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High-Fidelity Longitudinal Patient Simulation Using Real-World Data

arXiv:2601.17310v1 Announce Type: new Abstract: Simulation is a powerful tool for exploring uncertainty. Its potential in clinical medicine is transformative and includes personalized treatment planning and virtual clinical trials. However, simulating patient trajectories is challenging because of complex biological and sociocultural influences. Here, we show that real-world clinical records can be leveraged to empirically model patient timelines. We developed a generative simulator model that takes a patient's history as input and synthesizes fine-grained, realistic future trajectories. The model was pretrained on more than 200 million clinical records. It produced high-fidelity future timelines, closely matching event occurrence rates, laboratory test results, and temporal dynamics in real patient future data. It also accurately estimated future event probabilities, with observed-to-expected ratios consistently near 1.0 across diverse outcomes and time horizons. Our results reveal the untapped value of real-world data in electronic health records and introduce a scalable framework for in silico modeling of clinical care.

"Rebuilding" Statistics in the Age of AI: A Town Hall Discussion on Culture, Infrastructure, and Training

arXiv:2601.17510v1 Announce Type: cross Abstract: This article presents the full, original record of the 2024 Joint Statistical Meetings (JSM) town hall, "Statistics in the Age of AI," which convened leading statisticians to discuss how the field is evolving in response to advances in artificial intelligence, foundation models, large-scale empirical modeling, and data-intensive infrastructures. The town hall was structured around open panel discussion and extensive audience Q&A, with the aim of eliciting candid, experience-driven perspectives rather than formal presentations or prepared statements. This document preserves the extended exchanges among panelists and audience members, with minimal editorial intervention, and organizes the conversation around five recurring questions concerning disciplinary culture and practices, data curation and "data work," engagement with modern empirical modeling, training for large-scale AI applications, and partnerships with key AI stakeholders. By providing an archival record of this discussion, the preprint aims to support transparency, community reflection, and ongoing dialogue about the evolving role of statistics in the data- and AI-centric future.

GenAI-Net: A Generative AI Framework for Automated Biomolecular Network Design

arXiv:2601.17582v1 Announce Type: cross Abstract: Biomolecular networks underpin emerging technologies in synthetic biology-from robust biomanufacturing and metabolic engineering to smart therapeutics and cell-based diagnostics-and also provide a mechanistic language for understanding complex dynamics in natural and ecological systems. Yet designing chemical reaction networks (CRNs) that implement a desired dynamical function remains largely manual: while a proposed network can be checked by simulation, the reverse problem of discovering a network from a behavioral specification is difficult, requiring substantial human insight to navigate a vast space of topologies and kinetic parameters with nonlinear and possibly stochastic dynamics. Here we introduce GenAI-Net, a generative AI framework that automates CRN design by coupling an agent that proposes reactions to simulation-based evaluation defined by a user-specified objective. GenAI-Net efficiently produces novel, topologically diverse solutions across multiple design tasks, including dose responses, complex logic gates, classifiers, oscillators, and robust perfect adaptation in deterministic and stochastic settings (including noise reduction). By turning specifications into families of circuit candidates and reusable motifs, GenAI-Net provides a general route to programmable biomolecular circuit design and accelerates the translation from desired function to implementable mechanisms.

The Limits of AI Data Transparency Policy: Three Disclosure Fallacies

arXiv:2601.18127v1 Announce Type: cross Abstract: Data transparency has emerged as a rallying cry for addressing concerns about AI: data quality, privacy, and copyright chief among them. Yet while these calls are crucial for accountability, current transparency policies often fall short of their intended aims. Similar to nutrition facts for food, policies aimed at nutrition facts for AI currently suffer from a limited consideration of research on effective disclosures. We offer an institutional perspective and identify three common fallacies in policy implementations of data disclosures for AI. First, many data transparency proposals exhibit a specification gap between the stated goals of data transparency and the actual disclosures necessary to achieve such goals. Second, reform attempts exhibit an enforcement gap between required disclosures on paper and enforcement to ensure compliance in fact. Third, policy proposals manifest an impact gap between disclosed information and meaningful changes in developer practices and public understanding. Informed by the social science on transparency, our analysis identifies affirmative paths for transparency that are effective rather than merely symbolic.

