Investigating LLMs in Clinical Triage: Promising Capabilities, Persistent Intersectional Biases

Large Language Models (LLMs) have shown promise in clinical decision support, yet their application to triage remains underexplored. We systematically investigate the capabilities of LLMs in emergency department triage through two key dimensions: (1) robustness to distribution shifts and missing data, and (2) counterfactual analysis of intersectional biases across sex and race. We assess multiple LLM-based approaches, ranging from continued pre-training to in-context learning, as well as machine learning approaches. Our results indicate that LLMs exhibit superior robustness, and we investigate the key factors contributing to the promising LLM-based approaches. Furthermore, in this setting, we identify gaps in LLM preferences that emerge in particular intersections of sex and race. LLMs generally exhibit sex-based differences, but they are most pronounced in certain racial groups. These findings suggest that LLMs encode demographic preferences that may emerge in specific clinical contexts or particular combinations of characteristics.

Understanding the Repeat Curse in Large Language Models from a Feature Perspective

Large language models (LLMs) have made remarkable progress in various domains, yet they often suffer from repetitive text generation, a phenomenon we refer to as the "Repeat Curse". While previous studies have proposed decoding strategies to mitigate repetition, the underlying mechanism behind this issue remains insufficiently explored. In this work, we investigate the root causes of repetition in LLMs through the lens of mechanistic interpretability. Inspired by recent advances in Sparse Autoencoders (SAEs), which enable monosemantic feature extraction, we propose a novel approach, "Duplicatus Charm", to induce and analyze the Repeat Curse. Our method systematically identifies "Repetition Features" -the key model activations responsible for generating repetitive outputs. First, we locate the layers most involved in repetition through logit analysis. Next, we extract and stimulate relevant features using SAE-based activation manipulation. To validate our approach, we construct a repetition dataset covering token and paragraph level repetitions and introduce an evaluation pipeline to quantify the influence of identified repetition features. Furthermore, by deactivating these features, we have effectively mitigated the Repeat Curse.

ICAFS: Inter-Client-Aware Feature Selection for Vertical Federated Learning

Vertical federated learning (VFL) enables a paradigm for vertically partitioned data across clients to collaboratively train machine learning models. Feature selection (FS) plays a crucial role in Vertical Federated Learning (VFL) due to the unique nature that data are distributed across multiple clients. In VFL, different clients possess distinct subsets of features for overlapping data samples, making the process of identifying and selecting the most relevant features a complex yet essential task. Previous FS efforts have primarily revolved around intra-client feature selection, overlooking vital feature interaction across clients, leading to subpar model outcomes. We introduce ICAFS, a novel multi-stage ensemble approach for effective FS in VFL by considering inter-client interactions. By employing conditional feature synthesis alongside multiple learnable feature selectors, ICAFS facilitates ensemble FS over these selectors using synthetic embeddings. This method bypasses the limitations of private gradient sharing and allows for model training using real data with refined embeddings. Experiments on multiple real-world datasets demonstrate that ICAFS surpasses current state-of-the-art methods in prediction accuracy.

Crowdsourcing-Based Knowledge Graph Construction for Drug Side Effects Using Large Language Models with an Application on Semaglutide

Social media is a rich source of real-world data that captures valuable patient experience information for pharmacovigilance. However, mining data from unstructured and noisy social media content remains a challenging task. We present a systematic framework that leverages large language models (LLMs) to extract medication side effects from social media and organize them into a knowledge graph (KG). We apply this framework to semaglutide for weight loss using data from Reddit. Using the constructed knowledge graph, we perform comprehensive analyses to investigate reported side effects across different semaglutide brands over time. These findings are further validated through comparison with adverse events reported in the FAERS database, providing important patient-centered insights into semaglutide's side effects that complement its safety profile and current knowledge base of semaglutide for both healthcare professionals and patients. Our work demonstrates the feasibility of using LLMs to transform social media data into structured KGs for pharmacovigilance.

Why Reasoning Matters? A Survey of Advancements in Multimodal Reasoning (v1)

Reasoning is central to human intelligence, enabling structured problem-solving across diverse tasks. Recent advances in large language models (LLMs) have greatly enhanced their reasoning abilities in arithmetic, commonsense, and symbolic domains. However, effectively extending these capabilities into multimodal contexts-where models must integrate both visual and textual inputs-continues to be a significant challenge. Multimodal reasoning introduces complexities, such as handling conflicting information across modalities, which require models to adopt advanced interpretative strategies. Addressing these challenges involves not only sophisticated algorithms but also robust methodologies for evaluating reasoning accuracy and coherence. This paper offers a concise yet insightful overview of reasoning techniques in both textual and multimodal LLMs. Through a thorough and up-to-date comparison, we clearly formulate core reasoning challenges and opportunities, highlighting practical methods for post-training optimization and test-time inference. Our work provides valuable insights and guidance, bridging theoretical frameworks and practical implementations, and sets clear directions for future research.

