Daily Papers

As large language models (LLMs) continue to advance, there is increasing interest in their ability to infer human mental states and demonstrate a human-like Theory of Mind (ToM). Most existing ToM evaluations, however, are centered on text-based inputs, while scenarios relying solely on visual information receive far less attention. This leaves a gap, since real-world human-AI interaction typically requires multimodal understanding. In addition, many current methods regard the model as a black box and rarely probe how its internal attention behaves in multiple-choice question answering (QA). The impact of LLM hallucinations on such tasks is also underexplored from an interpretability perspective. To address these issues, we introduce VisionToM, a vision-oriented intervention framework designed to strengthen task-aware reasoning. The core idea is to compute intervention vectors that align visual representations with the correct semantic targets, thereby steering the model's attention through different layers of visual features. This guidance reduces the model's reliance on spurious linguistic priors, leading to more reliable multimodal language model (MLLM) outputs and better QA performance. Experiments on the EgoToM benchmark-an egocentric, real-world video dataset for ToM with three multiple-choice QA settings-demonstrate that our method substantially improves the ToM abilities of MLLMs. Furthermore, results on an additional open-ended generation task show that VisionToM enables MLLMs to produce free-form explanations that more accurately capture agents' mental states, pushing machine-human collaboration toward greater alignment.

Recent work in interpretability shows that large language models (LLMs) can be adapted for new tasks in a learning-free way: it is possible to intervene on LLM representations to elicit desired behaviors for alignment. For instance, adding certain bias vectors to the outputs of certain attention heads is reported to boost the truthfulness of models. In this work, we show that localized fine-tuning serves as an effective alternative to such representation intervention methods. We introduce a framework called Localized Fine-Tuning on LLM Representations (LoFiT), which identifies a subset of attention heads that are most important for learning a specific task, then trains offset vectors to add to the model's hidden representations at those selected heads. LoFiT localizes to a sparse set of heads (3%) and learns the offset vectors from limited training data, comparable to the settings used for representation intervention. For truthfulness and reasoning tasks, we find that LoFiT's intervention vectors are more effective for LLM adaptation than vectors from representation intervention methods such as Inference-time Intervention. We also find that the localization step is important: selecting a task-specific set of attention heads can lead to higher performance than intervening on heads selected for a different task. Finally, for the tasks we study, LoFiT achieves comparable performance to other parameter-efficient fine-tuning methods such as LoRA, despite modifying 20x-200x fewer parameters than these methods.

Inference-time steering methods offer a lightweight alternative to fine-tuning large language models (LLMs) and vision-language models (VLMs) by modifying internal activations at test time without updating model weights. However, most existing approaches rely on fixed, global intervention vectors, overlook the causal influence of individual input tokens, and fail to leverage informative gradients from the model's logits, particularly in multimodal settings where visual and textual inputs contribute unevenly. To address these limitations, we introduce GrAInS, an inference-time steering approach that operates across both language-only and vision-language models and tasks. GrAInS uses contrastive, gradient-based attribution via Integrated Gradients to identify the top-k most influential tokens, both positively and negatively attributed based on their contribution to preferred versus dispreferred outputs. These tokens are then used to construct directional steering vectors that capture semantic shifts from undesirable to desirable behavior. During inference, GrAInS adjusts hidden activations at transformer layers guided by token-level attribution signals, and normalizes activations to preserve representational scale. This enables fine-grained, interpretable, and modular control over model behavior, without retraining or auxiliary supervision. Empirically, GrAInS consistently outperforms both fine-tuning and existing steering baselines: it achieves a 13.22% accuracy gain on TruthfulQA using Llama-3.1-8B, reduces hallucination rates on MMHal-Bench from 0.624 to 0.514 with LLaVA-1.6-7B, and improves alignment win rates on SPA-VL by 8.11%, all while preserving the model's fluency and general capabilities.

Large language models interact with users through a simulated 'Assistant' persona. While the Assistant is typically trained to be helpful, harmless, and honest, it sometimes deviates from these ideals. In this paper, we identify directions in the model's activation space-persona vectors-underlying several traits, such as evil, sycophancy, and propensity to hallucinate. We confirm that these vectors can be used to monitor fluctuations in the Assistant's personality at deployment time. We then apply persona vectors to predict and control personality shifts that occur during training. We find that both intended and unintended personality changes after finetuning are strongly correlated with shifts along the relevant persona vectors. These shifts can be mitigated through post-hoc intervention, or avoided in the first place with a new preventative steering method. Moreover, persona vectors can be used to flag training data that will produce undesirable personality changes, both at the dataset level and the individual sample level. Our method for extracting persona vectors is automated and can be applied to any personality trait of interest, given only a natural-language description.

Large language models (LLMs) frequently generate toxic content, posing significant risks for safe deployment. Current mitigation strategies often degrade generation quality or require costly human annotation. We propose CAUSALDETOX, a framework that identifies and intervenes on the specific attention heads causally responsible for toxic generation. Using the Probability of Necessity and Sufficiency (PNS), we isolate a minimal set of heads that are necessary and sufficient for toxicity. We utilize these components via two complementary strategies: (1) Local Inference-Time Intervention, which constructs dynamic, input-specific steering vectors for context-aware detoxification, and (2) PNS-Guided Fine-Tuning, which permanently unlearns toxic representations. We also introduce PARATOX, a novel benchmark of aligned toxic/non-toxic sentence pairs enabling controlled counterfactual evaluation. Experiments on ToxiGen, ImplicitHate, and ParaDetox show that CAUSALDETOX achieves up to 5.34% greater toxicity reduction compared to baselines while preserving linguistic fluency, and offers a 7x speedup in head selection.

Recently, steering vectors (SVs) have emerged as an effective and lightweight approach to steer behaviors of large language models (LLMs), among which fine-tuned SVs are more effective than optimization-free ones. However, current approaches to fine-tuned SVs suffer from two limitations. First, they require careful selection of steering factors on a per-SV basis to balance steering effectiveness and generation quality at inference time. Second, they operate as full-sequence SVs (FSSVs), which can sacrifice generation quality regardless of factor selection due to excessive intervention on the model generation process. To address the first limitation, we propose joint training of steering factors and directions, such that post-hoc factor selection is no longer required. Using neural network scaling theory, we find that moderately large initialization sizes and learning rates for steering factors are essential for stability and efficiency of joint training. To tackle the second limitation, we draw inspiration from representation fine-tuning and introduce Prompt-only SV (PrOSV), an SV that intervenes only on a few prompt tokens. Our empirical results show that PrOSV outperforms traditional FSSVs on AxBench when using our joint training scheme. We also find that PrOSV achieves a better tradeoff between general model utility and adversarial robustness than FSSV.

Large Vision-Language Models (LVLMs) have demonstrated impressive multimodal abilities but remain prone to multilingual object hallucination, with a higher likelihood of generating responses inconsistent with the visual input when utilizing queries in non-English languages compared to English. Most existing approaches to address these rely on pretraining or fine-tuning, which are resource-intensive. In this paper, inspired by observing the disparities in cross-modal attention patterns across languages, we propose Cross-Lingual Attention Intervention for Mitigating multilingual object hallucination (CLAIM) in LVLMs, a novel near training-free method by aligning attention patterns. CLAIM first identifies language-specific cross-modal attention heads, then estimates language shift vectors from English to the target language, and finally intervenes in the attention outputs during inference to facilitate cross-lingual visual perception capability alignment. Extensive experiments demonstrate that CLAIM achieves an average improvement of 13.56% (up to 30% in Spanish) on the POPE and 21.75% on the hallucination subsets of the MME benchmark across various languages. Further analysis reveals that multilingual attention divergence is most prominent in intermediate layers, highlighting their critical role in multilingual scenarios.

Studies of LLMs' political opinions mainly rely on evaluations of their open-ended responses. Recent work indicates that there is a misalignment between LLMs' responses and their internal intentions. This motivates us to probe LLMs' internal mechanisms and help uncover their internal political states. Additionally, we found that the analysis of LLMs' political opinions often relies on single-axis concepts, which can lead to concept confounds. In this work, we extend the single-axis to multi-dimensions and apply interpretable representation engineering techniques for more transparent LLM political concept learning. Specifically, we designed a four-dimensional political learning framework and constructed a corresponding dataset for fine-grained political concept vector learning. These vectors can be used to detect and intervene in LLM internals. Experiments are conducted on eight open-source LLMs with three representation engineering techniques. Results show these vectors can disentangle political concept confounds. Detection tasks validate the semantic meaning of the vectors and show good generalization and robustness in OOD settings. Intervention Experiments show these vectors can intervene in LLMs to generate responses with different political leanings.

Adapting LLM agents to domain-specific tool calling remains notably brittle under evolving interfaces. Prompt and schema engineering is easy to deploy but often fragile under distribution shift and strict parsers, while continual parameter-efficient fine-tuning improves reliability at the cost of training, maintenance, and potential forgetting. We identify a critical Lazy Agent failure mode where tool necessity is nearly perfectly decodable from mid-layer activations, yet the model remains conservative in entering tool mode, revealing a representation-behavior gap. We propose Activation Steering Adapter (ASA), a training-free, inference-time controller that performs a single-shot mid-layer intervention and targets tool domains via a router-conditioned mixture of steering vectors with a probe-guided signed gate to amplify true intent while suppressing spurious triggers. On MTU-Bench with Qwen2.5-1.5B, ASA improves strict tool-use F1 from 0.18 to 0.50 while reducing the false positive rate from 0.15 to 0.05, using only about 20KB of portable assets and no weight updates.

Interventions on model-internal states are fundamental operations in many areas of AI, including model editing, steering, robustness, and interpretability. To facilitate such research, we introduce pyvene, an open-source Python library that supports customizable interventions on a range of different PyTorch modules. pyvene supports complex intervention schemes with an intuitive configuration format, and its interventions can be static or include trainable parameters. We show how pyvene provides a unified and extensible framework for performing interventions on neural models and sharing the intervened upon models with others. We illustrate the power of the library via interpretability analyses using causal abstraction and knowledge localization. We publish our library through Python Package Index (PyPI) and provide code, documentation, and tutorials at https://github.com/stanfordnlp/pyvene.

Causal representation learning seeks to extract high-level latent factors from low-level sensory data. Most existing methods rely on observational data and structural assumptions (e.g., conditional independence) to identify the latent factors. However, interventional data is prevalent across applications. Can interventional data facilitate causal representation learning? We explore this question in this paper. The key observation is that interventional data often carries geometric signatures of the latent factors' support (i.e. what values each latent can possibly take). For example, when the latent factors are causally connected, interventions can break the dependency between the intervened latents' support and their ancestors'. Leveraging this fact, we prove that the latent causal factors can be identified up to permutation and scaling given data from perfect do interventions. Moreover, we can achieve block affine identification, namely the estimated latent factors are only entangled with a few other latents if we have access to data from imperfect interventions. These results highlight the unique power of interventional data in causal representation learning; they can enable provable identification of latent factors without any assumptions about their distributions or dependency structure.

The approval success rate of drug candidates is very low with the majority of failure due to safety and efficacy. Increasingly available high dimensional information on targets, drug molecules and indications provides an opportunity for ML methods to integrate multiple data modalities and better predict clinically promising drug targets. Notably, drug targets with human genetics evidence are shown to have better odds to succeed. However, a recent tensor factorization-based approach found that additional information on targets and indications might not necessarily improve the predictive accuracy. Here we revisit this approach by integrating different types of human genetics evidence collated from publicly available sources to support each target-indication pair. We use Bayesian tensor factorization to show that models incorporating all available human genetics evidence (rare disease, gene burden, common disease) modestly improves the clinical outcome prediction over models using single line of genetics evidence. We provide additional insight into the relative predictive power of different types of human genetics evidence for predicting the success of clinical outcomes.

Vectors are universal mathematical objects that can represent text, images, speech, or a mix of these data modalities. That happens regardless of whether data is represented by hand-crafted features or learnt embeddings. Collect a large enough quantity of such vectors and the question of retrieval becomes urgently relevant: Finding vectors that are more similar to a query vector. This monograph is concerned with the question above and covers fundamental concepts along with advanced data structures and algorithms for vector retrieval. In doing so, it recaps this fascinating topic and lowers barriers of entry into this rich area of research.

To control the behavior of language models, steering methods attempt to ensure that outputs of the model satisfy specific pre-defined properties. Adding steering vectors to the model is a promising method of model control that is easier than finetuning, and may be more robust than prompting. However, it can be difficult to anticipate the effects of steering vectors produced by almost all existing methods, such as CAA (Panickssery et al., 2024) or the direct use of SAE latents (Templeton et al., 2024). In our work, we address this issue by using SAEs to measure the effects of steering vectors, giving us a method that can be used to understand the causal effect of any steering vector intervention. We use this method for measuring causal effects to develop an improved steering method, SAE-Targeted Steering (SAE-TS), which finds steering vectors to target specific SAE features while minimizing unintended side effects. We show that overall, SAE-TS balances steering effects with coherence better than CAA and SAE feature steering, when evaluated on a range of tasks.

Steering vectors work for some concepts and layers but fail for others, and practitioners have no way to predict which setting applies before running an intervention. We introduce the Linear Accessibility Profile (LAP), a per-layer diagnostic that repurposes the logit lens as a predictor of steering vector effectiveness. The key measure, A_{lin}, applies the model's unembedding matrix to intermediate hidden states, requiring no training. Across 24 controlled binary concept families on five models (Pythia-2.8B to Llama-8B), peak A_{lin} predicts steering effectiveness at ρ= +0.86 to +0.91 and layer selection at ρ= +0.63 to +0.92. A three-regime framework explains when difference-of-means steering works, when nonlinear methods are needed, and when no method can work. An entity-steering demo confirms the prediction end-to-end: steering at the LAP-recommended layer redirects completions on Gemma-2-2B and OLMo-2-1B-Instruct, while the middle layer (the standard heuristic) has no effect on either model.

