Attention-Based Offline Reinforcement Learning and Clustering for Interpretable Sepsis Treatment

Sepsis remains one of the leading causes of mortality in intensive care units, where timely and accurate treatment decisions can significantly impact patient outcomes. In this work, we propose an interpretable decision support framework. Our system integrates four core components: (1) a clustering-based stratification module that categorizes patients into low, intermediate, and high-risk groups upon ICU admission, using clustering with statistical validation; (2) a synthetic data augmentation pipeline leveraging variational autoencoders (VAE) and diffusion models to enrich underrepresented trajectories such as fluid or vasopressor administration; (3) an offline reinforcement learning (RL) agent trained using Advantage Weighted Regression (AWR) with a lightweight attention encoder and supported by an ensemble models for conservative, safety-aware treatment recommendations; and (4) a rationale generation module powered by a multi-modal large language model (LLM), which produces natural-language justifications grounded in clinical context and retrieved expert knowledge. Evaluated on the MIMIC-III and eICU datasets, our approach achieves high treatment accuracy while providing clinicians with interpretable and robust policy recommendations.

Report for NSF Workshop on AI for Electronic Design Automation

This report distills the discussions and recommendations from the NSF Workshop on AI for Electronic Design Automation (EDA), held on December 10, 2024 in Vancouver alongside NeurIPS 2024. Bringing together experts across machine learning and EDA, the workshop examined how AI-spanning large language models (LLMs), graph neural networks (GNNs), reinforcement learning (RL), neurosymbolic methods, etc.-can facilitate EDA and shorten design turnaround. The workshop includes four themes: (1) AI for physical synthesis and design for manufacturing (DFM), discussing challenges in physical manufacturing process and potential AI applications; (2) AI for high-level and logic-level synthesis (HLS/LLS), covering pragma insertion, program transformation, RTL code generation, etc.; (3) AI toolbox for optimization and design, discussing frontier AI developments that could potentially be applied to EDA tasks; and (4) AI for test and verification, including LLM-assisted verification tools, ML-augmented SAT solving, security/reliability challenges, etc. The report recommends NSF to foster AI/EDA collaboration, invest in foundational AI for EDA, develop robust data infrastructures, promote scalable compute infrastructure, and invest in workforce development to democratize hardware design and enable next-generation hardware systems. The workshop information can be found on the website https://ai4eda-workshop.github.io/.

Balancing Fairness and High Match Rates in Reciprocal Recommender Systems: A Nash Social Welfare Approach

Matching platforms, such as online dating services and job recommendations, have become increasingly prevalent. For the success of these platforms, it is crucial to design reciprocal recommender systems (RRSs) that not only increase the total number of matches but also avoid creating unfairness among users. In this paper, we investigate the fairness of RRSs on matching platforms. From the perspective of fair division, we define the users' opportunities to be recommended and establish the fairness concept of envy-freeness in the allocation of these opportunities. We first introduce the Social Welfare (SW) method, which approximately maximizes the number of matches, and show that it leads to significant unfairness in recommendation opportunities, illustrating the trade-off between fairness and match rates. To address this challenge, we propose the Nash Social Welfare (NSW) method, which alternately optimizes two NSW functions and achieves nearly envy-free recommendations. We further generalize the SW and NSW method to the $α$-SW method, which balances the trade-off between fairness and high match rates. Additionally, we develop a computationally efficient approximation algorithm for the SW/NSW/$α$-SW methods based on the Sinkhorn algorithm. Through extensive experiments on both synthetic datasets and two real-world datasets, we demonstrate the practical effectiveness of our approach.

Who Should Have Surgery? A Comparative Study of GenAI vs Supervised ML for CRS Surgical Outcome Prediction

