Daily Papers

Hospital information systems (HIS) have become an essential part of healthcare institutions and now incorporate prescribing support software. Prescription support software allows for structured information capture, which improves the safety, appropriateness and efficiency of prescriptions and reduces the number of adverse drug events (ADEs). However, such a system increases the amount of time physicians spend at a computer entering information instead of providing medical care. In addition, any new visiting clinician must learn to manage complex interfaces since each HIS has its own interfaces. In this paper, we present a natural language interface for e-prescribing software in the form of a spoken dialogue system accessible on a smartphone. This system allows prescribers to record their prescriptions verbally, a form of interaction closer to their usual practice. The system extracts the formal representation of the prescription ready to be checked by the prescribing software and uses the dialogue to request mandatory information, correct errors or warn of particular situations. Since, to the best of our knowledge, there is no existing voice-based prescription dialogue system, we present the system developed in a low-resource environment, focusing on dialogue modeling, semantic extraction and data augmentation. The system was evaluated in the wild with 55 participants. This evaluation showed that our system has an average prescription time of 66.15 seconds for physicians and 35.64 seconds for other experts, and a task success rate of 76\% for physicians and 72\% for other experts. All evaluation data were recorded and annotated to form PxCorpus, the first spoken drug prescription corpus that has been made fully available to the community (https://doi.org/10.5281/zenodo.6524162).

Doctors typically write in incomprehensible handwriting, making it difficult for both the general public and some pharmacists to understand the medications they have prescribed. It is not ideal for them to write the prescription quietly and methodically because they will be dealing with dozens of patients every day and will be swamped with work.As a result, their handwriting is illegible. This may result in reports or prescriptions consisting of short forms and cursive writing that a typical person or pharmacist won't be able to read properly, which will cause prescribed medications to be misspelled. However, some individuals are accustomed to writing prescriptions in regional languages because we all live in an area with a diversity of regional languages. It makes analyzing the content much more challenging. So, in this project, we'll use a recognition system to build a tool that can translate the handwriting of physicians in any language. This system will be made into an application which is fully autonomous in functioning. As the user uploads the prescription image the program will pre-process the image by performing image pre-processing, and word segmentations initially before processing the image for training. And it will be done for every language we require the model to detect. And as of the deduction model will be made using deep learning techniques including CNN, RNN, and LSTM, which are utilized to train the model. To match words from various languages that will be written in the system, Unicode will be used. Furthermore, fuzzy search and market basket analysis are employed to offer an end result that will be optimized from the pharmaceutical database and displayed to the user as a structured output.

Spoken medical dialogue systems are increasingly attracting interest to enhance access to healthcare services and improve quality and traceability of patient care. In this paper, we focus on medical drug prescriptions acquired on smartphones through spoken dialogue. Such systems would facilitate the traceability of care and would free clinicians' time. However, there is a lack of speech corpora to develop such systems since most of the related corpora are in text form and in English. To facilitate the research and development of spoken medical dialogue systems, we present, to the best of our knowledge, the first spoken medical drug prescriptions corpus, named PxSLU. It contains 4 hours of transcribed and annotated dialogues of drug prescriptions in French acquired through an experiment with 55 participants experts and non-experts in prescriptions. We also present some experiments that demonstrate the interest of this corpus for the evaluation and development of medical dialogue systems.

Large language models (LLMs) can generate clinical narratives that are insufficiently grounded in patient-specific evidence. In traditional Chinese medicine (TCM), errors can propagate from etiology and pathogenesis through syndrome diagnosis and treatment principles to prescription generation. We developed TCMClinicalReason-Bench using 2,000 multicenter electronic health record cases to distinguish case-grounded responses from fluent but unsupported diagnostic and therapeutic conclusions. Five general-purpose and two TCM-specific LLMs were evaluated in zero-shot settings. An evidence-constrained rubric assessed seven diagnostic and therapeutic components and three cross-block relations, allowing case-supported alternatives. Qwen3.7-Plus with TCM retrieval served as the automated judge, alongside parallel blinded ratings by five senior TCM clinicians on a 600-case subset. Structural completeness was nearly saturated (99.3-100.0%), but normalized content scores ranged from 40.7% to 54.1%. The five general-purpose models averaged 50.0%, versus 41.3% for the two smaller TCM-specific models. Cross-block logic consistency ranged from 60.8% to 66.8% and correlated moderately with content across cases (Pearson's r = 0.515-0.656). Deficits were greatest in prescription generation, prescription analysis, and symptom-guided modification. In judge stress testing on 100 independent cases, perturbation detection rates across the three relations were 57%, 56%, and 31%, with contradictions detected more reliably than omissions. Separating component quality from cross-block consistency localizes failures missed by endpoint and completeness metrics and identifies where clinician oversight remains necessary.

Access to real-world medication prescriptions is essential for medical research and healthcare quality improvement. However, access to real medication prescriptions is often limited due to the sensitive nature of the information expressed. Additionally, manually labelling these instructions for training and fine-tuning Natural Language Processing (NLP) models can be tedious and expensive. We introduce a novel task-specific model architecture, Label-To-Text-Transformer (LT3), tailored to generate synthetic medication prescriptions based on provided labels, such as a vocabulary list of medications and their attributes. LT3 is trained on a set of around 2K lines of medication prescriptions extracted from the MIMIC-III database, allowing the model to produce valuable synthetic medication prescriptions. We evaluate LT3's performance by contrasting it with a state-of-the-art Pre-trained Language Model (PLM), T5, analysing the quality and diversity of generated texts. We deploy the generated synthetic data to train the SpacyNER model for the Named Entity Recognition (NER) task over the n2c2-2018 dataset. The experiments show that the model trained on synthetic data can achieve a 96-98\% F1 score at Label Recognition on Drug, Frequency, Route, Strength, and Form. LT3 codes and data will be shared at https://github.com/HECTA-UoM/Label-To-Text-Transformer

Data curation has shifted the quality-compute frontier for language-model and contrastive image-text pretraining, but its role for vision-language models (VLMs) is far less established. We ask how far data curation alone can take VLM performance, holding architecture, training recipe, and compute fixed and varying only the training data. Our pipeline, applied to the MAmmoTH-VL single-image subset, lifts performance by +11.7pp on average across 20 public VLM benchmarks (spanning grounding, VQA, OCR/documents, captioning, spatial/3D, counting, charts, math, brand-ID, and multi-image reasoning) and by +11.3pp on average across all nine capability axes of DatBench, our high-fidelity VLM eval suite. At 2B, our curated model surpasses InternVL3.5-2B by 9.9pp at ~17x less training compute and closes the gap to Qwen3-VL-2B to within 1.8pp at ~87x less compute, from pretraining alone. Beyond accuracy, curation delivers four further properties: (1) Reliability: per-capability std across training seeds drops by ~67% and the lift survives a 4k-to-16k context-length sweep; (2) OOD generalization: the 9-eval OOD average rises by +7.2pp, and multi-image BLINK rises by +3.09pp despite single-image-only training, with Visual Correspondence gaining +11.8pp; (3) Behavioral gains beyond benchmarks: across ~1,100 open-ended queries the curated 2B is more honest and more specific than the matched-compute baseline, and more concise and less refusal-prone than a frontier 2B reference; (4) Pareto-dominance on inference cost: at every scale (1B, 2B, 4B) the curated model raises accuracy while lowering response FLOPs vs. the matched-compute baseline, and the curated 4B matches near-frontier accuracy at 3.3x lower response FLOPs than Qwen3-VL-4B. Data curation is a high-leverage tool for building better VLMs, reaching near-frontier accuracy at up to ~150x less training compute.