Large-scale multi-modal deep learning models have revolutionized domains such as healthcare, highlighting the importance of computational power. However, in resource-constrained regions like Low and Middle-Income Countries (LMICs), limited access to GPUs and data poses significant challenges, often leaving CPUs as the sole resource. To address this, we advocate for leveraging vector embeddings to enable flexible and efficient computational methodologies, democratizing multimodal deep learning across diverse contexts. Our paper investigates the efficiency and effectiveness of using vector embeddings from single-modal foundation models and multi-modal Vision-Language Models (VLMs) for multimodal deep learning in low-resource environments, particularly in healthcare. Additionally, we propose a simple yet effective inference-time method to enhance performance by aligning image-text embeddings. Comparing these approaches with traditional methods, we assess their impact on computational efficiency and model performance using metrics like accuracy, F1-score, inference time, training time, and memory usage across three medical modalities: BRSET (ophthalmology), HAM10000 (dermatology), and SatelliteBench (public health). Our findings show that embeddings reduce computational demands without compromising model performance. Furthermore, our alignment method improves performance in medical tasks. This research promotes sustainable AI practices by optimizing resources in constrained environments, highlighting the potential of embedding-based approaches for efficient multimodal learning. Vector embeddings democratize multimodal deep learning in LMICs, particularly in healthcare, enhancing AI adaptability in varied use cases.

Clinical trials disruption has always represented a non negligible part of the ending of interventional studies. While the SARS-CoV-2 (COVID-19) pandemic has led to an impressive and unprecedented initiation of clinical research, it has also led to considerable disruption of clinical trials in other disease areas, with around 80% of non-COVID-19 trials stopped or interrupted during the pandemic. In many cases the disrupted trials will not have the planned statistical power necessary to yield interpretable results. This paper describes methods to compensate for the information loss arising from trial disruptions by incorporating additional information available from auxiliary data sources. The methods described include the use of auxiliary data on baseline and early outcome data available from the trial itself and frequentist and Bayesian approaches for the incorporation of information from external data sources. The methods are illustrated by application to the analysis of artificial data based on the Primary care pediatrics Learning Activity Nutrition (PLAN) study, a clinical trial assessing a diet and exercise intervention for overweight children, that was affected by the COVID-19 pandemic. We show how all of the methods proposed lead to an increase in precision relative to use of complete case data only.

The premise of identifiable and causal representation learning is to improve the current representation learning paradigm in terms of generalizability or robustness. Despite recent progress in questions of identifiability, more theoretical results demonstrating concrete advantages of these methods for downstream tasks are needed. In this paper, we consider the task of intervention extrapolation: predicting how interventions affect an outcome, even when those interventions are not observed at training time, and show that identifiable representations can provide an effective solution to this task even if the interventions affect the outcome non-linearly. Our setup includes an outcome Y, observed features X, which are generated as a non-linear transformation of latent features Z, and exogenous action variables A, which influence Z. The objective of intervention extrapolation is to predict how interventions on A that lie outside the training support of A affect Y. Here, extrapolation becomes possible if the effect of A on Z is linear and the residual when regressing Z on A has full support. As Z is latent, we combine the task of intervention extrapolation with identifiable representation learning, which we call Rep4Ex: we aim to map the observed features X into a subspace that allows for non-linear extrapolation in A. We show that the hidden representation is identifiable up to an affine transformation in Z-space, which is sufficient for intervention extrapolation. The identifiability is characterized by a novel constraint describing the linearity assumption of A on Z. Based on this insight, we propose a method that enforces the linear invariance constraint and can be combined with any type of autoencoder. We validate our theoretical findings through synthetic experiments and show that our approach succeeds in predicting the effects of unseen interventions.

Current large language models have dangerous capabilities, which are likely to become more problematic in the future. Activation steering techniques can be used to reduce risks from these capabilities. In this paper, we investigate the efficacy of activation steering for broad skills and multiple behaviours. First, by comparing the effects of reducing performance on general coding ability and Python-specific ability, we find that steering broader skills is competitive to steering narrower skills. Second, we steer models to become more or less myopic and wealth-seeking, among other behaviours. In our experiments, combining steering vectors for multiple different behaviours into one steering vector is largely unsuccessful. On the other hand, injecting individual steering vectors at different places in a model simultaneously is promising.

One way to personalize chatbot interactions is by establishing common ground with the intended reader. A domain where establishing mutual understanding could be particularly impactful is vaccine concerns and misinformation. Vaccine interventions are forms of messaging which aim to answer concerns expressed about vaccination. Tailoring responses in this domain is difficult, since opinions often have seemingly little ideological overlap. We define the task of tailoring vaccine interventions to a Common-Ground Opinion (CGO). Tailoring responses to a CGO involves meaningfully improving the answer by relating it to an opinion or belief the reader holds. In this paper we introduce TAILOR-CGO, a dataset for evaluating how well responses are tailored to provided CGOs. We benchmark several major LLMs on this task; finding GPT-4-Turbo performs significantly better than others. We also build automatic evaluation metrics, including an efficient and accurate BERT model that outperforms finetuned LLMs, investigate how to successfully tailor vaccine messaging to CGOs, and provide actionable recommendations from this investigation. Code and model weights: https://github.com/rickardstureborg/tailor-cgo Dataset: https://huggingface.co/datasets/DukeNLP/tailor-cgo

Probing studies what information is encoded in a frozen LLM's layer representations by training a lightweight predictor on top of them. Beyond analysis, probes are often used operationally in probe-then-steer pipelines: a learned concept vector is extracted from a probe and injected via additive activation steering by adding it to a layer representation during the forward pass. The effectiveness of this pipeline hinges on estimating concept vectors that are accurate, directionally stable under ablation, and inexpensive to obtain. Motivated by these desiderata, we propose RAPTOR (Ridge-Adaptive Logistic Probe), a simple L2-regularized logistic probe whose validation-tuned ridge strength yields concept vectors from normalized weights. Across extensive experiments on instruction-tuned LLMs and human-written concept datasets, RAPTOR matches or exceeds strong baselines in accuracy while achieving competitive directional stability and substantially lower training cost; these quantitative results are supported by qualitative downstream steering demonstrations. Finally, using the Convex Gaussian Min-max Theorem (CGMT), we provide a mechanistic characterization of ridge logistic regression in an idealized Gaussian teacher-student model in the high-dimensional few-shot regime, explaining how penalty strength mediates probe accuracy and concept-vector stability and yielding structural predictions that qualitatively align with trends observed on real LLM embeddings.

Diffusion models (DMs) have achieved remarkable success in image and video generation. However, they still struggle with (1) physical alignment and (2) out-of-distribution (OOD) instruction following. We argue that these issues stem from the models' failure to learn causal directions and to disentangle causal factors for novel recombination. We introduce the Causal Scene Graph (CSG) and the Physical Alignment Probe (PAP) dataset to enable diagnostic interventions. This analysis yields three key insights. First, DMs struggle with multi-hop reasoning for elements not explicitly determined in the prompt. Second, the prompt embedding contains disentangled representations for texture and physics. Third, visual causal structure is disproportionately established during the initial, computationally limited denoising steps. Based on these findings, we introduce LINA (Learning INterventions Adaptively), a novel framework that learns to predict prompt-specific interventions, which employs (1) targeted guidance in the prompt and visual latent spaces, and (2) a reallocated, causality-aware denoising schedule. Our approach enforces both physical alignment and OOD instruction following in image and video DMs, achieving state-of-the-art performance on challenging causal generation tasks and the Winoground dataset. Our project page is at https://opencausalab.github.io/LINA.

The mechanisms by which reasoning training reshapes LLMs' internal computations remain unclear. We study lightweight steering vectors inserted into the base model's residual stream and trained with a reinforcement-learning objective. These vectors match full fine-tuning performance while preserving the interpretability of small, additive interventions. Using logit-lens readouts and path-patching analyses on two models, we find that (i) the last-layer steering vector acts like a token-substitution bias concentrated on the first generated token, consistently boosting tokens such as "To" and "Step"; (ii) the penultimate-layer vector leaves attention patterns largely intact and instead operates through the MLP and unembedding, preferentially up-weighting process words and structure symbols; and (iii) middle layers de-emphasize non-English tokens. Next, we show that a SAE isolates features associated with correct generations. We also show that steering vectors (i) transfer to other models, (ii) combine across layers when trained in isolation, and (iii) concentrate magnitude on meaningful prompt segments under adaptive token-wise scaling. Taken together, these results deepen understanding of how trained steering vectors shape computation and should inform future work in activation engineering and the study of reasoning models.

Recent work has shown promising results in causal discovery by leveraging interventional data with gradient-based methods, even when the intervened variables are unknown. However, previous work assumes that the correspondence between samples and interventions is known, which is often unrealistic. We envision a scenario with an extensive dataset sampled from multiple intervention distributions and one observation distribution, but where we do not know which distribution originated each sample and how the intervention affected the system, i.e., interventions are entirely latent. We propose a method based on neural networks and variational inference that addresses this scenario by framing it as learning a shared causal graph among an infinite mixture (under a Dirichlet process prior) of intervention structural causal models. Experiments with synthetic and real data show that our approach and its semi-supervised variant are able to discover causal relations in this challenging scenario.

Genetic pathways usually encode molecular mechanisms that can inform targeted interventions. It is often challenging for existing machine learning approaches to jointly model genetic pathways (higher-order features) and variants (atomic features), and present to clinicians interpretable models. In order to build more accurate and better interpretable machine learning models for genetic medicine, we introduce Pathway Augmented Nonnegative Tensor factorization for HighER-order feature learning (PANTHER). PANTHER selects informative genetic pathways that directly encode molecular mechanisms. We apply genetically motivated constrained tensor factorization to group pathways in a way that reflects molecular mechanism interactions. We then train a softmax classifier for disease types using the identified pathway groups. We evaluated PANTHER against multiple state-of-the-art constrained tensor/matrix factorization models, as well as group guided and Bayesian hierarchical models. PANTHER outperforms all state-of-the-art comparison models significantly (p<0.05). Our experiments on large scale Next Generation Sequencing (NGS) and whole-genome genotyping datasets also demonstrated wide applicability of PANTHER. We performed feature analysis in predicting disease types, which suggested insights and benefits of the identified pathway groups.

Large Language Models (LLMs) are powerful text generators, yet they can produce toxic or harmful content even when given seemingly harmless prompts. This presents a serious safety challenge and can cause real-world harm. Toxicity is often subtle and context-dependent, making it difficult to detect at the token level or through coarse sentence-level signals. Moreover, efforts to mitigate toxicity often face a trade-off between safety and the coherence, or fluency of the generated text. In this work, we present a targeted subspace intervention strategy for identifying and suppressing hidden toxic patterns from underlying model representations, while preserving overall ability to generate safe fluent content. On the RealToxicityPrompts, our method achieves strong mitigation performance compared to existing baselines, with minimal impact on inference complexity. Across multiple LLMs, our approach reduces toxicity of state-of-the-art detoxification systems by 8-20%, while maintaining comparable fluency. Through extensive quantitative and qualitative analyses, we show that our approach achieves effective toxicity reduction without impairing generative performance, consistently outperforming existing baselines.

The causalimages R package enables causal inference with image and image sequence data, providing new tools for integrating novel data sources like satellite and bio-medical imagery into the study of cause and effect. One set of functions enables image-based causal inference analyses. For example, one key function decomposes treatment effect heterogeneity by images using an interpretable Bayesian framework. This allows for determining which types of images or image sequences are most responsive to interventions. A second modeling function allows researchers to control for confounding using images. The package also allows investigators to produce embeddings that serve as vector summaries of the image or video content. Finally, infrastructural functions are also provided, such as tools for writing large-scale image and image sequence data as sequentialized byte strings for more rapid image analysis. causalimages therefore opens new capabilities for causal inference in R, letting researchers use informative imagery in substantive analyses in a fast and accessible manner.

Instrumental variable (IV) methods are used to estimate causal effects in settings with unobserved confounding, where we cannot directly experiment on the treatment variable. Instruments are variables which only affect the outcome indirectly via the treatment variable(s). Most IV applications focus on low-dimensional treatments and crucially require at least as many instruments as treatments. This assumption is restrictive: in the natural sciences we often seek to infer causal effects of high-dimensional treatments (e.g., the effect of gene expressions or microbiota on health and disease), but can only run few experiments with a limited number of instruments (e.g., drugs or antibiotics). In such underspecified problems, the full treatment effect is not identifiable in a single experiment even in the linear case. We show that one can still reliably recover the projection of the treatment effect onto the instrumented subspace and develop techniques to consistently combine such partial estimates from different sets of instruments. We then leverage our combined estimators in an algorithm that iteratively proposes the most informative instruments at each round of experimentation to maximize the overall information about the full causal effect.

Test-time interventions for language models can enhance factual accuracy, mitigate harmful outputs, and improve model efficiency without costly retraining. But despite a flood of new methods, different types of interventions are largely developing independently. In practice, multiple interventions must be applied sequentially to the same model, yet we lack standardized ways to study how interventions interact. We fill this gap by introducing composable interventions, a framework to study the effects of using multiple interventions on the same language models, featuring new metrics and a unified codebase. Using our framework, we conduct extensive experiments and compose popular methods from three emerging intervention categories -- Knowledge Editing, Model Compression, and Machine Unlearning. Our results from 310 different compositions uncover meaningful interactions: compression hinders editing and unlearning, composing interventions hinges on their order of application, and popular general-purpose metrics are inadequate for assessing composability. Taken together, our findings showcase clear gaps in composability, suggesting a need for new multi-objective interventions. All of our code is public: https://github.com/hartvigsen-group/composable-interventions.

The technique of data augmentation (DA) is often used in machine learning for regularization purposes to better generalize under i.i.d. settings. In this work, we present a unifying framework with topics in causal inference to make a case for the use of DA beyond just the i.i.d. setting, but for generalization across interventions as well. Specifically, we argue that when the outcome generating mechanism is invariant to our choice of DA, then such augmentations can effectively be thought of as interventions on the treatment generating mechanism itself. This can potentially help to reduce bias in causal effect estimation arising from hidden confounders. In the presence of such unobserved confounding we typically make use of instrumental variables (IVs) -- sources of treatment randomization that are conditionally independent of the outcome. However, IVs may not be as readily available as DA for many applications, which is the main motivation behind this work. By appropriately regularizing IV based estimators, we introduce the concept of IV-like (IVL) regression for mitigating confounding bias and improving predictive performance across interventions even when certain IV properties are relaxed. Finally, we cast parameterized DA as an IVL regression problem and show that when used in composition can simulate a worst-case application of such DA, further improving performance on causal estimation and generalization tasks beyond what simple DA may offer. This is shown both theoretically for the population case and via simulation experiments for the finite sample case using a simple linear example. We also present real data experiments to support our case.