Unheard in the Digital Age: Rethinking AI Bias and Speech Diversity

arXiv:2601.18641v1 Announce Type: cross Abstract: Speech remains one of the most visible yet overlooked vectors of inclusion and exclusion in contemporary society. While fluency is often equated with credibility and competence, individuals with atypical speech patterns are routinely marginalized. Given the current state of the debate, this article focuses on the structural biases that shape perceptions of atypical speech and are now being encoded into artificial intelligence. Automated speech recognition (ASR) systems and voice interfaces, trained predominantly on standardized speech, routinely fail to recognize or respond to diverse voices, compounding digital exclusion. As AI technologies increasingly mediate access to opportunity, the study calls for inclusive technological design, anti-bias training to minimize the impact of discriminatory algorithmic decisions, and enforceable policy reform that explicitly recognize speech diversity as a matter of equity, not merely accessibility. Drawing on interdisciplinary research, the article advocates for a cultural and institutional shift in how we value voice, urging co-created solutions that elevate the rights, representation, and realities of atypical speakers in the digital age. Ultimately, the article reframes speech inclusion as a matter of equity (not accommodation) and advocates for co-created AI systems that reflect the full spectrum of human voices.

Learning temporal embeddings from electronic health records of chronic kidney disease patients

arXiv:2601.18675v1 Announce Type: cross Abstract: We investigate whether temporal embedding models trained on longitudinal electronic health records can learn clinically meaningful representations without compromising predictive performance, and how architectural choices affect embedding quality. Model-guided medicine requires representations that capture disease dynamics while remaining transparent and task agnostic, whereas most clinical prediction models are optimised for a single task. Representation learning facilitates learning embeddings that generalise across downstream tasks, and recurrent architectures are well-suited for modelling temporal structure in observational clinical data. Using the MIMIC-IV dataset, we study patients with chronic kidney disease (CKD) and compare three recurrent architectures: a vanilla LSTM, an attention-augmented LSTM, and a time-aware LSTM (T-LSTM). All models are trained both as embedding models and as direct end-to-end predictors. Embedding quality is evaluated via CKD stage clustering and in-ICU mortality prediction. The T-LSTM produces more structured embeddings, achieving a lower Davies-Bouldin Index (DBI = 9.91) and higher CKD stage classification accuracy (0.74) than the vanilla LSTM (DBI = 15.85, accuracy = 0.63) and attention-augmented LSTM (DBI = 20.72, accuracy = 0.67). For in-ICU mortality prediction, embedding models consistently outperform end-to-end predictors, improving accuracy from 0.72-0.75 to 0.82-0.83, which indicates that learning embeddings as an intermediate step is more effective than direct end-to-end learning.

Computational Phenomenology of Borderline Personality Disorder: A Comparative Evaluation of LLM-Simulated Expert Personas and Human Clinical Experts

arXiv:2508.19008v2 Announce Type: replace Abstract: Building on a human-led thematic analysis of life-story interviews with inpatients with Borderline Personality Disorder, this study examines the capacity of large language models (OpenAI's GPT, Google's Gemini, and Anthropic's Claude) to support qualitative clinical analysis. The models were evaluated through a mixed procedure. Study A involved blinded and non-blinded expert judges in phenomenology and clinical psychology. Assessments included semantic congruence, Jaccard coefficients for overlap of outputs, multidimensional validity ratings of credibility, coherence, and the substantiveness of results, and their grounding in qualitative data. In Study B, neural methods were used to embed the theme descriptions created by humans and the models in a two-dimensional vector space to provide a computational measure of the difference between human and model semantics and linguistic style. In Study C, complementary non-expert evaluations were conducted to examine the influence of thematic verbosity on the perception of human authorship and content validity. Results of all three studies revealed variable overlap with the human analysis, with models being partly indistinguishable from, and also identifying themes originally omitted by, human researchers. The findings highlight both the variability and potential of AI-augmented thematic qualitative analysis to mitigate human interpretative bias and enhance sensitivity.