Hospitals in India still rely on handwritten medical records despite the availability of Electronic Medical Records (EMR), complicating statistical analysis and record retrieval. Handwritten records pose a unique challenge, requiring specialized data for training models to recognize medications and their recommendation patterns. While traditional handwriting recognition approaches employ 2-D LSTMs, recent studies have explored using Multimodal Large Language Models (MLLMs) for OCR tasks. Building on this approach, we focus on extracting medication names and dosages from simulated medical records. Our methodology MIRAGE (Multimodal Identification and Recognition of Annotations in indian GEneral prescriptions) involves fine-tuning the QWEN VL, LLaVA 1.6 and Idefics2 models on 743,118 high resolution simulated medical record images-fully annotated from 1,133 doctors across India. Our approach achieves 82% accuracy in extracting medication names and dosages.

The integration of Artificial Intelligence (AI), especially Large Language Models (LLMs), into the clinical diagnosis process offers significant potential to improve the efficiency and accessibility of medical care. While LLMs have shown some promise in the medical domain, their application in clinical diagnosis remains underexplored, especially in real-world clinical practice, where highly sophisticated, patient-specific decisions need to be made. Current evaluations of LLMs in this field are often narrow in scope, focusing on specific diseases or specialties and employing simplified diagnostic tasks. To bridge this gap, we introduce CliBench, a novel benchmark developed from the MIMIC IV dataset, offering a comprehensive and realistic assessment of LLMs' capabilities in clinical diagnosis. This benchmark not only covers diagnoses from a diverse range of medical cases across various specialties but also incorporates tasks of clinical significance: treatment procedure identification, lab test ordering and medication prescriptions. Supported by structured output ontologies, CliBench enables a precise and multi-granular evaluation, offering an in-depth understanding of LLM's capability on diverse clinical tasks of desired granularity. We conduct a zero-shot evaluation of leading LLMs to assess their proficiency in clinical decision-making. Our preliminary results shed light on the potential and limitations of current LLMs in clinical settings, providing valuable insights for future advancements in LLM-powered healthcare.

Identifying prescription medications is a frequent task for patients and medical professionals; however, this is an error-prone task as many pills have similar appearances (e.g. white round pills), which increases the risk of medication errors. In this paper, we introduce ePillID, the largest public benchmark on pill image recognition, composed of 13k images representing 9804 appearance classes (two sides for 4902 pill types). For most of the appearance classes, there exists only one reference image, making it a challenging low-shot recognition setting. We present our experimental setup and evaluation results of various baseline models on the benchmark. The best baseline using a multi-head metric-learning approach with bilinear features performed remarkably well; however, our error analysis suggests that they still fail to distinguish particularly confusing classes. The code and data are available at https://github.com/usuyama/ePillID-benchmark.

CMB-S4, the next-generation ground-based cosmic microwave background (CMB) observatory, will provide detailed maps of the CMB at millimeter wavelengths to dramatically advance our understanding of the origin and evolution of the universe. CMB-S4 will deploy large and small aperture telescopes with hundreds of thousands of detectors to observe the CMB at arcminute and degree resolutions at millimeter wavelengths. Inflationary science benefits from a deep delensing survey at arcminute resolutions capable of observing a large field of view at millimeter wavelengths. This kind of survey acts as a complement to a degree angular resolution survey. The delensing survey requires a nearly uniform distribution of cameras per frequency band across the focal plane. We present a large-throughput, large-aperture (5-meter diameter) freeform three-mirror anastigmatic telescope and an array of 85 cameras for CMB observations at arcminute resolutions, which meets the needs of the delensing survey of CMB-S4. A detailed prescription of this three-mirror telescope and cameras is provided, with a series of numerical calculations that indicate expected optical performance and mechanical tolerance.

Specialist epilepsy expertise is scarce in resource-constrained settings, making LLM-based decision support attractive for frontline clinicians managing longitudinal treatment. Such systems must adapt to local prescribing practice and know when to defer. We study this problem in Ugandan pediatric epilepsy care, predicting anti-seizure medication regimens from longitudinal unstructured clinic notes. Standard prompting achieves non-trivial agreement with physician prescriptions, but neurologist review shows that many errors reflect distribution-miscalibrated prescribing defaults rather than failures to parse the local record. We introduce MANANA, a non-parametric prompt-learning framework that learns local prescribing guidance from a small patient-level training set. MANANA converts observed prescription errors into auditable prompt memories, instantiated in single-agent and multi-agent variants, and improves over classical ML models, direct LLM prompting, and prompt-optimization baselines across two independently collected Ugandan cohorts. We further propose Bayesian prompt averaging, which converts the learned prompt trajectory into prescription likelihoods and an uncertainty-based deferral signal. On the independently collected held-out cohort, this improves visit-level top-3 prescription accuracy by 4-8 percentage points over prompt-optimization baselines and enables selective prediction: the system can auto-handle the most confident half of cases at 95% precision, or the most confident quarter at 99% precision, while deferring lower-confidence cases for specialist review.

We distinguish two regimes in task-oriented quantization with a known deterministic oracle action. For an unconstrained interior oracle and a smooth strongly concave utility, quantizing the oracle action by vector Lloyd-Max minimizes a mean-squared-error surrogate and achieves a β/α approximation to the optimal K-level task quantizer. The reduction is exact for isotropic quadratic loss, and the corresponding task rate--distortion function is bracketed by two ordinary rate--distortion functions. Budget-constrained quadratic scheduling is different: the oracle satisfies a variational inequality, so quantizing water-filled actions is not generally optimal. We derive the exact Lloyd-type conditions for this case. The optimal action for a quantizer cell is water-filling evaluated at the cell's conditional-mean load, and the optimal encoder partitions load space into affine power-diagram cells. Thus the correct prescription is to quantize the load and water-fill its centroid. The distinction is material whenever a cell crosses water-filling active-set boundaries.

Large language models have advanced medical reasoning, but clinically grounded reasoning in traditional Chinese medicine (TCM) remains challenging because prescription decisions require integrating domain knowledge, syndrome differentiation, treatment principles, herbal prescription composition, and dosage determination. We develop a TCM language model family comprising models with 4 billion, 8 billion, and 14 billion parameters. The artificial intelligence contribution is a staged clinical alignment framework integrating large scale continued pretraining on TCM and clinical records, complementary reasoning supervision, and prescription-centered reinforcement learning (RL). We further formulate herbal prescription generation as a structured RL problem with prescription-level feedback, enabling direct optimization of clinical decision outputs beyond knowledge reproduction and generic instruction following. The engineering application is TCM clinical decision support, particularly herbal prescription recommendation. We evaluate the models on a public benchmark containing 25,620 expert-verified items across 13 TCM knowledge and clinical reasoning tasks and on a private retrospective dataset of 4,348 spleen and stomach disease prescription cases. The 14 billion parameter reinforcement aligned model achieves a prescription generation F1 of 37.0 on the public benchmark, compared with 32.3 for DeepSeek-R1 with 671 billion total parameters, and a herb-level F1 of 52.8 on the clinical dataset with improved dosage agreement. Reinforcement post-training consistently improves prescription recommendation across all scales, while physician-source analysis shows that expert heterogeneity affects reward stability. These findings demonstrate a scalable pathway from domain grounding and reasoning supervision to clinically oriented prescription decision support.

Implicit neural representations (INRs) have arisen as useful methods for representing signals on Euclidean domains. By parameterizing an image as a multilayer perceptron (MLP) on Euclidean space, INRs effectively represent signals in a way that couples spatial and spectral features of the signal that is not obvious in the usual discrete representation, paving the way for continuous signal processing and machine learning approaches that were not previously possible. Although INRs using sinusoidal activation functions have been studied in terms of Fourier theory, recent works have shown the advantage of using wavelets instead of sinusoids as activation functions, due to their ability to simultaneously localize in both frequency and space. In this work, we approach such INRs and demonstrate how they resolve high-frequency features of signals from coarse approximations done in the first layer of the MLP. This leads to multiple prescriptions for the design of INR architectures, including the use of complex wavelets, decoupling of low and band-pass approximations, and initialization schemes based on the singularities of the desired signal.

