. NoTeeline lets users quickly jot down keypoints (micronotes), which are automatically expanded into full-fledged notes that capture the content of the user's micronotes and are consistent with the user's writing style. In a within-subjects study (N=12), we found that NoTeeline helps users create high-quality notes that capture the essence of their micronotes with a higher factual correctness (93.2%) while accurately reflecting their writing style. While using NoTeeline, participants experienced significantly reduced mental effort, captured satisfactory notes while writing 47% less text, and completed notetaking with 43.9% less time compared to a manual notetaking baseline.

A crucial step within secondary analysis of electronic health records (EHRs) is to identify the patient cohort under investigation. While EHRs contain medical billing codes that aim to represent the conditions and treatments patients may have, much of the information is only present in the patient notes. Therefore, it is critical to develop robust algorithms to infer patients' conditions and treatments from their written notes. In this paper, we introduce a dataset for patient phenotyping, a task that is defined as the identification of whether a patient has a given medical condition (also referred to as clinical indication or phenotype) based on their patient note. Nursing Progress Notes and Discharge Summaries from the Intensive Care Unit of a large tertiary care hospital were manually annotated for the presence of several high-context phenotypes relevant to treatment and risk of re-hospitalization. This dataset contains 1102 Discharge Summaries and 1000 Nursing Progress Notes. Each Discharge Summary and Progress Note has been annotated by at least two expert human annotators (one clinical researcher and one resident physician). Annotated phenotypes include treatment non-adherence, chronic pain, advanced/metastatic cancer, as well as 10 other phenotypes. This dataset can be utilized for academic and industrial research in medicine and computer science, particularly within the field of medical natural language processing.

Objective: We develop a deep learning framework based on the pre-trained Bidirectional Encoder Representations from Transformers (BERT) model using unstructured clinical notes from electronic health records (EHRs) to predict the risk of disease progression from Mild Cognitive Impairment (MCI) to Alzheimer's Disease (AD). Materials and Methods: We identified 3657 patients diagnosed with MCI together with their progress notes from Northwestern Medicine Enterprise Data Warehouse (NMEDW) between 2000-2020. The progress notes no later than the first MCI diagnosis were used for the prediction. We first preprocessed the notes by deidentification, cleaning and splitting, and then pretrained a BERT model for AD (AD-BERT) based on the publicly available Bio+Clinical BERT on the preprocessed notes. The embeddings of all the sections of a patient's notes processed by AD-BERT were combined by MaxPooling to compute the probability of MCI-to-AD progression. For replication, we conducted a similar set of experiments on 2563 MCI patients identified at Weill Cornell Medicine (WCM) during the same timeframe. Results: Compared with the 7 baseline models, the AD-BERT model achieved the best performance on both datasets, with Area Under receiver operating characteristic Curve (AUC) of 0.8170 and F1 score of 0.4178 on NMEDW dataset and AUC of 0.8830 and F1 score of 0.6836 on WCM dataset. Conclusion: We developed a deep learning framework using BERT models which provide an effective solution for prediction of MCI-to-AD progression using clinical note analysis.

Large Language Models (LLMs) have shown strong promise for mining Electronic Health Records (EHRs) by reasoning over longitudinal clinical information to capture context-rich patient trajectories. However, leveraging LLMs for structured EHRs (e.g., standardized diagnosis and medication codes) presents two key challenges. First, translating time-stamped EHR sequences into plain text can obscure both temporal structure and code identities, weakening the ability to capture code co-occurrence and longitudinal regularities. Second, unlike cohort-trained predictive models that learn a shared, task-aligned representation space across patients, LLMs are often applied in a case-isolated inference setting where each patient is processed independently without leveraging population-level patterns. To address these challenges, we introduce RePrompT, a time-aware LLM framework that integrates structured EHR encoders through prompt tuning, without modifying underlying architectures. Specifically, RePrompT recurrently incorporates latent states from prior visits to preserve longitudinal information, and injects population-level information through trainable prompt tokens derived from a cohort-trained, task-aligned EHR encoder. Experiments on MIMIC-III and MIMIC-IV demonstrate that RePrompT consistently outperforms both EHR-based and LLM-based baselines across multiple clinical prediction tasks.

Note-taking is a critical practice for capturing, organizing, and reflecting on information in both academic and professional settings. The recent success of large language models has accelerated the development of AI-assisted tools, yet existing solutions often struggle with efficiency. We present NoteBar, an AI-assisted note-taking tool that leverages persona information and efficient language models to automatically organize notes into multiple categories and better support user workflows. To support research and evaluation in this space, we further introduce a novel persona-conditioned dataset of 3,173 notes and 8,494 annotated concepts across 16 MBTI personas, offering both diversity and semantic richness for downstream tasks. Finally, we demonstrate that NoteBar can be deployed in a practical and cost-effective manner, enabling interactive use without reliance on heavy infrastructure. Together, NoteBar and its accompanying dataset provide a scalable and extensible foundation for advancing AI-assisted personal knowledge management.

Identifying patient cohorts is fundamental to numerous healthcare tasks, including clinical trial recruitment and retrospective studies. Current cohort retrieval methods in healthcare organizations rely on automated queries of structured data combined with manual curation, which are time-consuming, labor-intensive, and often yield low-quality results. Recent advancements in large language models (LLMs) and information retrieval (IR) offer promising avenues to revolutionize these systems. Major challenges include managing extensive eligibility criteria and handling the longitudinal nature of unstructured Electronic Medical Records (EMRs) while ensuring that the solution remains cost-effective for real-world application. This paper introduces a new task, Automatic Cohort Retrieval (ACR), and evaluates the performance of LLMs and commercial, domain-specific neuro-symbolic approaches. We provide a benchmark task, a query dataset, an EMR dataset, and an evaluation framework. Our findings underscore the necessity for efficient, high-quality ACR systems capable of longitudinal reasoning across extensive patient databases.

Clinical notes contain information about patients that goes beyond structured data like lab values and medications. However, clinical notes have been underused relative to structured data, because notes are high-dimensional and sparse. This work develops and evaluates representations of clinical notes using bidirectional transformers (ClinicalBERT). ClinicalBERT uncovers high-quality relationships between medical concepts as judged by humans. ClinicalBert outperforms baselines on 30-day hospital readmission prediction using both discharge summaries and the first few days of notes in the intensive care unit. Code and model parameters are available.

Large Language Models (LLMs) have emerged as a new paradigm for recommendation by converting interacted item history into language modeling. However, constrained by the limited context length of LLMs, existing approaches have to truncate item history in the prompt, focusing only on recent interactions and sacrificing the ability to model long-term history. To enable LLMs to model long histories, we pursue a concise embedding representation for items and sessions. In the LLM embedding space, we construct an item's embedding by aggregating its textual token embeddings; similarly, we construct a session's embedding by aggregating its item embeddings. While efficient, this way poses two challenges since it ignores the temporal significance of user interactions and LLMs do not natively interpret our custom embeddings. To overcome these, we propose PatchRec, a multi-grained patch training method consisting of two stages: (1) Patch Pre-training, which familiarizes LLMs with aggregated embeddings -- patches, and (2) Patch Fine-tuning, which enables LLMs to capture time-aware significance in interaction history. Extensive experiments show that PatchRec effectively models longer behavior histories with improved efficiency. This work facilitates the practical use of LLMs for modeling long behavior histories. Codes are available at https://github.com/ljy0ustc/PatchRec.

Recent research has demonstrated the capability of behavior signals captured by smartphones and wearables for longitudinal behavior modeling. However, there is a lack of a comprehensive public dataset that serves as an open testbed for fair comparison among algorithms. Moreover, prior studies mainly evaluate algorithms using data from a single population within a short period, without measuring the cross-dataset generalizability of these algorithms. We present the first multi-year passive sensing datasets, containing over 700 user-years and 497 unique users' data collected from mobile and wearable sensors, together with a wide range of well-being metrics. Our datasets can support multiple cross-dataset evaluations of behavior modeling algorithms' generalizability across different users and years. As a starting point, we provide the benchmark results of 18 algorithms on the task of depression detection. Our results indicate that both prior depression detection algorithms and domain generalization techniques show potential but need further research to achieve adequate cross-dataset generalizability. We envision our multi-year datasets can support the ML community in developing generalizable longitudinal behavior modeling algorithms.

As the general capabilities of artificial intelligence (AI) agents continue to evolve, their ability to learn to master multiple complex tasks through experience remains a key challenge. Current LLM agents, particularly those based on proprietary language models, typically rely on prompts to incorporate knowledge about the target tasks. This approach does not allow the agent to internalize this information and instead relies on ever-expanding prompts to sustain its functionality in diverse scenarios. This resembles a system of notes used by a person affected by anterograde amnesia, the inability to form new memories. In this paper, we propose a novel method to train AI agents to incorporate knowledge and skills for multiple tasks without the need for either cumbersome note systems or prior high-quality demonstration data. Our approach employs an iterative process where the agent collects new experiences, receives corrective feedback from humans in the form of hints, and integrates this feedback into its weights via a context distillation training procedure. We demonstrate the efficacy of our approach by implementing it in a Llama-3-based agent that, after only a few rounds of feedback, outperforms advanced models GPT-4o and DeepSeek-V3 in tasksets requiring correct sequencing of information retrieval, tool use, and question answering.

Knowledge-intensive language tasks require NLP systems to both provide the correct answer and retrieve supporting evidence for it in a given corpus. Autoregressive language models are emerging as the de-facto standard for generating answers, with newer and more powerful systems emerging at an astonishing pace. In this paper we argue that all this (and future) progress can be directly applied to the retrieval problem with minimal intervention to the models' architecture. Previous work has explored ways to partition the search space into hierarchical structures and retrieve documents by autoregressively generating their unique identifier. In this work we propose an alternative that doesn't force any structure in the search space: using all ngrams in a passage as its possible identifiers. This setup allows us to use an autoregressive model to generate and score distinctive ngrams, that are then mapped to full passages through an efficient data structure. Empirically, we show this not only outperforms prior autoregressive approaches but also leads to an average improvement of at least 10 points over more established retrieval solutions for passage-level retrieval on the KILT benchmark, establishing new state-of-the-art downstream performance on some datasets, while using a considerably lighter memory footprint than competing systems. Code and pre-trained models at https://github.com/facebookresearch/SEAL.

Large language models (LLMs) have become popular writing tools among students and may expand access to high-quality feedback for students with less access to traditional writing support. At the same time, LLMs may standardize student voice or invite overreliance. This study examines how adoption of LLM-assisted writing varies across socioeconomic groups and how it relates to outcomes in a high-stakes context: U.S. college admissions. We analyze a de-identified longitudinal dataset of applications to a selective university from 2020 to 2024 (N = 81,663). Estimating LLM use using a distribution-based detector trained on synthetic and historical essays, we tracked how student writing changed as LLM use proliferated, how adoption differed by socioeconomic status (SES), and whether potential benefits translated equitably into admissions outcomes. Using fee-waiver status as a proxy for SES, we observe post-2023 convergence in surface-level linguistic features, with the largest changes in fee-waived and rejected applicants. Estimated LLM use rose sharply in 2024 across all groups, with disproportionately larger increases among lower SES applicants, consistent with an access hypothesis in which LLMs substitute for scarce writing support. However, increased estimated LLM use was more strongly associated with declines in predicted admission probability for lower SES applicants than for higher SES applicants, even after controlling for academic credentials and stylometric features. These findings raise concerns about equity and the validity of essay-based evaluation in an era of AI-assisted writing and provide the first large-scale longitudinal evidence linking LLM adoption, linguistic change, and evaluative outcomes in college admissions.

Many people aim for change, but not everyone succeeds. While there are a number of social psychology theories that propose motivation-related characteristics of those who persist with change, few computational studies have explored the motivational stage of personal change. In this paper, we investigate a new dataset consisting of the writings of people who manifest intention to change, some of whom persist while others do not. Using a variety of linguistic analysis techniques, we first examine the writing patterns that distinguish the two groups of people. Persistent people tend to reference more topics related to long-term self-improvement and use a more complicated writing style. Drawing on these consistent differences, we build a classifier that can reliably identify the people more likely to persist, based on their language. Our experiments provide new insights into the motivation-related behavior of people who persist with their intention to change.

The performance of speaker verification systems is adversely affected by speaker aging. However, due to challenges in data collection, particularly the lack of sustained and large-scale longitudinal data for individuals, research on speaker aging remains difficult. In this paper, we present VoxAging, a large-scale longitudinal dataset collected from 293 speakers (226 English speakers and 67 Mandarin speakers) over several years, with the longest time span reaching 17 years (approximately 900 weeks). For each speaker, the data were recorded at weekly intervals. We studied the phenomenon of speaker aging and its effects on advanced speaker verification systems, analyzed individual speaker aging processes, and explored the impact of factors such as age group and gender on speaker aging research.

