Detecting HIV-Related Stigma in Clinical Narratives Using Large Language Models

Human immunodeficiency virus (HIV)-related stigma is a critical psychosocial determinant of health for people living with HIV (PLWH), influencing mental health, engagement in care, and treatment outcomes. Although stigma-related experiences are documented in clinical narratives, there is a lack of off-the-shelf tools to extract and categorize them. This study aims to develop a large language model (LLM)-based tool for identifying HIV stigma from clinical notes. We identified clinical notes from PLWH receiving care at the University of Florida (UF) Health between 2012 and 2022. Candidate sentences were identified using expert-curated stigma-related keywords and iteratively expanded via clinical word embeddings. A total of 1,332 sentences were manually annotated across four stigma subscales: Concern with Public Attitudes, Disclosure Concerns, Negative Self-Image, and Personalized Stigma. We compared GatorTron-large and BERT as encoder-based baselines, and GPT-OSS-20B, LLaMA-8B, and MedGemma-27B as generative LLMs, under zero-shot and few-shot prompting. GatorTron-large achieved the best overall performance (Micro F1 = 0.62). Few-shot prompting substantially improved generative model performance, with 5-shot GPT-OSS-20B and LLaMA-8B achieving Micro-F1 scores of 0.57 and 0.59, respectively. Performance varied by stigma subscale, with Negative Self-Image showing the highest predictability and Personalized Stigma remaining the most challenging. Zero-shot generative inference exhibited non-trivial failure rates (up to 32%). This study develops the first practical NLP tool for identifying HIV stigma in clinical notes.

A Parameter-Efficient Transfer Learning Approach through Multitask Prompt Distillation and Decomposition for Clinical NLP

Existing prompt-based fine-tuning methods typically learn task-specific prompts independently, imposing significant computing and storage overhead at scale when deploying multiple clinical natural language processing (NLP) systems. We present a multitask prompt distillation and decomposition framework that learns a single shared metaprompt from 21 diverse clinical source tasks and adapts it to unseen target tasks with fewer than 0.05% trainable parameters. Evaluated across five clinical NLP task types (named entity recognition, relation extraction, question answering, natural language inference, and summarization) on 10 held-out target datasets using three backbone models (LLaMA 3.1 8B, Meditron3 8B, gpt-oss 20B), our framework consistently outperforms LoRA by 1.5~1.7% despite using orders of magnitude fewer parameters, and exceeds single-task prompt tuning by 6.1~6.6%. The gpt-oss 20B model achieves the highest overall performance, particularly on clinical reasoning tasks. The strong zero- and few-shot performance demonstrates better transferability of the shared prompt representation.

Improving Clinical Trial Recruitment using Clinical Narratives and Large Language Models

Screening patients for enrollment is a well-known, labor-intensive bottleneck that leads to under-enrollment and, ultimately, trial failures. Recent breakthroughs in large language models (LLMs) offer a promising opportunity to use artificial intelligence to improve screening. This study systematically explored both encoder- and decoder-based generative LLMs for screening clinical narratives to facilitate clinical trial recruitment. We examined both general-purpose LLMs and medical-adapted LLMs and explored three strategies to alleviate the "Lost in the Middle" issue when handling long documents, including 1) Original long-context: using the default context windows of LLMs, 2) NER-based extractive summarization: converting the long document into summarizations using named entity recognition, 3) RAG: dynamic evidence retrieval based on eligibility criteria. The 2018 N2C2 Track 1 benchmark dataset is used for evaluation. Our experimental results show that the MedGemma model with the RAG strategy achieved the best micro-F1 score of 89.05%, outperforming other models. Generative LLMs have remarkably improved trial criteria that require long-term reasoning across long documents, whereas trial criteria that span a short piece of context (e.g., lab tests) show incremental improvements. The real-world adoption of LLMs for trial recruitment must consider specific criteria for selecting among rule-based queries, encoder-based LLMs, and generative LLMs to maximize efficiency within reasonable computing costs.