The Redfield equation with time-dependent coefficients (or TCL2 equation) gives one of the simplest perturbative descriptions of open quantum system dynamics derived from a microscopic theory. Its status as an approximation is nevertheless subtle: while perturbation theory fixes the reduced dynamics order-by-order in the system-environment coupling, solving the Redfield equation yields a particular resummation that need not preserve complete positivity. Here we compare Redfield evolution with an exponentiated (Magnus) resummation of the same second-order perturbative map, which is completely positive and trace preserving (CPTP) for a broad class of physical conditions. We also construct a simple CPTP resolvent resummation, illustrating the non-uniqueness of resummations of the same perturbative map. The Redfield and Magnus prescriptions agree to second order but differ through time-ordering corrections at higher orders. We exhibit a weak-coupling criterion which guarantees that Redfield evolution, even when non-Markovian, remains close to a CPTP map. We illustrate the criterion in two examples, focusing on finite-dimensional (qubit) systems. Our results clarify when, and why, Redfield evolution can remain reliable even when it is highly non-Lindbladian.

Machine learning recommendations are often evaluated one model at a time, despite deployment across interconnected decision makers. For continuous NPK fertilizer prescriptions, correlated errors can aggregate across farms and generate systemic costs. A model of shared and farm-specific recommendation errors links expected social loss to model adoption shares; the Herfindahl-Hirschman Index characterizes concentration effects when common model errors are independent and predictive risks are equal. A covariance-generalized formulation captures the dependence between model families. A two-model threshold characterizes when privately optimal monoculture is socially dominated, and a convex portfolio rule limits average private predictive regret. Nine model families across five Moroccan cereal systems provide a benchmark-based calibration. Under illustrative parameters and a 10% regret cap, accuracy-constrained diversification lowers modeled social loss in all five systems by 10.89-41.53% (mean 19.41%). Uniform allocation reduces modeled loss in this setting, but breaches the regret cap in every crop. Correlation sensitivity shows that highly dependent model errors attenuate the benefits of diversification. These counterfactual outcomes are not estimates of agronomic or monetary welfare; the framework identifies adoption architecture and error dependence as ecosystem-level evaluation variables.

We present E(3)-Pose, a novel fast pose estimation method that jointly and explicitly models rotation equivariance and object symmetry. Our work is motivated by the challenging problem of accounting for fetal head motion during a diagnostic MRI scan. We aim to enable automatic adaptive prescription of 2D diagnostic MRI slices with 6-DoF head pose estimation, supported by 3D MRI volumes rapidly acquired before each 2D slice. Existing methods struggle to generalize to clinical volumes, due to pose ambiguities induced by inherent anatomical symmetries, as well as low resolution, noise, and artifacts. In contrast, E(3)-Pose captures anatomical symmetries and rigid pose equivariance by construction, and yields robust estimates of the fetal head pose. Our experiments on publicly available and representative clinical fetal MRI datasets demonstrate the superior robustness and generalization of our method across domains. Crucially, E(3)-Pose achieves state-of-the-art accuracy on clinical MRI volumes, paving the way for clinical translation. Our implementation is available at github.com/ramyamut/E3-Pose.

High-quality expert chain-of-thought (CoT) data is one of the core bottlenecks in large language model (LLM) post-training. Existing data production methods each have structural limitations: crowdsourced annotation lacks deep reasoning paths; expert solo writing is constrained by the "expert blind spot" -- experts structurally skip reasoning steps they consider obvious; RLHF only produces preference signals rather than reasoning chains. This paper proposes the BC Protocol -- a structured dual-expert elicitation method for LLM post-training data production. The method carefully pairs a domain expert (crystallized intelligence) with a knowledge engineer (fluid intelligence), systematically externalizing the expert's implicit judgments as natural language reasoning chains. We introduce the Participant Aptitude Model, which defines six participant characteristic dimensions that affect elicitation quality. "Calibrated Ignorance" is an original concept proposed in this paper. We further propose "Selection-over-Prescription" as a methodological principle: for implicit knowledge elicitation tasks, investing quality-control resources in personnel selection yields a higher return than investing the same resources in process design. In a controlled experiment in the narrative fiction domain, we directly compared CoT produced by BC Protocol dual dialogue (Group A, (n=20)) against CoT written independently by the same domain expert (Group B, (n=20)). Three cross-vendor judge models -- GPT-4o, Claude Opus 4.5, and Gemini 2.5 Pro -- conducted blind evaluation across five dimensions (600 ratings total). Results show that the BC Protocol achieves an overwhelming advantage in "naturalness of reasoning process" (Group A mean 4.80 vs. Group B mean 1.30, (p=2.4\times10^{-8}), Cliff's (δ=1.0)).

Self-Distillation Policy Optimization (SDPO) provides dense token-level credit assignment for reinforcement learning with large language models by leveraging the model's own feedback-conditioned predictions as a self-teacher. Unlike GRPO, however, whose group-relative advantage naturally concentrates learning on a sweet spot of intermediate-difficulty questions, SDPO's KL-based advantage lacks an implicit notion of difficulty awareness. We analyze this gap through the lens of GRPO's advantage normalization. Extending the learnability framework to normalized rewards, we show that normalization absorbs the variance term p(1-p), equalizing leading-order learnability across questions and leaving p(1-p) as the sole residual scaling factor in the per-question gradient. This analysis yields a simple prescription: weight each question's SDPO loss by [p(1-p)]^{1/2}, resulting in SC-SDPO, a scale-consistent variant of SDPO. The proposed weights are obtained as a zero-cost byproduct of on-policy rollouts with batch-adaptive normalization, inducing an implicit curriculum that dynamically tracks the model's evolving competence. Experiments on scientific reasoning and tool-use benchmarks demonstrate that SC-SDPO consistently improves over SDPO, yielding gains of +3.2/+4.3 (mean@16/maj@16) on Qwen3-8B and +1.8/+3.0 on OLMo-3-7B, while preserving stable training dynamics throughout optimization.

State-of-the-art information extraction methods are limited by OCR errors. They work well for printed text in form-like documents, but unstructured, handwritten documents still remain a challenge. Adapting existing models to domain-specific training data is quite expensive, because of two factors, 1) limited availability of the domain-specific documents (such as handwritten prescriptions, lab notes, etc.), and 2) annotations become even more challenging as one needs domain-specific knowledge to decode inscrutable handwritten document images. In this work, we focus on the complex problem of extracting medicine names from handwritten prescriptions using only weakly labeled data. The data consists of images along with the list of medicine names in it, but not their location in the image. We solve the problem by first identifying the regions of interest, i.e., medicine lines from just weak labels and then injecting a domain-specific medicine language model learned using only synthetically generated data. Compared to off-the-shelf state-of-the-art methods, our approach performs >2.5x better in medicine names extraction from prescriptions.

An accurate description of the scalar potential at finite temperature is crucial for studying cosmological first-order phase transitions (FOPT) in the early Universe. At finite temperatures, a precise treatment of thermal resummations is essential, as bosonic fields encounter significant infrared issues that can compromise standard perturbative approaches. The Partial Dressing (or the tadpole resummation) method provides a self consistent resummation of higher order corrections, allowing the computation of thermal masses and the effective potential including the proper Boltzmann suppression factors and without relying on any high-temperature approximation. We systematically compare the Partial dressing resummation scheme results with the Parwani and Arnold Espinosa (AE) ones to investigate the thermal phase transition dynamics in the Two-Higgs-Doublet Model (2HDM). Our findings reveal that different resummation prescriptions can significantly alter the nature of the phase transition within the same region of parameter space, confirming the differences that have already been noticed between the Parwani and AE schemes. Notably, the more refined resummation prescription, the Partial Dressing scheme, does not support symmetry non-restoration in 2HDM at high temperatures observed using the AE prescription. Furthermore, we quantify the uncertainties in the stochastic gravitational wave (GW) spectrum from an FOPT due to variations in resummation methods, illustrating their role in shaping theoretical predictions for upcoming GW experiments. Finally, we discuss the capability of the High-Luminosity LHC and proposed GW experiments to probe the FOEWPT-favored region of the parameter space.

