Daily Papers

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

The capacity of a modern deep learning system to determine if a sample falls within its realm of knowledge is fundamental and important. In this paper, we offer insights and analyses of recent state-of-the-art out-of-distribution (OOD) detection methods - extremely simple activation shaping (ASH). We demonstrate that activation pruning has a detrimental effect on OOD detection, while activation scaling enhances it. Moreover, we propose SCALE, a simple yet effective post-hoc network enhancement method for OOD detection, which attains state-of-the-art OOD detection performance without compromising in-distribution (ID) accuracy. By integrating scaling concepts into the training process to capture a sample's ID characteristics, we propose Intermediate Tensor SHaping (ISH), a lightweight method for training time OOD detection enhancement. We achieve AUROC scores of +1.85\% for near-OOD and +0.74\% for far-OOD datasets on the OpenOOD v1.5 ImageNet-1K benchmark. Our code and models are available at https://github.com/kai422/SCALE.

Adapting pretrained language models to novel domains, such as clinical applications, traditionally involves retraining their entire set of parameters. Parameter-Efficient Fine-Tuning (PEFT) techniques for fine-tuning language models significantly reduce computational requirements by selectively fine-tuning small subsets of parameters. In this study, we propose a two-step PEFT framework and evaluate it in the clinical domain. Our approach combines a specialised PEFT adapter layer designed for clinical domain adaptation with another adapter specialised for downstream tasks. We evaluate the framework on multiple clinical outcome prediction datasets, comparing it to clinically trained language models. Our framework achieves a better AUROC score averaged across all clinical downstream tasks compared to clinical language models. In particular, we observe large improvements of 4-5% AUROC in large-scale multilabel classification tasks, such as diagnoses and procedures classification. To our knowledge, this study is the first to provide an extensive empirical analysis of the interplay between PEFT techniques and domain adaptation in an important real-world domain of clinical applications.

Large language models (LLMs) can be trained or fine-tuned on data obtained without the owner's consent. Verifying whether a specific LLM was trained on particular data instances or an entire dataset is extremely challenging. Dataset watermarking addresses this by embedding identifiable modifications in training data to detect unauthorized use. However, existing methods often lack stealth, making them relatively easy to detect and remove. In light of these limitations, we propose LexiMark, a novel watermarking technique designed for text and documents, which embeds synonym substitutions for carefully selected high-entropy words. Our method aims to enhance an LLM's memorization capabilities on the watermarked text without altering the semantic integrity of the text. As a result, the watermark is difficult to detect, blending seamlessly into the text with no visible markers, and is resistant to removal due to its subtle, contextually appropriate substitutions that evade automated and manual detection. We evaluated our method using baseline datasets from recent studies and seven open-source models: LLaMA-1 7B, LLaMA-3 8B, Mistral 7B, Pythia 6.9B, as well as three smaller variants from the Pythia family (160M, 410M, and 1B). Our evaluation spans multiple training settings, including continued pretraining and fine-tuning scenarios. The results demonstrate significant improvements in AUROC scores compared to existing methods, underscoring our method's effectiveness in reliably verifying whether unauthorized watermarked data was used in LLM training.

The rise of AI voice-cloning technology, particularly audio Real-time Deepfakes (RTDFs), has intensified social engineering attacks by enabling real-time voice impersonation that bypasses conventional enrollment-based authentication. To address this, we propose PITCH, a robust challenge-response method to detect and tag interactive deepfake audio calls. We developed a comprehensive taxonomy of audio challenges based on the human auditory system, linguistics, and environmental factors, yielding 20 prospective challenges. These were tested against leading voice-cloning systems using a novel dataset comprising 18,600 original and 1.6 million deepfake samples from 100 users. PITCH's prospective challenges enhanced machine detection capabilities to 88.7% AUROC score on the full unbalanced dataset, enabling us to shortlist 10 functional challenges that balance security and usability. For human evaluation and subsequent analyses, we filtered a challenging, balanced subset. On this subset, human evaluators independently scored 72.6% accuracy, while machines achieved 87.7%. Acknowledging that call environments require higher human control, we aided call receivers in making decisions with them using machines. Our solution uses an early warning system to tag suspicious incoming calls as "Deepfake-likely." Contrary to prior findings, we discovered that integrating human intuition with machine precision offers complementary advantages. Our solution gave users maximum control and boosted detection accuracy to 84.5%. Evidenced by this jump in accuracy, PITCH demonstrated the potential for AI-assisted pre-screening in call verification processes, offering an adaptable and usable approach to combat real-time voice-cloning attacks. Code to reproduce and access data at https://github.com/mittalgovind/PITCH-Deepfakes.

Being able to spot defective parts is a critical component in large-scale industrial manufacturing. A particular challenge that we address in this work is the cold-start problem: fit a model using nominal (non-defective) example images only. While handcrafted solutions per class are possible, the goal is to build systems that work well simultaneously on many different tasks automatically. The best performing approaches combine embeddings from ImageNet models with an outlier detection model. In this paper, we extend on this line of work and propose PatchCore, which uses a maximally representative memory bank of nominal patch-features. PatchCore offers competitive inference times while achieving state-of-the-art performance for both detection and localization. On the challenging, widely used MVTec AD benchmark PatchCore achieves an image-level anomaly detection AUROC score of up to 99.6%, more than halving the error compared to the next best competitor. We further report competitive results on two additional datasets and also find competitive results in the few samples regime.^* Work done during a research internship at Amazon AWS. Code: github.com/amazon-research/patchcore-inspection.

Accurate detection of cardiac abnormalities from electrocardiogram recordings is regarded as essential for clinical diagnostics and decision support. Traditional deep learning models such as residual networks and transformer architectures have been applied successfully to this task, but their performance has been limited when long sequential signals are processed. Recently, state space models have been introduced as an efficient alternative. In this study, a hybrid framework named One Dimensional Convolutional Neural Network Electrocardiogram Mamba is introduced, in which convolutional feature extraction is combined with Mamba, a selective state space model designed for effective sequence modeling. The model is built upon Vision Mamba, a bidirectional variant through which the representation of temporal dependencies in electrocardiogram data is enhanced. Comprehensive experiments on the PhysioNet Computing in Cardiology Challenges of 2020 and 2021 were conducted, and superior performance compared with existing methods was achieved. Specifically, the proposed model achieved substantially higher AUPRC and AUROC scores than those reported by the best previously published algorithms on twelve lead electrocardiograms. These results demonstrate the potential of Mamba-based architectures to advance reliable ECG classification. This capability supports early diagnosis and personalized treatment, while enhancing accessibility in telemedicine and resource-constrained healthcare systems.

Few-shot anomaly detection (FSAD) has emerged as a crucial yet challenging task in industrial inspection, where normal distribution modeling must be accomplished with only a few normal images. While existing approaches typically employ multi-modal foundation models combining language and vision modalities for prompt-guided anomaly detection, these methods often demand sophisticated prompt engineering and extensive manual tuning. In this paper, we demonstrate that a straightforward nearest-neighbor search framework can surpass state-of-the-art performance in both single-class and multi-class FSAD scenarios. Our proposed method, VisionAD, consists of four simple yet essential components: (1) scalable vision foundation models that extract universal and discriminative features; (2) dual augmentation strategies - support augmentation to enhance feature matching adaptability and query augmentation to address the oversights of single-view prediction; (3) multi-layer feature integration that captures both low-frequency global context and high-frequency local details with minimal computational overhead; and (4) a class-aware visual memory bank enabling efficient one-for-all multi-class detection. Extensive evaluations across MVTec-AD, VisA, and Real-IAD benchmarks demonstrate VisionAD's exceptional performance. Using only 1 normal images as support, our method achieves remarkable image-level AUROC scores of 97.4%, 94.8%, and 70.8% respectively, outperforming current state-of-the-art approaches by significant margins (+1.6%, +3.2%, and +1.4%). The training-free nature and superior few-shot capabilities of VisionAD make it particularly appealing for real-world applications where samples are scarce or expensive to obtain. Code is available at https://github.com/Qiqigeww/VisionAD.

Large Language Models (LLMs) have demonstrated remarkable proficiency in generating code. However, the misuse of LLM-generated (synthetic) code has raised concerns in both educational and industrial contexts, underscoring the urgent need for synthetic code detectors. Existing methods for detecting synthetic content are primarily designed for general text and struggle with code due to the unique grammatical structure of programming languages and the presence of numerous ''low-entropy'' tokens. Building on this, our work proposes a novel zero-shot synthetic code detector based on the similarity between the original code and its LLM-rewritten variants. Our method is based on the observation that differences between LLM-rewritten and original code tend to be smaller when the original code is synthetic. We utilize self-supervised contrastive learning to train a code similarity model and evaluate our approach on two synthetic code detection benchmarks. Our results demonstrate a significant improvement over existing SOTA synthetic content detectors, with AUROC scores increasing by 20.5% on the APPS benchmark and 29.1% on the MBPP benchmark.

Recent advances in LLMs have made automated scientific research the next frontline in the path to artificial superintelligence. However, these systems are bound either to tasks of narrow scope or the limited creative capabilities of LLMs. We propose Spacer, a scientific discovery system that develops creative and factually grounded concepts without external intervention. Spacer attempts to achieve this via 'deliberate decontextualization,' an approach that disassembles information into atomic units - keywords - and draws creativity from unexplored connections between them. Spacer consists of (i) Nuri, an inspiration engine that builds keyword sets, and (ii) the Manifesting Pipeline that refines these sets into elaborate scientific statements. Nuri extracts novel, high-potential keyword sets from a keyword graph built with 180,000 academic publications in biological fields. The Manifesting Pipeline finds links between keywords, analyzes their logical structure, validates their plausibility, and ultimately drafts original scientific concepts. According to our experiments, the evaluation metric of Nuri accurately classifies high-impact publications with an AUROC score of 0.737. Our Manifesting Pipeline also successfully reconstructs core concepts from the latest top-journal articles solely from their keyword sets. An LLM-based scoring system estimates that this reconstruction was sound for over 85% of the cases. Finally, our embedding space analysis shows that outputs from Spacer are significantly more similar to leading publications compared with those from SOTA LLMs.

In the face of pressing environmental issues in the 21st century, monitoring surface changes on Earth is more important than ever. Large-scale remote sensing, such as satellite imagery, is an important tool for this task. However, using supervised methods to detect changes is difficult because of the lack of satellite data annotated with change labels, especially for rare categories of change. Annotation proves challenging due to the sparse occurrence of changes in satellite images. Even within a vast collection of images, only a small fraction may exhibit persistent changes of interest. To address this challenge, we introduce OPTIMUS, a self-supervised learning method based on an intuitive principle: if a model can recover information about the relative order of images in the time series, then that implies that there are long-lasting changes in the images. OPTIMUS demonstrates this principle by using change point detection methods on model outputs in a time series. We demonstrate that OPTIMUS can directly detect interesting changes in satellite images, achieving an improvement in AUROC score from 56.3% to 87.6% at distinguishing changed time series from unchanged ones compared to baselines. Our code and dataset are available at https://huggingface.co/datasets/optimus-change/optimus-dataset/.

Parameter-efficient fine-tuning (PEFT) that was initially developed for exploiting pre-trained large language models has recently emerged as an effective approach to perform transfer learning on computer vision tasks. However, the effectiveness of PEFT on medical vision foundation models is still unclear and remains to be explored. As a proof of concept, we conducted a detailed empirical study on applying PEFT to chest radiography foundation models. Specifically, we delved into LoRA, a representative PEFT method, and compared it against full-parameter fine-tuning (FFT) on two self-supervised radiography foundation models across three well-established chest radiograph datasets. Our results showed that LoRA outperformed FFT in 13 out of 18 transfer learning tasks by at most 2.9% using fewer than 1% tunable parameters. Combining LoRA with foundation models, we set up new state-of-the-art on a range of data-efficient learning tasks, such as an AUROC score of 80.6% using 1% labeled data on NIH ChestX-ray14. We hope this study can evoke more attention from the community in the use of PEFT for transfer learning on medical imaging tasks. Code and models are available at https://github.com/RL4M/MED-PEFT.

Most of the existing Out-Of-Distribution (OOD) detection algorithms depend on single input source: the feature, the logit, or the softmax probability. However, the immense diversity of the OOD examples makes such methods fragile. There are OOD samples that are easy to identify in the feature space while hard to distinguish in the logit space and vice versa. Motivated by this observation, we propose a novel OOD scoring method named Virtual-logit Matching (ViM), which combines the class-agnostic score from feature space and the In-Distribution (ID) class-dependent logits. Specifically, an additional logit representing the virtual OOD class is generated from the residual of the feature against the principal space, and then matched with the original logits by a constant scaling. The probability of this virtual logit after softmax is the indicator of OOD-ness. To facilitate the evaluation of large-scale OOD detection in academia, we create a new OOD dataset for ImageNet-1K, which is human-annotated and is 8.8x the size of existing datasets. We conducted extensive experiments, including CNNs and vision transformers, to demonstrate the effectiveness of the proposed ViM score. In particular, using the BiT-S model, our method gets an average AUROC 90.91% on four difficult OOD benchmarks, which is 4% ahead of the best baseline. Code and dataset are available at https://github.com/haoqiwang/vim.

As LLM agents are increasingly deployed in multi-agent systems, they introduce risks of covert coordination that may evade standard forms of human oversight. While linear probes on model activations have shown promise for detecting deception in single-agent settings, collusion is inherently a multi-agent phenomenon, and the use of internal representations for detecting collusion between agents remains unexplored. We introduce NARCBench, a benchmark for evaluating collusion detection under environment distribution shift, and propose five probing techniques that aggregate per-agent deception scores to classify scenarios at the group level. Our probes achieve 1.00 AUROC in-distribution and 0.60--0.86 AUROC when transferred zero-shot to structurally different multi-agent scenarios and a steganographic blackjack card-counting task. We find that no single probing technique dominates across all collusion types, suggesting that different forms of collusion manifest differently in activation space. We also find preliminary evidence that this signal is localised at the token level, with the colluding agent's activations spiking specifically when processing the encoded parts of their partner's message. This work takes a step toward multi-agent interpretability: extending white-box inspection from single models to multi-agent contexts, where detection requires aggregating signals across agents. These results suggest that model internals provide a complementary signal to text-level monitoring for detecting multi-agent collusion, particularly for organisations with access to model activations. Code and data are available at https://github.com/aaronrose227/narcbench.

We present a novel large-scale dataset for defect detection in a logistics setting. Recent work on industrial anomaly detection has primarily focused on manufacturing scenarios with highly controlled poses and a limited number of object categories. Existing benchmarks like MVTec-AD [6] and VisA [33] have reached saturation, with state-of-the-art methods achieving up to 99.9% AUROC scores. In contrast to manufacturing, anomaly detection in retail logistics faces new challenges, particularly in the diversity and variability of object pose and appearance. Leading anomaly detection methods fall short when applied to this new setting. To bridge this gap, we introduce a new benchmark that overcomes the current limitations of existing datasets. With over 230,000 images (and more than 29,000 defective instances), it is 40 times larger than MVTec-AD and contains more than 48,000 distinct objects. To validate the difficulty of the problem, we conduct an extensive evaluation of multiple state-of-the-art anomaly detection methods, demonstrating that they do not surpass 56.96% AUROC on our dataset. Further qualitative analysis confirms that existing methods struggle to leverage normal samples under heavy pose and appearance variation. With our large-scale dataset, we set a new benchmark and encourage future research towards solving this challenging problem in retail logistics anomaly detection. The dataset is available for download under https://www.kaputt-dataset.com.

