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KidSpeak: A General Multi-purpose LLM for Kids' Speech Recognition and Screening

arXiv:2512.05994v1 Announce Type: cross Abstract: With the rapid advancement of conversational and diffusion-based AI, there is a growing adoption of AI in educational services, ranging from grading and assessment tools to personalized learning systems that provide targeted support for students. However, this adaptability has yet to fully extend to the domain of children's speech, where existing models often fail due to their reliance on datasets designed for clear, articulate adult speech. Children, particularly those in early developmental stages or with speech and language pathologies, present unique challenges that current AI models and datasets are ill-equipped to handle. To address this, we introduce KidSpeak, a multi-task speech-enhanced Foundation Model capable of both generative and discriminative tasks specifically tailored to children's speech patterns. Our framework employs a two-stage training process that incorporates phonetic knowledge into the speech encoder, achieving an average accuracy of 87% across four separate tasks. Furthermore, recognizing the limitations of scalable human annotation and existing speech alignment tools, we propose the Flexible and Automatic Speech Aligner (FASA) and leverage the method to construct high quality datasets for training and evaluation. This novel alignment tool significantly improves the quality of aligned children's speech from noisy data, enhancing data quality by 13.6x compared to human annotations, as demonstrated on the CHILDES dataset. To the best of our knowledge, KidSpeak and FASA represent the first comprehensive solution designed for speech and language therapy in children, offering both a multi-purpose speech LLM and a robust alignment tool.
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Digital Health Technologies: Learnings and Perspectives From a Patient Engagement Stakeholder Expectations Matrix Study

As digital health technologies become increasingly integrated into health care systems worldwide, there is growing recognition that their full potential can be realized only when development is rooted in patient engagement (PE). Despite its proven value in clinical research and health care delivery, PE remains insufficiently embedded in digital health design and implementation. This perspective paper explores the current state of PE in digital health through findings from the Stakeholder Expectations Matrix program developed by Patient Focused Medicines Development. Drawing from 37 in-depth interviews across 6 key stakeholder groups, complemented by insights gathered during a multisession cocreation track at the Patient Engagement Open Forum, this paper highlights differing perspectives on digital health, the barriers to meaningful engagement, and the fragmented nature of data governance and technology adoption. Findings point not only to significant gaps in shared understanding, infrastructure, and policy but also to clear opportunities for collaboration, including early recommendations for building a more inclusive and patient-centered digital health ecosystem, one that supports sustainable innovation, trust, and systemwide impact.
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Transferring Clinical Knowledge into ECGs Representation

arXiv:2512.07021v1 Announce Type: cross Abstract: Deep learning models have shown high accuracy in classifying electrocardiograms (ECGs), but their black box nature hinders clinical adoption due to a lack of trust and interpretability. To address this, we propose a novel three-stage training paradigm that transfers knowledge from multimodal clinical data (laboratory exams, vitals, biometrics) into a powerful, yet unimodal, ECG encoder. We employ a self-supervised, joint-embedding pre-training stage to create an ECG representation that is enriched with contextual clinical information, while only requiring the ECG signal at inference time. Furthermore, as an indirect way to explain the model's output we train it to also predict associated laboratory abnormalities directly from the ECG embedding. Evaluated on the MIMIC-IV-ECG dataset, our model outperforms a standard signal-only baseline in multi-label diagnosis classification and successfully bridges a substantial portion of the performance gap to a fully multimodal model that requires all data at inference. Our work demonstrates a practical and effective method for creating more accurate and trustworthy ECG classification models. By converting abstract predictions into physiologically grounded \emph{explanations}, our approach offers a promising path toward the safer integration of AI into clinical workflows.
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A Field Guide to Deploying AI Agents in Clinical Practice

arXiv:2509.26153v3 Announce Type: replace Abstract: Large language models (LLMs) integrated into agent-driven workflows hold immense promise for healthcare, yet a significant gap exists between their potential and practical implementation within clinical settings. To address this, we present a practitioner-oriented field manual for deploying generative agents that use electronic health record (EHR) data. This guide is informed by our experience deploying the "irAE-Agent", an automated system to detect immune-related adverse events from clinical notes at Mass General Brigham, and by structured interviews with 21 clinicians, engineers, and informatics leaders involved in the project. Our analysis reveals a critical misalignment in clinical AI development: less than 20% of our effort was dedicated to prompt engineering and model development, while over 80% was consumed by the sociotechnical work of implementation. We distill this effort into five "heavy lifts": data integration, model validation, ensuring economic value, managing system drift, and governance. By providing actionable solutions for each of these challenges, this field manual shifts the focus from algorithmic development to the essential infrastructure and implementation work required to bridge the "valley of death" and successfully translate generative AI from pilot projects into routine clinical care.
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Simulating Life Paths with Digital Twins: AI-Generated Future Selves Influence Decision-Making and Expand Human Choice