A dark-matter core and a soft nuclear equation of state can produce similar mass--radius signatures, motivating a complementary probe through the f-mode spectrum. We compute quadrupolar f-mode frequencies and gravitational-wave damping times in full general relativity for cold, nonrotating neutron stars admixed with self-interacting bosonic dark matter (DM). Our two-fluid survey spans 21 nuclear equations of state covering nucleonic, hyperonic, Δ-admixed, and combined hyperon--Δ compositions at F_{rm DM}=1--20%. The main sequences use λ=π and boson masses of 500 and 100,MeV for the core and halo studies, respectively. Independent normal-matter (NM) and DM displacements couple through the metric, yielding NM-led and DM-led f-mode branches whose radiative damping is determined by outgoing-wave boundary conditions. At 1.4,M_odot, the core DM-led damping time decreases from order 10^3,s at F_{rm DM}=1% to order 1,s at 20%, approximately following an empirical F_{rm DM}^{-2} dependence, while NM-led damping times remain within 0.12--0.33,s. Halo DM-led damping instead increases with dark fraction: at the same stellar mass and F_{rm DM}=20%, dark radii approach 88,km, frequencies fall to 0.14,kHz, and damping times reach approximately 450,s. Selected high-mass core sequences exhibit strong DM-led damping-time upturns not reproduced by the leading mass-quadrupole diagnostic. Representative core calculations show greater DM-led sensitivity to the bosonic self-coupling and retain both branches at ell=3. Under the adopted nonrotating, circular-binary prescriptions, no evaluated configuration satisfies all geometric and perturbative conditions for a controlled linear tidal resonance.

Robust and effective scaling of models from small to large width typically requires the precise adjustment of many algorithmic and architectural details, such as parameterization and optimizer choices. In this work, we propose a new perspective on parameterization by investigating a key assumption in prior work about the alignment between parameters and data and derive new theoretical results under weaker assumptions and a broader set of optimizers. Our extensive empirical investigation includes tens of thousands of models trained with all combinations of three optimizers, four parameterizations, several alignment assumptions, more than a dozen learning rates, and fourteen model sizes up to 26.8B parameters. We find that the best learning rate scaling prescription would often have been excluded by the assumptions in prior work. Our results show that all parameterizations, not just maximal update parameterization (muP), can achieve hyperparameter transfer; moreover, our novel per-layer learning rate prescription for standard parameterization outperforms muP. Finally, we demonstrate that an overlooked aspect of parameterization, the epsilon parameter in Adam, must be scaled correctly to avoid gradient underflow and propose Adam-atan2, a new numerically stable, scale-invariant version of Adam that eliminates the epsilon hyperparameter entirely.

Manual assignment of Anatomical Therapeutic Chemical (ATC) codes to prescription records is a significant bottleneck in healthcare research and operations at Ontario Health and InterRAI Canada, requiring extensive expert time and effort. To automate this process while maintaining data privacy, we develop a practical approach using locally deployable large language models (LLMs). Inspired by recent advances in automatic International Classification of Diseases (ICD) coding, our method frames ATC coding as a hierarchical information extraction task, guiding LLMs through the ATC ontology level by level. We evaluate our approach using GPT-4o as an accuracy ceiling and focus development on open-source Llama models suitable for privacy-sensitive deployment. Testing across Health Canada drug product data, the RABBITS benchmark, and real clinical notes from Ontario Health, our method achieves 78% exact match accuracy with GPT-4o and 60% with Llama 3.1 70B. We investigate knowledge grounding through drug definitions, finding modest improvements in accuracy. Further, we show that fine-tuned Llama 3.1 8B matches zero-shot Llama 3.1 70B accuracy, suggesting that effective ATC coding is feasible with smaller models. Our results demonstrate the feasibility of automatic ATC coding in privacy-sensitive healthcare environments, providing a foundation for future deployments.

Recent frontier large language models predominantly rely on Mixture-of-Experts (MoE) architectures. Despite empirical progress, there is still no principled understanding of how hyperparameters should scale with network width N, expert width N_e, number of experts M, sparsity K, and depth L to ensure both stability and optimal performance at scale. We take a principled step toward resolving this gap by analyzing three different scaling regimes: (I) co-scaling Nasymp N_e, (II) co-scaling Nasymp Masymp K, and (III) full proportional scaling of N, N_e, M, and K. For each regime, we develop a novel Dynamical Mean Field Theory (DMFT) description of the limiting training dynamics of MoEs that provides a formal foundation for our analysis. Within this framework, we derive the unique parameterization for SGD and Adam satisfying all maximal-update (μ) desiderata. We then show that the resulting μP prescription does not reliably induce monotonic improvement with scale or robust learning-rate transfer. We trace these pathologies to scale-dependent observables in the aggregation dynamics, which motivates a refined set of desiderata that we term maximal scale stability. Guided by this principle, we derive a Maximally Scale-Stable Parameterization (MSSP) for both SGD and Adam in all three scaling regimes, and characterize the corresponding limiting dynamics - qualitatively distinct from the μP limit - through a separate DMFT analysis. Experiments verify that MSSP robustly recovers learning rate transfer and monotonic improvement with scale across regimes. Combined with existing depth-scaling theory, these results provide a complete scaling prescription for MoE architectures as a function of width, depth, expert width, and number of experts.

In quantum mechanics the modulus square of the wave function is the probability of an event --- positivity is self-evident. Quantum field theory corresponds to quantum mechanics one-to-one: the wave function corresponds to the matrix element, so the probability of a process should be the modulus square of the matrix element, positive by construction. In the founding era of perturbative quantum field theory, however, Feynman, Schwinger and Tomonaga treated inclusive processes in quantum electrodynamics, where the truncation of the squared amplitude was forced by infrared cancellations and rendered harmless by the small coupling αsimeq1/137. Carried over to exclusive processes in quantum chromodynamics, where the coupling is large, this practice produced negative decay and production rates already at NLO, persisting at NNLO. We point out that for exclusive processes, whose initial and final states are colorless for QCD and electrically neutral for QED, the infrared divergences cancel amplitude by amplitude and the KLN constraint is absent, so the complete modulus square of the truncated amplitude is the proper, manifestly positive definition of the probability. We formulate amplitude-level NRQCD factorization as the systematic prescription that restores positivity, show that every amplitude-level truncated observable admits the effective representation Γ^{amp}=Γ_{LO}bigl|1+α_sπ(c_1+ic_2)+α_s^2{π^2}(c_3+ic_4)bigr|^2, and demonstrate, with the complete NNLO QCD corrections to J/ψto3γ, Υto3γ, e^+e^-to J/ψ+J/ψ and the eight exclusive charmonium production channels at B factories, that the prescription yields positive and better-converging predictions.

We propose a mass-dependent MOM scheme to renormalize UV divergence of unpolarized PDFs at one-loop order. This approach which is based on a once subtracted dispersion relation does not need any regulator. The overall counterterms are obtained from the imaginary part of large transverse momentum region in loop integrals. The mass-dependent characteristic of the scheme yields to mass-dependent splitting functions for the DGLAP evolution equations. While the flavor number is fixed at any renormalization scale, the decoupling theorem is automatically imposed by the mass-dependent splitting functions. The required symmetries are also automatically respected by our prescription.