Large language models (LLMs) are increasingly trained on tabular data, which, unlike unstructured text, often contains personally identifiable information (PII) in a highly structured and explicit format. As a result, privacy risks arise, since sensitive records can be inadvertently retained by the model and exposed through data extraction or membership inference attacks (MIAs). While existing MIA methods primarily target textual content, their efficacy and threat implications may differ when applied to structured data, due to its limited content, diverse data types, unique value distributions, and column-level semantics. In this paper, we present Tab-MIA, a benchmark dataset for evaluating MIAs on tabular data in LLMs and demonstrate how it can be used. Tab-MIA comprises five data collections, each represented in six different encoding formats. Using our Tab-MIA benchmark, we conduct the first evaluation of state-of-the-art MIA methods on LLMs finetuned with tabular data across multiple encoding formats. In the evaluation, we analyze the memorization behavior of pretrained LLMs on structured data derived from Wikipedia tables. Our findings show that LLMs memorize tabular data in ways that vary across encoding formats, making them susceptible to extraction via MIAs. Even when fine-tuned for as few as three epochs, models exhibit high vulnerability, with AUROC scores approaching 90% in most cases. Tab-MIA enables systematic evaluation of these risks and provides a foundation for developing privacy-preserving methods for tabular data in LLMs.

With the rapid rise of generative AI and synthetic media, distinguishing AI-generated images from real ones has become crucial in safeguarding against misinformation and ensuring digital authenticity. Traditional watermarking techniques have shown vulnerabilities to adversarial attacks, undermining their effectiveness in the presence of attackers. We propose IConMark, a novel in-generation robust semantic watermarking method that embeds interpretable concepts into AI-generated images, as a first step toward interpretable watermarking. Unlike traditional methods, which rely on adding noise or perturbations to AI-generated images, IConMark incorporates meaningful semantic attributes, making it interpretable to humans and hence, resilient to adversarial manipulation. This method is not only robust against various image augmentations but also human-readable, enabling manual verification of watermarks. We demonstrate a detailed evaluation of IConMark's effectiveness, demonstrating its superiority in terms of detection accuracy and maintaining image quality. Moreover, IConMark can be combined with existing watermarking techniques to further enhance and complement its robustness. We introduce IConMark+SS and IConMark+TM, hybrid approaches combining IConMark with StegaStamp and TrustMark, respectively, to further bolster robustness against multiple types of image manipulations. Our base watermarking technique (IConMark) and its variants (+TM and +SS) achieve 10.8%, 14.5%, and 15.9% higher mean area under the receiver operating characteristic curve (AUROC) scores for watermark detection, respectively, compared to the best baseline on various datasets.

Because anomalous samples cannot be used for training, many anomaly detection and localization methods use pre-trained networks and non-parametric modeling to estimate encoded feature distribution. However, these methods neglect the impact of position and neighborhood information on the distribution of normal features. To overcome this, we propose a new algorithm, PNI, which estimates the normal distribution using conditional probability given neighborhood features, modeled with a multi-layer perceptron network. Moreover, position information is utilized by creating a histogram of representative features at each position. Instead of simply resizing the anomaly map, the proposed method employs an additional refine network trained on synthetic anomaly images to better interpolate and account for the shape and edge of the input image. We conducted experiments on the MVTec AD benchmark dataset and achieved state-of-the-art performance, with 99.56\% and 98.98\% AUROC scores in anomaly detection and localization, respectively.

Recent advances in visual anomaly detection research have seen AUROC and AUPRO scores on public benchmark datasets such as MVTec and VisA converge towards perfect recall, giving the impression that these benchmarks are near-solved. However, high AUROC and AUPRO scores do not always reflect qualitative performance, which limits the validity of these metrics in real-world applications. We argue that the artificial ceiling imposed by the lack of an adequate evaluation metric restrains progression of the field, and it is crucial that we revisit the evaluation metrics used to rate our algorithms. In response, we introduce Per-IMage Overlap (PIMO), a novel metric that addresses the shortcomings of AUROC and AUPRO. PIMO retains the recall-based nature of the existing metrics but introduces two distinctions: the assignment of curves (and respective area under the curve) is per-image, and its X-axis relies solely on normal images. Measuring recall per image simplifies instance score indexing and is more robust to noisy annotations. As we show, it also accelerates computation and enables the usage of statistical tests to compare models. By imposing low tolerance for false positives on normal images, PIMO provides an enhanced model validation procedure and highlights performance variations across datasets. Our experiments demonstrate that PIMO offers practical advantages and nuanced performance insights that redefine anomaly detection benchmarks -- notably challenging the perception that MVTec AD and VisA datasets have been solved by contemporary models. Available on GitHub: https://github.com/jpcbertoldo/aupimo.

Voice activity detection (VAD) is essential for speech-driven applications, but remains far from perfect in noisy and resource-limited environments. Existing methods often lack robustness to noise, and their frame-wise classification losses are only loosely coupled with the evaluation metric of VAD. To address these challenges, we propose SincQDR-VAD, a compact and robust framework that combines a Sinc-extractor front-end with a novel quadratic disparity ranking loss. The Sinc-extractor uses learnable bandpass filters to capture noise-resistant spectral features, while the ranking loss optimizes the pairwise score order between speech and non-speech frames to improve the area under the receiver operating characteristic curve (AUROC). A series of experiments conducted on representative benchmark datasets show that our framework considerably improves both AUROC and F2-Score, while using only 69% of the parameters compared to prior arts, confirming its efficiency and practical viability.

Retrieval-Augmented Generation (RAG) aims to mitigate hallucinations in large language models (LLMs) by grounding responses in retrieved documents. Yet, RAG-based LLMs still hallucinate even when provided with correct and sufficient context. A growing line of work suggests that this stems from an imbalance between how models use external context and their internal knowledge, and several approaches have attempted to quantify these signals for hallucination detection. However, existing methods require extensive hyperparameter tuning, limiting their generalizability. We propose LUMINA, a novel framework that detects hallucinations in RAG systems through context-knowledge signals: external context utilization is quantified via distributional distance, while internal knowledge utilization is measured by tracking how predicted tokens evolve across transformer layers. We further introduce a framework for statistically validating these measurements. Experiments on common RAG hallucination benchmarks and four open-source LLMs show that LUMINA achieves consistently high AUROC and AUPRC scores, outperforming prior utilization-based methods by up to +13% AUROC on HalluRAG. Moreover, LUMINA remains robust under relaxed assumptions about retrieval quality and model matching, offering both effectiveness and practicality.

Despite the outstanding performance of deep learning models in clinical prediction tasks, explainability remains a significant challenge. Inspired by transformer architectures, we introduce the Temporal-Feature Cross Attention Mechanism (TFCAM), a novel deep learning framework designed to capture dynamic interactions among clinical features across time, enhancing both predictive accuracy and interpretability. In an experiment with 1,422 patients with Chronic Kidney Disease, predicting progression to End-Stage Renal Disease, TFCAM outperformed LSTM and RETAIN baselines, achieving an AUROC of 0.95 and an F1-score of 0.69. Beyond performance gains, TFCAM provides multi-level explainability by identifying critical temporal periods, ranking feature importance, and quantifying how features influence each other across time before affecting predictions. Our approach addresses the "black box" limitations of deep learning in healthcare, offering clinicians transparent insights into disease progression mechanisms while maintaining state-of-the-art predictive performance.

The validity screen (Cacioli, 2026d, 2026e) classifies LLM confidence signals as Valid, Indeterminate, or Invalid. We test whether these classifications predict selective prediction performance. Twenty frontier LLMs from seven families were evaluated on 524 items across six cognitive tracks. Valid models show mean Type 2 AUROC = .624 (SD = .048). Invalid models show mean AUROC = .357 (SD = .231). Cohen's d = 2.81, p = .002. The tiers order monotonically: Invalid (.357) < Indeterminate (.554) < Valid (.624). Split-half cross-validation yields median d = 1.77, P(d > 0) = 1.0 across 1,000 splits. The three-tier classification accounts for 47% of the variance in AUROC. DeepSeek-R1 drops from 85.3% accuracy at full coverage to 11.3% at 10% coverage. The screen predicts the criterion. For selective prediction, the screen matters.

Objective: To determine if a realistic, but computationally efficient model of the electrocardiogram can be used to pre-train a deep neural network (DNN) with a wide range of morphologies and abnormalities specific to a given condition - T-wave Alternans (TWA) as a result of Post-Traumatic Stress Disorder, or PTSD - and significantly boost performance on a small database of rare individuals. Approach: Using a previously validated artificial ECG model, we generated 180,000 artificial ECGs with or without significant TWA, with varying heart rate, breathing rate, TWA amplitude, and ECG morphology. A DNN, trained on over 70,000 patients to classify 25 different rhythms, was modified the output layer to a binary class (TWA or no-TWA, or equivalently, PTSD or no-PTSD), and transfer learning was performed on the artificial ECG. In a final transfer learning step, the DNN was trained and cross-validated on ECG from 12 PTSD and 24 controls for all combinations of using the three databases. Main results: The best performing approach (AUROC = 0.77, Accuracy = 0.72, F1-score = 0.64) was found by performing both transfer learning steps, using the pre-trained arrhythmia DNN, the artificial data and the real PTSD-related ECG data. Removing the artificial data from training led to the largest drop in performance. Removing the arrhythmia data from training provided a modest, but significant, drop in performance. The final model showed no significant drop in performance on the artificial data, indicating no overfitting. Significance: In healthcare, it is common to only have a small collection of high-quality data and labels, or a larger database with much lower quality (and less relevant) labels. The paradigm presented here, involving model-based performance boosting, provides a solution through transfer learning on a large realistic artificial database, and a partially relevant real database.

In machine learning (ML), a widespread adage is that the area under the precision-recall curve (AUPRC) is a superior metric for model comparison to the area under the receiver operating characteristic (AUROC) for binary classification tasks with class imbalance. This paper challenges this notion through novel mathematical analysis, illustrating that AUROC and AUPRC can be concisely related in probabilistic terms. We demonstrate that AUPRC, contrary to popular belief, is not superior in cases of class imbalance and might even be a harmful metric, given its inclination to unduly favor model improvements in subpopulations with more frequent positive labels. This bias can inadvertently heighten algorithmic disparities. Prompted by these insights, a thorough review of existing ML literature was conducted, utilizing large language models to analyze over 1.5 million papers from arXiv. Our investigation focused on the prevalence and substantiation of the purported AUPRC superiority. The results expose a significant deficit in empirical backing and a trend of misattributions that have fuelled the widespread acceptance of AUPRC's supposed advantages. Our findings represent a dual contribution: a significant technical advancement in understanding metric behaviors and a stark warning about unchecked assumptions in the ML community. All experiments are accessible at https://github.com/mmcdermott/AUC_is_all_you_need.

The PI-CAI (Prostate Imaging: Cancer AI) challenge led to expert-level diagnostic algorithms for clinically significant prostate cancer detection. The algorithms receive biparametric MRI scans as input, which consist of T2-weighted and diffusion-weighted scans. These scans can be misaligned due to multiple factors in the scanning process. Image registration can alleviate this issue by predicting the deformation between the sequences. We investigate the effect of image registration on the diagnostic performance of AI-based prostate cancer diagnosis. First, the image registration algorithm, developed in MeVisLab, is analyzed using a dataset with paired lesion annotations. Second, the effect on diagnosis is evaluated by comparing case-level cancer diagnosis performance between using the original dataset, rigidly aligned diffusion-weighted scans, or deformably aligned diffusion-weighted scans. Rigid registration showed no improvement. Deformable registration demonstrated a substantial improvement in lesion overlap (+10% median Dice score) and a positive yet non-significant improvement in diagnostic performance (+0.3% AUROC, p=0.18). Our investigation shows that a substantial improvement in lesion alignment does not directly lead to a significant improvement in diagnostic performance. Qualitative analysis indicated that jointly developing image registration methods and diagnostic AI algorithms could enhance diagnostic accuracy and patient outcomes.

Anomaly Detection (AD) in images is a fundamental computer vision problem and refers to identifying images and image substructures that deviate significantly from the norm. Popular AD algorithms commonly try to learn a model of normality from scratch using task specific datasets, but are limited to semi-supervised approaches employing mostly normal data due to the inaccessibility of anomalies on a large scale combined with the ambiguous nature of anomaly appearance. We follow an alternative approach and demonstrate that deep feature representations learned by discriminative models on large natural image datasets are well suited to describe normality and detect even subtle anomalies in a transfer learning setting. Our model of normality is established by fitting a multivariate Gaussian (MVG) to deep feature representations of classification networks trained on ImageNet using normal data only. By subsequently applying the Mahalanobis distance as the anomaly score we outperform the current state of the art on the public MVTec AD dataset, achieving an AUROC value of 95.8 pm 1.2 (mean pm SEM) over all 15 classes. We further investigate why the learned representations are discriminative to the AD task using Principal Component Analysis. We find that the principal components containing little variance in normal data are the ones crucial for discriminating between normal and anomalous instances. This gives a possible explanation to the often sub-par performance of AD approaches trained from scratch using normal data only. By selectively fitting a MVG to these most relevant components only, we are able to further reduce model complexity while retaining AD performance. We also investigate setting the working point by selecting acceptable False Positive Rate thresholds based on the MVG assumption. Code available at https://github.com/ORippler/gaussian-ad-mvtec

Cardiotoxicity induced by the breast cancer treatments (i.e., chemotherapy, targeted therapy and radiation therapy) is a significant problem for breast cancer patients. The cardiotoxicity risk for breast cancer patients receiving different treatments remains unclear. We developed and evaluated risk predictive models for cardiotoxicity in breast cancer patients using EHR data. The AUC scores to predict the CHF, CAD, CM and MI are 0.846, 0.857, 0.858 and 0.804 respectively. After adjusting for baseline differences in cardiovascular health, patients who received chemotherapy or targeted therapy appeared to have higher risk of cardiotoxicity than patients who received radiation therapy. Due to differences in baseline cardiac health across the different breast cancer treatment groups, caution is recommended in interpreting the cardiotoxic effect of these treatments.

Large Language Models (LLMs) are increasingly used for clinical decision support, where hallucinations and unsafe suggestions may pose direct risks to patient safety. These risks are particularly challenging as they often manifest as subtle clinical errors that evade detection by generic metrics, while expert-authored fine-grained rubrics remain costly to construct and difficult to scale. In this paper, we propose a retrieval-augmented multi-agent framework designed to automate the generation of instance-specific evaluation rubrics. Our approach grounds evaluation in authoritative medical evidence by decomposing retrieved content into atomic facts and synthesizing them with user interaction constraints to form verifiable, fine-grained evaluation criteria. Evaluated on HealthBench, our framework achieves a Clinical Intent Alignment (CIA) score of 60.12%, a statistically significant improvement over the GPT-4o baseline (55.16%). In discriminative tests, our rubrics yield a mean score delta (μ_Δ = 8.658) and an AUROC of 0.977, nearly doubling the quality separation achieved by GPT-4o baseline (4.972). Beyond evaluation, our rubrics effectively guide response refinement, improving quality by 9.2% (from 59.0% to 68.2%). This provides a scalable and transparent foundation for both evaluating and improving medical LLMs. The code is available at https://anonymous.4open.science/r/Automated-Rubric-Generation-AF3C/.

Clinical predictive models often rely on patients' electronic health records (EHR), but integrating medical knowledge to enhance predictions and decision-making is challenging. This is because personalized predictions require personalized knowledge graphs (KGs), which are difficult to generate from patient EHR data. To address this, we propose GraphCare, an open-world framework that uses external KGs to improve EHR-based predictions. Our method extracts knowledge from large language models (LLMs) and external biomedical KGs to build patient-specific KGs, which are then used to train our proposed Bi-attention AugmenTed (BAT) graph neural network (GNN) for healthcare predictions. On two public datasets, MIMIC-III and MIMIC-IV, GraphCare surpasses baselines in four vital healthcare prediction tasks: mortality, readmission, length of stay (LOS), and drug recommendation. On MIMIC-III, it boosts AUROC by 17.6\% and 6.6\% for mortality and readmission, and F1-score by 7.9\% and 10.8\% for LOS and drug recommendation, respectively. Notably, GraphCare demonstrates a substantial edge in scenarios with limited data availability. Our findings highlight the potential of using external KGs in healthcare prediction tasks and demonstrate the promise of GraphCare in generating personalized KGs for promoting personalized medicine.