Current LLM benchmarks focus on evaluating models' memory of facts and semantic relations, primarily assessing semantic aspects of long-term memory. However, in humans, long-term memory also includes episodic memory, which links memories to their contexts, such as the time and place they occurred. The ability to contextualize memories is crucial for many cognitive tasks and everyday functions. This form of memory has not been evaluated in LLMs with existing benchmarks. To address the gap in evaluating memory in LLMs, we introduce Sequence Order Recall Tasks (SORT), which we adapt from tasks used to study episodic memory in cognitive psychology. SORT requires LLMs to recall the correct order of text segments, and provides a general framework that is both easily extendable and does not require any additional annotations. We present an initial evaluation dataset, Book-SORT, comprising 36k pairs of segments extracted from 9 books recently added to the public domain. Based on a human experiment with 155 participants, we show that humans can recall sequence order based on long-term memory of a book. We find that models can perform the task with high accuracy when relevant text is given in-context during the SORT evaluation. However, when presented with the book text only during training, LLMs' performance on SORT falls short. By allowing to evaluate more aspects of memory, we believe that SORT will aid in the emerging development of memory-augmented models.

The growing availability of longitudinal Magnetic Resonance Imaging (MRI) datasets has facilitated Artificial Intelligence (AI)-driven modeling of disease progression, making it possible to predict future medical scans for individual patients. However, despite significant advancements in AI, current methods continue to face challenges including achieving patient-specific individualization, ensuring spatiotemporal consistency, efficiently utilizing longitudinal data, and managing the substantial memory demands of 3D scans. To address these challenges, we propose Brain Latent Progression (BrLP), a novel spatiotemporal model designed to predict individual-level disease progression in 3D brain MRIs. The key contributions in BrLP are fourfold: (i) it operates in a small latent space, mitigating the computational challenges posed by high-dimensional imaging data; (ii) it explicitly integrates subject metadata to enhance the individualization of predictions; (iii) it incorporates prior knowledge of disease dynamics through an auxiliary model, facilitating the integration of longitudinal data; and (iv) it introduces the Latent Average Stabilization (LAS) algorithm, which (a) enforces spatiotemporal consistency in the predicted progression at inference time and (b) allows us to derive a measure of the uncertainty for the prediction at the global and voxel level. We train and evaluate BrLP on 11,730 T1-weighted (T1w) brain MRIs from 2,805 subjects and validate its generalizability on an external test set comprising 2,257 MRIs from 962 subjects. Our experiments compare BrLP-generated MRI scans with real follow-up MRIs, demonstrating state-of-the-art accuracy compared to existing methods. The code is publicly available at: https://github.com/LemuelPuglisi/BrLP.

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.

This study quantifies the association between non-adherence to antipsychotic medications and adverse outcomes in individuals with schizophrenia. We frame the problem using survival analysis, focusing on the time to the earliest of several adverse events (early death, involuntary hospitalization, jail booking). We extend standard causal inference methods (T-learner, S-learner, nearest neighbor matching) to utilize various survival models to estimate individual and average treatment effects, where treatment corresponds to medication non-adherence. Analyses are repeated using different amounts of longitudinal information (3, 6, 9, and 12 months). Using data from Allegheny County in western Pennsylvania, we find strong evidence that non-adherence advances adverse outcomes by approximately 1 to 4 months. Ablation studies confirm that county-provided risk scores adjust for key confounders, as their removal amplifies the estimated effects. Subgroup analyses by medication formulation (injectable vs. oral) and medication type consistently show that non-adherence is associated with earlier adverse events. These findings highlight the clinical importance of adherence in delaying psychiatric crises and show that integrating survival analysis with causal inference tools can yield policy-relevant insights. We caution that although we apply causal inference, we only make associative claims and discuss assumptions needed for causal interpretation.

Longitudinal health agents must reason across multi-source trajectories that combine continuous device streams, sparse clinical exams, and episodic life events - yet evaluating them is hard: real-world data cannot be released at scale, and temporally grounded attribution questions seldom admit definitive answers without structured ground truth. We present ESL-Bench, an event-driven synthesis framework and benchmark providing 100 synthetic users, each with a 1-5 year trajectory comprising a health profile, a multi-phase narrative plan, daily device measurements, periodic exam records, and an event log with explicit per-indicator impact parameters. Each indicator follows a baseline stochastic process driven by discrete events with sigmoid-onset, exponential-decay kernels under saturation and projection constraints; a hybrid pipeline delegates sparse semantic artifacts to LLM-based planning and dense indicator dynamics to algorithmic simulation with hard physiological bounds. Users are each paired with 100 evaluation queries across five dimensions - Lookup, Trend, Comparison, Anomaly, Explanation - stratified into Easy, Medium, and Hard tiers, with all ground-truth answers programmatically computable from the recorded event-indicator relationships. Evaluating 13 methods spanning LLMs with tools, DB-native agents, and memory-augmented RAG, we find that DB agents (48-58%) substantially outperform memory RAG baselines (30-38%), with the gap concentrated on Comparison and Explanation queries where multi-hop reasoning and evidence attribution are required.

Automated radiology report generation offers an effective solution to alleviate radiologists' workload. However, most existing methods focus primarily on single or fixed-view images to model current disease conditions, which limits diagnostic accuracy and overlooks disease progression. Although some approaches utilize longitudinal data to track disease progression, they still rely on single images to analyze current visits. To address these issues, we propose enhanced contrastive learning with Multi-view Longitudinal data to facilitate chest X-ray Report Generation, named MLRG. Specifically, we introduce a multi-view longitudinal contrastive learning method that integrates spatial information from current multi-view images and temporal information from longitudinal data. This method also utilizes the inherent spatiotemporal information of radiology reports to supervise the pre-training of visual and textual representations. Subsequently, we present a tokenized absence encoding technique to flexibly handle missing patient-specific prior knowledge, allowing the model to produce more accurate radiology reports based on available prior knowledge. Extensive experiments on MIMIC-CXR, MIMIC-ABN, and Two-view CXR datasets demonstrate that our MLRG outperforms recent state-of-the-art methods, achieving a 2.3% BLEU-4 improvement on MIMIC-CXR, a 5.5% F1 score improvement on MIMIC-ABN, and a 2.7% F1 RadGraph improvement on Two-view CXR.

We propose a computationally efficient inferential procedure for longitudinal function-on-function regression. The method follows a marginal three-step approach: (1) fit massive pointwise longitudinal scalar-on-function regression models, (2) smooth the resulting estimates along the bivariate functional domain, and (3) compute confidence bands using either an analytic approach for Gaussian data or a cluster bootstrap for Gaussian or non-Gaussian data. Simulation studies demonstrate that the proposed method achieves accurate estimation and valid inference, while substantially reducing computational burden compared to existing approaches. Methods are motivated by a physical activity intervention trial in older adults where high-dimensional wearable data were collected longitudinally across multiple visits. Our applications reveal significant increases in physical activity in the morning using interpersonal intervention strategies, but not intrapersonal strategies. The proposed methods are implemented in an R package.

Objective: Data unavailability has been one of the biggest barriers in clinical natural language processing. This paper is aimed at providing a large-scale and publicly available patient note dataset, named PMC-Patients, with relevant articles and similar patients annotations. The ultimate goal of PMC-Patients is to facilitate the development of retrieval-based clinical decision support systems. Materials and Methods: To collect PMC-Patients, we extract patient notes from case reports in PubMed Central by recognizing certain section patterns. Patient-article relevance and patient-patient similarity are annotated by citation relationships in PubMed. In addition, we perform three tasks with PMC-Patients to demonstrate its utility in providing clinical decision support for a given patient, including (1) classifying whether another patient is similar, (2) retrieving similar patients in PMC-Patients, and (3) retrieving relevant articles in PubMed. Results: We collect and release PMC-Patients under the CC BY-NC-SA license, which becomes the largest publicly available patient note dataset so far. PMC-Patients contains 167k patient notes that are annotated with 3.1M relevant articles and 293k similar patients. Qualitative and quantitative analyses reveal the high quality and richness of our dataset. Experiments show that classifying the similarity of patient pairs is relatively easy, but it is hard to retrieve similar patients or relevant articles for a given patient from a large set of candidates. Conclusion: We present PMC-Patients, a large-scale dataset of patient notes with high quality, easy access, diverse conditions, and rich annotations. The proposed dataset can also serve as a hard benchmark for evaluating retrieval-based clinical decision support systems.

In recent years, large language models have shown substantial potential in psychological support tasks. However, existing psychological counseling data mostly rely on single-turn question answering or short multi-turn dialogues, making it difficult to characterize how college students' psychological distress accumulates, interacts, and gradually evolves over long periods within campus life events. To address this issue, this paper proposes Psy-Chronicle, a structured data-generation framework for synthesizing long-horizon campus psychological counseling dialogues. We generate a semester-spanning temporal stress event graph to model the chronological order and evolutionary dependencies among campus stress events. Through interactive simulation between a student agent and a counselor agent, together with a structured memory integration mechanism, Psy-Chronicle generates long-horizon dialogues with continuity across counseling sessions. Based on Psy-Chronicle, we construct and open-source CPCD, a Chinese long-horizon dialogue dataset for college psychological counseling, containing 100 student profiles, 90,000 counseling dialogues. We further build CPCD-Bench to evaluate models' long-horizon campus counseling capabilities from three dimensions: session-level response, long-horizon memory recall, and temporal-causal reasoning. Experimental results show that CPCD effectively improves session-level response generation and long-horizon memory recall for models with the same base architecture. Meanwhile, improvements in temporal-causal reasoning remain limited, indicating that event-chain organization and causal explanation are key challenges in long-horizon psychological counseling modeling. The related code and data are available at: https://github.com/EdwinUSTB/Psy-Chronicle

Summarization of clinical narratives is a long-standing research problem. Here, we introduce the task of hospital-course summarization. Given the documentation authored throughout a patient's hospitalization, generate a paragraph that tells the story of the patient admission. We construct an English, text-to-text dataset of 109,000 hospitalizations (2M source notes) and their corresponding summary proxy: the clinician-authored "Brief Hospital Course" paragraph written as part of a discharge note. Exploratory analyses reveal that the BHC paragraphs are highly abstractive with some long extracted fragments; are concise yet comprehensive; differ in style and content organization from the source notes; exhibit minimal lexical cohesion; and represent silver-standard references. Our analysis identifies multiple implications for modeling this complex, multi-document summarization task.

Understanding causal narratives communicated in clinical notes can help make strides towards personalized healthcare. Extracted causal information from clinical notes can be combined with structured EHR data such as patients' demographics, diagnoses, and medications. This will enhance healthcare providers' ability to identify aspects of a patient's story communicated in the clinical notes and help make more informed decisions. In this work, we propose annotation guidelines, develop an annotated corpus and provide baseline scores to identify types and direction of causal relations between a pair of biomedical concepts in clinical notes; communicated implicitly or explicitly, identified either in a single sentence or across multiple sentences. We annotate a total of 2714 de-identified examples sampled from the 2018 n2c2 shared task dataset and train four different language model based architectures. Annotation based on our guidelines achieved a high inter-annotator agreement i.e. Fleiss' kappa (kappa) score of 0.72, and our model for identification of causal relations achieved a macro F1 score of 0.56 on the test data. The high inter-annotator agreement for clinical text shows the quality of our annotation guidelines while the provided baseline F1 score sets the direction for future research towards understanding narratives in clinical texts.

Interrogating the evolution of biological changes at early stages of life requires longitudinal profiling of molecules, such as DNA methylation, which can be challenging with children. We introduce a probabilistic and longitudinal machine learning framework based on multi-mean Gaussian processes (GPs), accounting for individual and gene correlations across time. This method provides future predictions of DNA methylation status at different individual ages while accounting for uncertainty. Our model is trained on a birth cohort of children with methylation profiled at ages 0-4, and we demonstrated that the status of methylation sites for each child can be accurately predicted at ages 5-7. We show that methylation profiles predicted by multi-mean GPs can be used to estimate other phenotypes, such as epigenetic age, and enable comparison to other health measures of interest. This approach encourages epigenetic studies to move towards longitudinal design for investigating epigenetic changes during development, ageing and disease progression.

Emotional states, as indicators of affect, are pivotal to overall health, making their accurate prediction before onset crucial. Current studies are primarily centered on immediate short-term affect detection using data from wearable and mobile devices. These studies typically focus on objective sensory measures, often neglecting other forms of self-reported information like diaries and notes. In this paper, we propose a multimodal deep learning model for affect status forecasting. This model combines a transformer encoder with a pre-trained language model, facilitating the integrated analysis of objective metrics and self-reported diaries. To validate our model, we conduct a longitudinal study, enrolling college students and monitoring them over a year, to collect an extensive dataset including physiological, environmental, sleep, metabolic, and physical activity parameters, alongside open-ended textual diaries provided by the participants. Our results demonstrate that the proposed model achieves predictive accuracy of 82.50% for positive affect and 82.76% for negative affect, a full week in advance. The effectiveness of our model is further elevated by its explainability.

