Abstract:Detecting LLM-generated text in specialized and high-stakes domains like medicine and law is crucial for combating misinformation and ensuring authenticity. However, current zero-shot detectors, while effective on general text, often fail when applied to specialized content due to domain shift. We provide a theoretical analysis showing this failure is fundamentally linked to the KL divergence between human, detector, and source text distributions. To address this, we propose DivScore, a zero-shot detection framework using normalized entropy-based scoring and domain knowledge distillation to robustly identify LLM-generated text in specialized domains. We also release a domain-specific benchmark for LLM-generated text detection in the medical and legal domains. Experiments on our benchmark show that DivScore consistently outperforms state-of-the-art detectors, with 14.4% higher AUROC and 64.0% higher recall (0.1% false positive rate threshold). In adversarial settings, DivScore demonstrates superior robustness than other baselines, achieving on average 22.8% advantage in AUROC and 29.5% in recall. Code and data are publicly available.
Abstract:Timely and personalized treatment decisions are essential across a wide range of healthcare settings where patient responses vary significantly and evolve over time. Clinical data used to support these decisions are often irregularly sampled, sparse, and noisy. Existing decision support systems commonly rely on discretization and imputation, which can distort critical temporal dynamics and degrade decision quality. Moreover, they often overlook the clinical significance of irregular recording frequencies, filtering out patterns in how and when data is collected. Reinforcement Learning (RL) is a natural fit for clinical decision-making, enabling sequential, long-term optimization in dynamic, uncertain environments. However, most existing treatment recommendation systems are model-free and trained solely on offline data, making them sample-inefficient, sensitive to data quality, and poorly generalizable across tasks or cohorts. To address these limitations, we propose MedDreamer, a two-phase model-based RL framework for personalized treatment recommendation. MedDreamer uses a world model with an Adaptive Feature Integration (AFI) module to effectively model irregular, sparse clinical data. Through latent imagination, it simulates plausible patient trajectories to enhance learning, refining its policy using a mix of real and imagined experiences. This enables learning policies that go beyond suboptimal historical decisions while remaining grounded in clinical data. To our knowledge, this is the first application of latent imagination to irregular healthcare data. Evaluations on sepsis and mechanical ventilation (MV) treatment using two large-scale EHR datasets show that MedDreamer outperforms both model-free and model-based baselines in clinical outcomes and off-policy metrics.
Abstract:Background: Obstructive sleep apnea syndrome (OSAS) during pregnancy is common and can negatively affect fetal outcomes. However, studies on the immediate effects of maternal hypoxia on fetal heart rate (FHR) changes are lacking. Methods: We used time-synchronized polysomnography (PSG) and cardiotocography (CTG) data from two cohorts to analyze the correlation between maternal hypoxia and FHR changes (accelerations or decelerations). Maternal hypoxic event characteristics were analyzed using generalized linear modeling (GLM) to assess their associations with different FHR changes. Results: A total of 118 pregnant women participated. FHR changes were significantly associated with maternal hypoxia, primarily characterized by accelerations. A longer hypoxic duration correlated with more significant FHR accelerations (P < 0.05), while prolonged hypoxia and greater SpO2 drop were linked to FHR decelerations (P < 0.05). Both cohorts showed a transient increase in FHR during maternal hypoxia, which returned to baseline after the event resolved. Conclusion: Maternal hypoxia significantly affects FHR, suggesting that maternal OSAS may contribute to fetal hypoxia. These findings highlight the importance of maternal-fetal interactions and provide insights for future interventions.