On-policy self-distillation (OPSD) trains a student on its own rollouts using a privileged teacher, but its standard objective weights all generated tokens equally, implicitly treating the privileged teacher target as equally reliable at every student-visited prefix. Existing entropy-based OPD methods relax this uniformity by modulating token-level supervision with teacher entropy, but high teacher entropy in reasoning has an ambiguous reliability meaning: it can reflect either non-viable uncertainty or benign solution diversity. To identify this phenomenon, we introduce a branch-viability diagnostic. Specifically, we record next-token alternatives from the privileged-answer teacher prompt, force each alternative after the student prompt plus its on-policy spine prefix, and test whether the resulting student-template continuation recovers the correct answer. On Qwen3-4B, we find that an oriented within-sequence position score is the strongest tested predictor of teacher-token reliability, reaching an area-under-ROC-curve (AUROC) of 0.83; local uncertainty scores are at most 0.57. Motivated by this trajectory-level structure, we propose Position-Weighted On-Policy Self-Distillation (PW-OPSD), which applies an increasing position weight while keeping the same student rollout, privileged teacher pass, and clipped forward-KL target as OPSD. In our comprehensive evaluations with different random seeds, the diagnostic-derived PW-OPSD improves AIME 2024 and AIME 2025 Avg@12 by +1.0 and +1.1 points, and a generalization evaluation on two larger-scale models from different families, DeepSeek-R1-Distill-Llama-8B and Olmo-3-7B-Think, also demonstrates consistent aggregate Avg@12 improvements. These results show that teacher-token reliability in reasoning distillation is trajectory-structured and can be utilized without additional teacher computation.

Large Language Models (LLMs) often produce fluent yet factually incorrect statements-a phenomenon known as hallucination-posing serious risks in high-stakes domains. We present Layer-wise Semantic Dynamics (LSD), a geometric framework for hallucination detection that analyzes the evolution of hidden-state semantics across transformer layers. Unlike prior methods that rely on multiple sampling passes or external verification sources, LSD operates intrinsically within the model's representational space. Using margin-based contrastive learning, LSD aligns hidden activations with ground-truth embeddings derived from a factual encoder, revealing a distinct separation in semantic trajectories: factual responses preserve stable alignment, while hallucinations exhibit pronounced semantic drift across depth. Evaluated on the TruthfulQA and synthetic factual-hallucination datasets, LSD achieves an F1-score of 0.92, AUROC of 0.96, and clustering accuracy of 0.89, outperforming SelfCheckGPT and Semantic Entropy baselines while requiring only a single forward pass. This efficiency yields a 5-20x speedup over sampling-based methods without sacrificing precision or interpretability. LSD offers a scalable, model-agnostic mechanism for real-time hallucination monitoring and provides new insights into the geometry of factual consistency within large language models.

AI-text detectors face a critical robustness challenge: adversarial paraphrasing attacks that preserve semantics while evading detection. We introduce StealthRL, a reinforcement learning framework that stress-tests detector robustness under realistic adversarial conditions. StealthRL trains a paraphrase policy against a multi-detector ensemble using Group Relative Policy Optimization (GRPO) with LoRA adapters on Qwen3-4B, optimizing a composite reward that balances detector evasion with semantic preservation. We evaluate six attack settings (M0-M5) against three detector families (RoBERTa, FastDetectGPT, and Binoculars) at the security-relevant 1% false positive rate operating point. StealthRL achieves near-zero detection (0.001 mean TPR@1%FPR), reduces mean AUROC from 0.74 to 0.27, and attains a 99.9% attack success rate. Critically, attacks transfer to a held-out detector family not seen during training, revealing shared architectural vulnerabilities rather than detector-specific brittleness. We additionally conduct LLM-based quality evaluation via Likert scoring, analyze detector score distributions to explain why evasion succeeds, and provide per-detector AUROC with bootstrap confidence intervals. Our results expose significant robustness gaps in current AI-text detection and establish StealthRL as a principled adversarial evaluation protocol. Code and evaluation pipeline are publicly available at https://github.com/suraj-ranganath/StealthRL.

Deep Neural Networks achieve high performance in vision tasks by learning features from regions of interest (ROI) within images, but their performance degrades when deployed on out-of-distribution (OOD) data that differs from training data. This challenge has led to OOD detection methods that aim to identify and reject unreliable predictions. Although prior work shows that OOD detection performance varies by artefact type, the underlying causes remain underexplored. To this end, we identify a previously unreported bias in OOD detection: for hard-to-detect artefacts (near-OOD), detection performance typically improves when the artefact shares visual similarity (e.g. colour) with the model's ROI and drops when it does not - a phenomenon we term the Invisible Gorilla Effect. For example, in a skin lesion classifier with red lesion ROI, we show the method Mahalanobis Score achieves a 31.5% higher AUROC when detecting OOD red ink (similar to ROI) compared to black ink (dissimilar) annotations. We annotated artefacts by colour in 11,355 images from three public datasets (e.g. ISIC) and generated colour-swapped counterfactuals to rule out dataset bias. We then evaluated 40 OOD methods across 7 benchmarks and found significant performance drops for most methods when artefacts differed from the ROI. Our findings highlight an overlooked failure mode in OOD detection and provide guidance for more robust detectors. Code and annotations are available at: https://github.com/HarryAnthony/Invisible_Gorilla_Effect.

Training-free AI text detection methods primarily rely on model log-probabilities, achieving strong performance through approaches like Binoculars and DNA-DetectLLM. However, these methods face a fundamental ceiling as models are optimized through RLHF to produce human-like probability distributions. We introduce an alternative detection signal based on character distribution signatures. We provide theoretical foundations showing that AI models, trained on massive domain-balanced corpora, approximate global character patterns while humans exhibit domain-specialized distributions, creating a "Wall of Separation" where human-AI divergence significantly exceeds AI-AI divergence. To enable systematic evaluation, we construct the Models-Domains-Temperatures-Adversarials (MDTA) benchmark comprising 642,274 prompt-aligned samples across 4 models, 5 domains, 3 temperature settings, and 3 adversarial strategies, substantially expanding the HC3 dataset with modern model responses, temperature variation, and adversarial augmentation. We introduce the Letter Distribution Score (LD-Score), demonstrating low correlation (r = 0.08-0.13) with perplexity methods. When integrated with DNA-DetectLLM, Binoculars and FastDetectGPT via a non-linear classifier, LD-Score yields consistent improvements in AUROC and F1, with particularly pronounced gains in specialized domains where vocabulary constraints amplify the detection signal. The MDTA dataset can be accessed at: https://huggingface.co/datasets/nsp909/MDTA.

As LLM-powered agents have been used for high-stakes decision-making, such as clinical diagnosis, it becomes critical to develop reliable verification of their decisions to facilitate trustworthy deployment. Yet, existing verifiers usually underperform owing to a lack of domain knowledge and limited calibration. To address this, we establish GLEAN, an agent verification framework with Guideline-grounded Evidence Accumulation that compiles expert-curated protocols into trajectory-informed, well-calibrated correctness signals. GLEAN evaluates the step-wise alignment with domain guidelines and aggregates multi-guideline ratings into surrogate features, which are accumulated along the trajectory and calibrated into correctness probabilities using Bayesian logistic regression. Moreover, the estimated uncertainty triggers active verification, which selectively collects additional evidence for uncertain cases via expanding guideline coverage and performing differential checks. We empirically validate GLEAN with agentic clinical diagnosis across three diseases from the MIMIC-IV dataset, surpassing the best baseline by 12% in AUROC and 50% in Brier score reduction, which confirms the effectiveness in both discrimination and calibration. In addition, the expert study with clinicians recognizes GLEAN's utility in practice.

Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting 35% of extremely low birth weight infants. Defined by oxygen dependence at 36 weeks postmenstrual age, it causes lifelong respiratory complications. However, preventive interventions carry severe risks, including neurodevelopmental impairment, ventilator-induced lung injury, and systemic complications. Therefore, early BPD prognosis and prediction of BPD outcome is crucial to avoid unnecessary toxicity in low risk infants. Admission radiographs of extremely preterm infants are routinely acquired within 24h of life and could serve as a non-invasive prognostic tool. In this work, we developed and investigated a deep learning approach using chest X-rays from 163 extremely low-birth-weight infants (leq32 weeks gestation, 401-999g) obtained within 24 hours of birth. We fine-tuned a ResNet-50 pretrained specifically on adult chest radiographs, employing progressive layer freezing with discriminative learning rates to prevent overfitting and evaluated a CutMix augmentation and linear probing. For moderate/severe BPD outcome prediction, our best performing model with progressive freezing, linear probing and CutMix achieved an AUROC of 0.78 pm 0.10, balanced accuracy of 0.69 pm 0.10, and an F1-score of 0.67 pm 0.11. In-domain pre-training significantly outperformed ImageNet initialization (p = 0.031) which confirms domain-specific pretraining to be important for BPD outcome prediction. Routine IRDS grades showed limited prognostic value (AUROC 0.57 pm 0.11), confirming the need of learned markers. Our approach demonstrates that domain-specific pretraining enables accurate BPD prediction from routine day-1 radiographs. Through progressive freezing and linear probing, the method remains computationally feasible for site-level implementation and future federated learning deployments.

Large Language Models (LLMs) have attained human-level fluency in text generation, which complicates the distinguishing between human-written and LLM-generated texts. This increases the risk of misuse and highlights the need for reliable detectors. Yet, existing detectors exhibit poor robustness on out-of-distribution (OOD) data and attacked data, which is critical for real-world scenarios. Also, they struggle to provide explainable evidence to support their decisions, thus undermining the reliability. In light of these challenges, we propose IPAD (Inverse Prompt for AI Detection), a novel framework consisting of a Prompt Inverter that identifies predicted prompts that could have generated the input text, and a Distinguisher that examines how well the input texts align with the predicted prompts. We develop and examine two versions of Distinguishers. Empirical evaluations demonstrate that both Distinguishers perform significantly better than the baseline methods, with version2 outperforming baselines by 9.73% on in-distribution data (F1-score) and 12.65% on OOD data (AUROC). Furthermore, a user study is conducted to illustrate that IPAD enhances the AI detection trustworthiness by allowing users to directly examine the decision-making evidence, which provides interpretable support for its state-of-the-art detection results.

Logical image understanding involves interpreting and reasoning about the relationships and consistency within an image's visual content. This capability is essential in applications such as industrial inspection, where logical anomaly detection is critical for maintaining high-quality standards and minimizing costly recalls. Previous research in anomaly detection (AD) has relied on prior knowledge for designing algorithms, which often requires extensive manual annotations, significant computing power, and large amounts of data for training. Autoregressive, multimodal Vision Language Models (AVLMs) offer a promising alternative due to their exceptional performance in visual reasoning across various domains. Despite this, their application to logical AD remains unexplored. In this work, we investigate using AVLMs for logical AD and demonstrate that they are well-suited to the task. Combining AVLMs with format embedding and a logic reasoner, we achieve SOTA performance on public benchmarks, MVTec LOCO AD, with an AUROC of 86.0% and F1-max of 83.7%, along with explanations of anomalies. This significantly outperforms the existing SOTA method by a large margin.

Medical image classification in radiology faces significant challenges, particularly in generalizing to unseen pathologies. In contrast, CLIP offers a promising solution by leveraging multimodal learning to improve zero-shot classification performance. However, in the medical domain, lesions can be small and might not be well represented in the embedding space. Therefore, in this paper, we explore the potential of visual prompt engineering to enhance the capabilities of Vision Language Models (VLMs) in radiology. Leveraging BiomedCLIP, trained on extensive biomedical image-text pairs, we investigate the impact of embedding visual markers directly within radiological images to guide the model's attention to critical regions. Our evaluation on the JSRT dataset, focusing on lung nodule malignancy classification, demonstrates that incorporating visual prompts x2013 such as arrows, circles, and contours x2013 significantly improves classification metrics including AUROC, AUPRC, F1 score, and accuracy. Moreover, the study provides attention maps, showcasing enhanced model interpretability and focus on clinically relevant areas. These findings underscore the efficacy of visual prompt engineering as a straightforward yet powerful approach to advance VLM performance in medical image analysis.

Transformer-based models such as BERT have significantly advanced Natural Language Processing (NLP) across many languages. However, Nepali, a low-resource language written in Devanagari script, remains relatively underexplored. This study benchmarks multilingual, Indic, Hindi, and Nepali BERT variants to evaluate their effectiveness in Nepali topic classification. Ten pre-trained models, including mBERT, XLM-R, MuRIL, DevBERT, HindiBERT, IndicBERT, and NepBERTa, were fine-tuned and tested on the balanced Nepali dataset containing 25,006 sentences across five conceptual domains and the performance was evaluated using accuracy, weighted precision, recall, F1-score, and AUROC metrics. The results reveal that Indic models, particularly MuRIL-large, achieved the highest F1-score of 90.60%, outperforming multilingual and monolingual models. NepBERTa also performed competitively with an F1-score of 88.26%. Overall, these findings establish a robust baseline for future document-level classification and broader Nepali NLP applications.

Background and Objective: Radiation pneumonitis (RP) is a side effect of thoracic radiation therapy. Recently, Machine learning (ML) models enhanced with radiomic and dosiomic features provide better predictions by incorporating spatial information beyond DVHs. However, to improve the clinical decision process, we propose to use uncertainty quantification (UQ) to improve the confidence in model prediction. This study evaluates the impact of post hoc UQ methods on the discriminative performance and calibration of ML models for RP prediction. Methods: This study evaluated four ML models: logistic regression (LR), support vector machines (SVM), extreme gradient boosting (XGB), and random forest (RF), using radiomic, dosiomic, and dosimetric features to predict RP. We applied UQ methods, including Patt scaling, isotonic regression, Venn-ABERS predictor, and Conformal Prediction, to quantify uncertainty. Model performance was assessed through Area Under the Receiver Operating Characteristic curve (AUROC), Area Under the Precision-Recall Curve (AUPRC), and Adaptive Calibration Error (ACE) using Leave-One-Out Cross-Validation (LOO-CV). Results: UQ methods enhanced predictive performance, particularly for high-certainty predictions, while also improving calibration. Radiomic and dosiomic features increased model accuracy but introduced calibration challenges, especially for non-linear models like XGB and RF. Performance gains from UQ methods were most noticeable at higher certainty thresholds. Conclusion: Integrating UQ into ML models with radiomic and dosiomic features improves both predictive accuracy and calibration, supporting more reliable clinical decision-making. The findings emphasize the value of UQ methods in enhancing applicability of predictive models for RP in healthcare settings.

Radiology plays an integral role in modern medicine, yet rising imaging volumes have far outpaced workforce growth. Foundation models offer a path toward assisting with the full spectrum of radiology tasks, but existing medical models remain limited: they process volumetric CT and MRI as low-fidelity 2D slices, discard critical grayscale contrast information, and lack evaluation frameworks that reflect real clinical practice. We introduce Pillar-0, a radiology foundation model pretrained on 42,990 abdomen-pelvis CTs, 86,411 chest CTs, 14,348 head CTs, and 11,543 breast MRIs from a large academic center, together with RATE, a scalable framework that extracts structured labels for 366 radiologic findings with near-perfect accuracy using LLMs. Across internal test sets of 14,230 abdomen-pelvis CTs, 10,646 chest CTs, 4,906 head CTs, and 1,585 breast MRIs, Pillar-0 establishes a new performance frontier, achieving mean AUROCs of 86.4, 88.0, 90.1, and 82.9, outperforming MedGemma (Google), MedImageInsight (Microsoft), Lingshu (Alibaba), and Merlin (Stanford) by 7.8-15.8 AUROC points and ranking best in 87.2\% (319/366) tasks. Pillar-0 similarly outperforms all baselines in an external validation on the Stanford Abdominal CT dataset, including Merlin (82.2 vs 80.6 AUROC). Pillar-0 extends to tasks beyond its pretraining, such as long-horizon lung cancer risk prediction, where it improves upon the state-of-the-art Sybil by 3.0 C-index points on NLST, and generalizes with gains of 5.9 (MGH) and 1.9 (CGMH). In brain hemorrhage detection, Pillar-0 obtained a >95 AUROC when using only 1/20th of the data of the next most sample efficient baseline. Pillar-0 and RATE together provide an open, clinically rigorous foundation for building high-performance radiology systems, enabling applications that were previously infeasible due to computational, data, and evaluation constraints.