MEDIC: Comprehensive Evaluation of Leading Indicators for LLM Safety and Utility in Clinical Applications

arXiv:2409.07314v2 Announce Type: replace-cross Abstract: While Large Language Models (LLMs) achieve superhuman performance on standardized medical licensing exams, these static benchmarks have become saturated and increasingly disconnected from the functional requirements of clinical workflows. To bridge the gap between theoretical capability and verified utility, we introduce MEDIC, a comprehensive evaluation framework establishing leading indicators across various clinical dimensions. Beyond standard question-answering, we assess operational capabilities using deterministic execution protocols and a novel Cross-Examination Framework (CEF), which quantifies information fidelity and hallucination rates without reliance on reference texts. Our evaluation across a heterogeneous task suite exposes critical performance trade-offs: we identify a significant knowledge-execution gap, where proficiency in static retrieval does not predict success in operational tasks such as clinical calculation or SQL generation. Furthermore, we observe a divergence between passive safety (refusal) and active safety (error detection), revealing that models fine-tuned for high refusal rates often fail to reliably audit clinical documentation for factual accuracy. These findings demonstrate that no single architecture dominates across all dimensions, highlighting the necessity of a portfolio approach to clinical model deployment. As part of this investigation, we released a public leaderboard on Hugging Face.\footnote{https://huggingface.co/spaces/m42-health/MEDIC-Benchmark}

Pretrain Value, Not Reward: Decoupled Value Policy Optimization

arXiv:2502.16944v2 Announce Type: replace-cross Abstract: In this paper, we explore how directly pretraining a value model simplifies and stabilizes reinforcement learning from human feedback (RLHF). In reinforcement learning, value estimation is the key to policy optimization, distinct from reward supervision. The value function predicts the \emph{return-to-go} of a partial answer, that is, how promising the partial answer is if it were continued to completion. In RLHF, however, the standard pipeline first pretrains a reward model and then learns a value function online, even though no new reward signals are available once preference data is collected. This makes critic learning redundant, as the process of training a reward model and then deriving a value model is informationally equivalent to directly pretraining a value model. Importantly, this requires no additional supervision, and our value model is trained on exactly the same data used for reward modeling. Building on this insight, we introduce \emph{Decoupled Value Policy Optimization} (DVPO), a framework that pretrains a \emph{Global Value Model} (GVM) offline and freezes it as a universal critic for policy learning. The GVM provides stable, fine-grained credit assignment without critic drift or trajectory sampling. Experiments across MT-Bench, Alpaca-Eval, and Arena-Hard demonstrate that DVPO matches or surpasses state-of-the-art RLHF methods. These results highlight RLHF can be reframed as policy-only optimization guided by a single pretrained value model.

uPVC-Net: A Universal Premature Ventricular Contraction Detection Deep Learning Algorithm

arXiv:2506.11238v2 Announce Type: replace-cross Abstract: Introduction: Premature Ventricular Contractions (PVCs) are common cardiac arrhythmias originating from the ventricles. Accurate detection remains challenging due to variability in electrocardiogram (ECG) waveforms caused by differences in lead placement, recording conditions, and population demographics. Methods: We developed uPVC-Net, a universal deep learning model to detect PVCs from any single-lead ECG recordings. The model is developed on four independent ECG datasets comprising a total of 8.3 million beats collected from Holter monitors and a modern wearable ECG patch. uPVC-Net employs a custom architecture and a multi-source, multi-lead training strategy. For each experiment, one dataset is held out to evaluate out-of-distribution (OOD) generalization. Results: uPVC-Net achieved an AUC between 97.8% and 99.1% on the held-out datasets. Notably, performance on wearable single-lead ECG data reached an AUC of 99.1%. Conclusion: uPVC-Net exhibits strong generalization across diverse lead configurations and populations, highlighting its potential for robust, real-world clinical deployment.

