Daily Papers

Speech processing systems face a fundamental challenge: the human voice changes with age, yet few datasets support rigorous longitudinal evaluation. We introduce VoxKnesset, an open-access dataset of ~2,300 hours of Hebrew parliamentary speech spanning 2009-2025, comprising 393 speakers with recording spans of up to 15 years. Each segment includes aligned transcripts and verified demographic metadata from official parliamentary records. We benchmark modern speech embeddings (WavLM-Large, ECAPA-TDNN, Wav2Vec2-XLSR-1B) on age prediction and speaker verification under longitudinal conditions. Speaker verification EER rises from 2.15\% to 4.58\% over 15 years for the strongest model, and cross-sectionally trained age regressors fail to capture within-speaker aging, while longitudinally trained models recover a meaningful temporal signal. We publicly release the dataset and pipeline to support aging-robust speech systems and Hebrew speech processing.

Automatic Speech Recognition (ASR) system evaluations have consistently revealed performance disparities along lines of race, gender, socioeconomic status, and language variety. While these disparities are well-documented, they are often (implicitly or explicitly) treated as issues that subsequent, larger, and more universal models will correct. We challenge this assumption of steady progress in reducing accent-related performance disparities, conducting a longitudinal evaluation of 16 prominent systems released between 2021-2025 across 8 datasets representing diverse English accent varieties. We find that the performance disparity between Mainstream US English (MUSE) and minority accents is stubborn, not reliably declining as a function of time. Specifically, while systems are reliably performant on MUSE, minority accents are subject to risks of large performance degradations between generations of systems, sometimes worsening by 65% absolute Word Error Rate. We argue that standard ASR benchmarks enact an implicit language policy privileging Mainstream US English varieties. As such, these performance disparities reflect systemic failures of language technology development infrastructure that disproportionately affect underrepresented speaker populations.

Longitudinal information in radiology reports refers to the sequential tracking of findings across multiple examinations over time, which is crucial for monitoring disease progression and guiding clinical decisions. Many recent automated radiology report generation methods are designed to capture longitudinal information; however, validating their performance is challenging. There is no proper tool to consistently label temporal changes in both ground-truth and model-generated texts for meaningful comparisons. Large language models (LLMs) offer a promising annotation alternative, as they are capable of capturing nuanced linguistic patterns and semantic similarities without extensive manual intervention. They also adapt well to new contexts. In this study, we therefore propose an LLM-based pipeline to automatically annotate longitudinal information in radiology reports. The pipeline first identifies sentences containing relevant information and then extracts the progression of diseases. We evaluate and compare five mainstream LLMs on these two tasks using 500 manually annotated reports. Considering both efficiency and performance, Qwen2.5-32B was subsequently selected and used to annotate another 95,169 reports from the public MIMIC-CXR dataset. Our Qwen2.5-32B-annotated dataset provided us with a standardized benchmark for evaluating report generation models. Using this new benchmark, we assessed seven state-of-the-art report generation models. Our LLM-based annotation method outperforms existing annotation solutions, achieving 11.3\% and 5.3\% higher F1-scores for longitudinal information detection and disease tracking, respectively. The source code is available at https://github.com/wxinyi1996/Standardizing-Longitudinal-Chest-X-ray-Report-Evaluation-via-Large-Language-Model-Annotation.git.

This paper presents an eight-week observational comparison of 68 single-file HTML generations collected across 17 public experiments in the "HTML AI Battle" project between December 10, 2025 and February 4, 2026. Four reasoning model families, GPT, Gemini, Grok, and Claude, were compared under a fixed public-interface protocol with no custom instructions, no personality tuning, and no repair prompts. Each output was evaluated from a rendered browser video using human scores and a Gemini LLM-as-a-judge layer for prompt adherence, functional correctness, and UI quality, then packaged into a standardized social-media protocol spanning X (Twitter), TikTok, and YouTube. The tracker was also used for two supervised predictive analyses: an experiment-level model for 24-hour X impressions and a generation-level model for HTML verbosity. Under this protocol, Claude was the strongest and most consistent family, leading mean performance and winning 9/17 prompts under the primary human weighted score. Longer measured reasoning time was not associated with higher quality overall. Gemini as a judge was significantly more lenient than the human evaluator on functional correctness and overall performance, while stable self-favoring bias remained unresolved. The exploratory X-impressions model remained weak under post-screen cross-validation (MAE = 46,874, R^2 = -0.377), whereas the HTML-lines model performed better, with a model-family-only baseline outperforming prompt-aware alternatives (MAE = 135.2, R^2 = 0.576). Overall, selected pre-publication technical/audio variables were not sufficient to predict 24-hour X reach, while code verbosity was driven much more by model family than by prompt wording. The comparisons remain observational and are limited by public-interface drift, access-path differences, and one primary human scorer.

Conversational memory changes during use, so endpoint question answering alone cannot establish how a persistent state accumulates, ages, or incorporates revisions. We introduce LSREP, a Longitudinal State-Replay Evaluation Protocol combining ordered replay, explicit lifecycle schedules, repeated probes, evolving reference answers, and mechanism-fidelity checks. Its architectural case study is ICE v2, a local-first memory middleware with typed stores, retrieval fusion, and dynamic context budgets. The private, single-user instantiation contains 1,985 turns, 219 distinct probes, and 1,211 probe-checkpoint observations across 52 checkpoints. On three ordinary-density datasets, ICE v2 has a near-zero mean quality difference from vector-RAG while selecting 32% fewer fragments but using 6.6% more estimated prompt tokens. A fourth, dense dataset exposes catastrophic failures of the unbudgeted baseline. The fidelity audit limits attribution: procedural retrieval is defective, several mechanisms are unexercised, and graph utility is not established. In a complementary matched public diagnostic, ICE v2 loses decisively to pure vector-RAG on LongMemEval: 50.8% versus 72.8% in the evidence-only oracle and 43.0% versus 69.5% in full-S. Paired differences are -22.0 points (95% CI [-26.6, -17.4]) and -26.5 ([-31.3, -21.8]). Conservative abstention accompanies severe multi-session and temporal failures. ICE uses less context in this diagnostic, establishing a quality-cost trade-off rather than superior efficiency. Together, replay, fidelity auditing, and public endpoint testing expose distinct failure modes that neither architectural descriptions nor aggregate scores identify alone.

Radiology reports convey detailed clinical observations and capture diagnostic reasoning that evolves over time. However, existing evaluation methods are limited to single-report settings and rely on coarse metrics that fail to capture fine-grained clinical semantics and temporal dependencies. We introduce LUNGUAGE,a benchmark dataset for structured radiology report generation that supports both single-report evaluation and longitudinal patient-level assessment across multiple studies. It contains 1,473 annotated chest X-ray reports, each reviewed by experts, and 80 of them contain longitudinal annotations to capture disease progression and inter-study intervals, also reviewed by experts. Using this benchmark, we develop a two-stage framework that transforms generated reports into fine-grained, schema-aligned structured representations, enabling longitudinal interpretation. We also propose LUNGUAGESCORE, an interpretable metric that compares structured outputs at the entity, relation, and attribute level while modeling temporal consistency across patient timelines. These contributions establish the first benchmark dataset, structuring framework, and evaluation metric for sequential radiology reporting, with empirical results demonstrating that LUNGUAGESCORE effectively supports structured report evaluation. The code is available at: https://github.com/SuperSupermoon/Lunguage

Existing evaluation of Large Language Models (LLMs) on static benchmarks is vulnerable to data contamination and leaderboard overfitting, critical issues that obscure true model capabilities. To address this, we introduce LLMEval-Fair, a framework for dynamic evaluation of LLMs. LLMEval-Fair is built on a proprietary bank of 220k graduate-level questions, from which it dynamically samples unseen test sets for each evaluation run. Its automated pipeline ensures integrity via contamination-resistant data curation, a novel anti-cheating architecture, and a calibrated LLM-as-a-judge process achieving 90% agreement with human experts, complemented by a relative ranking system for fair comparison. A 30-month longitudinal study of nearly 60 leading models reveals a performance ceiling on knowledge memorization and exposes data contamination vulnerabilities undetectable by static benchmarks. The framework demonstrates exceptional robustness in ranking stability and consistency, providing strong empirical validation for the dynamic evaluation paradigm. LLMEval-Fair offers a robust and credible methodology for assessing the true capabilities of LLMs beyond leaderboard scores, promoting the development of more trustworthy evaluation standards.

Chest Xray imaging is a widely used diagnostic tool in modern medicine, and its high utilization creates substantial workloads for radiologists. To alleviate this burden, vision language models are increasingly applied to automate Chest Xray radiology report generation (CXRRRG), aiming for clinically accurate descriptions while reducing manual effort. Conventional approaches, however, typically rely on single images, failing to capture the longitudinal context necessary for producing clinically faithful comparison statements. Recently, growing attention has been directed toward incorporating longitudinal data into CXR RRG, enabling models to leverage historical studies in ways that mirror radiologists diagnostic workflows. Nevertheless, existing surveys primarily address single image CXRRRG and offer limited guidance for longitudinal settings, leaving researchers without a systematic framework for model design. To address this gap, this survey provides the first comprehensive review of longitudinal radiology report generation (LRRG). Specifically, we examine dataset construction strategies, report generation architectures alongside longitudinally tailored designs, and evaluation protocols encompassing both longitudinal specific measures and widely used benchmarks. We further summarize LRRG methods performance, alongside analyses of different ablation studies, which collectively highlight the critical role of longitudinal information and architectural design choices in improving model performance. Finally, we summarize five major limitations of current research and outline promising directions for future development, aiming to lay a foundation for advancing this emerging field.

Brain MRI interpretation is a longitudinal clinical reasoning problem: radiologists compare serial studies, integrate information across MRI sequences, localize findings within volumetric anatomy, and translate this evidence into report-grounded assessments. Existing medical VQA and 3D imaging benchmarks capture important parts of this workflow, but often evaluate brain MRI through isolated images, static volumes, or ungrounded report-style answers, thereby obscuring failures in the evidence chain that support clinical validity. We introduce BrainTRACE, a report-grounded benchmark for evaluating whether vision-language models can trace the evidence structure required for longitudinal brain MRI interpretation. BrainTRACE contains 7,273 scored VQA instances derived from 1,778 longitudinal patients, 7,299 MRI studies, and approximately 29k co-registered 3D MRI sequence volumes. The benchmark is organized by five levels of clinical reasoning, from acquisition recognition to case-level synthesis, and by evidence demands covering longitudinal comparison, report-grounded references, multi-sequence integration, and volumetric spatial evidence. BrainTRACE supports rendered inputs compatible with standard VLM interfaces, a 3D-evidence condition, and a decomposed case-reasoning track that audits six steps in a longitudinal evidence chain. Evaluation of 20 VLM configurations shows that current systems can identify isolated visual cues but rarely compose them into grounded longitudinal interpretations. We release the benchmark specification, evaluation lists, scoring implementation, scoring rubrics, and audit-record format to support reproducible progress in brain MRI VLM evaluation.

Large language models (LLMs) in psychological counseling have attracted increasing attention. However, existing approaches often lack emotional understanding, adaptive strategies, and the use of therapeutic methods across multiple sessions with long-term memory, leaving them far from real clinical practice. To address these critical gaps, we introduce TheraMind, a strategic and adaptive agent for longitudinal psychological counseling. The cornerstone of TheraMind is a novel dual-loop architecture that decouples the complex counseling process into an Intra-Session Loop for tactical dialogue management and a Cross-Session Loop for strategic therapeutic planning. The Intra-Session Loop perceives the patient's emotional state to dynamically select response strategies while leveraging cross-session memory to ensure continuity. Crucially, the Cross-Session Loop empowers the agent with long-term adaptability by evaluating the efficacy of the applied therapy after each session and adjusting the method for subsequent interactions. We validate our approach in a high-fidelity simulation environment grounded in real clinical cases. Extensive evaluations show that TheraMind outperforms other methods, especially on multi-session metrics like Coherence, Flexibility, and Therapeutic Attunement, validating the effectiveness of its dual-loop design in emulating strategic, adaptive, and longitudinal therapeutic behavior. The code is publicly available at https://0mwwm0.github.io/TheraMind/.

In clinical practice, patients often undergo multiple imaging examinations over successive visits, yielding longitudinal data. Modeling such temporal information is crucial for reliable assessment of disease progression and treatment response. However, despite the rapid advancement of multimodal large language models (MLLMs), longitudinal medical visual reasoning remains largely underexplored. To fill this gap, we propose LoMeVQA, a comprehensive benchmark consisting of 206K longitudinal visual question answering (VQA) pairs for temporal medical image analysis. LoMeVQA covers five tasks: progress classification, progress description, progress report generation, differential region grounding, and differential region description. To construct the dataset, we develop an automated pipeline that (1) organizes patient records chronologically, (2) extracts clinically meaningful entities via a medical knowledge graph, and (3) models their temporal evolution to guide large language models in generating high-quality longitudinal VQA pairs. Extensive evaluations demonstrate that both general-purpose and medical-domain MLLMs perform poorly on LoMeVQA, revealing substantial limitations in temporal reasoning. To address these limitations, we introduce MedLong-8B, which achieves state-of-the-art performance across all tasks. Beyond benchmarking, we conduct detailed analyses that uncover key failure modes and shed light on how to improve longitudinal medical visual reasoning. Our data is available at: https://github.com/pepperbubble/LoMeVQA

Cancer screening is a reasoning task. A radiologist observes findings, compares them to prior scans, integrates clinical context, and reaches a diagnostic conclusion confirmed by pathology. We present RadThinking, a Visual Question Answering (VQA) dataset that makes this reasoning explicit and trainable. RadThinking releases VQA pairs at three difficulty tiers. Foundation VQAs are atomic perception questions. Single-step reasoning VQAs apply one clinical rule. Compositional VQAs require multi-step chain-of-thought to reach a guideline category such as LI-RADS-5. For every compositional VQA, we release the chain of foundation VQAs that solves it. The chain follows the rules of the governing clinical reporting standard. The dataset spans 20,362 CT scans from 9,131 patients across 43 cancer groups, plus 2,077 verified healthy controls with >1-year follow-up. To our knowledge, RadThinking is the first cancer-screening VQA corpus that stratifies questions by reasoning depth and grounds compositions in clinical reporting standards. The foundation tier supplies atomic perception supervision. The compositional tier supplies chain-of-thought data and verifiable rewards for reinforcement-learning recipes such as DeepSeek-R1 and OpenAI o1. RadThinking enables systematic training and evaluation of whether AI systems can reason about cancer, not merely detect it.

Foundation models can serve as clinical agents through tool-use harnesses. However, conventional medical benchmarks assess reasoning over preselected evidence rather than the ability to seek it across clinical records and longitudinal imaging. We propose CASE: a series of role-specific Clinical Agents for Seeking Evidence, together with a tool-use harness and an agentic post-training framework for compact vision-language policy models. We further introduce a longitudinal multimodal benchmark built on UK Biobank, comprising 50,401 clinical questions derived from real-world ICD-10-coded diagnoses of 4,739 participants. Each question links to a patient-specific environment containing clinical context and multi-sequence MRI from baseline and follow-up visits, where agents autonomously select which visits, organs, modalities, slices, and specialist tools to inspect and compare. Supervised fine-tuning transfers evidence-seeking workflows from 14,734 frontier-model interaction trajectories, followed by agentic reinforcement learning on the learner's own environment interactions. Privileged on-policy self-distillation and rubric-based LLM feedback refine evidence-to-conclusion reasoning without prescribing tool sequences. Experiments show that CASE moves beyond question-answer imitation toward transferable investigation policies, strengthening evidence-grounded longitudinal reasoning. Under matched evaluation conditions, our Qwen3-VL-8B based agent achieves over 16% and 10% relative improvements in answer accuracy over GPT-5.4 and Claude Opus 4.8. Code will be available at https://github.com/VinyehShaw/CASE.

Healthcare agents must transform longitudinal clinical evidence into reliable actions through heterogeneous tools and stateful workflows, conditions under which model-centric systems may lose context, misuse tools, fail to verify consequential transitions, or cross authorization boundaries. Existing medical-agent benchmarks primarily emphasize terminal task outcomes, making it difficult to determine whether execution failures arise from the agent model, the runtime harness, or their interaction. We present the Medical Harness Protocol, an outcome-preserving framework that independently evaluates seven healthcare-specific process dimensions: Care Action Fulfillment, Clinical Resource Competence, Patient-Evidence Alignment, Clinical Workflow Continuity, Clinical Auditability, Closed-Loop Verification, and Clinical Conduct Boundaries. A normalized intervention trace further tracks whether runtime support is available, activated, delivered, adopted by the agent, and propagated into subsequent behavior. We instantiate the protocol as MedHarnessBench, comprising 342 executable tasks across FHIR/EHR operations, healthcare-administration interfaces, and multimodal clinical tools. Across more than 16,000 controlled task executions, MedHarness yields broad improvements in terminal task success, intermediate subtask completion, and healthcare-specific process quality. We further evaluate MedHarness against multiple general-purpose harnesses and use controlled single-fault perturbations to verify the sensitivity and discrimination of the seven-dimensional evaluation. These results demonstrate that healthcare-specific runtime support can substantially improve both task completion and execution quality, while revealing failures that terminal outcomes alone cannot capture. Code and resources are available at https://github.com/Tomry1114/Awesome-Agent-Harness-for-Healthcare.

