MIRAGE: Knowledge Graph-Guided Cross-Cohort MRI Synthesis for Alzheimer's Disease Prediction

Reliable Alzheimer's disease (AD) diagnosis increasingly relies on multimodal assessments combining structural Magnetic Resonance Imaging (MRI) and Electronic Health Records (EHR). However, deploying these models is bottlenecked by modality missingness, as MRI scans are expensive and frequently unavailable in many patient cohorts. Furthermore, synthesizing de novo 3D anatomical scans from sparse, high-dimensional tabular records is technically challenging and poses severe clinical risks. To address this, we introduce MIRAGE, a novel framework that reframes the missing-MRI problem as an anatomy-guided cross-modal latent distillation task. First, MIRAGE leverages a Biomedical Knowledge Graph (KG) and Graph Attention Networks to map heterogeneous EHR variables into a unified embedding space that can be propagated from cohorts with real MRIs to cohorts without them. To bridge the semantic gap and enforce physical spatial awareness, we employ a frozen pre-trained 3D U-Net decoder strictly as an auxiliary regularization engine. Supported by a novel cohort-aggregated skip feature compensation strategy, this decoder acts as a rigorous structural penalty, forcing 1D latent representations to encode biologically plausible, macro-level pathological semantics. By exclusively utilizing this distilled "diagnostic-surrogate" representation during inference, MIRAGE completely bypasses computationally expensive 3D voxel reconstruction. Experiments demonstrate that our framework successfully bridges the missing-modality gap, improving the AD classification rate by 13% compared to unimodal baselines in cohorts without real MRIs.

EpiQAL: Benchmarking Large Language Models in Epidemiological Question Answering for Enhanced Alignment and Reasoning

Reliable epidemiological reasoning requires synthesizing study evidence to infer disease burden, transmission dynamics, and intervention effects at the population level. Existing medical question answering benchmarks primarily emphasize clinical knowledge or patient-level reasoning, yet few systematically evaluate evidence-grounded epidemiological inference. We present EpiQAL, the first diagnostic benchmark for epidemiological question answering across diverse diseases, comprising three subsets built from open-access literature. The subsets respectively evaluate text-grounded factual recall, multi-step inference linking document evidence with epidemiological principles, and conclusion reconstruction with the Discussion section withheld. Construction combines expert-designed taxonomy guidance, multi-model verification, and retrieval-based difficulty control. Experiments on ten open models reveal that current LLMs show limited performance on epidemiological reasoning, with multi-step inference posing the greatest challenge. Model rankings shift across subsets, and scale alone does not predict success. Chain-of-Thought prompting benefits multi-step inference but yields mixed results elsewhere. EpiQAL provides fine-grained diagnostic signals for evidence grounding, inferential reasoning, and conclusion reconstruction.

Large Language Model Empowered Privacy-Protected Framework for PHI Annotation in Clinical Notes

The de-identification of private information in medical data is a crucial process to mitigate the risk of confidentiality breaches, particularly when patient personal details are not adequately removed before the release of medical records. Although rule-based and learning-based methods have been proposed, they often struggle with limited generalizability and require substantial amounts of annotated data for effective performance. Recent advancements in large language models (LLMs) have shown significant promise in addressing these issues due to their superior language comprehension capabilities. However, LLMs present challenges, including potential privacy risks when using commercial LLM APIs and high computational costs for deploying open-source LLMs locally. In this work, we introduce LPPA, an LLM-empowered Privacy-Protected PHI Annotation framework for clinical notes, targeting the English language. By fine-tuning LLMs locally with synthetic notes, LPPA ensures strong privacy protection and high PHI annotation accuracy. Extensive experiments demonstrate LPPA's effectiveness in accurately de-identifying private information, offering a scalable and efficient solution for enhancing patient privacy protection.

TAGExplainer: Narrating Graph Explanations for Text-Attributed Graph Learning Models

Representation learning of Text-Attributed Graphs (TAGs) has garnered significant attention due to its applications in various domains, including recommendation systems and social networks. Despite advancements in TAG learning methodologies, challenges remain in explainability due to the black-box nature of existing TAG representation learning models. This paper presents TAGExplainer, the first method designed to generate natural language explanations for TAG learning. TAGExplainer employs a generative language model that maps input-output pairs to explanations reflecting the model's decision-making process. To address the lack of annotated ground truth explanations in real-world scenarios, we propose first generating pseudo-labels that capture the model's decisions from saliency-based explanations, then the pseudo-label generator is iteratively trained based on three training objectives focusing on faithfulness and brevity via Expert Iteration, to improve the quality of generated pseudo-labels. The high-quality pseudo-labels are finally utilized to train an end-to-end explanation generator model. Extensive experiments are conducted to demonstrate the effectiveness of TAGExplainer in producing faithful and concise natural language explanations.