Improving Pediatric Emergency Department Triage with Modality Dropout in Late Fusion Multimodal EHR Models

Emergency department triage relies heavily on both quantitative vital signs and qualitative clinical notes, yet multimodal machine learning models predicting triage acuity often suffer from modality collapse by over-relying on structured tabular data. This limitation severely hinders demographic generalizability, particularly for pediatric patients where developmental variations in vital signs make unstructured clinical narratives uniquely crucial. To address this gap, we propose a late-fusion multimodal architecture that processes tabular vitals via XGBoost and unstructured clinical text via Bio_ClinicalBERT, combined through a Logistic Regression meta-classifier to predict the 5-level Emergency Severity Index. To explicitly target the external validity problem, we train our model exclusively on adult encounters from the MIMIC-IV and NHAMCS datasets and evaluate its zero-shot generalization on a traditionally overlooked pediatric cohort. Furthermore, we employ symmetric modality dropout during training to prevent the ensemble from overfitting to adult-specific clinical correlations. Our results demonstrate that the multimodal framework significantly outperforms single-modality baselines. Most notably, applying a 30-40% symmetric modality dropout rate yielded steep performance improvements in the unseen pediatric cohort, elevating the Quadratic Weighted Kappa to 0.351. These findings highlight modality dropout as a critical regularization technique for mitigating modality collapse and enhancing cross-demographic generalization in clinical AI.

Designing probabilistic AI monsoon forecasts to inform agricultural decision-making

Hundreds of millions of farmers make high-stakes decisions under uncertainty about future weather. Forecasts can inform these decisions, but available choices and their risks and benefits vary between farmers. We introduce a decision-theory framework for designing useful forecasts in settings where the forecaster cannot prescribe optimal actions because farmers' circumstances are heterogeneous. We apply this framework to the case of seasonal onset of monsoon rains, a key date for planting decisions and agricultural investments in many tropical countries. We develop a system for tailoring forecasts to the requirements of this framework by blending systematically benchmarked artificial intelligence (AI) weather prediction models with a new "evolving farmer expectations" statistical model. This statistical model applies Bayesian inference to historical observations to predict time-varying probabilities of first-occurrence events throughout a season. The blended system yields more skillful Indian monsoon forecasts at longer lead times than its components or any multi-model average. In 2025, this system was deployed operationally in a government-led program that delivered subseasonal monsoon onset forecasts to 38 million Indian farmers, skillfully predicting that year's early-summer anomalous dry period. This decision-theory framework and blending system offer a pathway for developing climate adaptation tools for large vulnerable populations around the world.

Decision-oriented benchmarking to transform AI weather forecast access: Application to the Indian monsoon

Artificial intelligence weather prediction (AIWP) models now often outperform traditional physics-based models on common metrics while requiring orders-of-magnitude less computing resources and time. Open-access AIWP models thus hold promise as transformational tools for helping low- and middle-income populations make decisions in the face of high-impact weather shocks. Yet, current approaches to evaluating AIWP models focus mainly on aggregated meteorological metrics without considering local stakeholders' needs in decision-oriented, operational frameworks. Here, we introduce such a framework that connects meteorology, AI, and social sciences. As an example, we apply it to the 150-year-old problem of Indian monsoon forecasting, focusing on benefits to rain-fed agriculture, which is highly susceptible to climate change. AIWP models skillfully predict an agriculturally relevant onset index at regional scales weeks in advance when evaluated out-of-sample using deterministic and probabilistic metrics. This framework informed a government-led effort in 2025 to send 38 million Indian farmers AI-based monsoon onset forecasts, which captured an unusual weeks-long pause in monsoon progression. This decision-oriented benchmarking framework provides a key component of a blueprint for harnessing the power of AIWP models to help large vulnerable populations adapt to weather shocks in the face of climate variability and change.

Search over Self-Edit Strategies for LLM Adaptation

Many LLM-based open-ended search systems freeze the foundation model that proposes improvements to existing solutions, which may bottleneck long-run progress. Recent work has explored updating the proposal model at test time [arXiv:2511.23473], but the update strategy is still typically hand-specified. Therefore, this study investigated whether an LLM can use task feedback to decide how it should update its weights. For tractability, we focused on the simpler case where there is only one round of self-improvement, and restricted the update operator to self-supervised next token prediction (NTP), leaving the model freedom in choosing its training data and key NTP hyperparameters. Using the Self-Adapting Language Models (SEAL) [arXiv:2506.10943] framework as a testbed, we relaxed its fixed human template constraint and allowed the model to generate its own self-edit templates, thereby giving it more control over its training data and hyperparameters. Two variants were studied, differing in whether template generation was conditioned on a lightweight archive of past templates. In SEAL's Single-Passage Knowledge Incorporation setting with Qwen3-8B on SQuAD [arXiv:1606.05250], the no-archive variant performed comparably to the weaker "Implications" baseline, while the archive variant outperformed "Implications" and approached the strongest human-designed "Rewrite" baseline without surpassing it. Further analysis of collapse in the model's exploration revealed that a naive archive can confer some short-term robustness but can also accelerate homogenization, suggesting that explicit novelty pressure may be required to consistently advance beyond carefully optimized human strategies. Our code is available at https://github.com/cheongalc/search-self-edit-strategies .