Following each patient visit, physicians draft long semi-structured clinical summaries called SOAP notes. While invaluable to clinicians and researchers, creating digital SOAP notes is burdensome, contributing to physician burnout. In this paper, we introduce the first complete pipelines to leverage deep summarization models to generate these notes based on transcripts of conversations between physicians and patients. After exploring a spectrum of methods across the extractive-abstractive spectrum, we propose Cluster2Sent, an algorithm that (i) extracts important utterances relevant to each summary section; (ii) clusters together related utterances; and then (iii) generates one summary sentence per cluster. Cluster2Sent outperforms its purely abstractive counterpart by 8 ROUGE-1 points, and produces significantly more factual and coherent sentences as assessed by expert human evaluators. For reproducibility, we demonstrate similar benefits on the publicly available AMI dataset. Our results speak to the benefits of structuring summaries into sections and annotating supporting evidence when constructing summarization corpora.

The rise of deep learning technologies has quickly advanced many fields, including that of generative music systems. There exist a number of systems that allow for the generation of good sounding short snippets, yet, these generated snippets often lack an overarching, longer-term structure. In this work, we propose CM-HRNN: a conditional melody generation model based on a hierarchical recurrent neural network. This model allows us to generate melodies with long-term structures based on given chord accompaniments. We also propose a novel, concise event-based representation to encode musical lead sheets while retaining the notes' relative position within the bar with respect to the musical meter. With this new data representation, the proposed architecture can simultaneously model the rhythmic, as well as the pitch structures in an effective way. Melodies generated by the proposed model were extensively evaluated in quantitative experiments as well as a user study to ensure the musical quality of the output as well as to evaluate if they contain repeating patterns. We also compared the system with the state-of-the-art AttentionRNN. This comparison shows that melodies generated by CM-HRNN contain more repeated patterns (i.e., higher compression ratio) and a lower tonal tension (i.e., more tonally concise). Results from our listening test indicate that CM-HRNN outperforms AttentionRNN in terms of long-term structure and overall rating.

Chest Xray imaging is a widely used diagnostic tool in modern medicine, and its high utilization creates substantial workloads for radiologists. To alleviate this burden, vision language models are increasingly applied to automate Chest Xray radiology report generation (CXRRRG), aiming for clinically accurate descriptions while reducing manual effort. Conventional approaches, however, typically rely on single images, failing to capture the longitudinal context necessary for producing clinically faithful comparison statements. Recently, growing attention has been directed toward incorporating longitudinal data into CXR RRG, enabling models to leverage historical studies in ways that mirror radiologists diagnostic workflows. Nevertheless, existing surveys primarily address single image CXRRRG and offer limited guidance for longitudinal settings, leaving researchers without a systematic framework for model design. To address this gap, this survey provides the first comprehensive review of longitudinal radiology report generation (LRRG). Specifically, we examine dataset construction strategies, report generation architectures alongside longitudinally tailored designs, and evaluation protocols encompassing both longitudinal specific measures and widely used benchmarks. We further summarize LRRG methods performance, alongside analyses of different ablation studies, which collectively highlight the critical role of longitudinal information and architectural design choices in improving model performance. Finally, we summarize five major limitations of current research and outline promising directions for future development, aiming to lay a foundation for advancing this emerging field.

Clinical notes in Electronic Health Records (EHR) present rich documented information of patients to inference phenotype for disease diagnosis and study patient characteristics for cohort selection. Unsupervised user embedding aims to encode patients into fixed-length vectors without human supervisions. Medical concepts extracted from the clinical notes contain rich connections between patients and their clinical categories. However, existing unsupervised approaches of user embeddings from clinical notes do not explicitly incorporate medical concepts. In this study, we propose a concept-aware unsupervised user embedding that jointly leverages text documents and medical concepts from two clinical corpora, MIMIC-III and Diabetes. We evaluate user embeddings on both extrinsic and intrinsic tasks, including phenotype classification, in-hospital mortality prediction, patient retrieval, and patient relatedness. Experiments on the two clinical corpora show our approach exceeds unsupervised baselines, and incorporating medical concepts can significantly improve the baseline performance.

Many empirical studies of labor market questions rely on estimating relatively simple predictive models using small, carefully constructed longitudinal survey datasets based on hand-engineered features. Large Language Models (LLMs), trained on massive datasets, encode vast quantities of world knowledge and can be used for the next job prediction problem. However, while an off-the-shelf LLM produces plausible career trajectories when prompted, the probability with which an LLM predicts a particular job transition conditional on career history will not, in general, align with the true conditional probability in a given population. Recently, Vafa et al. (2024) introduced a transformer-based "foundation model", CAREER, trained using a large, unrepresentative resume dataset, that predicts transitions between jobs; it further demonstrated how transfer learning techniques can be used to leverage the foundation model to build better predictive models of both transitions and wages that reflect conditional transition probabilities found in nationally representative survey datasets. This paper considers an alternative where the fine-tuning of the CAREER foundation model is replaced by fine-tuning LLMs. For the task of next job prediction, we demonstrate that models trained with our approach outperform several alternatives in terms of predictive performance on the survey data, including traditional econometric models, CAREER, and LLMs with in-context learning, even though the LLM can in principle predict job titles that are not allowed in the survey data. Further, we show that our fine-tuned LLM-based models' predictions are more representative of the career trajectories of various workforce subpopulations than off-the-shelf LLM models and CAREER. We conduct experiments and analyses that highlight the sources of the gains in the performance of our models for representative predictions.

The impact of person-job fit on job satisfaction and performance is widely acknowledged, which highlights the importance of providing workers with next steps at the right time in their career. This task of predicting the next step in a career is known as career path prediction, and has diverse applications such as turnover prevention and internal job mobility. Existing methods to career path prediction rely on large amounts of private career history data to model the interactions between job titles and companies. We propose leveraging the unexplored textual descriptions that are part of work experience sections in resumes. We introduce a structured dataset of 2,164 anonymized career histories, annotated with ESCO occupation labels. Based on this dataset, we present a novel representation learning approach, CareerBERT, specifically designed for work history data. We develop a skill-based model and a text-based model for career path prediction, which achieve 35.24% and 39.61% recall@10 respectively on our dataset. Finally, we show that both approaches are complementary as a hybrid approach achieves the strongest result with 43.01% recall@10.

The development of large language models tailored for handling patients' clinical notes is often hindered by the limited accessibility and usability of these notes due to strict privacy regulations. To address these challenges, we first create synthetic large-scale clinical notes using publicly available case reports extracted from biomedical literature. We then use these synthetic notes to train our specialized clinical large language model, Asclepius. While Asclepius is trained on synthetic data, we assess its potential performance in real-world applications by evaluating it using real clinical notes. We benchmark Asclepius against several other large language models, including GPT-3.5-turbo and other open-source alternatives. To further validate our approach using synthetic notes, we also compare Asclepius with its variants trained on real clinical notes. Our findings convincingly demonstrate that synthetic clinical notes can serve as viable substitutes for real ones when constructing high-performing clinical language models. This conclusion is supported by detailed evaluations conducted by both GPT-4 and medical professionals. All resources including weights, codes, and data used in the development of Asclepius are made publicly accessible for future research.

Longitudinal multimodal data, including electronic health records (EHR) and sequential chest X-rays (CXRs), is critical for modeling disease progression, yet remains underutilized due to two key challenges: (1) redundancy in consecutive CXR sequences, where static anatomical regions dominate over clinically-meaningful dynamics, and (2) temporal misalignment between sparse, irregular imaging and continuous EHR data. We introduce DiPro, a novel framework that addresses these challenges through region-aware disentanglement and multi-timescale alignment. First, we disentangle static (anatomy) and dynamic (pathology progression) features in sequential CXRs, prioritizing disease-relevant changes. Second, we hierarchically align these static and dynamic CXR features with asynchronous EHR data via local (pairwise interval-level) and global (full-sequence) synchronization to model coherent progression pathways. Extensive experiments on the MIMIC dataset demonstrate that DiPro could effectively extract temporal clinical dynamics and achieve state-of-the-art performance on both disease progression identification and general ICU prediction tasks.

Long-term memory is crucial for agents in specialized web environments, where success depends on recalling interface affordances, state dynamics, workflows, and recurring failure modes. However, existing memory benchmarks for agents mostly focus on user histories, short traces, or downstream task success, leaving open how to directly evaluate whether memory systems effectively internalize environment-specific experience. To address this gap, we introduce LongMemEval-V2 (LME-V2), a benchmark for evaluating whether memory systems can help agents acquire the experience needed to become knowledgeable colleagues in customized environments. LME-V2 contains 451 manually curated questions covering five core memory abilities for web agents: static state recall, dynamic state tracking, workflow knowledge, environment gotchas, and premise awareness. Questions are paired with history trajectories containing up to 500 trajectories and 115M tokens. We use a context gathering formulation: memory systems consume history trajectories and return compact evidence for downstream question answering. We propose a suite of two memory methods: AgentRunbook-R, an efficient RAG-based memory with knowledge pools for raw state observations, events, and strategy notes, and AgentRunbook-C, which stores trajectories as files and invokes a coding agent to gather evidence in an augmented sandbox. Experiments show that AgentRunbook-C achieves the best performance with 72.5% average accuracy, outperforming the strongest RAG baseline (48.5%) and the off-the-shelf coding agent baseline (69.3%). Despite the strong performance gains, coding agent based methods have high latency costs. While AgentRunbook-C advances the accuracy-latency Pareto frontier, substantial room for improvement remains. Together, these results establish LME-V2 as a challenging testbed for developing long-term memory systems for environment experience.

Accurate segmentation of Multiple Sclerosis (MS) lesions in longitudinal MRI scans is crucial for monitoring disease progression and treatment efficacy. Although changes across time are taken into account when assessing images in clinical practice, most existing deep learning methods treat scans from different timepoints separately. Among studies utilizing longitudinal images, a simple channel-wise concatenation is the primary albeit suboptimal method employed to integrate timepoints. We introduce a novel approach that explicitly incorporates temporal differences between baseline and follow-up scans through a unique architectural inductive bias called Difference Weighting Block. It merges features from two timepoints, emphasizing changes between scans. We achieve superior scores in lesion segmentation (Dice Score, Hausdorff distance) as well as lesion detection (lesion-level F_1 score) as compared to state-of-the-art longitudinal and single timepoint models across two datasets. Our code is made publicly available at www.github.com/MIC-DKFZ/Longitudinal-Difference-Weighting.

Chest X-Ray (CXR) report generation is a promising approach to improving the efficiency of CXR interpretation. However, a significant increase in diagnostic accuracy is required before that can be realised. Motivated by this, we propose a framework that is more inline with a radiologist's workflow by considering longitudinal data. Here, the decoder is additionally conditioned on the report from the subject's previous imaging study via a prompt. We also propose a new reward for reinforcement learning based on CXR-BERT, which computes the similarity between reports. We conduct experiments on the MIMIC-CXR dataset. The results indicate that longitudinal data improves CXR report generation. CXR-BERT is also shown to be a promising alternative to the current state-of-the-art reward based on RadGraph. This investigation indicates that longitudinal CXR report generation can offer a substantial increase in diagnostic accuracy. Our Hugging Face model is available at: https://huggingface.co/aehrc/cxrmate and code is available at: https://github.com/aehrc/cxrmate.

Continuity of care is crucial to ensuring positive health outcomes for patients discharged from an inpatient hospital setting, and improved information sharing can help. To share information, caregivers write discharge notes containing action items to share with patients and their future caregivers, but these action items are easily lost due to the lengthiness of the documents. In this work, we describe our creation of a dataset of clinical action items annotated over MIMIC-III, the largest publicly available dataset of real clinical notes. This dataset, which we call CLIP, is annotated by physicians and covers 718 documents representing 100K sentences. We describe the task of extracting the action items from these documents as multi-aspect extractive summarization, with each aspect representing a type of action to be taken. We evaluate several machine learning models on this task, and show that the best models exploit in-domain language model pre-training on 59K unannotated documents, and incorporate context from neighboring sentences. We also propose an approach to pre-training data selection that allows us to explore the trade-off between size and domain-specificity of pre-training datasets for this task.

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.

A widely held hypothesis for why generative recommendation (GR) models outperform conventional item ID-based models is that they generalize better. However, there is few systematic way to verify this hypothesis beyond a superficial comparison of overall performance. To address this gap, we categorize each data instance based on the specific capability required for a correct prediction: either memorization (reusing item transition patterns observed during training) or generalization (composing known patterns to predict unseen item transitions). Extensive experiments show that GR models perform better on instances that require generalization, whereas item ID-based models perform better when memorization is more important. To explain this divergence, we shift the analysis from the item level to the token level and show that what appears to be item-level generalization often reduces to token-level memorization for GR models. Finally, we show that the two paradigms are complementary. We propose a simple memorization-aware indicator that adaptively combines them on a per-instance basis, leading to improved overall recommendation performance.