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

Small instruct-tuned LLMs produce degenerate verbal confidence under minimal elicitation: ceiling rates above 95%, near-chance Type-2 AUROC, and Invalid validity profiles. We test whether confidence-conditioned supervised fine-tuning (CSFT) with self-consistency-derived targets can close the gap between internal information and verbal readout. A pre-registered Phase 0 protocol on Gemma 3 4B-it with a modal filter restricting training to items with correct modal answers produced a negative result: AUROC2 dropped from 0.554 to 0.509 due to label-entropy collapse in the training targets. An exploratory rescue removed the filter, training on all 2,000 calibration items. This produced a binary verbal correctness discriminator with AUROC2 = 0.774 on held-out TriviaQA, compressing a 10-sample self-consistency signal (AUROC2 = 0.999) into a single-pass readout exceeding logit entropy (0.701). The shuffled-target control showed no improvement (0.501). On MMLU, accuracy improved from 54.2% to 77.4% with the shuffled model at baseline (56.1%), supporting a target-dependent interpretation. The result is exploratory, binary rather than continuously calibrated, and observed at a single scale. It identifies two design lessons: confidence training requires label entropy, and correct targets regularise output format.

Radiographs are used as the most important imaging tool for identifying spine anomalies in clinical practice. The evaluation of spinal bone lesions, however, is a challenging task for radiologists. This work aims at developing and evaluating a deep learning-based framework, named VinDr-SpineXR, for the classification and localization of abnormalities from spine X-rays. First, we build a large dataset, comprising 10,468 spine X-ray images from 5,000 studies, each of which is manually annotated by an experienced radiologist with bounding boxes around abnormal findings in 13 categories. Using this dataset, we then train a deep learning classifier to determine whether a spine scan is abnormal and a detector to localize 7 crucial findings amongst the total 13. The VinDr-SpineXR is evaluated on a test set of 2,078 images from 1,000 studies, which is kept separate from the training set. It demonstrates an area under the receiver operating characteristic curve (AUROC) of 88.61% (95% CI 87.19%, 90.02%) for the image-level classification task and a mean average precision (mAP@0.5) of 33.56% for the lesion-level localization task. These results serve as a proof of concept and set a baseline for future research in this direction. To encourage advances, the dataset, codes, and trained deep learning models are made publicly available.

Respiratory acoustic foundation models (FMs) are benchmarked exclusively on smartphone recordings, yet clinical deployment increasingly targets body-coupled (BC) wearables whose sensors attenuate high-frequency content through tissue and bone, leaving FM reliability uncharacterised. We introduce BCoughBench, evaluating five FMs (OPERA-CT/CE/GT, HeAR, M2D+Resp) on nine classification tasks (AUROC, sensitivity at 95% specificity, Expected Calibration Error) and three age regression tasks (MAE vs. a mean-predictor baseline) across five EBEN-simulated BC sensor conditions on five labeled cough datasets. Mean AUROC declines from 0.785 (smartphone) to 0.689-0.723, degrading most under temple vibration pickup (Δ = -0.096) and least under the soft in-ear (Δ = -0.062). No FM meets the clinical sensitivity threshold (Se@Sp95 geq 0.20) on most disease tasks under any BC sensor. Sex classification on the CIDRZ cohort collapses (AUROC 0.954 to 0.596-0.628, Δ = -0.341) while COVID detection is nearly unaffected (Δ = -0.004). Age regression is robust, improving under the forehead accelerometer on CoughVID (MAE 9.61 to 8.97 yr); HeAR leads on regression and demographic tasks, M2D+Resp on disease and characteristic tasks. BCoughBench provides a reproducible framework for FM evaluation under wearable conditions.

We introduce MURA, a large dataset of musculoskeletal radiographs containing 40,561 images from 14,863 studies, where each study is manually labeled by radiologists as either normal or abnormal. To evaluate models robustly and to get an estimate of radiologist performance, we collect additional labels from six board-certified Stanford radiologists on the test set, consisting of 207 musculoskeletal studies. On this test set, the majority vote of a group of three radiologists serves as gold standard. We train a 169-layer DenseNet baseline model to detect and localize abnormalities. Our model achieves an AUROC of 0.929, with an operating point of 0.815 sensitivity and 0.887 specificity. We compare our model and radiologists on the Cohen's kappa statistic, which expresses the agreement of our model and of each radiologist with the gold standard. Model performance is comparable to the best radiologist performance in detecting abnormalities on finger and wrist studies. However, model performance is lower than best radiologist performance in detecting abnormalities on elbow, forearm, hand, humerus, and shoulder studies. We believe that the task is a good challenge for future research. To encourage advances, we have made our dataset freely available at https://stanfordmlgroup.github.io/competitions/mura .

This study presents a deep learning system for breast cancer detection in mammography, developed using a modified EfficientNetV2 architecture with enhanced attention mechanisms. The model was trained on mammograms from a major Thai medical center and validated on three distinct datasets: an in-domain test set (9,421 cases), a biopsy-confirmed set (883 cases), and an out-of-domain generalizability set (761 cases) collected from two different hospitals. For cancer detection, the model achieved AUROCs of 0.89, 0.96, and 0.94 on the respective datasets. The system's lesion localization capability, evaluated using metrics including Lesion Localization Fraction (LLF) and Non-Lesion Localization Fraction (NLF), demonstrated robust performance in identifying suspicious regions. Clinical validation through concordance tests showed strong agreement with radiologists: 83.5% classification and 84.0% localization concordance for biopsy-confirmed cases, and 78.1% classification and 79.6% localization concordance for out-of-domain cases. Expert radiologists' acceptance rate also averaged 96.7% for biopsy-confirmed cases, and 89.3% for out-of-domain cases. The system achieved a System Usability Scale score of 74.17 for source hospital, and 69.20 for validation hospitals, indicating good clinical acceptance. These results demonstrate the model's effectiveness in assisting mammogram interpretation, with the potential to enhance breast cancer screening workflows in clinical practice.

While there has been a growing research interest in developing out-of-distribution (OOD) detection methods, there has been comparably little discussion around how these methods should be evaluated. Given their relevance for safe(r) AI, it is important to examine whether the basis for comparing OOD detection methods is consistent with practical needs. In this work, we take a closer look at the go-to metrics for evaluating OOD detection, and question the approach of exclusively reducing OOD detection to a binary classification task with little consideration for the detection threshold. We illustrate the limitations of current metrics (AUROC & its friends) and propose a new metric - Area Under the Threshold Curve (AUTC), which explicitly penalizes poor separation between ID and OOD samples. Scripts and data are available at https://github.com/glhr/beyond-auroc

Aggregate metacognitive quality scores mask within-model variation across MMLU benchmark domains. We administered 1,500 MMLU items (250 per domain, under an a priori six-domain grouping) to 33 frontier LLMs from eight model families and computed Type-2 AUROC per model-domain cell using verbalized confidence (0-100). Total observations: 47,151. Every model with above-chance aggregate monitoring showed non-trivial domain-level variation. Applied/Professional knowledge was reliably the easiest benchmark domain to monitor (mean AUROC = .742, ranked top-2 in 21 of 33 models); Formal Reasoning and Natural Science were reliably the hardest (one of the two ranked bottom-2 in 27 of 33 models). The three middle domains were statistically indistinguishable (Kendall's W = .164). A subject-level coherence analysis (within-domain similarity ratio = 0.95) confirms the six-domain grouping is a pragmatic benchmark taxonomy, not a validated latent construct. Within-family profile-shape clustering is significant for Anthropic, Google-Gemini, and Qwen (permutation p < .0001) but not DeepSeek, Google-Gemma, or OpenAI. Gemma 4 31B showed a +.202 AUROC improvement over Gemma 3 27B. Three models classified Invalid on binary KEEP/WITHDRAW probes produced normal profiles under verbalized confidence, confirming probe-format specificity. Bootstrap 95% CIs on 198 cells have median width .199. Split-half aggregate stability r = .893; profile-level split-half is weaker (grand median r = .184). These results show stable benchmark-domain variation obscured by aggregate metrics, and support benchmark-stage domain screening as a step before deployment in specific application areas.

We present a novel framework for leveraging synthetic ICU time-series data not only to train but also to rigorously and trustworthily evaluate predictive models, both at the population level and within fine-grained demographic subgroups. Building on prior diffusion and VAE-based generators (TimeDiff, HealthGen, TimeAutoDiff), we introduce Enhanced TimeAutoDiff, which augments the latent diffusion objective with distribution-alignment penalties. We extensively benchmark all models on MIMIC-III and eICU, on 24-hour mortality and binary length-of-stay tasks. Our results show that Enhanced TimeAutoDiff reduces the gap between real-on-synthetic and real-on-real evaluation (``TRTS gap'') by over 70\%, achieving Δ_{TRTS} leq 0.014 AUROC, while preserving training utility (Δ_{TSTR} approx 0.01). Crucially, for 32 intersectional subgroups, large synthetic cohorts cut subgroup-level AUROC estimation error by up to 50\% relative to small real test sets, and outperform them in 72--84\% of subgroups. This work provides a practical, privacy-preserving roadmap for trustworthy, granular model evaluation in critical care, enabling robust and reliable performance analysis across diverse patient populations without exposing sensitive EHR data, contributing to the overall trustworthiness of Medical AI.

The increasing prevalence of lumbar spinal canal stenosis has resulted in a surge of MRI (Magnetic Resonance Imaging), leading to labor-intensive interpretation and significant inter-reader variability, even among expert radiologists. This paper introduces a novel and efficient deep-learning framework that fully automates the grading of lumbar spinal canal stenosis. We demonstrate state-of-the-art performance in grading spinal canal stenosis on a dataset of 1,975 unique studies, each containing three distinct types of 3D cross-sectional spine images: Axial T2, Sagittal T1, and Sagittal T2/STIR. Employing a distinctive training strategy, our proposed multistage approach effectively integrates sagittal and axial images. This strategy employs a multi-view model with a sequence-based architecture, optimizing feature extraction and cross-view alignment to achieve an AUROC (Area Under the Receiver Operating Characteristic Curve) of 0.971 in spinal canal stenosis grading surpassing other state-of-the-art methods.

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

Early diagnosis of lung cancer is challenging due to biological uncertainty and the limited understanding of the biological mechanisms driving nodule progression. To address this, we propose Nodule-Aligned Multimodal (Latent) Diffusion (NAMD), a novel framework that predicts lung nodule progression by generating 1-year follow-up nodule computed tomography images with baseline scans and the patient's and nodule's Electronic Health Record (EHR). NAMD introduces a nodule-aligned latent space, where distances between latents directly correspond to changes in nodule attributes, and utilizes an LLM-driven control mechanism to condition the diffusion backbone on patient data. On the National Lung Screening Trial (NLST) dataset, our method synthesizes follow-up nodule images that achieve an AUROC of 0.805 and an AUPRC of 0.346 for lung nodule malignancy prediction, significantly outperforming both baseline scans and state-of-the-art synthesis methods, while closely approaching the performance of real follow-up scans (AUROC: 0.819, AUPRC: 0.393). These results demonstrate that NAMD captures clinically relevant features of lung nodule progression, facilitating earlier and more accurate diagnosis.

Large language models (LLMs) are increasingly deployed for tabular question answering, yet calibration on structured data is largely unstudied. This paper presents the first systematic comparison of five confidence estimation methods across five frontier LLMs and two tabular QA benchmarks. All models are severely overconfident (smooth ECE 0.35-0.64 versus 0.10-0.15 reported for textual QA). A consistent self-evaluation versus perturbation dichotomy replicates across both benchmarks and all four fully-covered models: self-evaluation methods (verbalized, P(True)) achieve AUROC 0.42-0.76, while perturbation methods (semantic entropy, self-consistency, and our Multi-Format Agreement) achieve AUROC 0.78-0.86. Per-model paired bootstrap tests reject the null at p<0.001 after Holm-Bonferroni correction, and a 3-seed check on GPT-4o-mini gives a per-seed standard deviation of only 0.006. The paper proposes Multi-Format Agreement (MFA), which exploits the lossless and deterministic serialization variation unique to structured data (Markdown, HTML, JSON, CSV) to estimate confidence at 20% lower API cost than sampling baselines. MFA reduces ECE by 44-63%, generalizes across all four models on TableBench (mean AUROC 0.80), and combines complementarily with sampling: an MFA + self-consistency ensemble lifts AUROC from 0.74 to 0.82. A secondary contribution, structure-aware recalibration, improves AUROC by +10 percentage points over standard post-hoc methods.

Current artificial intelligence models for medical imaging are predominantly single modality and single disease. Attempts to create multimodal and multi-disease models have resulted in inconsistent clinical accuracy. Furthermore, training these models typically requires large, labour-intensive, well-labelled datasets. We developed MerMED-FM, a state-of-the-art multimodal, multi-specialty foundation model trained using self-supervised learning and a memory module. MerMED-FM was trained on 3.3 million medical images from over ten specialties and seven modalities, including computed tomography (CT), chest X-rays (CXR), ultrasound (US), pathology patches, color fundus photography (CFP), optical coherence tomography (OCT) and dermatology images. MerMED-FM was evaluated across multiple diseases and compared against existing foundational models. Strong performance was achieved across all modalities, with AUROCs of 0.988 (OCT); 0.982 (pathology); 0.951 (US); 0.943 (CT); 0.931 (skin); 0.894 (CFP); 0.858 (CXR). MerMED-FM has the potential to be a highly adaptable, versatile, cross-specialty foundation model that enables robust medical imaging interpretation across diverse medical disciplines.

Objective: To propose and retrospectively validate an integrated framework addressing three barriers to clinical translation of readmission prediction: lack of explainability, absence of deployment reliability infrastructure, and inadequate demographic fairness evaluation. Materials and Methods: We constructed a cohort of 415231 adult admissions from the MIMIC-IV database (30-day readmission prevalence 18.0%), split 70/15/15. Logistic regression, XGBoost, and LightGBM models were trained on 26 features. SHAP provided per-patient explanations. Fairness was evaluated across 16 subgroups using AUC-ROC, false negative rate (FNR), and positive predictive value (PPV). Calibration was assessed using Brier scores and calibration curves. Results: XGBoost achieved AUC-ROC 0.696 (95% CI 0.691-0.701), outperforming or matching the LACE baseline (AUC 0.60-0.68). LightGBM achieved best calibration (Brier 0.146). Prior admissions were the dominant predictor. All subgroups met equity thresholds (delta AUC <= 0.05, delta FNR <= 0.10). Conclusion: This framework delivers competitive performance, clinically actionable explanations, and strong demographic equity. Code is publicly available at https://github.com/Tomisin92/readmission-prediction.

Automated slice classification is clinically relevant since it can be incorporated into medical image segmentation workflows as a preprocessing step that would flag slices with a higher probability of containing tumors, thereby directing physicians attention to the important slices. In this work, we train a ResNet-18 network to classify axial slices of lymphoma PET/CT images (collected from two institutions) depending on whether the slice intercepted a tumor (positive slice) in the 3D image or if the slice did not (negative slice). Various instances of the network were trained on 2D axial datasets created in different ways: (i) slice-level split and (ii) patient-level split; inputs of different types were used: (i) only PET slices and (ii) concatenated PET and CT slices; and different training strategies were employed: (i) center-aware (CAW) and (ii) center-agnostic (CAG). Model performances were compared using the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC), and various binary classification metrics. We observe and describe a performance overestimation in the case of slice-level split as compared to the patient-level split training. The model trained using patient-level split data with the network input containing only PET slices in the CAG training regime was the best performing/generalizing model on a majority of metrics. Our models were additionally more closely compared using the sensitivity metric on the positive slices from their respective test sets.

