Daily Papers

As the global burden of Alzheimer's disease (AD) continues to grow, early and accurate detection has become increasingly critical, especially in regions with limited access to advanced diagnostic tools. We propose BRAINS (Biomedical Retrieval-Augmented Intelligence for Neurodegeneration Screening) to address this challenge. This novel system harnesses the powerful reasoning capabilities of Large Language Models (LLMs) for Alzheimer's detection and monitoring. BRAINS features a dual-module architecture: a cognitive diagnostic module and a case-retrieval module. The Diagnostic Module utilizes LLMs fine-tuned on cognitive and neuroimaging datasets -- including MMSE, CDR scores, and brain volume metrics -- to perform structured assessments of Alzheimer's risk. Meanwhile, the Case Retrieval Module encodes patient profiles into latent representations and retrieves similar cases from a curated knowledge base. These auxiliary cases are fused with the input profile via a Case Fusion Layer to enhance contextual understanding. The combined representation is then processed with clinical prompts for inference. Evaluations on real-world datasets demonstrate BRAINS effectiveness in classifying disease severity and identifying early signs of cognitive decline. This system not only shows strong potential as an assistive tool for scalable, explainable, and early-stage Alzheimer's disease detection, but also offers hope for future applications in the field.

We present the findings of "The Alzheimer's Disease Prediction Of Longitudinal Evolution" (TADPOLE) Challenge, which compared the performance of 92 algorithms from 33 international teams at predicting the future trajectory of 219 individuals at risk of Alzheimer's disease. Challenge participants were required to make a prediction, for each month of a 5-year future time period, of three key outcomes: clinical diagnosis, Alzheimer's Disease Assessment Scale Cognitive Subdomain (ADAS-Cog13), and total volume of the ventricles. The methods used by challenge participants included multivariate linear regression, machine learning methods such as support vector machines and deep neural networks, as well as disease progression models. No single submission was best at predicting all three outcomes. For clinical diagnosis and ventricle volume prediction, the best algorithms strongly outperform simple baselines in predictive ability. However, for ADAS-Cog13 no single submitted prediction method was significantly better than random guesswork. Two ensemble methods based on taking the mean and median over all predictions, obtained top scores on almost all tasks. Better than average performance at diagnosis prediction was generally associated with the additional inclusion of features from cerebrospinal fluid (CSF) samples and diffusion tensor imaging (DTI). On the other hand, better performance at ventricle volume prediction was associated with inclusion of summary statistics, such as the slope or maxima/minima of biomarkers. TADPOLE's unique results suggest that current prediction algorithms provide sufficient accuracy to exploit biomarkers related to clinical diagnosis and ventricle volume, for cohort refinement in clinical trials for Alzheimer's disease. However, results call into question the usage of cognitive test scores for patient selection and as a primary endpoint in clinical trials.

Purpose: Hard-to-interpret Black-box Machine Learning (ML) were often used for early Alzheimer's Disease (AD) detection. Methods: To interpret eXtreme Gradient Boosting (XGBoost), Random Forest (RF), and Support Vector Machine (SVM) black-box models a workflow based on Shapley values was developed. All models were trained on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset and evaluated for an independent ADNI test set, as well as the external Australian Imaging and Lifestyle flagship study of Ageing (AIBL), and Open Access Series of Imaging Studies (OASIS) datasets. Shapley values were compared to intuitively interpretable Decision Trees (DTs), and Logistic Regression (LR), as well as natural and permutation feature importances. To avoid the reduction of the explanation validity caused by correlated features, forward selection and aspect consolidation were implemented. Results: Some black-box models outperformed DTs and LR. The forward-selected features correspond to brain areas previously associated with AD. Shapley values identified biologically plausible associations with moderate to strong correlations with feature importances. The most important RF features to predict AD conversion were the volume of the amygdalae, and a cognitive test score. Good cognitive test performances and large brain volumes decreased the AD risk. The models trained using cognitive test scores significantly outperformed brain volumetric models (p<0.05). Cognitive Normal (CN) vs. AD models were successfully transferred to external datasets. Conclusion: In comparison to previous work, improved performances for ADNI and AIBL were achieved for CN vs. Mild Cognitive Impairment (MCI) classification using brain volumes. The Shapley values and the feature importances showed moderate to strong correlations.