Countering Catastrophic Forgetting of Large Language Models for Better Instruction Following via Weight-Space Model Merging

Large language models have been adopted in the medical domain for clinical documentation to reduce clinician burden. However, studies have reported that LLMs often "forget" a significant amount of instruction-following ability when fine-tuned using a task-specific medical dataset, a critical challenge in adopting general-purpose LLMs for clinical applications. This study presents a model merging framework to efficiently adapt general-purpose LLMs to the medical domain by countering this forgetting issue. By merging a clinical foundation model (GatorTronLlama) with a general instruct model (Llama-3.1-8B-Instruct) via interpolation-based merge methods, we seek to derive a domain-adapted model with strong performance on clinical tasks while retaining instruction-following ability. Comprehensive evaluation across medical benchmarks and five clinical generation tasks (e.g., radiology and discharge summarization) shows that merged models can effectively mitigate catastrophic forgetting, preserve clinical domain expertise, and retain instruction-following ability. In addition, our model merging strategies demonstrate training efficiency, achieving performance on par with fully fine-tuned baselines under severely constrained supervision (e.g., 64-shot vs. 256-shot). Consequently, weight-space merging constitutes a highly scalable solution for adapting open-source LLMs to clinical applications, facilitating broader deployment in resource-constrained healthcare environments.

G-STAR: End-to-End Global Speaker-Tracking Attributed Recognition

We study timestamped speaker-attributed ASR for long-form, multi-party speech with overlap, where chunk-wise inference must preserve meeting-level speaker identity consistency while producing time-stamped, speaker-labeled transcripts. Previous Speech-LLM systems tend to prioritize either local diarization or global labeling, but often lack the ability to capture fine-grained temporal boundaries or robust cross-chunk identity linking. We propose G-STAR, an end-to-end system that couples a time-aware speaker-tracking module with a Speech-LLM transcription backbone. The tracker provides structured speaker cues with temporal grounding, and the LLM generates attributed text conditioned on these cues. G-STAR supports both component-wise optimization and joint end-to-end training, enabling flexible learning under heterogeneous supervision and domain shift. Experiments analyze cue fusion, local versus long-context trade-offs and hierarchical objectives.

MedGPT-oss: Training a General-Purpose Vision-Language Model for Biomedicine

Biomedical multimodal assistants have the potential to unify radiology, pathology, and clinical-text reasoning, yet a critical deployment gap remains: top-performing systems are either closed-source or computationally prohibitive, precluding the on-premises deployment required for patient privacy and PHI compliance. We introduce MEDGPT-OSS, an open-weight, 20B-parameter generalist vision-language model designed to facilitate open research in clinical AI. Rather than relying on architectural complexity, MEDGPT-OSS pairs the GPT-oss language backbone with a visual front-end via a optimized, three-stage training curriculum. By progressively domain-adapting these modules through rigorous data curation and long-context multimodal alignment, we demonstrate that a 20B model can bridge the capacity gap. It successfully outperforms larger open medical models on out-of-distribution (OOD) multimodal reasoning and complex text-only clinical tasks. By unifying diverse modalities under a single instruction-following interface, MEDGPT-OSS maintains a parameter-efficient footprint fully compatible with commodity GPUs. We release the complete training recipe, open-weight checkpoints, and a rigorous evaluation harness to serve as a verifiable foundation for privacy-preserving, institution-specific clinical AI research.

UniVBench: Towards Unified Evaluation for Video Foundation Models

Video foundation models aim to integrate video understanding, generation, editing, and instruction following within a single framework, making them a central direction for next-generation multimodal systems. However, existing evaluation benchmarks remain fragmented and limited in scope, as they each target a single task, rely on task-specific metrics, and typically use short or simple video clips. As a result, they do not capture the unified capabilities that these models are designed to deliver. To address this gap, we introduce UniVBench, a benchmark purpose-built for evaluating video foundation models across four core abilities: video understanding, video generation, video editing, and a newly proposed task, video reconstruction, which assesses how faithfully a model can reproduce video content it has encountered. Our benchmark substantially expands the complexity of evaluation by incorporating 200 high-quality, diverse and multi-shot videos, each paired with detailed captions, multi-format editing instructions, and reference images. All videos are human-created and carefully validated, offering richer cinematic information than prior benchmarks. In addition, we develop a unified agentic evaluation system (UniV-Eval) that standardizes prompting, instruction parsing, and scoring across all tasks, enabling fair, scalable, and reproducible comparisons of unified video models. By grounding evaluation in instruction-based multi-shot video tasks, UniVBench provides the first framework for measuring the integrated capabilities that video foundation models aim to achieve. Extensive human annotations ensure our evaluation aligns with human judgment, enabling rigorous assessment and accelerating progress toward robust video intelligence.