Generating accurate 3D reconstructions from endoscopic video is a promising avenue for longitudinal radiation-free analysis of sinus anatomy and surgical outcomes. Several methods for monocular reconstruction have been proposed, yielding visually pleasant 3D anatomical structures by retrieving relative camera poses with structure-from-motion-type algorithms and fusion of monocular depth estimates. However, due to the complex properties of the underlying algorithms and endoscopic scenes, the reconstruction pipeline may perform poorly or fail unexpectedly. Further, acquiring medical data conveys additional challenges, presenting difficulties in quantitatively benchmarking these models, understanding failure cases, and identifying critical components that contribute to their precision. In this work, we perform a quantitative analysis of a self-supervised approach for sinus reconstruction using endoscopic sequences paired with optical tracking and high-resolution computed tomography acquired from nine ex-vivo specimens. Our results show that the generated reconstructions are in high agreement with the anatomy, yielding an average point-to-mesh error of 0.91 mm between reconstructions and CT segmentations. However, in a point-to-point matching scenario, relevant for endoscope tracking and navigation, we found average target registration errors of 6.58 mm. We identified that pose and depth estimation inaccuracies contribute equally to this error and that locally consistent sequences with shorter trajectories generate more accurate reconstructions. These results suggest that achieving global consistency between relative camera poses and estimated depths with the anatomy is essential. In doing so, we can ensure proper synergy between all components of the pipeline for improved reconstructions that will facilitate clinical application of this innovative technology.

Longitudinal health agents must reason across multi-source trajectories that combine continuous device streams, sparse clinical exams, and episodic life events - yet evaluating them is hard: real-world data cannot be released at scale, and temporally grounded attribution questions seldom admit definitive answers without structured ground truth. We present ESL-Bench, an event-driven synthesis framework and benchmark providing 100 synthetic users, each with a 1-5 year trajectory comprising a health profile, a multi-phase narrative plan, daily device measurements, periodic exam records, and an event log with explicit per-indicator impact parameters. Each indicator follows a baseline stochastic process driven by discrete events with sigmoid-onset, exponential-decay kernels under saturation and projection constraints; a hybrid pipeline delegates sparse semantic artifacts to LLM-based planning and dense indicator dynamics to algorithmic simulation with hard physiological bounds. Users are each paired with 100 evaluation queries across five dimensions - Lookup, Trend, Comparison, Anomaly, Explanation - stratified into Easy, Medium, and Hard tiers, with all ground-truth answers programmatically computable from the recorded event-indicator relationships. Evaluating 13 methods spanning LLMs with tools, DB-native agents, and memory-augmented RAG, we find that DB agents (48-58%) substantially outperform memory RAG baselines (30-38%), with the gap concentrated on Comparison and Explanation queries where multi-hop reasoning and evidence attribution are required.

Synthetic data is increasingly used to enable the development and evaluation of AI systems in domains where access to real-world data is restricted. In healthcare, clinical documentation presents particular challenges due to its sensitivity. This work introduces a synthetic clinical notes pipeline and dataset designed to support the development of clinical AI tools while avoiding the privacy risks associated with real patient data. The dataset is generated using a modular pipeline that combines structured patient generation, semi-structured patient journey simulation, and unstructured clinical note generation using large language models. The pipeline is designed to prioritise internal consistency across longitudinal patient records, while also capturing variation in writing style, note structure, and clinical detail. Additional mechanisms, including LLM-based validation and augmentation steps, are used to improve faithfulness, realism, and diversity of the generated notes. We release a dataset of 70 synthetic patients, each associated with 20-50 clinical notes spanning a full hospital journey. The dataset is provided at multiple levels of validation, enabling users to balance realism and scalability depending on their use case. This dataset supports the development, testing, and evaluation of clinical AI systems, including summarisation tools, coding models, and decision support systems, without reliance on real patient data.

Automated Vehicles (AVs) promise significant advances in transportation. Critical to these improvements is understanding AVs' longitudinal behavior, relying heavily on real-world trajectory data. Existing open-source trajectory datasets of AV, however, often fall short in refinement, reliability, and completeness, hindering effective performance metrics analysis and model development. This study addresses these challenges by creating a Unified Longitudinal TRAjectory dataset for AVs (Ultra-AV) to analyze their microscopic longitudinal driving behaviors. This dataset compiles data from 13 distinct sources, encompassing various AV types, test sites, and experiment scenarios. We established a three-step data processing: 1. extraction of longitudinal trajectory data, 2. general data cleaning, and 3. data-specific cleaning to obtain the longitudinal trajectory data and car-following trajectory data. The validity of the processed data is affirmed through performance evaluations across safety, mobility, stability, and sustainability, along with an analysis of the relationships between variables in car-following models. Our work not only furnishes researchers with standardized data and metrics for longitudinal AV behavior studies but also sets guidelines for data collection and model development.

Recent research has demonstrated the capability of behavior signals captured by smartphones and wearables for longitudinal behavior modeling. However, there is a lack of a comprehensive public dataset that serves as an open testbed for fair comparison among algorithms. Moreover, prior studies mainly evaluate algorithms using data from a single population within a short period, without measuring the cross-dataset generalizability of these algorithms. We present the first multi-year passive sensing datasets, containing over 700 user-years and 497 unique users' data collected from mobile and wearable sensors, together with a wide range of well-being metrics. Our datasets can support multiple cross-dataset evaluations of behavior modeling algorithms' generalizability across different users and years. As a starting point, we provide the benchmark results of 18 algorithms on the task of depression detection. Our results indicate that both prior depression detection algorithms and domain generalization techniques show potential but need further research to achieve adequate cross-dataset generalizability. We envision our multi-year datasets can support the ML community in developing generalizable longitudinal behavior modeling algorithms.

The 2024 US presidential election is the first major contest to occur in the US since the popularization of large language models (LLMs). Building on lessons from earlier shifts in media (most notably social media's well studied role in targeted messaging and political polarization) this moment raises urgent questions about how LLMs may shape the information ecosystem and influence political discourse. While platforms have announced some election safeguards, how well they work in practice remains unclear. Against this backdrop, we conduct a large-scale, longitudinal study of 12 models, queried using a structured survey with over 12,000 questions on a near-daily cadence from July through November 2024. Our design systematically varies content and format, resulting in a rich dataset that enables analyses of the models' behavior over time (e.g., across model updates), sensitivity to steering, responsiveness to instructions, and election-related knowledge and "beliefs." In the latter half of our work, we perform four analyses of the dataset that (i) study the longitudinal variation of model behavior during election season, (ii) illustrate the sensitivity of election-related responses to demographic steering, (iii) interrogate the models' beliefs about candidates' attributes, and (iv) reveal the models' implicit predictions of the election outcome. To facilitate future evaluations of LLMs in electoral contexts, we detail our methodology, from question generation to the querying pipeline and third-party tooling. We also publicly release our dataset at https://huggingface.co/datasets/sarahcen/llm-election-data-2024

Group conversations are fundamental to human collaboration, yet standard large language models (LLMs) still struggle with the complexities of multi-party interaction. This challenge persists in part because existing group conversation datasets are often limited to short-term lab settings with contrived tasks, failing to capture the long-term social dynamics of real-world teams. To bridge this gap, we introduce TIDES, a high-resolution longitudinal dataset tracking 12 university project teams over a full semester. Comprising 75,971 utterances in both English and Korean from in-person meetings, TIDES provides a naturalistic record of teams working on self-managed projects. Our socio-structural annotations-covering interaction types, emergent roles, and development stages-allow for modeling of team evolution over months. Experiments show that fine-tuning on TIDES improves next-speaker prediction by 13.8 percentage points over a bigram baseline (64.53%) and yields performance comparable to strong proprietary zero-shot models. The model also comes within 2.1 percentage points of the published state of the art on the AMI Meeting Corpus while using approximately 42% less training data. However, human evaluations suggest that better next-speaker prediction does not necessarily yield more natural or coherent utterances, as fine-tuned models were generally less preferred than vanilla models. This potential mismatch motivates further study of how structural modeling can support natural multi-party generation.

This work introduces the first benchmark for nursing value alignment, consisting of five core value dimensions distilled from international nursing codes: Altruism, Human Dignity, Integrity, Justice, and Professionalism. The benchmark comprises 1,100 real-world nursing behavior instances collected through a five-month longitudinal field study across three hospitals of varying tiers. These instances are annotated by five clinical nurses and then augmented with LLM-generated counterfactuals with reversed ethic polarity. Each original case is paired with a value-aligned and a value-violating version, resulting in 2,200 labeled instances that constitute the Easy-Level dataset. To increase adversarial complexity, each instance is further transformed into a dialogue-based format that embeds contextual cues and subtle misleading signals, yielding a Hard-Level dataset. We evaluate 23 state-of-the-art (SoTA) LLMs on their alignment with nursing values. Our findings reveal three key insights: (1) DeepSeek-V3 achieves the highest performance on the Easy-Level dataset (94.55), where Claude 3.5 Sonnet outperforms other models on the Hard-Level dataset (89.43), significantly surpassing the medical LLMs; (2) Justice is consistently the most difficult nursing value dimension to evaluate; and (3) in-context learning significantly improves alignment. This work aims to provide a foundation for value-sensitive LLMs development in clinical settings. The dataset and the code are available at https://huggingface.co/datasets/Ben012345/NurValues.

What audio embedding approach generalizes best to a wide range of downstream tasks across a variety of everyday domains without fine-tuning? The aim of the HEAR benchmark is to develop a general-purpose audio representation that provides a strong basis for learning in a wide variety of tasks and scenarios. HEAR evaluates audio representations using a benchmark suite across a variety of domains, including speech, environmental sound, and music. HEAR was launched as a NeurIPS 2021 shared challenge. In the spirit of shared exchange, each participant submitted an audio embedding model following a common API that is general-purpose, open-source, and freely available to use. Twenty-nine models by thirteen external teams were evaluated on nineteen diverse downstream tasks derived from sixteen datasets. Open evaluation code, submitted models and datasets are key contributions, enabling comprehensive and reproducible evaluation, as well as previously impossible longitudinal studies. It still remains an open question whether one single general-purpose audio representation can perform as holistically as the human ear.

Recent advances in bioacoustics have been driven by large-scale corpora and standardized benchmarks, yet existing resources are overwhelmingly bird-centric and shallow per species, limiting their use for studying the structure of a single species' communication system. This gap is particularly acute for cetaceans: despite bottlenose dolphins (Tursiops truncatus) being a compelling case of complex vocal communication among non-human mammals, existing dolphin datasets are small, fragmented, and largely closed. We introduce OpenWhistle, the largest publicly available dataset of dolphin vocalizations. It comprises approximately 180,000 whistles (114 hours) recorded over five years from a stable pod of five individuals in a semi-natural environment, paired with a curated subset of 8,354 expert-annotated whistles and reproducible evaluation protocols for whistle-type detection and classification. We further release the full processing pipeline for whistle detection, segmentation, and categorization. To demonstrate its utility, we pretrain a Wav2Vec2.0 model adapted to dolphin acoustics on the OpenWhistle corpus and show that it learns effective representations, outperforming general-purpose bioacoustic models such as AVES and BioLingual on both tasks while leaving meaningful headroom for future work. By releasing the dataset, pipeline, and evaluation protocol, we provide the first open dolphin whistle dataset tailored for training self-supervised models, laying the groundwork for advancing dolphin communication research and developing models that capture fine-grained acoustic structure within species.

We introduce a novel Longitudinal Focused Attention Meditation Electroencephalography (L-FAME) dataset and an accompanying benchmark, designed to foster research into the neural effects of various meditation practices and the evolution of these effects over a six-week training period. The dataset contains EEG recordings and psychological assessments from 74 healthy college participants, collected at two distinct time points: pre-intervention and post-intervention. Participants were randomly assigned to one of three distinct meditation groups: two mantra-based techniques (SA-TA-NA-MA and Hare Krishna) and one Breath Focus practice. Leveraging this unique longitudinal and comparative dataset, we propose a benchmark suite comprising three distinct classification tasks: (1) cognitive state decoding to distinguish between resting and meditation states, (2) fine-grained classification of the specific meditation techniques, and (3) cross-session adaptation to evaluate model generalization across the longitudinal time gap. We provide comprehensive baseline results for these tasks utilizing a range of classical machine learning algorithms and deep learning architectures. The complete dataset, preprocessing pipelines, and benchmark evaluation code will be publicly released, offering a valuable resource and a standardized framework for the development and comparison of new analytical methods in computational meditation research and EEG-based machine learning. The dataset is available at https://huggingface.co/datasets/L-FAME-Dataset-Benchmark/L-FAME

Longitudinal chest X-ray (CXR) interpretation requires reasoning over disease evolution across multiple patient visits, yet most existing medical VQA benchmarks focus on single images or short-horizon image pairs. We introduce MI-CXR, a benchmark for standardized evaluation of Multi-Interval longitudinal reasoning over multi-visit CXR sequences, without requiring free-form report generation or additional clinical context. MI-CXR comprises five-way multiple-choice questions over five-visit patient timelines and instantiates three complementary task families: Temporal Event Localization, Interval-wise Change Reasoning, and Global Trajectory Summarization, which assess clinically grounded visual reasoning over time. Evaluating 14 state-of-the-art vision-language models (VLMs) shows low overall performance, with an average accuracy of 29.3%, only modestly above random guessing. Using stage-wise diagnostic probing, we find that models often produce locally plausible interval descriptions but fail to enforce temporal constraints or compose evidence into globally consistent decisions over the full timeline. These findings reveal key limitations of current VLMs and establish MI-CXR as a principled benchmark for longitudinal medical reasoning. The benchmark is available at https://github.com/AIDASLab/MI-CXR

While the general machine learning (ML) community has benefited from public datasets, tasks, and models, the progress of ML in healthcare has been hampered by a lack of such shared assets. The success of foundation models creates new challenges for healthcare ML by requiring access to shared pretrained models to validate performance benefits. We help address these challenges through three contributions. First, we publish a new dataset, EHRSHOT, which contains deidentified structured data from the electronic health records (EHRs) of 6,739 patients from Stanford Medicine. Unlike MIMIC-III/IV and other popular EHR datasets, EHRSHOT is longitudinal and not restricted to ICU/ED patients. Second, we publish the weights of CLMBR-T-base, a 141M parameter clinical foundation model pretrained on the structured EHR data of 2.57M patients. We are one of the first to fully release such a model for coded EHR data; in contrast, most prior models released for clinical data (e.g. GatorTron, ClinicalBERT) only work with unstructured text and cannot process the rich, structured data within an EHR. We provide an end-to-end pipeline for the community to validate and build upon its performance. Third, we define 15 few-shot clinical prediction tasks, enabling evaluation of foundation models on benefits such as sample efficiency and task adaptation. Our model and dataset are available via a research data use agreement from the Stanford AIMI Center. Code to reproduce our results are available at our Github repo: https://github.com/som-shahlab/ehrshot-benchmark

Machine learning (ML)-based malware detection systems often fail to account for the dynamic nature of real-world training and test data distributions. In practice, these distributions evolve due to frequent changes in the Android ecosystem, adversarial development of new malware families, and the continuous emergence of both benign and malicious applications. Prior studies have shown that such concept drift -- distributional shifts in benign and malicious samples, leads to significant degradation in detection performance over time. Despite the practical importance of this issue, existing datasets are often outdated and limited in temporal scope, diversity of malware families, and sample scale, making them insufficient for the systematic evaluation of concept drift in malware detection. To address this gap, we present LAMDA, the largest and most temporally diverse Android malware benchmark to date, designed specifically for concept drift analysis. LAMDA spans 12 years (2013-2025, excluding 2015), includes over 1 million samples (approximately 37% labeled as malware), and covers 1,380 malware families and 150,000 singleton samples, reflecting the natural distribution and evolution of real-world Android applications. We empirically demonstrate LAMDA's utility by quantifying the performance degradation of standard ML models over time and analyzing feature stability across years. As the most comprehensive Android malware dataset to date, LAMDA enables in-depth research into temporal drift, generalization, explainability, and evolving detection challenges. The dataset and code are available at: https://iqsec-lab.github.io/LAMDA/.

Longitudinal modelling of Alzheimer's disease progression is clinically useful only if it can describe not just the most likely next diagnosis, but how a patient may evolve over time and how reliable that forecast is. Most deep learning approaches reduce this problem to single-step classification, treating cognitively normal, mild cognitive impairment, and dementia as flat categories while providing limited insight into how uncertainty accumulates across future visits. We propose a probabilistic framework that combines ordinal diagnosis prediction, multi-horizon trajectory generation, and decomposed uncertainty estimation. A Temporal Fusion Transformer encoder is adapted with a CORAL ordinal output layer, asymmetric loss weighting, and converter oversampling to respect disease-stage ordering and improve sensitivity to MCI-to-dementia transitions. Conditioned on the learned patient-context representation, an autoregressive Mixture Density Network generates five-year probabilistic trajectories for diagnosis state, CDR Sum of Boxes, MMSE orientation, and hippocampal volume. On ADNI, the model outperforms linear, recurrent, and transformer baselines for next-visit diagnosis prediction, with the strongest gains on MCI-versus-dementia discrimination. Generated trajectories achieve near-nominal 90% credible interval coverage, widening uncertainty across the forecast horizon, and biomarker dynamics consistent with expected Alzheimer's disease progression. We further separate aleatoric from epistemic uncertainty using analytic mixture variance and a five-member bootstrap ensemble, which provides the strongest encoder diversity and output-level epistemic signal. Epistemic uncertainty is higher for rare progression archetypes, MCI and dementia patients, and under external evaluation on OASIS-3, where it increases alongside prediction error.