A common expectation is that career productivity peaks rather early and then gradually declines with seniority. But whether this holds true is still an open question. Here we investigate the productivity trajectories of almost 8,500 scientists from over fifty disciplines using methods from time series analysis, dimensionality reduction, and network science, showing that there exist six universal productivity patterns in research. Based on clusters of productivity trajectories and network representations where researchers with similar productivity patterns are connected, we identify constant, u-shaped, decreasing, periodic-like, increasing, and canonical productivity patterns, with the latter two describing almost three-fourths of researchers. In fact, we find that canonical curves are the most prevalent, but contrary to expectations, productivity peaks occur much more frequently around mid-career rather than early. These results outline the boundaries of possible career paths in science and caution against the adoption of stereotypes in tenure and funding decisions.

Understanding memorisation in language models has practical and societal implications, e.g., studying models' training dynamics or preventing copyright infringements. Prior work defines memorisation as the causal effect of training with an instance on the model's ability to predict that instance. This definition relies on a counterfactual: the ability to observe what would have happened had the model not seen that instance. Existing methods struggle to provide computationally efficient and accurate estimates of this counterfactual. Further, they often estimate memorisation for a model architecture rather than for a specific model instance. This paper fills an important gap in the literature, proposing a new, principled, and efficient method to estimate memorisation based on the difference-in-differences design from econometrics. Using this method, we characterise a model's memorisation profile--its memorisation trends across training--by only observing its behaviour on a small set of instances throughout training. In experiments with the Pythia model suite, we find that memorisation (i) is stronger and more persistent in larger models, (ii) is determined by data order and learning rate, and (iii) has stable trends across model sizes, thus making memorisation in larger models predictable from smaller ones.

Memorization, or the tendency of large language models (LLMs) to output entire sequences from their training data verbatim, is a key concern for safely deploying language models. In particular, it is vital to minimize a model's memorization of sensitive datapoints such as those containing personal identifiable information (PII). The prevalence of such undesirable memorization can pose issues for model trainers, and may even require discarding an otherwise functional model. We therefore seek to predict which sequences will be memorized before a large model's full train-time by extrapolating the memorization behavior of lower-compute trial runs. We measure memorization of the Pythia model suite and plot scaling laws for forecasting memorization, allowing us to provide equi-compute recommendations to maximize the reliability (recall) of such predictions. We additionally provide further novel discoveries on the distribution of memorization scores across models and data. We release all code and data necessary to reproduce the results in this paper at https://github.com/EleutherAI/pythia

Physicians spend significant time documenting clinical encounters, a burden that contributes to professional burnout. To address this, robust automation tools for medical documentation are crucial. We introduce MedSynth -- a novel dataset of synthetic medical dialogues and notes designed to advance the Dialogue-to-Note (Dial-2-Note) and Note-to-Dialogue (Note-2-Dial) tasks. Informed by an extensive analysis of disease distributions, this dataset includes over 10,000 dialogue-note pairs covering over 2000 ICD-10 codes. We demonstrate that our dataset markedly enhances the performance of models in generating medical notes from dialogues, and dialogues from medical notes. The dataset provides a valuable resource in a field where open-access, privacy-compliant, and diverse training data are scarce. Code is available at https://github.com/ahmadrezarm/MedSynth/tree/main and the dataset is available at https://huggingface.co/datasets/Ahmad0067/MedSynth.

Brief hospital course (BHC) summaries are common clinical documents generated by summarizing clinical notes. While large language models (LLMs) depict remarkable capabilities in automating real-world tasks, their capabilities for healthcare applications such as BHC synthesis have not been shown. To enable the adaptation of LLMs for BHC synthesis, we introduce a novel benchmark consisting of a pre-processed dataset extracted from MIMIC-IV notes, encapsulating clinical note, and brief hospital course (BHC) pairs. We assess the performance of two general-purpose LLMs and three healthcare-adapted LLMs to improve BHC synthesis from clinical notes. Using clinical notes as input for generating BHCs, we apply prompting-based (using in-context learning) and fine-tuning-based adaptation strategies to three open-source LLMs (Clinical-T5-Large, Llama2-13B, FLAN-UL2) and two proprietary LLMs (GPT-3.5, GPT-4). We quantitatively evaluate the performance of these LLMs across varying context-length inputs using conventional natural language similarity metrics. We further perform a qualitative study where five diverse clinicians blindly compare clinician-written BHCs and two LLM-generated BHCs for 30 samples across metrics of comprehensiveness, conciseness, factual correctness, and fluency. Overall, we present a new benchmark and pre-processed dataset for using LLMs in BHC synthesis from clinical notes. We observe high-quality summarization performance for both in-context proprietary and fine-tuned open-source LLMs using both quantitative metrics and a qualitative clinical reader study. We propose our work as a benchmark to motivate future works to adapt and assess the performance of LLMs in BHC synthesis.

Advances in large language models (LLMs) provide new opportunities in healthcare for improved patient care, clinical decision-making, and enhancement of physician and administrator workflows. However, the potential of these models importantly depends on their ability to generalize effectively across clinical environments and populations, a challenge often underestimated in early development. To better understand reasons for these challenges and inform mitigation approaches, we evaluated ClinicLLM, an LLM trained on [HOSPITAL]'s clinical notes, analyzing its performance on 30-day all-cause readmission prediction focusing on variability across hospitals and patient characteristics. We found poorer generalization particularly in hospitals with fewer samples, among patients with government and unspecified insurance, the elderly, and those with high comorbidities. To understand reasons for lack of generalization, we investigated sample sizes for fine-tuning, note content (number of words per note), patient characteristics (comorbidity level, age, insurance type, borough), and health system aspects (hospital, all-cause 30-day readmission, and mortality rates). We used descriptive statistics and supervised classification to identify features. We found that, along with sample size, patient age, number of comorbidities, and the number of words in notes are all important factors related to generalization. Finally, we compared local fine-tuning (hospital specific), instance-based augmented fine-tuning and cluster-based fine-tuning for improving generalization. Among these, local fine-tuning proved most effective, increasing AUC by 0.25% to 11.74% (most helpful in settings with limited data). Overall, this study provides new insights for enhancing the deployment of large language models in the societally important domain of healthcare, and improving their performance for broader populations.

Memorization in language models is typically treated as a homogenous phenomenon, neglecting the specifics of the memorized data. We instead model memorization as the effect of a set of complex factors that describe each sample and relate it to the model and corpus. To build intuition around these factors, we break memorization down into a taxonomy: recitation of highly duplicated sequences, reconstruction of inherently predictable sequences, and recollection of sequences that are neither. We demonstrate the usefulness of our taxonomy by using it to construct a predictive model for memorization. By analyzing dependencies and inspecting the weights of the predictive model, we find that different factors influence the likelihood of memorization differently depending on the taxonomic category.

Large Language Models (LLMs) frequently memorize long sequences verbatim, often with serious legal and privacy implications. Much prior work has studied such verbatim memorization using observational data. To complement such work, we develop a framework to study verbatim memorization in a controlled setting by continuing pre-training from Pythia checkpoints with injected sequences. We find that (1) non-trivial amounts of repetition are necessary for verbatim memorization to happen; (2) later (and presumably better) checkpoints are more likely to verbatim memorize sequences, even for out-of-distribution sequences; (3) the generation of memorized sequences is triggered by distributed model states that encode high-level features and makes important use of general language modeling capabilities. Guided by these insights, we develop stress tests to evaluate unlearning methods and find they often fail to remove the verbatim memorized information, while also degrading the LM. Overall, these findings challenge the hypothesis that verbatim memorization stems from specific model weights or mechanisms. Rather, verbatim memorization is intertwined with the LM's general capabilities and thus will be very difficult to isolate and suppress without degrading model quality.

Skin carcinoma is the most prevalent form of cancer globally, accounting for over $8 billion in annual healthcare expenditures. In clinical settings, physicians document patient visits using detailed SOAP (Subjective, Objective, Assessment, and Plan) notes. However, manually generating these notes is labor-intensive and contributes to clinician burnout. In this work, we propose a weakly supervised multimodal framework to generate clinically structured SOAP notes from limited inputs, including lesion images and sparse clinical text. Our approach reduces reliance on manual annotations, enabling scalable, clinically grounded documentation while alleviating clinician burden and reducing the need for large annotated data. Our method achieves performance comparable to GPT-4o, Claude, and DeepSeek Janus Pro across key clinical relevance metrics. To evaluate clinical quality, we introduce two novel metrics MedConceptEval and Clinical Coherence Score (CCS) which assess semantic alignment with expert medical concepts and input features, respectively.

We introduce a novel Longitudinal Focused Attention Meditation Electroencephalography (L-FAME) dataset and an accompanying benchmark, designed to foster research into the neural effects of various meditation practices and the evolution of these effects over a six-week training period. The dataset contains EEG recordings and psychological assessments from 74 healthy college participants, collected at two distinct time points: pre-intervention and post-intervention. Participants were randomly assigned to one of three distinct meditation groups: two mantra-based techniques (SA-TA-NA-MA and Hare Krishna) and one Breath Focus practice. Leveraging this unique longitudinal and comparative dataset, we propose a benchmark suite comprising three distinct classification tasks: (1) cognitive state decoding to distinguish between resting and meditation states, (2) fine-grained classification of the specific meditation techniques, and (3) cross-session adaptation to evaluate model generalization across the longitudinal time gap. We provide comprehensive baseline results for these tasks utilizing a range of classical machine learning algorithms and deep learning architectures. The complete dataset, preprocessing pipelines, and benchmark evaluation code will be publicly released, offering a valuable resource and a standardized framework for the development and comparison of new analytical methods in computational meditation research and EEG-based machine learning. The dataset is available at https://huggingface.co/datasets/L-FAME-Dataset-Benchmark/L-FAME

Recent multimodal large language models (MLLMs) have demonstrated significant potential in open-ended conversation, generating more accurate and personalized responses. However, their abilities to memorize, recall, and reason in sustained interactions within real-world scenarios remain underexplored. This paper introduces MMRC, a Multi-Modal Real-world Conversation benchmark for evaluating six core open-ended abilities of MLLMs: information extraction, multi-turn reasoning, information update, image management, memory recall, and answer refusal. With data collected from real-world scenarios, MMRC comprises 5,120 conversations and 28,720 corresponding manually labeled questions, posing a significant challenge to existing MLLMs. Evaluations on 20 MLLMs in MMRC indicate an accuracy drop during open-ended interactions. We identify four common failure patterns: long-term memory degradation, inadequacies in updating factual knowledge, accumulated assumption of error propagation, and reluctance to say no. To mitigate these issues, we propose a simple yet effective NOTE-TAKING strategy, which can record key information from the conversation and remind the model during its responses, enhancing conversational capabilities. Experiments across six MLLMs demonstrate significant performance improvements.

In this work, we introduce Brain Latent Progression (BrLP), a novel spatiotemporal disease progression model based on latent diffusion. BrLP is designed to predict the evolution of diseases at the individual level on 3D brain MRIs. Existing deep generative models developed for this task are primarily data-driven and face challenges in learning disease progressions. BrLP addresses these challenges by incorporating prior knowledge from disease models to enhance the accuracy of predictions. To implement this, we propose to integrate an auxiliary model that infers volumetric changes in various brain regions. Additionally, we introduce Latent Average Stabilization (LAS), a novel technique to improve spatiotemporal consistency of the predicted progression. BrLP is trained and evaluated on a large dataset comprising 11,730 T1-weighted brain MRIs from 2,805 subjects, collected from three publicly available, longitudinal Alzheimer's Disease (AD) studies. In our experiments, we compare the MRI scans generated by BrLP with the actual follow-up MRIs available from the subjects, in both cross-sectional and longitudinal settings. BrLP demonstrates significant improvements over existing methods, with an increase of 22% in volumetric accuracy across AD-related brain regions and 43% in image similarity to the ground-truth scans. The ability of BrLP to generate conditioned 3D scans at the subject level, along with the novelty of integrating prior knowledge to enhance accuracy, represents a significant advancement in disease progression modeling, opening new avenues for precision medicine. The code of BrLP is available at the following link: https://github.com/LemuelPuglisi/BrLP.

Longitudinal brain analysis is essential for understanding healthy aging and identifying pathological deviations. Longitudinal registration of sequential brain MRI underpins such analyses. However, existing methods are limited by reliance on densely sampled time series, a trade-off between accuracy and temporal smoothness, and an inability to prospectively forecast future brain states. To overcome these challenges, we introduce TimeFlow, a learning-based framework for longitudinal brain MRI registration. TimeFlow uses a U-Net backbone with temporal conditioning to model neuroanatomy as a continuous function of age. Given only two scans from an individual, TimeFlow estimates accurate and temporally coherent deformation fields, enabling non-linear extrapolation to predict future brain states. This is achieved by our proposed inter-/extra-polation consistency constraints applied to both the deformation fields and deformed images. Remarkably, these constraints preserve temporal consistency and continuity without requiring explicit smoothness regularizers or densely sampled sequential data. Extensive experiments demonstrate that TimeFlow outperforms state-of-the-art methods in terms of both future timepoint forecasting and registration accuracy. Moreover, TimeFlow supports novel biological brain aging analyses by differentiating neurodegenerative trajectories from normal aging without requiring segmentation, thereby eliminating the need for labor-intensive annotations and mitigating segmentation inconsistency. TimeFlow offers an accurate, data-efficient, and annotation-free framework for longitudinal analysis of brain aging and chronic diseases, capable of forecasting brain changes beyond the observed study period.