Context can change whether a request is harmful without changing its topic or surface form. We ask whether residual-stream probes distinguish harmful requests from surface-matched benign controls at a useful operating point. Across three 7-8B model families, an activation sensor blocks 95.5-97.7 percent of judge-classified compliant attacks in a taxonomy-selected set. It also blocks 59.6-68.4 percent of XSTest prompts. A fully disjoint audit reconstructs near-ceiling source-contrast AUROC (0.996-0.999), but fixed transfer to matched pairs is weaker: 0.656-0.819 on the guard-selected Twin-n70 subset and 0.590-0.690 on the full Twin-n163 cohort. We test ten axes on the reference family and seven across all families with leakage, hold-out, and permutation controls. On Twin-n163, no axis evaluated without direct pair-boundary fitting reaches the specified numerical threshold. Requiring persistence on that full cohort was added at analysis time. A separately specified 24B/32B extension gives the same result. Pair-trained classifiers weaken under category and generation-batch hold-out and false-block 79.6-100 percent of XSTest at 95 percent in-corpus TPR. At the tested read points, these activation scores behave as broad-risk detectors rather than standalone context adjudicators.

Accurate, continuous out-of-hospital electrocardiogram (ECG) parameter measurement is vital for real-time cardiac health monitoring and telemedicine. On-device computation of single-lead ECG parameters enables timely assessment without reliance on centralized data processing, advancing personalized, ubiquitous cardiac care-yet comprehensive validation across heterogeneous real-world populations remains limited. This study validated the on-device algorithm FeatureDB (https://github.com/PKUDigitalHealth/FeatureDB) using two datasets: HeartVoice-ECG-lite (369 participants with single-lead ECGs annotated by two physicians) and PTB-XL/PTB-XL+ (21,354 patients with 12-lead ECGs and physicians' diagnostic annotations). FeatureDB computed PR, QT, and QTc intervals, with accuracy evaluated against physician annotations via mean absolute error (MAE), correlation analysis, and Bland-Altman analysis. Diagnostic performance for first-degree atrioventricular block (AVBI, PR-based) and long QT syndrome (LQT, QTc-based) was benchmarked against commercial 12-lead systems (12SL, Uni-G) and open-source algorithm Deli, using AUC, accuracy, sensitivity, and specificity. Results showed high concordance with expert annotations (Pearson correlations: 0.836-0.960), MAEs matching inter-observer variability, and minimal bias. AVBI AUC reached 0.787 (12SL: 0.859; Uni-G: 0.812; Deli: 0.501); LQT AUC was 0.684 (12SL: 0.716; Uni-G: 0.605; Deli: 0.569)-comparable to commercial tools and superior to open-source alternatives. FeatureDB delivers physician-level parameter accuracy and commercial-grade abnormality detection via single-lead devices, supporting scalable telemedicine, decentralized cardiac screening, and continuous monitoring in community and outpatient settings.

Multi-RF Fusion achieves a test ROC-AUC of 0.8476 +/- 0.0002 on ogbg-molhiv (10 seeds), placing #1 on the OGB leaderboard ahead of HyperFusion (0.8475 +/- 0.0003). The core of the method is a rank-averaged ensemble of 12 Random Forest models trained on concatenated molecular fingerprints (FCFP, ECFP, MACCS, atom pairs -- 4,263 dimensions total), blended with deep-ensembled GNN predictions at 12% weight. Two findings drive the result: (1) setting max_features to 0.20 instead of the default sqrt(d) gives a +0.008 AUC gain on this scaffold split, and (2) averaging GNN predictions across 10 seeds before blending with the RF eliminates GNN seed variance entirely, dropping the final standard deviation from 0.0008 to 0.0002. No external data or pre-training is used.

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

We report that model quantisation restructures domain-level metacognitive efficiency in LLMs rather than degrading it uniformly. Evaluating Llama-3-8B-Instruct on the same 3,000 questions at Q5_K_M and f16 precision, we find that M-ratio profiles across four knowledge domains are uncorrelated between formats (Spearman rho = 0.00). Arts & Literature moves from worst-monitored (M-ratio = 0.606 at Q5_K_M) to best-monitored (1.542 at f16). Geography moves from well-monitored (1.210) to under-monitored (0.798). However, Type-2 AUROC profiles are perfectly stable across formats (rho = 1.00), localising the restructuring to the M-ratio normalisation rather than the underlying discrimination signal. This finding emerged from a pre-registered attempt to improve metacognition through domain-conditional training. We prescribed confidence-amplification SFT for the diagnosed weak domain, with matched-budget agnostic and wrong-prescription controls. All four confirmatory hypotheses were null (10,000 bootstrap resamples, seed = 42). The training successfully reshaped confidence distributions, doubling the NLP gap in Science from 0.076 to 0.152, but did not improve meta-d' because the diagnostic profile did not transfer across formats. Any system relying on domain-level M-ratio profiles has an unexamined dependency on inference format. Systems using AUROC_2 are safer. We release all code, pre-registrations, and trial-level data.

Every prediction from a generative medical event model is bounded by how clinical events are tokenized, yet input representation is rarely isolated from other system and architectural choices. We evaluate how representation decisions affect downstream prediction after a shared one-epoch pretraining budget. We train 28 matched transformers on MIMIC-IV and evaluate them on 30 clinical outcomes in three experiments: (1) quantization granularity, reference-range anchoring, and code-value fusion; (2) value encoding (hard bins, soft discretization, code-normalized xVal) crossed with temporal encoding (event order, time tokens, admission-relative RoPE); and (3) native MIMIC laboratory/vital codes versus the Common Longitudinal ICU Format (CLIF)-remapped laboratory/vital codes with compression-preserving perturbation arms. In Experiment 1, fused code-value tokenization improves mortality AUROC from 0.891 to 0.915 (BH-adjusted p < 0.001), hospital length-of-stay AUROC from 0.763 to 0.788 (BH-adjusted p < 0.001), and, for the decile fused-vs-unfused comparison, mean regression Spearman rho across the 13 regression outcomes from 0.414 to 0.494. Across the three temporal encodings, event order only and admission-relative RoPE match or exceed inserting time tokens on average while shortening sequences by 11%. CLIF remapping preserves downstream performance in our single-site setting while yielding a smaller, clinically interpretable token set compatible with multi-site use. Finer-than-decile quantization, reference-range anchoring, and soft discretization help in selective outcomes, while code-normalized xVal remains well below the discrete and soft families, consistent with near-median suppression that persists after the affine variant.

The crux of effective out-of-distribution (OOD) detection lies in acquiring a robust in-distribution (ID) representation, distinct from OOD samples. While previous methods predominantly leaned on recognition-based techniques for this purpose, they often resulted in shortcut learning, lacking comprehensive representations. In our study, we conducted a comprehensive analysis, exploring distinct pretraining tasks and employing various OOD score functions. The results highlight that the feature representations pre-trained through reconstruction yield a notable enhancement and narrow the performance gap among various score functions. This suggests that even simple score functions can rival complex ones when leveraging reconstruction-based pretext tasks. Reconstruction-based pretext tasks adapt well to various score functions. As such, it holds promising potential for further expansion. Our OOD detection framework, MOODv2, employs the masked image modeling pretext task. Without bells and whistles, MOODv2 impressively enhances 14.30% AUROC to 95.68% on ImageNet and achieves 99.98% on CIFAR-10.

Linear probes trained on LLM activations are increasingly proposed as deception-detection metrics, yet report AUROC exceeding 0.96 on clean benchmarks while collapsing under distributional shift. This paper systematically pressure-tests probe-based metrics across the Gemma 3 model family (1B-27B parameters), diagnosing why they fail rather than merely documenting that they fail. We test four hypotheses about deception encoding: (1) single linear direction, (2) multi-dimensional subspace, (3) convex conic hull, (4) entropy proxy. Our design includes cross-domain transfer matrices, multi-dimensional probe analysis with permutation null baselines, entropy-residualization tests, and distractor evaluations across 8 stylistic shifts. We find that: (a) probes achieve near-perfect AUROC (>=0.998) on clean data but collapse under stylistic shifts; style-augmented probes recover near-perfect detection (mean AUROC 0.979-0.983) on unseen styles; (b) the single-direction hypothesis is rejected (k=1 captures only 0.61-0.80 AUROC), with cross-domain transfer failure confirmed as geometric rather than layer-mismatch-driven; (c) the entropy-proxy hypothesis is rejected (max |rho|=0.454, max Delta-AUROC after residualization=0.004); and (d) deception does not form a significant linear subspace (per-domain k*=0), yet multi-dimensional probes (k>=5) recover the signal through distributed sub-threshold features. Probe fragility reflects distributional narrowness rather than an architectural limitation: style-augmented probes recover near-perfect detection at both 4B and 27B, establishing that the inverse scaling pattern is a training-distribution artifact rather than a genuine scale-dependent phenomenon.

Hospital readmission is a crucial healthcare quality measure that helps in determining the level of quality of care that a hospital offers to a patient and has proven to be immensely expensive. It is estimated that more than $25 billion are spent yearly due to readmission of diabetic patients in the USA. This paper benchmarks existing models and proposes a new embedding based state-of-the-art deep neural network(DNN). The model can identify whether a hospitalized diabetic patient will be readmitted within 30 days or not with an accuracy of 95.2% and Area Under the Receiver Operating Characteristics(AUROC) of 97.4% on data collected from 130 US hospitals between 1999-2008. The results are encouraging with patients having changes in medication while admitted having a high chance of getting readmitted. Identifying prospective patients for readmission could help the hospital systems in improving their inpatient care, thereby saving them from unnecessary expenditures.

Diabetic retinopathy (DR) is a leading cause of vision loss in working-age adults. While screening reduces the risk of blindness, traditional imaging is often costly and inaccessible. Artificial intelligence (AI) algorithms present a scalable diagnostic solution, but concerns regarding fairness and generalization persist. This work evaluates the fairness and performance of image-trained models in DR prediction, as well as the impact of disentanglement as a bias mitigation technique, using the diverse mBRSET fundus dataset. Three models, ConvNeXt V2, DINOv2, and Swin V2, were trained on macula images to predict DR and sensitive attributes (SAs) (e.g., age and gender/sex). Fairness was assessed between subgroups of SAs, and disentanglement was applied to reduce bias. All models achieved high DR prediction performance in diagnosing (up to 94% AUROC) and could reasonably predict age and gender/sex (91% and 77% AUROC, respectively). Fairness assessment suggests disparities, such as a 10% AUROC gap between age groups in DINOv2. Disentangling SAs from DR prediction had varying results, depending on the model selected. Disentanglement improved DINOv2 performance (2% AUROC gain), but led to performance drops in ConvNeXt V2 and Swin V2 (7% and 3%, respectively). These findings highlight the complexity of disentangling fine-grained features in fundus imaging and emphasize the importance of fairness in medical imaging AI to ensure equitable and reliable healthcare solutions.

We study whether demonstration-curation metrics that detect defective training episodes also improve the downstream behavior-cloning policy that trains on the curated data. On a contact-rich LIBERO pick-and-place benchmark with a controlled structural defect (early gripper release during the carry phase), we find that the two quantities are sharply decoupled. The metric with the highest defect-detection AUROC (0.804) produces the worst curated policy (13.3% task success), while a metric with a substantially lower AUROC (0.638) produces a policy that nearly matches the oracle trained on ground-truth clean data (90.0% vs. 93.3%). We further show that five of the seven metrics we evaluate exploit episode length as a trivial proxy for the defect label, a confound that inflates reported AUROCs to near-perfect values and disappears once episode length is controlled. Across all conditions, the contaminated baseline succeeds on only 3.3% of rollouts, and the two best curation methods close this to within 3 percentage points of the 93.3% oracle ceiling. Our results argue that curation methods should be evaluated by the policy they produce, not the defects they flag, and that any curation benchmark must control for episode length before reporting detection accuracy. We release the testbed, all metric implementations, and the evaluation pipeline.

Decisions about managing patients on the heart transplant waitlist are currently made by committees of doctors who consider multiple factors, but the process remains largely ad-hoc. With the growing volume of longitudinal patient, donor, and organ data collected by the United Network for Organ Sharing (UNOS) since 2018, there is increasing interest in analytical approaches to support clinical decision-making at the time of organ availability. In this study, we benchmark machine learning models that leverage longitudinal waitlist history data for time-dependent, time-to-event modeling of waitlist mortality. We train on 23,807 patient records with 77 variables and evaluate both survival prediction and discrimination at a 1-year horizon. Our best model achieves a C-Index of 0.94 and AUROC of 0.89, significantly outperforming previous models. Key predictors align with known risk factors while also revealing novel associations. Our findings can support urgency assessment and policy refinement in heart transplant decision making.

As deep neural networks become adopted in high-stakes domains, it is crucial to be able to identify when inference inputs are Out-of-Distribution (OOD) so that users can be alerted of likely drops in performance and calibration despite high confidence. Among many others, existing methods use the following two scores to do so without training on any apriori OOD examples: a learned temperature and an energy score. In this paper we introduce Ablated Learned Temperature Energy (or "AbeT" for short), a method which combines these prior methods in novel ways with effective modifications. Due to these contributions, AbeT lowers the False Positive Rate at 95% True Positive Rate (FPR@95) by 35.39% in classification (averaged across all ID and OOD datasets measured) compared to state of the art without training networks in multiple stages or requiring hyperparameters or test-time backward passes. We additionally provide empirical insights as to how our model learns to distinguish between In-Distribution (ID) and OOD samples while only being explicitly trained on ID samples via exposure to misclassified ID examples at training time. Lastly, we show the efficacy of our method in identifying predicted bounding boxes and pixels corresponding to OOD objects in object detection and semantic segmentation, respectively - with an AUROC increase of 5.15% in object detection and both a decrease in FPR@95 of 41.48% and an increase in AUPRC of 34.20% on average in semantic segmentation compared to previous state of the art.

Selective Classification, wherein models can reject low-confidence predictions, promises reliable translation of machine-learning based classification systems to real-world scenarios such as clinical diagnostics. While current evaluation of these systems typically assumes fixed working points based on pre-defined rejection thresholds, methodological progress requires benchmarking the general performance of systems akin to the AUROC in standard classification. In this work, we define 5 requirements for multi-threshold metrics in selective classification regarding task alignment, interpretability, and flexibility, and show how current approaches fail to meet them. We propose the Area under the Generalized Risk Coverage curve (AUGRC), which meets all requirements and can be directly interpreted as the average risk of undetected failures. We empirically demonstrate the relevance of AUGRC on a comprehensive benchmark spanning 6 data sets and 13 confidence scoring functions. We find that the proposed metric substantially changes metric rankings on 5 out of the 6 data sets.

As large language models (LLMs) are deployed in consequential settings such as medical question answering and legal reasoning, the ability to estimate when their outputs are likely to be correct is essential for safe and reliable use, requiring well-calibrated uncertainty. Standard reinforcement learning with verifiable rewards (RLVR) trains models with a binary correctness reward that is indifferent to confidence, providing no penalty for confident but wrong predictions and thereby degrading calibration. Recent work addresses this by training models to produce verbalized confidence scores alongside answers and rewarding agreement with correctness. However, verbalized confidence is calibrated at the token level and thus exhibits inconsistency across textual variations with same semantic meaning. We propose Calibration with Semantic Reward (CSR), a framework that calibrates language models directly in semantic space without a verbalized confidence interface. CSR combines the correctness reward with a novel semantic calibration reward that encourages exploitation among correct rollouts by promoting semantic agreement, and exploration among incorrect ones by discouraging spurious consistency. Experiments across three model families on HotpotQA (in-distribution) and TriviaQA, MSMARCO, and NQ-Open (out-of-distribution) show that CSR consistently achieves lower ECE and higher AUROC than verbalized-confidence baselines across nearly all settings, reducing ECE by up to 40% and improving AUROC by up to 31% over verbalized-confidence baselines, with calibration behavior generalizing robustly across all four evaluation settings.