Objective: We develop a deep learning framework based on the pre-trained Bidirectional Encoder Representations from Transformers (BERT) model using unstructured clinical notes from electronic health records (EHRs) to predict the risk of disease progression from Mild Cognitive Impairment (MCI) to Alzheimer's Disease (AD). Materials and Methods: We identified 3657 patients diagnosed with MCI together with their progress notes from Northwestern Medicine Enterprise Data Warehouse (NMEDW) between 2000-2020. The progress notes no later than the first MCI diagnosis were used for the prediction. We first preprocessed the notes by deidentification, cleaning and splitting, and then pretrained a BERT model for AD (AD-BERT) based on the publicly available Bio+Clinical BERT on the preprocessed notes. The embeddings of all the sections of a patient's notes processed by AD-BERT were combined by MaxPooling to compute the probability of MCI-to-AD progression. For replication, we conducted a similar set of experiments on 2563 MCI patients identified at Weill Cornell Medicine (WCM) during the same timeframe. Results: Compared with the 7 baseline models, the AD-BERT model achieved the best performance on both datasets, with Area Under receiver operating characteristic Curve (AUC) of 0.8170 and F1 score of 0.4178 on NMEDW dataset and AUC of 0.8830 and F1 score of 0.6836 on WCM dataset. Conclusion: We developed a deep learning framework using BERT models which provide an effective solution for prediction of MCI-to-AD progression using clinical note analysis.

The drug development pipeline for a new compound can last 10-20 years and cost over 10 billion. Drug repurposing offers a more time- and cost-effective alternative. Computational approaches based on biomedical knowledge graph representations have recently yielded new drug repurposing hypotheses. In this study, we present a novel, disease-specific hypergraph representation learning technique to derive contextual embeddings of biological pathways of various lengths but that all start at any given drug and all end at the disease of interest. Further, we extend this method to multi-disease hypergraphs. To determine the repurposing potential of each of the 1,522 drugs, we derive drug-specific distributions of cosine similarity values and ultimately consider the median for ranking. Cosine similarity values are computed between (1) all biological pathways starting at the considered drug and ending at the disease of interest and (2) all biological pathways starting at drugs currently prescribed against that disease and ending at the disease of interest. We illustrate our approach with Alzheimer's disease (AD) and two of its risk factors: hypertension (HTN) and type 2 diabetes (T2D). We compare each drug's rank across four hypergraph settings (single- or multi-disease): AD only, AD + HTN, AD + T2D, and AD + HTN + T2D. Notably, our framework led to the identification of two promising drugs whose repurposing potential was significantly higher in hypergraphs combining two diseases: dapagliflozin (antidiabetic; moved up, from top 32% to top 7%, across all considered drugs) and debrisoquine (antihypertensive; moved up, from top 76% to top 23%). Our approach serves as a hypothesis generation tool, to be paired with a validation pipeline relying on laboratory experiments and semi-automated parsing of the biomedical literature.

Alzheimer's Disease (AD) is a progressive neurodegenerative disorder that primarily affects the aging population by impairing cognitive and motor functions. Early detection of AD through accessible methodologies like magnetic resonance imaging (MRI) is vital for developing effective interventions to halt or slow the disease's progression. This study aims to perform a comprehensive analysis of machine learning techniques for selecting MRI-based biomarkers and classifying individuals into healthy controls (HC) and unstable controls (uHC) who later show mild cognitive impairment within five years. The research utilizes MRI data from the Alzheimer's Disease Neuroinformatics Initiative (ADNI) and the Open Access Series of Imaging Studies 3 (OASIS-3), focusing on both HC and uHC participants. The study addresses the challenges of imbalanced data by testing classification methods on balanced and unbalanced datasets, and harmonizes data using polynomial regression to mitigate nuisance variables like age, gender, and intracranial volume. Results indicate that Gaussian Naive Bayes and RusBoost classifiers shows an optimal performance, achieving accuracies of up to 76.46% and 72.48% respectively on the ADNI dataset. For the OASIS-3 dataset, Kernel Naive Bayes and RusBoost yield accuracies ranging from 64.66% to 75.71%, improving further in age-matched datasets. Brain regions like the entorhinal cortex, hippocampus, lateral ventricle, and lateral orbitofrontal cortex are identified as significantly impacted during early cognitive decline. Despite limitations such as small sample sizes, the study's harmonization approach enhances the robustness of biomarker selection, suggesting the potential of this semi-automatic machine learning pipeline for early AD detection using MRI.

Research related to automatically detecting Alzheimer's disease (AD) is important, given the high prevalence of AD and the high cost of traditional methods. Since AD significantly affects the content and acoustics of spontaneous speech, natural language processing and machine learning provide promising techniques for reliably detecting AD. We compare and contrast the performance of two such approaches for AD detection on the recent ADReSS challenge dataset: 1) using domain knowledge-based hand-crafted features that capture linguistic and acoustic phenomena, and 2) fine-tuning Bidirectional Encoder Representations from Transformer (BERT)-based sequence classification models. We also compare multiple feature-based regression models for a neuropsychological score task in the challenge. We observe that fine-tuned BERT models, given the relative importance of linguistics in cognitive impairment detection, outperform feature-based approaches on the AD detection task.

