Three Generations of Healthcare IT: From the Digital Record to the Computable Care Process

Objective. Healthcare IT is usually organized by the technologies it adopts. We instead organize it by the unit of information a system makes computable, and describe a computational layer whose object is patient-specific clinical intent. Approach. We give criteria for a computational layer, derive three (record, clinical state, and a proposed layer of intent), and formalize the Actionable Clinical Record (ACR) as the atomic object of the third layer. Discussion. The framework distinguishes prescribed, observed, and intended process; existing standards represent intent once it is structured but do not recover it from natural communication, the capability we localize. The ACR is complementary to FHIR workflow resources, guidelines, and process mining; a companion feasibility study illustrates tractability for one narrow subproblem. Conclusion. Computable clinical intent is a coherent research direction; the ACR, its readiness ladder, and an executable-correctness evaluation framework are reusable constructs for subsequent work to extend, evaluate, or falsify.

Clinical Communication Processing with Models Trained on LLM-Generated Synthetic Data: A Structured Survey and Novel Application Case Studies

Much clinical value is conveyed not through structured records but through communication: exchanges in which patients describe symptoms, clinicians reason and give instructions, ambulances hand over to emergency departments, and nurses pass on a shift. Such language differs from tabular data because meaning depends on speaker role, intent, causality, uncertainty, omission, and channel noise. Healthcare natural language processing must therefore interpret information as conveyed rather than coded. This requires well-annotated corpora, which are scarce because authentic exchanges are private, fragmented, and costly to annotate. Large language models offer a way forward by transforming clinical sources, such as records, diagnostic labels, symptom lists, or care plans, into written and transcribed communication for downstream models. We present a structured narrative survey organized by source representation, communication form and participants, generation method, and downstream task, complemented by thirteen novel case studies. These build clinical NLP systems for communication channels and languages without labeled real-world data, including EMS pre-arrival reports, field-radio casualty documentation, nurse handoffs, patient-portal triage, and low-resource discharge communication. They show that synthetic communication can bootstrap such systems. Findings include the competitiveness of fine-tuned encoder models over evaluated zero-shot baselines and the value of deliberately degraded communication for robustness. The main limitation is that most studies evaluate on held-out synthetic communication, while train-on-synthetic, test-on-authentic evidence remains limited. We conclude that syn-thetic clinical communication is becoming a practical research resource; establishing it as reusable clinical infrastructure will require authentic-data transfer, safety and external validation.

Modeling Normal Is All You Need: Joint Latent Clustering for Anomaly Detection in Multimodal Cyber-Physical Systems

Faults on a cyber-physical system (CPS) are too rare and unrepresentative to characterise, or even to select a model on, so detection must instead model normal behaviour; the standard point-adjusted evaluation, however, rewards detectors that never do. CPS normal behaviour is the union of many imbalanced, curved, thin-fringed operating regimes rather than a single blob; we state this structure as ten assumptions (A1-A10), abbreviated Massive, Implicit, Imbalanced Multimodality (MIIM). We model the normal law with a jointly learned latent representation plus explicit Gaussian-mixture mode clustering, scored in the latent rather than by a global density or a reconstruction residual, and evaluate under a deliberately fair protocol: raw point-wise metrics with no point adjustment, a trivial-detector difficulty split, prevalence-matched F1, and train-normal-only calibration. On three real CPS datasets (WADI, HAI, SKAB), the detector wins both the combined column and the difficult correlation/dynamics-fault column on all three, reaching difficult-subset AUROC 0.831 on HAI, 0.726 on WADI, and 0.610 on SKAB. The margin is largest on the two multimodal datasets the MIIM assumptions target and slimmest on the near-unimodal one, tracking multimodality as the thesis predicts, and it holds against three deep detectors (USAD, TranAD, GDN) re-computed with the same raw metrics, all of which collapse on the difficult subset. The methodological contributions are the MIIM assumption set, the difficulty-stratified fair protocol, and a latent-only score that drops reconstruction because a flexible decoder rebuilds the hard faults faithfully.