On the Fundamental Limits of LLMs at Scale

arXiv:2511.12869v2 Announce Type: replace-cross Abstract: Large Language Models (LLMs) have benefited enormously from scaling, yet these gains are bounded by five fundamental limitations: (1) hallucination, (2) context compression, (3) reasoning degradation, (4) retrieval fragility, and (5) multimodal misalignment. While existing surveys describe these phenomena empirically, they lack a rigorous theoretical synthesis connecting them to the foundational limits of computation, information, and learning. This work closes that gap by presenting a unified, proof-informed framework that formalizes the innate theoretical ceilings of LLM scaling. First, computability and uncomputability imply an irreducible residue of error: for any computably enumerable model family, diagonalization guarantees inputs on which some model must fail, and undecidable queries (e.g., halting-style tasks) induce infinite failure sets for all computable predictors. Second, information-theoretic and statistical constraints bound attainable accuracy even on decidable tasks, finite description length enforces compression error, and long-tail factual knowledge requires prohibitive sample complexity. Third, geometric and computational effects compress long contexts far below their nominal size due to positional under-training, encoding attenuation, and softmax crowding. We further show how likelihood-based training favors pattern completion over inference, how retrieval under token limits suffers from semantic drift and coupling noise, and how multimodal scaling inherits shallow cross-modal alignment. Across sections, we pair theorems and empirical evidence to outline where scaling helps, where it saturates, and where it cannot progress, providing both theoretical foundations and practical mitigation paths like bounded-oracle retrieval, positional curricula, and sparse or hierarchical attention.

Empowering LLMs for Structure-Based Drug Design via Exploration-Augmented Latent Inference

arXiv:2601.15333v2 Announce Type: replace-cross Abstract: Large Language Models (LLMs) possess strong representation and reasoning capabilities, but their application to structure-based drug design (SBDD) is limited by insufficient understanding of protein structures and unpredictable molecular generation. To address these challenges, we propose Exploration-Augmented Latent Inference for LLMs (ELILLM), a framework that reinterprets the LLM generation process as an encoding, latent space exploration, and decoding workflow. ELILLM explicitly explores portions of the design problem beyond the model's current knowledge while using a decoding module to handle familiar regions, generating chemically valid and synthetically reasonable molecules. In our implementation, Bayesian optimization guides the systematic exploration of latent embeddings, and a position-aware surrogate model efficiently predicts binding affinity distributions to inform the search. Knowledge-guided decoding further reduces randomness and effectively imposes chemical validity constraints. We demonstrate ELILLM on the CrossDocked2020 benchmark, showing strong controlled exploration and high binding affinity scores compared with seven baseline methods. These results demonstrate that ELILLM can effectively enhance LLMs capabilities for SBDD.

Multimodal digital biopsy for preoperative prediction of occult peritoneal metastasis in gastric cancer

npj Digital Medicine, Published online: 26 January 2026; doi:10.1038/s41746-025-02268-9

Multimodal digital biopsy for preoperative prediction of occult peritoneal metastasis in gastric cancer

Feasibility, Acceptability, and Perspectives Regarding the Use of Activity Tracking Wearable Devices Among Home Health Aides: Mixed Methods Study

Background: Home health aides and attendants (HHAs) provide in-home care to the growing population of older adults who want to age in place. Despite their vital role in patient care, HHAs are an underserved and vulnerable population of health care professionals who often experience poor health themselves. Activity tracking devices offer a promising way to improve HHAs’ health-related awareness and promote health behavior change, particularly regarding physical activity and sleep quality, 2 areas in which the workforce struggles. Objective: This study aimed to understand how feasible it is for HHAs to use activity tracking devices and assess their perceptions of such devices for improving their health. Specifically, we conducted (1) a field study to assess the use, feasibility, and acceptability of these devices among HHAs and (2) a qualitative study to understand HHAs’ perspectives on and reactions to activity trackers on and off the job. Methods: We partnered with the 1199 Service Employees International Union Training and Employment Fund to conduct a field study with home care agency–employed HHAs working in New York City, New York. Participants wore activity tracking devices for 4 weeks that collected data on physical activity and sleep. The HHAs were subsequently interviewed on their experiences with and attitudes toward the devices and asked to reflect on personalized visualizations of their data to prompt them to think aloud. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using grounded theory. Results: A total of 17 HHAs participated; their mean age was 48.7 (SD 12.2) years, 15 (88%) were women, 11 (65%) identified as Black, 5 (29%) identified as Hispanic or Latinx, and they had worked as HHAs for a mean of 11.7 (SD 7.5) years. In total, 94% (n=16) of the HHAs wore their activity trackers for the full 28-day study period. Participants took a mean of 10,230 (SD 3586) daily steps during the study period and slept for a mean of 6.27 (SD 0.58) hours per night. Overall, 4 key themes emerged: (1) activity tracking devices enhanced participants’ health awareness by providing empirical data for self-reflection; (2) this increased awareness led to positive behavior changes, including setting and achieving health-related goals; (3) HHAs believed that these devices could improve not only their own health but also that of their patients through positive behavior changes; and (4) despite this optimism, participants emphasized that their ability to modify sleep and activity patterns was constrained by social and occupational determinants, with sleep improvements being particularly challenging. Conclusions: Our findings suggest that appropriately designed personal tracking interventions could offer a promising approach to supporting positive health-related changes in this historically overlooked workforce, potentially improving their well-being and the quality of care they provide to their patients.