Abstract:While recent multimodal large language models (MLLMs) have advanced automated ECG interpretation, they still face two key limitations: (1) insufficient multimodal synergy between time series signals and visual ECG representations, and (2) limited explainability in linking diagnoses to granular waveform evidence. We introduce GEM, the first MLLM unifying ECG time series, 12-lead ECG images and text for grounded and clinician-aligned ECG interpretation. GEM enables feature-grounded analysis, evidence-driven reasoning, and a clinician-like diagnostic process through three core innovations: a dual-encoder framework extracting complementary time series and image features, cross-modal alignment for effective multimodal understanding, and knowledge-guided instruction generation for generating high-granularity grounding data (ECG-Grounding) linking diagnoses to measurable parameters ($e.g.$, QRS/PR Intervals). Additionally, we propose the Grounded ECG Understanding task, a clinically motivated benchmark designed to comprehensively assess the MLLM's capability in grounded ECG understanding. Experimental results on both existing and our proposed benchmarks show GEM significantly improves predictive performance (CSN $7.4\% \uparrow$), explainability ($22.7\% \uparrow$), and grounding ($24.8\% \uparrow$), making it more suitable for real-world clinical applications. GitHub repository: https://github.com/lanxiang1017/GEM.git
Abstract:Due to the presence of the natural gap between Knowledge Graph (KG) structures and the natural language, the effective integration of holistic structural information of KGs with Large Language Models (LLMs) has emerged as a significant question. To this end, we propose a two-stage framework to learn and apply quantized codes for each entity, aiming for the seamless integration of KGs with LLMs. Firstly, a self-supervised quantized representation (SSQR) method is proposed to compress both KG structural and semantic knowledge into discrete codes (\ie, tokens) that align the format of language sentences. We further design KG instruction-following data by viewing these learned codes as features to directly input to LLMs, thereby achieving seamless integration. The experiment results demonstrate that SSQR outperforms existing unsupervised quantized methods, producing more distinguishable codes. Further, the fine-tuned LLaMA2 and LLaMA3.1 also have superior performance on KG link prediction and triple classification tasks, utilizing only 16 tokens per entity instead of thousands in conventional prompting methods.
Abstract:3D models are favored over 2D for 3D medical image segmentation tasks due to their ability to leverage inter-slice relationship, yielding higher segmentation accuracy. However, 3D models demand significantly more GPU memory with increased model size and intermediate tensors. A common solution is to use patch-based training and make whole-volume predictions with sliding window (SW) inference. SW inference reduces memory usage but is slower due to equal resource allocation across patches and less accurate as it overlooks global features beyond patches. We propose NMSW-Net (No-More-Sliding-Window-Net), a novel framework that enhances efficiency and accuracy of any given 3D segmentation model by eliminating SW inference and incorporating global predictions when necessary. NMSW-Net incorporates a differentiable Top-k module to sample only the relevant patches that enhance segmentation accuracy, thereby minimizing redundant computations. Additionally, it learns to leverage coarse global predictions when patch prediction alone is insufficient. NMSW-Net is model-agnostic, making it compatible with any 3D segmentation model that previously relied on SW inference. Evaluated across 3 tasks with 3 segmentation backbones, NMSW-Net achieves competitive or sometimes superior accuracy compared to SW, while reducing computational complexity by 90% (87.5 to 7.95 TFLOPS), delivering 4x faster inference on the H100 GPU (19.0 to 4.3 sec), and 7x faster inference on the Intel Xeon Gold CPU (1710 to 230 seconds).
Abstract:Multi-modal class-incremental learning (MMCIL) seeks to leverage multi-modal data, such as audio-visual and image-text pairs, thereby enabling models to learn continuously across a sequence of tasks while mitigating forgetting. While existing studies primarily focus on the integration and utilization of multi-modal information for MMCIL, a critical challenge remains: the issue of missing modalities during incremental learning phases. This oversight can exacerbate severe forgetting and significantly impair model performance. To bridge this gap, we propose PAL, a novel exemplar-free framework tailored to MMCIL under missing-modality scenarios. Concretely, we devise modality-specific prompts to compensate for missing information, facilitating the model to maintain a holistic representation of the data. On this foundation, we reformulate the MMCIL problem into a Recursive Least-Squares task, delivering an analytical linear solution. Building upon these, PAL not only alleviates the inherent under-fitting limitation in analytic learning but also preserves the holistic representation of missing-modality data, achieving superior performance with less forgetting across various multi-modal incremental scenarios. Extensive experiments demonstrate that PAL significantly outperforms competitive methods across various datasets, including UPMC-Food101 and N24News, showcasing its robustness towards modality absence and its anti-forgetting ability to maintain high incremental accuracy.