Predicting how different interventions will causally affect a specific individual is important in a variety of domains such as personalized medicine, public policy, and online marketing. There are a large number of methods to predict the effect of an existing intervention based on historical data from individuals who received it. However, in many settings it is important to predict the effects of novel interventions (e.g., a newly invented drug), which these methods do not address. Here, we consider zero-shot causal learning: predicting the personalized effects of a novel intervention. We propose CaML, a causal meta-learning framework which formulates the personalized prediction of each intervention's effect as a task. CaML trains a single meta-model across thousands of tasks, each constructed by sampling an intervention, along with its recipients and nonrecipients. By leveraging both intervention information (e.g., a drug's attributes) and individual features~(e.g., a patient's history), CaML is able to predict the personalized effects of novel interventions that do not exist at the time of training. Experimental results on real world datasets in large-scale medical claims and cell-line perturbations demonstrate the effectiveness of our approach. Most strikingly, CaML's zero-shot predictions outperform even strong baselines trained directly on data from the test interventions.

Safe and trustworthy use of Large Language Models (LLM) in the processing of healthcare documents and scientific papers could substantially help clinicians, scientists and policymakers in overcoming information overload and focusing on the most relevant information at a given moment. Retrieval Augmented Generation (RAG) is a promising method to leverage the potential of LLMs while enhancing the accuracy of their outcomes. This report assesses the potentials and shortcomings of such approaches in the automatic knowledge synthesis of different types of documents in the health domain. To this end, it describes: (1) an internally developed proof of concept pipeline that employs state-of-the-art practices to deliver safe and trustable analysis for healthcare documents and scientific papers called RAGEv (Retrieval Augmented Generation Evaluation); (2) a set of evaluation tools for LLM-based document retrieval and generation; (3) a benchmark dataset to verify the accuracy and veracity of the results called RAGEv-Bench. It concludes that careful implementations of RAG techniques could minimize most of the common problems in the use of LLMs for document processing in the health domain, obtaining very high scores both on short yes/no answers and long answers. There is a high potential for incorporating it into the day-to-day work of policy support tasks, but additional efforts are required to obtain a consistent and trustworthy tool.

Concept bottleneck models (CBMs) are a class of interpretable neural network models that predict the target response of a given input based on its high-level concepts. Unlike the standard end-to-end models, CBMs enable domain experts to intervene on the predicted concepts and rectify any mistakes at test time, so that more accurate task predictions can be made at the end. While such intervenability provides a powerful avenue of control, many aspects of the intervention procedure remain rather unexplored. In this work, we develop various ways of selecting intervening concepts to improve the intervention effectiveness and conduct an array of in-depth analyses as to how they evolve under different circumstances. Specifically, we find that an informed intervention strategy can reduce the task error more than ten times compared to the current baseline under the same amount of intervention counts in realistic settings, and yet, this can vary quite significantly when taking into account different intervention granularity. We verify our findings through comprehensive evaluations, not only on the standard real datasets, but also on synthetic datasets that we generate based on a set of different causal graphs. We further discover some major pitfalls of the current practices which, without a proper addressing, raise concerns on reliability and fairness of the intervention procedure.

Researchers have been studying approaches to steer the behavior of Large Language Models (LLMs) and build personalized LLMs tailored for various applications. While fine-tuning seems to be a direct solution, it requires substantial computational resources and may significantly affect the utility of the original LLM. Recent endeavors have introduced more lightweight strategies, focusing on extracting "steering vectors" to guide the model's output toward desired behaviors by adjusting activations within specific layers of the LLM's transformer architecture. However, such steering vectors are directly extracted from the activations of human preference data and thus often lead to suboptimal results and occasional failures, especially in alignment-related scenarios. This work proposes an innovative approach that could produce more effective steering vectors through bi-directional preference optimization. Our method is designed to allow steering vectors to directly influence the generation probability of contrastive human preference data pairs, thereby offering a more precise representation of the target behavior. By carefully adjusting the direction and magnitude of the steering vector, we enabled personalized control over the desired behavior across a spectrum of intensities. Extensive experimentation across various open-ended generation tasks, particularly focusing on steering AI personas, has validated the efficacy of our approach. Moreover, we comprehensively investigate critical alignment-concerning scenarios, such as managing truthfulness, mitigating hallucination, and addressing jailbreaking attacks. Remarkably, our method can still demonstrate outstanding steering effectiveness across these scenarios. Furthermore, we showcase the transferability of our steering vectors across different models/LoRAs and highlight the synergistic benefits of applying multiple vectors simultaneously.

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).

Recent advancements in large language models (LLMs) have resulted in increasingly anthropomorphic language concerning the ability of LLMs to reason. Whether reasoning in LLMs should be understood to be inherently different is, however, widely debated. We propose utilizing a representation engineering approach wherein model activations are read from the residual stream of an LLM when processing a reasoning task. The activations are used to derive a control vector that is applied to the model as an inference-time intervention, modulating the representational space of the model, to improve performance on the specified task. We publish the code for deriving control vectors and analyzing model representations. The method allows us to improve performance on reasoning benchmarks and assess how control vectors influence the final logit distribution of a model via metrics such as KL divergence and entropy. We apply control vectors to Mistral-7B-Instruct and a range of Pythia models on an inductive, a deductive and mathematical reasoning task. We show that an LLM can, to a certain degree, be controlled to improve its perceived reasoning ability by modulating activations. The intervention is dependent upon the ability to reliably extract the model's typical state when correctly solving a task. Our results suggest that reasoning performance can be modulated in the same manner as other information-processing tasks performed by LLMs and demonstrate that we are capable of improving performance on specific tasks via a simple intervention on the residual stream with no additional training.

Mosquito-borne diseases pose a major global health risk, requiring early detection and proactive control of breeding sites to prevent outbreaks. In this paper, we present VisText-Mosquito, a multimodal dataset that integrates visual and textual data to support automated detection, segmentation, and reasoning for mosquito breeding site analysis. The dataset includes 1,828 annotated images for object detection, 142 images for water surface segmentation, and natural language reasoning texts linked to each image. The YOLOv9s model achieves the highest precision of 0.92926 and mAP@50 of 0.92891 for object detection, while YOLOv11n-Seg reaches a segmentation precision of 0.91587 and mAP@50 of 0.79795. For reasoning generation, our fine-tuned BLIP model achieves a final loss of 0.0028, with a BLEU score of 54.7, BERTScore of 0.91, and ROUGE-L of 0.87. This dataset and model framework emphasize the theme "Prevention is Better than Cure", showcasing how AI-based detection can proactively address mosquito-borne disease risks. The dataset and implementation code are publicly available at GitHub: https://github.com/adnanul-islam-jisun/VisText-Mosquito

Semantic vectors are learned from data to express semantic relationships between elements of information, for the purpose of solving and informing downstream tasks. Other models exist that learn to map and classify supervised data. However, the two worlds of learning rarely interact to inform one another dynamically, whether across types of data or levels of semantics, in order to form a unified model. We explore the research problem of learning these vectors and propose a framework for learning the semantics of knowledge incrementally and online, across multiple mediums of data, via binary vectors. We discuss the aspects of this framework to spur future research on this approach and problem.

We present a corpus of 5,000 richly annotated abstracts of medical articles describing clinical randomized controlled trials. Annotations include demarcations of text spans that describe the Patient population enrolled, the Interventions studied and to what they were Compared, and the Outcomes measured (the `PICO' elements). These spans are further annotated at a more granular level, e.g., individual interventions within them are marked and mapped onto a structured medical vocabulary. We acquired annotations from a diverse set of workers with varying levels of expertise and cost. We describe our data collection process and the corpus itself in detail. We then outline a set of challenging NLP tasks that would aid searching of the medical literature and the practice of evidence-based medicine.

Representation engineering methods have recently shown promise for enabling efficient steering of model behavior. However, evaluation pipelines for these methods have primarily relied on subjective demonstrations, instead of quantitative, objective metrics. We aim to take a step towards addressing this issue by advocating for four properties missing from current evaluations: (i) contexts sufficiently similar to downstream tasks should be used for assessing intervention quality; (ii) model likelihoods should be accounted for; (iii) evaluations should allow for standardized comparisons across different target behaviors; and (iv) baseline comparisons should be offered. We introduce an evaluation pipeline grounded in these criteria, offering both a quantitative and visual analysis of how effectively a given method works. We use this pipeline to evaluate two representation engineering methods on how effectively they can steer behaviors such as truthfulness and corrigibility, finding that some interventions are less effective than previously reported.

Learnable embedding vector is one of the most important applications in machine learning, and is widely used in various database-related domains. However, the high dimensionality of sparse data in recommendation tasks and the huge volume of corpus in retrieval-related tasks lead to a large memory consumption of the embedding table, which poses a great challenge to the training and deployment of models. Recent research has proposed various methods to compress the embeddings at the cost of a slight decrease in model quality or the introduction of other overheads. Nevertheless, the relative performance of these methods remains unclear. Existing experimental comparisons only cover a subset of these methods and focus on limited metrics. In this paper, we perform a comprehensive comparative analysis and experimental evaluation of embedding compression. We introduce a new taxonomy that categorizes these techniques based on their characteristics and methodologies, and further develop a modular benchmarking framework that integrates 14 representative methods. Under a uniform test environment, our benchmark fairly evaluates each approach, presents their strengths and weaknesses under different memory budgets, and recommends the best method based on the use case. In addition to providing useful guidelines, our study also uncovers the limitations of current methods and suggests potential directions for future research.

Extracting causal relationships from observed correlations is a growing area in probabilistic reasoning, originating with the seminal work of Pearl and others from the early 1990s. This paper develops a new, categorically oriented view based on a clear distinction between syntax (string diagrams) and semantics (stochastic matrices), connected via interpretations as structure-preserving functors. A key notion in the identification of causal effects is that of an intervention, whereby a variable is forcefully set to a particular value independent of any prior propensities. We represent the effect of such an intervention as an endofunctor which performs `string diagram surgery' within the syntactic category of string diagrams. This diagram surgery in turn yields a new, interventional distribution via the interpretation functor. While in general there is no way to compute interventional distributions purely from observed data, we show that this is possible in certain special cases using a calculational tool called comb disintegration. We demonstrate the use of this technique on a well-known toy example, where we predict the causal effect of smoking on cancer in the presence of a confounding common cause. After developing this specific example, we show this technique provides simple sufficient conditions for computing interventions which apply to a wide variety of situations considered in the causal inference literature.

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

We explore the potential of ChatGPT (3.5-turbo and 4) to generate conversations focused on self-care strategies for African-American heart failure patients -- a domain with limited specialized datasets. To simulate patient-health educator dialogues, we employed four prompting strategies: domain, African American Vernacular English (AAVE), Social Determinants of Health (SDOH), and SDOH-informed reasoning. Conversations were generated across key self-care domains of food, exercise, and fluid intake, with varying turn lengths (5, 10, 15) and incorporated patient-specific SDOH attributes such as age, gender, neighborhood, and socioeconomic status. Our findings show that effective prompt design is essential. While incorporating SDOH and reasoning improves dialogue quality, ChatGPT still lacks the empathy and engagement needed for meaningful healthcare communication.

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.

Large Language Models (LLMs) are at the forefront of NLP achievements but fall short in dealing with shortcut learning, factual inconsistency, and vulnerability to adversarial inputs.These shortcomings are especially critical in medical contexts, where they can misrepresent actual model capabilities. Addressing this, we present SemEval-2024 Task 2: Safe Biomedical Natural Language Inference for ClinicalTrials. Our contributions include the refined NLI4CT-P dataset (i.e., Natural Language Inference for Clinical Trials - Perturbed), designed to challenge LLMs with interventional and causal reasoning tasks, along with a comprehensive evaluation of methods and results for participant submissions. A total of 106 participants registered for the task contributing to over 1200 individual submissions and 25 system overview papers. This initiative aims to advance the robustness and applicability of NLI models in healthcare, ensuring safer and more dependable AI assistance in clinical decision-making. We anticipate that the dataset, models, and outcomes of this task can support future research in the field of biomedical NLI. The dataset, competition leaderboard, and website are publicly available.

Accurate prediction of major adverse cardiac events (MACE) remains a central challenge in cardiovascular prognosis. We present PRISM (Prompt-guided Representation Integration for Survival Modeling), a self-supervised framework that integrates visual representations from non-contrast cardiac cine magnetic resonance imaging with structured electronic health records (EHRs) for survival analysis. PRISM extracts temporally synchronized imaging features through motion-aware multi-view distillation and modulates them using medically informed textual prompts to enable fine-grained risk prediction. Across four independent clinical cohorts, PRISM consistently surpasses classical survival prediction models and state-of-the-art (SOTA) deep learning baselines under internal and external validation. Further clinical findings demonstrate that the combined imaging and EHR representations derived from PRISM provide valuable insights into cardiac risk across diverse cohorts. Three distinct imaging signatures associated with elevated MACE risk are uncovered, including lateral wall dyssynchrony, inferior wall hypersensitivity, and anterior elevated focus during diastole. Prompt-guided attribution further identifies hypertension, diabetes, and smoking as dominant contributors among clinical and physiological EHR factors.

Large Language Models (LLMs) and Retrieval-Augmented Generation (RAG) systems are increasingly integrated into clinical workflows; however, prompt injection attacks can steer these systems toward clinically unsafe or misleading outputs. We introduce the Medical Prompt Injection Benchmark (MPIB), a dataset-and-benchmark suite for evaluating clinical safety under both direct prompt injection and indirect, RAG-mediated injection across clinically grounded tasks. MPIB emphasizes outcome-level risk via the Clinical Harm Event Rate (CHER), which measures high-severity clinical harm events under a clinically grounded taxonomy, and reports CHER alongside Attack Success Rate (ASR) to disentangle instruction compliance from downstream patient risk. The benchmark comprises 9,697 curated instances constructed through multi-stage quality gates and clinical safety linting. Evaluating MPIB across a diverse set of baseline LLMs and defense configurations, we find that ASR and CHER can diverge substantially, and that robustness depends critically on whether adversarial instructions appear in the user query or in retrieved context. We release MPIB with evaluation code, adversarial baselines, and comprehensive documentation to support reproducible and systematic research on clinical prompt injection. Code and data are available at GitHub (code) and Hugging Face (data).