Artificial intelligence has reshaped medical imaging, yet the use of AI on clinical data for prospective decision support remains limited. We study pre-operative prediction of clinically meaningful improvement in chronic rhinosinusitis (CRS), defining success as a more than 8.9-point reduction in SNOT-22 at 6 months (MCID). In a prospectively collected cohort where all patients underwent surgery, we ask whether models using only pre-operative clinical data could have identified those who would have poor outcomes, i.e. those who should have avoided surgery. We benchmark supervised ML (logistic regression, tree ensembles, and an in-house MLP) against generative AI (ChatGPT, Claude, Gemini, Perplexity), giving each the same structured inputs and constraining outputs to binary recommendations with confidence. Our best ML model (MLP) achieves 85 % accuracy with superior calibration and decision-curve net benefit. GenAI models underperform on discrimination and calibration across zero-shot setting. Notably, GenAI justifications align with clinician heuristics and the MLP's feature importance, repeatedly highlighting baseline SNOT-22, CT/endoscopy severity, polyp phenotype, and physchology/pain comorbidities. We provide a reproducible tabular-to-GenAI evaluation protocol and subgroup analyses. Findings support an ML-first, GenAI- augmented workflow: deploy calibrated ML for primary triage of surgical candidacy, with GenAI as an explainer to enhance transparency and shared decision-making.

HyFormer: Revisiting the Roles of Sequence Modeling and Feature Interaction in CTR Prediction

Industrial large-scale recommendation models (LRMs) face the challenge of jointly modeling long-range user behavior sequences and heterogeneous non-sequential features under strict efficiency constraints. However, most existing architectures employ a decoupled pipeline: long sequences are first compressed with a query-token based sequence compressor like LONGER, followed by fusion with dense features through token-mixing modules like RankMixer, which thereby limits both the representation capacity and the interaction flexibility. This paper presents HyFormer, a unified hybrid transformer architecture that tightly integrates long-sequence modeling and feature interaction into a single backbone. From the perspective of sequence modeling, we revisit and redesign query tokens in LRMs, and frame the LRM modeling task as an alternating optimization process that integrates two core components: Query Decoding which expands non-sequential features into Global Tokens and performs long sequence decoding over layer-wise key-value representations of long behavioral sequences; and Query Boosting which enhances cross-query and cross-sequence heterogeneous interactions via efficient token mixing. The two complementary mechanisms are performed iteratively to refine semantic representations across layers. Extensive experiments on billion-scale industrial datasets demonstrate that HyFormer consistently outperforms strong LONGER and RankMixer baselines under comparable parameter and FLOPs budgets, while exhibiting superior scaling behavior with increasing parameters and FLOPs. Large-scale online A/B tests in high-traffic production systems further validate its effectiveness, showing significant gains over deployed state-of-the-art models. These results highlight the practicality and scalability of HyFormer as a unified modeling framework for industrial LRMs.

The Unfairness of Multifactorial Bias in Recommendation

Popularity bias and positivity bias are two prominent sources of bias in recommender systems. Both arise from input data, propagate through recommendation models, and lead to unfair or suboptimal outcomes. Popularity bias occurs when a small subset of items receives most interactions, while positivity bias stems from the over-representation of high rating values. Although each bias has been studied independently, their combined effect, to which we refer to as multifactorial bias, remains underexplored. In this work, we examine how multifactorial bias influences item-side fairness, focusing on exposure bias, which reflects the unequal visibility of items in recommendation outputs. Through simulation studies, we find that positivity bias is disproportionately concentrated on popular items, further amplifying their over-exposure. Motivated by this insight, we adapt a percentile-based rating transformation as a pre-processing strategy to mitigate multifactorial bias. Experiments using six recommendation algorithms across four public datasets show that this approach improves exposure fairness with negligible accuracy loss. We also demonstrate that integrating this pre-processing step into post-processing fairness pipelines enhances their effectiveness and efficiency, enabling comparable or better fairness with reduced computational cost. These findings highlight the importance of addressing multifactorial bias and demonstrate the practical value of simple, data-driven pre-processing methods for improving fairness in recommender systems.

Semantic Communication in Underwater IoT Networks for Meaning-Driven Connectivity

The Internet of Underwater Things (IoUT) is revolutionizing marine sensing and environmental monitoring, as well as subaquatic exploration, which are enabled by interconnected and intelligent subsystems. Nevertheless, underwater communication is constrained by narrow bandwidth, high latency, and strict energy constraints, which are the source of efficiency problems in traditional data-centric networks. To tackle these problematic issues, this work provides a survey of recent advances in Semantic Communication (SC) for IoUT, a novel communication paradigm that seeks to harness not raw symbol information but rather its meaning and/or contextual significance. In this paper, we investigate the emerging advanced AI-powered frameworks, including large language models (LLMs), diffusion-based generative encoders, and federated learning (FL), that bridge semantic compression with context-aware prioritization and robust information reconstruction over noisy underwater channels. Hybrid acoustic-optical-RF architectures and edge-intelligent semantic encoders are also considered enablers of sustainable, adaptive operations. Examples in underwater archaeology, marine ecology, and autonomous underwater vehicles (AUVs) coordination are provided as a relief to illustrate the merits of meaning-driven connectivity. The paper concludes with some recommendations, including semantic representations standardization, cross-domain interpolation, and privacy-support schemes. These issues must be addressed in the future before trustworthy SC-enabled IoUT systems can be developed for underwater communication.

