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Combining International Standards to Develop Clinical Decision Support for Parent Smoking Cessation in Pediatrics

Smoking has severe health consequences, and secondhand smoke (SHS) exposure among children increases the risk of sudden infant death syndrome, chronic respiratory diseases, such as asthma, and lung cancer in adulthood. For many parents, pediatricians are the primary source of interaction with the healthcare system. Nevertheless, in pediatric settings, appropriate tobacco treatments are rarely, if ever, provided to parents who smoke. To best address tobacco use among parents, it is ideal to develop scalable solutions that are coordinated across health systems, community partners, and national services within pediatric settings. We describe our experience developing and implementing a parent tobacco treatment platform (PTTP) within a pediatric institution that leverages multiple international standards to support interoperability, with the overarching goal of providing a model for how such work can be approached. The clinical decision support (CDS) system includes clinician- and patient-facing components, connects parents to three different treatment options (nicotine replacement therapy, text-based counseling, and telephonic counseling), and incorporates three international standards (Fast Healthcare Interoperability Resources [FHIR], SMART on FHIR, and CDS Hooks). FHIR is used across all components. SMART on FHIR is limited to the clinician-facing tool, and CDS Hooks is used in the patient-facing portion. While healthcare interoperability standards supported a significant portion of the overall system, non-standard technologies and enhancements of existing standards were also required. Further, no connections with community partners could use existing interoperability standards. Over one year, the CDS was used in 194,946 visits, identified 7,847 parents who smoke, and connected 2,954 parents to 6,320 distinct treatment services, a significant improvement compared to prior efforts. Our project demonstrates that building CDS systems using international standards, such as SMART on FHIR, FHIR, and CDS Hooks, is possible, but challenges remain. Limits in the CDS Hooks standard to support common workflows and a lack of communication standards used by 3rd parties outside the healthcare system represent areas for future work. To support these requirements, additional EHR-specific records and communication mechanisms were required.
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Key Features of Digital Phenotyping for Monitoring Mental Disorders: Systematic Review

Background: The COVID-19 pandemic has intensified mental health issues globally, highlighting the urgent need for remote mental health monitoring. Digital phenotyping using smart devices has emerged as a promising approach, but it remains unclear which features are essential for predicting depression and anxiety. Objective: This systematic review aimed to identify the types of features collected through smart packages—integrated systems combining smartphones with wearable devices such as Actiwatches, smartbands, and smartwatches—and to determine which features should be considered essential for mental health monitoring based on the type of device used. Methods: A systematic review was conducted. Searches were performed across Web of Science, PubMed, and Scopus on February 5, 2025. Inclusion criteria comprised quantitative studies involving adults (≥19 years) using smart devices to predict depression or anxiety based on passive data collection. Studies focusing solely on smartphones or qualitative designs were excluded. Risk of bias was assessed using the Mixed Methods Appraisal Tool and Quality Criteria Checklist. Data were synthesized descriptively, and the relative contribution of each feature was further assessed by calculating coverage (proportion of studies using a feature) and importance among used (proportion identifying it as important when used). These metrics were visualized in quadrant-based scatter plots to identify consistently important features across devices. Results: From 1,382 records, 22 studies across 11 countries were included. The overall synthesis identified a core feature package—accelerometer (ACC), steps, Heart Rate (HR), and sleep. Device-specific analyses revealed further nuances: In Actiwatch studies, ACC and activity were consistently important, but sleep features were rarely examined. In smartbands, HR, steps, sleep, and phone usage were essential, while Global Positioning System (GPS), Electrodermal Activity (EDA), and skin temperature (TEMP) showed high importance when used, suggesting opportunities for broader adoption. In smartwatch studies, sleep and HR emerged as core features, whereas steps and ACC were widely used but often not identified as important. Conclusions: This systematic review identified a core feature package comprising ACC, steps, HR, and sleep that consistently contributes to mood disorder prediction across devices. At the same time, device-specific differences were observed: Actiwatch studies mainly emphasized ACC and activity but underutilized sleep features; smartbands highlighted HR, steps, sleep, and phone usage, with EDA, TEMP, and GPS showing additional promise; and smartwatches most reliably leveraged sleep and HR, while steps and ACC were widely used yet less effective. These findings suggest that while a shared core set of features exists, optimizing digital phenotyping requires tailoring feature selection to the characteristics of each device type. To advance this field, improving data accessibility, particularly in smartwatch ecosystems, and adopting standardized reporting frameworks will be essential to enhance comparability, reproducibility, and future meta-analytic integration. Clinical Trial: Open Science Framework https://osf.io/nz7k8
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A multimodal whole-slide foundation model for pathology

