Extending ZACH-ViT to Robust Medical Imaging: Corruption and Adversarial Stress Testing in Low-Data Regimes

The recently introduced ZACH-ViT (Zero-token Adaptive Compact Hierarchical Vision Transformer) formalized a compact permutation-invariant Vision Transformer for medical imaging and argued that architectural alignment with spatial structure can matter more than universal benchmark dominance. Its design was motivated by the observation that positional embeddings and a dedicated class token encode fixed spatial assumptions that may be suboptimal when spatial organization is weakly informative, locally distributed, or variable across biomedical images. The foundational study established a regime-dependent clean performance profile across MedMNIST, but did not examine robustness in detail. In this work, we present the first robustness-focused extension of ZACH-ViT by evaluating its behavior under common image corruptions and adversarial perturbations in the same low-data setting. We compare ZACH-ViT with three scratch-trained compact baselines, ABMIL, Minimal-ViT, and TransMIL, on seven MedMNIST datasets using 50 samples per class, fixed hyperparameters, and five random seeds. Across the benchmark, ZACH-ViT achieves the best overall mean rank on clean data (1.57) and under common corruptions (1.57), indicating a favorable balance between baseline predictive performance and robustness to realistic image degradation. Under adversarial stress, all models deteriorate substantially; nevertheless, ZACH-ViT remains competitive, ranking first under FGSM (2.00) and second under PGD (2.29), where ABMIL performs best overall. These results extend the original ZACH-ViT narrative: the advantages of compact permutation-invariant transformers are not limited to clean evaluation, but can persist under realistic perturbation stress in low-data medical imaging, while adversarial robustness remains an open challenge for all evaluated models.

LLMs for Drug-Drug Interaction Prediction: A Comprehensive Comparison

The increasing volume of drug combinations in modern therapeutic regimens needs reliable methods for predicting drug-drug interactions (DDIs). While Large Language Models (LLMs) have revolutionized various domains, their potential in pharmaceutical research, particularly in DDI prediction, remains largely unexplored. This study thoroughly investigates LLMs' capabilities in predicting DDIs by uniquely processing molecular structures (SMILES), target organisms, and gene interaction data as raw text input from the latest DrugBank dataset. We evaluated 18 different LLMs, including proprietary models (GPT-4, Claude, Gemini) and open-source variants (from 1.5B to 72B parameters), first assessing their zero-shot capabilities in DDI prediction. We then fine-tuned selected models (GPT-4, Phi-3.5 2.7B, Qwen-2.5 3B, Gemma-2 9B, and Deepseek R1 distilled Qwen 1.5B) to optimize their performance. Our comprehensive evaluation framework included validation across 13 external DDI datasets, comparing against traditional approaches such as l2-regularized logistic regression. Fine-tuned LLMs demonstrated superior performance, with Phi-3.5 2.7B achieving a sensitivity of 0.978 in DDI prediction, with an accuracy of 0.919 on balanced datasets (50% positive, 50% negative cases). This result represents an improvement over both zero-shot predictions and state-of-the-art machine-learning methods used for DDI prediction. Our analysis reveals that LLMs can effectively capture complex molecular interaction patterns and cases where drug pairs target common genes, making them valuable tools for practical applications in pharmaceutical research and clinical settings.

Design and Evaluation of a CDSS for Drug Allergy Management Using LLMs and Pharmaceutical Data Integration

Medication errors significantly threaten patient safety, leading to adverse drug events and substantial economic burdens on healthcare systems. Clinical Decision Support Systems (CDSSs) aimed at mitigating these errors often face limitations, including reliance on static databases and rule-based algorithms, which can result in high false alert rates and alert fatigue among clinicians. This paper introduces HELIOT, an innovative CDSS for drug allergy management, integrating Large Language Models (LLMs) with a comprehensive pharmaceutical data repository. HELIOT leverages advanced natural language processing capabilities to interpret complex medical texts and synthesize unstructured data, overcoming the limitations of traditional CDSSs. An empirical evaluation using a synthetic patient dataset and expert-verified ground truth demonstrates HELIOT's high accuracy, precision, recall, and F1 score, uniformly reaching 100\% across multiple experimental runs. The results underscore HELIOT's potential to enhance decision support in clinical settings, offering a scalable, efficient, and reliable solution for managing drug allergies.

A data-centric approach to class-specific bias in image data augmentation

Data augmentation (DA) enhances model generalization in computer vision but may introduce biases, impacting class accuracy unevenly. Our study extends this inquiry, examining DA's class-specific bias across various datasets, including those distinct from ImageNet, through random cropping. We evaluated this phenomenon with ResNet50, EfficientNetV2S, and SWIN ViT, discovering that while residual models showed similar bias effects, Vision Transformers exhibited greater robustness or altered dynamics. This suggests a nuanced approach to model selection, emphasizing bias mitigation. We also refined a "data augmentation robustness scouting" method to manage DA-induced biases more efficiently, reducing computational demands significantly (training 112 models instead of 1860; a reduction of factor 16.2) while still capturing essential bias trends.