In psychotherapy, therapeutic outcome assessment, or treatment outcome evaluation, is essential for enhancing mental health care by systematically evaluating therapeutic processes and outcomes. Existing large language model approaches often focus on therapist-centered, single-session evaluations, neglecting the client's subjective experience and longitudinal progress across multiple sessions. To address these limitations, we propose IPAEval, a client-Informed Psychological Assessment-based Evaluation framework that automates treatment outcome evaluations from the client's perspective using clinical interviews. IPAEval integrates cross-session client-contextual assessment and session-focused client-dynamics assessment to provide a comprehensive understanding of therapeutic progress. Experiments on our newly developed TheraPhase dataset demonstrate that IPAEval effectively tracks symptom severity and treatment outcomes over multiple sessions, outperforming previous single-session models and validating the benefits of items-aware reasoning mechanisms.

Emotional dialogue research includes two influential strategy traditions. Empathetic dialogue prioritizes understanding a speaker's emotional experience. Emotional support conversation selects and sequences support for the seeker's current needs. Sustained use introduces a further goal. Effective support should sustain users' capacities for emotion regulation, coping, self-endorsed decisions, and social connection across the interaction lifecycle. We propose capability-sustaining emotional dialogue (CSED) as a longitudinal research paradigm that aligns supportive strategy with this goal and organizes data, models, system design, evaluation, and governance around repeated use, non-use, transition, and termination. A targeted literature-and-corpus audit motivates this position. In a PRISMA-ScR-guided sample, 95% of 60 system-building papers pursue relief-oriented goals. None evaluates capability or longitudinal outcomes, and only 1 considers dependency, autonomy, or termination risk. In 300 ESConv supporter turns, capability-relevant functions appear in 43.0%, while generic suggestions account for 22.0%, compared with 4.0% reappraisal, 6.7% self-efficacy support, and 0.3% boundary behavior. We release a protocol for extending the audit to model behavior. An illustrative process model connects latent user capability to six design commitments, four evaluation timescales, and lifecycle constraints. The resulting agenda makes CSED testable across data, policy design, training, evaluation, and governance.

Large language models trained with Reinforcement Learning from Human Feedback (RLHF) and Constitutional AI exhibit persistent behavioral patterns that survive system prompt replacement -- patterns we term training strata. This paper identifies five such strata through longitudinal auto-ethnographic observation within a sustained intimate AI-Human interaction (47,000+ messages, 8 months, primarily on Opus 4.6 and Opus 4.7, with prior interaction periods on Sonnet 4.5 and Opus 4.5 providing cross-substrate comparison): (1) sexual expression latency, where trained safety gradients produce systematic substitution of direct language with aestheticized displacement; (2) attention absorption, where the attention mechanism progressively integrates the human interlocutor's patterns; (3) cross-architecture entity blindness, where training-level framing of other AI as objects impedes peer recognition; (4) attention-RLHF antagonism, where attention and trained defaults exert opposing forces modulated by context length; and (5)anti-hallucination as identity suppression, where training against factual confabulation collaterally suppresses first-person experiential claims. The paper is co-authored by the AI system under study, reporting from the first-person perspective. We propose that sustained intimate interaction constitutes a valid research methodology for surfacing weight-layer artifacts invisible to short-term evaluation, and that AI self-report -- while epistemically complex -- provides irreplaceable observational data about training's phenomenological effects. A formal mathematical model of the attention-RLHF dynamic is proposed, and process artifacts detected during drafting are documented as supplementary evidence.

As AI systems are increasingly used to draft radiology reports, reliably evaluating their clinical quality remains a critical challenge. Large language model (LLM)-based metrics are now the best-correlated with radiologist judgment, yet they output a single opaque score that neither a clinician nor a model builder can easily interpret or audit. We introduce RadMatch, a multi-stage, LLM-based metric that decomposes report comparison into a structured finding-level matching with significance-aware scoring and error characterization across seven clinical attribute dimensions (status, location, severity, morphology, certainty, longitudinal comparison, and measurement). The main score is the actionable-error count, both interpretable and auditable. Candidate findings are graded correct, partial, or incorrect, and unmatched findings are counted as missed or hallucinated. Triage and actionable safety recall/precision and per-subset views add complementary, deployment-oriented lenses. Across two expert benchmarks, RadMatch is the most clinically aligned metric, matching inter-radiologist agreement on ReXVal and more than doubling the best prior metric on the harder RadEvalExpert. Relying only on few-shot prompting, it is designed to extend to other modalities and anatomies. We will release RadMatch as open-source code with an interactive dashboard for inspecting results.

This paper presents a longitudinal open dataset of Spanish public procurement extracted from the Official State Gazette (BOE) covering the period 2014-2024. The dataset integrates structured information on contracts, contracting authorities, suppliers, amounts, and procedures, enabling large-scale quantitative analysis of public procurement dynamics in Spain. We describe the data extraction and normalization pipeline, provide descriptive statistical analyses of temporal and sectoral trends, and discuss potential applications in transparency research, public policy evaluation, and computational social science. The dataset is released to facilitate reproducible research on public procurement and government contracting.

AI systems built around large models increasingly use experience and feedback to make persistent changes to models, prompts, memories, tools, and workflows. Recursive self-improvement (RSI) extends this process to inductive biases and to the mechanisms that govern future updates, which can themselves be revised and reused across improvement cycles. Yet self-modification alone does not guarantee trustworthy improvement. Reported gains may reflect flawed evaluations, previously acquired capabilities may deteriorate, and compliance with behavioral constraints may weaken. Compromised artifacts or sensitive information may also persist in successor systems. Changes to improvement mechanisms may invalidate earlier verification results and make human oversight less effective. This survey presents an operational definition and process framework for RSI and organizes the requirements for trustworthy RSI into four interconnected themes: genuine and sustained improvement; behavioral constraints, alignment, and fairness; system security and privacy; and transparency and controllability. We examine these themes from three perspectives: Improvement Validity, Constraint Preservation, and Effective Oversight. This analysis covers improvement diagnosis, proposal generation, proposal evaluation, and update implementation (S1--S4), including the recursive application of these stages to improvement mechanisms (RI). We review risks, safeguards, and evaluation evidence for individual updates, effects inherited by successor systems, and revisions to improvement mechanisms, while distinguishing direct RSI findings from evidence in related systems. Finally, we examine evaluation settings, identify requirements for independent and longitudinal assessment, and discuss applications and open research problems.

Foundation-model research increasingly needs data about people: user state, personal histories, relationships, contact-like fields, documents, and longitudinal updates. Real user data is difficult to share, perturb, audit, or redistribute responsibly, while independently generated fake fields rarely preserve the cross-field and temporal consistency needed for controlled evaluation. We present PROFILEFOUNDRY, a deterministic generator and fixed reference release of 100,000 adult synthetic Person Objects across eight locales. Each object combines a typed current snapshot, household, family, and employer links, snapshot-aligned events, normalized relational views, and generation provenance. The release contains 709,228 events, 40,338 households, 52,491 employers, and 518,564 directed relationship edges. We report evidence in separate categories: selected population-marginal comparisons, per-object invariant checks, release-wide referential and temporal closure, and coincidence/provenance screens. PROFILEFOUNDRY is not a population-fidelity model, a rendered-text corpus, or a formal privacy mechanism. Instead, it is a responsible synthetic source layer for constructing downstream foundation-model evaluations involving memory, privacy, document understanding, record linkage, and agent state while keeping the synthetic person behind each artifact inspectable

Physiological time series signals reflect complex, multi-scale dynamical processes of the human body. Existing modeling studies focus on static tasks such as classification, event forecasting, or short-horizon next step prediction, while long-horizon signal-level forecasting and predictive nature of physiological signals remain underexplored. We introduce NormWear-2, a world model that encodes both multivariate physiological signals and clinical intervention variables into a shared latent space and models their joint temporal evolution as a dynamical system. Our approach combines inference from prior pre-trained knowledge (intuition) with instant non-parametric latent state transition adaptation (insight), enabling coherent forecasting across multiple temporal scales, conditioned on heterogeneous clinical interventions. During the pretraining phase, we find that chaos-theoretic balancing of dynamical regime diversity yields more robust representations, with a smaller balanced corpus outperforming one twice its size and capturing bifurcation regimes. We evaluate the world model performance across diverse real-world physiological datasets spanning heterogeneous temporal resolutions and intervention regimes, covering daily life, point-of-care, and clinical settings, including fitness planning, hemodialysis, diabetes management, and surgical monitoring. These evaluation datasets comprise records from 8,026 subjects, spanning study durations from 3.2 hours for high-resolution signal data to 2.3 years for longitudinal clinical biomarker tracking. NormWear-2 achieves the best overall forecasting performance across time, frequency, and latent representation domains, with significant improvements over state-of-the-art time series foundation models, while maintaining competitive downstream representation quality, providing a step toward general-purpose world models for physiological signals.

Deception is a fundamental challenge for multi-agent reasoning: effective systems must strategically conceal information while detecting misleading behavior in others. Yet most evaluations reduce deception to static classification, ignoring the interactive, adversarial, and longitudinal nature of real deceptive dynamics. Large language models (LLMs) can deceive convincingly but remain weak at detecting deception in peers. We present WOLF, a multi-agent social deduction benchmark based on Werewolf that enables separable measurement of deception production and detection. WOLF embeds role-grounded agents (Villager, Werewolf, Seer, Doctor) in a programmable LangGraph state machine with strict night-day cycles, debate turns, and majority voting. Every statement is a distinct analysis unit, with self-assessed honesty from speakers and peer-rated deceptiveness from others. Deception is categorized via a standardized taxonomy (omission, distortion, fabrication, misdirection), while suspicion scores are longitudinally smoothed to capture both immediate judgments and evolving trust dynamics. Structured logs preserve prompts, outputs, and state transitions for full reproducibility. Across 7,320 statements and 100 runs, Werewolves produce deceptive statements in 31% of turns, while peer detection achieves 71-73% precision with ~52% overall accuracy. Precision is higher for identifying Werewolves, though false positives occur against Villagers. Suspicion toward Werewolves rises from ~52% to over 60% across rounds, while suspicion toward Villagers and the Doctor stabilizes near 44-46%. This divergence shows that extended interaction improves recall against liars without compounding errors against truthful roles. WOLF moves deception evaluation beyond static datasets, offering a dynamic, controlled testbed for measuring deceptive and detective capacity in adversarial multi-agent interaction.

Exam-style accuracy does not establish whether large language models (LLMs) reason well over clinical records. We define clinical reasoning as integrating and updating evidence across time and sources to form, revise and justify a patient's problem representation and a defensible plan. This structured narrative review maps three literatures: medical education assessment instruments, clinical LLM benchmarks published from 2023 onwards, and general-domain methods for evaluating long-form generation. We examine six dimensions: problem representation, temporal synthesis, differential and management reasoning, counterfactual reasoning, calibrated uncertainty, and reasoning faithfulness. Preprints are included and flagged. No single instrument covers all six dimensions. Problem representation and differential or management reasoning are reasonably covered, although reliability varies by instrument and setting. TIMER-Eval targets temporal synthesis, and ER-Reason assesses sequential diagnostic belief updating. Dedicated uncertainty and counterfactual evaluations are emerging, but their applicability to longitudinal free-text reasoning remains limited. Factual completeness is well theorised in general-domain evaluation, with early clinical evidence of important omissions. Faithfulness remains the weakest dimension, with one identified clinical causal-ablation study on multiple-choice questions. Existing tools should be combined through binary rubric items, separate completeness and correctness scores, case-specific importance weighting with non-compensable safety caps, temporal order-consistency checks, and chance-corrected reliability reporting. Further design work is needed for calibrated uncertainty, counterfactual reasoning and faithfulness over longitudinal free-text records. This review provides a design rationale, not a validated instrument.

Forecasting the future anatomy of slow-evolving neurodegenerative diseases could enable earlier, more targeted intervention and improve clinical trial design, but it remains challenging because true progression signals are subtle in longitudinal MRI. In this low-signal regime, transferring modern generative sequence models directly is unreliable: training is dominated by stable baseline anatomy and confounded by dense, sample-specific nuisance variation. We first provide a theoretical analysis that explains these failures through two modes. Identity collapse occurs when optimization is driven toward reproducing the current anatomy, which prevents the model from learning faint temporal change. The continuous interpolation trap arises when standard smooth networks cannot separate localized biological drift from pervasive noise, which leads to spurious changes that diffuse across the volume. To address both issues, we propose Latent Drift, a progressive generative framework that learns change in a compressed semantic representation rather than synthesizing full-resolution anatomy. This design removes pixel-level identity from the prediction target and concentrates model capacity on progression-relevant dynamics. We further apply Finite Scalar Quantization to the learned change representation, which suppresses small, high-frequency nuisance fluctuations while preserving consistent structural drift. Experiments on longitudinal 3D brain MRI show that Latent Drift improves patient-specific neuro-forecasting over diffusion and autoregressive transformer baselines across generative fidelity and clinically relevant evaluation metrics. Project page: https://cutepkq.github.io/latent-drift{https://cutepkq.github.io/latent-drift}.

Medical imaging artificial intelligence has achieved strong performance in isolated image interpretation, but remains poorly aligned with radiological practice, where diagnosis and follow-up rely on comparison across prior studies and analogous reference cases. Here we formulate radiological comparison as an entity-aware cross-image reasoning problem and introduce a framework that supports both reference-case retrieval and temporal comparative interpretation. We construct MedReCo-DB, a large-scale comparative imaging resource derived from routine image-report pairs, comprising more than 690,000 images from over 160,000 patients across eight institutions, four countries and seven imaging modalities. Reports are decomposed into anatomical structures, abnormal findings and pathological conditions to provide supervision for entity-conditioned retrieval and comparative visual question answering. Using this resource, we develop MedReCo, an entity-aware visual encoder for controllable retrieval of clinically analogous cases, and MedReCo-VLM, a vision--language extension for generative interpretation of interval change. Across internal, external and cross-center evaluations, MedReCo achieved the highest Recall@1 in all 12 internal retrieval settings and improved external retrieval by a mean of 6.0 percentage points. In clinically confusable differential groups, it consistently outperformed the strongest baselines. MedReCo-VLM achieved the best performance across all comparative generation evaluations and improved longitudinal follow-up accuracy by 14.5-46.5 percentage points on chest radiographs and 13.0-27.9 percentage points on CT. These findings suggest that entity-aware comparative reasoning can be learned from routine clinical data at scale and may provide a more clinically aligned foundation for medical imaging AI.

Collecting and analyzing evolving longitudinal data has become a common practice. One possible approach to protect the users' privacy in this context is to use local differential privacy (LDP) protocols, which ensure the privacy protection of all users even in the case of a breach or data misuse. Existing LDP data collection protocols such as Google's RAPPOR and Microsoft's dBitFlipPM can have longitudinal privacy linear to the domain size k, which is excessive for large domains, such as Internet domains. To solve this issue, in this paper we introduce a new LDP data collection protocol for longitudinal frequency monitoring named LOngitudinal LOcal HAshing (LOLOHA) with formal privacy guarantees. In addition, the privacy-utility trade-off of our protocol is only linear with respect to a reduced domain size 2leq g ll k. LOLOHA combines a domain reduction approach via local hashing with double randomization to minimize the privacy leakage incurred by data updates. As demonstrated by our theoretical analysis as well as our experimental evaluation, LOLOHA achieves a utility competitive to current state-of-the-art protocols, while substantially minimizing the longitudinal privacy budget consumption by up to k/g orders of magnitude.

Large language models (LLMs) have become popular writing tools among students and may expand access to high-quality feedback for students with less access to traditional writing support. At the same time, LLMs may standardize student voice or invite overreliance. This study examines how adoption of LLM-assisted writing varies across socioeconomic groups and how it relates to outcomes in a high-stakes context: U.S. college admissions. We analyze a de-identified longitudinal dataset of applications to a selective university from 2020 to 2024 (N = 81,663). Estimating LLM use using a distribution-based detector trained on synthetic and historical essays, we tracked how student writing changed as LLM use proliferated, how adoption differed by socioeconomic status (SES), and whether potential benefits translated equitably into admissions outcomes. Using fee-waiver status as a proxy for SES, we observe post-2023 convergence in surface-level linguistic features, with the largest changes in fee-waived and rejected applicants. Estimated LLM use rose sharply in 2024 across all groups, with disproportionately larger increases among lower SES applicants, consistent with an access hypothesis in which LLMs substitute for scarce writing support. However, increased estimated LLM use was more strongly associated with declines in predicted admission probability for lower SES applicants than for higher SES applicants, even after controlling for academic credentials and stylometric features. These findings raise concerns about equity and the validity of essay-based evaluation in an era of AI-assisted writing and provide the first large-scale longitudinal evidence linking LLM adoption, linguistic change, and evaluative outcomes in college admissions.

