arXiv:2511.22935v2 Announce Type: replace-cross Abstract: Electrocardiogram (ECG) analysis plays a vital role in the early detection, monitoring, and management of various cardiovascular conditions. While existing models have achieved notable success in ECG interpretation, they fail to leverage the interrelated nature of various cardiac abnormalities. Conversely, developing a specific model capable of extracting all relevant features for multiple ECG tasks remains a significant challenge. Large-scale foundation models, though powerful, are not typically pretrained on ECG data, making full re-training or fine-tuning computationally expensive. To address these challenges, we propose EnECG(Mixture of Experts-based Ensemble Learning for ECG Multi-tasks), an ensemble-based framework that integrates multiple specialized foundation models, each excelling in different aspects of ECG interpretation. Instead of relying on a single model or single task, EnECG leverages the strengths of multiple specialized models to tackle a variety of ECG-based tasks. To mitigate the high computational cost of full re-training or fine-tuning, we introduce a lightweight adaptation strategy: attaching dedicated output layers to each foundation model and applying Low-Rank Adaptation (LoRA) only to these newly added parameters. We then adopt a Mixture of Experts (MoE) mechanism to learn ensemble weights, effectively combining the complementary expertise of individual models. Our experimental results demonstrate that by minimizing the scope of fine-tuning, EnECG can help reduce computational and memory costs while maintaining the strong representational power of foundation models. This framework not only enhances feature extraction and predictive performance but also ensures practical efficiency for real-world clinical applications. The code is available at https://github.com/yuhaoxu99/EnECG.git.

arXiv:2603.02434v1 Announce Type: cross Abstract: Reliable Alzheimer's disease (AD) diagnosis increasingly relies on multimodal assessments combining structural Magnetic Resonance Imaging (MRI) and Electronic Health Records (EHR). However, deploying these models is bottlenecked by modality missingness, as MRI scans are expensive and frequently unavailable in many patient cohorts. Furthermore, synthesizing de novo 3D anatomical scans from sparse, high-dimensional tabular records is technically challenging and poses severe clinical risks. To address this, we introduce MIRAGE, a novel framework that reframes the missing-MRI problem as an anatomy-guided cross-modal latent distillation task. First, MIRAGE leverages a Biomedical Knowledge Graph (KG) and Graph Attention Networks to map heterogeneous EHR variables into a unified embedding space that can be propagated from cohorts with real MRIs to cohorts without them. To bridge the semantic gap and enforce physical spatial awareness, we employ a frozen pre-trained 3D U-Net decoder strictly as an auxiliary regularization engine. Supported by a novel cohort-aggregated skip feature compensation strategy, this decoder acts as a rigorous structural penalty, forcing 1D latent representations to encode biologically plausible, macro-level pathological semantics. By exclusively utilizing this distilled "diagnostic-surrogate" representation during inference, MIRAGE completely bypasses computationally expensive 3D voxel reconstruction. Experiments demonstrate that our framework successfully bridges the missing-modality gap, improving the AD classification rate by 13% compared to unimodal baselines in cohorts without real MRIs.

arXiv:2602.18650v1 Announce Type: cross Abstract: Personalized nutrition intervention for patients with multimorbidity is critical for improving health outcomes, yet remains challenging because it requires the simultaneous integration of heterogeneous clinical conditions, medications, and dietary guidelines. Single-agent large language models (LLMs) often suffer from context overload and attention dilution when processing such high-dimensional patient profiles. We introduce NutriOrion, a hierarchical multi-agent framework with a parallel-then-sequential reasoning topology. NutriOrion decomposes nutrition planning into specialized domain agents with isolated contexts to mitigate anchoring bias, followed by a conditional refinement stage. The framework includes a multi-objective prioritization algorithm to resolve conflicting dietary requirements and a safety constraint mechanism that injects pharmacological contraindications as hard negative constraints during synthesis, ensuring clinical validity by construction rather than post-hoc filtering. For clinical interoperability, NutriOrion maps synthesized insights into the ADIME standard and FHIR R4 resources. Evaluated on 330 stroke patients with multimorbidity, NutriOrion outperforms multiple baselines, including GPT-4.1 and alternative multi-agent architectures. It achieves a 12.1 percent drug-food interaction violation rate, demonstrates strong personalization with negative correlations (-0.26 to -0.35) between patient biomarkers and recommended risk nutrients, and yields clinically meaningful dietary improvements, including a 167 percent increase in fiber and a 27 percent increase in potassium, alongside reductions in sodium (9 percent) and sugars (12 percent).

arXiv:2510.23038v2 Announce Type: replace-cross Abstract: Large Language Models (LLMs) are widely used as judges to evaluate response quality, providing a scalable alternative to human evaluation. However, most LLM judges operate solely on intrinsic text-based reasoning, limiting their ability to verify complex constraints or perform accurate computation. Motivated by the success of tool-integrated reasoning (TIR) in numerous tasks, we propose TIR-Judge, an end-to-end RL framework for training LLM judges that integrates a code executor for precise evaluation. TIR-Judge is built on three principles: (i) diverse training across verifiable and non-verifiable domains, (ii) flexible judgment formats (pointwise, pairwise, listwise), and (iii) iterative RL that bootstraps directly from the initial model without distillation. On seven public benchmarks, TIR-Judge surpasses strong reasoning-based judges by up to 6.4% (pointwise) and 7.7% (pairwise), and achieves listwise performance comparable to Claude-Opus-4 despite having only 8B parameters. Remarkably, TIR-Judge-Zero - trained entirely without distilled judge trajectories, matches the performance of distilled variants, demonstrating that tool-augmented judges can self-evolve through iterative reinforcement learning.