Article: Virtual Panel - AI in the Trenches: How Developers Are Rewriting the Software Process

This virtual panel brings together engineers, architects, and technical leaders to explore how AI is changing the landscape of software development. Practitioners share their insights on successes and failures when AI is incorporated into daily workflows, emphasizing the significance of context, validation, and cultural adaptation in making AI a sustainable element of modern engineering practices.

By Arthur Casals, Mariia Bulycheva, May Walter, Phil Calçado, Andreas Kollegger

PyHealth 2.0: A Comprehensive Open-Source Toolkit for Accessible and Reproducible Clinical Deep Learning

arXiv:2601.16414v1 Announce Type: cross Abstract: Difficulty replicating baselines, high computational costs, and required domain expertise create persistent barriers to clinical AI research. To address these challenges, we introduce PyHealth 2.0, an enhanced clinical deep learning toolkit that enables predictive modeling in as few as 7 lines of code. PyHealth 2.0 offers three key contributions: (1) a comprehensive toolkit addressing reproducibility and compatibility challenges by unifying 15+ datasets, 20+ clinical tasks, 25+ models, 5+ interpretability methods, and uncertainty quantification including conformal prediction within a single framework that supports diverse clinical data modalities - signals, imaging, and electronic health records - with translation of 5+ medical coding standards; (2) accessibility-focused design accommodating multimodal data and diverse computational resources with up to 39x faster processing and 20x lower memory usage, enabling work from 16GB laptops to production systems; and (3) an active open-source community of 400+ members lowering domain expertise barriers through extensive documentation, reproducible research contributions, and collaborations with academic health systems and industry partners, including multi-language support via RHealth. PyHealth 2.0 establishes an open-source foundation and community advancing accessible, reproducible healthcare AI. Available at pip install pyhealth.

DeepEra: A Deep Evidence Reranking Agent for Scientific Retrieval-Augmented Generated Question Answering

arXiv:2601.16478v1 Announce Type: cross Abstract: With the rapid growth of scientific literature, scientific question answering (SciQA) has become increasingly critical for exploring and utilizing scientific knowledge. Retrieval-Augmented Generation (RAG) enhances LLMs by incorporating knowledge from external sources, thereby providing credible evidence for scientific question answering. But existing retrieval and reranking methods remain vulnerable to passages that are semantically similar but logically irrelevant, often reducing factual reliability and amplifying hallucinations.To address this challenge, we propose a Deep Evidence Reranking Agent (DeepEra) that integrates step-by-step reasoning, enabling more precise evaluation of candidate passages beyond surface-level semantics. To support systematic evaluation, we construct SciRAG-SSLI (Scientific RAG - Semantically Similar but Logically Irrelevant), a large-scale dataset comprising about 300K SciQA instances across 10 subjects, constructed from 10M scientific corpus. The dataset combines naturally retrieved contexts with systematically generated distractors to test logical robustness and factual grounding. Comprehensive evaluations confirm that our approach achieves superior retrieval performance compared to leading rerankers. To our knowledge, this work is the first to comprehensively study and empirically validate innegligible SSLI issues in two-stage RAG frameworks.