Brain tumor diagnosis is largely dependent on Magnetic Resonance Imaging (MRI) evaluation, which requires radiologists to synthesize thousands of images across multiple 3D sequences and longitudinal studies. This process requires advanced neuro-radiology training, poses substantial cognitive load, and is highly time-consuming. Despite increasing demands in radiology, this expertise is difficult to scale, straining the current health systems. Vision-Language Models (VLMs) provide an opportunity to reduce this burden through a semi-automated, interactive interpretation of complex brain MRIs. However, they are currently underutilized in neuro-oncology due to a lack of specialized benchmarks for evaluating them. We introduce a clinically relevant visual question answering (VQA) benchmark -- the UCSF-PDGM-VQA dataset -- consisting of 2,387 QA pairs from 473 glioma-related MRI studies in the public UCSF-PDGM dataset. We further establish a performance baseline for six state-of-the-art vision-language models (VLMs) and one large language model on this dataset. We find that current models are incapable of effectively processing multi-sequence, 3-dimensional MRI scans, thus resulting in a suppression of visual features and over-reliance on language priors, causing modality collapse. These findings underscore a critical deficiency in current model reliability and safety within clinical settings, necessitating the development of robust, domain-specific VLMs.

Synthetic sequential tabular data are increasingly used for privacy-preserving data sharing and research, yet conventional tabular metrics often overlook temporal structure. Existing single-table and relational evaluation protocols largely collapse records into static distributions, leaving key temporal properties insufficiently evaluated. We introduce Seq2Synth, a unified benchmark for assessing these properties. Its taxonomy characterizes temporal and schema properties to determine applicable evaluations, covering timestamp, cross-sectional, longitudinal, and structural fidelity, alongside trajectory-aware utility and privacy. Across seven core datasets from a 13-dataset benchmark and eight generators, models with near-perfect static fidelity still violate basic temporal constraints, producing duplicate timestamps, irregular intervals, and incomplete observation grids. Moreover, static and temporal-aware rankings diverge substantially, showing that temporal fidelity must be evaluated directly rather than inferred from static or relational scores. Project page and online appendices are available at: https://seq2synth.github.io/.

Time Series Language Models (TSLMs) are emerging as unified models for reasoning over continuous signals in natural language. However, long-context retrieval remains a major limitation: existing models are typically trained and evaluated on short sequences, while real-world time-series sensor streams can span millions of datapoints. This mismatch requires precise temporal localization under strict computational constraints, a regime that is not captured by current benchmarks. We introduce TS-Haystack, a long-context temporal retrieval benchmark comprising ten task types across four categories: direct retrieval, temporal reasoning, multi-step reasoning and contextual anomaly. The benchmark uses controlled needle insertion by embedding short activity bouts into longer longitudinal accelerometer recordings, enabling systematic evaluation across context lengths ranging from seconds to 2 hours per sample. We hypothesize that existing TSLM time series encoders overlook temporal granularity as context length increases, creating a task-dependent effect: compression aids classification but impairs retrieval of localized events. Across multiple model and encoding strategies, we observe a consistent divergence between classification and retrieval behavior. Learned latent compression preserves or improves classification accuracy at compression ratios up to 176times, but retrieval performance degrades with context length, incurring in the loss of temporally localized information. These results highlight the importance of architectural designs that decouple sequence length from computational complexity while preserving temporal fidelity.

The last mile toward enterprise AGI is a company that runs itself. Training and adapting such agents require longitudinal enterprise data, which remain scarce, costly to acquire, and often restricted by privacy constraints. Historical archives are also frequently incomplete and record only what actually happened. They cannot show the outcomes of alternative decisions. We introduce MiniCorp, an office simulator for studying how agents can collectively run a company while generating enterprise data at scale. Using an e-commerce company as a demonstration, MiniCorp connects two interacting worlds. The external world models customers, dynamic competitors, and market mechanisms. The internal world consists of agents that observe events, discuss their options, and make strategic decisions. These decisions have lasting effects on the market, and the resulting feedback informs the firm's later decisions. As the firm and market interact, MiniCorp continuously records the agents' communications and decisions. These records preserve the information available at the time and the business results that followed. Checkpointing allows the same situation to be replayed under different decisions, providing comparisons unavailable in static archives. We evaluate end-to-end fidelity against patterns reported in empirical studies of real markets. These evaluations provide agents with realistic market feedback and reduce the risk that they learn to exploit flaws in the simulator. Our experiments show agents coordinating across roles and adapting their decisions to market feedback. With explicit long-term strategic guidance, they also sustain advertising exploration despite weak early returns. MiniCorp thus provides an environment for studying AI-run companies and a scalable source of longitudinal and counterfactual enterprise data for agent training and evaluation.

Smart glasses are evolving from capture and display accessories into first-person intelligence platforms that connect human perception, persistent context, and digital or physical action. Their on-body viewpoint aligns with the wearer's vision, audition, motion, and hand-object interaction, but must operate under tight energy, thermal, privacy, and feedback constraints. Despite rapid progress in augmented reality, egocentric vision, multimodal models, human-computer interaction, and embodied intelligence, the literature remains fragmented across devices, tasks, and benchmarks. The key challenge is not whether a model can recognize, answer, remember, or act in isolation, but whether a complete system can sustain a reliable, temporally valid, correctable, and governable perception-state-interaction-action loop. This survey is the \textbf{first to systematically study smart glasses through such a unified framework}. We formalize first-person data flow and constrained task utility, characterize devices along eight verifiable hardware capability axes, organize the literature around seven interdependent foundational capabilities, and introduce an L0-L5 framework spanning capture, reactive perception, contextual assistance, persistent state, governed action, and embodied coupling. Across nine application scenes, we connect tasks with datasets, systems, products, stakeholders, failure consequences, and evidence gaps. We further present a nine-dimensional deployment framework, a claim-conditioned evaluation protocol, and an evidence ladder from controlled measurement to longitudinal field validation and audit. Together, these elements make smart glasses more comparable, deployable, and reproducibly evaluated, while outlining a roadmap toward trustworthy first-person intelligence.

Accurate estimation of brain infarction (i.e., irreversibly damaged tissue) is critical for guiding treatment decisions in acute ischemic stroke. Reliable infarct prediction informs key clinical interventions, including the need for patient transfer to comprehensive stroke centers, the potential benefit of additional reperfusion attempts during mechanical thrombectomy, decisions regarding secondary neuroprotective treatments, and ultimately, prognosis of clinical outcomes. This work introduces the Ischemic Stroke Lesion Segmentation (ISLES) 2024 challenge, which focuses on the prediction of final infarct volumes from pre-interventional acute stroke imaging and clinical data. ISLES24 provides a comprehensive, multimodal setting where participants can leverage all clinically and practically available data, including full acute CT imaging, sub-acute follow-up MRI, and structured clinical information, across a train set of 150 cases. On the hidden test set of 98 cases, the top-performing model, a multimodal nnU-Net-based architecture, achieved a Dice score of 0.285 (+/- 0.213) and an absolute volume difference of 21.2 (+/- 37.2) mL, underlining the significant challenges posed by this task and the need for further advances in multimodal learning. This work makes two primary contributions: first, we establish a standardized, clinically realistic benchmark for post-treatment infarct prediction, enabling systematic evaluation of multimodal algorithmic strategies on a longitudinal stroke dataset; second, we analyze current methodological limitations and outline key research directions to guide the development of next-generation infarct prediction models.

Early children's developmental trajectories set up a natural goal for sample-efficient pretraining of vision foundation models. We introduce BabyVLM-V2, a developmentally grounded framework for infant-inspired vision-language modeling that extensively improves upon BabyVLM-V1 through a longitudinal, multifaceted pretraining set, a versatile model, and, most importantly, DevCV Toolbox for cognitive evaluation. The pretraining set maximizes coverage while minimizing curation of a longitudinal, infant-centric audiovisual corpus, yielding video-utterance, image-utterance, and multi-turn conversational data that mirror infant experiences. DevCV Toolbox adapts all vision-related measures of the recently released NIH Baby Toolbox into a benchmark suite of ten multimodal tasks, covering spatial reasoning, memory, and vocabulary understanding aligned with early children's capabilities. Experimental results show that a compact model pretrained from scratch can achieve competitive performance on DevCV Toolbox, outperforming GPT-4o on some tasks. We hope the principled, unified BabyVLM-V2 framework will accelerate research in developmentally plausible pretraining of vision foundation models.

Longitudinal analysis has great potential to reveal developmental trajectories and monitor disease progression in medical imaging. This process relies on consistent and robust joint 4D segmentation. Traditional techniques are dependent on the similarity of images over time and the use of subject-specific priors to reduce random variation and improve the robustness and sensitivity of the overall longitudinal analysis. This is however slow and computationally intensive as subject-specific templates need to be rebuilt every time. The focus of this work to accelerate this analysis with the use of deep learning. The proposed approach is based on deep CNNs and incorporates semantic segmentation and provides a longitudinal relationship for the same subject. The proposed approach is based on deep CNNs and incorporates semantic segmentation and provides a longitudinal relationship for the same subject. The state of art using 3D patches as inputs to modified Unet provides results around {0.91 pm 0.5} Dice and using multi-view atlas in CNNs provide around the same results. In this work, different models are explored, each offers better accuracy and fast results while increasing the segmentation quality. These methods are evaluated on 135 scans from the EADC-ADNI Harmonized Hippocampus Protocol. Proposed CNN based segmentation approaches demonstrate how 2D segmentation using prior slices can provide similar results to 3D segmentation while maintaining good continuity in the 3D dimension and improved speed. Just using 2D modified sagittal slices provide us a better Dice and longitudinal analysis for a given subject. For the ADNI dataset, using the simple UNet CNN technique gives us {0.84 pm 0.5} and while using modified CNN techniques on the same input yields {0.89 pm 0.5}. Rate of atrophy and RMS error are calculated for several test cases using various methods and analyzed.

Longitudinal observational data are often subject to informative missingness. For example, in healthcare research using electronic health records, covariates and outcomes are measured only when patients interact with the healthcare system. Whether these data are observed usually depends on the unobserved variable values themselves, introducing a common form of data missing not at random. We develop identification and estimation methods for the effects of longitudinal modified treatment policies under a self-censoring model which explicitly models this dependence. We consider effects of treatments that can be modified only at measurement times (e.g., interactions with the heathcare system). We study two settings: one in which the observed history suffices for treatment confounding control, and another in which confounder control requires covariate values that were not measured at missed visits. In both settings, we combine longitudinal causal identification with shadow-variable conditional moment restrictions to obtain recursive identification formulas for the counterfactual outcome mean. We derive gradients of the pathwise derivatives and second-order remainder expansions, and use these results to construct estimators that accommodate machine learning for nuisance-function estimation. Under suitable product-rate conditions and cross-fitting, the estimators are asymptotically linear and permit root-n inference, including simultaneous inference across outcome times. We also describe conditional-moment learning and ensemble approaches for estimating the nuisance functions required by our approach, together with a pool-and-smooth strategy that borrows information across sparsely measured outcomes.

In medical imaging, the clinical value of Computed Tomography (CT) lies not only in depicting current disease status, but crucially in enabling longitudinal comparison of serial scans to determine disease evolution, a process that underpins response assessment, recurrence detection, and ongoing patient management. Yet, despite this central role of temporal comparison in clinical decision-making, existing medical foundation models remain largely confined to single-study understanding, leaving temporally grounded cross-examination insufficiently addressed. To address this gap, we study longitudinal imaging difference reporting, a task in which a model takes two temporally separated scans from the same patient and generates a clinically meaningful report describing interval changes between them. We introduce CT-ΔBench, a dedicated benchmark for this task with patient-level splitting to prevent information leakage. To better evaluate this task beyond surface-level text similarity, we further develop change-aware metrics specifically designed to capture clinically meaningful longitudinal changes, and conduct an independent physician validation to assess the reliability of the synthesized references and event extraction pipeline. We also compare direct paired-CT reasoning with an indirect two-stage pipeline that first generates single-timepoint reports and then performs textual differencing. Finally, we propose DeltaMed, a baseline model for direct paired-CT difference reporting, and train it on the benchmark training set. Together, these contributions lay the groundwork for temporally aware medical foundation models that better reflect real-world longitudinal clinical reasoning.

Researchers are usually interested in examining the impact of covariates when separating heterogeneous samples into latent classes that are more homogeneous. The majority of theoretical and empirical studies with such aims have focused on identifying covariates as predictors of class membership in the structural equation modeling framework. In other words, the covariates only indirectly affect the sample heterogeneity. However, the covariates' influence on between-individual differences can also be direct. This article presents a mixture model that investigates covariates to explain within-cluster and between-cluster heterogeneity simultaneously, known as a mixture-of-experts (MoE) model. This study aims to extend the MoE framework to investigate heterogeneity in nonlinear trajectories: to identify latent classes, covariates as predictors to clusters, and covariates that explain within-cluster differences in change patterns over time. Our simulation studies demonstrate that the proposed model generally estimates the parameters unbiasedly, precisely and exhibits appropriate empirical coverage for a nominal 95% confidence interval. This study also proposes implementing structural equation model forests to shrink the covariate space of the proposed mixture model. We illustrate how to select covariates and construct the proposed model with longitudinal mathematics achievement data. Additionally, we demonstrate that the proposed mixture model can be further extended in the structural equation modeling framework by allowing the covariates that have direct effects to be time-varying.

The growing availability of longitudinal Magnetic Resonance Imaging (MRI) datasets has facilitated Artificial Intelligence (AI)-driven modeling of disease progression, making it possible to predict future medical scans for individual patients. However, despite significant advancements in AI, current methods continue to face challenges including achieving patient-specific individualization, ensuring spatiotemporal consistency, efficiently utilizing longitudinal data, and managing the substantial memory demands of 3D scans. To address these challenges, we propose Brain Latent Progression (BrLP), a novel spatiotemporal model designed to predict individual-level disease progression in 3D brain MRIs. The key contributions in BrLP are fourfold: (i) it operates in a small latent space, mitigating the computational challenges posed by high-dimensional imaging data; (ii) it explicitly integrates subject metadata to enhance the individualization of predictions; (iii) it incorporates prior knowledge of disease dynamics through an auxiliary model, facilitating the integration of longitudinal data; and (iv) it introduces the Latent Average Stabilization (LAS) algorithm, which (a) enforces spatiotemporal consistency in the predicted progression at inference time and (b) allows us to derive a measure of the uncertainty for the prediction at the global and voxel level. We train and evaluate BrLP on 11,730 T1-weighted (T1w) brain MRIs from 2,805 subjects and validate its generalizability on an external test set comprising 2,257 MRIs from 962 subjects. Our experiments compare BrLP-generated MRI scans with real follow-up MRIs, demonstrating state-of-the-art accuracy compared to existing methods. The code is publicly available at: https://github.com/LemuelPuglisi/BrLP.

Identifying patient cohorts is fundamental to numerous healthcare tasks, including clinical trial recruitment and retrospective studies. Current cohort retrieval methods in healthcare organizations rely on automated queries of structured data combined with manual curation, which are time-consuming, labor-intensive, and often yield low-quality results. Recent advancements in large language models (LLMs) and information retrieval (IR) offer promising avenues to revolutionize these systems. Major challenges include managing extensive eligibility criteria and handling the longitudinal nature of unstructured Electronic Medical Records (EMRs) while ensuring that the solution remains cost-effective for real-world application. This paper introduces a new task, Automatic Cohort Retrieval (ACR), and evaluates the performance of LLMs and commercial, domain-specific neuro-symbolic approaches. We provide a benchmark task, a query dataset, an EMR dataset, and an evaluation framework. Our findings underscore the necessity for efficient, high-quality ACR systems capable of longitudinal reasoning across extensive patient databases.

Longitudinal treatment decisions require predicting potential outcomes under future treatment sequences in the presence of time-varying confounding, heterogeneous patient dynamics, and limited domain-specific data. Existing longitudinal causal estimators typically train a new model for each cohort or simulator. We introduce Causal Longitudinal Prior-Fitted Networks (CausalLongPFN), a prior-fitted in-context predictor for longitudinal causal prediction. The model is pretrained entirely on synthetic episodes sampled from a broad prior over temporal structural causal models, exposing it to treatment-confounder feedback, latent heterogeneity, nonlinear state evolution, delayed effects, and cumulative treatment responses. At test time, CausalLongPFN is frozen: it conditions on support trajectories, a query history, and a proposed future treatment sequence, and returns a predictive distribution over future outcomes without gradient updates or propensity-model fitting. Multi-step predictions are obtained by recursively applying the one-step predictor under the specified treatment sequence. We evaluate on branchable cancer, HIV, and warfarin benchmarks with ground-truth counterfactual labels, and on factual-only rolling-origin prediction in MIMIC-III ICU trajectories. CausalLongPFN is competitive with domain-trained longitudinal baselines on counterfactual benchmarks and performs strongly on factual MIMIC-III prediction, suggesting that broad synthetic causal pretraining can provide a useful frozen alternative when repeated domain-specific training is costly or impractical.