Dwarf galaxies serve as powerful laboratories for investigating the underlying physics of galaxy evolution including the impact of baryonic feedback processes and environmental influences. We compare the visual and structural properties of dwarf galaxies in ultra-deep HSC-SSP imaging of the COSMOS field with those measured from realistic HSC-like synthetic observations of dwarfs generated by the Illustris TNG50 and NewHorizon simulations. Using S\'ersic profile fitting and non-parametric morphological metrics (Gini, M_{20}, asymmetry, and concentration), we evaluate the diversity of structural properties in observed and simulated galaxies. Our analysis shows that NewHorizon and TNG50 galaxies lie at opposite extremes of observed structural trends: NewHorizon produces diffuse, extended galaxies with shallow S\'ersic indices, while TNG50 yields compact, concentrated systems with steep indices. Both simulations reproduce observed structural trends more closely at higher stellar masses (M_{star}sim10^{9.5} {rm M_{odot}}) but fail to capture the full diversity of COSMOS dwarfs at lower masses. Non-parametric metrics further show that NewHorizon galaxies exhibit more uneven, clumpy light distributions while TNG50 galaxies have smoother but excessively concentrated profiles. These structural differences reflect underlying differences in their physical prescriptions and are likely driven by differing approaches to ISM physics, supernova feedback and star formation in addition to differences in numerical resolution. Our findings highlight the unique power of low-mass galaxies to constrain differences in simulation physics, especially star formation and feedback. Upcoming surveys from facilities like the Vera C. Rubin Observatory and Euclid will enable more rigorous comparisons with simulations, offering deeper insights into the physical processes shaping galaxy evolution.

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

Most competitive 4-bit LLM research pipelines now open the same way: apply a linear, function-preserving transform (rotation, scaling, permutation, non-orthogonal affine) so the outlier mass sits more favorably against the group scales, and only then round. Yet we are aware of no survey dedicated to this transform stage, and its literature is quietly re-deriving an older theory. We identify and formalize the principle that organizes it, the Great Inversion: allocation-flexible coding rewards energy concentration, whereas the grouped shared-scale quantization a deployed matrix instruction performs rewards within-group flattening. Classical transform coding (1963: decorrelate, allocate bits, quantize) spends different bits per coordinate at a fixed total rate; for a Gaussian source at high rate the Karhunen-Loeve transform's concentration minimizes distortion. A deployed operand tile instead carries one absolute-maximum scale per group and equal bits everywhere, with no allocation; on a uniform grid that objective rewards flattening, approached by Hadamard incoherence. We prove that opposition under within-group majorization: the prescriptions point in opposite directions, each backed by a proof against its own objective, and for a generic spectrum no optimality guarantee transfers. A second axis is the number format: the non-uniform FP4 grid makes flattening buy less, MXFP4's power-of-two block scale still rewards a rotation confined to that block, and NVFP4's mantissa-carrying scale largely removes that pull, so the target pole depends jointly on allocation regime and format. We survey 200 works to a June 2026 cutoff; classify 43 transform methods by structure, data-awareness, searched-versus-constructed, and runtime cost; record, where reported, how they compose with GPTQ rounding; distill a first-choice guide by deployment regime; and close with the open problems it exposes.

We study the dynamics of gravitons in a squeezed vacuum state in a thermal radiation background. Unlike traditional treatments that rely on the Boltzmann equation, we employ the Heisenberg equation and average it over general quantum states. In contrast to the usual Boltzmann-based descriptions, our approach captures the subtleties arising from quantum coherence in different number eigenstates, which is essential for soft graviton modes in the squeezed vacuum state. Our new method successfully reproduces the previous one-loop results within the in-in formalism when the expansion parameter is small and deviates significantly as the parameter increases, indicating that our results extend beyond the one-loop in-in formalism. We examine the implications of graviton emission effects stimulated by quantum coherence in both flat and expanding backgrounds. In the flat background, it is found that backreaction of radiation on the spacetime dynamics is crucial for significant stimulated emission. In the expanding background, to avoid the subtleties associated with superhorizon modes, we investigate the effect of emission within the horizon immediately after reheating and find a significant effect. We examined the IR graviton evolution from a symmetry perspective and propose a regularization prescription to eliminate the secular growth problem.

Medical dialogue systems (MDS) aim to provide patients with medical services, such as diagnosis and prescription. Since most patients cannot precisely describe their symptoms, dialogue understanding is challenging for MDS. Previous studies mainly addressed this by extracting the mentioned medical entities as critical dialogue history information. In this work, we argue that it is also essential to capture the transitions of the medical entities and the doctor's dialogue acts in each turn, as they help the understanding of how the dialogue flows and enhance the prediction of the entities and dialogue acts to be adopted in the following turn. Correspondingly, we propose a Dual Flow enhanced Medical (DFMed) dialogue generation framework. It extracts the medical entities and dialogue acts used in the dialogue history and models their transitions with an entity-centric graph flow and a sequential act flow, respectively. We employ two sequential models to encode them and devise an interweaving component to enhance their interactions. Experiments on two datasets demonstrate that our method exceeds baselines in both automatic and manual evaluations.

Electronic Health Record (EHR) retrieval plays a pivotal role in various clinical tasks, but its development has been severely impeded by the lack of publicly available benchmarks. In this paper, we introduce a novel public EHR retrieval benchmark, CliniQ, to address this gap. We consider two retrieval settings: Single-Patient Retrieval and Multi-Patient Retrieval, reflecting various real-world scenarios. Single-Patient Retrieval focuses on finding relevant parts within a patient note, while Multi-Patient Retrieval involves retrieving EHRs from multiple patients. We build our benchmark upon 1,000 discharge summary notes along with the ICD codes and prescription labels from MIMIC-III, and collect 1,246 unique queries with 77,206 relevance judgments by further leveraging powerful LLMs as annotators. Additionally, we include a novel assessment of the semantic gap issue in EHR retrieval by categorizing matching types into string match and four types of semantic matches. On our proposed benchmark, we conduct a comprehensive evaluation of various retrieval methods, ranging from conventional exact match to popular dense retrievers. Our experiments find that BM25 sets a strong baseline and performs competitively to the dense retrievers, and general domain dense retrievers surprisingly outperform those designed for the medical domain. In-depth analyses on various matching types reveal the strengths and drawbacks of different methods, enlightening the potential for targeted improvement. We believe that our benchmark will stimulate the research communities to advance EHR retrieval systems.

Large language models offer transformative potential for healthcare, yet their responsible and equitable development depends critically on a deeper understanding of how training data characteristics influence model behavior, including the potential for bias. Current practices in dataset curation and bias assessment often lack the necessary transparency, creating an urgent need for comprehensive evaluation frameworks to foster trust and guide improvements. In this study, we present an in-depth analysis of potential downstream biases in clinical language models, with a focus on differential opioid prescription tendencies across diverse demographic groups, such as ethnicity, gender, and age. As part of this investigation, we introduce HC4: Healthcare Comprehensive Commons Corpus, a novel and extensively curated pretraining dataset exceeding 89 billion tokens. Our evaluation leverages both established general benchmarks and a novel, healthcare-specific methodology, offering crucial insights to support fairness and safety in clinical AI applications.

We seek to identify the most relevant benefits offered by Medicare Advantage Health Plans that drive membership and market share. As an example, we explore plans operating in a single county in New Jersey between 2018 and 2023. A dataset of benefits from publicly available data sources was created and the variance inflation factor was applied to identify the correlation between the extracted features, to avoid multicollinearity and overparameterization problems. We categorized the variable Market Share and used it as a multinomial response variable with three categories: less than 0.3\%, 0.3\% to 1.5\%, and over 1.5\%. Categories were chosen to achieve approximately uniform distribution of plans (47, 60, and 65 respectively). We built a multinomial Lasso model using 5-fold cross-validation to tune the penalty parameter. Lasso forced some features to be dropped from the model, which reduces the risk of overfitting and increases the interpretability of the results. For each category, important variables are different. Certain brands drive market share, as do PPO plans and prescription drug coverage. Benefits, particularly ancillary benefits that are not part of CMS's required benefits, appear to have little influence, while financial terms such as deductibles, copays, and out-of-pocket limits are associated with higher market share. Finally, we evaluated the predictive accuracy of the Lasso model with the test set. The accuracy is 0.76.

