EarlyDx: An Admission-Anchored Benchmark for Open-Ended Generation of Evidence-Supported ED-Encounter Diagnoses

Clinical diagnosis at hospital admission must be made rapidly from limited, incomplete evidence. Existing diagnosis-prediction benchmarks are poorly suited to this setting: they restrict prediction to closed code sets, exclude free-text notes, and supervise with discharge diagnoses that incorporate the full inpatient course. We introduce EarlyDx, a large-scale benchmark for open-ended early diagnosis, built from 154,834 emergency department encounters in MIMIC-IV. Each encounter is restricted to records available at admission time $t_0$ and supervised by the diagnoses recorded during the ED encounter rather than at discharge. An LLM auditor further verifies every free-text label as supported, partially supported, or unsupported by that evidence; the primary evaluation scores only fully supported labels. Under a semantic LLM-as-judge protocol, no evaluated system --- frontier general, medical-specialized, or in-domain post-trained --- synthesizes admission-time evidence reliably. Zero-shot models score largely by extraction, recovering only 3-31% of diagnoses that must be inferred rather than read from the record; post-training raises inference-dependent recall to 56%, but a sizeable margin remains, and on time-critical conditions no system attains a clinician's balance of sensitivity and precision. We release the full construction and evaluation pipeline at here.

LastAct: Trajectory-Guided Latest-Activity Localization for Real-Time Smart-Home Activity Recognition

Human Activity Recognition (HAR) from ambient sensors enables smart-home applications such as health monitoring and assisted living. In realistic deployments, however, sensor events arrive as a continuous stream and activity boundaries are unknown. Sliding-window inference therefore produces many windows that straddle transitions and contain mixed activities, creating boundary contamination that violates the pre-segmented instance assumption used by most benchmarks and models. Moreover, many pipelines under-use spatial context by treating sensor IDs as independent tokens. We present LastAct, a trajectory-centric framework for streaming smart-home HAR that targets the most recent activity under mixed windows while explicitly modeling spatial structure. LastAct projects sensor events onto the home floorplan to form a layout-aligned trajectory image sequence that preserves spatial continuity. A lightweight gate identifies contaminated windows, and a boundary localizer estimates the last transition to enable boundary-guided masking that emphasizes post-boundary evidence and suppresses stale context. For efficiency, we reuse a precomputed layout-aligned template cache to avoid repeated rendering. Empirically, across four public smart-home datasets under near-realistic mixed-activity protocols, LastAct achieves competitive or superior performance on pure windows and yields substantial Macro-F1 gains on cross/mixed windows, demonstrating improved robustness under near-realistic sliding-window regimes.