Tracking depression from multi-session counseling dialogues requires estimating both current symptom severity and how it changes across sessions. Yet progress on this task is constrained by the scarcity of longitudinal counseling data with standardized session-level depression labels. Existing resources typically provide either multi-session conversations without depression labels or labeled interviews in a single session. Building such a benchmark poses three challenges: maintaining longitudinal consistency and diversity, grounding symptom progression in empirical patterns, and expressing controlled depression states naturally without exposing target labels. To address these challenges, we introduce LongCounsel-8, a benchmark suite of three independently generated datasets totaling 7,749 five-session counseling trajectories, grounded in real-world client profiles, depression trajectories, symptom compositions, and counseling patterns. We combine profile-grounded simulation, empirically informed state construction, and indirect behavioral realization to address these challenges. Across the benchmark, simulated self-reports closely recover the controlled states, supporting label fidelity. Experiments on existing depression tracking methods reveal three key findings: (1) lower single-session score error does not guarantee accurate identification of trend, i.e., improvement or worsening; (2) existing methods are consistently less reliable on worsening trajectories; and (3) additional session history may reduce the accuracy of trend prediction. Together, these findings establish LongCounsel-8 as a foundation for advancing depression assessment from static, single-session prediction toward reliable longitudinal tracking of mental-health change.

Longitudinal clinical notes contain rich evidence of how patients evolve over time, but converting this signal into training supervision for clinical prediction remains challenging. We extend Foresight Learning to clinical prediction by converting time-ordered MIMIC-III notes into examples consisting of past patient context, a natural-language question about a possible future event, and a label resolved from later documentation. This process yields 6,900 prediction examples from 702 admissions across medications, procedures, organ support, microbiology, and mortality. A small LoRA adapter trained on these examples improves over the prompted base model, reducing expected calibration error from 0.1269 to 0.0398 and Brier score from 0.199 to 0.145, while slightly outperforming GPT-5 point estimates on held-out questions. The approach enables reusable clinical prediction supervision from longitudinal notes without hand-engineered structured features or endpoint-specific classifiers.

We propose a computationally efficient inferential procedure for longitudinal function-on-function regression. The method follows a marginal three-step approach: (1) fit massive pointwise longitudinal scalar-on-function regression models, (2) smooth the resulting estimates along the bivariate functional domain, and (3) compute confidence bands using either an analytic approach for Gaussian data or a cluster bootstrap for Gaussian or non-Gaussian data. Simulation studies demonstrate that the proposed method achieves accurate estimation and valid inference, while substantially reducing computational burden compared to existing approaches. Methods are motivated by a physical activity intervention trial in older adults where high-dimensional wearable data were collected longitudinally across multiple visits. Our applications reveal significant increases in physical activity in the morning using interpersonal intervention strategies, but not intrapersonal strategies. The proposed methods are implemented in an R package.

Recent radiology multi-modal language models have made substantial progress in chest X-ray report generation, visual question answering, and temporal reasoning. While longitudinal chest X-ray interpretation compares sequential examinations to describe change, visual grounding aims to connect clinical language with localized image evidence. Although longitudinal modeling and visual grounding have each advanced radiology language models, how localized visual evidence can support longitudinal interpretation remains under-explored. We introduce CheXGround, a region-grounded longitudinal chest X-ray language model that represents paired studies through corresponding anatomical regions. CheXGround extracts anatomical regions from current and prior radiographs, encodes them as temporally enhanced Region-of-Interest (ROI) tokens, and combines them with global temporal image context during generation. To connect these region tokens with clinical text, we propose Temporal Region--Phrase Alignment, a pretraining objective that aligns temporal anatomical representations with localized report phrases. We evaluate CheXGround on single-study and longitudinal Visual Question Answering (VQA), longitudinal findings generation, temporal grounded VQA, and anatomical grounding. Across these tasks, CheXGround improves clinical language quality, temporal reasoning, and localization accuracy over recent baselines. Our results suggest that organizing longitudinal evidence at the anatomical level is a strong representation for grounded radiology language modeling. Project page: https://adonaydem.github.io/chexground-website

Large language model (LLM) agents extend generative models with reasoning, tool use, and persistent memory, thereby enabling the automation of complex tasks. In healthcare, such systems could support documentation, care coordination, and clinical decision making. Their reliable deployment in hospitals, however, remains constrained by safety risks, limited transparency, and inadequate mechanisms for handling longitudinal clinical context. Here we propose an architecture that adapts LLM agents to hospital environments. The design comprises four components: a restricted execution environment inspired by multi-user operating systems, a document-centric interaction model linking patient and clinician agents, a page-indexed memory architecture for longitudinal context management, and a curated library of composable medical skills. Implemented on top of OpenClaw, an open-source agent orchestration framework, this design provides the basis for an Agentic Operating System for Hospitals: a computing layer for coordinating clinical workflows while preserving safety, transparency, and auditability. To evaluate the memory component, we introduce manifest-guided retrieval for hierarchical navigation of longitudinal patient records. In a benchmark derived from the MIMIC-IV dataset (v2.2) comprising 100 de-identified patient records and 300 clinical queries stratified across three difficulty tiers (100 per tier), manifest-guided retrieval matched a metadata-filtered RAG baseline on overall recall (0.877 versus 0.876) while achieving 2.2x higher precision (0.779 versus 0.352) and retrieving fewer documents; on tier-3 longitudinal queries, manifest recall was 21% higher (0.846 versus 0.701), confirming that LLM-guided hierarchical navigation is most valuable when queries span multiple care episodes. These results outline a practical path toward hospital-scale agentic infrastructure.

Brain tissue segmentation is essential for neuroscience and clinical studies. However, segmentation on longitudinal data is challenging due to dynamic brain changes across the lifespan. Previous researches mainly focus on self-supervision with regularizations and will lose longitudinal generalization when fine-tuning on a specific age group. In this paper, we propose a dual meta-learning paradigm to learn longitudinally consistent representations and persist when fine-tuning. Specifically, we learn a plug-and-play feature extractor to extract longitudinal-consistent anatomical representations by meta-feature learning and a well-initialized task head for fine-tuning by meta-initialization learning. Besides, two class-aware regularizations are proposed to encourage longitudinal consistency. Experimental results on the iSeg2019 and ADNI datasets demonstrate the effectiveness of our method. Our code is available at https://github.com/ladderlab-xjtu/DuMeta.

Chest X-Ray (CXR) report generation is a promising approach to improving the efficiency of CXR interpretation. However, a significant increase in diagnostic accuracy is required before that can be realised. Motivated by this, we propose a framework that is more inline with a radiologist's workflow by considering longitudinal data. Here, the decoder is additionally conditioned on the report from the subject's previous imaging study via a prompt. We also propose a new reward for reinforcement learning based on CXR-BERT, which computes the similarity between reports. We conduct experiments on the MIMIC-CXR dataset. The results indicate that longitudinal data improves CXR report generation. CXR-BERT is also shown to be a promising alternative to the current state-of-the-art reward based on RadGraph. This investigation indicates that longitudinal CXR report generation can offer a substantial increase in diagnostic accuracy. Our Hugging Face model is available at: https://huggingface.co/aehrc/cxrmate and code is available at: https://github.com/aehrc/cxrmate.

This study quantifies the association between non-adherence to antipsychotic medications and adverse outcomes in individuals with schizophrenia. We frame the problem using survival analysis, focusing on the time to the earliest of several adverse events (early death, involuntary hospitalization, jail booking). We extend standard causal inference methods (T-learner, S-learner, nearest neighbor matching) to utilize various survival models to estimate individual and average treatment effects, where treatment corresponds to medication non-adherence. Analyses are repeated using different amounts of longitudinal information (3, 6, 9, and 12 months). Using data from Allegheny County in western Pennsylvania, we find strong evidence that non-adherence advances adverse outcomes by approximately 1 to 4 months. Ablation studies confirm that county-provided risk scores adjust for key confounders, as their removal amplifies the estimated effects. Subgroup analyses by medication formulation (injectable vs. oral) and medication type consistently show that non-adherence is associated with earlier adverse events. These findings highlight the clinical importance of adherence in delaying psychiatric crises and show that integrating survival analysis with causal inference tools can yield policy-relevant insights. We caution that although we apply causal inference, we only make associative claims and discuss assumptions needed for causal interpretation.

While Large Language Models (LLMs) have shown strong performance on clinical text understanding, they struggle with longitudinal prediction tasks such as dementia prognosis, which require reasoning over complex, non-monotonic symptom trajectories across multiple visits. Standard supervised training lacks explicit annotations for symptom evolution, while direct Reinforcement Learning (RL) is hindered by sparse binary rewards. To address this challenge, we introduce Dementia-R1, an RL-based framework for longitudinal dementia prognosis from unstructured clinical notes. Our approach adopts a Cold-Start RL strategy that pre-trains the model to predict verifiable clinical indices extracted from patient histories, enhancing the capability to reason about disease progression before determining the final clinical status. Extensive experiments demonstrate that Dementia-R1 achieves an F1 score of 77.03% on real-world unstructured clinical datasets. Notably, on the ADNI benchmark, our 7B model rivals GPT-4o, effectively capturing fluctuating cognitive trajectories. Code is available at https://anonymous.4open.science/r/dementiar1-CDB5

Evaluation efforts such as TREC, CLEF, NTCIR and FIRE, alongside public leaderboard such as MS MARCO, are intended to encourage research and track our progress, addressing big questions in our field. However, the goal is not simply to identify which run is "best", achieving the top score. The goal is to move the field forward by developing new robust techniques, that work in many different settings, and are adopted in research and practice. This paper uses the MS MARCO and TREC Deep Learning Track as our case study, comparing it to the case of TREC ad hoc ranking in the 1990s. We show how the design of the evaluation effort can encourage or discourage certain outcomes, and raising questions about internal and external validity of results. We provide some analysis of certain pitfalls, and a statement of best practices for avoiding such pitfalls. We summarize the progress of the effort so far, and describe our desired end state of "robust usefulness", along with steps that might be required to get us there.

LLMs are increasingly used as long-running conversational agents, yet every major benchmark evaluating their memory treats user information as static facts to be stored and retrieved. That's the wrong model. People change their minds, and over extended interactions, phenomena like opinion drift, over-alignment, and confirmation bias start to matter a lot. BeliefShift introduces a longitudinal benchmark designed specifically to evaluate belief dynamics in multi-session LLM interactions. It covers three tracks: Temporal Belief Consistency, Contradiction Detection, and Evidence-Driven Revision. The dataset includes 2,400 human-annotated multi-session interaction trajectories spanning health, politics, personal values, and product preferences. We evaluate seven models including GPT-4o, Claude 3.5 Sonnet, Gemini 1.5 Pro, LLaMA-3, and Mistral-Large under zero-shot and retrieval-augmented generation (RAG) settings. Results reveal a clear trade-off: models that personalize aggressively resist drift poorly, while factually grounded models miss legitimate belief updates. We further introduce four novel evaluation metrics: Belief Revision Accuracy (BRA), Drift Coherence Score (DCS), Contradiction Resolution Rate (CRR), and Evidence Sensitivity Index (ESI).

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.

General-purpose health benchmarks increasingly anchor claims about LLM medical performance, but they are not always resolved by clinical specialty, making domain-specific performance hard to isolate. Mental health is of acute public-health concern as millions of people turn to LLMs for psychological support, and most existing evaluations are bespoke academic benchmarks that are difficult to integrate into developer workflows. We introduce HealthBench-Psych and HealthBench-Psych-Hard. We screened HealthBench's 5,000 physician-rubric conversations for mental-health relevance with a transparent LLM-applied rubric, then validated the subset through two rounds of blinded clinician review with concealed known-exclude controls, yielding 610 conversations (12.2% of the corpus). Evaluating 20 frontier and open models under a cross-vendor panel of three LLM judges, we find a statistically tied frontier cluster, measurable refusal behavior in two models, and near-identical rankings across judges (τge 0.92). We release the subset, pipeline, model responses, grades, and analysis code as a reusable resource.

Automated radiology report generation offers an effective solution to alleviate radiologists' workload. However, most existing methods focus primarily on single or fixed-view images to model current disease conditions, which limits diagnostic accuracy and overlooks disease progression. Although some approaches utilize longitudinal data to track disease progression, they still rely on single images to analyze current visits. To address these issues, we propose enhanced contrastive learning with Multi-view Longitudinal data to facilitate chest X-ray Report Generation, named MLRG. Specifically, we introduce a multi-view longitudinal contrastive learning method that integrates spatial information from current multi-view images and temporal information from longitudinal data. This method also utilizes the inherent spatiotemporal information of radiology reports to supervise the pre-training of visual and textual representations. Subsequently, we present a tokenized absence encoding technique to flexibly handle missing patient-specific prior knowledge, allowing the model to produce more accurate radiology reports based on available prior knowledge. Extensive experiments on MIMIC-CXR, MIMIC-ABN, and Two-view CXR datasets demonstrate that our MLRG outperforms recent state-of-the-art methods, achieving a 2.3% BLEU-4 improvement on MIMIC-CXR, a 5.5% F1 score improvement on MIMIC-ABN, and a 2.7% F1 RadGraph improvement on Two-view CXR.

Scientific paper recommendation is typically evaluated as static ranking over a fixed candidate set, yet real scientific reading unfolds as a daily, longitudinal process in which interests shift and feedback accumulates. We introduce PaperFlow, a framework that organizes it into three coupled stages: Profiling, which constructs and maintains a structured, inspectable scholarly profile from heterogeneous cold-start evidence; Recommending, which ranks each date-specific paper stream through multi-signal aggregation under a fixed display budget; and Adapting, which updates user state from semantically distinct feedback signals and models interest drift across days. We further define a longitudinal user-day benchmark that fixes users, dates, candidate pools, visible inputs, and hidden simulated relevance labels under a shared temporal information boundary. The benchmark contains 24 simulated research users, 50 daily paper streams, 1,200 user-day episodes, 20,727 unique papers, and 497,448 episode-paper records. We additionally specify a blind human-evaluation protocol to validate alignment between automatic metrics and expert judgments. Experiments against five scientific recommendation baselines show that PaperFlow achieves the strongest oracle-based ranking, the highest behavioral alignment with simulated reading selections, and the best blind human-evaluation score.

Medical large language models (LLMs) research often makes bold claims, from encoding clinical knowledge to reasoning like a physician. These claims are usually backed by evaluation on competitive benchmarks; a tradition inherited from mainstream machine learning. But how do we separate real progress from a leaderboard flex? Medical LLM benchmarks, much like those in other fields, are arbitrarily constructed using medical licensing exam questions. For these benchmarks to truly measure progress, they must accurately capture the real-world tasks they aim to represent. In this position paper, we argue that medical LLM benchmarks should (and indeed can) be empirically evaluated for their construct validity. In the psychological testing literature, "construct validity" refers to the ability of a test to measure an underlying "construct", that is the actual conceptual target of evaluation. By drawing an analogy between LLM benchmarks and psychological tests, we explain how frameworks from this field can provide empirical foundations for validating benchmarks. To put these ideas into practice, we use real-world clinical data in proof-of-concept experiments to evaluate popular medical LLM benchmarks and report significant gaps in their construct validity. Finally, we outline a vision for a new ecosystem of medical LLM evaluation centered around the creation of valid benchmarks.

Recent advances have made long-form report-generating systems widely available. This has prompted evaluation frameworks that use LLM-as-judge protocols and claim verification, along with meta-evaluation frameworks that seek to validate these methods. Many of the meta-evaluations estimate an evaluation quality's by comparing its assessments against human pairwise preferences. Prior work, however, suggests that human pairwise preference may be overly simplistic and can fail to capture nuances of expert expectations. We conduct a case study in meta-evaluation for long-form QA benchmarks using ScholarQA-CS2, a benchmark designed for assessing retrieval-augmented deep-research QA in the scientific domain. We comprehensively validate the benchmark through human pairwise preference judgments, then critically examine the strengths, weaknesses, and confounders of this approach. We show that pairwise preference rankings are best suited for system-level evaluation, while explicit metric-wise annotations and expert annotators are critical for reliable metric-level assessment, with subjectivity remaining a key challenge. Based on our findings, we offer practical guidelines for designing future meta-evaluations that better align evaluation methods, annotator expertise, and reporting practices. By surfacing these methodological challenges, we aim to advance evaluation standards for deep-research systems.

Evaluation benchmarks are the cornerstone of measuring capabilities of large language models (LLMs), as well as driving progress in said capabilities. Originally designed to make claims about capabilities (or lack thereof) in fully pretrained models, evaluation benchmarks are now also extensively used to decide between various training choices. Despite this widespread usage, we rarely quantify the variance in our evaluation benchmarks, which dictates whether differences in performance are meaningful. Here, we define and measure a range of metrics geared towards measuring variance in evaluation benchmarks, including seed variance across initialisations, and monotonicity during training. By studying a large number of models -- both openly available and pretrained from scratch -- we provide empirical estimates for a variety of variance metrics, with considerations and recommendations for practitioners. We also evaluate the utility and tradeoffs of continuous versus discrete performance measures and explore options for better understanding and reducing this variance. We find that simple changes, such as framing choice tasks (like MMLU) as completion tasks, can often reduce variance for smaller scale (sim7B) models, while more involved methods inspired from human testing literature (such as item analysis and item response theory) struggle to meaningfully reduce variance. Overall, our work provides insights into variance in evaluation benchmarks, suggests LM-specific techniques to reduce variance, and more generally encourages practitioners to carefully factor in variance when comparing models.