This paper describes the iterative use of service learning to develop, review, and improve computing-based artifacts. It is well-known that computing students benefit from service-learning experiences as do the community partners. It is also well-known that computing artifacts rarely function well long-term without versioning and updates. Service-learning projects are often one-time engagements, completed by single teams of students over the course of a semester course. This limits the benefit for community partners that do not have the expertise or resources to review and update a project on their own. Over several years, teams of undergraduate students in a capstone course created tailored social media plans for numerous small rural organizations. The projects were required to meet client specific needs, with identified audiences, measurable goals, and strategies and tactics to reach the identified goals. This paper builds on previously results for 60 projects conducted over several years. Nine clients were selected to participate in the iterative follow-up process, where new student teams conducted client interviews, reviewed the initial plans, and analyzed metrics from the current strategies and tactics to provide updated, improved artifacts. Using ABET learning objectives as a basis, clients reviewed the student teams and artifacts. This longitudinal study discusses the impact of this intervention to increase implementation and sustained use rates of computing artifacts developed through service learning. Both students and clients reported high satisfaction levels, and clients were particularly satisfied with the iterative improvement process. This research demonstrates an innovative practice for creating and maintaining computing artifacts through iterative service learning, while addressing the resource constraints of small organizations.

Speech patterns have been identified as potential diagnostic markers for neuropsychiatric conditions. However, most studies only compare a single clinical group to healthy controls, whereas clinical practice often requires differentiating between multiple potential diagnoses (multiclass settings). To address this, we assembled a dataset of repeated recordings from 420 participants (67 with major depressive disorder, 106 with schizophrenia and 46 with autism, as well as matched controls), and tested the performance of a range of conventional machine learning models and advanced Transformer models on both binary and multiclass classification, based on voice and text features. While binary models performed comparably to previous research (F1 scores between 0.54-0.75 for autism spectrum disorder, ASD; 0.67-0.92 for major depressive disorder, MDD; and 0.71-0.83 for schizophrenia); when differentiating between multiple diagnostic groups performance decreased markedly (F1 scores between 0.35-0.44 for ASD, 0.57-0.75 for MDD, 0.15-0.66 for schizophrenia, and 0.38-0.52 macro F1). Combining voice and text-based models yielded increased performance, suggesting that they capture complementary diagnostic information. Our results indicate that models trained on binary classification may learn to rely on markers of generic differences between clinical and non-clinical populations, or markers of clinical features that overlap across conditions, rather than identifying markers specific to individual conditions. We provide recommendations for future research in the field, suggesting increased focus on developing larger transdiagnostic datasets that include more fine-grained clinical features, and that can support the development of models that better capture the complexity of neuropsychiatric conditions and naturalistic diagnostic assessment.

Large language models (LLMs) have the potential to transform medicine, but real-world clinical scenarios contain extraneous information that can hinder performance. The rise of assistive technologies like ambient dictation, which automatically generates draft notes from live patient encounters, has the potential to introduce additional noise making it crucial to assess the ability of LLM's to filter relevant data. To investigate this, we developed MedDistractQA, a benchmark using USMLE-style questions embedded with simulated real-world distractions. Our findings show that distracting statements (polysemous words with clinical meanings used in a non-clinical context or references to unrelated health conditions) can reduce LLM accuracy by up to 17.9%. Commonly proposed solutions to improve model performance such as retrieval-augmented generation (RAG) and medical fine-tuning did not change this effect and in some cases introduced their own confounders and further degraded performance. Our findings suggest that LLMs natively lack the logical mechanisms necessary to distinguish relevant from irrelevant clinical information, posing challenges for real-world applications. MedDistractQA and our results highlights the need for robust mitigation strategies to enhance LLM resilience to extraneous information.

Clinical information extraction, which involves structuring clinical concepts from unstructured medical text, remains a challenging problem that could benefit from the inclusion of tabular background information available in electronic health records. Existing open-source datasets lack explicit links between structured features and clinical concepts in the text, motivating the need for a new research dataset. We introduce SimSUM, a benchmark dataset of 10,000 simulated patient records that link unstructured clinical notes with structured background variables. Each record simulates a patient encounter in the domain of respiratory diseases and includes tabular data (e.g., symptoms, diagnoses, underlying conditions) generated from a Bayesian network whose structure and parameters are defined by domain experts. A large language model (GPT-4o) is prompted to generate a clinical note describing the encounter, including symptoms and relevant context. These notes are annotated with span-level symptom mentions. We conduct an expert evaluation to assess note quality and run baseline predictive models on both the tabular and textual data. The SimSUM dataset is primarily designed to support research on clinical information extraction in the presence of tabular background variables, which can be linked through domain knowledge to concepts of interest to be extracted from the text -- namely, symptoms in the case of SimSUM. Secondary uses include research on the automation of clinical reasoning over both tabular data and text, causal effect estimation in the presence of tabular and/or textual confounders, and multi-modal synthetic data generation. SimSUM is not intended for training clinical decision support systems or production-grade models, but rather to facilitate reproducible research in a simplified and controlled setting.

Memory-augmented LLM agents store and retrieve information from prior interactions, yet the relative importance of how memories are written versus how they are retrieved remains unclear. We introduce a diagnostic framework that analyzes how performance differences manifest across write strategies, retrieval methods, and memory utilization behavior, and apply it to a 3x3 study crossing three write strategies (raw chunks, Mem0-style fact extraction, MemGPT-style summarization) with three retrieval methods (cosine, BM25, hybrid reranking). On LoCoMo, retrieval method is the dominant factor: average accuracy spans 20 points across retrieval methods (57.1% to 77.2%) but only 3-8 points across write strategies. Raw chunked storage, which requires zero LLM calls, matches or outperforms expensive lossy alternatives, suggesting that current memory pipelines may discard useful context that downstream retrieval mechanisms fail to compensate for. Failure analysis shows that performance breakdowns most often manifest at the retrieval stage rather than at utilization. We argue that, under current retrieval practices, improving retrieval quality yields larger gains than increasing write-time sophistication. Code is publicly available at https://github.com/boqiny/memory-probe.

Playlists have become a significant part of our listening experience because of the digital cloud-based services such as Spotify, Pandora, Apple Music. Owing to the meteoric rise in the usage of playlists, recommending playlists is crucial to music services today. Although there has been a lot of work done in playlist prediction, the area of playlist representation hasn't received that level of attention. Over the last few years, sequence-to-sequence models, especially in the field of natural language processing, have shown the effectiveness of learned embeddings in capturing the semantic characteristics of sequences. We can apply similar concepts to music to learn fixed length representations for playlists and use those representations for downstream tasks such as playlist discovery, browsing, and recommendation. In this work, we formulate the problem of learning a fixed-length playlist representation in an unsupervised manner, using Sequence-to-sequence (Seq2seq) models, interpreting playlists as sentences and songs as words. We compare our model with two other encoding architectures for baseline comparison. We evaluate our work using the suite of tasks commonly used for assessing sentence embeddings, along with a few additional tasks pertaining to music, and a recommendation task to study the traits captured by the playlist embeddings and their effectiveness for the purpose of music recommendation.

Unstructured clinical notes contain essential patient information but are challenging for physicians to search and interpret efficiently. Although large language models (LLMs) have shown promise in question answering (QA), most existing systems lack transparency, usability, and alignment with clinical workflows. This work introduces an interactive QA system that enables physicians to query clinical notes via text or voice and receive extractive answers highlighted directly in the note for traceability. The system was built using OpenAI models with zero-shot prompting and evaluated across multiple metrics, including exact string match, word overlap, SentenceTransformer similarity, and BERTScore. Results show that while exact match scores ranged from 47 to 62 percent, semantic similarity scores exceeded 87 percent, indicating strong contextual alignment even when wording varied. To assess usability, the system was also evaluated using simulated clinical personas. Seven diverse physician and nurse personas interacted with the system across scenario-based tasks and provided structured feedback. The evaluations highlighted strengths in intuitive design and answer accessibility, alongside opportunities for enhancing explanation clarity.

Large Language Models (LLMs) are increasingly being explored for clinical question answering and decision support, yet safe deployment critically requires reliable handling of patient measurements in heterogeneous clinical notes. Existing evaluations of LLMs for clinical numerical reasoning provide limited operation-level coverage, restricted primarily to arithmetic computation, and rarely assess the robustness of numerical understanding across clinical note formats. We introduce ClinicNumRobBench, a benchmark of 1,624 context-question instances with ground-truth answers that evaluates four main types of clinical numeracy: value retrieval, arithmetic computation, relational comparison, and aggregation. To stress-test robustness, ClinicNumRobBench presents longitudinal MIMIC-IV vital-sign records in three semantically equivalent representations, including a real-world note-style variant derived from the Open Patients dataset, and instantiates queries using 42 question templates. Experiments on 14 LLMs show that value retrieval is generally strong, with most models exceeding 85% accuracy, while relational comparison and aggregation remain challenging, with some models scoring below 15%. Fine-tuning on medical data can reduce numeracy relative to base models by over 30%, and performance drops under note-style variation indicate LLM sensitivity to format. ClinicNumRobBench offers a rigorous testbed for clinically reliable numerical reasoning. Code and data URL are available on https://github.com/MinhVuong2000/ClinicNumRobBench.

Chronotype compares individuals' circadian phase to others. It contextualizes mental health risk assessments and detection of social jet lag, which can hamper mental health and cognitive performance. Existing ways of determining chronotypes, such as Dim Light Melatonin Onset (DLMO) or the Morningness-Eveningness Questionnaire (MEQ), are limited by being discrete in time and time-intensive to update, meaning they rarely capture real-world variability across time. Chronotyping users based on a daily planner app might augment existing methods to enable assessment continuously and at scale. This paper reports the construction of a supervised binary classifier that attempts to demonstrate the feasibility of this approach. 1,460 registered users from the Owaves app opted in by filling out the MEQ survey between July 14, 2022, and May 1, 2023. 142 met the eligibility criteria. We used multimodal app data from individuals identified as morning and evening types from MEQ data, basing the classifier on app time series data. This included daily timing for 8 main lifestyle activity types: exercise, sleep, social interactions, meal times, relaxation, work, play, and miscellaneous, as defined in the app. The timing of activities showed substantial change across time, as well as heterogeneity by activity type. Our novel chronotyping classifier was able to predict the morningness and eveningness of its users with an ROC AUC of 0.70. Our findings demonstrate the feasibility of chronotype classification from multimodal, real-world app data, while highlighting fundamental challenges to applying discrete and fixed labels to complex, dynamic, multimodal behaviors. Our findings suggest a potential for real-time monitoring of shifts in chronotype specific to different causes (i.e. types of activity), which could feasibly be used to support future, prospective mental health support research.

Recent immense breakthroughs in generative models such as in GPT4 have precipitated re-imagined ubiquitous usage of these models in all applications. One area that can benefit by improvements in artificial intelligence (AI) is healthcare. The note generation task from doctor-patient encounters, and its associated electronic medical record documentation, is one of the most arduous time-consuming tasks for physicians. It is also a natural prime potential beneficiary to advances in generative models. However with such advances, benchmarking is more critical than ever. Whether studying model weaknesses or developing new evaluation metrics, shared open datasets are an imperative part of understanding the current state-of-the-art. Unfortunately as clinic encounter conversations are not routinely recorded and are difficult to ethically share due to patient confidentiality, there are no sufficiently large clinic dialogue-note datasets to benchmark this task. Here we present the Ambient Clinical Intelligence Benchmark (ACI-BENCH) corpus, the largest dataset to date tackling the problem of AI-assisted note generation from visit dialogue. We also present the benchmark performances of several common state-of-the-art approaches.

Multi-behavior sequential recommendation (MBSR) aims to incorporate behavior types of interactions for better recommendations. Existing approaches focus on the next-item prediction objective, neglecting the value of integrating the target behavior type into the learning objective. In this paper, we propose MBGen, a novel Multi-Behavior sequential Generative recommendation framework. We formulate the MBSR task into a consecutive two-step process: (1) given item sequences, MBGen first predicts the next behavior type to frame the user intention, (2) given item sequences and a target behavior type, MBGen then predicts the next items. To model such a two-step process, we tokenize both behaviors and items into tokens and construct one single token sequence with both behaviors and items placed interleaved. Furthermore, MBGen learns to autoregressively generate the next behavior and item tokens in a unified generative recommendation paradigm, naturally enabling a multi-task capability. Additionally, we exploit the heterogeneous nature of token sequences in the generative recommendation and propose a position-routed sparse architecture to efficiently and effectively scale up models. Extensive experiments on public datasets demonstrate that MBGen significantly outperforms existing MBSR models across multiple tasks.