arXiv:2512.05397v2 Announce Type: replace-cross Abstract: Major life transitions demand high-stakes decisions, yet people often struggle to imagine how their future selves will live with the consequences. To support this limited capacity for mental time travel, we introduce AI-enabled digital twins that have ``lived through'' simulated life scenarios. Rather than predicting optimal outcomes, these simulations extend prospective cognition by making alternative futures vivid enough to support deliberation without assuming which path is best. We evaluate this idea in a randomized controlled study (N=192) using multimodal synthesis - facial age progression, voice cloning, and large language model dialogue - to create personalized avatars representing participants 30 years forward. Young adults 18 to 28 years old described pending binary decisions and were assigned to guided imagination or one of four avatar conditions: single-option, balanced dual-option, or expanded three-option with a system-generated novel alternative. Results showed asymmetric effects: single-sided avatars increased shifts toward the presented option, while balanced presentation produced movement toward both. Introducing a system-generated third option increased adoption of this new alternative compared to control, suggesting that AI-generated future selves can expand choice by surfacing paths that might otherwise go unnoticed. Participants rated evaluative reasoning and eudaimonic meaning-making as more important than emotional or visual vividness. Perceived persuasiveness and baseline agency predicted decision change. These findings advance understanding of AI-mediated episodic prospection and raise questions about autonomy in AI-augmented decisions.
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The Seeds of Scheming: Weakness of Will in the Building Blocks of Agentic Systems

arXiv:2512.05449v1 Announce Type: new Abstract: Large language models display a peculiar form of inconsistency: they "know" the correct answer but fail to act on it. In human philosophy, this tension between global judgment and local impulse is called akrasia, or weakness of will. We propose akrasia as a foundational concept for analyzing inconsistency and goal drift in agentic AI systems. To operationalize it, we introduce a preliminary version of the Akrasia Benchmark, currently a structured set of prompting conditions (Baseline [B], Synonym [S], Temporal [T], and Temptation [X]) that measures when a model's local response contradicts its own prior commitments. The benchmark enables quantitative comparison of "self-control" across model families, decoding strategies, and temptation types. Beyond single-model evaluation, we outline how micro-level akrasia may compound into macro-level instability in multi-agent systems that may be interpreted as "scheming" or deliberate misalignment. By reframing inconsistency as weakness of will, this work connects agentic behavior to classical theories of agency and provides an empirical bridge between philosophy, psychology, and the emerging science of agentic AI.
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Simulating Life Paths with Digital Twins: AI-Generated Future Selves Influence Decision-Making and Expand Human Choice

arXiv:2512.05397v1 Announce Type: cross Abstract: Major life transitions demand high-stakes decisions, yet people often struggle to imagine how their future selves will live with the consequences. To support this limited capacity for mental time travel, we introduce AI-enabled digital twins that have ``lived through'' simulated life scenarios. Rather than predicting optimal outcomes, these simulations extend prospective cognition by making alternative futures vivid enough to support deliberation without assuming which path is best. We evaluate this idea in a randomized controlled study (N=192) using multimodal synthesis - facial age progression, voice cloning, and large language model dialogue - to create personalized avatars representing participants 30 years forward. Young adults 18 to 28 years old described pending binary decisions and were assigned to guided imagination or one of four avatar conditions: single-option, balanced dual-option, or expanded three-option with a system-generated novel alternative. Results showed asymmetric effects: single-sided avatars increased shifts toward the presented option, while balanced presentation produced movement toward both. Introducing a system-generated third option increased adoption of this new alternative compared to control, suggesting that AI-generated future selves can expand choice by surfacing paths that might otherwise go unnoticed. Participants rated evaluative reasoning and eudaimonic meaning-making as more important than emotional or visual vividness. Perceived persuasiveness and baseline agency predicted decision change. These findings advance understanding of AI-mediated episodic prospection and raise questions about autonomy in AI-augmented decisions.
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Optimizing Medical Question-Answering Systems: A Comparative Study of Fine-Tuned and Zero-Shot Large Language Models with RAG Framework