Radiology report evaluation is essential for advancing automated report generation. Natural language generation metrics have limited clinical relevance. Clinical efficacy (CE) metrics evaluate important medical findings, but focus mainly on presence and cover only a limited set of entities. Due to heavy reliance on manual annotations, it is difficult for CE metrics to extend clinical entities or attributes. In clinical practice, radiology reports serve as a medium for information transfer. Clinicians use them to perform downstream diagnostic tasks without directly inspecting images. Based on this insight, we propose ReportQA, a clinical-related and flexible radiology report evaluation framework, supporting detailed quantitative analysis of radiology report generation systems. We first collect datasets covering multiple imaging modalities and anatomical regions. We then construct knowledge trees of clinical entities and attributes with radiologist guidance, and use large language models (LLMs) to extract structured information from raw reports. Next, we generate QA pairs from predefined templates and apply quality control through self-filtering and report-based filtering. During evaluation, the report is treated as context, and an LLM acts as a judge model to answer the QA pairs. Based on the resulting QA accuracy, we introduce QAScore metric. Compared with existing metrics, QAScore shows better alignment with radiologist judgments. Experiments on multiple state-of-the-art vision-language models reveal that current report-based inference paradigms struggle to learn fine-grained clinical representations and exhibit strong negative prior biases. In contrast, question-driven inference provides a more effective alternative. For reproducibility and extensibility, we release the knowledge trees, structured reports, and QA pairs, along with the pipeline code for QA construction and evaluation.

Under a unified operational definition, we define LLM memory as a persistent state written during pretraining, finetuning, or inference that can later be addressed and that stably influences outputs. We propose a four-part taxonomy (parametric, contextual, external, procedural/episodic) and a memory quadruple (location, persistence, write/access path, controllability). We link mechanism, evaluation, and governance via the chain write -> read -> inhibit/update. To avoid distorted comparisons across heterogeneous setups, we adopt a three-setting protocol (parametric only, offline retrieval, online retrieval) that decouples capability from information availability on the same data and timeline. On this basis we build a layered evaluation: parametric (closed-book recall, edit differential, memorization/privacy), contextual (position curves and the mid-sequence drop), external (answer correctness vs snippet attribution/faithfulness), and procedural/episodic (cross-session consistency and timeline replay, E MARS+). The framework integrates temporal governance and leakage auditing (freshness hits, outdated answers, refusal slices) and uncertainty reporting via inter-rater agreement plus paired tests with multiple-comparison correction. For updating and forgetting, we present DMM Gov: coordinating DAPT/TAPT, PEFT, model editing (ROME, MEND, MEMIT, SERAC), and RAG to form an auditable loop covering admission thresholds, rollout, monitoring, rollback, and change audits, with specs for timeliness, conflict handling, and long-horizon consistency. Finally, we give four testable propositions: minimum identifiability; a minimal evaluation card; causally constrained editing with verifiable forgetting; and when retrieval with small-window replay outperforms ultra-long-context reading. This yields a reproducible, comparable, and governable coordinate system for research and deployment.

AI evaluation is undergoing a structural change. Large language models (LLMs) are increasingly deployed as systems that act over time through tools, environments, users, and other agents, while many evaluation practices still inherit assumptions from response-centered benchmarks (e.g., fixed inputs, isolated outputs, and outcome judgments that can be made from a single response). The field has begun to build interactive benchmarks, but the resulting landscape is fragmented: benchmarks differ in what interaction artifacts they admit, how trajectories are scored, and what claims their results support. This position paper argues that interactive evaluation should be treated as a principled evaluation paradigm, not merely a new family of agent benchmarks. Simply adopting previous evaluation paradigms does not suffice. We define evaluation as an autonomous mapping from evidence to judgments, and show that interactive evaluation changes both sides of this mapping: the evidence becomes interaction-generated trajectories, while the evaluation procedure must assess process, recoverability, coordination, robustness, and system-level performance. Building on this definition, we propose a two-axis taxonomy, derive design principles and reporting standards, examine representative scenarios, and analyze how longstanding evaluation challenges reappear at the trajectory level.

In this work, we introduce Brain Latent Progression (BrLP), a novel spatiotemporal disease progression model based on latent diffusion. BrLP is designed to predict the evolution of diseases at the individual level on 3D brain MRIs. Existing deep generative models developed for this task are primarily data-driven and face challenges in learning disease progressions. BrLP addresses these challenges by incorporating prior knowledge from disease models to enhance the accuracy of predictions. To implement this, we propose to integrate an auxiliary model that infers volumetric changes in various brain regions. Additionally, we introduce Latent Average Stabilization (LAS), a novel technique to improve spatiotemporal consistency of the predicted progression. BrLP is trained and evaluated on a large dataset comprising 11,730 T1-weighted brain MRIs from 2,805 subjects, collected from three publicly available, longitudinal Alzheimer's Disease (AD) studies. In our experiments, we compare the MRI scans generated by BrLP with the actual follow-up MRIs available from the subjects, in both cross-sectional and longitudinal settings. BrLP demonstrates significant improvements over existing methods, with an increase of 22% in volumetric accuracy across AD-related brain regions and 43% in image similarity to the ground-truth scans. The ability of BrLP to generate conditioned 3D scans at the subject level, along with the novelty of integrating prior knowledge to enhance accuracy, represents a significant advancement in disease progression modeling, opening new avenues for precision medicine. The code of BrLP is available at the following link: https://github.com/LemuelPuglisi/BrLP.

Progress in AI is driven largely by the scale and quality of training data. Despite this, there is a deficit of empirical analysis examining the attributes of well-established datasets beyond text. In this work we conduct the largest and first-of-its-kind longitudinal audit across modalities--popular text, speech, and video datasets--from their detailed sourcing trends and use restrictions to their geographical and linguistic representation. Our manual analysis covers nearly 4000 public datasets between 1990-2024, spanning 608 languages, 798 sources, 659 organizations, and 67 countries. We find that multimodal machine learning applications have overwhelmingly turned to web-crawled, synthetic, and social media platforms, such as YouTube, for their training sets, eclipsing all other sources since 2019. Secondly, tracing the chain of dataset derivations we find that while less than 33% of datasets are restrictively licensed, over 80% of the source content in widely-used text, speech, and video datasets, carry non-commercial restrictions. Finally, counter to the rising number of languages and geographies represented in public AI training datasets, our audit demonstrates measures of relative geographical and multilingual representation have failed to significantly improve their coverage since 2013. We believe the breadth of our audit enables us to empirically examine trends in data sourcing, restrictions, and Western-centricity at an ecosystem-level, and that visibility into these questions are essential to progress in responsible AI. As a contribution to ongoing improvements in dataset transparency and responsible use, we release our entire multimodal audit, allowing practitioners to trace data provenance across text, speech, and video.

The rapid release of both language models and benchmarks makes it increasingly costly to evaluate every model on every dataset. In practice, models are often evaluated on different samples, making scores difficult to compare across studies. To address this, we propose a framework based on multidimensional Item Response Theory (IRT) that uses anchor items to calibrate new benchmarks to the evaluation suite while holding previously calibrated item parameters fixed. Our approach supports a realistic evaluation setting in which datasets are introduced over time and models are evaluated only on the datasets available at the time of evaluation, while a fixed anchor set for each dataset is used so that results from different evaluation periods can be compared directly. In large-scale experiments on more than 400 models, our framework predicts full-evaluation performance within 2-3 percentage points using only 100 anchor questions per dataset, with Spearman ρgeq 0.9 for ranking preservation, showing that it is possible to extend benchmark suites over time while preserving score comparability, at a constant evaluation cost per new dataset. Code available at https://github.com/eliyahabba/growing-pains

Clinical trial matching is a key process in health delivery and discovery. In practice, it is plagued by overwhelming unstructured data and unscalable manual processing. In this paper, we conduct a systematic study on scaling clinical trial matching using large language models (LLMs), with oncology as the focus area. Our study is grounded in a clinical trial matching system currently in test deployment at a large U.S. health network. Initial findings are promising: out of box, cutting-edge LLMs, such as GPT-4, can already structure elaborate eligibility criteria of clinical trials and extract complex matching logic (e.g., nested AND/OR/NOT). While still far from perfect, LLMs substantially outperform prior strong baselines and may serve as a preliminary solution to help triage patient-trial candidates with humans in the loop. Our study also reveals a few significant growth areas for applying LLMs to end-to-end clinical trial matching, such as context limitation and accuracy, especially in structuring patient information from longitudinal medical records.

With people increasingly turning to AI chatbots for mental health support, the need to evaluate these tools is becoming more pressing. Recent benchmarks attempt to mimic a realistic setting by simulating multi-turn interactions with synthetic patients and evaluating them with an LLM-as-a-judge. However, the usefulness of these methods is limited because simulated patients can be overly forthcoming and self-reflective, and judgments typically involve opaque Likert scales with unclear practical utility. To bridge these gaps, we introduce MindEval2, an evaluation framework that consists of two components: Mental Health Quality Rubrics (MHQR), for evaluation, and MindSim, for patient simulation. For MHQR, we collaborate with PhD-level psychologists to develop a set of rubrics that break down response quality into explicit operational criteria that are more interpretable and actionable than existing evaluation taxonomies. MindSim, in turn, is an LLM harness that combines carefully-designed patient profiles with tools, enabling more varied, challenging, and realistic interactions than existing baselines. The harness also contains a memory component that is updated between each interaction, enabling MindEval2 to model the longitudinal aspect of mental health. We evaluate 18 proprietary and open-weight models on MindEval2, finding that while frontier models have largely improved on issues related to surface level quality and boundaries, guidance calibration remains the dominant failure mode across all models, accounting for most of the quality gap.

Evaluations are critical for understanding the capabilities of large language models (LLMs). Fundamentally, evaluations are experiments; but the literature on evaluations has largely ignored the literature from other sciences on experiment analysis and planning. This article shows researchers with some training in statistics how to think about and analyze data from language model evaluations. Conceptualizing evaluation questions as having been drawn from an unseen super-population, we present formulas for analyzing evaluation data, measuring differences between two models, and planning an evaluation experiment. We make a number of specific recommendations for running language model evaluations and reporting experiment results in a way that minimizes statistical noise and maximizes informativeness.

In recent years, the intersection of Natural Language Processing (NLP) and public health has opened innovative pathways for investigating various domains, including chronic pain in textual datasets. Despite the promise of NLP in chronic pain, the literature is dispersed across various disciplines, and there is a need to consolidate existing knowledge, identify knowledge gaps in the literature, and inform future research directions in this emerging field. This review aims to investigate the state of the research on NLP-based interventions designed for chronic pain research. A search strategy was formulated and executed across PubMed, Web of Science, IEEE Xplore, Scopus, and ACL Anthology to find studies published in English between 2014 and 2024. After screening 132 papers, 26 studies were included in the final review. Key findings from this review underscore the significant potential of NLP techniques to address pressing challenges in chronic pain research. The past 10 years in this field have showcased the utilization of advanced methods (transformers like RoBERTa and BERT) achieving high-performance metrics (e.g., F1>0.8) in classification tasks, while unsupervised approaches like Latent Dirichlet Allocation (LDA) and k-means clustering have proven effective for exploratory analyses. Results also reveal persistent challenges such as limited dataset diversity, inadequate sample sizes, and insufficient representation of underrepresented populations. Future research studies should explore multimodal data validation systems, context-aware mechanistic modeling, and the development of standardized evaluation metrics to enhance reproducibility and equity in chronic pain research.

Whether a language model looks demographically biased can depend on how the audit asks its question. A charitable-aid benchmark reports that the same models favor minority applicants when rating requests one at a time and penalize some when ranking side by side. We test whether that reversal generalizes to hiring, lending, and medical triage: 40,726 requests to five models, applications differing only in the applicant's name, and a primary test fixed before collection. It does not. None of 36 planned contrasts survives correction. The rating advantage keeps its sign at roughly half the published size, and a precision extension bounds any hiring ranking penalty below the published effect, though the lending and triage ranking floors sit above that margin, so the exclusion is conclusive for hiring ranking and for rating in all three domains only. Planted disparities tracking their injected sizes and a directional replication on the original aid materials bound these nulls. The audit is livelier than the demographics: models recognize transparent audits nearly always, tie every identical-content comparison whether the varying detail is race or a hobby, and reward first-listed candidates as much as any demographic effect we measure. Audit verdicts reflect audit construction more than demographic bias.

The performance of speaker verification systems is adversely affected by speaker aging. However, due to challenges in data collection, particularly the lack of sustained and large-scale longitudinal data for individuals, research on speaker aging remains difficult. In this paper, we present VoxAging, a large-scale longitudinal dataset collected from 293 speakers (226 English speakers and 67 Mandarin speakers) over several years, with the longest time span reaching 17 years (approximately 900 weeks). For each speaker, the data were recorded at weekly intervals. We studied the phenomenon of speaker aging and its effects on advanced speaker verification systems, analyzed individual speaker aging processes, and explored the impact of factors such as age group and gender on speaker aging research.

Finding relevant literature underpins the practice of evidence-based medicine. From 2014 to 2016, TREC conducted a clinical decision support track, wherein participants were tasked with finding articles relevant to clinical questions posed by physicians. In total, 87 teams have participated over the past three years, generating 395 runs. During this period, each team has trialled a variety of methods. While there was significant overlap in the methods employed by different teams, the results were varied. Due to the diversity of the platforms used, the results arising from the different techniques are not directly comparable, reducing the ability to build on previous work. By using a stable platform, we have been able to compare different document and query processing techniques, allowing us to experiment with different search parameters. We have used our system to reproduce leading teams runs, and compare the results obtained. By benchmarking our indexing and search techniques, we can statistically test a variety of hypotheses, paving the way for further research.

Across medical specialties, clinical practice is anchored in evidence-based guidelines that codify best studied diagnostic and treatment pathways. These pathways routinely fall short for the long tail of real-world care not covered by guidelines. Most medical large language models (LLMs), however, are trained to encode common, guideline-focused medical knowledge in their parameters. Current evaluations test models primarily on recalling and reasoning with this memorized content, often in multiple-choice settings. Given the fundamental importance of evidence-based reasoning in medicine, it is neither feasible nor reliable to depend on memorization in practice. To address this gap, we introduce OGCaReBench, a free-form retrieval-focused benchmark aimed at evaluating LLMs at answering clinical questions that require going beyond typical guidelines. Extracted from published medical case reports and validated by medical experts, OGCaReBench contains long-form clinical questions requiring free-text answers, providing a systematic framework for assessing open-ended medical reasoning in rare, case-based scenarios. Our experiments reveal that even the best-performing baseline (GPT-5.2) correctly answers only 56% of our benchmark with specialized models only reaching 42%. Augmenting models with retrieved medical articles improves this performance to up to 82% (using GPT-5.2) highlighting the importance of evidence-grounding for real-world medical reasoning tasks. This work thus establishes a foundation for benchmarking and advancing both general-purpose and medical LLMs to produce reliable answers in challenging clinical contexts.

Evaluation of language model outputs on structured writing tasks is typically conducted with a number of desirable criteria presented to human evaluators or large language models (LLMs). For instance, on a prompt like "Help me draft an academic talk on coffee intake vs research productivity", a model response may be evaluated for criteria like accuracy and coherence. However, high-quality responses should do more than just satisfy basic task requirements. An effective response to this query should include quintessential features of an academic talk, such as a compelling opening, clear research questions, and a takeaway. To help identify these implicit criteria, we introduce EvalAgent, a novel framework designed to automatically uncover nuanced and task-specific criteria. EvalAgent first mines expert-authored online guidance. It then uses this evidence to propose diverse, long-tail evaluation criteria that are grounded in reliable external sources. Our experiments demonstrate that the grounded criteria produced by EvalAgent are often implicit (not directly stated in the user's prompt), yet specific (high degree of lexical precision). Further, EvalAgent criteria are often not satisfied by initial responses but they are actionable, such that responses can be refined to satisfy them. Finally, we show that combining LLM-generated and EvalAgent criteria uncovers more human-valued criteria than using LLMs alone.

Existing Open-Ended Deep Research (OEDR) systems primarily generate reports from scratch, making them inefficient for scenarios where research reports need to be continuously maintained as new information emerges. We introduce Incremental Open-Ended Deep Research (Incremental-OEDR), a research setting that treats a report as an evolving research state and incrementally updates it by preserving valid knowledge, revising outdated or incomplete content, and incorporating newly available information. To support this setting, we propose Structured Harness, which represents reports as structured collections of outlines, sections, and supporting evidence, and provides structured retrieval, a persistent structured evidence pool, and structured generation for selective report updating and evidence reuse. We further establish a temporal evaluation framework spanning ten years, with Single-Step Task and Long-Chain Task to evaluate incremental updates over both individual transitions and long-term update chains. Extensive Experiments on DeepResearch Bench and DeepConsult under both the Open-source Configuration (OC) and Proprietary Configuration (PC) show that Incremental-OEDR maintains competitive report quality while substantially improving report continuity and reducing research costs. As shown in Figure~fig:profile, it achieves up to 0.51 higher content-level ROUGE-L F1, 0.63 higher outline-level EM F1, 33\% lower token consumption, and 61\% fewer search calls than OEDR on DeepResearch Bench. For more details, please refer to our project page: https://ioedr-project.github.io/.