Large Language Models (LLMs) have become an essential infrastructure for Artificial General Intelligence (AGI), yet their lack of well-defined memory management systems hinders the development of long-context reasoning, continual personalization, and knowledge consistency.Existing models mainly rely on static parameters and short-lived contextual states, limiting their ability to track user preferences or update knowledge over extended periods.While Retrieval-Augmented Generation (RAG) introduces external knowledge in plain text, it remains a stateless workaround without lifecycle control or integration with persistent representations.Recent work has modeled the training and inference cost of LLMs from a memory hierarchy perspective, showing that introducing an explicit memory layer between parameter memory and external retrieval can substantially reduce these costs by externalizing specific knowledge. Beyond computational efficiency, LLMs face broader challenges arising from how information is distributed over time and context, requiring systems capable of managing heterogeneous knowledge spanning different temporal scales and sources. To address this challenge, we propose MemOS, a memory operating system that treats memory as a manageable system resource. It unifies the representation, scheduling, and evolution of plaintext, activation-based, and parameter-level memories, enabling cost-efficient storage and retrieval. As the basic unit, a MemCube encapsulates both memory content and metadata such as provenance and versioning. MemCubes can be composed, migrated, and fused over time, enabling flexible transitions between memory types and bridging retrieval with parameter-based learning. MemOS establishes a memory-centric system framework that brings controllability, plasticity, and evolvability to LLMs, laying the foundation for continual learning and personalized modeling.

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.

In this work, we introduce Multiple Embedding Model for EHR (MEME), an approach that views Electronic Health Records (EHR) as multimodal data. This approach incorporates "pseudo-notes", textual representations of tabular EHR concepts such as diagnoses and medications, and allows us to effectively employ Large Language Models (LLMs) for EHR representation. This framework also adopts a multimodal approach, embedding each EHR modality separately. We demonstrate the effectiveness of MEME by applying it to several tasks within the Emergency Department across multiple hospital systems. Our findings show that MEME surpasses the performance of both single modality embedding methods and traditional machine learning approaches. However, we also observe notable limitations in generalizability across hospital institutions for all tested models.

Lifelong user behavior sequences, comprising up to tens of thousands of history behaviors, are crucial for capturing user interests and predicting user responses in modern recommendation systems. A two-stage paradigm is typically adopted to handle these long sequences: a few relevant behaviors are first searched from the original long sequences via an attention mechanism in the first stage and then aggregated with the target item to construct a discriminative representation for prediction in the second stage. In this work, we identify and characterize, for the first time, a neglected deficiency in existing long-sequence recommendation models: a single set of embeddings struggles with learning both attention and representation, leading to interference between these two processes. Initial attempts to address this issue using linear projections -- a technique borrowed from language processing -- proved ineffective, shedding light on the unique challenges of recommendation models. To overcome this, we propose the Decoupled Attention and Representation Embeddings (DARE) model, where two distinct embedding tables are initialized and learned separately to fully decouple attention and representation. Extensive experiments and analysis demonstrate that DARE provides more accurate search of correlated behaviors and outperforms baselines with AUC gains up to 0.9% on public datasets and notable online system improvements. Furthermore, decoupling embedding spaces allows us to reduce the attention embedding dimension and accelerate the search procedure by 50% without significant performance impact, enabling more efficient, high-performance online serving.

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.

Speech processing systems face a fundamental challenge: the human voice changes with age, yet few datasets support rigorous longitudinal evaluation. We introduce VoxKnesset, an open-access dataset of ~2,300 hours of Hebrew parliamentary speech spanning 2009-2025, comprising 393 speakers with recording spans of up to 15 years. Each segment includes aligned transcripts and verified demographic metadata from official parliamentary records. We benchmark modern speech embeddings (WavLM-Large, ECAPA-TDNN, Wav2Vec2-XLSR-1B) on age prediction and speaker verification under longitudinal conditions. Speaker verification EER rises from 2.15\% to 4.58\% over 15 years for the strongest model, and cross-sectionally trained age regressors fail to capture within-speaker aging, while longitudinally trained models recover a meaningful temporal signal. We publicly release the dataset and pipeline to support aging-robust speech systems and Hebrew speech processing.

In recent years, Large Language Models (LLMs) have enabled users to provide highly specific music recommendation requests using natural language prompts (e.g. "Can you recommend some old classics for slow dancing?"). In this setup, the recommended tracks are predicted by the LLM in an autoregressive way, i.e. the LLM generates the track titles one token at a time. While intuitive, this approach has several limitation. First, it is based on a general purpose tokenization that is optimized for words rather than for track titles. Second, it necessitates an additional entity resolution layer that matches the track title to the actual track identifier. Third, the number of decoding steps scales linearly with the length of the track title, slowing down inference. In this paper, we propose to address the task of prompt-based music recommendation as a generative retrieval task. Within this setting, we introduce novel, effective, and efficient representations of track identifiers that significantly outperform commonly used strategies. We introduce Text2Tracks, a generative retrieval model that learns a mapping from a user's music recommendation prompt to the relevant track IDs directly. Through an offline evaluation on a dataset of playlists with language inputs, we find that (1) the strategy to create IDs for music tracks is the most important factor for the effectiveness of Text2Tracks and semantic IDs significantly outperform commonly used strategies that rely on song titles as identifiers (2) provided with the right choice of track identifiers, Text2Tracks outperforms sparse and dense retrieval solutions trained to retrieve tracks from language prompts.

A 20-year analysis of CrossRef metadata demonstrates that global scholarly output -- encompassing publications, retractions, and preprints -- exhibits strikingly inertial growth, well-described by exponential, quadratic, and logistic models with nearly indistinguishable goodness-of-fit. Retraction dynamics, in particular, remain stable and minimally affected by the COVID-19 shock, which contributed less than 1% to total notices. Since 2004, publications doubled every 9.8 years, retractions every 11.4 years, and preprints at the fastest rate, every 5.6 years. The findings underscore a system primed for ongoing stress at unchanged structural bottlenecks. Although model forecasts diverge beyond 2024, the evidence suggests that the future trajectory of scholarly communication will be determined by persistent systemic inertia rather than episodic disruptions -- unless intentionally redirected by policy or AI-driven reform.

This paper examines memory mechanisms in Large Language Models (LLMs), emphasizing their importance for context-rich responses, reduced hallucinations, and improved efficiency. It categorizes memory into sensory, short-term, and long-term, with sensory memory corresponding to input prompts, short-term memory processing immediate context, and long-term memory implemented via external databases or structures. The text-based memory section covers acquisition (selection and summarization), management (updating, accessing, storing, and resolving conflicts), and utilization (full-text search, SQL queries, semantic search). The KV cache-based memory section discusses selection methods (regularity-based summarization, score-based approaches, special token embeddings) and compression techniques (low-rank compression, KV merging, multimodal compression), along with management strategies like offloading and shared attention mechanisms. Parameter-based memory methods (LoRA, TTT, MoE) transform memories into model parameters to enhance efficiency, while hidden-state-based memory approaches (chunk mechanisms, recurrent transformers, Mamba model) improve long-text processing by combining RNN hidden states with current methods. Overall, the paper offers a comprehensive analysis of LLM memory mechanisms, highlighting their significance and future research directions.

We explore local vs. global evolution of knowledge systems through the framework of socio-epistemic networks (SEN), applying two complementary methods to a corpus of scientific texts. The framework comprises three interconnected layers-social, semiotic (material), and semantic-proposing a multilayered approach to understanding structural developments of knowledge. To analyse diachronic changes on the semantic layer, we first use information-theoretic measures based on relative entropy to detect semantic shifts, assess their significance, and identify key driving features. Second, variations in document embedding densities reveal changes in semantic neighbourhoods, tracking how concentration of similar documents increase, remain stable, or disperse. This enables us to trace document trajectories based on content (topics) or metadata (authorship, institution). Case studies of Joseph Silk and Hans-J\"urgen Treder illustrate how individual scholar's work aligns with broader disciplinary shifts in general relativity and gravitation research, demonstrating the applications, limitations, and further potential of this approach.

Skin carcinoma is the most prevalent form of cancer globally, accounting for over $8 billion in annual healthcare expenditures. Early diagnosis, accurate and timely treatment are critical to improving patient survival rates. In clinical settings, physicians document patient visits using detailed SOAP (Subjective, Objective, Assessment, and Plan) notes. However, manually generating these notes is labor-intensive and contributes to clinician burnout. In this work, we propose skin-SOAP, a weakly supervised multimodal framework to generate clinically structured SOAP notes from limited inputs, including lesion images and sparse clinical text. Our approach reduces reliance on manual annotations, enabling scalable, clinically grounded documentation while alleviating clinician burden and reducing the need for large annotated data. Our method achieves performance comparable to GPT-4o, Claude, and DeepSeek Janus Pro across key clinical relevance metrics. To evaluate this clinical relevance, we introduce two novel metrics MedConceptEval and Clinical Coherence Score (CCS) which assess semantic alignment with expert medical concepts and input features, respectively.

Physiological time series signals reflect complex, multi-scale dynamical processes of the human body. Existing modeling studies focus on static tasks such as classification, event forecasting, or short-horizon next step prediction, while long-horizon signal-level forecasting and predictive nature of physiological signals remain underexplored. We introduce NormWear-2, a world model that encodes both multivariate physiological signals and clinical intervention variables into a shared latent space and models their joint temporal evolution as a dynamical system. Our approach combines inference from prior pre-trained knowledge (intuition) with instant non-parametric latent state transition adaptation (insight), enabling coherent forecasting across multiple temporal scales, conditioned on heterogeneous clinical interventions. During the pretraining phase, we find that chaos-theoretic balancing of dynamical regime diversity yields more robust representations, with a smaller balanced corpus outperforming one twice its size and capturing bifurcation regimes. We evaluate the world model performance across diverse real-world physiological datasets spanning heterogeneous temporal resolutions and intervention regimes, covering daily life, point-of-care, and clinical settings, including fitness planning, hemodialysis, diabetes management, and surgical monitoring. These evaluation datasets comprise records from 8,026 subjects, spanning study durations from 3.2 hours for high-resolution signal data to 2.3 years for longitudinal clinical biomarker tracking. NormWear-2 achieves the best overall forecasting performance across time, frequency, and latent representation domains, with significant improvements over state-of-the-art time series foundation models, while maintaining competitive downstream representation quality, providing a step toward general-purpose world models for physiological signals.

Existing approaches for generating multitrack music with transformer models have been limited in terms of the number of instruments, the length of the music segments and slow inference. This is partly due to the memory requirements of the lengthy input sequences necessitated by existing representations. In this work, we propose a new multitrack music representation that allows a diverse set of instruments while keeping a short sequence length. Our proposed Multitrack Music Transformer (MMT) achieves comparable performance with state-of-the-art systems, landing in between two recently proposed models in a subjective listening test, while achieving substantial speedups and memory reductions over both, making the method attractive for real time improvisation or near real time creative applications. Further, we propose a new measure for analyzing musical self-attention and show that the trained model attends more to notes that form a consonant interval with the current note and to notes that are 4N beats away from the current step.

Large language models (LMs) have been shown to memorize parts of their training data, and when prompted appropriately, they will emit the memorized training data verbatim. This is undesirable because memorization violates privacy (exposing user data), degrades utility (repeated easy-to-memorize text is often low quality), and hurts fairness (some texts are memorized over others). We describe three log-linear relationships that quantify the degree to which LMs emit memorized training data. Memorization significantly grows as we increase (1) the capacity of a model, (2) the number of times an example has been duplicated, and (3) the number of tokens of context used to prompt the model. Surprisingly, we find the situation becomes more complicated when generalizing these results across model families. On the whole, we find that memorization in LMs is more prevalent than previously believed and will likely get worse as models continues to scale, at least without active mitigations.

The training of modern large language models (LLMs) takes place in a regime where most training examples are seen only a few times by the model during the course of training. What does a model remember about such examples seen only a few times during training and how long does that memory persist in the face of continuous training with new examples? Here, we investigate these questions through simple recognition, recall, and retention experiments with LLMs. In recognition experiments, we ask if the model can distinguish the seen example from a novel example; in recall experiments, we ask if the model can correctly recall the seen example when cued by a part of it; and in retention experiments, we periodically probe the model's memory for the original examples as the model is trained continuously with new examples. We find that a single exposure is generally sufficient for a model to achieve near perfect accuracy even in very challenging recognition experiments. We estimate that the recognition performance of even small language models easily exceeds human recognition performance reported in similar experiments with humans (Shepard, 1967). Achieving near perfect recall takes more exposures, but most models can do it in just 3 exposures. The flip side of this remarkable capacity for fast learning is that precise memories are quickly overwritten: recall performance for the original examples drops steeply over the first 10 training updates with new examples, followed by a more gradual decline. Even after 100K updates, however, some of the original examples are still recalled near perfectly. A qualitatively similar retention pattern has been observed in human long-term memory retention studies before (Bahrick, 1984). Finally, recognition is much more robust to interference than recall and memory for natural language sentences is generally superior to memory for stimuli without structure.