One of the challenges in online reinforcement learning (RL) is that the agent needs to trade off the exploration of the environment and the exploitation of the samples to optimize its behavior. Whether we optimize for regret, sample complexity, state-space coverage or model estimation, we need to strike a different exploration-exploitation trade-off. In this paper, we propose to tackle the exploration-exploitation problem following a decoupled approach composed of: 1) An "objective-specific" algorithm that (adaptively) prescribes how many samples to collect at which states, as if it has access to a generative model (i.e., a simulator of the environment); 2) An "objective-agnostic" sample collection exploration strategy responsible for generating the prescribed samples as fast as possible. Building on recent methods for exploration in the stochastic shortest path problem, we first provide an algorithm that, given as input the number of samples b(s,a) needed in each state-action pair, requires O(B D + D^{3/2} S^2 A) time steps to collect the B=sum_{s,a} b(s,a) desired samples, in any unknown communicating MDP with S states, A actions and diameter D. Then we show how this general-purpose exploration algorithm can be paired with "objective-specific" strategies that prescribe the sample requirements to tackle a variety of settings -- e.g., model estimation, sparse reward discovery, goal-free cost-free exploration in communicating MDPs -- for which we obtain improved or novel sample complexity guarantees.

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.

We study complex saddle points of the worldline path integral for massive charged particles in two-dimensional maximally symmetric backgrounds threaded by homogeneous electric fields. Within the worldline formalism, we show that the semiclassical saddles generically require complexifying both the target spacetime and the proper-time parameter. The resulting solutions comprise two slices of a single complex family, distinguished by the direction of proper-time evolution. The one evolving in imaginary proper time carries an action that typically controls the exponential suppression of non-perturbative effects, while that evolving in real proper time may encode additional complex phases responsible for quantum interference between saddles. Treating this family as a whole, we give a prescription for constructing and classifying all topologically inequivalent instanton sectors, and we find that the worldline action depends only on their topological data, namely winding numbers around the compact directions and certain isolated punctures. Moreover, in Anti-de Sitter spacetime, the qualitative structure of the solutions is governed by the dimensionless ratio R |eE|/m (R being the curvature radius), which distinguishes sub-extremal, extremal, and super-extremal regimes. By contrast, no analogous distinction occurs in de Sitter---where the instantons are insensitive to this ratio---or in Minkowski spacetime, which lacks a curvature scale altogether. We also recast the action as a sum over residues of the relevant (non-conserved) conjugate momentum, making transparent which analytic data control each contribution. Finally, we discuss the subtleties that arise when solutions built in various local patches are lifted to global (Anti-)de Sitter space. These impose further necessary conditions on which saddles can in principle contribute to the one-loop path integral.

Self-evolving agents are usually built around prescribed optimization pipelines: the framework decides how to gather evidence, revise a persistent artifact, select candidates, and stop. We ask whether this task-specific procedure remains necessary when a frontier model acts as the optimizer. We introduce Open-Ended Optimization (OEO), which keeps the objective, permitted interactions, resource budget, data boundary, and evaluation fixed while allowing the optimizer to compose the improvement process online. We compare OEO with two complementary prescribed approaches: SkillOpt, a staged pipeline with bounded edits, and GEPA, a reflective evolutionary search. Across 14 head-to-head comparisons over 8 benchmark-target-model settings, GPT-5.5-driven OEO records 12 wins, 1 tie, and 1 narrow loss of 0.21 percentage points. It uses a median 34.3 percent of SkillOpt's configured target-interaction token budget. A one-shot, zero-interaction control shows that the gains are not explained by a single prior-driven rewrite. However, delegation has a capability boundary: SkillOpt outperforms OEO with a medium optimizer, and a weak optimizer cannot operate through the unchanged OEO interface. In the fully instrumented OEO-SkillOpt pair, trajectory analysis further shows that prescription changes how optimization proceeds more consistently than it changes final behavior. Together, these findings recast prescribed pipelines as capability-dependent scaffolding: essential constraints remain external, but a sufficiently capable optimizer can compose the route from measurable feedback to persistent improvement.

Natural language tasks like Named Entity Recognition (NER) in the clinical domain on non-English texts can be very time-consuming and expensive due to the lack of annotated data. Cross-lingual transfer (CLT) is a way to circumvent this issue thanks to the ability of multilingual large language models to be fine-tuned on a specific task in one language and to provide high accuracy for the same task in another language. However, other methods leveraging translation models can be used to perform NER without annotated data in the target language, by either translating the training set or test set. This paper compares cross-lingual transfer with these two alternative methods, to perform clinical NER in French and in German without any training data in those languages. To this end, we release MedNERF a medical NER test set extracted from French drug prescriptions and annotated with the same guidelines as an English dataset. Through extensive experiments on this dataset and on a German medical dataset (Frei and Kramer, 2021), we show that translation-based methods can achieve similar performance to CLT but require more care in their design. And while they can take advantage of monolingual clinical language models, those do not guarantee better results than large general-purpose multilingual models, whether with cross-lingual transfer or translation.

Scaling laws are typically fit using a family of models with a narrow range of frozen hyper-parameter choices. In this work we study scaling laws using a wide range of architecture and hyper-parameter choices, and highlight their impact on resulting prescriptions. As a primary artifact of our research, we release the Gemstones: the most comprehensive open-source scaling law dataset to date, consisting of over 4000 checkpoints from transformers with up to 2 billion parameters; these models have been trained with different learning rates, cooldown schedules, and architectural shapes. Our checkpoints enable more complex studies of scaling, such as a law that predicts language modeling performance as a function of model width and depth. By examining the various facets of our model suite, we find that the prescriptions of scaling laws can be highly sensitive to the experimental design process and the specific model checkpoints used during fitting. Code: https://github.com/mcleish7/gemstone-scaling-laws

While scaling laws guide compute allocation for LLM pre-training, analogous prescriptions for reinforcement learning (RL) post-training of large language models (LLMs) remain poorly understood. We study the compute-optimal allocation of sampling compute for on-policy RL methods in LLMs, framing scaling as a compute-constrained optimization over three resources: parallel rollouts per problem, number of problems per batch, and number of update steps. We find that the compute-optimal number of parallel rollouts per problem increases predictably with compute budget and then saturates. This trend holds across both easy and hard problems, though driven by different mechanisms: solution sharpening on easy problems and coverage expansion on hard problems. We further show that increasing the number of parallel rollouts mitigates interference across problems, while the number of problems per batch primarily affects training stability and can be chosen within a broad range. Validated across base models and data distributions, our results recast RL scaling laws as prescriptive allocation rules and provide practical guidance for compute-efficient LLM RL post-training.

Substance use disorders (SUDs) are a growing concern globally, necessitating enhanced understanding of the problem and its trends through data-driven research. Social media are unique and important sources of information about SUDs, particularly since the data in such sources are often generated by people with lived experiences. In this paper, we introduce Reddit-Impacts, a challenging Named Entity Recognition (NER) dataset curated from subreddits dedicated to discussions on prescription and illicit opioids, as well as medications for opioid use disorder. The dataset specifically concentrates on the lesser-studied, yet critically important, aspects of substance use--its clinical and social impacts. We collected data from chosen subreddits using the publicly available Application Programming Interface for Reddit. We manually annotated text spans representing clinical and social impacts reported by people who also reported personal nonmedical use of substances including but not limited to opioids, stimulants and benzodiazepines. Our objective is to create a resource that can enable the development of systems that can automatically detect clinical and social impacts of substance use from text-based social media data. The successful development of such systems may enable us to better understand how nonmedical use of substances affects individual health and societal dynamics, aiding the development of effective public health strategies. In addition to creating the annotated data set, we applied several machine learning models to establish baseline performances. Specifically, we experimented with transformer models like BERT, and RoBERTa, one few-shot learning model DANN by leveraging the full training dataset, and GPT-3.5 by using one-shot learning, for automatic NER of clinical and social impacts. The dataset has been made available through the 2024 SMM4H shared tasks.