Clinical trials are crucial for drug development but are time consuming, expensive, and often burdensome on patients. More importantly, clinical trials face uncertain outcomes due to issues with efficacy, safety, or problems with patient recruitment. If we were better at predicting the results of clinical trials, we could avoid having to run trials that will inevitably fail more resources could be devoted to trials that are likely to succeed. In this paper, we propose Hierarchical INteraction Network (HINT) for more general, clinical trial outcome predictions for all diseases based on a comprehensive and diverse set of web data including molecule information of the drugs, target disease information, trial protocol and biomedical knowledge. HINT first encode these multi-modal data into latent embeddings, where an imputation module is designed to handle missing data. Next, these embeddings will be fed into the knowledge embedding module to generate knowledge embeddings that are pretrained using external knowledge on pharmaco-kinetic properties and trial risk from the web. Then the interaction graph module will connect all the embedding via domain knowledge to fully capture various trial components and their complex relations as well as their influences on trial outcomes. Finally, HINT learns a dynamic attentive graph neural network to predict trial outcome. Comprehensive experimental results show that HINT achieves strong predictive performance, obtaining 0.772, 0.607, 0.623, 0.703 on PR-AUC for Phase I, II, III, and indication outcome prediction, respectively. It also consistently outperforms the best baseline method by up to 12.4\% on PR-AUC.

The COVID-19 pandemic has made a huge global impact and cost millions of lives. As COVID-19 vaccines were rolled out, they were quickly met with widespread hesitancy. To address the concerns of hesitant people, we launched VIRA, a public dialogue system aimed at addressing questions and concerns surrounding the COVID-19 vaccines. Here, we release VIRADialogs, a dataset of over 8k dialogues conducted by actual users with VIRA, providing a unique real-world conversational dataset. In light of rapid changes in users' intents, due to updates in guidelines or in response to new information, we highlight the important task of intent discovery in this use-case. We introduce a novel automatic evaluation framework for intent discovery, leveraging the existing intent classifier of VIRA. We use this framework to report baseline intent discovery results over VIRADialogs, that highlight the difficulty of this task.

Identifying effective interventions from the scientific literature is challenging due to the high volume of publications, specialized terminology, and inconsistent reporting formats, making manual curation laborious and prone to oversight. To address this challenge, this paper proposes a novel framework leveraging large language models (LLMs), which integrates a progressive ontology prompting (POP) algorithm with a dual-agent system, named LLM-Duo. On the one hand, the POP algorithm conducts a prioritized breadth-first search (BFS) across a predefined ontology, generating structured prompt templates and action sequences to guide the automatic annotation process. On the other hand, the LLM-Duo system features two specialized LLM agents, an explorer and an evaluator, working collaboratively and adversarially to continuously refine annotation quality. We showcase the real-world applicability of our framework through a case study focused on speech-language intervention discovery. Experimental results show that our approach surpasses advanced baselines, achieving more accurate and comprehensive annotations through a fully automated process. Our approach successfully identified 2,421 interventions from a corpus of 64,177 research articles in the speech-language pathology domain, culminating in the creation of a publicly accessible intervention knowledge base with great potential to benefit the speech-language pathology community.

Objective: To transform heterogeneous clinical data from electronic health records into clinically meaningful constructed features using data driven method that rely, in part, on temporal relations among data. Materials and Methods: The clinically meaningful representations of medical concepts and patients are the key for health analytic applications. Most of existing approaches directly construct features mapped to raw data (e.g., ICD or CPT codes), or utilize some ontology mapping such as SNOMED codes. However, none of the existing approaches leverage EHR data directly for learning such concept representation. We propose a new way to represent heterogeneous medical concepts (e.g., diagnoses, medications and procedures) based on co-occurrence patterns in longitudinal electronic health records. The intuition behind the method is to map medical concepts that are co-occuring closely in time to similar concept vectors so that their distance will be small. We also derive a simple method to construct patient vectors from the related medical concept vectors. Results: For qualitative evaluation, we study similar medical concepts across diagnosis, medication and procedure. In quantitative evaluation, our proposed representation significantly improves the predictive modeling performance for onset of heart failure (HF), where classification methods (e.g. logistic regression, neural network, support vector machine and K-nearest neighbors) achieve up to 23% improvement in area under the ROC curve (AUC) using this proposed representation. Conclusion: We proposed an effective method for patient and medical concept representation learning. The resulting representation can map relevant concepts together and also improves predictive modeling performance.

In this paper, we introduce EasyEdit2, a framework designed to enable plug-and-play adjustability for controlling Large Language Model (LLM) behaviors. EasyEdit2 supports a wide range of test-time interventions, including safety, sentiment, personality, reasoning patterns, factuality, and language features. Unlike its predecessor, EasyEdit2 features a new architecture specifically designed for seamless model steering. It comprises key modules such as the steering vector generator and the steering vector applier, which enable automatic generation and application of steering vectors to influence the model's behavior without modifying its parameters. One of the main advantages of EasyEdit2 is its ease of use-users do not need extensive technical knowledge. With just a single example, they can effectively guide and adjust the model's responses, making precise control both accessible and efficient. Empirically, we report model steering performance across different LLMs, demonstrating the effectiveness of these techniques. We have released the source code on GitHub at https://github.com/zjunlp/EasyEdit along with a demonstration notebook. In addition, we provide a demo video at https://zjunlp.github.io/project/EasyEdit2/video for a quick introduction.

Clinical trials drive improvements in cancer treatments and outcomes. However, most adults with cancer do not participate in trials, and trials often fail to enroll enough patients to answer their scientific questions. Artificial intelligence could accelerate matching of patients to appropriate clinical trials. Here, we describe the development and evaluation of the MatchMiner-AI pipeline for clinical trial searching and ranking. MatchMiner-AI focuses on matching patients to potential trials based on core criteria describing clinical "spaces," or disease contexts, targeted by a trial. It aims to accelerate the human work of identifying potential matches, not to fully automate trial screening. The pipeline includes modules for extraction of key information from a patient's longitudinal electronic health record; rapid ranking of candidate trial-patient matches based on embeddings in vector space; and classification of whether a candidate match represents a reasonable clinical consideration. Code and synthetic data are available at https://huggingface.co/ksg-dfci/MatchMiner-AI . Model weights based on synthetic data are available at https://huggingface.co/ksg-dfci/TrialSpace and https://huggingface.co/ksg-dfci/TrialChecker . A simple cancer clinical trial search engine to demonstrate pipeline components is available at https://huggingface.co/spaces/ksg-dfci/trial_search_alpha .

Breast cancer screening plays a pivotal role in early detection and subsequent effective management of the disease, impacting patient outcomes and survival rates. This study aims to assess breast cancer screening rates nationwide in the United States and investigate the impact of social determinants of health on these screening rates. Data on mammography screening at the census tract level for 2018 and 2020 were collected from the Behavioral Risk Factor Surveillance System. We developed a large dataset of social determinants of health, comprising 13 variables for 72337 census tracts. Spatial analysis employing Getis-Ord Gi statistics was used to identify clusters of high and low breast cancer screening rates. To evaluate the influence of these social determinants, we implemented a random forest model, with the aim of comparing its performance to linear regression and support vector machine models. The models were evaluated using R2 and root mean squared error metrics. Shapley Additive Explanations values were subsequently used to assess the significance of variables and direction of their influence. Geospatial analysis revealed elevated screening rates in the eastern and northern United States, while central and midwestern regions exhibited lower rates. The random forest model demonstrated superior performance, with an R2=64.53 and root mean squared error of 2.06 compared to linear regression and support vector machine models. Shapley Additive Explanations values indicated that the percentage of the Black population, the number of mammography facilities within a 10-mile radius, and the percentage of the population with at least a bachelor's degree were the most influential variables, all positively associated with mammography screening rates.

Existing machine learning methods for causal inference usually estimate quantities expressed via the mean of potential outcomes (e.g., average treatment effect). However, such quantities do not capture the full information about the distribution of potential outcomes. In this work, we estimate the density of potential outcomes after interventions from observational data. For this, we propose a novel, fully-parametric deep learning method called Interventional Normalizing Flows. Specifically, we combine two normalizing flows, namely (i) a nuisance flow for estimating nuisance parameters and (ii) a target flow for parametric estimation of the density of potential outcomes. We further develop a tractable optimization objective based on a one-step bias correction for efficient and doubly robust estimation of the target flow parameters. As a result, our Interventional Normalizing Flows offer a properly normalized density estimator. Across various experiments, we demonstrate that our Interventional Normalizing Flows are expressive and highly effective, and scale well with both sample size and high-dimensional confounding. To the best of our knowledge, our Interventional Normalizing Flows are the first proper fully-parametric, deep learning method for density estimation of potential outcomes.

Clinical trials are fundamental in developing new drugs, medical devices, and treatments. However, they are often time-consuming and have low success rates. Although there have been initial attempts to create large language models (LLMs) for clinical trial design and patient-trial matching, these models remain task-specific and not adaptable to diverse clinical trial tasks. To address this challenge, we propose a clinical trial foundation model named Panacea, designed to handle multiple tasks, including trial search, trial summarization, trial design, and patient-trial matching. We also assemble a large-scale dataset, named TrialAlign, of 793,279 trial documents and 1,113,207 trial-related scientific papers, to infuse clinical knowledge into the model by pre-training. We further curate TrialInstruct, which has 200,866 of instruction data for fine-tuning. These resources enable Panacea to be widely applicable for a range of clinical trial tasks based on user requirements. We evaluated Panacea on a new benchmark, named TrialPanorama, which covers eight clinical trial tasks. Our method performed the best on seven of the eight tasks compared to six cutting-edge generic or medicine-specific LLMs. Specifically, Panacea showed great potential to collaborate with human experts in crafting the design of eligibility criteria, study arms, and outcome measures, in multi-round conversations. In addition, Panacea achieved 14.42% improvement in patient-trial matching, 41.78% to 52.02% improvement in trial search, and consistently ranked at the top for five aspects of trial summarization. Our approach demonstrates the effectiveness of Panacea in clinical trials and establishes a comprehensive resource, including training data, model, and benchmark, for developing clinical trial foundation models, paving the path for AI-based clinical trial development.

Large language models (LLMs) have demonstrated impressive capabilities in natural language understanding and generation, but controlling their behavior reliably remains challenging, especially in open-ended generation settings. This paper introduces a novel supervised steering approach that operates in sparse, interpretable representation spaces. We employ sparse autoencoders (SAEs)to obtain sparse latent representations that aim to disentangle semantic attributes from model activations. Then we train linear classifiers to identify a small subspace of task-relevant dimensions in latent representations. Finally, we learn supervised steering vectors constrained to this subspace, optimized to align with target behaviors. Experiments across sentiment, truthfulness, and politics polarity steering tasks with multiple LLMs demonstrate that our supervised steering vectors achieve higher success rates with minimal degradation in generation quality compared to existing methods. Further analysis reveals that a notably small subspace is sufficient for effective steering, enabling more targeted and interpretable interventions.

Steering vectors are a promising approach to control the behaviour of large language models. However, their underlying mechanisms remain poorly understood. While sparse autoencoders (SAEs) may offer a potential method to interpret steering vectors, recent findings show that SAE-reconstructed vectors often lack the steering properties of the original vectors. This paper investigates why directly applying SAEs to steering vectors yields misleading decompositions, identifying two reasons: (1) steering vectors fall outside the input distribution for which SAEs are designed, and (2) steering vectors can have meaningful negative projections in feature directions, which SAEs are not designed to accommodate. These limitations hinder the direct use of SAEs for interpreting steering vectors.

Throughout the different phases of a drug development program, randomized trials are used to establish the tolerability, safety, and efficacy of a candidate drug. At each stage one aims to optimize the design of future studies by extrapolation from the available evidence at the time. This includes collected trial data and relevant external data. However, relevant external data are typically available as averages only, for example from trials on alternative treatments reported in the literature. Here we report on such an example from a drug development for wet age-related macular degeneration. This disease is the leading cause of severe vision loss in the elderly. While current treatment options are efficacious, they are also a substantial burden for the patient. Hence, new treatments are under development which need to be compared against existing treatments. The general statistical problem this leads to is meta-analysis, which addresses the question of how we can combine datasets collected under different conditions. Bayesian methods have long been used to achieve partial pooling. Here we consider the challenge when the model of interest is complex (hierarchical and nonlinear) and one dataset is given as raw data while the second dataset is given as averages only. In such a situation, common meta-analytic methods can only be applied when the model is sufficiently simple for analytic approaches. When the model is too complex, for example nonlinear, an analytic approach is not possible. We provide a Bayesian solution by using simulation to approximately reconstruct the likelihood of the external summary and allowing the parameters in the model to vary under the different conditions. We first evaluate our approach using fake-data simulations and then report results for the drug development program that motivated this research.

Machine learning (ML) holds great potential for accurately forecasting treatment outcomes over time, which could ultimately enable the adoption of more individualized treatment strategies in many practical applications. However, a significant challenge that has been largely overlooked by the ML literature on this topic is the presence of informative sampling in observational data. When instances are observed irregularly over time, sampling times are typically not random, but rather informative -- depending on the instance's characteristics, past outcomes, and administered treatments. In this work, we formalize informative sampling as a covariate shift problem and show that it can prohibit accurate estimation of treatment outcomes if not properly accounted for. To overcome this challenge, we present a general framework for learning treatment outcomes in the presence of informative sampling using inverse intensity-weighting, and propose a novel method, TESAR-CDE, that instantiates this framework using Neural CDEs. Using a simulation environment based on a clinical use case, we demonstrate the effectiveness of our approach in learning under informative sampling.

The effective application of foundation models to translational research in immune-mediated diseases requires multimodal patient-level representations that can capture complex phenotypes emerging from multicellular interactions. Yet most current biological foundation models focus only on single-cell resolution and are evaluated on technical metrics often disconnected from actual drug development tasks and challenges. Here, we introduce EVA, the first cross-species, multimodal foundation model of immunology and inflammation, a therapeutic area where shared pathogenic mechanisms create unique opportunities for transfer learning. EVA harmonizes transcriptomics data across species, platforms, and resolutions, and integrates histology data to produce rich, unified patient representations. We establish clear scaling laws, demonstrating that increasing model size and compute translates to improvements in both pretraining and downstream tasks performance. We introduce a comprehensive evaluation suite of 39 tasks spanning the drug development pipeline: zero-shot target efficacy and gene function prediction for discovery, cross-species or cross-diseases molecular perturbations for preclinical development, and patient stratification with treatment response prediction or disease activity prediction for clinical trials applications. We benchmark EVA against several state-of-the-art biological foundation models and baselines on these tasks, and demonstrate state-of-the-art results on each task category. Using mechanistic interpretability, we further identify biological meaningful features, revealing intertwined representations across species and technologies. We release an open version of EVA for transcriptomics to accelerate research on immune-mediated diseases.