To overcome the limitations of manual administrative coding in geriatric Cardiovascular Risk Management, this study introduces an automated classification framework leveraging unstructured Electronic Health Records (EHRs). Using a dataset of 3,482 patients, we benchmarked three distinct modeling paradigms on longitudinal Dutch clinical narratives: classical machine learning baselines, specialized deep learning architectures optimized for large-context sequences, and general-purpose generative Large Language Models (LLMs) in a zero-shot setting. Additionally, we evaluated a late fusion strategy to integrate unstructured text with structured medication embeddings and anthropometric data. Our analysis reveals that the custom Transformer architecture outperforms both traditional methods and generative llms, achieving the highest F1-scores and Matthews Correlation Coefficients. These findings underscore the critical role of specialized hierarchical attention mechanisms in capturing long-range dependencies within medical texts, presenting a robust, automated alternative to manual workflows for clinical risk stratification.

Generative recommendation (GenRec) models typically model user behavior via full attention, but scaling to lifelong sequences is hindered by prohibitive computational costs and noise accumulation from stochastic interactions. To address these challenges, we introduce Rec2PM, a framework that compresses long user interaction histories into compact Preference Memory tokens. Unlike traditional recurrent methods that suffer from serial training, Rec2PM employs a novel self-referential teacher-forcing strategy: it leverages a global view of the history to generate reference memories, which serve as supervision targets for parallelized recurrent updates. This allows for fully parallel training while maintaining the capability for iterative updates during inference. Additionally, by representing memory as token embeddings rather than extensive KV caches, Rec2PM achieves extreme storage efficiency. Experiments on large-scale benchmarks show that Rec2PM significantly reduces inference latency and memory footprint while achieving superior accuracy compared to full-sequence models. Analysis reveals that the Preference Memory functions as a denoising Information Bottleneck, effectively filtering interaction noise to capture robust long-term interests.

Standard artificial neural networks suffer from the well-known issue of catastrophic forgetting, making continual or lifelong learning difficult for machine learning. In recent years, numerous methods have been proposed for continual learning, but due to differences in evaluation protocols it is difficult to directly compare their performance. To enable more structured comparisons, we describe three continual learning scenarios based on whether at test time task identity is provided and--in case it is not--whether it must be inferred. Any sequence of well-defined tasks can be performed according to each scenario. Using the split and permuted MNIST task protocols, for each scenario we carry out an extensive comparison of recently proposed continual learning methods. We demonstrate substantial differences between the three scenarios in terms of difficulty and in terms of how efficient different methods are. In particular, when task identity must be inferred (i.e., class incremental learning), we find that regularization-based approaches (e.g., elastic weight consolidation) fail and that replaying representations of previous experiences seems required for solving this scenario.

Memory retention challenges in deep neural architectures have ongoing limitations in the ability to process and recall extended contextual information. Token dependencies degrade as sequence length increases, leading to a decline in coherence and factual consistency across longer outputs. A structured approach is introduced to mitigate this issue through the reweaving of latent states captured at different processing layers, reinforcing token representations over extended sequences. The proposed Contextual Memory Reweaving framework incorporates a Layered Latent State Reconstruction mechanism to systematically integrate past contextual embeddings without introducing external memory modules. Experimental results demonstrate improvements in recall accuracy across a range of sequence lengths, with notable gains in the retention of rarely occurring tokens and numerical reasoning consistency. Further analysis of computational efficiency indicates that the additional processing overhead remains within acceptable thresholds, enabling scalability across different model sizes. Evaluations in long-form text generation and ambiguous query resolution highlight the capacity of memory reweaving to enhance continuity and reduce inconsistencies over extended outputs. Attention weight distributions reveal more structured allocation patterns, suggesting that reweaved latent states contribute to improved contextual awareness. The findings establish a framework for refining memory retention mechanisms in language models, addressing long-standing challenges in handling complex, multi-step reasoning tasks.

While recent generative models can produce engaging music, their utility is limited. The variation in the music is often left to chance, resulting in compositions that lack structure. Pieces extending beyond a minute can become incoherent or repetitive. This paper introduces an approach for generating structured, arbitrarily long musical pieces. Central to this approach is the creation of musical segments using a conditional generative model, with transitions between these segments. The generation of prompts that determine the high-level composition is distinct from the creation of finer, lower-level details. A large language model is then used to suggest the musical form.

Automatically summarizing patients' main problems from daily progress notes using natural language processing methods helps to battle against information and cognitive overload in hospital settings and potentially assists providers with computerized diagnostic decision support. Problem list summarization requires a model to understand, abstract, and generate clinical documentation. In this work, we propose a new NLP task that aims to generate a list of problems in a patient's daily care plan using input from the provider's progress notes during hospitalization. We investigate the performance of T5 and BART, two state-of-the-art seq2seq transformer architectures, in solving this problem. We provide a corpus built on top of progress notes from publicly available electronic health record progress notes in the Medical Information Mart for Intensive Care (MIMIC)-III. T5 and BART are trained on general domain text, and we experiment with a data augmentation method and a domain adaptation pre-training method to increase exposure to medical vocabulary and knowledge. Evaluation methods include ROUGE, BERTScore, cosine similarity on sentence embedding, and F-score on medical concepts. Results show that T5 with domain adaptive pre-training achieves significant performance gains compared to a rule-based system and general domain pre-trained language models, indicating a promising direction for tackling the problem summarization task.

Understanding how individuals with Parkinson's disease (PD) describe cognitive experiences in their daily lives can offer valuable insights into disease-related cognitive and emotional changes. However, extracting such information from unstructured patient narratives is challenging due to the subtle, overlapping nature of cognitive constructs. This study developed and evaluated natural language processing (NLP) models to automatically identify categories that reflect various cognitive processes from de-identified first-person narratives. Three model families, a Bio_ClinicalBERT-based span categorization model for nested entity recognition, a fine-tuned Meta-Llama-3-8B-Instruct model using QLoRA for instruction following, and GPT-4o mini evaluated under zero- and few-shot settings, were compared on their performance on extracting seven categories. Our findings indicated that model performance varied substantially across categories and model families. The fine-tuned Meta-Llama-3-8B-Instruct achieved the highest overall F1-scores (0.74 micro-average and 0.59 macro-average), particularly excelling in context-dependent categories such as thought and social interaction. Bio_ClinicalBERT exhibited high precision but low recall and performed comparable to Llama for some category types such as location and time but failed on other categories such as thought, emotion and social interaction. Compared to conventional information extraction tasks, this task presents a greater challenge due to the abstract and overlapping nature of narrative accounts of complex cognitive processes. Nonetheless, with continued refinement, these NLP systems hold promise for enabling low-burden, longitudinal monitoring of cognitive function and serving as a valuable complement to formal neuropsychological assessments in PD.

Scholarly writing presents a complex space that generally follows a methodical procedure to plan and produce both rationally sound and creative compositions. Recent works involving large language models (LLM) demonstrate considerable success in text generation and revision tasks; however, LLMs still struggle to provide structural and creative feedback on the document level that is crucial to academic writing. In this paper, we introduce a novel taxonomy that categorizes scholarly writing behaviors according to intention, writer actions, and the information types of the written data. We also provide ManuScript, an original dataset annotated with a simplified version of our taxonomy to show writer actions and the intentions behind them. Motivated by cognitive writing theory, our taxonomy for scientific papers includes three levels of categorization in order to trace the general writing flow and identify the distinct writer activities embedded within each higher-level process. ManuScript intends to provide a complete picture of the scholarly writing process by capturing the linearity and non-linearity of writing trajectory, such that writing assistants can provide stronger feedback and suggestions on an end-to-end level. The collected writing trajectories are viewed at https://minnesotanlp.github.io/REWARD_demo/

Do transformers "think ahead" during inference at a given position? It is known transformers prepare information in the hidden states of the forward pass at t that is then used in future forward passes t+tau. We posit two explanations for this phenomenon: pre-caching, in which off-diagonal gradient terms present in training result in the model computing features at t irrelevant to the present inference task but useful for the future, and breadcrumbs, in which features most relevant to time step t are already the same as those that would most benefit inference at time t+tau. We test these hypotheses by training language models without propagating gradients to past timesteps, a scheme we formalize as myopic training. In a synthetic data setting, we find clear evidence for pre-caching. In the autoregressive language modeling setting, our experiments are more suggestive of the breadcrumbs hypothesis.

Medication reconciliation at clinical handoffs is a high-stakes, error-prone process. Large language models are increasingly proposed to assist with this task using FHIR-structured patient records, but a fundamental and largely unstudied variable is how the FHIR data is serialised before being passed to the model. We present the first systematic comparison of four FHIR serialisation strategies (Raw JSON, Markdown Table, Clinical Narrative, and Chronological Timeline) across five open-weight models (Phi-3.5-mini, Mistral-7B, BioMistral-7B, Llama-3.1-8B, Llama-3.3-70B) on a controlled benchmark of 200 synthetic patients, totalling 4,000 inference runs. We find that serialisation strategy has a large, statistically significant effect on performance for models up to 8B parameters: Clinical Narrative outperforms Raw JSON by up to 19 F1 points for Mistral-7B (r = 0.617, p < 10^{-10}). This advantage reverses at 70B, where Raw JSON achieves the best mean F1 of 0.9956. In all 20 model and strategy combinations, mean precision exceeds mean recall: omission is the dominant failure mode, with models more often missing an active medication than fabricating one, which changes how clinical safety auditing priorities should be set. Smaller models plateau at roughly 7-10 concurrent active medications, leaving polypharmacy patients, the patients most at risk from reconciliation errors, systematically underserved. BioMistral-7B, a domain-pretrained model without instruction tuning, produces zero usable output in all conditions, showing that domain pretraining alone is not sufficient for structured extraction. These results offer practical, evidence-based format recommendations for clinical LLM deployment: Clinical Narrative for models up to 8B, Raw JSON for 70B and above. The complete pipeline is reproducible on open-source tools running on an AWS g6e.xlarge instance (NVIDIA L40S, 48 GB VRAM).

Social and behavioral determinants of health (SDOH) play a significant role in shaping health outcomes, and extracting these determinants from clinical notes is a first step to help healthcare providers systematically identify opportunities to provide appropriate care and address disparities. Progress on using NLP methods for this task has been hindered by the lack of high-quality publicly available labeled data, largely due to the privacy and regulatory constraints on the use of real patients' information. This paper introduces a new dataset, SDOH-NLI, that is based on publicly available notes and which we release publicly. We formulate SDOH extraction as a natural language inference (NLI) task, and provide binary textual entailment labels obtained from human raters for a cross product of a set of social history snippets as premises and SDOH factors as hypotheses. Our dataset differs from standard NLI benchmarks in that our premises and hypotheses are obtained independently. We evaluate both "off-the-shelf" entailment models as well as models fine-tuned on our data, and highlight the ways in which our dataset appears more challenging than commonly used NLI datasets.

Large Language Models (LLMs) have recently emerged as an effective tool to assist individuals in writing various types of content, including professional documents such as recommendation letters. Though bringing convenience, this application also introduces unprecedented fairness concerns. Model-generated reference letters might be directly used by users in professional scenarios. If underlying biases exist in these model-constructed letters, using them without scrutinization could lead to direct societal harms, such as sabotaging application success rates for female applicants. In light of this pressing issue, it is imminent and necessary to comprehensively study fairness issues and associated harms in this real-world use case. In this paper, we critically examine gender biases in LLM-generated reference letters. Drawing inspiration from social science findings, we design evaluation methods to manifest biases through 2 dimensions: (1) biases in language style and (2) biases in lexical content. We further investigate the extent of bias propagation by analyzing the hallucination bias of models, a term that we define to be bias exacerbation in model-hallucinated contents. Through benchmarking evaluation on 2 popular LLMs- ChatGPT and Alpaca, we reveal significant gender biases in LLM-generated recommendation letters. Our findings not only warn against using LLMs for this application without scrutinization, but also illuminate the importance of thoroughly studying hidden biases and harms in LLM-generated professional documents.

Health conditions among patients in intensive care units (ICUs) are monitored via electronic health records (EHRs), composed of numerical time series and lengthy clinical note sequences, both taken at irregular time intervals. Dealing with such irregularity in every modality, and integrating irregularity into multimodal representations to improve medical predictions, is a challenging problem. Our method first addresses irregularity in each single modality by (1) modeling irregular time series by dynamically incorporating hand-crafted imputation embeddings into learned interpolation embeddings via a gating mechanism, and (2) casting a series of clinical note representations as multivariate irregular time series and tackling irregularity via a time attention mechanism. We further integrate irregularity in multimodal fusion with an interleaved attention mechanism across temporal steps. To the best of our knowledge, this is the first work to thoroughly model irregularity in multimodalities for improving medical predictions. Our proposed methods for two medical prediction tasks consistently outperforms state-of-the-art (SOTA) baselines in each single modality and multimodal fusion scenarios. Specifically, we observe relative improvements of 6.5\%, 3.6\%, and 4.3\% in F1 for time series, clinical notes, and multimodal fusion, respectively. These results demonstrate the effectiveness of our methods and the importance of considering irregularity in multimodal EHRs.

