A Cloud-Edge System for Multimodal Clinical Screening in Resource-Constrained Rural Settings

Medical AI has demonstrated specialist-level diagnostic accuracy, yet these capabilities remain largely inaccessible in resource-constrained rural settings where bandwidth is scarce, compute is limited, and clinical decision-making requires integrating heterogeneous modalities. We introduce a cloud--edge collaborative architecture that addresses these constraints: lightweight, domain-specific models on the edge transform raw medical data into compact structured outputs, while a cloud LLM synthesizes these outputs into clinical summaries. An LLM-based orchestrator dynamically selects diagnostic tools based on patient context, promoting comprehensive modality coverage without processing irrelevant inputs. We evaluate on 20 multimodal clinical cases spanning cardiac, obstetric, trauma, and screening scenarios under three simulated network profiles (500,kbps--5,Mbps). The hybrid system achieves 98--99% diagnostic tool recall with 92--96% precision, matches or exceeds cloud-only baselines on clinical accuracy, and maintains bandwidth-invariant latency (25--35,s) at 4--15x lower token cost. These results highlight the role of architectural design in enabling efficient multimodal integration and improving factual grounding compared to cloud-only approaches under deployment constraints.

CTBench: Evaluating Troubleshooting Capabilities of AI Agents in Realistic Telecom Network Operations

Agents are increasingly considered for automating network operations and maintenance, where engineers must diagnose network faults, optimize configurations to enhance services, and reduce operational costs while acting under strict constraints. However, existing evaluations fail to accurately model real network characteristics or assess agents under partially observable telecom environments with diverse vendors, devices, protocols, and interfaces. In this paper, we introduce CTBench, a public benchmark for assessing whether an agent behaves like a competent telecom troubleshooting engineer. CTBench focuses on root cause analysis and path restoration. Each task is constructed by experts and annotated with rich task metadata, including golden evidence steps. CTBench uses expert-grounded metrics that evaluate both final answers and the diagnostic evidence. Experiments with representative harness-model combinations show that state-of-the-art agents perform very well at identifying endpoints in path-restoration tasks but, more generally, underperform in root cause analysis. In particular, agents struggle with interface state, link-layer, service-management, and other operational faults. Most importantly, even when agents produce plausible or correct final answers, they often fail to provide the evidence-grounded diagnoses required in operational practice. Our results further show that path restoration is generally more resource expensive, yet larger resource usage does not necessarily translate into better diagnosis.

TIER-MoE: Trust-Informed Expert Routing via Conditional Modality Risk for Multimodal Fusion in Biomedical Classification

The promise of multimodal fusion lies in combining complementary sources of evidence, yet more evidence does not always yield a better prediction. Recent multimodal models have advanced fusion through richer cross-modal interaction and sample-adaptive fusion. However, the influence assigned to a modality during fusion does not reveal whether that source is unreliable, redundant, or poorly matched to a specialized expert. To address this limitation, we introduce TIER-MoE, a risk-guided subspace mixture-of-experts model that defines sample-specific modality reliability as the prediction loss its unimodal predictor is expected to incur. This risk is learned from out-of-fold predictions generated by models that were not trained on the corresponding sample. TIER-MoE combines the estimated risk with expert-specific subspace compatibility for sparse modality-expert routing, while an always-active shared path preserves multimodal complementarity. We evaluate TIER-MoE on four public multimodal biomedical datasets spanning Alzheimer's disease status, skin-lesion malignancy, and retinal classification. Results demonstrate its superiority over state-of-the-art methods in predictive performance and probability calibration, with consistent improvements in Macro-F1 and Brier score and strong zero-shot generalization to an external cohort.

SLAI T-Rex: Full-Parameter Post-training of the DeepSeek-V4 Family on Ascend SuperPOD