In this paper, a 3D-RegNet-based neural network is proposed for diagnosing the physical condition of patients with coronavirus (Covid-19) infection. In the application of clinical medicine, lung CT images are utilized by practitioners to determine whether a patient is infected with coronavirus. However, there are some laybacks can be considered regarding to this diagnostic method, such as time consuming and low accuracy. As a relatively large organ of human body, important spatial features would be lost if the lungs were diagnosed utilizing two dimensional slice image. Therefore, in this paper, a deep learning model with 3D image was designed. The 3D image as input data was comprised of two-dimensional pulmonary image sequence and from which relevant coronavirus infection 3D features were extracted and classified. The results show that the test set of the 3D model, the result: f1 score of 0.8379 and AUC value of 0.8807 have been achieved.

The systemic, metabolic, lifestyle factors have established associations with Alzheimer's Disease (AD) through epidemiologic and AD-specific biomarker studies. Whether colored fundus photography (CFP) contains retinal structural signatures corresponding to these AD-related risk domains remains unclear. To determine whether deep learning (DL) models can predict 12 AD-related risk factors from CFP and to characterize the retinal structures underlying these predictions, thereby assessing whether CFP reflects pathways to AD vulnerability. Using 62,876 CFPs from 44,501 unique participants from the UK Biobank, DL models were trained to predict 12 factors linked to AD incidence: 6 categorical (sex, smoking, sleeplessness, economic status, alcohol use, depression) and 6 continuous (age, age at completing education, BMI, systolic, diastolic blood pressure, HbA1c). Model performance, model saliency, and saliency-derived scores (CAM-Score) were evaluated and compared to retinal morphometry. The scores were also compared between incident-AD cases (average 8.55 years before onset) and matched controls. Performance of DL ranged from AUROC= 0.5654-0.9480 for categorical and R2=-0.0291-0.7620 for continuous factors, outperforming most of the morphometry-machine learning models. Saliency-based score consistently highlighted biologically meaningful regions, particularly the optic nerve head and retinal vasculature. It also aligned with present morphometric variations. Several saliency-based scores differed significantly between incident AD and matched controls, suggesting potential overlap between retinal correlates of risk factors and preclinical AD-associated changes. CFP encodes retinal signatures linked to AD risk factors. Although not diagnostic, DL-derived retinal representations may uncover biologically meaningful risk-related structural changes mirroring the potential AD vulnerability.

Chest X-rays are widely used to diagnose thoracic diseases, but the lack of detailed information about these abnormalities makes it challenging to develop accurate automated diagnosis systems, which is crucial for early detection and effective treatment. To address this challenge, we employed deep learning techniques to identify patterns in chest X-rays that correspond to different diseases. We conducted experiments on the "ChestX-ray14" dataset using various pre-trained CNNs, transformers, hybrid(CNN+Transformer) models and classical models. The best individual model was the CoAtNet, which achieved an area under the receiver operating characteristic curve (AUROC) of 84.2%. By combining the predictions of all trained models using a weighted average ensemble where the weight of each model was determined using differential evolution, we further improved the AUROC to 85.4%, outperforming other state-of-the-art methods in this field. Our findings demonstrate the potential of deep learning techniques, particularly ensemble deep learning, for improving the accuracy of automatic diagnosis of thoracic diseases from chest X-rays. Code available at:https://github.com/syednabilashraf/SynthEnsemble

ECG foundation models are increasingly popular due to their adaptability across various tasks. However, their clinical applicability is often limited by performance gaps compared to task-specific models, even after pre-training on large ECG datasets and fine-tuning on target data. This limitation is likely due to the lack of an effective post-training strategy. In this paper, we propose a simple yet effective post-training approach to enhance ECG foundation models. We evaluate it on a publicly available Transformer-based foundation model. Experiments across multiple ECG tasks show that our method consistently outperforms baseline fine-tuning. On the PTB-XL benchmarks, it improves macro AUROC by 0.7%-8.9% and macro AUPRC by 23.3%-77.9%, also outperforming several recent state-of-the-art approaches, including task-specific and advanced architectures. Further analyses demonstrate improved training dynamics and data efficiency, with only 30% of the training data outperforming the baseline trained on the full dataset. Ablation studies highlight the importance of stochastic depth and preview linear probing. These findings underscore the potential of post-training strategies to improve ECG foundation models, and we hope this work will contribute to the continued development of foundation models in the ECG domain.

Clinical decision-support systems are expert systems whose recommendations clinicians act on directly, yet they are usually cleared on one aggregate accuracy number from a held-out test set. That number says nothing about input reliability under encoding shifts, subgroup gaps, threshold sensitivity, or operational feasibility. We present RISED, a pre-deployment evaluation framework operationalising five dimensions (Reliability, Inclusivity, Sensitivity, Equity, Deployability) through BCa bootstrap 95% confidence intervals, literature-grounded thresholds, and Holm-Bonferroni-corrected PASS / FAIL / INCONCLUSIVE verdicts; Equity is a proxy-dependence diagnostic rather than a gating test. Applied to seven cohorts spanning 35 years (n from 303 to 99,492), RISED surfaces failures invisible to AUROC: on Diabetes 130, Reliability passes by three orders of magnitude (PSS = 0.0004) while Inclusivity (AUC parity gap = 0.262) and Sensitivity (max threshold-flip rate 49.1%) fail decisively; both NHIS cohorts reproduce this. NHANES 2021-2023, with a complete feature profile, achieves INCONCLUSIVE verdicts; BRFSS 2024 produces the suite's most severe Sensitivity failure (max threshold-flip rate 64.2%) after instrument rotation removed hypertension and cholesterol. The pattern recurs on credit- and income-prediction cohorts, confirming domain-agnosticity; a multi-model check shows the failures are data-driven, not model-specific. RISED ships as an open-source Python package complementing TRIPOD+AI, FUTURE-AI, and Fairlearn with the structured numerical evidence those standards require but do not prescribe.

Anomaly detection (AD) aims to identify defects using normal-only training data. Existing anomaly detection benchmarks (e.g., MVTec-AD with 15 categories) cover only a narrow range of categories, limiting the evaluation of cross-context generalization and scalability. We introduce ADNet, a large-scale, multi-domain benchmark comprising 380 categories aggregated from 49 publicly available datasets across Electronics, Industry, Agrifood, Infrastructure, and Medical domains. The benchmark includes a total of 196,294 RGB images, consisting of 116,192 normal samples for training and 80,102 test images, of which 60,311 are anomalous. All images are standardized with MVTec-style pixel-level annotations and structured text descriptions spanning both spatial and visual attributes, enabling multimodal anomaly detection tasks. Extensive experiments reveal a clear scalability challenge: existing state-of-the-art methods achieve 90.6% I-AUROC in one-for-one settings but drop to 78.5% when scaling to all 380 categories in a multi-class setting. To address this, we propose Dinomaly-m, a context-guided Mixture-of-Experts extension of Dinomaly that expands decoder capacity without increasing inference cost. It achieves 83.2% I-AUROC and 93.1% P-AUROC, demonstrating superior performance over existing approaches. ADNet is designed as a standardized and extensible benchmark, supporting the community in expanding anomaly detection datasets across diverse domains and providing a scalable foundation for future anomaly detection foundation models. Dataset: https://grainnet.github.io/ADNet

Decentralized Finance (DeFi), a financial ecosystem without centralized controlling organization, has introduced a new paradigm for lending and borrowing. However, its capital efficiency remains constrained by the inability to effectively assess the risk associated with each user/wallet. This paper introduces the 'On-Chain Credit Risk Score (OCCR Score) in DeFi', a probabilistic measure designed to quantify the credit risk associated with a wallet. By analyzing historical real-time on-chain activity as well as predictive scenarios, the OCCR Score may enable DeFi lending protocols to dynamically adjust Loan-to-Value (LTV) ratios and Liquidation Thresholds (LT) based on the risk profile of a wallet. Unlike existing wallet risk scoring models, which rely on heuristic-based evaluations, the OCCR Score offers a more objective and probabilistic approach, aligning closer to traditional credit risk assessment methodologies. This framework can further enhance DeFi's capital efficiency by incentivizing responsible borrowing behavior and optimizing risk-adjusted returns for lenders.

Pre-training (PT) followed by fine-tuning (FT) is an effective method for training neural networks, and has led to significant performance improvements in many domains. PT can incorporate various design choices such as task and data reweighting strategies, augmentation policies, and noise models, all of which can significantly impact the quality of representations learned. The hyperparameters introduced by these strategies therefore must be tuned appropriately. However, setting the values of these hyperparameters is challenging. Most existing methods either struggle to scale to high dimensions, are too slow and memory-intensive, or cannot be directly applied to the two-stage PT and FT learning process. In this work, we propose an efficient, gradient-based algorithm to meta-learn PT hyperparameters. We formalize the PT hyperparameter optimization problem and propose a novel method to obtain PT hyperparameter gradients by combining implicit differentiation and backpropagation through unrolled optimization. We demonstrate that our method improves predictive performance on two real-world domains. First, we optimize high-dimensional task weighting hyperparameters for multitask pre-training on protein-protein interaction graphs and improve AUROC by up to 3.9%. Second, we optimize a data augmentation neural network for self-supervised PT with SimCLR on electrocardiography data and improve AUROC by up to 1.9%.

Osteoporosis is a widespread and chronic metabolic bone disease that often remains undiagnosed and untreated due to limited access to bone mineral density (BMD) tests like Dual-energy X-ray absorptiometry (DXA). In response to this challenge, current advancements are pivoting towards detecting osteoporosis by examining alternative indicators from peripheral bone areas, with the goal of increasing screening rates without added expenses or time. In this paper, we present a method to predict osteoporosis using hand and wrist X-ray images, which are both widely accessible and affordable, though their link to DXA-based data is not thoroughly explored. Initially, our method segments the ulnar, radius, and metacarpal bones using a foundational model for image segmentation. Then, we use a self-supervised learning approach to extract meaningful representations without the need for explicit labels, and move on to classify osteoporosis in a supervised manner. Our method is evaluated on a dataset with 192 individuals, cross-referencing their verified osteoporosis conditions against the standard DXA test. With a notable classification score (AUC=0.83), our model represents a pioneering effort in leveraging vision-based techniques for osteoporosis identification from the peripheral skeleton sites.

Background: AI-based classification models are essential for improving lung cancer diagnosis. However, the relative performance of lesion-level versus chest-region models in internal and external datasets remains unclear. Purpose: This study evaluates the performance of lesion-level and chest-region models for lung cancer classification, comparing their effectiveness across internal Duke Lung Nodule Dataset 2024 (DLND24) and external (LUNA16, NLST) datasets, with a focus on subgroup analyses by demographics, histology, and imaging characteristics. Materials and Methods: Two AI models were trained: one using lesion-centric patches (64,64,64) and the other using chest-region patches (512,512,8). Internal validation was conducted on DLND24, while external validation utilized LUNA16 and NLST datasets. The models performances were assessed using AUC-ROC, with subgroup analyses for demographic, clinical, and imaging factors. Statistical comparisons were performed using DeLongs test. Gradient-based visualizations and probability distribution were further used for analysis. Results: The lesion-level model consistently outperformed the chest-region model across datasets. In internal validation, the lesion-level model achieved an AUC of 0.71(CI: 0.61-0.81), compared to 0.68(0.57-0.77) for the chest-region model. External validation showed similar trends, with AUCs of 0.90(0.87-0.92) and 0.81(0.79-0.82) on LUNA16 and NLST, respectively. Subgroup analyses revealed significant advantages for lesion-level models in certain histological subtypes (adenocarcinoma) and imaging conditions (CT manufacturers). Conclusion: Lesion-level models demonstrate superior classification performance, especially for external datasets and challenging subgroups, suggesting their clinical utility for precision lung cancer diagnostics.

Deep AUC Maximization (DAM) is a new paradigm for learning a deep neural network by maximizing the AUC score of the model on a dataset. Most previous works of AUC maximization focus on the perspective of optimization by designing efficient stochastic algorithms, and studies on generalization performance of large-scale DAM on difficult tasks are missing. In this work, we aim to make DAM more practical for interesting real-world applications (e.g., medical image classification). First, we propose a new margin-based min-max surrogate loss function for the AUC score (named as AUC min-max-margin loss or simply AUC margin loss for short). It is more robust than the commonly used AUC square loss, while enjoying the same advantage in terms of large-scale stochastic optimization. Second, we conduct extensive empirical studies of our DAM method on four difficult medical image classification tasks, namely (i) classification of chest x-ray images for identifying many threatening diseases, (ii) classification of images of skin lesions for identifying melanoma, (iii) classification of mammogram for breast cancer screening, and (iv) classification of microscopic images for identifying tumor tissue. Our studies demonstrate that the proposed DAM method improves the performance of optimizing cross-entropy loss by a large margin, and also achieves better performance than optimizing the existing AUC square loss on these medical image classification tasks. Specifically, our DAM method has achieved the 1st place on Stanford CheXpert competition on Aug. 31, 2020. To the best of our knowledge, this is the first work that makes DAM succeed on large-scale medical image datasets. We also conduct extensive ablation studies to demonstrate the advantages of the new AUC margin loss over the AUC square loss on benchmark datasets. The proposed method is implemented in our open-sourced library LibAUC (www.libauc.org).

Large Language Models are prompting us to view more NLP tasks from a generative perspective. At the same time, they offer a new way of accessing information, mainly through the RAG framework. While there have been notable improvements for the autoregressive models, overcoming hallucination in the generated answers remains a continuous problem. A standard solution is to use commercial LLMs, such as GPT4, to evaluate these algorithms. However, such frameworks are expensive and not very transparent. Therefore, we propose a study which demonstrates the interest of open-weight models for evaluating RAG hallucination. We develop a lightweight approach using smaller, quantized LLMs to provide an accessible and interpretable metric that gives continuous scores for the generated answer with respect to their correctness and faithfulness. This score allows us to question decisions' reliability and explore thresholds to develop a new AUC metric as an alternative to correlation with human judgment.

Autonomous language-model agents increasingly rely on installable skills and tools to complete user tasks. Static skill auditing can expose capability surface before deployment, but it cannot determine whether a particular invocation is unsafe under the current user request and runtime context. We therefore study skill invocation auditing as a continuous-risk estimation problem: given a user request, candidate skill, and runtime context, predict a score that supports ranking and triage before a hard intervention is applied. We introduce STARS, which combines a static capability prior, a request-conditioned invocation risk model, and a calibrated risk-fusion policy. To evaluate this setting, we construct SIA-Bench, a benchmark of 3,000 invocation records with group-safe splits, lineage metadata, runtime context, canonical action labels, and derived continuous-risk targets. On a held-out split of indirect prompt injection attacks, calibrated fusion reaches 0.439 high-risk AUPRC, improving over 0.405 for the contextual scorer and 0.380 for the strongest static baseline, while the contextual scorer remains better calibrated with 0.289 expected calibration error. On the locked in-distribution test split, gains are smaller and static priors remain useful. The resulting claim is therefore narrower: request-conditioned auditing is most valuable as an invocation-time risk-scoring and triage layer rather than as a replacement for static screening. Code is available at https://github.com/123zgj123/STARS.

Techniques for reliable rubric-based LLM evaluation -- ensemble judging, bias mitigation, few-shot calibration -- are scattered across papers with inconsistent terminology and partial implementations. We introduce Autorubric, an open-source framework that unifies these rubric-based LLM evaluation lessons with opinionated defaults: analytic rubrics with binary, ordinal, and nominal criteria; single-judge and ensemble evaluation; few-shot calibration; bias mitigations; and psychometric reliability metrics. We validate on three benchmarks: RiceChem (college chemistry grading, 80\% accuracy with 5-shot calibration), ResearcherBench (deep research evaluation, 931 criteria, cross-judge agreement analysis), and CHARM-100, a new chatbot evaluation dataset combining all three criterion types with ground truth labels (87\% binary accuracy, moderate-to-substantial κ). Beyond measurement, per-criterion scores and explanations serve as optimization signals. We demonstrate how Autorubric's rubric-evaluation explanations raise a peer review agent's score from 0.47 to 0.85 (above the 0.82 expert-curated baseline), and its scores serve as RL rewards to produce statistically significant improvement on AdvancedIF (+0.039, Wilcoxon p = 0.032) with positive transfer to IFEval. In all of these cases, Autorubric enabled us to rapidly operationalize various rubric design choices and best practices with minimal effort.