Actionable Advice from Reviews via Mixture of LoRA Experts: A Two-LLM Pipeline for Issue Extraction and Business Recommendations

Customer reviews contain detailed, domain specific signals about service failures and user expectations, but converting this unstructured feedback into actionable business decisions remains difficult. We study review-to-action generation: producing concrete, implementable recommendations grounded in review text. We propose a modular two-LLM framework in which an Issue model extracts salient issues and assigns coarse themes, and an Advice model generates targeted operational fixes conditioned on the extracted issue representation. To enable specialization without expensive full fine-tuning, we adapt the Advice model using a mixture of LoRA experts strategy: multiple low-rank adapters are trained and a lightweight gating mechanism performs token-level expert mixing at inference, combining complementary expertise across issue types. We construct synthetic review-issue-advice triples from Yelp reviews (airlines and restaurants) to supervise training, and evaluate recommendations using an eight dimension operational rubric spanning actionability, specificity, feasibility, expected impact, novelty, non-redundancy, bias, and clarity. Across both domains, our approach consistently outperforms prompting-only and single-adapter baselines, yielding higher actionability and specificity while retaining favorable efficiency-quality trade-offs.

Multimodal Generative Engine Optimization: Rank Manipulation for Vision-Language Model Rankers

Vision-Language Models (VLMs) are rapidly replacing unimodal encoders in modern retrieval and recommendation systems. While their capabilities are well-documented, their robustness against adversarial manipulation in competitive ranking scenarios remains largely unexplored. In this paper, we uncover a critical vulnerability in VLM-based product search: multimodal ranking attacks. We present Multimodal Generative Engine Optimization (MGEO), a novel adversarial framework that enables a malicious actor to unfairly promote a target product by jointly optimizing imperceptible image perturbations and fluent textual suffixes. Unlike existing attacks that treat modalities in isolation, MGEO employs an alternating gradient-based optimization strategy to exploit the deep cross-modal coupling within the VLM. Extensive experiments on real-world datasets using state-of-the-art models demonstrate that our coordinated attack significantly outperforms text-only and image-only baselines. These findings reveal that multimodal synergy, typically a strength of VLMs, can be weaponized to compromise the integrity of search rankings without triggering conventional content filters.

LIBRA: Language Model Informed Bandit Recourse Algorithm for Personalized Treatment Planning

We introduce a unified framework that seamlessly integrates algorithmic recourse, contextual bandits, and large language models (LLMs) to support sequential decision-making in high-stakes settings such as personalized medicine. We first introduce the recourse bandit problem, where a decision-maker must select both a treatment action and a feasible, minimal modification to mutable patient features. To address this problem, we develop the Generalized Linear Recourse Bandit (GLRB) algorithm. Building on this foundation, we propose LIBRA, a Language Model-Informed Bandit Recourse Algorithm that strategically combines domain knowledge from LLMs with the statistical rigor of bandit learning. LIBRA offers three key guarantees: (i) a warm-start guarantee, showing that LIBRA significantly reduces initial regret when LLM recommendations are near-optimal; (ii) an LLM-effort guarantee, proving that the algorithm consults the LLM only $O(\log^2 T)$ times, where $T$ is the time horizon, ensuring long-term autonomy; and (iii) a robustness guarantee, showing that LIBRA never performs worse than a pure bandit algorithm even when the LLM is unreliable. We further establish matching lower bounds that characterize the fundamental difficulty of the recourse bandit problem and demonstrate the near-optimality of our algorithms. Experiments on synthetic environments and a real hypertension-management case study confirm that GLRB and LIBRA improve regret, treatment quality, and sample efficiency compared with standard contextual bandits and LLM-only benchmarks. Our results highlight the promise of recourse-aware, LLM-assisted bandit algorithms for trustworthy LLM-bandits collaboration in personalized high-stakes decision-making.