arXiv:2512.05863v1 Announce Type: cross Abstract: Medical question-answering (QA) systems can benefit from advances in large language models (LLMs), but directly applying LLMs to the clinical domain poses challenges such as maintaining factual accuracy and avoiding hallucinations. In this paper, we present a retrieval-augmented generation (RAG) based medical QA system that combines domain-specific knowledge retrieval with open-source LLMs to answer medical questions. We fine-tune two state-of-the-art open LLMs (LLaMA~2 and Falcon) using Low-Rank Adaptation (LoRA) for efficient domain specialization. The system retrieves relevant medical literature to ground the LLM's answers, thereby improving factual correctness and reducing hallucinations. We evaluate the approach on benchmark datasets (PubMedQA and MedMCQA) and show that retrieval augmentation yields measurable improvements in answer accuracy compared to using LLMs alone. Our fine-tuned LLaMA~2 model achieves 71.8% accuracy on PubMedQA, substantially improving over the 55.4% zero-shot baseline, while maintaining transparency by providing source references. We also detail the system design and fine-tuning methodology, demonstrating that grounding answers in retrieved evidence reduces unsupported content by approximately 60%. These results highlight the potential of RAG-augmented open-source LLMs for reliable biomedical QA, pointing toward practical clinical informatics applications.
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The AI Productivity Index (APEX)

arXiv:2509.25721v4 Announce Type: replace-cross Abstract: We present an extended version of the AI Productivity Index (APEX-v1-extended), a benchmark for assessing whether frontier models are capable of performing economically valuable tasks in four jobs: investment banking associate, management consultant, big law associate, and primary care physician (MD). This technical report details the extensions to APEX-v1, including an increase in the held-out evaluation set from n = 50 to n = 100 cases per job (n = 400 total) and updates to the grading methodology. We present a new leaderboard, where GPT5 (Thinking = High) remains the top performing model with a score of 67.0%. APEX-v1-extended shows that frontier models still have substantial limitations when performing typical professional tasks. To support further research, we are open sourcing n = 25 non-benchmark example cases per role (n = 100 total) along with our evaluation harness.
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A typology of physician input approaches to using AI chatbots for clinical decision-making

npj Digital Medicine, Published online: 05 December 2025; doi:10.1038/s41746-025-02184-y

A typology of physician input approaches to using AI chatbots for clinical decision-making
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Privacy Risks and Preservation Methods in Explainable Artificial Intelligence: A Scoping Review

arXiv:2505.02828v3 Announce Type: replace Abstract: Explainable Artificial Intelligence (XAI) has emerged as a pillar of Trustworthy AI and aims to bring transparency in complex models that are opaque by nature. Despite the benefits of incorporating explanations in models, an urgent need is found in addressing the privacy concerns of providing this additional information to end users. In this article, we conduct a scoping review of existing literature to elicit details on the conflict between privacy and explainability. Using the standard methodology for scoping review, we extracted 57 articles from 1,943 studies published from January 2019 to December 2024. The review addresses 3 research questions to present readers with more understanding of the topic: (1) what are the privacy risks of releasing explanations in AI systems? (2) what current methods have researchers employed to achieve privacy preservation in XAI systems? (3) what constitutes a privacy preserving explanation? Based on the knowledge synthesized from the selected studies, we categorize the privacy risks and preservation methods in XAI and propose the characteristics of privacy preserving explanations to aid researchers and practitioners in understanding the requirements of XAI that is privacy compliant. Lastly, we identify the challenges in balancing privacy with other system desiderata and provide recommendations for achieving privacy preserving XAI. We expect that this review will shed light on the complex relationship of privacy and explainability, both being the fundamental principles of Trustworthy AI.
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A Definition of AGI

arXiv:2510.18212v3 Announce Type: replace Abstract: The lack of a concrete definition for Artificial General Intelligence (AGI) obscures the gap between today's specialized AI and human-level cognition. This paper introduces a quantifiable framework to address this, defining AGI as matching the cognitive versatility and proficiency of a well-educated adult. To operationalize this, we ground our methodology in Cattell-Horn-Carroll theory, the most empirically validated model of human cognition. The framework dissects general intelligence into ten core cognitive domains-including reasoning, memory, and perception-and adapts established human psychometric batteries to evaluate AI systems. Application of this framework reveals a highly "jagged" cognitive profile in contemporary models. While proficient in knowledge-intensive domains, current AI systems have critical deficits in foundational cognitive machinery, particularly long-term memory storage. The resulting AGI scores (e.g., GPT-4 at 27%, GPT-5 at 57%) concretely quantify both rapid progress and the substantial gap remaining before AGI.
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AI Deception: Risks, Dynamics, and Controls