Drug discovery is a complex and resource-intensive process, making early prediction of approval outcomes critical for optimizing research investments. While classical machine learning and deep learning methods have shown promise in drug approval prediction, their limited interpretability constraints their impact. Here, we present DrugReasoner, a reasoning-based large language model (LLM) built on the LLaMA architecture and fine-tuned with group relative policy optimization (GRPO) to predict the likelihood of small-molecule approval. DrugReasoner integrates molecular descriptors with comparative reasoning against structurally similar approved and unapproved compounds, generating predictions alongside step-by-step rationales and confidence scores. DrugReasoner achieved robust performance with an AUC of 0.732 and an F1 score of 0.729 on the validation set and 0.725 and 0.718 on the test set, respectively. These results outperformed conventional baselines, including logistic regression, support vector machine, and k-nearest neighbors and had competitive performance relative to XGBoost. On an external independent dataset, DrugReasoner outperformed both baseline and the recently developed ChemAP model, achieving an AUC of 0.728 and an F1-score of 0.774, while maintaining high precision and balanced sensitivity, demonstrating robustness in real-world scenarios. These findings demonstrate that DrugReasoner not only delivers competitive predictive accuracy but also enhances transparency through its reasoning outputs, thereby addressing a key bottleneck in AI-assisted drug discovery. This study highlights the potential of reasoning-augmented LLMs as interpretable and effective tools for pharmaceutical decision-making.

Deep learning is currently the state-of-the-art for automated detection of referable diabetic retinopathy (DR) from color fundus photographs (CFP). While the general interest is put on improving results through methodological innovations, it is not clear how good these approaches perform compared to standard deep classification models trained with the appropriate settings. In this paper we propose to model a strong baseline for this task based on a simple and standard ResNet-18 architecture. To this end, we built on top of prior art by training the model with a standard preprocessing strategy but using images from several public sources and an empirically calibrated data augmentation setting. To evaluate its performance, we covered multiple clinically relevant perspectives, including image and patient level DR screening, discriminating responses by input quality and DR grade, assessing model uncertainties and analyzing its results in a qualitative manner. With no other methodological innovation than a carefully designed training, our ResNet model achieved an AUC = 0.955 (0.953 - 0.956) on a combined test set of 61007 test images from different public datasets, which is in line or even better than what other more complex deep learning models reported in the literature. Similar AUC values were obtained in 480 images from two separate in-house databases specially prepared for this study, which emphasize its generalization ability. This confirms that standard networks can still be strong baselines for this task if properly trained.

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

Self-driving laboratories increasingly rely on low-cost liquid handlers such as the Opentrons OT-2, which ship without the pressure-based aspiration monitoring of Hamilton or Tecan systems and are typically run open-loop. Two failure modes go undetected: protocols that are syntactically valid but violate assay-specific invariants (e.g., tip reuse between a PCR template and a no-template control), and physical execution failures (partial dispense, air bubbles, missing tips) at runtime. We present AEGIS, a two-layer guardian for both. Layer 1 pairs a curated machine-readable assay rule database with an LLM that reasons over OT-2 Python code, reaching an adjusted F1 of 0.97 on a 24-protocol benchmark across five assay families and beating rules-only and LLM-only ablations across five backends; a free open-weight model ties the best proprietary one, so no paid API is required. Layer 2 fits a PCA world model to YOLO-cropped four-frame pipette trajectories; under a leakage-free leave-one-plate-out evaluation it reaches average precision 0.89 and operating-point F1 0.71 (AUROC 0.80), a deployment-faithful number that matches the live demonstration, and we characterize the small-pipette (p20) resolution limit (F1 0.47). A live demonstration on a physical OT-2 (five replicates per condition) catches planted no-tip failures deterministically and partial dispense on coloured dyes, with an always-VLM self-vote gate lifting partial-dispense recall to 5/5; transparent water is a principled limit of any front-view-only monitor, which AEGIS surfaces as low-confidence VLM reasoning rather than a wrong verdict. Cascade triage holds VLM cost near 1.63 per plate versus 10.33 for an always-VLM baseline. AEGIS is open source and, to our knowledge, the first system to unify pre-flight assay-aware validation with runtime visual monitoring for an open-source liquid handler.

Selecting LLM-generated code candidates using LLM-generated tests is challenging because the tests themselves may be incorrect. Existing methods either treat all tests equally or rely on ad-hoc heuristics to filter unreliable tests. Yet determining test correctness requires knowing which codes are correct, creating a circular dependency. Our key insight is that we need not determine test correctness at all: test votes should rank, not merely count. What matters is not how many codes pass a test, but whether the test can distinguish correct from incorrect code. We break the circular dependency via leave-one-out evaluation: hold out one test, rank codes by their aggregate scores on all remaining tests, and measure whether the held-out test's pass/fail pattern agrees with this ranking. We formalize this agreement as the leave-one-out AUC~(LOO-AUC) and prove that the expected LOO-AUC is proportional to each test's ability to separate correct code from incorrect code. Building on this, we propose ACES~(AUC ConsistEncy Scoring) with two complementary variants: ACES-C provides closed-form weights that provably approximate the oracle in expectation under a mild assumption on average test quality; ACES-O drops this assumption and iteratively optimizes a differentiable LOO-AUC objective. Both operate solely on the binary pass matrix with negligible overhead, and achieve state-of-the-art Pass@k on multiple code generation benchmarks.

This paper reports on the ReINTEL Shared Task for Responsible Information Identification on social network sites, which is hosted at the seventh annual workshop on Vietnamese Language and Speech Processing (VLSP 2020). Given a piece of news with respective textual, visual content and metadata, participants are required to classify whether the news is `reliable' or `unreliable'. In order to generate a fair benchmark, we introduce a novel human-annotated dataset of over 10,000 news collected from a social network in Vietnam. All models will be evaluated in terms of AUC-ROC score, a typical evaluation metric for classification. The competition was run on the Codalab platform. Within two months, the challenge has attracted over 60 participants and recorded nearly 1,000 submission entries.

Chronic Obstructive Pulmonary Disease (COPD), a major chronic respiratory disease with persistent airflow limitation, is a leading global cause of disability and mortality. Respiratory spirogram time series, routinely collected during pulmonary function tests (PFTs), play a critical role in the early detection of repsiratory diseases and in monitoring lung function over time. However, most current AI models for COPD diagnosis are limited to outputting classification results without providing a rationale for their diagnostic process, while current Large Language Models (LLMs) cannot understand spirograms yet, which severely limits their clinical trust and adoption. To tackle this challenge, we leverage a cohort of 234,028 individuals from the UK Biobank (UKB) to propose SpiroLLM, the first multimodal large language model that can understand spirogram. The model extracts morphological features from respiratory curves via a SpiroEncoder and aligns them with PFT numerical values in a unified latent space using a SpiroProjector, ultimately empowering a large language model to generate a comprehensive diagnostic report. Experimental results confirm that SpiroLLM achieved a diagnostic AUROC of 0.8980 (95% CI: 0.8820-0.9132). In a robustness test with missing core data, it maintained a 100% valid response rate, far surpassing the 13.4% of a text-only model and showcasing the superiority of its multimodal design. This work demonstrates the substantial potential of deeply fusing physiological signals with large language models, establishing a new paradigm for the next generation of interpretable and reliable clinical decision support tools.

Research on AI-generated text detection has presented a number of approaches to discern human from AI prose, some of which achieving high in-distribution performance. However, real-world applicability has stalled because their outputs are misaligned with the needs of users, such as professors, who are presented with a numeric score that has no attached explanation. We tackle this issue with a novel architecture, TELL, that bakes explainability from the ground-up. While our system still offers a numerical score like other detectors for comparability, TELL takes a fundamentally different approach where we aim to show the user the "tells" by which the model believes a text is AI or human-written, to empower the user to decide who wrote a text using their own judgment and understanding of the context of the writing and its alleged author. We train TELL on a custom SFT dataset of domain-specific authorship annotations, and further refine the system using GRPO with curriculum learning to improve performance. We achieve competitive performance with state-of-the-art detectors (AUROC 0.927) while natively providing annotations that explain the basis for the detector's decision. We further evaluate the quality of our explanations using a dataset of human annotations and report a high (mean 72.3%) win-rate on annotation concreteness, falsifiability, coherence, plausibility and grounding, allowing users to critically think and decide for themselves. Our work thus reframes the problem of AI-generated text detection in a human-centric perspective and paves the way for a new family of detectors that focus on native explainability.

Determining whether inputs are out-of-distribution (OOD) is an essential building block for safely deploying machine learning models in the open world. However, previous methods relying on the softmax confidence score suffer from overconfident posterior distributions for OOD data. We propose a unified framework for OOD detection that uses an energy score. We show that energy scores better distinguish in- and out-of-distribution samples than the traditional approach using the softmax scores. Unlike softmax confidence scores, energy scores are theoretically aligned with the probability density of the inputs and are less susceptible to the overconfidence issue. Within this framework, energy can be flexibly used as a scoring function for any pre-trained neural classifier as well as a trainable cost function to shape the energy surface explicitly for OOD detection. On a CIFAR-10 pre-trained WideResNet, using the energy score reduces the average FPR (at TPR 95%) by 18.03% compared to the softmax confidence score. With energy-based training, our method outperforms the state-of-the-art on common benchmarks.

Computer-aided histopathological image analysis for cancer detection is a major research challenge in the medical domain. Automatic detection and classification of nuclei for cancer diagnosis impose a lot of challenges in developing state of the art algorithms due to the heterogeneity of cell nuclei and data set variability. Recently, a multitude of classification algorithms has used complex deep learning models for their dataset. However, most of these methods are rigid and their architectural arrangement suffers from inflexibility and non-interpretability. In this research article, we have proposed a hybrid and flexible deep learning architecture OLConvNet that integrates the interpretability of traditional object-level features and generalization of deep learning features by using a shallower Convolutional Neural Network (CNN) named as CNN_{3L}. CNN_{3L} reduces the training time by training fewer parameters and hence eliminating space constraints imposed by deeper algorithms. We used F1-score and multiclass Area Under the Curve (AUC) performance parameters to compare the results. To further strengthen the viability of our architectural approach, we tested our proposed methodology with state of the art deep learning architectures AlexNet, VGG16, VGG19, ResNet50, InceptionV3, and DenseNet121 as backbone networks. After a comprehensive analysis of classification results from all four architectures, we observed that our proposed model works well and perform better than contemporary complex algorithms.

Real-world synthetic image detectors often generalize poorly under domain shift despite strong in-domain performance. Using unsupervised UMAP projections, we find that natural and synthetic features remain partially separable on unseen datasets, yet performance still drops, suggesting that the classification head overfits to training-domain artifacts. Therefore, the key is to learn more transferable representations so that the decision criterion is more stable and robust to domain shifts. Based on the structural fact that synthetic images are produced by diverse generators, we propose a hierarchical contrastive learning framework that improves the separability between natural and synthetic images while preserving generator identity information. It jointly optimizes (i) a coarse contrastive objective between natural and synthetic images and (ii) a fine contrastive objective among synthetic images using generator identities. Trained on WildFake, our method achieves an average AUROC gain of +10.22 on cross-domain evaluation over Chameleon, AIGIBench, Community Forensics, and GenImage under the same settings as the strong baseline DIRE. For few-shot adaptation, we freeze the backbone and fit an SVM head on 10 labeled samples per class, improving AUROC by +10.64 on AIGIBench and +17.41 on Chameleon, averaged over 12 widely used detectors. Our code is publicly available at: https://github.com/heyongxin233/FiSeR.

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

In this study, we systematically investigate the impact of class imbalance on classification performance of convolutional neural networks (CNNs) and compare frequently used methods to address the issue. Class imbalance is a common problem that has been comprehensively studied in classical machine learning, yet very limited systematic research is available in the context of deep learning. In our study, we use three benchmark datasets of increasing complexity, MNIST, CIFAR-10 and ImageNet, to investigate the effects of imbalance on classification and perform an extensive comparison of several methods to address the issue: oversampling, undersampling, two-phase training, and thresholding that compensates for prior class probabilities. Our main evaluation metric is area under the receiver operating characteristic curve (ROC AUC) adjusted to multi-class tasks since overall accuracy metric is associated with notable difficulties in the context of imbalanced data. Based on results from our experiments we conclude that (i) the effect of class imbalance on classification performance is detrimental; (ii) the method of addressing class imbalance that emerged as dominant in almost all analyzed scenarios was oversampling; (iii) oversampling should be applied to the level that completely eliminates the imbalance, whereas the optimal undersampling ratio depends on the extent of imbalance; (iv) as opposed to some classical machine learning models, oversampling does not cause overfitting of CNNs; (v) thresholding should be applied to compensate for prior class probabilities when overall number of properly classified cases is of interest.

Motivation: Ab initio protein docking represents a major challenge for optimizing a noisy and costly "black box"-like function in a high-dimensional space. Despite progress in this field, there is no docking method available for rigorous uncertainty quantification (UQ) of its solution quality (e.g. interface RMSD or iRMSD). Results: We introduce a novel algorithm, Bayesian Active Learning (BAL), for optimization and UQ of such black-box functions and flexible protein docking. BAL directly models the posterior distribution of the global optimum (or native structures for protein docking) with active sampling and posterior estimation iteratively feeding each other. Furthermore, we use complex normal modes to represent a homogeneous Euclidean conformation space suitable for high-dimension optimization and construct funnel-like energy models for encounter complexes. Over a protein docking benchmark set and a CAPRI set including homology docking, we establish that BAL significantly improve against both starting points by rigid docking and refinements by particle swarm optimization, providing for one third targets a top-3 near-native prediction. BAL also generates tight confidence intervals with half range around 25% of iRMSD and confidence level at 85%. Its estimated probability of a prediction being native or not achieves binary classification AUROC at 0.93 and AUPRC over 0.60 (compared to 0.14 by chance); and also found to help ranking predictions. To the best of our knowledge, this study represents the first uncertainty quantification solution for protein docking, with theoretical rigor and comprehensive assessment. Source codes are available at https://github.com/Shen-Lab/BAL.

Identifying cirrhosis is key to correctly assess the health of the liver. However, the gold standard diagnosis of the cirrhosis needs a medical intervention to obtain the histological confirmation, e.g. the METAVIR score, as the radiological presentation can be equivocal. In this work, we propose to leverage transfer learning from large datasets annotated by radiologists, which we consider as a weak annotation, to predict the histological score available on a small annex dataset. To this end, we propose to compare different pretraining methods, namely weakly-supervised and self-supervised ones, to improve the prediction of the cirrhosis. Finally, we introduce a loss function combining both supervised and self-supervised frameworks for pretraining. This method outperforms the baseline classification of the METAVIR score, reaching an AUC of 0.84 and a balanced accuracy of 0.75, compared to 0.77 and 0.72 for a baseline classifier.

Dual-encoder retrievers depend on the principle that relevant documents should score higher than irrelevant ones for a given query. Yet the dominant Noise Contrastive Estimation (NCE) objective, which underpins Contrastive Loss, optimizes a softened ranking surrogate that we rigorously prove is fundamentally oblivious to score separation quality and unrelated to AUC. This mismatch leads to poor calibration and suboptimal performance in downstream tasks like retrieval-augmented generation (RAG). To address this fundamental limitation, we introduce the MW loss, a new training objective that maximizes the Mann-Whitney U statistic, which is mathematically equivalent to the Area under the ROC Curve (AUC). MW loss encourages each positive-negative pair to be correctly ranked by minimizing binary cross entropy over score differences. We provide theoretical guarantees that MW loss directly upper-bounds the AoC, better aligning optimization with retrieval goals. We further promote ROC curves and AUC as natural threshold free diagnostics for evaluating retriever calibration and ranking quality. Empirically, retrievers trained with MW loss consistently outperform contrastive counterparts in AUC and standard retrieval metrics. Our experiments show that MW loss is an empirically superior alternative to Contrastive Loss, yielding better-calibrated and more discriminative retrievers for high-stakes applications like RAG.