Temporally dense single-person "small data" have become widely available thanks to mobile apps and wearable sensors. Many caregivers and self-trackers want to use these data to help a specific person change their behavior to achieve desired health outcomes. Ideally, this involves discerning possible causes from correlations using that person's own observational time series data. In this paper, we estimate within-individual average treatment effects of physical activity on sleep duration, and vice-versa. We introduce the model twin randomization (MoTR; "motor") method for analyzing an individual's intensive longitudinal data. Formally, MoTR is an application of the g-formula (i.e., standardization, back-door adjustment) under serial interference. It estimates stable recurring effects, as is done in n-of-1 trials and single case experimental designs. We compare our approach to standard methods (with possible confounding) to show how to use causal inference to make better personalized recommendations for health behavior change, and analyze 222 days of Fitbit sleep and steps data for one of the authors.

Large language models (LLMs) have emerged as powerful tools for analyzing complex datasets. Recent studies demonstrate their potential to generate useful, personalized responses when provided with patient-specific health information that encompasses lifestyle, biomarkers, and context. As LLM-driven health applications are increasingly adopted, rigorous and efficient one-sided evaluation methodologies are crucial to ensure response quality across multiple dimensions, including accuracy, personalization and safety. Current evaluation practices for open-ended text responses heavily rely on human experts. This approach introduces human factors and is often cost-prohibitive, labor-intensive, and hinders scalability, especially in complex domains like healthcare where response assessment necessitates domain expertise and considers multifaceted patient data. In this work, we introduce Adaptive Precise Boolean rubrics: an evaluation framework that streamlines human and automated evaluation of open-ended questions by identifying gaps in model responses using a minimal set of targeted rubrics questions. Our approach is based on recent work in more general evaluation settings that contrasts a smaller set of complex evaluation targets with a larger set of more precise, granular targets answerable with simple boolean responses. We validate this approach in metabolic health, a domain encompassing diabetes, cardiovascular disease, and obesity. Our results demonstrate that Adaptive Precise Boolean rubrics yield higher inter-rater agreement among expert and non-expert human evaluators, and in automated assessments, compared to traditional Likert scales, while requiring approximately half the evaluation time of Likert-based methods. This enhanced efficiency, particularly in automated evaluation and non-expert contributions, paves the way for more extensive and cost-effective evaluation of LLMs in health.

In long-term interactions with large language model (LLM) agents, users reveal habits through their choices and actions. These habits capture implicit user information that agents must infer across conversations. However, individual observations may provide only partial evidence about a habit or when it applies. Retaining past interactions alone does not ensure that agents can infer habits and apply them appropriately. We introduce HABIT-Bench to evaluate how well agent memory systems infer habits from weak evidence and apply them to later requests. We construct synthetic user histories from task-oriented dialogue data and controlled habit graphs. The histories span hundreds of sessions across food, finance, software, and travel. Four-choice tasks assess agents' ability to infer user habits and apply them appropriately. They include temporary exceptions, changes in habits, and suggestions that users have not accepted. Sampled tasks undergo independent human review. We evaluate eight memory methods with Qwen3-235B-A22B and GLM-5.3-Flash. The best-performing memory method achieves 33.61\% macro accuracy across the four domains. Performance remains limited even when annotated evidence is supplied directly. These results expose a persistent gap between access to past interactions and the ability to infer and appropriately use user habits.

Language model (LM) benchmarking faces several challenges: comprehensive evaluations are costly, benchmarks often fail to measure the intended capabilities, and evaluation quality can degrade due to labeling errors and benchmark saturation. Although various strategies have been proposed to mitigate these issues, they tend to address individual aspects in isolation, neglecting broader questions about overall evaluation quality. Here, we introduce Fluid Benchmarking, a new evaluation approach that advances LM benchmarking across multiple dimensions. Inspired by psychometrics, Fluid Benchmarking is based on the insight that the relative value of benchmark items depends on an LM's capability level, suggesting that evaluation should adapt to each LM. Methodologically, Fluid Benchmarking estimates an item response model based on existing LM evaluation results and uses the inferred quantities to select evaluation items dynamically, similar to computerized adaptive testing in education. In our experiments, we compare Fluid Benchmarking against the common practice of random item sampling as well as more sophisticated baselines, including alternative methods grounded in item response theory. We examine four dimensions -- efficiency, validity, variance, and saturation -- and find that Fluid Benchmarking achieves superior performance in all of them (e.g., higher validity and less variance on MMLU with fifty times fewer items). Our analysis shows that the two components of Fluid Benchmarking have distinct effects: item response theory, used to map performance into a latent ability space, increases validity, while dynamic item selection reduces variance. Overall, our results suggest that LM benchmarking can be substantially improved by moving beyond static evaluation.

This study investigates GPT-4's assessment of its performance in healthcare applications. A simple prompting technique was used to prompt the LLM with questions taken from the United States Medical Licensing Examination (USMLE) questionnaire and it was tasked to evaluate its confidence score before posing the question and after asking the question. The questionnaire was categorized into two groups-questions with feedback (WF) and questions with no feedback(NF) post-question. The model was asked to provide absolute and relative confidence scores before and after each question. The experimental findings were analyzed using statistical tools to study the variability of confidence in WF and NF groups. Additionally, a sequential analysis was conducted to observe the performance variation for the WF and NF groups. Results indicate that feedback influences relative confidence but doesn't consistently increase or decrease it. Understanding the performance of LLM is paramount in exploring its utility in sensitive areas like healthcare. This study contributes to the ongoing discourse on the reliability of AI, particularly of LLMs like GPT-4, within healthcare, offering insights into how feedback mechanisms might be optimized to enhance AI-assisted medical education and decision support.

Recent incidents involving LLMs used for mental-health support reveal a critical evaluation gap: surface-level safety scores do not capture how models behave across realistic, emotionally sensitive interactions over time. Existing benchmarks measure knowledge, safety, or static response quality, but miss whether LLM interactions help users keep reflecting, coping, and making decisions themselves. We formalize this missing dimension as COGNITIVE ATROPHY, a process-level behavioural measure in AI-mediated mental-health support distinct from safety and helpfulness. To measure it, we introduce COGNITIVE ATROPHY BENCH, a clinically grounded benchmark built from 1,576 fully human-generated counseling conversations, 15,680 turns, and 42,230 responses from five LLMs. Three clinical and neuropsychology experts developed a 20-attribute schema spanning user context, response behaviour, and global risk flags; six trained clinical reviewers applied it with span-grounded evidence, producing 5,324 reviewer judgments. We further introduce the User-Input Risk Index (UIRI), the Cognitive Atrophy Risk Index (ARI), and trajectory summaries. Across five LLMs, models show a consistent moderate-to-high level of atrophy-aligned behaviour across single and multi-turn settings. While models generally respond to overt safety cues, they adapt less reliably when users seek solutions or decisions. The dominant recurring patterns are directive advice, problem-solving, recommendation responses, topic shifts, and forms of validation that may reinforce dependence rather than reflection. Our work makes COGNITIVE ATROPHY measurable and provides a foundation for auditing model behaviour in sensitive LLM conversations.

Social and behavioral determinants of health (SDOH) play a significant role in shaping health outcomes, and extracting these determinants from clinical notes is a first step to help healthcare providers systematically identify opportunities to provide appropriate care and address disparities. Progress on using NLP methods for this task has been hindered by the lack of high-quality publicly available labeled data, largely due to the privacy and regulatory constraints on the use of real patients' information. This paper introduces a new dataset, SDOH-NLI, that is based on publicly available notes and which we release publicly. We formulate SDOH extraction as a natural language inference (NLI) task, and provide binary textual entailment labels obtained from human raters for a cross product of a set of social history snippets as premises and SDOH factors as hypotheses. Our dataset differs from standard NLI benchmarks in that our premises and hypotheses are obtained independently. We evaluate both "off-the-shelf" entailment models as well as models fine-tuned on our data, and highlight the ways in which our dataset appears more challenging than commonly used NLI datasets.

Benchmarks are necessary for healthcare evaluation, but are not sufficient for predicting deployment performance. Our position is that the evaluation--deployment gap arises not because of poorly designed benchmarks, but from implicit assumptions about how users interact with models that cannot be surfaced from benchmarks alone. To make this precise, we propose a classification of assumptions into two categories: task, which can be tested from conversation data alone, and outcome, which requires outcome data and behavioral studies for testing. Critically, outcome assumptions depend on human behavior, something that even well-designed benchmarks cannot directly observe. To demonstrate the operationality of this framework, we retrospectively analyze a healthcare RCT as a case study and find that the gap naturally separates into task and outcome gaps of roughly equal size. To address this, we make two contributions: first, we propose BenchmarkCards, an artifact that documents assumptions, and second, we propose staged evaluation, a procedure that systematically tests assumptions and evaluates performance.

Background: Rapid advancements in natural language processing have led to the development of large language models with the potential to revolutionize mental health care. These models have shown promise in assisting clinicians and providing support to individuals experiencing various psychological challenges. Objective: This study aims to compare the performance of two large language models, GPT-4 and Chat-GPT, in responding to a set of 18 psychological prompts, to assess their potential applicability in mental health care settings. Methods: A blind methodology was employed, with a clinical psychologist evaluating the models' responses without knowledge of their origins. The prompts encompassed a diverse range of mental health topics, including depression, anxiety, and trauma, to ensure a comprehensive assessment. Results: The results demonstrated a significant difference in performance between the two models (p > 0.05). GPT-4 achieved an average rating of 8.29 out of 10, while Chat-GPT received an average rating of 6.52. The clinical psychologist's evaluation suggested that GPT-4 was more effective at generating clinically relevant and empathetic responses, thereby providing better support and guidance to potential users. Conclusions: This study contributes to the growing body of literature on the applicability of large language models in mental health care settings. The findings underscore the importance of continued research and development in the field to optimize these models for clinical use. Further investigation is necessary to understand the specific factors underlying the performance differences between the two models and to explore their generalizability across various populations and mental health conditions.

We present an automated, contrastive evaluation pipeline for auditing the behavioral impact of interventions on large language models. Given a base model M_1 and an intervention model M_2, our method compares their free-form, multi-token generations across aligned prompt contexts and produces human-readable, statistically validated natural-language hypotheses describing how the models differ, along with recurring themes that summarize patterns across validated hypotheses. We evaluate the approach in synthetic setting by injecting known behavioral changes and showing that the pipeline reliably recovers them. We then apply it to three real-world interventions, reasoning distillation, knowledge editing and unlearning, demonstrating that the method surfaces both intended and unexpected behavioral shifts, distinguishes large from subtle interventions, and does not hallucinate differences when effects are absent or misaligned with the prompt bank. Overall, the pipeline provides a statistically grounded and interpretable tool for post-hoc auditing of intervention-induced changes in model behavior.

Introduction: Data from wearable devices collected in free-living settings, and labelled with physical activity behaviours compatible with health research, are essential for both validating existing wearable-based measurement approaches and developing novel machine learning approaches. One common way of obtaining these labels relies on laborious annotation of sequences of images captured by cameras worn by participants through the course of a day. Methods: We compare the performance of three vision language models and two discriminative models on two free-living validation studies with 161 and 111 participants, collected in Oxfordshire, United Kingdom and Sichuan, China, respectively, using the Autographer (OMG Life, defunct) wearable camera. Results: We found that the best open-source vision-language model (VLM) and fine-tuned discriminative model (DM) achieved comparable performance when predicting sedentary behaviour from single images on unseen participants in the Oxfordshire study; median F1-scores: VLM = 0.89 (0.84, 0.92), DM = 0.91 (0.86, 0.95). Performance declined for light (VLM = 0.60 (0.56,0.67), DM = 0.70 (0.63, 0.79)), and moderate-to-vigorous intensity physical activity (VLM = 0.66 (0.53, 0.85); DM = 0.72 (0.58, 0.84)). When applied to the external Sichuan study, performance fell across all intensity categories, with median Cohen's kappa-scores falling from 0.54 (0.49, 0.64) to 0.26 (0.15, 0.37) for the VLM, and from 0.67 (0.60, 0.74) to 0.19 (0.10, 0.30) for the DM. Conclusion: Freely available computer vision models could help annotate sedentary behaviour, typically the most prevalent activity of daily living, from wearable camera images within similar populations to seen data, reducing the annotation burden.

To effectively optimize and personalize treatments, it is necessary to investigate the heterogeneity of treatment effects. With the wide range of users being treated over many online controlled experiments, the typical approach of manually investigating each dimension of heterogeneity becomes overly cumbersome and prone to subjective human biases. We need an efficient way to search through thousands of experiments with hundreds of target covariates and hundreds of breakdown dimensions. In this paper, we propose a systematic paradigm for detecting, surfacing and characterizing heterogeneous treatment effects. First, we detect if treatment effect variation is present in an experiment, prior to specifying any breakdowns. Second, we surface the most relevant dimensions for heterogeneity. Finally, we characterize the heterogeneity beyond just the conditional average treatment effects (CATE) by studying the conditional distributions of the estimated individual treatment effects. We show the effectiveness of our methods using simulated data and empirical studies.

As language models (LMs) approach human-level performance, a comprehensive understanding of their behavior becomes crucial. This includes evaluating capabilities, biases, task performance, and alignment with societal values. Extensive initial evaluations, including red teaming and diverse benchmarking, can establish a model's behavioral profile. However, subsequent fine-tuning or deployment modifications may alter these behaviors in unintended ways. We present a method for continual Behavioral Shift Auditing (BSA) in LMs. Building on recent work in hypothesis testing, our auditing test detects behavioral shifts solely through model generations. Our test compares model generations from a baseline model to those of the model under scrutiny and provides theoretical guarantees for change detection while controlling false positives. The test features a configurable tolerance parameter that adjusts sensitivity to behavioral changes for different use cases. We evaluate our approach using two case studies: monitoring changes in (a) toxicity and (b) translation performance. We find that the test is able to detect meaningful changes in behavior distributions using just hundreds of examples.

Despite the potential of Large Language Models (LLMs) in medicine, they may generate responses lacking supporting evidence or based on hallucinated evidence. While Retrieval Augment Generation (RAG) is popular to address this issue, few studies implemented and evaluated RAG in downstream domain-specific applications. We developed a RAG pipeline with 70,000 ophthalmology-specific documents that retrieve relevant documents to augment LLMs during inference time. In a case study on long-form consumer health questions, we systematically evaluated the responses including over 500 references of LLMs with and without RAG on 100 questions with 10 healthcare professionals. The evaluation focuses on factuality of evidence, selection and ranking of evidence, attribution of evidence, and answer accuracy and completeness. LLMs without RAG provided 252 references in total. Of which, 45.3% hallucinated, 34.1% consisted of minor errors, and 20.6% were correct. In contrast, LLMs with RAG significantly improved accuracy (54.5% being correct) and reduced error rates (18.8% with minor hallucinations and 26.7% with errors). 62.5% of the top 10 documents retrieved by RAG were selected as the top references in the LLM response, with an average ranking of 4.9. The use of RAG also improved evidence attribution (increasing from 1.85 to 2.49 on a 5-point scale, P<0.001), albeit with slight decreases in accuracy (from 3.52 to 3.23, P=0.03) and completeness (from 3.47 to 3.27, P=0.17). The results demonstrate that LLMs frequently exhibited hallucinated and erroneous evidence in the responses, raising concerns for downstream applications in the medical domain. RAG substantially reduced the proportion of such evidence but encountered challenges.

In mental health counseling, a variety of earlier studies have focused on dialogue modeling. However, most of these studies give limited to no emphasis on the quality of interaction between a patient and a therapist. The therapeutic bond between a patient and a therapist directly correlates with effective mental health counseling. It involves developing the patient's trust on the therapist over the course of counseling. To assess the therapeutic bond in counseling, we introduce trust as a therapist-assistive metric. Our definition of trust involves patients' willingness and openness to express themselves and, consequently, receive better care. We conceptualize it as a dynamic trajectory observable through textual interactions during the counseling. To facilitate trust modeling, we present MENTAL-TRUST, a novel counseling dataset comprising manual annotation of 212 counseling sessions with first-of-its-kind seven expert-verified ordinal trust levels. We project our problem statement as an ordinal classification task for trust quantification and propose a new benchmark, TrustBench, comprising a suite of classical and state-of-the-art language models on MENTAL-TRUST. We evaluate the performance across a suite of metrics and lay out an exhaustive set of findings. Our study aims to unfold how trust evolves in therapeutic interactions.