CoEval: Ranking Language Models for Custom Tasks Without Labeled Data or Trustworthy Benchmarks

Selecting a pretrained language model, or evaluating a fine-tuned one, for a specific application is a high-value decision, yet the public benchmarks used to make it are poorly suited: a generic benchmark need not reflect a particular sub-domain or sub-task, and its scores are suspect when its items have leaked into pretraining and are recalled rather than solved. We present CoEval, an open framework that supplies a trustworthy, task-specific signal through ensemble self-evaluation: from a task or domain description, a pool of models rotates through all three roles, teacher, student, and judge, to generate a fresh, contamination-free benchmark, answer it, and score one another, with no human labels or raters. Because every model also answers as a student, the responses are the data that weight each question by its discriminative power and each judge by its consensus with the panel. Where ground truth exists, CoEval recovers the true ranking and tracks objective correctness at \r{ho}=0.86, and the weighting recovers the gold ranking of thirteen models at Spearman 0.95. Reliability comes from panel composition, not size: this label-free weighting zeroes out broken judges and down-weights saturated questions, so neither distorts the ranking. Generated items show zero verbatim overlap with five public benchmarks, the panel cancels verbosity bias and precludes same-family self-preference, and rankings are domain-specific: three different models top four de-novo domains, so a generic leaderboard misdirects most practitioners. The same pipeline reruns on each model release, giving any team a contamination-free leaderboard for its application.

Framing, Judging, Steering: An Assessable Competency Model for Teach-ing Students to Reason With Generative AI

Generative AI makes answers easy and understanding hard, and uncritical use invites cognitive offloading. Schools still measure unaided performance, yet the real task is to produce good work with AI: framing an ill-defined task, judging the output, and steering the model toward a better result. This ability is rarely assessed in its own right; where measured, it collapses into one "prompting" score that cannot diagnose why AI use succeeds or fails. We propose CoRe-3 (Co-Reasoning), a competency model factoring productive AI use into three assessable skills we abbreviate FJS: Framing (specifying an ill-defined task before invoking AI), Judging (evaluating output for errors and unstated assumptions), and Steering (iteratively redirecting the model). Its distinguishing claim is the separation of pre-generation Framing from post-generation Steering, with Judging as the gate between. We ground the skills in theory, state five testable propositions, and instantiate them in CoReasoningLab, an open platform that presents flawed AI output and scores them independently. Over simulated learners (generated and graded by different models), the skills dissociate: each tracks its own manipulated competence while staying flat in the others, and grades become correlated when one competence is shared across all three (convergent and discriminant validity), across grader backends from two providers. Human-rater agreement and outcomes are next; we release the instrument, data, and protocol.

Reliable Extraction of Clinical Follow-Up Instructions: A Hybrid Neural-Symbolic Pipeline

Objective. Outpatient notes carry follow-up instructions pairing actions with future times ("MRI brain in two weeks"). Extracting (action, date) pairs supports scheduling and audit, but generative extractors miss the date because linking and arithmetic are implicit in decoding. We test a hybrid neural-symbolic pipeline against direct generation. Methods. We define TestSpecification and TimeSpecification entities and a ScheduledFor relation. BioBERT feeds BIO tagging and a biaffine linker; entities are canonicalized via a 28-action ontology and times normalized to day offsets deterministically. We evaluate on a 2,000-note synthetic outpatient corpus with action-disjoint splits (18 train, 6 OOV-test) against zero-shot GPT-4o-mini and LoRA-fine-tuned LLaMA-3 8B with note-level bootstrap 95% CIs. Results. On 259-note seen and OOV splits the hybrid pipeline achieves Test-Time Pair F1 of 0.997 and 0.986 with 0.00-day MAE. Baselines reach high action F1 (LLaMA-3 0.992; GPT-4o-mini 0.963 seen) but Pair F1 stays at 0.51-0.57 (LLaMA-3) and 0.53 (GPT-4o-mini), CIs non-overlapping with the hybrid. Conclusion. Separating learned entity extraction from deterministic date arithmetic outperforms generation on this benchmark, generalizes to held-out actions, and exposes failure modes. Transfer to real EHR notes is the next validation; a first-pass realism check is in Limitations.

DGLD: Domain-Gated Latent Diffusion for the Discovery of Novel Energetic Materials

Energetic-materials performance gains translate directly into reduced propellant mass, smaller warheads, and more efficient civilian gas-generators, yet no new HMX-class compound has been disclosed in fifteen years. Designing one is a sparse-label problem: of ~66 k labelled CHNO molecules only ~3 k carry experimental or DFT-quality measurements, and naive generative models trained on the full mixture either memorise the high-performance tail or extrapolate without calibration. We introduce Domain-Gated Latent Diffusion (DGLD): a label-quality gate at training time, multi-task score-model guidance at sample time, and a four-stage chemistry-validation funnel ending in first-principles DFT audit. The result is 12 DFT-confirmed novel leads. The headline compound, 3,4,5-trinitro-1,2-isoxazole (L1), reaches \r{ho}_"cal" =2.09 g/cm3 and D_"K-J,cal" =8.25 km/s and is structurally dissimilar from all 65 980 training molecules (nearest-neighbour Tanimoto 0.27). A co-headline lead, E1 (4-nitro-1,2,3,5-oxatriazole), exceeds L1 on calibrated detonation velocity (D_"K-J,cal" =9.00 km/s) from a chemotype family disjoint from L1's. DGLD is the only method to land in the productive quadrant (simultaneously novel and on-target) at DFT level. SMILES-LSTM memorises 18.3% of its outputs exactly; SELFIES-GA's best novel candidate loses 3.5 km/s under DFT audit; REINVENT 4 generates novel high-N heterocycles but peaks at D=9.02 km/s. Code, checkpoints, and 918 mined hard negatives are released on Zenodo (DOI 10.5281/zenodo.19821953); the next compound to enter the HMX-class band can be discovered, validated, and recommended for synthesis at the cost of a few GPU-days.