Provably Efficient Algorithms for S- and Non-Rectangular Robust MDPs with General Parameterization

We study robust Markov decision processes (RMDPs) with general policy parameterization under s-rectangular and non-rectangular uncertainty sets. Prior work is largely limited to tabular policies, and hence either lacks sample complexity guarantees or incurs high computational cost. Our method reduces the average reward RMDPs to entropy-regularized discounted robust MDPs, restoring strong duality and enabling tractable equilibrium computation. We prove novel Lipschitz and Lipschitz-smoothness properties for general policy parameterizations that extends to infinite state spaces. To address infinite-horizon gradient estimation, we introduce a multilevel Monte Carlo gradient estimator with $\tilde{\mathcal{O}}(ε^{-2})$ sample complexity, a factor of $\mathcal{O}(ε^{-2})$ improvement over prior work. Building on this, we design a projected gradient descent algorithm for s-rectangular uncertainty ($\mathcal{O}(ε^{-5})$) and a Frank--Wolfe algorithm for non-rectangular uncertainty ($\mathcal{O}(ε^{-4})$ discounted, $\mathcal{O}(ε^{-10.5})$ average reward), significantly improving prior results in both the discounted setting and average reward setting. Our work is the first one to provide sample complexity guarantees for RMDPs with general policy parameterization beyond $(s, a)$-rectangularity. It also provides the first such guarantees in the average reward setting and improves existing bounds for discounted robust MDPs.

AdaFuse: Adaptive Ensemble Decoding with Test-Time Scaling for LLMs

Large language models (LLMs) exhibit complementary strengths arising from differences in pretraining data, model architectures, and decoding behaviors. Inference-time ensembling provides a practical way to combine these capabilities without retraining. However, existing ensemble approaches suffer from fundamental limitations. Most rely on fixed fusion granularity, which lacks the flexibility required for mid-generation adaptation and fails to adapt to different generation characteristics across tasks. To address these challenges, we propose AdaFuse, an adaptive ensemble decoding framework that dynamically selects semantically appropriate fusion units during generation. Rather than committing to a fixed granularity, AdaFuse adjusts fusion behavior on the fly based on the decoding context, with words serving as basic building blocks for alignment. To be specific, we introduce an uncertainty-based criterion to decide whether to apply ensembling at each decoding step. Under confident decoding states, the model continues generation directly. In less certain states, AdaFuse invokes a diversity-aware scaling strategy to explore alternative candidate continuations and inform ensemble decisions. This design establishes a synergistic interaction between adaptive ensembling and test-time scaling, where ensemble decisions guide targeted exploration, and the resulting diversity in turn strengthens ensemble quality. Experiments on open-domain question answering, arithmetic reasoning, and machine translation demonstrate that AdaFuse consistently outperforms strong ensemble baselines, achieving an average relative improvement of 6.88%. The code is available at https://github.com/CCM0111/AdaFuse.

Learnable Query Aggregation with KV Routing for Cross-view Geo-localisation

Cross-view geo-localisation (CVGL) aims to estimate the geographic location of a query image by matching it with images from a large-scale database. However, the significant view-point discrepancies present considerable challenges for effective feature aggregation and alignment. To address these challenges, we propose a novel CVGL system that incorporates three key improvements. Firstly, we leverage the DINOv2 backbone with a convolution adapter fine-tuning to enhance model adaptability to cross-view variations. Secondly, we propose a multi-scale channel reallocation module to strengthen the diversity and stability of spatial representations. Finally, we propose an improved aggregation module that integrates a Mixture-of-Experts (MoE) routing into the feature aggregation process. Specifically, the module dynamically selects expert subspaces for the keys and values in a cross-attention framework, enabling adaptive processing of heterogeneous input domains. Extensive experiments on the University-1652 and SUES-200 datasets demonstrate that our method achieves competitive performance with fewer trained parameters.