Evaluating Large Vision-language Models for Surgical Tool Detection

arXiv:2601.16895v1 Announce Type: cross Abstract: Surgery is a highly complex process, and artificial intelligence has emerged as a transformative force in supporting surgical guidance and decision-making. However, the unimodal nature of most current AI systems limits their ability to achieve a holistic understanding of surgical workflows. This highlights the need for general-purpose surgical AI systems capable of comprehensively modeling the interrelated components of surgical scenes. Recent advances in large vision-language models that integrate multimodal data processing offer strong potential for modeling surgical tasks and providing human-like scene reasoning and understanding. Despite their promise, systematic investigations of VLMs in surgical applications remain limited. In this study, we evaluate the effectiveness of large VLMs for the fundamental surgical vision task of detecting surgical tools. Specifically, we investigate three state-of-the-art VLMs, Qwen2.5, LLaVA1.5, and InternVL3.5, on the GraSP robotic surgery dataset under both zero-shot and parameter-efficient LoRA fine-tuning settings. Our results demonstrate that Qwen2.5 consistently achieves superior detection performance in both configurations among the evaluated VLMs. Furthermore, compared with the open-set detection baseline Grounding DINO, Qwen2.5 exhibits stronger zero-shot generalization and comparable fine-tuned performance. Notably, Qwen2.5 shows superior instrument recognition, while Grounding DINO demonstrates stronger localization.

Advances in Artificial Intelligence: A Review for the Creative Industries

arXiv:2501.02725v5 Announce Type: replace Abstract: Artificial intelligence (AI) has undergone transformative advances since 2022, particularly through generative AI, large language models (LLMs), and diffusion models, fundamentally reshaping the creative industries. However, existing reviews have not comprehensively addressed these recent breakthroughs and their integrated impact across the creative production pipeline. This paper addresses this gap by providing a systematic review of AI technologies that have emerged or matured since our 2022 review, examining their applications across content creation, information analysis, post-production enhancement, compression, and quality assessment. We document how transformers, LLMs, diffusion models, and implicit neural representations have established new capabilities in text-to-image/video generation, real-time 3D reconstruction, and unified multi-task frameworks-shifting AI from support tool to core creative technology. Beyond technological advances, we analyze the trend toward unified AI frameworks that integrate multiple creative tasks, replacing task-specific solutions. We critically examine the evolving role of human-AI collaboration, where human oversight remains essential for creative direction and mitigating AI hallucinations. Finally, we identify emerging challenges including copyright concerns, bias mitigation, computational demands, and the need for robust regulatory frameworks. This review provides researchers and practitioners with a comprehensive understanding of current AI capabilities, limitations, and future trajectories in creative applications.

EmbedAgent: Benchmarking Large Language Models in Embedded System Development

arXiv:2506.11003v3 Announce Type: replace-cross Abstract: Large Language Models (LLMs) have shown promise in various tasks, yet few benchmarks assess their capabilities in embedded system development. In this paper, we introduce EmbedAgent, a paradigm designed to simulate real-world roles in embedded system development, such as Embedded System Programmer, Architect, and Integrator. This paradigm enables LLMs to be tested in tasks that bridge the gap between digital and physical systems, allowing for a more comprehensive assessment of their capabilities. To evaluate LLMs on these tasks, we propose Embedbench, the first comprehensive benchmark for embedded system programming, circuit design, and cross-platform migration. Embedbench consists of 126 cases, covering 9 electronic components across 3 hardware platforms. Through extensive experiments on 10 mainstream LLMs, we uncover several key findings. Surprisingly, despite the simplicity of the cases, DeepSeek-R1 achieves only a 55.6% pass@1 rate when provided with schematic information, and 50.0% when tasked with generating the schematics itself. In the cross-platform migration tasks, LLMs show relatively strong performance with MicroPython on the Raspberry Pi Pico (with the top model achieving 73.8% pass@1), but perform poorly on ESP-IDF, where the best model reaches only 29.4% pass@1. Interestingly, we observe that general-purpose chat LLMs like DeepSeek-V3 often fail to utilize relevant pre-trained knowledge in this domain, while reasoning LLMs tend to overthink and overlook efficient knowledge during pretraining. Based on these insights, we propose two strategies: retrieval augmented generation and compiler feedback-to enhance LLM performance. These strategies result in significant improvements, with Deepseek-R1 reaching a 65.1% pass@1 with correct schematics, and 53.1% without. Additionally, the accuracy of the Arduino to ESP32 migration task improves from 21.4% to 27.8%.
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