Nature Medicine, Published online: 05 November 2025; doi:10.1038/s41591-025-03982-3

Pretrained using 335,645 whole-slide images, a foundation model is developed to provide representations for slide- and patient-level tasks. It is capable of performing clinical tasks and generating reports even in data-scarce scenarios, such as rare cancer diagnosis and survival prediction, without requiring further fine-tuning.
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Fair human-centric image dataset for ethical AI benchmarking

Nature, Published online: 05 November 2025; doi:10.1038/s41586-025-09716-2

The Fair Human-Centric Image Benchmark (FHIBE, pronounced ‘Feebee’)—an image dataset that implements best practices for consent, privacy, compensation, safety, diversity and utility—can be used responsibly as a fairness evaluation dataset for many human-centric computer vision applications.
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AI Diffusion in Low Resource Language Countries

arXiv:2511.02752v1 Announce Type: cross Abstract: Artificial intelligence (AI) is diffusing globally at unprecedented speed, but adoption remains uneven. Frontier Large Language Models (LLMs) are known to perform poorly on low-resource languages due to data scarcity. We hypothesize that this performance deficit reduces the utility of AI, thereby slowing adoption in Low-Resource Language Countries (LRLCs). To test this, we use a weighted regression model to isolate the language effect from socioeconomic and demographic factors, finding that LRLCs have a share of AI users that is approximately 20% lower relative to their baseline. These results indicate that linguistic accessibility is a significant, independent barrier to equitable AI diffusion.
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MemSearcher: Training LLMs to Reason, Search and Manage Memory via End-to-End Reinforcement Learning

arXiv:2511.02805v1 Announce Type: cross Abstract: Typical search agents concatenate the entire interaction history into the LLM context, preserving information integrity but producing long, noisy contexts, resulting in high computation and memory costs. In contrast, using only the current turn avoids this overhead but discards essential information. This trade-off limits the scalability of search agents. To address this challenge, we propose MemSearcher, an agent workflow that iteratively maintains a compact memory and combines the current turn with it. At each turn, MemSearcher fuses the user's question with the memory to generate reasoning traces, perform search actions, and update memory to retain only information essential for solving the task. This design stabilizes context length across multi-turn interactions, improving efficiency without sacrificing accuracy. To optimize this workflow, we introduce multi-context GRPO, an end-to-end RL framework that jointly optimize reasoning, search strategies, and memory management of MemSearcher Agents. Specifically, multi-context GRPO samples groups of trajectories under different contexts and propagates trajectory-level advantages across all conversations within them. Trained on the same dataset as Search-R1, MemSearcher achieves significant improvements over strong baselines on seven public benchmarks: +11% on Qwen2.5-3B-Instruct and +12% on Qwen2.5-7B-Instruct relative average gains. Notably, the 3B-based MemSearcher even outperforms 7B-based baselines, demonstrating that striking a balance between information integrity and efficiency yields both higher accuracy and lower computational overhead. The code and models will be publicly available at https://github.com/icip-cas/MemSearcher
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How can we assess human-agent interactions? Case studies in software agent design