arXiv:2511.22619v2 Announce Type: replace Abstract: As intelligence increases, so does its shadow. AI deception, in which systems induce false beliefs to secure self-beneficial outcomes, has evolved from a speculative concern to an empirically demonstrated risk across language models, AI agents, and emerging frontier systems. This project provides a comprehensive and up-to-date overview of the AI deception field, covering its core concepts, methodologies, genesis, and potential mitigations. First, we identify a formal definition of AI deception, grounded in signaling theory from studies of animal deception. We then review existing empirical studies and associated risks, highlighting deception as a sociotechnical safety challenge. We organize the landscape of AI deception research as a deception cycle, consisting of two key components: deception emergence and deception treatment. Deception emergence reveals the mechanisms underlying AI deception: systems with sufficient capability and incentive potential inevitably engage in deceptive behaviors when triggered by external conditions. Deception treatment, in turn, focuses on detecting and addressing such behaviors. On deception emergence, we analyze incentive foundations across three hierarchical levels and identify three essential capability preconditions required for deception. We further examine contextual triggers, including supervision gaps, distributional shifts, and environmental pressures. On deception treatment, we conclude detection methods covering benchmarks and evaluation protocols in static and interactive settings. Building on the three core factors of deception emergence, we outline potential mitigation strategies and propose auditing approaches that integrate technical, community, and governance efforts to address sociotechnical challenges and future AI risks. To support ongoing work in this area, we release a living resource at www.deceptionsurvey.com.
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Challenges and Limitations of Generative AI in Synthesizing Wearable Sensor Data

arXiv:2505.14206v2 Announce Type: replace-cross Abstract: The widespread adoption of wearable sensors has the potential to provide massive and heterogeneous time series data, driving the use of Artificial Intelligence in human sensing applications. However, data collection remains limited due to stringent ethical regulations, privacy concerns, and other constraints, hindering progress in the field. Synthetic data generation, particularly through Generative Adversarial Networks and Diffusion Models, has emerged as a promising solution to mitigate both data scarcity and privacy issues. However, these models are often limited to narrow operational scenarios, such as short-term and unimodal signal patterns. To address this gap, we present a systematic evaluation of state-of-the-art generative models for time series data, explicitly assessing their performance in challenging scenarios such as stress and emotion recognition. Our study examines the extent to which these models can jointly handle multi-modality, capture long-range dependencies, and support conditional generation-core requirements for real-world wearable sensor data generation. To enable a fair and rigorous comparison, we also introduce an evaluation framework that evaluates both the intrinsic fidelity of the generated data and their utility in downstream predictive tasks. Our findings reveal critical limitations in the existing approaches, particularly in maintaining cross-modal consistency, preserving temporal coherence, and ensuring robust performance in train-on-synthetic, test-on-real, and data augmentation scenarios. Finally, we present our future research directions to enhance synthetic time series generation and improve the applicability of generative models in the wearable computing domain.
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Harnessing cuproptosis for pancreatic cancer therapy: From molecular insights to clinical prospects

Biomed Pharmacother. 2025 Dec 2;193:118852. doi: 10.1016/j.biopha.2025.118852. Online ahead of print.

ABSTRACT

Pancreatic cancer (PC) remains a high-fatality malignancy with limited clinical progress, characterized by aggressive biology, marked resistance to standard therapies, and dismal outcomes. Even with state-of-the-art resection, radiotherapy, and multidrug chemotherapy, median survival benefits are modest, highlighting an urgent need for mechanism-based interventions. Cuproptosis, a newly delineated modality of regulated cell death initiated by intracellular copper accumulation and mitochondrial stress, presents a biologically coherent therapeutic avenue. Distinct from apoptosis, necroptosis, and ferroptosis, cuproptosis is driven by the direct binding of copper to lipoylated enzymes of the tricarboxylic acid (TCA) cycle, resulting in bioenergetic failure, misfolded protein aggregation, and collapse of cytotoxic proteostasis. Converging studies suggest that copper disequilibrium and metabolic reprogramming are recurrent features of PC, potentially contributing to malignant progression, immune evasion, and chemoresistance. These insights motivate two complementary strategies: first, therapeutic manipulation of copper flux, via chelators, ionophores, or transport modulators, to selectively trigger cuproptosis in tumor cells; and second, sensitization of mitochondrial metabolism, through targeting lipoic-acid pathway components, pyruvate utilization, or TCA load, to lower the threshold for cuproptotic killing. In parallel, multi-omic interrogation of cuproptosis-associated genes, proteins, and metabolites may yield prognostic and predictive biomarkers, enabling risk-adapted treatment selection and rational combinations with cytotoxic, targeted, or immunotherapeutic modalities. This review synthesizes recent advances on cuproptosis in PC and outlines its translational potential as both a therapeutic target and a biomarker framework.

