From Token to Token Pair: Efficient Prompt Compression for Large Language Models in Clinical Prediction

By processing electronic health records (EHRs) as natural language sequences, large language models (LLMs) have shown potential in clinical prediction tasks such as mortality prediction and phenotyping. However, longitudinal or highly frequent EHRs often yield excessively long token sequences that result in high computational costs and even reduced performance. Existing solutions either add modules for compression or remove less important tokens, which introduce additional inference latency or risk losing clinical information. To achieve lossless compression of token sequences without additional cost or loss of performance, we propose Medical Token-Pair Encoding (MedTPE), a layered method that extends standard tokenisation for EHR sequences. MedTPE merges frequently co-occurring medical token pairs into composite tokens, providing lossless compression while preserving the computational complexity through a dependency-aware replacement strategy. Only the embeddings of the newly introduced tokens of merely 0.5-1.0% of the LLM's parameters are fine-tuned via self-supervised learning. Experiments on real-world datasets for two clinical scenarios demonstrate that MedTPE reduces input token length by up to 31% and inference latency by 34-63%, while maintaining or even improving both predictive performance and output format compliance across multiple LLMs and four clinical prediction tasks. Furthermore, MedTPE demonstrates robustness across different input context lengths and generalisability to scientific and financial domains and different languages.

Towards Generation-Efficient Uncertainty Estimation in Large Language Models

Uncertainty estimation is important for deploying LLMs in high-stakes applications such as healthcare and finance, where hallucinations can appear fluent and plausible while being factually incorrect, making it difficult for users to judge whether an output should be trusted. Existing methods require one or more full autoregressive generations to estimate uncertainty, which introduces substantial inference cost and often delays uncertainty assessment. In this paper, we investigate whether effective uncertainty estimation can be achieved with partial generation or even input-only information. Specifically, we first develop a unified framework that formulates uncertainty estimation as an early estimation problem over the autoregressive generation process of LLMs. This framework organises existing and proposed estimators by the information they observe, ranging from multi-generation to input-only prediction, and clarifies the performance-cost trade-off underlying different uncertainty estimation methods. Building on this view, we study two largely underexplored low-cost settings: estimating uncertainty with part of the generation, and predicting uncertainty from the input prompt. We propose Logit Magnitude, which uses top-M logit evidence to estimate uncertainty from an early-stopped generation prefix, and MetaUE, which distils generation-based uncertainty into a lightweight input-only estimator trained with uncertainty scores. Extensive experiments on general and domain-specific benchmarks show that Logit Magnitude achieves strong performance, and partial generations of LLMs are often sufficient for effective uncertainty estimation. MetaUE further provides a competitive input-only approximation in several settings. These findings suggest that effective uncertainty estimation requires less generation than commonly assumed, enabling unreliable responses to be identified earlier.

The Taxonomies, Training, and Applications of Event Stream Modelling for Electronic Health Records

The widespread adoption of electronic health records (EHRs) enables the acquisition of heterogeneous clinical data, spanning lab tests, vital signs, medications, and procedures, which offer transformative potential for artificial intelligence in healthcare. Although traditional modelling approaches have typically relied on multivariate time series, they often struggle to accommodate the inherent sparsity and irregularity of real-world clinical workflows. Consequently, research has shifted toward event stream representation, which treats patient records as continuous sequences, thereby preserving the precise temporal structure of the patient journey. However, the existing literature remains fragmented, characterised by inconsistent definitions, disparate modelling architectures, and varying training protocols. To address these gaps, this review establishes a unified definition of EHR event streams and introduces a novel taxonomy that categorises models based on their handling of event time, type, and value. We systematically review training strategies, ranging from supervised learning to self-supervised methods, and provide a comprehensive discussion of applications across clinical scenarios. Finally, we identify open critical challenges and future directions, with the aim of clarifying the current landscape and guiding the development of next-generation healthcare models.