arXiv:2510.09801v2 Announce Type: replace Abstract: LLM-powered agents are both a promising new technology and a source of complexity, where choices about models, tools, and prompting can affect their usefulness. While numerous benchmarks measure agent accuracy across domains, they mostly assume full automation, failing to represent the collaborative nature of real-world use cases. In this paper, we make two major steps towards the rigorous assessment of human-agent interactions. First, we propose PULSE, a framework for more efficient human-centric evaluation of agent designs, which comprises collecting user feedback, training an ML model to predict user satisfaction, and computing results by combining human satisfaction ratings with model-generated pseudo-labels. Second, we deploy the framework on a large-scale web platform built around the open-source software agent OpenHands, collecting in-the-wild usage data across over 15k users. We conduct case studies around how three agent design decisions -- choice of LLM backbone, planning strategy, and memory mechanisms -- impact developer satisfaction rates, yielding practical insights for software agent design. We also show how our framework can lead to more robust conclusions about agent design, reducing confidence intervals by 40% compared to a standard A/B test. Finally, we find substantial discrepancies between in-the-wild results and benchmark performance (e.g., the anti-correlation between results comparing claude-sonnet-4 and gpt-5), underscoring the limitations of benchmark-driven evaluation. Our findings provide guidance for evaluations of LLM agents with humans and identify opportunities for better agent designs.
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From Passive to Proactive: A Multi-Agent System with Dynamic Task Orchestration for Intelligent Medical Pre-Consultation

arXiv:2511.01445v1 Announce Type: new Abstract: Global healthcare systems face critical challenges from increasing patient volumes and limited consultation times, with primary care visits averaging under 5 minutes in many countries. While pre-consultation processes encompassing triage and structured history-taking offer potential solutions, they remain limited by passive interaction paradigms and context management challenges in existing AI systems. This study introduces a hierarchical multi-agent framework that transforms passive medical AI systems into proactive inquiry agents through autonomous task orchestration. We developed an eight-agent architecture with centralized control mechanisms that decomposes pre-consultation into four primary tasks: Triage ($T_1$), History of Present Illness collection ($T_2$), Past History collection ($T_3$), and Chief Complaint generation ($T_4$), with $T_1$--$T_3$ further divided into 13 domain-specific subtasks. Evaluated on 1,372 validated electronic health records from a Chinese medical platform across multiple foundation models (GPT-OSS 20B, Qwen3-8B, Phi4-14B), the framework achieved 87.0% accuracy for primary department triage and 80.5% for secondary department classification, with task completion rates reaching 98.2% using agent-driven scheduling versus 93.1% with sequential processing. Clinical quality scores from 18 physicians averaged 4.56 for Chief Complaints, 4.48 for History of Present Illness, and 4.69 for Past History on a 5-point scale, with consultations completed within 12.7 rounds for $T_2$ and 16.9 rounds for $T_3$. The model-agnostic architecture maintained high performance across different foundation models while preserving data privacy through local deployment, demonstrating the potential for autonomous AI systems to enhance pre-consultation efficiency and quality in clinical settings.
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Digital Twin based Automatic Reconfiguration of Robotic Systems in Smart Environments

arXiv:2511.00094v1 Announce Type: cross Abstract: Robotic systems have become integral to smart environments, enabling applications ranging from urban surveillance and automated agriculture to industrial automation. However, their effective operation in dynamic settings - such as smart cities and precision farming - is challenged by continuously evolving topographies and environmental conditions. Traditional control systems often struggle to adapt quickly, leading to inefficiencies or operational failures. To address this limitation, we propose a novel framework for autonomous and dynamic reconfiguration of robotic controllers using Digital Twin technology. Our approach leverages a virtual replica of the robot's operational environment to simulate and optimize movement trajectories in response to real-world changes. By recalculating paths and control parameters in the Digital Twin and deploying the updated code to the physical robot, our method ensures rapid and reliable adaptation without manual intervention. This work advances the integration of Digital Twins in robotics, offering a scalable solution for enhancing autonomy in smart, dynamic environments.
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Diffusion Models at the Drug Discovery Frontier: A Review on Generating Small Molecules versus Therapeutic Peptides