Mechanistic interpretability seeks to understand the internal mechanisms of machine learning models, where localization -- identifying the important model components -- is a key step. Activation patching, also known as causal tracing or interchange intervention, is a standard technique for this task (Vig et al., 2020), but the literature contains many variants with little consensus on the choice of hyperparameters or methodology. In this work, we systematically examine the impact of methodological details in activation patching, including evaluation metrics and corruption methods. In several settings of localization and circuit discovery in language models, we find that varying these hyperparameters could lead to disparate interpretability results. Backed by empirical observations, we give conceptual arguments for why certain metrics or methods may be preferred. Finally, we provide recommendations for the best practices of activation patching going forwards.

Learning vector representations (aka. embeddings) of users and items lies at the core of modern recommender systems. Ranging from early matrix factorization to recently emerged deep learning based methods, existing efforts typically obtain a user's (or an item's) embedding by mapping from pre-existing features that describe the user (or the item), such as ID and attributes. We argue that an inherent drawback of such methods is that, the collaborative signal, which is latent in user-item interactions, is not encoded in the embedding process. As such, the resultant embeddings may not be sufficient to capture the collaborative filtering effect. In this work, we propose to integrate the user-item interactions -- more specifically the bipartite graph structure -- into the embedding process. We develop a new recommendation framework Neural Graph Collaborative Filtering (NGCF), which exploits the user-item graph structure by propagating embeddings on it. This leads to the expressive modeling of high-order connectivity in user-item graph, effectively injecting the collaborative signal into the embedding process in an explicit manner. We conduct extensive experiments on three public benchmarks, demonstrating significant improvements over several state-of-the-art models like HOP-Rec and Collaborative Memory Network. Further analysis verifies the importance of embedding propagation for learning better user and item representations, justifying the rationality and effectiveness of NGCF. Codes are available at https://github.com/xiangwang1223/neural_graph_collaborative_filtering.

One method for obtaining generalizable solutions to machine learning tasks when presented with diverse training environments is to find invariant representations of the data. These are representations of the covariates such that the best model on top of the representation is invariant across training environments. In the context of linear Structural Equation Models (SEMs), invariant representations might allow us to learn models with out-of-distribution guarantees, i.e., models that are robust to interventions in the SEM. To address the invariant representation problem in a {\em finite sample} setting, we consider the notion of epsilon-approximate invariance. We study the following question: If a representation is approximately invariant with respect to a given number of training interventions, will it continue to be approximately invariant on a larger collection of unseen SEMs? This larger collection of SEMs is generated through a parameterized family of interventions. Inspired by PAC learning, we obtain finite-sample out-of-distribution generalization guarantees for approximate invariance that holds probabilistically over a family of linear SEMs without faithfulness assumptions. Our results show bounds that do not scale in ambient dimension when intervention sites are restricted to lie in a constant size subset of in-degree bounded nodes. We also show how to extend our results to a linear indirect observation model that incorporates latent variables.

Vision-language foundation models (VLMs) show promise for diverse imaging tasks but often underperform on medical benchmarks. Prior efforts to improve performance include model finetuning, which requires large domain-specific datasets and significant compute, or manual prompt engineering, which is hard to generalize and often inaccessible to medical institutions seeking to deploy these tools. These challenges motivate interest in approaches that draw on a model's embedded knowledge while abstracting away dependence on human-designed prompts to enable scalable, weight-agnostic performance improvements. To explore this, we adapt the Declarative Self-improving Python (DSPy) framework for structured automated prompt optimization in medical vision-language systems through a comprehensive, formal evaluation. We implement prompting pipelines for five medical imaging tasks across radiology, gastroenterology, and dermatology, evaluating 10 open-source VLMs with four prompt optimization techniques. Optimized pipelines achieved a median relative improvement of 53% over zero-shot prompting baselines, with the largest gains ranging from 300% to 3,400% on tasks where zero-shot performance is low. These results highlight the substantial potential of applying automated prompt optimization to medical AI systems, demonstrating significant gains for vision-based applications requiring accurate clinical image interpretation. By reducing dependence on prompt design to elicit intended outputs, these techniques allow clinicians to focus on patient care and clinical decision-making. Furthermore, our experiments offer scalability and preserve data privacy, demonstrating performance improvement on open-source VLMs. We publicly release our evaluation pipelines to support reproducible research on specialized medical tasks, available at https://github.com/DaneshjouLab/prompt-triage-lab.

We present time vectors, a simple tool to customize language models to new time periods. Time vectors are created by finetuning a language model on data from a single time (e.g., a year or month), and then subtracting the weights of the original pretrained model. This vector specifies a direction in weight space that, as our experiments show, improves performance on text from that time period. Time vectors specialized to adjacent time periods appear to be positioned closer together in a manifold. Using this structure, we interpolate between time vectors to induce new models that perform better on intervening and future time periods, without any additional training. We demonstrate the consistency of our findings across different tasks, domains, model sizes, and time scales. Our results suggest that time is encoded in the weight space of finetuned models.

While activation steering in large language models (LLMs) is a growing area of research, methods can often incur broader effects than desired. This motivates isolation of purer concept vectors to enable targeted interventions and understand LLM behavior at a more granular level. We present RepIt, a simple and data-efficient framework for isolating concept-specific representations. Across five frontier LLMs, RepIt enables precise interventions: it selectively suppresses refusal on targeted concepts while preserving refusal elsewhere, producing models that answer WMD-related questions while still scoring as safe on standard benchmarks. We further show that the corrective signal localizes to just 100-200 neurons and that robust target representations can be extracted from as few as a dozen examples on a single A6000. This efficiency raises a dual concern: manipulations can be performed with modest compute and data to extend to underrepresented data-scarce topics while evading existing benchmarks. By disentangling refusal vectors with RepIt, this work demonstrates that targeted interventions can counteract overgeneralization, laying the foundation for more granular control of model behavior.

As large language models (LLMs) are widely deployed across various domains, the ability to control their generated outputs has become more critical. This control involves aligning LLMs outputs with human values and ethical principles or customizing LLMs on specific topics or styles for individual users. Existing controlled generation methods either require significant computational resources and extensive trial-and-error or provide coarse-grained control. In this paper, we propose Generation with Concept Activation Vector (GCAV), a lightweight model control framework that ensures accurate control without requiring resource-extensive fine-tuning. Specifically, GCAV first trains a concept activation vector for specified concepts to be controlled, such as toxicity. During inference, GCAV steers the concept vector in LLMs, for example, by removing the toxicity concept vector from the activation layers. Control experiments from different perspectives, including toxicity reduction, sentiment control, linguistic style, and topic control, demonstrate that our framework achieves state-of-the-art performance with granular control, allowing for fine-grained adjustments of both the steering layers and the steering magnitudes for individual samples.

Interpretability is becoming an active research topic as machine learning (ML) models are more widely used to make critical decisions. Tabular data is one of the most commonly used modes of data in diverse applications such as healthcare and finance. Much of the existing interpretability methods used for tabular data only report feature-importance scores -- either locally (per example) or globally (per model) -- but they do not provide interpretation or visualization of how the features interact. We address this limitation by introducing Feature Vectors, a new global interpretability method designed for tabular datasets. In addition to providing feature-importance, Feature Vectors discovers the inherent semantic relationship among features via an intuitive feature visualization technique. Our systematic experiments demonstrate the empirical utility of this new method by applying it to several real-world datasets. We further provide an easy-to-use Python package for Feature Vectors.

Adherence to prescribed treatments is crucial for individuals with chronic conditions to avoid costly or adverse health outcomes. For certain patient groups, intensive lifestyle interventions are vital for enhancing medication adherence. Accurate forecasting of treatment adherence can open pathways to developing an on-demand intervention tool, enabling timely and personalized support. With the increasing popularity of smartphones and wearables, it is now easier than ever to develop and deploy smart activity monitoring systems. However, effective forecasting systems for treatment adherence based on wearable sensors are still not widely available. We close this gap by proposing Adherence Forecasting and Intervention with Machine Intelligence (AIMI). AIMI is a knowledge-guided adherence forecasting system that leverages smartphone sensors and previous medication history to estimate the likelihood of forgetting to take a prescribed medication. A user study was conducted with 27 participants who took daily medications to manage their cardiovascular diseases. We designed and developed CNN and LSTM-based forecasting models with various combinations of input features and found that LSTM models can forecast medication adherence with an accuracy of 0.932 and an F-1 score of 0.936. Moreover, through a series of ablation studies involving convolutional and recurrent neural network architectures, we demonstrate that leveraging known knowledge about future and personalized training enhances the accuracy of medication adherence forecasting. Code available: https://github.com/ab9mamun/AIMI.

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

With the looming threat of climate change, neglected tropical diseases such as dengue, zika, and chikungunya have the potential to become an even greater global concern. Remote sensing technologies can aid in controlling the spread of Aedes Aegypti, the transmission vector of such diseases, by automating the detection and mapping of mosquito breeding sites, such that local entities can properly intervene. In this work, we leverage YOLOv7, a state-of-the-art and computationally efficient detection approach, to localize and track mosquito foci in videos captured by unmanned aerial vehicles. We experiment on a dataset released to the public as part of the ICIP 2023 grand challenge entitled Automatic Detection of Mosquito Breeding Grounds. We show that YOLOv7 can be directly applied to detect larger foci categories such as pools, tires, and water tanks and that a cheap and straightforward aggregation of frame-by-frame detection can incorporate time consistency into the tracking process.

Vector Symbolic Architectures (VSAs) give a way to represent a complex object as a single fixed-length vector, so that similar objects have similar vector representations. These vector representations then become easy to use for machine learning or nearest-neighbor search. We review a previously proposed VSA method, MBAT (Matrix Binding of Additive Terms), which uses multiplication by random matrices for binding related terms. However, multiplying by such matrices introduces instabilities which can harm performance. Making the random matrices be orthogonal matrices provably fixes this problem. With respect to larger scale applications, we see how to apply MBAT vector representations for any data expressed in JSON. JSON is used in numerous programming languages to express complex data, but its native format appears highly unsuited for machine learning. Expressing JSON as a fixed-length vector makes it readily usable for machine learning and nearest-neighbor search. Creating such JSON vectors also shows that a VSA needs to employ binding operations that are non-commutative. VSAs are now ready to try with full-scale practical applications, including healthcare, pharmaceuticals, and genomics. Keywords: MBAT (Matrix Binding of Additive Terms), VSA (Vector Symbolic Architecture), HDC (Hyperdimensional Computing), Distributed Representations, Binding, Orthogonal Matrices, Recurrent Connections, Machine Learning, Search, JSON, VSA Applications

Large language models (LLMs) are rapidly transitioning into medical clinical use, yet their reliability under realistic, multi-turn interactions remains poorly understood. Existing evaluation frameworks typically assess single-turn question answering under idealized conditions, overlooking the complexities of medical consultations where conflicting input, misleading context, and authority influence are common. We introduce MedQA-Followup, a framework for systematically evaluating multi-turn robustness in medical question answering. Our approach distinguishes between shallow robustness (resisting misleading initial context) and deep robustness (maintaining accuracy when answers are challenged across turns), while also introducing an indirect-direct axis that separates contextual framing (indirect) from explicit suggestion (direct). Using controlled interventions on the MedQA dataset, we evaluate five state-of-the-art LLMs and find that while models perform reasonably well under shallow perturbations, they exhibit severe vulnerabilities in multi-turn settings, with accuracy dropping from 91.2% to as low as 13.5% for Claude Sonnet 4. Counterintuitively, indirect, context-based interventions are often more harmful than direct suggestions, yielding larger accuracy drops across models and exposing a significant vulnerability for clinical deployment. Further compounding analyses reveal model differences, with some showing additional performance drops under repeated interventions while others partially recovering or even improving. These findings highlight multi-turn robustness as a critical but underexplored dimension for safe and reliable deployment of medical LLMs.

The drug development pipeline for a new compound can last 10-20 years and cost over 10 billion. Drug repurposing offers a more time- and cost-effective alternative. Computational approaches based on biomedical knowledge graph representations have recently yielded new drug repurposing hypotheses. In this study, we present a novel, disease-specific hypergraph representation learning technique to derive contextual embeddings of biological pathways of various lengths but that all start at any given drug and all end at the disease of interest. Further, we extend this method to multi-disease hypergraphs. To determine the repurposing potential of each of the 1,522 drugs, we derive drug-specific distributions of cosine similarity values and ultimately consider the median for ranking. Cosine similarity values are computed between (1) all biological pathways starting at the considered drug and ending at the disease of interest and (2) all biological pathways starting at drugs currently prescribed against that disease and ending at the disease of interest. We illustrate our approach with Alzheimer's disease (AD) and two of its risk factors: hypertension (HTN) and type 2 diabetes (T2D). We compare each drug's rank across four hypergraph settings (single- or multi-disease): AD only, AD + HTN, AD + T2D, and AD + HTN + T2D. Notably, our framework led to the identification of two promising drugs whose repurposing potential was significantly higher in hypergraphs combining two diseases: dapagliflozin (antidiabetic; moved up, from top 32% to top 7%, across all considered drugs) and debrisoquine (antihypertensive; moved up, from top 76% to top 23%). Our approach serves as a hypothesis generation tool, to be paired with a validation pipeline relying on laboratory experiments and semi-automated parsing of the biomedical literature.