Efficient ANN-Guided Distillation: Aligning Rate-based Features of Spiking Neural Networks through Hybrid Block-wise Replacement

Spiking Neural Networks (SNNs) have garnered considerable attention as a potential alternative to Artificial Neural Networks (ANNs). Recent studies have highlighted SNNs' potential on large-scale datasets. For SNN training, two main approaches exist: direct training and ANN-to-SNN (ANN2SNN) conversion. To fully leverage existing ANN models in guiding SNN learning, either direct ANN-to-SNN conversion or ANN-SNN distillation training can be employed. In this paper, we propose an ANN-SNN distillation framework from the ANN-to-SNN perspective, designed with a block-wise replacement strategy for ANN-guided learning. By generating intermediate hybrid models that progressively align SNN feature spaces to those of ANN through rate-based features, our framework naturally incorporates rate-based backpropagation as a training method. Our approach achieves results comparable to or better than state-of-the-art SNN distillation methods, showing both training and learning efficiency.

C^2 ATTACK: Towards Representation Backdoor on CLIP via Concept Confusion

Backdoor attacks pose a significant threat to deep learning models, enabling adversaries to embed hidden triggers that manipulate the behavior of the model during inference. Traditional backdoor attacks typically rely on inserting explicit triggers (e.g., external patches, or perturbations) into input data, but they often struggle to evade existing defense mechanisms. To address this limitation, we investigate backdoor attacks through the lens of the reasoning process in deep learning systems, drawing insights from interpretable AI. We conceptualize backdoor activation as the manipulation of learned concepts within the model's latent representations. Thus, existing attacks can be seen as implicit manipulations of these activated concepts during inference. This raises interesting questions: why not manipulate the concepts explicitly? This idea leads to our novel backdoor attack framework, Concept Confusion Attack (C^2 ATTACK), which leverages internal concepts in the model's reasoning as "triggers" without introducing explicit external modifications. By avoiding the use of real triggers and directly activating or deactivating specific concepts in latent spaces, our approach enhances stealth, making detection by existing defenses significantly harder. Using CLIP as a case study, experimental results demonstrate the effectiveness of C^2 ATTACK, achieving high attack success rates while maintaining robustness against advanced defenses.

Rethinking Prompt-based Debiasing in Large Language Models

Investigating bias in large language models (LLMs) is crucial for developing trustworthy AI. While prompt-based through prompt engineering is common, its effectiveness relies on the assumption that models inherently understand biases. Our study systematically analyzed this assumption using the BBQ and StereoSet benchmarks on both open-source models as well as commercial GPT model. Experimental results indicate that prompt-based is often superficial; for instance, the Llama2-7B-Chat model misclassified over 90% of unbiased content as biased, despite achieving high accuracy in identifying bias issues on the BBQ dataset. Additionally, specific evaluation and question settings in bias benchmarks often lead LLMs to choose "evasive answers", disregarding the core of the question and the relevance of the response to the context. Moreover, the apparent success of previous methods may stem from flawed evaluation metrics. Our research highlights a potential "false prosperity" in prompt-base efforts and emphasizes the need to rethink bias metrics to ensure truly trustworthy AI.

Temporal Separation with Entropy Regularization for Knowledge Distillation in Spiking Neural Networks

Spiking Neural Networks (SNNs), inspired by the human brain, offer significant computational efficiency through discrete spike-based information transfer. Despite their potential to reduce inference energy consumption, a performance gap persists between SNNs and Artificial Neural Networks (ANNs), primarily due to current training methods and inherent model limitations. While recent research has aimed to enhance SNN learning by employing knowledge distillation (KD) from ANN teacher networks, traditional distillation techniques often overlook the distinctive spatiotemporal properties of SNNs, thus failing to fully leverage their advantages. To overcome these challenge, we propose a novel logit distillation method characterized by temporal separation and entropy regularization. This approach improves existing SNN distillation techniques by performing distillation learning on logits across different time steps, rather than merely on aggregated output features. Furthermore, the integration of entropy regularization stabilizes model optimization and further boosts the performance. Extensive experimental results indicate that our method surpasses prior SNN distillation strategies, whether based on logit distillation, feature distillation, or a combination of both. The code will be available on GitHub.

Can Large Language Models Identify Implicit Suicidal Ideation? An Empirical Evaluation

We present a comprehensive evaluation framework for assessing Large Language Models' (LLMs) capabilities in suicide prevention, focusing on two critical aspects: the Identification of Implicit Suicidal ideation (IIS) and the Provision of Appropriate Supportive responses (PAS). We introduce \ourdata, a novel dataset of 1,308 test cases built upon psychological frameworks including D/S-IAT and Negative Automatic Thinking, alongside real-world scenarios. Through extensive experiments with 8 widely used LLMs under different contextual settings, we find that current models struggle significantly with detecting implicit suicidal ideation and providing appropriate support, highlighting crucial limitations in applying LLMs to mental health contexts. Our findings underscore the need for more sophisticated approaches in developing and evaluating LLMs for sensitive psychological applications.