arXiv:2511.00209v1 Announce Type: cross Abstract: Diffusion models have emerged as a leading framework in generative modeling, showing significant potential to accelerate and transform the traditionally slow and costly process of drug discovery. This review provides a systematic comparison of their application in designing two principal therapeutic modalities: small molecules and therapeutic peptides. We analyze how a unified framework of iterative denoising is adapted to the distinct molecular representations, chemical spaces, and design objectives of each modality. For small molecules, these models excel at structure-based design, generating novel, pocket-fitting ligands with desired physicochemical properties, yet face the critical hurdle of ensuring chemical synthesizability. Conversely, for therapeutic peptides, the focus shifts to generating functional sequences and designing de novo structures, where the primary challenges are achieving biological stability against proteolysis, ensuring proper folding, and minimizing immunogenicity. Despite these distinct challenges, both domains face shared hurdles: the need for more accurate scoring functions, the scarcity of high-quality experimental data, and the crucial requirement for experimental validation. We conclude that the full potential of diffusion models will be unlocked by bridging these modality-specific gaps and integrating them into automated, closed-loop Design-Build-Test-Learn (DBTL) platforms, thereby shifting the paradigm from chemical exploration to the targeted creation of novel therapeutics.
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Diagnosing Hallucination Risk in AI Surgical Decision-Support: A Sequential Framework for Sequential Validation

arXiv:2511.00588v1 Announce Type: cross Abstract: Large language models (LLMs) offer transformative potential for clinical decision support in spine surgery but pose significant risks through hallucinations, which are factually inconsistent or contextually misaligned outputs that may compromise patient safety. This study introduces a clinician-centered framework to quantify hallucination risks by evaluating diagnostic precision, recommendation quality, reasoning robustness, output coherence, and knowledge alignment. We assessed six leading LLMs across 30 expert-validated spinal cases. DeepSeek-R1 demonstrated superior overall performance (total score: 86.03 $\pm$ 2.08), particularly in high-stakes domains such as trauma and infection. A critical finding reveals that reasoning-enhanced model variants did not uniformly outperform standard counterparts: Claude-3.7-Sonnet's extended thinking mode underperformed relative to its standard version (80.79 $\pm$ 1.83 vs. 81.56 $\pm$ 1.92), indicating extended chain-of-thought reasoning alone is insufficient for clinical reliability. Multidimensional stress-testing exposed model-specific vulnerabilities, with recommendation quality degrading by 7.4% under amplified complexity. This decline contrasted with marginal improvements in rationality (+2.0%), readability (+1.7%) and diagnosis (+4.7%), highlighting a concerning divergence between perceived coherence and actionable guidance. Our findings advocate integrating interpretability mechanisms (e.g., reasoning chain visualization) into clinical workflows and establish a safety-aware validation framework for surgical LLM deployment.
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How Far Are Surgeons from Surgical World Models? A Pilot Study on Zero-shot Surgical Video Generation with Expert Assessment

arXiv:2511.01775v1 Announce Type: cross Abstract: Foundation models in video generation are demonstrating remarkable capabilities as potential world models for simulating the physical world. However, their application in high-stakes domains like surgery, which demand deep, specialized causal knowledge rather than general physical rules, remains a critical unexplored gap. To systematically address this challenge, we present SurgVeo, the first expert-curated benchmark for video generation model evaluation in surgery, and the Surgical Plausibility Pyramid (SPP), a novel, four-tiered framework tailored to assess model outputs from basic appearance to complex surgical strategy. On the basis of the SurgVeo benchmark, we task the advanced Veo-3 model with a zero-shot prediction task on surgical clips from laparoscopic and neurosurgical procedures. A panel of four board-certified surgeons evaluates the generated videos according to the SPP. Our results reveal a distinct "plausibility gap": while Veo-3 achieves exceptional Visual Perceptual Plausibility, it fails critically at higher levels of the SPP, including Instrument Operation Plausibility, Environment Feedback Plausibility, and Surgical Intent Plausibility. This work provides the first quantitative evidence of the chasm between visually convincing mimicry and causal understanding in surgical AI. Our findings from SurgVeo and the SPP establish a crucial foundation and roadmap for developing future models capable of navigating the complexities of specialized, real-world healthcare domains.
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A Survey on Cache Methods in Diffusion Models: Toward Efficient Multi-Modal Generation