VQ-DSC-R: Robust Vector Quantized-Enabled Digital Semantic Communication With OFDM Transmission

Digital mapping of semantic features is essential for achieving interoperability between semantic communication and practical digital infrastructure. However, current research efforts predominantly concentrate on analog semantic communication with simplified channel models. To bridge these gaps, we develop a robust vector quantized-enabled digital semantic communication (VQ-DSC-R) system built upon orthogonal frequency division multiplexing (OFDM) transmission. Our work encompasses the framework design of VQ-DSC-R, followed by a comprehensive optimization study. Firstly, we design a Swin Transformer-based backbone for hierarchical semantic feature extraction, integrated with VQ modules that map the features into a shared semantic quantized codebook (SQC) for efficient index transmission. Secondly, we propose a differentiable vector quantization with adaptive noise-variance (ANDVQ) scheme to mitigate quantization errors in SQC, which dynamically adjusts the quantization process using K-nearest neighbor statistics, while exponential moving average mechanism stabilizes SQC training. Thirdly, for robust index transmission over multipath fading channel and noise, we develop a conditional diffusion model (CDM) to refine channel state information, and design an attention-based module to dynamically adapt to channel noise. The entire VQ-DSC-R system is optimized via a three-stage training strategy. Extensive experiments demonstrate superiority of VQ-DSC-R over benchmark schemes, achieving high compression ratios and robust performance in practical scenarios.

From Generative Engines to Actionable Simulators: The Imperative of Physical Grounding in World Models

A world model is an AI system that simulates how an environment evolves under actions, enabling planning through imagined futures rather than reactive perception. Current world models, however, suffer from visual conflation: the mistaken assumption that high-fidelity video generation implies an understanding of physical and causal dynamics. We show that while modern models excel at predicting pixels, they frequently violate invariant constraints, fail under intervention, and break down in safety-critical decision-making. This survey argues that visual realism is an unreliable proxy for world understanding. Instead, effective world models must encode causal structure, respect domain-specific constraints, and remain stable over long horizons. We propose a reframing of world models as actionable simulators rather than visual engines, emphasizing structured 4D interfaces, constraint-aware dynamics, and closed-loop evaluation. Using medical decision-making as an epistemic stress test, where trial-and-error is impossible and errors are irreversible, we demonstrate that a world model's value is determined not by how realistic its rollouts appear, but by its ability to support counterfactual reasoning, intervention planning, and robust long-horizon foresight.

SurvBench: A Standardised Preprocessing Pipeline for Multi-Modal Electronic Health Record Survival Analysis

Electronic health record (EHR) data present tremendous opportunities for advancing survival analysis through deep learning, yet reproducibility remains severely constrained by inconsistent preprocessing methodologies. We present SurvBench, a comprehensive, open-source preprocessing pipeline that transforms raw PhysioNet datasets into standardised, model-ready tensors for multi-modal survival analysis. SurvBench provides data loaders for three major critical care databases, MIMIC-IV, eICU, and MC-MED, supporting diverse modalities including time-series vitals, static demographics, ICD diagnosis codes, and radiology reports. The pipeline implements rigorous data quality controls, patient-level splitting to prevent data leakage, explicit missingness tracking, and standardised temporal aggregation. SurvBench handles both single-risk (e.g., in-hospital mortality) and competing-risks scenarios (e.g., multiple discharge outcomes). The outputs are compatible with pycox library packages and implementations of standard statistical and deep learning models. By providing reproducible, configuration-driven preprocessing with comprehensive documentation, SurvBench addresses the "preprocessing gap" that has hindered fair comparison of deep learning survival models, enabling researchers to focus on methodological innovation rather than data engineering.

Think Consistently, Reason Efficiently: Energy-Based Calibration for Implicit Chain-of-Thought

Large Language Models (LLMs) have demonstrated strong reasoning capabilities through \emph{Chain-of-Thought} (CoT) prompting, which enables step-by-step intermediate reasoning. However, explicit CoT methods rely on discrete token-level reasoning processes that are prone to error propagation and limited by vocabulary expressiveness, often resulting in rigid and inconsistent reasoning trajectories. Recent research has explored implicit or continuous reasoning in latent spaces, allowing models to perform internal reasoning before generating explicit output. Although such approaches alleviate some limitations of discrete CoT, they generally lack explicit mechanisms to enforce consistency among reasoning steps, leading to divergent reasoning paths and unstable outcomes. To address this issue, we propose EBM-CoT, an Energy-Based Chain-of-Thought Calibration framework that refines latent thought representations through an energy-based model (EBM). Our method dynamically adjusts latent reasoning trajectories toward lower-energy, high-consistency regions in the embedding space, improving both reasoning accuracy and consistency without modifying the base language model. Extensive experiments across mathematical, commonsense, and symbolic reasoning benchmarks demonstrate that the proposed framework significantly enhances the consistency and efficiency of multi-step reasoning in LLMs.