Full-parameter post-training of trillion-parameter-scale MoE models introduces substantial system-level challenges for large-scale distributed training, including severe memory pressure, non-overlapped communication overhead, and inefficient kernel execution. While most large-scale LLM training systems are built around GPU-based clusters, this report presents an end-to-end optimization practice on the Ascend NPU SuperPOD. Using the DeepSeek-V4 model family as the target workload, we develop a hierarchical optimization framework spanning model-level parallelism, computation-communication orchestration, and low-level kernel execution. The resulting system achieves 34.22% Model FLOPs Utilization (MFU) with a 2.93x improvement over the open-source baseline recipe while maintaining training stability. Building on this optimized infrastructure, we further establish a CPT and SFT workflow for complex Operations Research (OR) tasks. We refer to the integrated framework as SLAI T-Rex. Using DeepSeek-V4-Flash, we develop OR-oriented CPT and SFT data pipelines that combine collected domain resources with solver-verified synthetic optimization documents. The resulting dataset contains 10K high-quality SFT samples spanning four task categories and three problem representations. The specialized model achieves the highest average zero-shot Pass@1 score among the evaluated models, reaching 71.81% and outperforming GPT-5.4-Mini and the base DeepSeek-V4-Flash model by 3.98 and 11.27 percentage points, respectively. Overall, this work demonstrates a full-stack pathway from efficient trillion-parameter model post-training on Ascend infra to domain-specialized Flash models for solver-grounded mathematical modeling, advancing frontier-model systems for complex reasoning.

Evaluating and Understanding Model Editing for Medical Vision Language Models

Model editing promises a fast, targeted way to correct post-deployment mistakes in medical vision-language models (VLMs) without costly retraining. However, existing multimodal model editing benchmarks focus on general-purpose tasks and do not reflect realistic clinical domain requirements and variability. To address this, we introduce M3Bench, a clinically grounded benchmark for multimodal model editing that evaluates whether an edit remains reliable, precise, and generalizable under the challenges of image and text variation, modality and protocol shifts, clinical knowledge composition, and temporal progression. M3Bench contains 16,276 questions spanning diverse anatomy, modalities, and specialties, and supports both single and sequential edits. By evaluating 4 representative editors across 6 medical and general VLMs, we find that no method excels across all criteria. Gradient-based editors achieve strong transfer but suffer from catastrophic locality violations, whereas memory-based methods preserve locality but lack compositional generality and exhibit high backbone-dependent hyperparameter sensitivity. We further attribute these failures to the latent space geometry of VLMs and how different editing methods shift its landscape. Overall, M3Bench establishes a rigorous clinical stress test for multimodal model editing and offers actionable guidance for safer post-deployment adaptation. The benchmark is publicly available at https://github.com/BioMed-AI-Lab-U-Michgan/M3Bench .

Beyond Time Series: Spatial Reasoning for Epidemic Forecasting via Multimodal Learning

Epidemic forecasting models typically rely on surveillance data reported over administrative regions, treating them as atomic units, thereby obscuring sub-regional spatial structure that shapes disease dynamics. We introduce a spatially structured multimodal epidemic forecasting setting that integrates region-level temporal surveillance data with spatially localized auxiliary signals that are misaligned in resolution and structure, reflecting realistic public health reporting constraints. Building on this formulation, we propose M-SPICE (Multimodal SPatIal Context for Epidemic Forecasting), a structure-aware spatiotemporal forecasting framework that performs joint reasoning over temporal disease dynamics and spatial context via attention-based multimodal fusion, allowing spatial signals to selectively condition temporal representations across forecast horizons. We evaluate our approach on real-world COVID-19, influenza, and influenza-like illness (ILI) forecasting tasks under realistic real-time evaluation protocols. Across all forecasting settings, our method consistently outperforms state-of-the-art multivariate time-series, multimodal, and epidemiological forecasting baselines while maintaining strong probabilistic forecasting performance. Finally, interpretability analyses reveal when, where, and how spatial signals are leveraged, highlighting settings in which purely temporal, region-aggregated models are most likely to fail.

On the Cone Effect and Modality Gap in Medical Vision-Language Embeddings

Vision-Language Models (VLMs) exhibit a characteristic "cone effect" in which nonlinear encoders map embeddings into highly concentrated regions of the representation space, contributing to cross-modal separation known as the modality gap. While this phenomenon has been widely observed, its practical impact on supervised multimodal learning -particularly in medical domains- remains unclear. In this work, we introduce a lightweight post-hoc mechanism that keeps pretrained VLM encoders frozen while continuously controlling cross-modal separation through a single hyperparameter {λ}. This enables systematic analysis of how the modality gap affects downstream multimodal performance without expensive retraining. We evaluate generalist (CLIP, SigLIP) and medically specialized (BioMedCLIP, MedSigLIP) models across diverse medical and natural datasets in a supervised multimodal settings. Results consistently show that reducing excessive modality gap improves downstream performance, with medical datasets exhibiting stronger sensitivity to gap modulation; however, fully collapsing the gap is not always optimal, and intermediate, task-dependent separation yields the best results. These findings position the modality gap as a tunable property of multimodal representations rather than a quantity that should be universally minimized.