The recommendation of medication is a vital aspect of intelligent healthcare systems, as it involves prescribing the most suitable drugs based on a patient's specific health needs. Unfortunately, many sophisticated models currently in use tend to overlook the nuanced semantics of medical data, while only relying heavily on identities. Furthermore, these models face significant challenges in handling cases involving patients who are visiting the hospital for the first time, as they lack prior prescription histories to draw upon. To tackle these issues, we harness the powerful semantic comprehension and input-agnostic characteristics of Large Language Models (LLMs). Our research aims to transform existing medication recommendation methodologies using LLMs. In this paper, we introduce a novel approach called Large Language Model Distilling Medication Recommendation (LEADER). We begin by creating appropriate prompt templates that enable LLMs to suggest medications effectively. However, the straightforward integration of LLMs into recommender systems leads to an out-of-corpus issue specific to drugs. We handle it by adapting the LLMs with a novel output layer and a refined tuning loss function. Although LLM-based models exhibit remarkable capabilities, they are plagued by high computational costs during inference, which is impractical for the healthcare sector. To mitigate this, we have developed a feature-level knowledge distillation technique, which transfers the LLM's proficiency to a more compact model. Extensive experiments conducted on two real-world datasets, MIMIC-III and MIMIC-IV, demonstrate that our proposed model not only delivers effective results but also is efficient. To ease the reproducibility of our experiments, we release the implementation code online.

While 4-bit quantization has emerged as a memory-optimal choice for non-reasoning models and zero-shot tasks across scales, we show that this universal prescription fails for reasoning models, where the KV cache rather than model size can dominate memory. Through systematic experiments across 1,700 inference scenarios on AIME25 and GPQA-Diamond, we find a scale-dependent trade-off: models with an effective size below 8-bit 4B parameters achieve better accuracy by allocating memory to more weights rather than longer generation, while larger models achieve better accuracy by allocating memory to longer generations. This scale threshold also determines when parallel scaling becomes memory-efficient and whether KV cache eviction outperforms KV quantization. Our findings show that memory optimization for LLMs cannot be scale-agnostic, while providing principled guidelines: for small reasoning models, prioritize model capacity over test-time compute, while for larger ones, maximize test-time compute. Our results suggest that optimizing reasoning models for deployment requires fundamentally different strategies from those established for non-reasoning models.

While large language models (LLMs) have shown promise in diagnostic dialogue, their capabilities for effective management reasoning - including disease progression, therapeutic response, and safe medication prescription - remain under-explored. We advance the previously demonstrated diagnostic capabilities of the Articulate Medical Intelligence Explorer (AMIE) through a new LLM-based agentic system optimised for clinical management and dialogue, incorporating reasoning over the evolution of disease and multiple patient visit encounters, response to therapy, and professional competence in medication prescription. To ground its reasoning in authoritative clinical knowledge, AMIE leverages Gemini's long-context capabilities, combining in-context retrieval with structured reasoning to align its output with relevant and up-to-date clinical practice guidelines and drug formularies. In a randomized, blinded virtual Objective Structured Clinical Examination (OSCE) study, AMIE was compared to 21 primary care physicians (PCPs) across 100 multi-visit case scenarios designed to reflect UK NICE Guidance and BMJ Best Practice guidelines. AMIE was non-inferior to PCPs in management reasoning as assessed by specialist physicians and scored better in both preciseness of treatments and investigations, and in its alignment with and grounding of management plans in clinical guidelines. To benchmark medication reasoning, we developed RxQA, a multiple-choice question benchmark derived from two national drug formularies (US, UK) and validated by board-certified pharmacists. While AMIE and PCPs both benefited from the ability to access external drug information, AMIE outperformed PCPs on higher difficulty questions. While further research would be needed before real-world translation, AMIE's strong performance across evaluations marks a significant step towards conversational AI as a tool in disease management.

Compute-optimal scaling laws guide the training of frontier language models yet remain largely unexplored for visual generation. We present a systematic scaling law study for text-to-image diffusion models using Abra, a controlled family of flow-matching transformers trained across three orders of magnitude worth of compute (10^{19} to 10^{22} FLOPs), reaching significantly larger compute budgets than previous works. We demonstrate that diffusion models scale just as predictably as language models but require far more data to train optimally: compute optimality occurs at approximately 200 image tokens per parameter, ten times the Chinchilla compute-optimal prescription for LLMs. We show that unlike language models, diffusion models are robust to overtraining and that practitioners should err on the side of more data rather than a larger model. Finally, we show that this predictability extends beyond training loss to generative quality metrics, optimal CFG settings, representation quality, and even the shape of the training curves, which collapse onto a universal form.

RANSAC scoring and local optimization (LO) impose different robustness requirements, motivating the separation of hypothesis selection from refinement. We systematically isolate the effects of robust-loss shape, incorrectly specified inlier scales, and optimization strategy on essential matrix, fundamental matrix, and homography estimation. A profile-marginal score marginalizes the nuisance inlier scale and selects an inlier partition, from which we estimate the scale that sets the LO loss width; this makes LO robust to an inlier scale specified too large, whereas one specified too small degrades selection itself. Refinement needs gradient from correspondences the seed currently rejects: optimizers that reweight from current residuals stay pinned to their seed, whereas methods with broad basins recover strongly perturbed seeds yet degrade accurate score-selected hypotheses, so basin size alone is insufficient to assess RANSAC LO. Joint half-quadratic optimization balances the two and is the most consistent strategy across model classes. An optimizer matched to the profile-marginal score, which never decreases it, does not reach the best accuracy, challenging the prescription that scoring and refinement objectives should match. Composed from these findings, our RANSAC reduces the median essential-matrix pose error of a state-of-the-art RANSAC on PhotoTourism from 2.23 degrees to 1.58 degrees with a correctly specified inlier scale and from 38 degrees to 6.2 degrees when it is grossly misspecified (128x too large).

As AI systems become an increasing part of people's everyday lives, it becomes ever more important that they understand people's ethical norms. Motivated by descriptive ethics, a field of study that focuses on people's descriptive judgments rather than theoretical prescriptions on morality, we investigate a novel, data-driven approach to machine ethics. We introduce Scruples, the first large-scale dataset with 625,000 ethical judgments over 32,000 real-life anecdotes. Each anecdote recounts a complex ethical situation, often posing moral dilemmas, paired with a distribution of judgments contributed by the community members. Our dataset presents a major challenge to state-of-the-art neural language models, leaving significant room for improvement. However, when presented with simplified moral situations, the results are considerably more promising, suggesting that neural models can effectively learn simpler ethical building blocks. A key take-away of our empirical analysis is that norms are not always clean-cut; many situations are naturally divisive. We present a new method to estimate the best possible performance on such tasks with inherently diverse label distributions, and explore likelihood functions that separate intrinsic from model uncertainty.