Toward a Benchmark for Controllable Simulation of Imperfect Students with Large Language Models

Teacher education requires deliberate practice with learners who exhibit identifiable strengths, weaknesses, and partial mastery. Large language models could support such practice by simulating students with known skill components, enabling teachers to rehearse explanations, diagnoses, and instructional responses. For this purpose, however, the central requirement is neither to maximize benchmark accuracy nor to suppress isolated facts, but to control model behavior so that it reflects a specified skill profile. This paper investigates whether prompted language models can be steered to retain some skills while suppressing others. We introduce a benchmark-oriented framework in which an explicit skill vector represents a simulated student, prompt-based control specifies retained and missing competencies, and behavior is evaluated using profile-alignment metrics, retained-versus-forgotten comparisons, and cross-skill calibration analyses. The results show that selective partial mastery can be induced and measured in a structured mathematics setting, although the degree of controllability remains model-dependent. These findings position controllable learner simulation as a distinct research problem at the intersection of teacher education, educational simulation, and language-model control.

A Controlled Synthetic Benchmark for Educational Aspect-Based Sentiment Analysis

Educational aspect-based sentiment analysis (ABSA) can support course improvement, but public aspect-labeled student feedback remains scarce because educational reviews are private, institution-specific, and expensive to annotate. This study introduces a controlled synthetic benchmark for educational ABSA built from 10,000 synthetic course reviews with explicit train-validation-test splits and a 20-aspect pedagogical schema spanning instructional quality, assessment and course management, learning demand, learning environment, and engagement. The corpus is generated with sampled target labels, sampled nuance attributes, and a realism-tuned prompt refined through a three-cycle judge-editor procedure. On the resulting benchmark, local baselines with TF-IDF, two-step transformers, and joint encoders show that the task is nontrivial; the strongest untuned model, BERT, reaches a held-out detection micro-F1 of 0.2760, while a modest lower-rate BERT schedule improves this to 0.2930. Full-test GPT-based inference with gpt-5.2 reaches 0.2519 micro-F1 in zero-shot mode and 0.2501 with retrieval-based few-shot prompting, placing batch inference above the classical baseline and close to the compact joint encoders. A conservative external evaluation on 2,829 mapped student-feedback reviews from Herath et al. yields a micro-F1 of 0.4593 for BERT on a 9-aspect overlap, indicating partial synthetic-to-real transfer. Realism and faithfulness analyses are reported as generator diagnostics that clarify how the benchmark was stabilized and where label noise remains. The study therefore contributes a synthetic educational ABSA corpus, a documented generation procedure, and a reproducible benchmark setting for a domain in which public labeled data remain difficult to obtain.

Acting on the Unseen: Communication-Free Collaborative Filtering for Decentralized Multi-Robot Task Allocation

Multi-robot task allocation usually assumes some combination of communication, known task models, or a coordinator. We study the opposite extreme, a regime common in practice but overlooked in theory, which we name Zero-Knowledge MRTA (ZK-MRTA): a robot team with no prior knowledge (no task models, not even the latent rank), no communication (no messages, no parameter sharing, no coordinator), and only a partial and privately-noisy view of a public stream of teammates' outcomes. A hidden low-rank structure governs which robot suits which task, and there are far more tasks than rounds, so most (robot, task) pairs are never attempted. Yet each robot can act well on tasks it never attempted, and onboard new tasks, by running online low-rank collaborative filtering over the broadcast (SwarmCF). The advantage over any structure-free learner is categorical, not a constant factor: a structure-free learner is provably at the prior-mean error floor on unseen pairs. We prove a matching per-robot sample complexity (Θ(d) versus Θ(n), in the rank d and the task count n), an anytime (cumulative-reward) separation under task scarcity, and a deterministic condition under which decentralized recovery from the masked broadcast is exact (validated empirically). Experiments quantify the value of the broadcast, a positive scaling law (per-robot unseen-pair skill rises with team size), and the strongest masking-robustness and anytime profile among low-rank methods, recovering most (about 80% on earned skill) of a centralized full-communication ceiling, and holding under capacity-1 contention and in a robotics-grounded sensing instance.