EDCO: Dynamic Curriculum Orchestration for Domain-specific Large Language Model Fine-tuning

Domain-specific large language models (LLMs), typically developed by fine-tuning a pre-trained general-purpose LLM on specialized datasets, represent a significant advancement in applied AI. A common strategy in LLM fine-tuning is curriculum learning, which pre-orders training samples based on metrics like difficulty to improve learning efficiency compared to a random sampling strategy. However, most existing methods for LLM fine-tuning rely on a static curriculum, designed prior to training, which lacks adaptability to the model's evolving needs during fine-tuning. To address this, we propose EDCO, a novel framework based on two key concepts: inference entropy and dynamic curriculum orchestration. Inspired by recent findings that maintaining high answer entropy benefits long-term reasoning gains, EDCO prioritizes samples with high inference entropy in a continuously adapted curriculum. EDCO integrates three core components: an efficient entropy estimator that uses prefix tokens to approximate full-sequence entropy, an entropy-based curriculum generator that selects data points with the highest inference entropy, and an LLM trainer that optimizes the model on the selected curriculum. Comprehensive experiments in communication, medicine and law domains, EDCO outperforms traditional curriculum strategies for fine-tuning Qwen3-4B and Llama3.2-3B models under supervised and reinforcement learning settings. Furthermore, the proposed efficient entropy estimation reduces computational time by 83.5% while maintaining high accuracy.

CURENet: Combining Unified Representations for Efficient Chronic Disease Prediction

Electronic health records (EHRs) are designed to synthesize diverse data types, including unstructured clinical notes, structured lab tests, and time-series visit data. Physicians draw on these multimodal and temporal sources of EHR data to form a comprehensive view of a patient's health, which is crucial for informed therapeutic decision-making. Yet, most predictive models fail to fully capture the interactions, redundancies, and temporal patterns across multiple data modalities, often focusing on a single data type or overlooking these complexities. In this paper, we present CURENet, a multimodal model (Combining Unified Representations for Efficient chronic disease prediction) that integrates unstructured clinical notes, lab tests, and patients' time-series data by utilizing large language models (LLMs) for clinical text processing and textual lab tests, as well as transformer encoders for longitudinal sequential visits. CURENet has been capable of capturing the intricate interaction between different forms of clinical data and creating a more reliable predictive model for chronic illnesses. We evaluated CURENet using the public MIMIC-III and private FEMH datasets, where it achieved over 94\% accuracy in predicting the top 10 chronic conditions in a multi-label framework. Our findings highlight the potential of multimodal EHR integration to enhance clinical decision-making and improve patient outcomes.

Representation Learning of Lab Values via Masked AutoEncoder

Accurate imputation of missing laboratory values in electronic health records (EHRs) is critical to enable robust clinical predictions and reduce biases in AI systems in healthcare. Existing methods, such as variational autoencoders (VAEs) and decision tree-based approaches such as XGBoost, struggle to model the complex temporal and contextual dependencies in EHR data, mainly in underrepresented groups. In this work, we propose Lab-MAE, a novel transformer-based masked autoencoder framework that leverages self-supervised learning for the imputation of continuous sequential lab values. Lab-MAE introduces a structured encoding scheme that jointly models laboratory test values and their corresponding timestamps, enabling explicit capturing temporal dependencies. Empirical evaluation on the MIMIC-IV dataset demonstrates that Lab-MAE significantly outperforms the state-of-the-art baselines such as XGBoost across multiple metrics, including root mean square error (RMSE), R-squared (R2), and Wasserstein distance (WD). Notably, Lab-MAE achieves equitable performance across demographic groups of patients, advancing fairness in clinical predictions. We further investigate the role of follow-up laboratory values as potential shortcut features, revealing Lab-MAE's robustness in scenarios where such data is unavailable. The findings suggest that our transformer-based architecture, adapted to the characteristics of the EHR data, offers a foundation model for more accurate and fair clinical imputation models. In addition, we measure and compare the carbon footprint of Lab-MAE with the baseline XGBoost model, highlighting its environmental requirements.