Chest X-ray imaging (CXR) is an important diagnostic tool used in hospitals to assess patient conditions and monitor changes over time. Generative models, specifically diffusion-based models, have shown promise in generating realistic synthetic X-rays. However, these models mainly focus on conditional generation using single-time-point data, i.e., typically CXRs taken at a specific time with their corresponding reports, limiting their clinical utility, particularly for capturing temporal changes. To address this limitation, we propose a novel framework, EHRXDiff, which predicts future CXR images by integrating previous CXRs with subsequent medical events, e.g., prescriptions, lab measures, etc. Our framework dynamically tracks and predicts disease progression based on a latent diffusion model, conditioned on the previous CXR image and a history of medical events. We comprehensively evaluate the performance of our framework across three key aspects, including clinical consistency, demographic consistency, and visual realism. We demonstrate that our framework generates high-quality, realistic future images that capture potential temporal changes, suggesting its potential for further development as a clinical simulation tool. This could offer valuable insights for patient monitoring and treatment planning in the medical field.

The James Webb Space Telescope (JWST) has recently discovered a new population of objects at high redshift referred to as `Little Red Dots' (LRDs). Their nature currently remains elusive, despite their surprisingly high inferred number densities. This emerging population of red point-like sources is reshaping our view of the early Universe and may shed light on the formation of high-redshift supermassive black holes. Here we present a spectroscopically confirmed LRD CANUCS-LRD-z8.6 at z_{rm spec}=8.6319pm 0.0005 hosting an Active Galactic Nucleus (AGN), using JWST data. This source shows the typical spectral shape of an LRD (blue UV and red optical continuum, unresolved in JWST imaging), along with broad Hbeta line emission, detection of high-ionization emission lines (CIV, NIV]) and very high electron temperature indicative of the presence of AGN. This is also combined with a very low metallicity (Z<0.1 Z_odot). The presence of all these diverse features in one source makes CANUCS-LRD-z8.6 unique. We show that the inferred black hole mass of CANUCS-LRD-z8.6 (M_{rm BH}=1.0^{+0.6}_{-0.4}times 10^{8}rm ~M_odot) strongly challenges current standard theoretical models and simulations of black hole formation, and forces us to adopt `ad hoc' prescriptions. Indeed if massive seeds, or light seeds with super-Eddington accretion, are considered, the observed BH mass of CANUCS-LRD-z8.6 at z=8.6 can be reproduced. Moreover, the black hole is over-massive compared to its host, relative to the local M_{rm BH}-M_* relations, pointing towards an earlier and faster evolution of the black hole compared to its host galaxy.

Recent observations by JWST have revealed supersolar ^{14}N abundances in galaxies at very high redshift. On the other hand, these galaxies show subsolar metallicity. The observed N/O ratios are difficult to reproduce in the framework of chemical evolution models for the Milky Way. Our aim is to reproduce these high N/O ratios with chemical evolution models assuming different histories of star formation triggering galactic winds coupled with detailed nucleosynthesis prescriptions for ^{14}N, ^{12}C, ^{16}O and ^{56}Fe. We compute several models for small galaxies (10^{9} - 10^{10} M_{odot}) with high star formation efficiency and strong galactic winds. These winds are assumed to be differential, carrying out mainly the products of the explosion of core-collapse supernovae. We find that only models with high star formation rates, normal initial mass function, and differential galactic winds can reproduce the observed chemical abundances. We also find that with the same assumptions about star formation and galactic winds, but with a very rapid formation resulting from fast gas infall, we can also reproduce the estimated ages of these objects. We find no necessity to invoke peculiar nucleosynthesis from Population III stars, very massive stars and supermassive stars.

In this work, we leverage CMB data from the Atacama Cosmology Telescope (ACT) and LSS data from the imaging survey conducted by the Dark Energy Spectroscopic Instrument (DESI) to study the distribution of gas around galaxy groups at low redshift, z approx 0.3, via the kinematic Sunyaev-Zel'dovich (kSZ) effect. In particular, we perform velocity-weighted stacking on the photometric Bright Galaxy Sample (BGS) to isolate the monopole and quadrupole of the kSZ signal, orienting the stacked images along 2D filaments identified using the Hessian of the projected gravitational potential. We find a 7.2σ detection in the monopole of the signal (i.e., the gas density profile) and a 4σ detection in the quadrupole (m = 2), constituting the first measurement of the alignment between gas distribution and the cosmic web through the kSZ effect. As it is a linear probe of the local gas density, the kSZ has heightened sensitivity to the warm-hot intergalactic medium (WHIM), which is believed to house the majority of the ``missing baryons.'' Mapping out the gas density at low redshifts, as enabled by our measurements, is crucial for weak lensing surveys, for which the impact of baryons on small scales is a major impediment. We compare the anisotropic signal against two hydrodynamical simulations, TNG300-1 and Illustris, which have very different baryonic feedback prescriptions. We find that the anisotropic signal measured in the data is comparable but slightly larger and more extended compared with the simulations. This suggests that there is excess accretion and feedback taking place through the filaments, hinting at the possible presence of spin-filament alignment of the BGS objects.

Sepsis management in the ICU requires sequential treatment decisions under rapidly evolving patient physiology. Although large language models (LLMs) encode broad clinical knowledge and can reason over guidelines, they are not inherently grounded in action-conditioned patient dynamics. We introduce SepsisAgent, a world model-augmented LLM agent for sepsis treatment recommendation. SepsisAgent uses a learned Clinical World Model to simulate patient responses under candidate fluid--vasopressor interventions, and follows a propose--simulate--refine workflow before committing to a prescription. We first show that world-model access alone yields inconsistent LLM decision performance, motivating agent-specific training. We then train SepsisAgent through a three-stage curriculum: patient-dynamics supervised fine-tuning, propose--simulate--refine behavior cloning, and world-model-based agentic reinforcement learning. On MIMIC-IV sepsis trajectories, SepsisAgent outperforms all traditional RL and LLM-based baselines in off-policy value while achieving the best safety profile under guideline adherence and unsafe-action metrics. Further analysis shows that repeated interaction with the Clinical World Model enables the agent to learn regularities in patient evolution, which remain useful even when simulator access is removed.

Social skills such as negotiation and leadership are crucial for personal and professional success in today's interconnected world. However, scalable and effective training remains a significant challenge due to the scarcity of expert coaching. In this work, we introduce SocialCoach, an LLM-powered agentic tutoring system for personalized social skill learning. SocialCoach constructs a theory-to-practice corpus of traceable strategies, cases, and practice scenarios, and uses this corpus for both scheduling and reflective tutoring. We formulate social practice personalization as cold-start, retrieval-constrained sequential practice scheduling. Given a learner profile, simulated proficiency state, and observed practice history, a policy produces structured prescriptions that are realized through corpus retrieval. To enhance scheduling effectiveness, we optimize complete pathways with trajectory-level GRPO using rubric-judge based pairwise preferences. Additionally, we instantiate the scheduling approach in a deployed platform with goal-driven practice and knowledge-grounded reflective tutoring. Finally, in the synthetic cold-start setting, experiment results show that SocialCoach achieves higher pathway-quality ratings than baselines in scheduling and tutoring quality. We also conduct human studies to demonstrate its usefulness for real-world social skill learning.

Capturing static and dynamic electron correlation simultaneously at manageable computational cost remains a key challenge in electronic structure theory. Motivated by the recurring role of effective temperature in self-consistent field methods we extend the adiabatic connection mechanism from density functional theory to include a temperature dimension. This gives rise to thermally enhanced hybrid functionals, in which static correlation is captured via fractional occupations generated by an effective "correlation temperature" within thermal Hartree-Fock, while dynamic correlation is described by established density functional approximations. The framework formally unifies information-density matrix functional theory (i-DMFT) and thermally-assisted-occupation (TAO-)DFT as special cases, clarifying their theoretical basis and the respective prescriptions for the temperature parameter. We assess the performance of several thermally enhanced hybrids for different cases where i-DMFT was previously shown to fail. Furthermore, we discuss and test different schemes for determining the correlation temperature and investigate the accuracy of different such choices for a benchmark set derived from biphenyl. The results help to clarify the achievable balance of accuracy, generality, and efficiency, establishing thermally enhanced hybrids as a systematic route toward low-cost treatment of both correlation types.