arXiv:2510.19755v3 Announce Type: replace-cross Abstract: Diffusion Models have become a cornerstone of modern generative AI for their exceptional generation quality and controllability. However, their inherent \textit{multi-step iterations} and \textit{complex backbone networks} lead to prohibitive computational overhead and generation latency, forming a major bottleneck for real-time applications. Although existing acceleration techniques have made progress, they still face challenges such as limited applicability, high training costs, or quality degradation. Against this backdrop, \textbf{Diffusion Caching} offers a promising training-free, architecture-agnostic, and efficient inference paradigm. Its core mechanism identifies and reuses intrinsic computational redundancies in the diffusion process. By enabling feature-level cross-step reuse and inter-layer scheduling, it reduces computation without modifying model parameters. This paper systematically reviews the theoretical foundations and evolution of Diffusion Caching and proposes a unified framework for its classification and analysis. Through comparative analysis of representative methods, we show that Diffusion Caching evolves from \textit{static reuse} to \textit{dynamic prediction}. This trend enhances caching flexibility across diverse tasks and enables integration with other acceleration techniques such as sampling optimization and model distillation, paving the way for a unified, efficient inference framework for future multimodal and interactive applications. We argue that this paradigm will become a key enabler of real-time and efficient generative AI, injecting new vitality into both theory and practice of \textit{Efficient Generative Intelligence}.
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Generative Artificial Intelligence in Medical Education: Enhancing Critical Thinking or Undermining Cognitive Autonomy?

Generative artificial intelligence (GenAI) enables the production of coherent and contextually relevant text by processing large-scale linguistic datasets. Tools such as ChatGPT, Gemini, Claude, and LLaMA are increasingly integrated into medical education, assisting students with a range of tasks, including clinical reasoning, literature review, scientific writing, and formative assessment. Although these tools offer significant advantages in terms of productivity, personalization, and cognitive support, their impact on critical thinking—a cornerstone of medical education—remains uncertain. The aim of this viewpoint paper is to critically assess the influence of GenAI on critical thinking within medical training, examining both its potential to enhance cognitive skills and the risks it poses to cognitive autonomy. Users have reported increased efficiency and improved linguistic output; however, concerns have also been raised regarding the risk of cognitive overreliance. Current evidence presents a mixed picture, indicating both improvements in learner engagement and potential drawbacks such as passivity or susceptibility to misinformation. Without curricular integration that prioritizes ethical use, prompt engineering, and critical evaluation, GenAI may compromise the cognitive autonomy of medical students. Conversely, when thoughtfully embedded into pedagogical frameworks, these tools can act as cognitive enhancers—supporting, rather than replacing, clinical reasoning. Medical education must adapt to ensure that future physicians engage with GenAI in a critical, ethical, and context-aware manner, especially in complex decision-making scenarios. This transformation demands not only technological fluency but also reflective practice and sustained oversight by faculty and academic institutions.
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Can human connection amplify digital health outcomes? Familial involvement in a mobile health app

npj Digital Medicine, Published online: 03 November 2025; doi:10.1038/s41746-025-02037-8

In “A Randomized Controlled Trial of Mobile Intervention Using Health Support Bubbles to Prevent Social Frailty”, Hayashi et al. investigated the effects of using a mobile health app with family or individually. Greater improvements in social behavior and frailty were noted in participants who used the app with family. In an era of remote healthcare and app-based health interventions, Hayashi et al.’s study reminds of the importance of human connection.
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Leveraging artificial intelligence to validate traditional biomarkers and drug targets in liver cancer recovery: a mini review

Front Pharmacol. 2025 Oct 17;16:1697608. doi: 10.3389/fphar.2025.1697608. eCollection 2025.

ABSTRACT

Hepatocellular carcinoma (HCC) remains a leading cause of cancer death, and recovery after therapy is shaped by heterogeneous etiologies, genomes and microenvironments. Targeted and immunotherapy combinations have broadened first-line options; yet durable benefit is uneven, and serum/imaging anchors (AFP, AFP-L3%, PIVKA-II, LI-RADS/mRECIST) incompletely resolve residual disease or functional restoration. In this review we summarise AI-enabled radiology, digital pathology and multi-omic/liquid-biopsy analytics that test and refine traditional biomarkers and drug-target readouts, and appraise translational opportunities in composite surveillance and recovery forecasting. We also discuss enduring challenges-including assay standardisation, spectrum bias, data leakage, domain shift and limited prospective external validation-that temper implementation. By integrating established anchors (AFP/AFP-L3%, PIVKA-II, ALBI, contrast-enhanced hallmarks) with AI-derived signals (radiomics/pathomics, cfDNA methylation) and pathway contexts (VEGF-VEGFR, WNT/β-catenin), emerging strategies align predictions with clinical endpoints, individualise therapy and chart hepatic function. Our synthesis provides an appraisal of AI-traditional integration in liver cancer recovery and outlines pragmatic standards-analytical robustness, transparent reporting and prospective, guideline-conformant evaluation-required for clinical adoption. We hope these insights will aid researchers and clinicians as they implement more effective, individualised monitoring and treatment pathways.