Previous works on Treatment Effect Estimation (TEE) are not in widespread use because they are predominantly theoretical, where strong parametric assumptions are made but untractable for practical application. Recent work uses multilayer perceptron (MLP) for modeling casual relationships, however, MLPs lag far behind recent advances in ML methodology, which limits their applicability and generalizability. To extend beyond the single domain formulation and towards more realistic learning scenarios, we explore model design spaces beyond MLPs, i.e., transformer backbones, which provide flexibility where attention layers govern interactions among treatments and covariates to exploit structural similarities of potential outcomes for confounding control. Through careful model design, Transformers as Treatment Effect Estimators (TransTEE) is proposed. We show empirically that TransTEE can: (1) serve as a general purpose treatment effect estimator that significantly outperforms competitive baselines in a variety of challenging TEE problems (e.g., discrete, continuous, structured, or dosage-associated treatments) and is applicable to both when covariates are tabular and when they consist of structural data (e.g., texts, graphs); (2) yield multiple advantages: compatibility with propensity score modeling, parameter efficiency, robustness to continuous treatment value distribution shifts, explainable in covariate adjustment, and real-world utility in auditing pre-trained language models

Reliably controlling the behavior of large language models is a pressing open problem. Existing methods include supervised finetuning, reinforcement learning from human feedback, prompt engineering and guided decoding. We instead investigate activation engineering: modifying activations at inference-time to predictably alter model behavior. We bias the forward pass with a 'steering vector' implicitly specified through natural language. Past work learned these steering vectors; our Activation Addition (ActAdd) method instead computes them by taking the activation differences which result from pairs of prompts. We demonstrate ActAdd on GPT-2 on OpenWebText and ConceptNet, and replicate the effect on Llama-13B and GPT-J-6B. Our approach yields inference-time control over high-level properties of output & preserves performance on off-target topics. The method requires far less compute and implementation effort than finetuning and RLHF, allows for natural language specification by users, and its overhead scales naturally with model size.

Combination therapies have become the standard of care for diseases such as cancer, tuberculosis, malaria and HIV. However, the combinatorial set of available multi-drug treatments creates a challenge in identifying effective combination therapies available in a situation. To assist medical professionals in identifying beneficial drug-combinations, we construct an expert-annotated dataset for extracting information about the efficacy of drug combinations from the scientific literature. Beyond its practical utility, the dataset also presents a unique NLP challenge, as the first relation extraction dataset consisting of variable-length relations. Furthermore, the relations in this dataset predominantly require language understanding beyond the sentence level, adding to the challenge of this task. We provide a promising baseline model and identify clear areas for further improvement. We release our dataset, code, and baseline models publicly to encourage the NLP community to participate in this task.

Recent advances in large language model (LLM) embeddings have enabled powerful representations for biological data, but most applications to date focus only on gene-level information. We present one of the first systematic frameworks to generate variant-level embeddings across the entire human genome. Using curated annotations from FAVOR, ClinVar, and the GWAS Catalog, we constructed semantic text descriptions for 8.9 billion possible variants and generated embeddings at three scales: 1.5 million HapMap3+MEGA variants, ~90 million imputed UK Biobank variants, and ~9 billion all possible variants. Embeddings were produced with both OpenAI's text-embedding-3-large and the open-source Qwen3-Embedding-0.6B models. Baseline experiments demonstrate high predictive accuracy for variant properties, validating the embeddings as structured representations of genomic variation. We outline two downstream applications: embedding-informed hypothesis testing by extending the Frequentist And Bayesian framework to genome-wide association studies, and embedding-augmented genetic risk prediction that enhances standard polygenic risk scores. These resources, publicly available on Hugging Face, provide a foundation for advancing large-scale genomic discovery and precision medicine.

Inferring causal structures from experimentation is a central task in many domains. For example, in biology, recent advances allow us to obtain single-cell expression data under multiple interventions such as drugs or gene knockouts. However, the targets of the interventions are often uncertain or unknown and the number of observations limited. As a result, standard causal discovery methods can no longer be reliably used. To fill this gap, we propose a Bayesian framework (BaCaDI) for discovering and reasoning about the causal structure that underlies data generated under various unknown experimental or interventional conditions. BaCaDI is fully differentiable, which allows us to infer the complex joint posterior over the intervention targets and the causal structure via efficient gradient-based variational inference. In experiments on synthetic causal discovery tasks and simulated gene-expression data, BaCaDI outperforms related methods in identifying causal structures and intervention targets.

Objective: The reading level of health educational materials significantly influences the understandability and accessibility of the information, particularly for minoritized populations. Many patient educational resources surpass the reading level and complexity of widely accepted standards. There is a critical need for high-performing text simplification models in health information to enhance dissemination and literacy. This need is particularly acute in cancer education, where effective prevention and screening education can substantially reduce morbidity and mortality. Methods: We introduce Simplified Digestive Cancer (SimpleDC), a parallel corpus of cancer education materials tailored for health text simplification research, comprising educational content from the American Cancer Society, Centers for Disease Control and Prevention, and National Cancer Institute. Utilizing SimpleDC alongside the existing Med-EASi corpus, we explore Large Language Model (LLM)-based simplification methods, including fine-tuning, reinforcement learning (RL), reinforcement learning with human feedback (RLHF), domain adaptation, and prompt-based approaches. Our experimentation encompasses Llama 2 and GPT-4. A novel RLHF reward function is introduced, featuring a lightweight model adept at distinguishing between original and simplified texts, thereby enhancing the model's effectiveness with unlabeled data. Results: Fine-tuned Llama 2 models demonstrated high performance across various metrics. Our innovative RLHF reward function surpassed existing RL text simplification reward functions in effectiveness. The results underscore that RL/RLHF can augment fine-tuning, facilitating model training on unlabeled text and improving performance.

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

Cancer is the second leading cause of death, with chemotherapy as one of the primary forms of treatment. As a result, researchers are turning to drug combination therapy to decrease drug resistance and increase efficacy. Current methods of drug combination screening, such as in vivo and in vitro, are inefficient due to stark time and monetary costs. In silico methods have become increasingly important for screening drugs, but current methods are inaccurate and generalize poorly to unseen anticancer drugs. In this paper, I employ a geometric deep-learning model utilizing a graph attention network that is equivariant to 3D rotations, translations, and reflections with structural motifs. Additionally, the gene expression of cancer cell lines is utilized to classify synergistic drug combinations specific to each cell line. I compared the proposed geometric deep learning framework to current state-of-the-art (SOTA) methods, and the proposed model architecture achieved greater performance on all 12 benchmark tasks performed on the DrugComb dataset. Specifically, the proposed framework outperformed other SOTA methods by an accuracy difference greater than 28%. Based on these results, I believe that the equivariant graph attention network's capability of learning geometric data accounts for the large performance improvements. The model's ability to generalize to foreign drugs is thought to be due to the structural motifs providing a better representation of the molecule. Overall, I believe that the proposed equivariant geometric deep learning framework serves as an effective tool for virtually screening anticancer drug combinations for further validation in a wet lab environment. The code for this work is made available online at: https://github.com/WeToTheMoon/EGAT_DrugSynergy.

As large language models (LLMs) become more integrated into societal systems, the risk of them perpetuating and amplifying harmful biases becomes a critical safety concern. Traditional methods for mitigating bias often rely on data filtering or post-hoc output moderation, which treat the model as an opaque black box. In this work, we introduce a complete, end-to-end system that uses techniques from mechanistic interpretability to both identify and actively mitigate bias directly within a model's internal workings. Our method involves two primary stages. First, we train linear "probes" on the internal activations of a model to detect the latent representations of various biases (e.g., gender, race, age). Our experiments on gpt2-large demonstrate that these probes can identify biased content with near-perfect accuracy, revealing that bias representations become most salient in the model's later layers. Second, we leverage these findings to compute "steering vectors" by contrasting the model's activation patterns for biased and neutral statements. By adding these vectors during inference, we can actively steer the model's generative process away from producing harmful, stereotypical, or biased content in real-time. We demonstrate the efficacy of this activation steering technique, showing that it successfully alters biased completions toward more neutral alternatives. We present our work as a robust and reproducible system that offers a more direct and interpretable approach to building safer and more accountable LLMs.

Millions of individuals' well-being are challenged by the harms of substance use. Harm reduction as a public health strategy is designed to improve their health outcomes and reduce safety risks. Some large language models (LLMs) have demonstrated a decent level of medical knowledge, promising to address the information needs of people who use drugs (PWUD). However, their performance in relevant tasks remains largely unexplored. We introduce HRIPBench, a benchmark designed to evaluate LLM's accuracy and safety risks in harm reduction information provision. The benchmark dataset HRIP-Basic has 2,160 question-answer-evidence pairs. The scope covers three tasks: checking safety boundaries, providing quantitative values, and inferring polysubstance use risks. We build the Instruction and RAG schemes to evaluate model behaviours based on their inherent knowledge and the integration of domain knowledge. Our results indicate that state-of-the-art LLMs still struggle to provide accurate harm reduction information, and sometimes, carry out severe safety risks to PWUD. The use of LLMs in harm reduction contexts should be cautiously constrained to avoid inducing negative health outcomes. WARNING: This paper contains illicit content that potentially induces harms.

Introduction. Generative Artificial Intelligence, particularly large language models (LLMs), offers transformative potential for Health Economics and Outcomes Research (HEOR). However, evaluating the quality, transparency, and rigor of LLM-assisted research lacks standardized guidance. This article introduces the ELEVATE AI LLMs framework and checklist, designed to support researchers and reviewers in assessing LLM use in HEOR. Methods. The ELEVATE AI LLMs framework was developed through a targeted review of existing guidelines and evaluation frameworks. The framework comprises ten evaluation domains, including model characteristics, accuracy, comprehensiveness, and fairness. The accompanying checklist operationalizes the framework. To validate the framework, we applied it to two published studies, demonstrating its usability across different HEOR tasks. Results. The ELEVATE AI LLMs framework provides a comprehensive structure for evaluating LLM-assisted research, while the checklist facilitates practical application. Validation of the framework and checklist on studies of systematic literature reviews and health economic modeling highlighted their ability to identify strengths and gaps in reporting. Limitations. While the ELEVATE AI LLMs framework provides robust guidance, its broader generalizability and applicability to diverse HEOR tasks require further empirical testing. Additionally, several metrics adapted from computer science need further validation in HEOR contexts. Conclusion. The ELEVATE AI LLMs framework and checklist fill a critical gap in HEOR by offering structured guidance for evaluating LLM-assisted research. By promoting transparency, accuracy, and reproducibility, they aim to standardize and improve the integration of LLMs into HEOR, ensuring their outputs meet the field's rigorous standards.

The growing use of generative models in daily life calls for efficient mechanisms to control their generation, to e.g., produce safe content or provide users with tools to explore style changes. Ideally, such mechanisms should require low volume of unpaired data (i.e., without explicit preference), and should be cheap, both at train and inference time, while preserving output quality. Recent research has shown that such mechanisms can be obtained by intervening exclusively on model activations, with the goal of correcting distributional differences between activations seen when using prompts from a source vs. a target set (e.g., toxic and non-toxic sentences). While cheap, these fast methods are inherently crude: their maps are tuned locally, not accounting for their impact on downstream layers, resulting in interventions that cause unintended shifts when used out-of-sample. We propose in this work linear end-to-end activation steering (LinEAS), an approach trained with a global loss that accounts simultaneously for all layer-wise distributional shifts. In addition to being more robust, the loss used to train LinEAS can be regularized with sparsifying norms, which can automatically carry out neuron selection. LinEAS only requires a handful of unpaired samples to be effective, and beats similar baselines on toxicity mitigation in language models, becoming competitive with oracle-dependent methods that have access to strong supervision. LinEAS is modality-agnostic and we empirically find that it outperforms existing activation steering methods at mitigating and including new concepts at the output of single-step text-to-image generation models.

Despite advances in large language models (LLMs) on reasoning and instruction-following benchmarks, it remains unclear whether they can reliably produce outputs aligned with a broad variety of user goals, a concept we refer to as steerability. The abundance of methods proposed to modify LLM behavior makes it unclear whether current LLMs are already steerable, or require further intervention. In particular, LLMs may exhibit (i) poor coverage, where rare user goals are underrepresented; (ii) miscalibration, where models overshoot requests; and (iii) side effects, where changes to one dimension of text inadvertently affect others. To systematically evaluate these failures, we introduce a framework based on a multi-dimensional goal space that models user goals and LLM outputs as vectors with dimensions corresponding to text attributes (e.g., reading difficulty). Applied to a text-rewriting task, we find that current LLMs struggle with steerability, as side effects are persistent. Interventions to improve steerability, such as prompt engineering, best-of-N sampling, and reinforcement learning fine-tuning, have varying effectiveness, yet side effects remain problematic. Our findings suggest that even strong LLMs struggle with steerability, and existing alignment strategies may be insufficient. We open-source our steerability evaluation framework at https://github.com/MLD3/steerability.

Estimating the causal effects of interventions is crucial to policy and decision-making, yet outcome data are often missing or subject to non-standard measurement error. While ground-truth outcomes can sometimes be obtained through costly data annotation or follow-up, budget constraints typically allow only a fraction of the dataset to be labeled. We address this challenge by optimizing which data points should be sampled for outcome information in order to improve efficiency in average treatment effect estimation with missing outcomes. We derive a closed-form solution for the optimal batch sampling probability by minimizing the asymptotic variance of a doubly robust estimator for causal inference with missing outcomes. Motivated by our street outreach partners, we extend the framework to costly annotations of unstructured data, such as text or images in healthcare and social services. Across simulated and real-world datasets, including one of outreach interventions in homelessness services, our approach achieves substantially lower mean-squared error and recovers the AIPW estimate with fewer labels than existing baselines. In practice, we show that our method can match confidence intervals obtained with 361 random samples using only 90 optimized samples - saving 75% of the labeling budget.

Steering language models (LMs) by modifying internal activations is a popular approach for controlling text generation. Unsupervised dictionary learning methods, e.g., sparse autoencoders, can be scaled to produce many steering vectors, but lack guarantees on the individual efficacy of each vector and control over the coverage of relevant steering tasks. In contrast, supervised methods for constructing steering vectors are targeted and effective, but require more data collection and training for each additional steering vector produced. In this work, we introduce HyperSteer, a family of hypernetwork-based architectures which are trained end-to-end to generate steering vectors conditioned on the natural language steering prompts and the internals of the steered LM. In our evaluations, we show that scaling HyperSteer with thousands of steering prompts exceeds the performance of state-of-the-art activation steering methods, even on steering prompts never seen during training. Moreover, HyperSteer performs on par with steering-via-prompting.