Abstract:Healthcare systems worldwide face persistent challenges in efficiency, accessibility, and personalization. Powered by modern AI technologies such as multimodal large language models and world models, Embodied AI (EmAI) represents a transformative frontier, offering enhanced autonomy and the ability to interact with the physical world to address these challenges. As an interdisciplinary and rapidly evolving research domain, "EmAI in healthcare" spans diverse fields such as algorithms, robotics, and biomedicine. This complexity underscores the importance of timely reviews and analyses to track advancements, address challenges, and foster cross-disciplinary collaboration. In this paper, we provide a comprehensive overview of the "brain" of EmAI for healthcare, wherein we introduce foundational AI algorithms for perception, actuation, planning, and memory, and focus on presenting the healthcare applications spanning clinical interventions, daily care & companionship, infrastructure support, and biomedical research. Despite its promise, the development of EmAI for healthcare is hindered by critical challenges such as safety concerns, gaps between simulation platforms and real-world applications, the absence of standardized benchmarks, and uneven progress across interdisciplinary domains. We discuss the technical barriers and explore ethical considerations, offering a forward-looking perspective on the future of EmAI in healthcare. A hierarchical framework of intelligent levels for EmAI systems is also introduced to guide further development. By providing systematic insights, this work aims to inspire innovation and practical applications, paving the way for a new era of intelligent, patient-centered healthcare.
Abstract:Multimodal survival analysis aims to combine heterogeneous data sources (e.g., clinical, imaging, text, genomics) to improve the prediction quality of survival outcomes. However, this task is particularly challenging due to high heterogeneity and noise across data sources, which vary in structure, distribution, and context. Additionally, the ground truth is often censored (uncertain) due to incomplete follow-up data. In this paper, we propose a novel evidential multimodal survival fusion model, EsurvFusion, designed to combine multimodal data at the decision level through an evidence-based decision fusion layer that jointly addresses both data and model uncertainty while incorporating modality-level reliability. Specifically, EsurvFusion first models unimodal data with newly introduced Gaussian random fuzzy numbers, producing unimodal survival predictions along with corresponding aleatoric and epistemic uncertainties. It then estimates modality-level reliability through a reliability discounting layer to correct the misleading impact of noisy data modalities. Finally, a multimodal evidence-based fusion layer is introduced to combine the discounted predictions to form a unified, interpretable multimodal survival analysis model, revealing each modality's influence based on the learned reliability coefficients. This is the first work that studies multimodal survival analysis with both uncertainty and reliability. Extensive experiments on four multimodal survival datasets demonstrate the effectiveness of our model in handling high heterogeneity data, establishing new state-of-the-art on several benchmarks.
Abstract:Time-to-event analysis, or Survival analysis, provides valuable insights into clinical prognosis and treatment recommendations. However, this task is typically more challenging than other regression tasks due to the censored observations. Moreover, concerns regarding the reliability of predictions persist among clinicians, mainly attributed to the absence of confidence assessment, robustness, and calibration of prediction. To address those challenges, we introduce an evidential regression model designed especially for time-to-event prediction tasks, with which the most plausible event time, is directly quantified by aggregated Gaussian random fuzzy numbers (GRFNs). The GRFNs are a newly introduced family of random fuzzy subsets of the real line that generalizes both Gaussian random variables and Gaussian possibility distributions. Different from conventional methods that construct models based on strict data distribution, e.g., proportional hazard function, our model only assumes the event time is encoded in a real line GFRN without any strict distribution assumption, therefore offering more flexibility in complex data scenarios. Furthermore, the epistemic and aleatory uncertainty regarding the event time is quantified within the aggregated GRFN as well. Our model can, therefore, provide more detailed clinical decision-making guidance with two more degrees of information. The model is fit by minimizing a generalized negative log-likelihood function that accounts for data censoring based on uncertainty evidence reasoning. Experimental results on simulated datasets with varying data distributions and censoring scenarios, as well as on real-world datasets across diverse clinical settings and tasks, demonstrate that our model achieves both accurate and reliable performance, outperforming state-of-the-art methods.