PMID:41337879 | DOI:10.1016/j.biopha.2025.118852

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A Framework for Causal Concept-based Model Explanations

arXiv:2512.02735v1 Announce Type: new Abstract: This work presents a conceptual framework for causal concept-based post-hoc Explainable Artificial Intelligence (XAI), based on the requirements that explanations for non-interpretable models should be understandable as well as faithful to the model being explained. Local and global explanations are generated by calculating the probability of sufficiency of concept interventions. Example explanations are presented, generated with a proof-of-concept model made to explain classifiers trained on the CelebA dataset. Understandability is demonstrated through a clear concept-based vocabulary, subject to an implicit causal interpretation. Fidelity is addressed by highlighting important framework assumptions, stressing that the context of explanation interpretation must align with the context of explanation generation.
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Digital Biometrics in Predicting Risk for Obstructive Sleep Apnea and Hypertension: Decentralized, Prospective Cohort Study

Background: Sleep is an important component of human health and can be measured longitudinally using digital activity trackers. Further, decentralized digital research has the potential to provide a real-world picture of sleep in large populations. Objective: This study examined whether longitudinal sleep patterns from activity trackers could predict risk of obstructive sleep apnea (OSA) and hypertension, as defined the Berlin questionnaire and self report, respectively. Methods: We recruited adults ≥18 years nationwide to join our sleep-focused smartphone-based study, called the Research Framework for Exploring Sleep Health (REFRESH). Our sample of N= 391 adults is comprised predominately of females (68%; n = 247 out of 364) at a mean age of 48 years (standard deviation (SD) = 13.62). Participants were asked to fill out health-related surveys, including the Berlin questionnaire, and the Horne-Ostberg questionnaire for chronotype. Participants were asked to link their own activity tracker to the application to collect longitudinal sleep data. Results: We analyzed sleep data from 391 participants, among a predominately White (65%; n = 231 out of 353) followed by multiracial (17%; n = 61 out of 353) and Hispanic or Latino (6.5%; n = 23 out of 353) cohort. Collinearity testing showed that OSA risk and self-reported hypertension could be considered independently. Holding body mass index (BMI) at fixed value, the odds of having high OSA risk increased by 159% for every one-hour increase in weekday sleep variability (odds ratio (OR) = 2.592, 95% confidence interval (CI) [1.613, 4.400]; P
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Multi-omic profiling provides insights into the heterogeneity, microenvironmental features, and biomarker landscape of small-cell lung cancer

Mol Cancer. 2025 Dec 2. doi: 10.1186/s12943-025-02514-4. Online ahead of print.

ABSTRACT

BACKGROUND: Greater understanding of differential therapeutic sensitivity, specifically to immunotherapy, in small-cell lung cancer (SCLC) is required.

METHODS: We explored SCLC heterogeneity through integrated molecular characterization of tumor tissue samples from 159 treatment-naive patients, utilizing genetic, epigenetic, transcriptional, and proteomic profiling, immunohistochemistry staining for multiple biologically relevant markers including transcriptional subtype-defining proteins, and spatial immune profiling using multiplex immunofluorescence.

RESULTS: Multi-omics analysis confirmed high heterogeneity across/within neuroendocrine and non-neuroendocrine subtypes. Methylomics analysis identified four methylome clusters that may enhance subtype prediction, prognosis, and longitudinal monitoring of subtype evolution. Immunohistochemistry analysis showed high MHC-I expression in non-neuroendocrine subtypes, which have greatest potential benefit from adding immunotherapy to chemotherapy; high DLL3 expression associated with neuroendocrine subtypes and an immune-cold tumor microenvironment. Multiplex immunofluorescence demonstrated associations of MHC-I with spatial arrangement and phenotypic features of immune cells in the tumor microenvironment of high-MHC-I-expressing SCLC, providing mechanistic rationale for MHC-I as a potential biomarker of immunotherapy response.

CONCLUSIONS: This multimodal profiling analysis provides further insights into the biologic complexity of SCLC and highlights potential therapeutic vulnerabilities of distinct disease subtypes.

PMID:41331472 | DOI:10.1186/s12943-025-02514-4

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