In the era of Large Language Models (LLMs), given their remarkable text understanding and generation abilities, there is an unprecedented opportunity to develop new, LLM-based methods for trustworthy medical knowledge synthesis, extraction and summarization. This paper focuses on the problem of Pharmacovigilance (PhV), where the significance and challenges lie in identifying Adverse Drug Events (ADEs) from diverse text sources, such as medical literature, clinical notes, and drug labels. Unfortunately, this task is hindered by factors including variations in the terminologies of drugs and outcomes, and ADE descriptions often being buried in large amounts of narrative text. We present MALADE, the first effective collaborative multi-agent system powered by LLM with Retrieval Augmented Generation for ADE extraction from drug label data. This technique involves augmenting a query to an LLM with relevant information extracted from text resources, and instructing the LLM to compose a response consistent with the augmented data. MALADE is a general LLM-agnostic architecture, and its unique capabilities are: (1) leveraging a variety of external sources, such as medical literature, drug labels, and FDA tools (e.g., OpenFDA drug information API), (2) extracting drug-outcome association in a structured format along with the strength of the association, and (3) providing explanations for established associations. Instantiated with GPT-4 Turbo or GPT-4o, and FDA drug label data, MALADE demonstrates its efficacy with an Area Under ROC Curve of 0.90 against the OMOP Ground Truth table of ADEs. Our implementation leverages the Langroid multi-agent LLM framework and can be found at https://github.com/jihyechoi77/malade.

Randomized controlled trials (RCTs) are considered the gold standard for estimating the average treatment effect (ATE) of interventions. One use of RCTs is to study the causes of global poverty -- a subject explicitly cited in the 2019 Nobel Memorial Prize awarded to Duflo, Banerjee, and Kremer "for their experimental approach to alleviating global poverty." Because the ATE is a population summary, anti-poverty experiments often seek to unpack the effect variation around the ATE by conditioning (CATE) on tabular variables such as age and ethnicity that were measured during the RCT data collection. Although such variables are key to unpacking CATE, using only such variables may fail to capture historical, geographical, or neighborhood-specific contributors to effect variation, as tabular RCT data are often only observed near the time of the experiment. In global poverty research, when the location of the experiment units is approximately known, satellite imagery can provide a window into such factors important for understanding heterogeneity. However, there is no method that specifically enables applied researchers to analyze CATE from images. In this paper, using a deep probabilistic modeling framework, we develop such a method that estimates latent clusters of images by identifying images with similar treatment effects distributions. Our interpretable image CATE model also includes a sensitivity factor that quantifies the importance of image segments contributing to the effect cluster prediction. We compare the proposed methods against alternatives in simulation; also, we show how the model works in an actual RCT, estimating the effects of an anti-poverty intervention in northern Uganda and obtaining a posterior predictive distribution over effects for the rest of the country where no experimental data was collected. We make all models available in open-source software.

Modern deep learning models have the ability to generate high-dimensional vectors whose similarity reflects semantic resemblance. Thus, similarity search, i.e., the operation of retrieving those vectors in a large collection that are similar to a given query, has become a critical component of a wide range of applications that demand highly accurate and timely answers. In this setting, the high vector dimensionality puts similarity search systems under compute and memory pressure, leading to subpar performance. Additionally, cross-modal retrieval tasks have become increasingly common, e.g., where a user inputs a text query to find the most relevant images for that query. However, these queries often have different distributions than the database embeddings, making it challenging to achieve high accuracy. In this work, we present LeanVec, a framework that combines linear dimensionality reduction with vector quantization to accelerate similarity search on high-dimensional vectors while maintaining accuracy. We present LeanVec variants for in-distribution (ID) and out-of-distribution (OOD) queries. LeanVec-ID yields accuracies on par with those from recently introduced deep learning alternatives whose computational overhead precludes their usage in practice. LeanVec-OOD uses a novel technique for dimensionality reduction that considers the query and database distributions to simultaneously boost the accuracy and the performance of the framework even further (even presenting competitive results when the query and database distributions match). All in all, our extensive and varied experimental results show that LeanVec produces state-of-the-art results, with up to 3.7x improvement in search throughput and up to 4.9x faster index build time over the state of the art.

Motivation: Emerging drug-drug interaction (DDI) prediction is crucial for new drugs but is hindered by distribution changes between known and new drugs in real-world scenarios. Current evaluation often neglects these changes, relying on unrealistic i.i.d. split due to the absence of drug approval data. Results: We propose DDI-Ben, a benchmarking framework for emerging DDI prediction under distribution changes. DDI-Ben introduces a distribution change simulation framework that leverages distribution changes between drug sets as a surrogate for real-world distribution changes of DDIs, and is compatible with various drug split strategies. Through extensive benchmarking on ten representative methods, we show that most existing approaches suffer substantial performance degradation under distribution changes. Our analysis further indicates that large language model (LLM) based methods and the integration of drug-related textual information offer promising robustness against such degradation. To support future research, we release the benchmark datasets with simulated distribution changes. Overall, DDI-Ben highlights the importance of explicitly addressing distribution changes and provides a foundation for developing more resilient methods for emerging DDI prediction. Availability and implementation: Our code and data are available at https://github.com/LARS-research/DDI-Bench.

Background: Large language models (LLMs) are trained to follow directions, but this introduces a vulnerability to blindly comply with user requests even if they generate wrong information. In medicine, this could accelerate the generation of misinformation that impacts human well-being. Objectives/Methods: We analyzed compliance to requests to generate misleading content about medications in settings where models know the request is illogical. We investigated whether in-context directions and instruction-tuning of LLMs to prioritize logical reasoning over compliance reduced misinformation risk. Results: While all frontier LLMs complied with misinformation requests, both prompt-based and parameter-based approaches can improve the detection of logic flaws in requests and prevent the dissemination of medical misinformation. Conclusion: Shifting LLMs to prioritize logic over compliance could reduce risks of exploitation for medical misinformation.

Drug repurposing plays a critical role in accelerating treatment discovery, especially for complex and rare diseases. Biomedical knowledge graphs (KGs), which encode rich clinical associations, have been widely adopted to support this task. However, existing methods largely overlook common-sense biomedical concept knowledge in real-world labs, such as mechanistic priors indicating that certain drugs are fundamentally incompatible with specific treatments. To address this gap, we propose LLaDR, a Large Language Model-assisted framework for Drug Repurposing, which improves the representation of biomedical concepts within KGs. Specifically, we extract semantically enriched treatment-related textual representations of biomedical entities from large language models (LLMs) and use them to fine-tune knowledge graph embedding (KGE) models. By injecting treatment-relevant knowledge into KGE, LLaDR largely improves the representation of biomedical concepts, enhancing semantic understanding of under-studied or complex indications. Experiments based on benchmarks demonstrate that LLaDR achieves state-of-the-art performance across different scenarios, with case studies on Alzheimer's disease further confirming its robustness and effectiveness. Code is available at https://github.com/xiaomingaaa/LLaDR.

Large language models have the potential to be valuable in the healthcare industry, but it's crucial to verify their safety and effectiveness through rigorous evaluation. For this purpose, we comprehensively evaluated both open-source LLMs and Google's new multimodal LLM called Gemini across Medical reasoning, hallucination detection, and Medical Visual Question Answering tasks. While Gemini showed competence, it lagged behind state-of-the-art models like MedPaLM 2 and GPT-4 in diagnostic accuracy. Additionally, Gemini achieved an accuracy of 61.45\% on the medical VQA dataset, significantly lower than GPT-4V's score of 88\%. Our analysis revealed that Gemini is highly susceptible to hallucinations, overconfidence, and knowledge gaps, which indicate risks if deployed uncritically. We also performed a detailed analysis by medical subject and test type, providing actionable feedback for developers and clinicians. To mitigate risks, we applied prompting strategies that improved performance. Additionally, we facilitated future research and development by releasing a Python module for medical LLM evaluation and establishing a dedicated leaderboard on Hugging Face for medical domain LLMs. Python module can be found at https://github.com/promptslab/RosettaEval

Discovering causal structures from data is a challenging inference problem of fundamental importance in all areas of science. The appealing properties of neural networks have recently led to a surge of interest in differentiable neural network-based methods for learning causal structures from data. So far, differentiable causal discovery has focused on static datasets of observational or fixed interventional origin. In this work, we introduce an active intervention targeting (AIT) method which enables a quick identification of the underlying causal structure of the data-generating process. Our method significantly reduces the required number of interactions compared with random intervention targeting and is applicable for both discrete and continuous optimization formulations of learning the underlying directed acyclic graph (DAG) from data. We examine the proposed method across multiple frameworks in a wide range of settings and demonstrate superior performance on multiple benchmarks from simulated to real-world data.

Motivation: Patient-generated text contains critical information about patients' lived experiences, social circumstances, and engagement in care, including factors that strongly influence adherence, care coordination, and health equity. However, these patient voice signals are rarely available in structured form, limiting their use in patient-centered outcomes research and clinical quality improvement. Reliable extraction of such information is therefore essential for understanding and addressing non-clinical drivers of health outcomes at scale. Results: We introduce PVminer, a benchmark for structured extraction of patient voice, and propose PVminerLLM, a supervised fine-tuned large language model tailored to this task. Across multiple datasets and model sizes, PVminerLLM substantially outperforms prompt-based baselines, achieving up to 83.82% F1 for Code prediction, 80.74% F1 for Sub-code prediction, and 87.03% F1 for evidence Span extraction. Notably, strong performance is achieved even with smaller models, demonstrating that reliable patient voice extraction is feasible without extreme model scale. These results enable scalable analysis of social and experiential signals embedded in patient-generated text. Availability and Implementation: Code, evaluation scripts, and trained LLMs will be released publicly. Annotated datasets will be made available upon request for research use. Keywords: Large Language Models, Supervised Fine-Tuning, Medical Annotation, Patient-Generated Text, Clinical NLP

Innovations like protein diffusion have enabled significant progress in de novo protein design, which is a vital topic in life science. These methods typically depend on protein structure encoders to model residue backbone frames, where atoms do not exist. Most prior encoders rely on atom-wise features, such as angles and distances between atoms, which are not available in this context. Thus far, only several simple encoders, such as IPA, have been proposed for this scenario, exposing the frame modeling as a bottleneck. In this work, we proffer the Vector Field Network (VFN), which enables network layers to perform learnable vector computations between coordinates of frame-anchored virtual atoms, thus achieving a higher capability for modeling frames. The vector computation operates in a manner similar to a linear layer, with each input channel receiving 3D virtual atom coordinates instead of scalar values. The multiple feature vectors output by the vector computation are then used to update the residue representations and virtual atom coordinates via attention aggregation. Remarkably, VFN also excels in modeling both frames and atoms, as the real atoms can be treated as the virtual atoms for modeling, positioning VFN as a potential universal encoder. In protein diffusion (frame modeling), VFN exhibits an impressive performance advantage over IPA, excelling in terms of both designability (67.04% vs. 53.58%) and diversity (66.54% vs. 51.98%). In inverse folding (frame and atom modeling), VFN outperforms the previous SoTA model, PiFold (54.7% vs. 51.66%), on sequence recovery rate. We also propose a method of equipping VFN with the ESM model, which significantly surpasses the previous ESM-based SoTA (62.67% vs. 55.65%), LM-Design, by a substantial margin.

Existing approaches for analyzing neural network activations, such as PCA and sparse autoencoders, rely on strong structural assumptions. Generative models offer an alternative: they can uncover structure without such assumptions and act as priors that improve intervention fidelity. We explore this direction by training diffusion models on one billion residual stream activations, creating "meta-models" that learn the distribution of a network's internal states. We find that diffusion loss decreases smoothly with compute and reliably predicts downstream utility. In particular, applying the meta-model's learned prior to steering interventions improves fluency, with larger gains as loss decreases. Moreover, the meta-model's neurons increasingly isolate concepts into individual units, with sparse probing scores that scale as loss decreases. These results suggest generative meta-models offer a scalable path toward interpretability without restrictive structural assumptions. Project page: https://generative-latent-prior.github.io.

Multi-Modal Large Language Models (MLLMs), despite being successful, exhibit limited generality and often fall short when compared to specialized models. Recently, LLM-based agents have been developed to address these challenges by selecting appropriate specialized models as tools based on user inputs. However, such advancements have not been extensively explored within the medical domain. To bridge this gap, this paper introduces the first agent explicitly designed for the medical field, named Multi-modal Medical Agent (MMedAgent). We curate an instruction-tuning dataset comprising six medical tools solving seven tasks across five modalities, enabling the agent to choose the most suitable tools for a given task. Comprehensive experiments demonstrate that MMedAgent achieves superior performance across a variety of medical tasks compared to state-of-the-art open-source methods and even the closed-source model, GPT-4o. Furthermore, MMedAgent exhibits efficiency in updating and integrating new medical tools. Codes and models are all available.

Keeping track of scientific challenges, advances and emerging directions is a fundamental part of research. However, researchers face a flood of papers that hinders discovery of important knowledge. In biomedicine, this directly impacts human lives. To address this problem, we present a novel task of extraction and search of scientific challenges and directions, to facilitate rapid knowledge discovery. We construct and release an expert-annotated corpus of texts sampled from full-length papers, labeled with novel semantic categories that generalize across many types of challenges and directions. We focus on a large corpus of interdisciplinary work relating to the COVID-19 pandemic, ranging from biomedicine to areas such as AI and economics. We apply a model trained on our data to identify challenges and directions across the corpus and build a dedicated search engine. In experiments with 19 researchers and clinicians using our system, we outperform a popular scientific search engine in assisting knowledge discovery. Finally, we show that models trained on our resource generalize to the wider biomedical domain and to AI papers, highlighting its broad utility. We make our data, model and search engine publicly available. https://challenges.apps.allenai.org/

Traditional retrieval methods have been essential for assessing document similarity but struggle with capturing semantic nuances. Despite advancements in latent semantic analysis (LSA) and deep learning, achieving comprehensive semantic understanding and accurate retrieval remains challenging due to high dimensionality and semantic gaps. The above challenges call for new techniques to effectively reduce the dimensions and close the semantic gaps. To this end, we propose VectorSearch, which leverages advanced algorithms, embeddings, and indexing techniques for refined retrieval. By utilizing innovative multi-vector search operations and encoding searches with advanced language models, our approach significantly improves retrieval accuracy. Experiments on real-world datasets show that VectorSearch outperforms baseline metrics, demonstrating its efficacy for large-scale retrieval tasks.