BioX-Bridge: Model Bridging for Unsupervised Cross-Modal Knowledge Transfer across Biosignals

Biosignals offer valuable insights into the physiological states of the human body. Although biosignal modalities differ in functionality, signal fidelity, sensor comfort, and cost, they are often intercorrelated, reflecting the holistic and interconnected nature of human physiology. This opens up the possibility of performing the same tasks using alternative biosignal modalities, thereby improving the accessibility, usability, and adaptability of health monitoring systems. However, the limited availability of large labeled datasets presents challenges for training models tailored to specific tasks and modalities of interest. Unsupervised cross-modal knowledge transfer offers a promising solution by leveraging knowledge from an existing modality to support model training for a new modality. Existing methods are typically based on knowledge distillation, which requires running a teacher model alongside student model training, resulting in high computational and memory overhead. This challenge is further exacerbated by the recent development of foundation models that demonstrate superior performance and generalization across tasks at the cost of large model sizes. To this end, we explore a new framework for unsupervised cross-modal knowledge transfer of biosignals by training a lightweight bridge network to align the intermediate representations and enable information flow between foundation models and across modalities. Specifically, we introduce an efficient strategy for selecting alignment positions where the bridge should be constructed, along with a flexible prototype network as the bridge architecture. Extensive experiments across multiple biosignal modalities, tasks, and datasets show that BioX-Bridge reduces the number of trainable parameters by 88--99\% while maintaining or even improving transfer performance compared to state-of-the-art methods.

Bridging Data Gaps of Rare Conditions in ICU: A Multi-Disease Adaptation Approach for Clinical Prediction

Artificial Intelligence has revolutionised critical care for common conditions. Yet, rare conditions in the intensive care unit (ICU), including recognised rare diseases and low-prevalence conditions in the ICU, remain underserved due to data scarcity and intra-condition heterogeneity. To bridge such gaps, we developed KnowRare, a domain adaptation-based deep learning framework for predicting clinical outcomes for rare conditions in the ICU. KnowRare mitigates data scarcity by initially learning condition-agnostic representations from diverse electronic health records through self-supervised pre-training. It addresses intra-condition heterogeneity by selectively adapting knowledge from clinically similar conditions with a developed condition knowledge graph. Evaluated on two ICU datasets across five clinical prediction tasks (90-day mortality, 30-day readmission, ICU mortality, remaining length of stay, and phenotyping), KnowRare consistently outperformed existing state-of-the-art models. Additionally, KnowRare demonstrated superior predictive performance compared to established ICU scoring systems, including APACHE IV and IV-a. Case studies further demonstrated KnowRare's flexibility in adapting its parameters to accommodate dataset-specific and task-specific characteristics, its generalisation to common conditions under limited data scenarios, and its rationality in selecting source conditions. These findings highlight KnowRare's potential as a robust and practical solution for supporting clinical decision-making and improving care for rare conditions in the ICU.

SurvUnc: A Meta-Model Based Uncertainty Quantification Framework for Survival Analysis

Survival analysis, which estimates the probability of event occurrence over time from censored data, is fundamental in numerous real-world applications, particularly in high-stakes domains such as healthcare and risk assessment. Despite advances in numerous survival models, quantifying the uncertainty of predictions from these models remains underexplored and challenging. The lack of reliable uncertainty quantification limits the interpretability and trustworthiness of survival models, hindering their adoption in clinical decision-making and other sensitive applications. To bridge this gap, in this work, we introduce SurvUnc, a novel meta-model based framework for post-hoc uncertainty quantification for survival models. SurvUnc introduces an anchor-based learning strategy that integrates concordance knowledge into meta-model optimization, leveraging pairwise ranking performance to estimate uncertainty effectively. Notably, our framework is model-agnostic, ensuring compatibility with any survival model without requiring modifications to its architecture or access to its internal parameters. Especially, we design a comprehensive evaluation pipeline tailored to this critical yet overlooked problem. Through extensive experiments on four publicly available benchmarking datasets and five representative survival models, we demonstrate the superiority of SurvUnc across multiple evaluation scenarios, including selective prediction, misprediction detection, and out-of-domain detection. Our results highlight the effectiveness of SurvUnc in enhancing model interpretability and reliability, paving the way for more trustworthy survival predictions in real-world applications.