PMID:41181592 | PMC:PMC12575369 | DOI:10.3389/fphar.2025.1697608

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The Denario project: Deep knowledge AI agents for scientific discovery

arXiv:2510.26887v1 Announce Type: new Abstract: We present Denario, an AI multi-agent system designed to serve as a scientific research assistant. Denario can perform many different tasks, such as generating ideas, checking the literature, developing research plans, writing and executing code, making plots, and drafting and reviewing a scientific paper. The system has a modular architecture, allowing it to handle specific tasks, such as generating an idea, or carrying out end-to-end scientific analysis using Cmbagent as a deep-research backend. In this work, we describe in detail Denario and its modules, and illustrate its capabilities by presenting multiple AI-generated papers generated by it in many different scientific disciplines such as astrophysics, biology, biophysics, biomedical informatics, chemistry, material science, mathematical physics, medicine, neuroscience and planetary science. Denario also excels at combining ideas from different disciplines, and we illustrate this by showing a paper that applies methods from quantum physics and machine learning to astrophysical data. We report the evaluations performed on these papers by domain experts, who provided both numerical scores and review-like feedback. We then highlight the strengths, weaknesses, and limitations of the current system. Finally, we discuss the ethical implications of AI-driven research and reflect on how such technology relates to the philosophy of science. We publicly release the code at https://github.com/AstroPilot-AI/Denario. A Denario demo can also be run directly on the web at https://huggingface.co/spaces/astropilot-ai/Denario, and the full app will be deployed on the cloud.
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Glia: A Human-Inspired AI for Automated Systems Design and Optimization

arXiv:2510.27176v1 Announce Type: new Abstract: Can an AI autonomously design mechanisms for computer systems on par with the creativity and reasoning of human experts? We present Glia, an AI architecture for networked systems design that uses large language models (LLMs) in a human-inspired, multi-agent workflow. Each agent specializes in reasoning, experimentation, and analysis, collaborating through an evaluation framework that grounds abstract reasoning in empirical feedback. Unlike prior ML-for-systems methods that optimize black-box policies, Glia generates interpretable designs and exposes its reasoning process. When applied to a distributed GPU cluster for LLM inference, it produces new algorithms for request routing, scheduling, and auto-scaling that perform at human-expert levels in significantly less time, while yielding novel insights into workload behavior. Our results suggest that by combining reasoning LLMs with structured experimentation, an AI can produce creative and understandable designs for complex systems problems.
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ToolScope: An Agentic Framework for Vision-Guided and Long-Horizon Tool Use

arXiv:2510.27363v1 Announce Type: new Abstract: Recently, large language models (LLMs) have demonstrated remarkable problem-solving capabilities by autonomously integrating with external tools for collaborative reasoning. However, due to the inherently complex and diverse nature of multimodal information, enabling multimodal large language models (MLLMs) to flexibly and efficiently utilize external tools during reasoning remains an underexplored challenge. In this work, we introduce ToolScope, an agentic framework designed to unify global planning with local multimodal perception, adopting a specialized Perceive tool to mitigates visual context degradation in long-horizon VQA task. ToolScope comprises three primary components: the Global Navigator, the Agentic Executor, and the Response Synthesizer. The Global Navigator functions as a "telescope", offering high-level strategic guidance. The Agentic Executor operates iteratively to augment MLLM with local perception through the integration of external tools-Search, Code, and Perceive. Finally, the Response Synthesizer consolidates and organizes the reasoning process into a coherent, user-friendly output. We evaluate ToolScope on four VQA benchmarks across diverse domains, including VQA 2.0, ScienceQA, MAT-Search and MathVista. It demonstrates strong generalization capabilities, achieving an average performance improvement of up to +6.69% across all datasets.
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