The teaching career shares common global characteristics, such as internal promotion, performance evaluation, recruitment of top candidates, continuous training, specialization, and peer learning. This study aims to describe the factors associated with the value placed on the teaching career in Peru. A total of 28217 public school teachers were analyzed using data from the 2020 National Teacher Survey. A variable measuring the "value of the teaching career" was constructed using eight indicators and categorized as low, medium, or high. Another variable, vision of the future, was classified as pessimistic, conformist, or optimistic. This observational, cross-sectional, and analytical study included variables related to in-service training, working conditions, professional recognition, and sociodemographic characteristics. Among the teachers surveyed, 45.8 % expressed an optimistic outlook on the future of the profession, 48 % held a conformist view, and only 6.2 % reported a pessimistic perspective. A generalized linear model revealed that the value placed on the teaching career was significantly associated with male gender (p = 0.002), a professional career (p < 0.001), an optimistic outlook (p = 0.033), and working at the primary level (p < 0.001). It was concluded that Peruvian teachers predominantly hold conformist or optimistic views of their profession. This highlights the need to reinforce merit-based advancement, competency-based training, intrinsic motivation, and ongoing professional development

Recent sequential recommendation models rely increasingly on consecutive short-term user-item interaction sequences to model user interests. These approaches have, however, raised concerns about both short- and long-term interests. (1) {\it short-term}: interaction sequences may not result from a monolithic interest, but rather from several intertwined interests, even within a short period of time, resulting in their failures to model skip behaviors; (2) {\it long-term}: interaction sequences are primarily observed sparsely at discrete intervals, other than consecutively over the long run. This renders difficulty in inferring long-term interests, since only discrete interest representations can be derived, without taking into account interest dynamics across sequences. In this study, we address these concerns by learning (1) multi-scale representations of short-term interests; and (2) dynamics-aware representations of long-term interests. To this end, we present an Interest Dynamics modeling framework using generative Neural Processes, coined IDNP, to model user interests from a functional perspective. IDNP learns a global interest function family to define each user's long-term interest as a function instantiation, manifesting interest dynamics through function continuity. Specifically, IDNP first encodes each user's short-term interactions into multi-scale representations, which are then summarized as user context. By combining latent global interest with user context, IDNP then reconstructs long-term user interest functions and predicts interactions at upcoming query timestep. Moreover, IDNP can model such interest functions even when interaction sequences are limited and non-consecutive. Extensive experiments on four real-world datasets demonstrate that our model outperforms state-of-the-arts on various evaluation metrics.

Large language models (LLMs) are increasingly being used in user-facing applications, from providing medical consultations to job interview advice. Recent research suggests that these models are becoming increasingly proficient at inferring identity information about the author of a piece of text from linguistic patterns as subtle as the choice of a few words. However, little is known about how LLMs use this information in their decision-making in real-world applications. We perform the first comprehensive analysis of how identity markers present in a user's writing bias LLM responses across five different high-stakes LLM applications in the domains of medicine, law, politics, government benefits, and job salaries. We find that LLMs are extremely sensitive to markers of identity in user queries and that race, gender, and age consistently influence LLM responses in these applications. For instance, when providing medical advice, we find that models apply different standards of care to individuals of different ethnicities for the same symptoms; we find that LLMs are more likely to alter answers to align with a conservative (liberal) political worldview when asked factual questions by older (younger) individuals; and that LLMs recommend lower salaries for non-White job applicants and higher salaries for women compared to men. Taken together, these biases mean that the use of off-the-shelf LLMs for these applications may cause harmful differences in medical care, foster wage gaps, and create different political factual realities for people of different identities. Beyond providing an analysis, we also provide new tools for evaluating how subtle encoding of identity in users' language choices impacts model decisions. Given the serious implications of these findings, we recommend that similar thorough assessments of LLM use in user-facing applications are conducted before future deployment.

Deploying large language models in long-horizon, goal-oriented interactions remains challenging because similar entities and facts recur under different latent goals and constraints, causing memory systems to retrieve context-mismatched evidence. We propose STITCH (Structured Intent Tracking in Contextual History), an agentic memory system that indexes each trajectory step with a structured retrieval cue, contextual intent, and retrieves history by matching the current step's intent. Contextual intent provides compact signals that disambiguate repeated mentions and reduce interference: (1) the current latent goal defining a thematic segment, (2) the action type, and (3) the salient entity types anchoring which attributes matter. During inference, STITCH filters and prioritizes memory snippets by intent compatibility, suppressing semantically similar but context-incompatible history. For evaluation, we introduce CAME-Bench, a benchmark for context-aware retrieval in realistic, dynamic, goal-oriented trajectories. Across CAME-Bench and LongMemEval, STITCH achieves state-of-the-art performance, outperforming the strongest baseline by 35.6%, with the largest gains as trajectory length increases. Our analysis shows that intent indexing substantially reduces retrieval noise, supporting intent-aware memory for robust long-horizon reasoning.

The use of episodic memory in continual learning has demonstrated effectiveness for alleviating catastrophic forgetting. In recent studies, gradient-based approaches have been developed to make more efficient use of compact episodic memory. Such approaches refine the gradients resulting from new samples by those from memorized samples, aiming to reduce the diversity of gradients from different tasks. In this paper, we clarify the relation between diversity of gradients and discriminativeness of representations, showing shared as well as conflicting interests between Deep Metric Learning and continual learning, thus demonstrating pros and cons of learning discriminative representations in continual learning. Based on these findings, we propose a simple method -- Semi-Discriminative Representation Loss (SDRL) -- for continual learning. In comparison with state-of-the-art methods, SDRL shows better performance with low computational cost on multiple benchmark tasks in the setting of online continual learning.

To build a French national electronic injury surveillance system based on emergency room visits, we aim to develop a coding system to classify their causes from clinical notes in free-text. Supervised learning techniques have shown good results in this area but require a large amount of expert annotated dataset which is time consuming and costly to obtain. We hypothesize that the Natural Language Processing Transformer model incorporating a generative self-supervised pre-training step can significantly reduce the required number of annotated samples for supervised fine-tuning. In this preliminary study, we test our hypothesis in the simplified problem of predicting whether a visit is the consequence of a traumatic event or not from free-text clinical notes. Using fully re-trained GPT-2 models (without OpenAI pre-trained weights), we assess the gain of applying a self-supervised pre-training phase with unlabeled notes prior to the supervised learning task. Results show that the number of data required to achieve a ginve level of performance (AUC>0.95) was reduced by a factor of 10 when applying pre-training. Namely, for 16 times more data, the fully-supervised model achieved an improvement <1% in AUC. To conclude, it is possible to adapt a multi-purpose neural language model such as the GPT-2 to create a powerful tool for classification of free-text notes with only a small number of labeled samples.

LLMs for clinical decision support often fail under small but clinically meaningful input shifts such as masking a symptom or negating a finding, despite high performance on static benchmarks. These reasoning failures frequently go undetected by standard NLP metrics, which are insensitive to latent representation shifts that drive diagnosis instability. We propose a geometry-aware evaluation framework, LAPD (Latent Agentic Perturbation Diagnostics), which systematically probes the latent robustness of clinical LLMs under structured adversarial edits. Within this framework, we introduce Latent Diagnosis Flip Rate (LDFR), a model-agnostic diagnostic signal that captures representational instability when embeddings cross decision boundaries in PCA-reduced latent space. Clinical notes are generated using a structured prompting pipeline grounded in diagnostic reasoning, then perturbed along four axes: masking, negation, synonym replacement, and numeric variation to simulate common ambiguities and omissions. We compute LDFR across both foundation and clinical LLMs, finding that latent fragility emerges even under minimal surface-level changes. Finally, we validate our findings on 90 real clinical notes from the DiReCT benchmark (MIMIC-IV), confirming the generalizability of LDFR beyond synthetic settings. Our results reveal a persistent gap between surface robustness and semantic stability, underscoring the importance of geometry-aware auditing in safety-critical clinical AI.

Loss of plasticity is a phenomenon where neural networks become more difficult to train during the course of learning. Continual learning algorithms seek to mitigate this effect by sustaining good predictive performance while maintaining network trainability. We develop new techniques for improving continual learning by first reconsidering how initialization can ensure trainability during early phases of learning. From this perspective, we derive new regularization strategies for continual learning that ensure beneficial initialization properties are better maintained throughout training. In particular, we investigate two new regularization techniques for continual learning: (i) Wasserstein regularization toward the initial weight distribution, which is less restrictive than regularizing toward initial weights; and (ii) regularizing weight matrix singular values, which directly ensures gradient diversity is maintained throughout training. We present an experimental analysis that shows these alternative regularizers can improve continual learning performance across a range of supervised learning tasks and model architectures. The alternative regularizers prove to be less sensitive to hyperparameters while demonstrating better training in individual tasks, sustaining trainability as new tasks arrive, and achieving better generalization performance.

Recurrent neural network is a powerful model that learns temporal patterns in sequential data. For a long time, it was believed that recurrent networks are difficult to train using simple optimizers, such as stochastic gradient descent, due to the so-called vanishing gradient problem. In this paper, we show that learning longer term patterns in real data, such as in natural language, is perfectly possible using gradient descent. This is achieved by using a slight structural modification of the simple recurrent neural network architecture. We encourage some of the hidden units to change their state slowly by making part of the recurrent weight matrix close to identity, thus forming kind of a longer term memory. We evaluate our model in language modeling experiments, where we obtain similar performance to the much more complex Long Short Term Memory (LSTM) networks (Hochreiter & Schmidhuber, 1997).

Probing the memorization of large language models holds significant importance. Previous works have established metrics for quantifying memorization, explored various influencing factors, such as data duplication, model size, and prompt length, and evaluated memorization by comparing model outputs with training corpora. However, the training corpora are of enormous scale and its pre-processing is time-consuming. To explore memorization without accessing training data, we propose a novel approach, named ROME, wherein memorization is explored by comparing disparities across memorized and non-memorized. Specifically, models firstly categorize the selected samples into memorized and non-memorized groups, and then comparing the demonstrations in the two groups from the insights of text, probability, and hidden state. Experimental findings show the disparities in factors including word length, part-of-speech, word frequency, mean and variance, just to name a few.

To develop effective sequential recommender systems, numerous methods have been proposed to model historical user behaviors. Despite the effectiveness, these methods share the same fast thinking paradigm. That is, for making recommendations, these methods typically encodes user historical interactions to obtain user representations and directly match these representations with candidate item representations. However, due to the limited capacity of traditional lightweight recommendation models, this one-step inference paradigm often leads to suboptimal performance. To tackle this issue, we present a novel slow thinking recommendation model, named STREAM-Rec. Our approach is capable of analyzing historical user behavior, generating a multi-step, deliberative reasoning process, and ultimately delivering personalized recommendations. In particular, we focus on two key challenges: (1) identifying the suitable reasoning patterns in recommender systems, and (2) exploring how to effectively stimulate the reasoning capabilities of traditional recommenders. To this end, we introduce a three-stage training framework. In the first stage, the model is pretrained on large-scale user behavior data to learn behavior patterns and capture long-range dependencies. In the second stage, we design an iterative inference algorithm to annotate suitable reasoning traces by progressively refining the model predictions. This annotated data is then used to fine-tune the model. Finally, in the third stage, we apply reinforcement learning to further enhance the model generalization ability. Extensive experiments validate the effectiveness of our proposed method.

Mental health disorders affect hundreds of millions globally, and the Web now serves as a primary medium for accessing support, information, and assessment. Large language models (LLMs) offer scalable and accessible assistance, yet their deployment in mental-health settings remains risky when their reasoning is incomplete, inconsistent, or ungrounded. Existing psychological LLMs emphasize emotional understanding or knowledge recall but overlook the step-wise, clinically aligned reasoning required for appraisal, diagnosis, intervention planning, abstraction, and verification. To address these issues, we introduce MentraSuite, a unified framework for advancing reliable mental-health reasoning. We propose MentraBench, a comprehensive benchmark spanning five core reasoning aspects, six tasks, and 13 datasets, evaluating both task performance and reasoning quality across five dimensions: conciseness, coherence, hallucination avoidance, task understanding, and internal consistency. We further present Mindora, a post-trained model optimized through a hybrid SFT-RL framework with an inconsistency-detection reward to enforce faithful and coherent reasoning. To support training, we construct high-quality trajectories using a novel reasoning trajectory generation strategy, that strategically filters difficult samples and applies a structured, consistency-oriented rewriting process to produce concise, readable, and well-balanced trajectories. Across 20 evaluated LLMs, Mindora achieves the highest average performance on MentraBench and shows remarkable performances in reasoning reliability, demonstrating its effectiveness for complex mental-health scenarios.