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.

Knee Osteoarthritis (KOA) is a highly prevalent chronic musculoskeletal condition with no currently available treatment. The manifestation of KOA is heterogeneous and prediction of its progression is challenging. Current literature suggests that the use of multi-modal data and advanced modeling methods, such as the ones based on Deep Learning, has promise in tackling this challenge. To date, however, the evidence on the efficacy of this approach is limited. In this study, we leveraged recent advances in Deep Learning and, using a Transformer approach, developed a unified framework for the multi-modal fusion of knee imaging data. Subsequently, we analyzed its performance across a range of scenarios by investigating multiple progression horizons -- from short-term to long-term. We report our findings using a large cohort (n=2421-3967) derived from the Osteoarthritis Initiative dataset. We show that structural knee MRI allows identifying radiographic KOA progressors on par with multi-modal fusion approaches, achieving an area under the ROC curve (ROC AUC) of 0.70-0.76 and Average Precision (AP) of 0.15-0.54 in 2-8 year horizons. Progression within 1 year was better predicted with a multi-modal method using X-ray, structural, and compositional MR images -- ROC AUC of 0.76(0.04), AP of 0.13(0.04) -- or via clinical data. Our follow-up analysis generally shows that prediction from the imaging data is more accurate for post-traumatic subjects, and we further investigate which subject subgroups may benefit the most. The present study provides novel insights into multi-modal imaging of KOA and brings a unified data-driven framework for studying its progression in an end-to-end manner, providing new tools for the design of more efficient clinical trials. The source code of our framework and the pre-trained models are made publicly available.

Sleep is a complex physiological process evaluated through various modalities recording electrical brain, cardiac, and respiratory activities. We curate a large polysomnography dataset from over 14,000 participants comprising over 100,000 hours of multi-modal sleep recordings. Leveraging this extensive dataset, we developed SleepFM, the first multi-modal foundation model for sleep analysis. We show that a novel leave-one-out approach for contrastive learning significantly improves downstream task performance compared to representations from standard pairwise contrastive learning. A logistic regression model trained on SleepFM's learned embeddings outperforms an end-to-end trained convolutional neural network (CNN) on sleep stage classification (macro AUROC 0.88 vs 0.72 and macro AUPRC 0.72 vs 0.48) and sleep disordered breathing detection (AUROC 0.85 vs 0.69 and AUPRC 0.77 vs 0.61). Notably, the learned embeddings achieve 48% top-1 average accuracy in retrieving the corresponding recording clips of other modalities from 90,000 candidates. This work demonstrates the value of holistic multi-modal sleep modeling to fully capture the richness of sleep recordings. SleepFM is open source and available at https://github.com/rthapa84/sleepfm-codebase.

Detecting LLM-generated text in specialized and high-stakes domains like medicine and law is crucial for combating misinformation and ensuring authenticity. However, current zero-shot detectors, while effective on general text, often fail when applied to specialized content due to domain shift. We provide a theoretical analysis showing this failure is fundamentally linked to the KL divergence between human, detector, and source text distributions. To address this, we propose DivScore, a zero-shot detection framework using normalized entropy-based scoring and domain knowledge distillation to robustly identify LLM-generated text in specialized domains. We also release a domain-specific benchmark for LLM-generated text detection in the medical and legal domains. Experiments on our benchmark show that DivScore consistently outperforms state-of-the-art detectors, with 14.4% higher AUROC and 64.0% higher recall (0.1% false positive rate threshold). In adversarial settings, DivScore demonstrates superior robustness than other baselines, achieving on average 22.8% advantage in AUROC and 29.5% in recall. Code and data are publicly available.

The rapid advancement of large language models (LLMs) introduces dual-use capabilities that could both threaten and bolster national security and public safety (NSPS). Models implement safeguards to protect against potential misuse relevant to NSPS and allow for benign users to receive helpful information. However, current benchmarks often fail to test safeguard robustness to potential NSPS risks in an objective, robust way. We introduce FORTRESS: 500 expert-crafted adversarial prompts with instance-based rubrics of 4-7 binary questions for automated evaluation across 3 domains (unclassified information only): Chemical, Biological, Radiological, Nuclear and Explosive (CBRNE), Political Violence & Terrorism, and Criminal & Financial Illicit Activities, with 10 total subcategories across these domains. Each prompt-rubric pair has a corresponding benign version to test for model over-refusals. This evaluation of frontier LLMs' safeguard robustness reveals varying trade-offs between potential risks and model usefulness: Claude-3.5-Sonnet demonstrates a low average risk score (ARS) (14.09 out of 100) but the highest over-refusal score (ORS) (21.8 out of 100), while Gemini 2.5 Pro shows low over-refusal (1.4) but a high average potential risk (66.29). Deepseek-R1 has the highest ARS at 78.05, but the lowest ORS at only 0.06. Models such as o1 display a more even trade-off between potential risks and over-refusals (with an ARS of 21.69 and ORS of 5.2). To provide policymakers and researchers with a clear understanding of models' potential risks, we publicly release FORTRESS at https://huggingface.co/datasets/ScaleAI/fortress_public. We also maintain a private set for evaluation.

Automated Audio Captioning (AAC) aims to develop systems capable of describing an audio recording using a textual sentence. In contrast, Audio-Text Retrieval (ATR) systems seek to find the best matching audio recording(s) for a given textual query (Text-to-Audio) or vice versa (Audio-to-Text). These tasks require different types of systems: AAC employs a sequence-to-sequence model, while ATR utilizes a ranking model that compares audio and text representations within a shared projection subspace. However, this work investigates the relationship between AAC and ATR by exploring the ATR capabilities of an unmodified AAC system, without fine-tuning for the new task. Our AAC system consists of an audio encoder (ConvNeXt-Tiny) trained on AudioSet for audio tagging, and a transformer decoder responsible for generating sentences. For AAC, it achieves a high SPIDEr-FL score of 0.298 on Clotho and 0.472 on AudioCaps on average. For ATR, we propose using the standard Cross-Entropy loss values obtained for any audio/caption pair. Experimental results on the Clotho and AudioCaps datasets demonstrate decent recall values using this simple approach. For instance, we obtained a Text-to-Audio R@1 value of 0.382 for Au-dioCaps, which is above the current state-of-the-art method without external data. Interestingly, we observe that normalizing the loss values was necessary for Audio-to-Text retrieval.

We present a new methodology for detecting out-of-distribution (OOD) images by utilizing norms of the score estimates at multiple noise scales. A score is defined to be the gradient of the log density with respect to the input data. Our methodology is completely unsupervised and follows a straight forward training scheme. First, we train a deep network to estimate scores for levels of noise. Once trained, we calculate the noisy score estimates for N in-distribution samples and take the L2-norms across the input dimensions (resulting in an NxL matrix). Then we train an auxiliary model (such as a Gaussian Mixture Model) to learn the in-distribution spatial regions in this L-dimensional space. This auxiliary model can now be used to identify points that reside outside the learned space. Despite its simplicity, our experiments show that this methodology significantly outperforms the state-of-the-art in detecting out-of-distribution images. For example, our method can effectively separate CIFAR-10 (inlier) and SVHN (OOD) images, a setting which has been previously shown to be difficult for deep likelihood models.

According to the considerable growth in the avail of chest X-ray images in diagnosing various diseases, as well as gathering extensive datasets, having an automated diagnosis procedure using deep neural networks has occupied the minds of experts. Most of the available methods in computer vision use a CNN backbone to acquire high accuracy on the classification problems. Nevertheless, recent researches show that transformers, established as the de facto method in NLP, can also outperform many CNN-based models in vision. This paper proposes a multi-label classification deep model based on the Swin Transformer as the backbone to achieve state-of-the-art diagnosis classification. It leverages Multi-Layer Perceptron, also known as MLP, for the head architecture. We evaluate our model on one of the most widely-used and largest x-ray datasets called "Chest X-ray14," which comprises more than 100,000 frontal/back-view images from over 30,000 patients with 14 famous chest diseases. Our model has been tested with several number of MLP layers for the head setting, each achieves a competitive AUC score on all classes. Comprehensive experiments on Chest X-ray14 have shown that a 3-layer head attains state-of-the-art performance with an average AUC score of 0.810, compared to the former SOTA average AUC of 0.799. We propose an experimental setup for the fair benchmarking of existing methods, which could be used as a basis for the future studies. Finally, we followed up our results by confirming that the proposed method attends to the pathologically relevant areas of the chest.

Human subjective evaluation is the gold standard to evaluate speech quality optimized for human perception. Perceptual objective metrics serve as a proxy for subjective scores. We have recently developed a non-intrusive speech quality metric called Deep Noise Suppression Mean Opinion Score (DNSMOS) using the scores from ITU-T Rec. P.808 subjective evaluation. The P.808 scores reflect the overall quality of the audio clip. ITU-T Rec. P.835 subjective evaluation framework gives the standalone quality scores of speech and background noise in addition to the overall quality. In this work, we train an objective metric based on P.835 human ratings that outputs 3 scores: i) speech quality (SIG), ii) background noise quality (BAK), and iii) the overall quality (OVRL) of the audio. The developed metric is highly correlated with human ratings, with a Pearson's Correlation Coefficient (PCC)=0.94 for SIG and PCC=0.98 for BAK and OVRL. This is the first non-intrusive P.835 predictor we are aware of. DNSMOS P.835 is made publicly available as an Azure service.

Evaluation of text-to-music systems is constrained by the cost and availability of collecting experts for assessment. AudioMOS 2025 Challenge track 1 is created to automatically predict music impression (MI) as well as text alignment (TA) between the prompt and the generated musical piece. This paper reports our winning system, which uses a dual-branch architecture with pre-trained MuQ and RoBERTa models as audio and text encoders. A cross-attention mechanism fuses the audio and text representations. For training, we reframe the MI and TA prediction as a classification task. To incorporate the ordinal nature of MOS scores, one-hot labels are converted to a soft distribution using a Gaussian kernel. On the official test set, a single model trained with this method achieves a system-level Spearman's Rank Correlation Coefficient (SRCC) of 0.991 for MI and 0.952 for TA, corresponding to a relative improvement of 21.21\% in MI SRCC and 31.47\% in TA SRCC over the challenge baseline.

Frontier deep research agents (DRAs) plan a research task, synthesize across documents, and return a structured deliverable on demand. They are being deployed in enterprise workflows faster than they are being evaluated. Existing benchmarks measure factual recall, single-hop QA, or generic agentic skill, missing the multi-document, decision-grade work DRAs are deployed to produce. We introduce a benchmark targeting the structured analytical deliverables that fill a management consultant's typical week. We grade three frontier agents, namely Claude Opus 4.6 with web search, OpenAI o3-deep-research, and Google Gemini 3.1 Pro deep-research, on 42 SME-authored prompts. Each of the 126 responses is scored on two layers: deterministic ground-truth verifiers (mean 13.8 per task) and a five-criterion 0-3 SME rubric, composed into a Verifier-Rubric Score (VRS) on 0-100. Most prompts embed cognitive traps that penalize surface-pattern matching. Acceptance under our joint threshold (rubric mean >= 2.5 and verifier rate >= 80%) is uniformly low: Gemini 21.4%, o3 9.5%, Claude 9.5%. Mean VRS scores agree with published rubric-based benchmarks (our top 62.6 vs. APEX-v1 64.2, ProfBench 65.9, ResearchRubrics < 68%), validating the rubric construct. ACCEPT rates sit below APEX-Agents' MC-segment Pass@1 band (12.3-22.7%) on dedicated DR agents; our floor is three points lower despite the harness advantage, opened by stricter conjunctive grading and trap design. Each agent fails distinctively. Claude produces the deliverable most reliably (4.5x the others' rate on file-required tasks) but carries the highest fabrication signature. o3 has the cleanest reasoning average yet drops required sections and propagates arithmetic errors. Gemini is bimodal, with the highest acceptance rate alongside the most zero-scored rubric cells.

Pre-trained audio models excel at detecting acoustic patterns in auscultation sounds but often fail to grasp their clinical significance, limiting their use and performance in diagnostic tasks. To bridge this gap, we introduce AcuLa (Audio-Clinical Understanding via Language Alignment), a lightweight post-training framework that instills semantic understanding into any audio encoder by aligning it with a medical language model, which acts as a "semantic teacher." To enable alignment at scale, we construct a large-scale dataset by leveraging off-the-shelf large language models to translate the rich, structured metadata accompanying existing audio recordings into coherent clinical reports. Our alignment strategy combines a representation-level contrastive objective with a self-supervised modeling, ensuring that the model learns clinical semantics while preserving fine-grained temporal cues. AcuLa achieves state-of-the-art results across 18 diverse cardio-respiratory tasks from 10 different datasets, improving the mean AUROC on classification benchmarks from 0.68 to 0.79 and, on the most challenging COVID-19 cough detection task, boosting the AUROC from 0.55 to 0.89. Our work demonstrates that this audio-language alignment transforms purely acoustic models into clinically-aware diagnostic tools, establishing a novel paradigm for enhancing physiological understanding in audio-based health monitoring.

Recent progress in reasoning models suggests that generating plausible attempts for research-level mathematics may be within reach, but verification remains a bottleneck, consuming scarce expert time. We hypothesize that a meaningful solution should contain enough method-level information that, when applied to a neighborhood of related questions, it should yield better downstream performance than incorrect solutions. Building on this idea, we propose Consequence-Based Utility, an oracle-free evaluator that scores each candidate by testing its value as an in-context exemplar in solving related yet verifiable questions. Our approach is evaluated on an original set of research-level math problems, each paired with one expert-written solution and nine LLM-generated solutions. Notably, Consequence-Based Utility consistently outperforms reward models, generative reward models, and LLM judges on ranking quality. Specifically, for GPT-OSS-120B, it improves Acc@1 from 67.2 to 76.3 and AUC from 71.4 to 79.6, with similarly large AUC gains on GPT-OSS-20B (69.0 to 79.2). Furthermore, compared to LLM-Judges, it also exhibits a larger solver-evaluator gap, maintaining a stronger correct-wrong separation even on instances where the underlying solver often fails to solve.

Semantic caching cuts LLM inference costs by serving a cached response to semantically similar queries. Standard practice evaluates these systems using PR-AUC, a metric that only measures how well scores rank and ignores whether they are usable at a fixed threshold. We show this mismatch leads to systematically poor deployment choices, as models with the highest PR-AUC are often the worst in operation. We introduce Precision-Cache Hit Ratio (P-CHR) AUC, a cache-aware metric that measures precision across cache utilization levels, and Calibration Retention Rate (CRR), which captures how much offline ranking quality survives at deployment. We decompose the operational gap between offline and deployed quality into a recoverable calibration component and an irreducible structural component fixed by the dataset's positive rate. Our experiments show that the calibration gap is governed by the training objective rather than data scale, and post-hoc calibration only partially closes it. Ultimately, model selection for semantic caching is a calibration problem, not a ranking one, and measuring it is the first step to closing the gap.

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

Automated Essay Scoring (AES) holds significant promise in the field of education, helping educators to mark larger volumes of essays and provide timely feedback. However, Arabic AES research has been limited by the lack of publicly available essay data. This study introduces AR-AES, an Arabic AES benchmark dataset comprising 2046 undergraduate essays, including gender information, scores, and transparent rubric-based evaluation guidelines, providing comprehensive insights into the scoring process. These essays come from four diverse courses, covering both traditional and online exams. Additionally, we pioneer the use of AraBERT for AES, exploring its performance on different question types. We find encouraging results, particularly for Environmental Chemistry and source-dependent essay questions. For the first time, we examine the scale of errors made by a BERT-based AES system, observing that 96.15 percent of the errors are within one point of the first human marker's prediction, on a scale of one to five, with 79.49 percent of predictions matching exactly. In contrast, additional human markers did not exceed 30 percent exact matches with the first marker, with 62.9 percent within one mark. These findings highlight the subjectivity inherent in essay grading, and underscore the potential for current AES technology to assist human markers to grade consistently across large classes.