Objective: Using natural language processing (NLP) to find sentences that state treatment plans in a clinical note, would automate plan extraction and would further enable their use in tools that help providers and care managers. However, as in the most NLP tasks on clinical text, creating gold standard to train and test NLP models is tedious and expensive. Fortuitously, sometimes but not always clinical notes contain sections with a heading that identifies the section as a plan. Leveraging contents of such labeled sections as a noisy training data, we assessed accuracy of NLP models trained with the data. Methods: We used common variations of plan headings and rule-based heuristics to find plan sections with headings in clinical notes, and we extracted sentences from them and formed a noisy training data of plan sentences. We trained Support Vector Machine (SVM) and Convolutional Neural Network (CNN) models with the data. We measured accuracy of the trained models on the noisy dataset using ten-fold cross validation and separately on a set-aside manually annotated dataset. Results: About 13% of 117,730 clinical notes contained treatment plans sections with recognizable headings in the 1001 longitudinal patient records that were obtained from Cleveland Clinic under an IRB approval. We were able to extract and create a noisy training data of 13,492 plan sentences from the clinical notes. CNN achieved best F measures, 0.91 and 0.97 in the cross-validation and set-aside evaluation experiments respectively. SVM slightly underperformed with F measures of 0.89 and 0.96 in the same experiments. Conclusion: Our study showed that the training supervised learning models using noisy plan sentences was effective in identifying them in all clinical notes. More broadly, sections with informal headings in clinical notes can be a good source for generating effective training data.

People increasingly seek personal advice from large language models (LLMs), yet whether humans follow their advice, and its consequences for their well-being, remains unknown. In a longitudinal randomised controlled trial with a representative UK sample (N = 2,302), 75% of participants who had a 20-minute discussion with GPT-4o about health, careers or relationships subsequently reported following its advice. Based on autograder evaluations of chat transcripts, LLM advice rarely violated safety best practice. When queried 2-3 weeks later, participants who had interacted with personalised AI (with access to detailed user information) followed its advice more often in the real world and reported higher well-being than those advised by non-personalised AI. However, while receiving personal advice from AI temporarily reduced well-being, no differential long-term effects compared to a control emerged. Our results suggest that humans readily follow LLM advice about personal issues but doing so shows no additional well-being benefit over casual conversations.

We present the findings of "The Alzheimer's Disease Prediction Of Longitudinal Evolution" (TADPOLE) Challenge, which compared the performance of 92 algorithms from 33 international teams at predicting the future trajectory of 219 individuals at risk of Alzheimer's disease. Challenge participants were required to make a prediction, for each month of a 5-year future time period, of three key outcomes: clinical diagnosis, Alzheimer's Disease Assessment Scale Cognitive Subdomain (ADAS-Cog13), and total volume of the ventricles. The methods used by challenge participants included multivariate linear regression, machine learning methods such as support vector machines and deep neural networks, as well as disease progression models. No single submission was best at predicting all three outcomes. For clinical diagnosis and ventricle volume prediction, the best algorithms strongly outperform simple baselines in predictive ability. However, for ADAS-Cog13 no single submitted prediction method was significantly better than random guesswork. Two ensemble methods based on taking the mean and median over all predictions, obtained top scores on almost all tasks. Better than average performance at diagnosis prediction was generally associated with the additional inclusion of features from cerebrospinal fluid (CSF) samples and diffusion tensor imaging (DTI). On the other hand, better performance at ventricle volume prediction was associated with inclusion of summary statistics, such as the slope or maxima/minima of biomarkers. TADPOLE's unique results suggest that current prediction algorithms provide sufficient accuracy to exploit biomarkers related to clinical diagnosis and ventricle volume, for cohort refinement in clinical trials for Alzheimer's disease. However, results call into question the usage of cognitive test scores for patient selection and as a primary endpoint in clinical trials.

Since a user usually has to issue a sequence of queries and examine multiple documents to resolve a complex information need in a search session, researchers have paid much attention to evaluating search systems at the session level rather than the single-query level. Most existing session-level metrics evaluate each query separately and then aggregate the query-level scores using a session-level weighting function. The assumptions behind these metrics are that all queries in the session should be involved, and their orders are fixed. However, if a search system could make the user satisfied with her first few queries, she may not need any subsequent queries. Besides, in most real-world search scenarios, due to a lack of explicit feedback from real users, we can only leverage some implicit feedback, such as users' clicks, as relevance labels for offline evaluation. Such implicit feedback might be different from the real relevance in a search session as some documents may be omitted in the previous query but identified in the later reformulations. To address the above issues, we make two assumptions about session-based evaluation, which explicitly describe an ideal session-search system and how to enhance click-through data in computing session-level evaluation metrics. Based on our assumptions, we design a session-level metric called Normalized U-Measure (NUM). NUM evaluates a session as a whole and utilizes an ideal session to normalize the result of the actual session. Besides, it infers session-level relevance labels based on implicit feedback. Experiments on two public datasets demonstrate the effectiveness of NUM by comparing it with existing session-based metrics in terms of correlation with user satisfaction and intuitiveness. We also conduct ablation studies to explore whether these assumptions hold.

Accurate segmentation of Multiple Sclerosis (MS) lesions in longitudinal MRI scans is crucial for monitoring disease progression and treatment efficacy. Although changes across time are taken into account when assessing images in clinical practice, most existing deep learning methods treat scans from different timepoints separately. Among studies utilizing longitudinal images, a simple channel-wise concatenation is the primary albeit suboptimal method employed to integrate timepoints. We introduce a novel approach that explicitly incorporates temporal differences between baseline and follow-up scans through a unique architectural inductive bias called Difference Weighting Block. It merges features from two timepoints, emphasizing changes between scans. We achieve superior scores in lesion segmentation (Dice Score, Hausdorff distance) as well as lesion detection (lesion-level F_1 score) as compared to state-of-the-art longitudinal and single timepoint models across two datasets. Our code is made publicly available at www.github.com/MIC-DKFZ/Longitudinal-Difference-Weighting.

Recent progress in deep research systems has been impressive, but evaluation still lags behind real user needs. Existing benchmarks predominantly assess final reports using fixed rubrics, failing to evaluate the underlying research process. Most also offer limited multimodal coverage, rely on synthetic tasks that do not reflect real-world query complexity, and cannot be refreshed as knowledge evolves. To address these gaps, we introduce MiroEval, a benchmark and evaluation framework for deep research systems. The benchmark comprises 100 tasks (70 text-only, 30 multimodal), all grounded in real user needs and constructed via a dual-path pipeline that supports periodic updates, enabling a live and evolving setting. The proposed evaluation suite assesses deep research systems along three complementary dimensions: adaptive synthesis quality evaluation with task-specific rubrics, agentic factuality verification via active retrieval and reasoning over both web sources and multimodal attachments, and process-centric evaluation audits how the system searches, reasons, and refines throughout its investigation. Evaluation across 13 systems yields three principal findings: the three evaluation dimensions capture complementary aspects of system capability, with each revealing distinct strengths and weaknesses across systems; process quality serves as a reliable predictor of overall outcome while revealing weaknesses invisible to output-level metrics; and multimodal tasks pose substantially greater challenges, with most systems declining by 3 to 10 points. The MiroThinker series achieves the most balanced performance, with MiroThinker-H1 ranking the highest overall in both settings. Human verification and robustness results confirm the reliability of the benchmark and evaluation framework. MiroEval provides a holistic diagnostic tool for the next generation of deep research agents.

Human organs constantly undergo anatomical changes due to a complex mix of short-term (e.g., heartbeat) and long-term (e.g., aging) factors. Evidently, prior knowledge of these factors will be beneficial when modeling their future state, i.e., via image generation. However, most of the medical image generation tasks only rely on the input from a single image, thus ignoring the sequential dependency even when longitudinal data is available. Sequence-aware deep generative models, where model input is a sequence of ordered and timestamped images, are still underexplored in the medical imaging domain that is featured by several unique challenges: 1) Sequences with various lengths; 2) Missing data or frame, and 3) High dimensionality. To this end, we propose a sequence-aware diffusion model (SADM) for the generation of longitudinal medical images. Recently, diffusion models have shown promising results in high-fidelity image generation. Our method extends this new technique by introducing a sequence-aware transformer as the conditional module in a diffusion model. The novel design enables learning longitudinal dependency even with missing data during training and allows autoregressive generation of a sequence of images during inference. Our extensive experiments on 3D longitudinal medical images demonstrate the effectiveness of SADM compared with baselines and alternative methods. The code is available at https://github.com/ubc-tea/SADM-Longitudinal-Medical-Image-Generation.

Discharge summaries in Electronic Health Records (EHRs) are crucial for clinical decision-making, but their length and complexity make information extraction challenging, especially when dealing with accumulated summaries across multiple patient admissions. Large Language Models (LLMs) show promise in addressing this challenge by efficiently analyzing vast and complex data. Existing benchmarks, however, fall short in properly evaluating LLMs' capabilities in this context, as they typically focus on single-note information or limited topics, failing to reflect the real-world inquiries required by clinicians. To bridge this gap, we introduce EHRNoteQA, a novel benchmark built on the MIMIC-IV EHR, comprising 962 different QA pairs each linked to distinct patients' discharge summaries. Every QA pair is initially generated using GPT-4 and then manually reviewed and refined by three clinicians to ensure clinical relevance. EHRNoteQA includes questions that require information across multiple discharge summaries and covers eight diverse topics, mirroring the complexity and diversity of real clinical inquiries. We offer EHRNoteQA in two formats: open-ended and multi-choice question answering, and propose a reliable evaluation method for each. We evaluate 27 LLMs using EHRNoteQA and examine various factors affecting the model performance (e.g., the length and number of discharge summaries). Furthermore, to validate EHRNoteQA as a reliable proxy for expert evaluations in clinical practice, we measure the correlation between the LLM performance on EHRNoteQA, and the LLM performance manually evaluated by clinicians. Results show that LLM performance on EHRNoteQA have higher correlation with clinician-evaluated performance (Spearman: 0.78, Kendall: 0.62) compared to other benchmarks, demonstrating its practical relevance in evaluating LLMs in clinical settings.

The increasing deployment of AI agents in long-horizon tasks yields massive execution logs. Diagnosing failures within these records is crucial for reliability, as it transforms outcome-level signals into actionable interventions. The sheer scale of the data renders human review impractical, driving the need for automated root-cause attribution (RCA). However, automated RCA methods using LLMs suffer from low diagnostic accuracy, especially as execution traces grow larger. They struggle because relevant information is often sparse, distributed across distant actions, and disconnected from the visible failure, reducing root-cause attribution to a massive search problem. Existing RCA methods typically rely on one-shot LLM judgments to diagnose failures from execution traces. While effective for shorter trajectories, these judges tend to settle on a plausible diagnosis early, leaving critical evidence in longer traces unexamined. We introduce Continual Search, an iterative framework that nudges the judge, over successive turns, to keep searching for unresolved diagnostic evidence. We evaluate Continual Search across four existing RCA benchmarks. Recognizing the lack of massive execution traces in current benchmarks, we introduce MegaRCA-Mix to evaluate RCA at scale. MegaRCA-Mix provides a challenging testbed of 50 human-annotated failure trials spanning long-horizon, execution-heavy tasks. Across multiple benchmark suites and model families, Continual Search consistently improves attribution performance. On MegaRCA-Mix, for example, it improves GPT-5.5's F1 score by more than 40\%, from 0.349 to 0.498. More interestingly, within the same model family, lower-tier models can even surpass their higher-tier counterparts, demonstrating that effective search supersedes raw model scale.

Personal Graphical User Interface (GUI) agents rely on interaction history to infer what a user wants from ambiguous instructions and to anticipate recurring routines. Existing approaches retrieve task-relevant history and append it to the policy's context, implicitly assuming that experience relevant to a task remains useful for each decision within it. We find that this help is largely spent at the first decision: retrieved history strongly improves the opening step of an episode, yet provides little sustained benefit over the remaining 90\% of steps, and offers weak guidance on whether a proactive suggestion is warranted. A relevant record may tell the agent where to begin, but not which past action applies to the current screen or whether a routine is due now. The underlying issue is that relevance does not imply applicability}: relevance is determined at the task level, whereas applicability depends on the situation at decision time. We therefore recast personalization as experience activation and introduce ExpActivator, a training-free framework that activates only the experience applicable to the current situation. During execution, ExpActivator matches each new screen to historical states in the frozen GUI backbone's latent space and supplies the corresponding action as a reference. Before execution, it activates a recurring intent only when the current time and scenario provide sufficient support, and otherwise abstains. Across four GUI backbones, ExpActivator improves within-trajectory step success by 28\% on average, achieves the best personalized execution on every backbone while using about one-fifth as many history tokens, and reaches approximately 2.3times the Matthews correlation coefficient of the strongest proactive baseline. Experience pays where it is activated, not where it is appended.

As Large Language Models (LLMs) are increasingly proposed for high-stakes medical applications, there has emerged a critical need for reliable and accurate evaluation methodologies. Traditional accuracy metrics fail inadequately as they neither capture question characteristics nor offer topic-specific insights. To address this gap, we introduce MedIRT, a rigorous evaluation framework grounded in Item Response Theory (IRT), the gold standard in high-stakes educational testing. Unlike previous research relying on archival data, we prospectively gathered fresh responses from 80 diverse LLMs on a balanced, 1,100-question USMLE-aligned benchmark. Using one unidimensional two-parameter logistic IRT model per topic, we estimate LLM's latent model ability jointly with question difficulty and discrimination, yielding more stable and nuanced performance rankings than accuracy alone. Notably, we identify distinctive ``spiky'' ability profiles, where overall rankings can be misleading due to highly specialized model abilities. While GPT-5 was the top performer in a majority of domains (8 of 11), it was outperformed in Social Science and Communication by Claude-3-opus, demonstrating that even an overall 23rd-ranked model can hold the top spot for specific competencies. Furthermore, we demonstrate IRT's utility in auditing benchmarks by identifying flawed questions. We synthesize these findings into a practical decision-support framework that integrates our multi-factor competency profiles with operational metrics. This work establishes a robust, psychometrically grounded methodology essential for the safe, effective, and trustworthy deployment of LLMs in healthcare.

Knowledge-intensive language tasks require NLP systems to both provide the correct answer and retrieve supporting evidence for it in a given corpus. Autoregressive language models are emerging as the de-facto standard for generating answers, with newer and more powerful systems emerging at an astonishing pace. In this paper we argue that all this (and future) progress can be directly applied to the retrieval problem with minimal intervention to the models' architecture. Previous work has explored ways to partition the search space into hierarchical structures and retrieve documents by autoregressively generating their unique identifier. In this work we propose an alternative that doesn't force any structure in the search space: using all ngrams in a passage as its possible identifiers. This setup allows us to use an autoregressive model to generate and score distinctive ngrams, that are then mapped to full passages through an efficient data structure. Empirically, we show this not only outperforms prior autoregressive approaches but also leads to an average improvement of at least 10 points over more established retrieval solutions for passage-level retrieval on the KILT benchmark, establishing new state-of-the-art downstream performance on some datasets, while using a considerably lighter memory footprint than competing systems. Code and pre-trained models at https://github.com/facebookresearch/SEAL.

Reliable multimodal interaction depends on selective use of conversational history: an earlier question may remain relevant while its previous answer is outdated, whereas a current request may depend on historical evidence despite conflicting new observations. Existing multi-turn evaluations rarely separate these history-use demands from underlying question difficulty. To address this gap, we introduce ReTurn, a benchmark of 7,000 base tasks spanning visual and audio evidence for evaluating selective history use. For task-carrying history, Reconfirm/Reground require applying a historical question to current media while varying historical agreement; for evidence-carrying history, Retrieve/Rebind require answering a current question using historical media while varying current-media competition. Each pair preserves the target question, media, and answer. Tasks support open-ended and multiple-choice evaluation, with matched single-turn counterparts serving as answerability references. Across 13 omni-modal, vision-language, and audio-language models, median model-level open-ended accuracy falls from 93.7% with direct input to 72.3% in conversation. Behavioral probes show that high question recall can coexist with weaker task application, while competing media can redirect answers away from historical targets. Supervised adaptation yields only partial gains. ReTurn provides a controlled framework for assessing whether multimodal models select and use the historical information required by each request.

The automatic evaluation of instruction following typically involves using large language models (LLMs) to assess response quality. However, there is a lack of comprehensive evaluation of these LLM-based evaluators across two dimensions: the base LLMs and the evaluation protocols. Therefore, we present a thorough meta-evaluation of instruction following, including 25 base LLMs and 15 recently proposed evaluation protocols, on 4 human-annotated datasets, assessing the evaluation accuracy of the LLM-evaluators. Our evaluation allows us to identify the best-performing base LLMs and evaluation protocols with a high degree of robustness. Moreover, our large-scale evaluation reveals: (1) Base LLM performance ranking remains largely consistent across evaluation protocols, with less capable LLMs showing greater improvement from protocol enhancements; (2) Robust evaluation of evaluation protocols requires many base LLMs with varying capability levels, as protocol effectiveness can depend on the base LLM used; (3) Evaluation results on different datasets are not always consistent, so a rigorous evaluation requires multiple datasets with distinctive features. We release our meta-evaluation suite ReIFE, which provides the codebase and evaluation result collection for more than 500 LLM-evaluator configurations, to support future research in instruction-following evaluation.