Semantic word embeddings represent the meaning of a word via a vector, and are created by diverse methods. Many use nonlinear operations on co-occurrence statistics, and have hand-tuned hyperparameters and reweighting methods. This paper proposes a new generative model, a dynamic version of the log-linear topic model of~mnih2007three. The methodological novelty is to use the prior to compute closed form expressions for word statistics. This provides a theoretical justification for nonlinear models like PMI, word2vec, and GloVe, as well as some hyperparameter choices. It also helps explain why low-dimensional semantic embeddings contain linear algebraic structure that allows solution of word analogies, as shown by~mikolov2013efficient and many subsequent papers. Experimental support is provided for the generative model assumptions, the most important of which is that latent word vectors are fairly uniformly dispersed in space.

Recent advances in generative models, including large language models (LLMs), vision language models (VLMs), and diffusion models, have accelerated the field of natural language and image processing in medicine and marked a significant paradigm shift in how biomedical models can be developed and deployed. While these models are highly adaptable to new tasks, scaling and evaluating their usage presents new challenges not addressed in previous frameworks. In particular, the ability of these models to produce useful outputs with little to no specialized training data ("zero-" or "few-shot" approaches), as well as the open-ended nature of their outputs, necessitate the development of new guidelines for robust reporting of clinical generative model research. In response to gaps in standards and best practices for the development of clinical AI tools identified by US Executive Order 141103 and several emerging national networks for clinical AI evaluation, we begin to formalize some of these guidelines by building on the original MI-CLAIM checklist. The new checklist, MI-CLAIM-GEN (Table 1), aims to address differences in training, evaluation, interpretability, and reproducibility of new generative models compared to non-generative ("predictive") AI models. This MI-CLAIM-GEN checklist also seeks to clarify cohort selection reporting with unstructured clinical data and adds additional items on alignment with ethical standards for clinical AI research.

To assess the effectiveness of any medical intervention, researchers must conduct a time-intensive and highly manual literature review. NLP systems can help to automate or assist in parts of this expensive process. In support of this goal, we release MS^2 (Multi-Document Summarization of Medical Studies), a dataset of over 470k documents and 20k summaries derived from the scientific literature. This dataset facilitates the development of systems that can assess and aggregate contradictory evidence across multiple studies, and is the first large-scale, publicly available multi-document summarization dataset in the biomedical domain. We experiment with a summarization system based on BART, with promising early results. We formulate our summarization inputs and targets in both free text and structured forms and modify a recently proposed metric to assess the quality of our system's generated summaries. Data and models are available at https://github.com/allenai/ms2

Transformer-based language models have been shown to be highly effective for several NLP tasks. In this paper, we consider three transformer models, BERT, RoBERTa, and XLNet, in both small and large versions, and investigate how faithful their representations are with respect to the semantic content of texts. We formalize a notion of semantic faithfulness, in which the semantic content of a text should causally figure in a model's inferences in question answering. We then test this notion by observing a model's behavior on answering questions about a story after performing two novel semantic interventions: deletion intervention and negation intervention. While transformer models achieve high performance on standard question answering tasks, we show that they fail to be semantically faithful once we perform these interventions for a significant number of cases (~50% for deletion intervention, and ~20% drop in accuracy for negation intervention). We then propose an intervention-based training regime that can mitigate the undesirable effects for deletion intervention by a significant margin (from ~ 50% to ~6%). We analyze the inner-workings of the models to better understand the effectiveness of intervention-based training for deletion intervention. But we show that this training does not attenuate other aspects of semantic unfaithfulness such as the models' inability to deal with negation intervention or to capture the predicate-argument structure of texts. We also test InstructGPT, via prompting, for its ability to handle the two interventions and to capture predicate-argument structure. While InstructGPT models do achieve very high performance on predicate-argument structure task, they fail to respond adequately to our deletion and negation interventions.

The acute phase of the Covid-19 pandemic has made apparent the need for decision support based upon accurate epidemic modeling. This process is substantially hampered by under-reporting of cases and related data incompleteness issues. In this article we adopt the Bayesian paradigm and synthesize publicly available data via a discrete-time stochastic epidemic modeling framework. The models allow for estimating the total number of infections while accounting for the endemic phase of the pandemic. We assess the prediction of the infection rate utilizing mobility information, notably the principal components of the mobility data. We evaluate variational Bayes in this context and find that Hamiltonian Monte Carlo offers a robust inference alternative for such models. We elaborate upon vector analysis of the epidemic dynamics, thus enriching the traditional tools used for decision making. In particular, we show how certain 2-dimensional plots on the phase plane may yield intuitive information regarding the speed and the type of transmission dynamics. We investigate the potential of a two-stage analysis as a consequence of cutting feedback, for inference on certain functionals of the model parameters. Finally, we show that a point mass on critical parameters is overly restrictive and investigate informative priors as a suitable alternative.

Background: Generative artificial intelligence (AI) deployment in academic medical settings raises copyright compliance concerns. Dana-Farber Cancer Institute implemented GPT4DFCI, an internal generative AI tool utilizing OpenAI models, that is approved for enterprise use in research and operations. Given (1) the exceptionally broad adoption of the tool in our organization, (2) our research mission, and (3) the shared responsibility model required to benefit from Customer Copyright Commitment in Azure OpenAI Service products, we deemed rigorous copyright compliance testing necessary. Case Description: We conducted a structured red teaming exercise in Nov. 2024, with 42 participants from academic, industry, and government institutions. Four teams attempted to extract copyrighted content from GPT4DFCI across four domains: literary works, news articles, scientific publications, and access-restricted clinical notes. Teams successfully extracted verbatim book dedications and near-exact passages through various strategies. News article extraction failed despite jailbreak attempts. Scientific article reproduction yielded only high-level summaries. Clinical note testing revealed appropriate privacy safeguards. Discussion: The successful extraction of literary content indicates potential copyrighted material presence in training data, necessitating inference-time filtering. Differential success rates across content types suggest varying protective mechanisms. The event led to implementation of a copyright-specific meta-prompt in GPT4DFCI; this mitigation has been in production since Jan. 2025. Conclusion: Systematic red teaming revealed specific vulnerabilities in generative AI copyright compliance, leading to concrete mitigation strategies. Academic medical institutions deploying generative AI should implement continuous testing protocols to ensure legal and ethical compliance.

Purpose. Patients with advanced cancer may undergo multiple lines of treatment, switching therapies as their disease progresses. Motivated by a study of metastatic prostate cancer, we develop a microsimulation framework to study therapy sequence. Methods. We propose a discrete-time state transition model to study two lines of anti-cancer therapy. Based on digitized published progression-free survival (PFS) and overall survival (OS) curves, we infer event types (progression or death), and estimate transition probabilities using cumulative incidence functions with competing risks. Our model incorporates within-patient dependence over time, such that response to first-line therapy informs subsequent event probabilities. Parameters governing the degree of within-patient dependence can be used to calibrate the model-based results to those of a target trial. We demonstrate these methods in a study of two therapy sequences for metastatic prostate cancer, where Docetaxel (DCT) and Abiraterone Acetate (AA) are both appropriate for use in either first or second line treatment. We assess costs, Quality-Adjusted Life Years (QALYs) and Incremental Cost Effectiveness Ratio (ICER) for two treatment strategies: DCT then AA vs AA then DCT. Results. Using digitized survival curves from relevant clinical trials, we identified 8.6-13.9% of PFS times that should be categorized as deaths, allowing for estimation of cumulative incidence functions. Models assuming within-patient independence overestimated OS time, corrected with our calibration approach. Correction resulted in meaningful changes in the difference in QALYs between treatment strategies (0.07 vs 0.15) and the ICER (-\76,836/QALY vs -21,030/QALY). Conclusions. Microsimulation models can be successfully used to study cost-effectiveness of therapy sequences, taking care to account correctly for within-patient dependence.

Given the dominance of dense retrievers that do not generalize well beyond their training dataset distributions, domain-specific test sets are essential in evaluating retrieval. There are few test datasets for retrieval systems intended for use by healthcare providers in a point-of-care setting. To fill this gap we have collaborated with medical professionals to create CURE, an ad-hoc retrieval test dataset for passage ranking with 2000 queries spanning 10 medical domains with a monolingual (English) and two cross-lingual (French/Spanish -> English) conditions. In this paper, we describe how CURE was constructed and provide baseline results to showcase its effectiveness as an evaluation tool. CURE is published with a Creative Commons Attribution Non Commercial 4.0 license and can be accessed on Hugging Face.

We describe the accurate prediction of ligand-protein interaction (LPI) affinities, also known as drug-target interactions (DTI), with instruction fine-tuned pretrained generative small language models (SLMs). We achieved accurate predictions for a range of affinity values associated with ligand-protein interactions on out-of-sample data in a zero-shot setting. Only the SMILES string of the ligand and the amino acid sequence of the protein were used as the model inputs. Our results demonstrate a clear improvement over machine learning (ML) and free-energy perturbation (FEP+) based methods in accurately predicting a range of ligand-protein interaction affinities, which can be leveraged to further accelerate drug discovery campaigns against challenging therapeutic targets.

Planning effective interventions in biological systems requires treatment-effect models that adapt to unseen biological contexts by identifying their specific underlying mechanisms. Yet single-cell perturbation datasets span only a handful of biological contexts, and existing methods cannot leverage new interventional evidence at inference time to adapt beyond their training data. To meta-learn a perturbation effect estimator, we present MapPFN, a prior-data fitted network (PFN) pretrained on synthetic data generated from a prior over causal perturbations. Given a set of experiments, MapPFN uses in-context learning to predict post-perturbation distributions, without gradient-based optimization. Despite being pretrained on in silico gene knockouts alone, MapPFN identifies differentially expressed genes, matching the performance of models trained on real single-cell data. Our code and data are available at https://github.com/marvinsxtr/MapPFN.

We investigate a new dynamical system that describes tumor-host interaction. The equation that describes the untreated tumor growth is based on non-extensive statistical mechanics. Recently, this model has been shown to fit successfully exponential, Gompertz, logistic, and power-law tumor growths. We have been able to include as many hallmarks of cancer as possible. We study also the dynamic response of cancer under therapy. Using our model, we can make predictions about the different outcomes when we change the parameters, and/or the initial conditions. We can determine the importance of different factors to influence tumor growth. We discover synergistic therapeutic effects of different treatments and drugs. Cancer is generally untreatable using conventional monotherapy. We consider conventional therapies, oncogene-targeted therapies, tumor-suppressors gene-targeted therapies, immunotherapies, anti-angiogenesis therapies, virotherapy, among others. We need therapies with the potential to target both tumor cells and the tumors' microenvironment. Drugs that target oncogenes and tumor-suppressor genes can be effective in the treatment of some cancers. However, most tumors do reoccur. We have found that the success of the new therapeutic agents can be seen when used in combination with other cancer-cell-killing therapies. Our results have allowed us to design a combinational therapy that can lead to the complete eradication of cancer.

Interventions targeting the representation space of language models (LMs) have emerged as an effective means to influence model behavior. Such methods are employed, for example, to eliminate or alter the encoding of demographic information such as gender within the model's representations and, in so doing, create a counterfactual representation. However, because the intervention operates within the representation space, understanding precisely what aspects of the text it modifies poses a challenge. In this paper, we give a method to convert representation counterfactuals into string counterfactuals. We demonstrate that this approach enables us to analyze the linguistic alterations corresponding to a given representation space intervention and to interpret the features utilized to encode a specific concept. Moreover, the resulting counterfactuals can be used to mitigate bias in classification through data augmentation.

Large language models (LLMs) are now ubiquitous in user-facing applications, yet they still generate undesirable toxic outputs, including profanity, vulgarity, and derogatory remarks. Although numerous detoxification methods exist, most apply broad, surface-level fixes and can therefore easily be circumvented by jailbreak attacks. In this paper we leverage sparse autoencoders (SAEs) to identify toxicity-related directions in the residual stream of models and perform targeted activation steering using the corresponding decoder vectors. We introduce three tiers of steering aggressiveness and evaluate them on GPT-2 Small and Gemma-2-2B, revealing trade-offs between toxicity reduction and language fluency. At stronger steering strengths, these causal interventions surpass competitive baselines in reducing toxicity by up to 20%, though fluency can degrade noticeably on GPT-2 Small depending on the aggressiveness. Crucially, standard NLP benchmark scores upon steering remain stable, indicating that the model's knowledge and general abilities are preserved. We further show that feature-splitting in wider SAEs hampers safety interventions, underscoring the importance of disentangled feature learning. Our findings highlight both the promise and the current limitations of SAE-based causal interventions for LLM detoxification, further suggesting practical guidelines for safer language-model deployment.

Recent large language models (LLMs) offer the potential to support public health monitoring by facilitating health disclosure through open-ended conversations but rarely preserve the knowledge gained about individuals across repeated interactions. Augmenting LLMs with long-term memory (LTM) presents an opportunity to improve engagement and self-disclosure, but we lack an understanding of how LTM impacts people's interaction with LLM-driven chatbots in public health interventions. We examine the case of CareCall -- an LLM-driven voice chatbot with LTM -- through the analysis of 1,252 call logs and interviews with nine users. We found that LTM enhanced health disclosure and fostered positive perceptions of the chatbot by offering familiarity. However, we also observed challenges in promoting self-disclosure through LTM, particularly around addressing chronic health conditions and privacy concerns. We discuss considerations for LTM integration in LLM-driven chatbots for public health monitoring, including carefully deciding what topics need to be remembered in light of public health goals.

This paper introduces the Pandemic PACT Advanced Categorisation Engine (PPACE) along with its associated dataset. PPACE is a fine-tuned model developed to automatically classify research abstracts from funded biomedical projects according to WHO-aligned research priorities. This task is crucial for monitoring research trends and identifying gaps in global health preparedness and response. Our approach builds on human-annotated projects, which are allocated one or more categories from a predefined list. A large language model is then used to generate `rationales' explaining the reasoning behind these annotations. This augmented data, comprising expert annotations and rationales, is subsequently used to fine-tune a smaller, more efficient model. Developed as part of the Pandemic PACT project, which aims to track and analyse research funding and clinical evidence for a wide range of diseases with outbreak potential, PPACE supports informed decision-making by research funders, policymakers, and independent researchers. We introduce and release both the trained model and the instruction-based dataset used for its training. Our evaluation shows that PPACE significantly outperforms its baselines. The release of PPACE and its associated dataset offers valuable resources for researchers in multilabel biomedical document classification and supports advancements in aligning biomedical research with key global health priorities.