Alzheimer's disease (AD) is a degenerative brain disease impairing a person's ability to perform day to day activities. The clinical manifestations of Alzheimer's disease are characterized by heterogeneity in age, disease span, progression rate, impairment of memory and cognitive abilities. Due to these variabilities, personalized care and treatment planning, as well as patient counseling about their individual progression is limited. Recent developments in machine learning to detect hidden patterns in complex, multi-dimensional datasets provides significant opportunities to address this critical need. In this work, we use unsupervised and supervised machine learning approaches for subtype identification and prediction. We apply machine learning methods to the extensive clinical observations available at the Alzheimer's Disease Neuroimaging Initiative (ADNI) data set to identify patient subtypes and to predict disease progression. Our analysis depicts the progression space for the Alzheimer's disease into low, moderate and high disease progression zones. The proposed work will enable early detection and characterization of distinct disease subtypes based on clinical heterogeneity. We anticipate that our models will enable patient counseling, clinical trial design, and ultimately individualized clinical care.

Alzheimer's disease (AD) is a chronic neurodegenerative disorder and the leading cause of dementia, significantly impacting cost, mortality, and burden worldwide. The advent of high-throughput omics technologies, such as genomics, transcriptomics, proteomics, and epigenomics, has revolutionized the molecular understanding of AD. Conventional AI approaches typically require the completion of all omics data at the outset to achieve optimal AD diagnosis, which are inefficient and may be unnecessary. To reduce the clinical cost and improve the accuracy of AD diagnosis using multi-omics data, we propose a novel staged graph convolutional network with uncertainty quantification (SGUQ). SGUQ begins with mRNA and progressively incorporates DNA methylation and miRNA data only when necessary, reducing overall costs and exposure to harmful tests. Experimental results indicate that 46.23% of the samples can be reliably predicted using only single-modal omics data (mRNA), while an additional 16.04% of the samples can achieve reliable predictions when combining two omics data types (mRNA + DNA methylation). In addition, the proposed staged SGUQ achieved an accuracy of 0.858 on ROSMAP dataset, which outperformed existing methods significantly. The proposed SGUQ can not only be applied to AD diagnosis using multi-omics data but also has the potential for clinical decision-making using multi-viewed data. Our implementation is publicly available at https://github.com/chenzhao2023/multiomicsuncertainty.

Understanding robustness and sensitivity of BERT models predicting Alzheimer's disease from text is important for both developing better classification models and for understanding their capabilities and limitations. In this paper, we analyze how a controlled amount of desired and undesired text alterations impacts performance of BERT. We show that BERT is robust to natural linguistic variations in text. On the other hand, we show that BERT is not sensitive to removing clinically important information from text.

Alzheimer's disease (AD) is a common neurodegenerative disease among the elderly. Early prediction and timely intervention of its prodromal stage, mild cognitive impairment (MCI), can decrease the risk of advancing to AD. Combining information from various modalities can significantly improve predictive accuracy. However, challenges such as missing data and heterogeneity across modalities complicate multimodal learning methods as adding more modalities can worsen these issues. Current multimodal fusion techniques often fail to adapt to the complexity of medical data, hindering the ability to identify relationships between modalities. To address these challenges, we propose an innovative multimodal approach for predicting MCI conversion, focusing specifically on the issues of missing positron emission tomography (PET) data and integrating diverse medical information. The proposed incomplete triple-modal MCI conversion prediction network is tailored for this purpose. Through the missing modal generation module, we synthesize the missing PET data from the magnetic resonance imaging and extract features using specifically designed encoders. We also develop a channel aggregation module and a triple-modal co-attention fusion module to reduce feature redundancy and achieve effective multimodal data fusion. Furthermore, we design a loss function to handle missing modality issues and align cross-modal features. These components collectively harness multimodal data to boost network performance. Experimental results on the ADNI1 and ADNI2 datasets show that our method significantly surpasses existing unimodal and other multimodal models. Our code is available at https://github.com/justinhxy/ITFC.

Disease risk prediction has attracted increasing attention in the field of modern healthcare, especially with the latest advances in artificial intelligence (AI). Electronic health records (EHRs), which contain heterogeneous patient information, are widely used in disease risk prediction tasks. One challenge of applying AI models for risk prediction lies in generating interpretable evidence to support the prediction results while retaining the prediction ability. In order to address this problem, we propose the method of jointly embedding words and labels whereby attention modules learn the weights of words from medical notes according to their relevance to the names of risk prediction labels. This approach boosts interpretability by employing an attention mechanism and including the names of prediction tasks in the model. However, its application is only limited to the handling of textual inputs such as medical notes. In this paper, we propose a label dependent attention model LDAM to 1) improve the interpretability by exploiting Clinical-BERT (a biomedical language model pre-trained on a large clinical corpus) to encode biomedically meaningful features and labels jointly; 2) extend the idea of joint embedding to the processing of time-series data, and develop a multi-modal learning framework for integrating heterogeneous information from medical notes and time-series health status indicators. To demonstrate our method, we apply LDAM to the MIMIC-III dataset to predict different disease risks. We evaluate our method both quantitatively and qualitatively. Specifically, the predictive power of LDAM will be shown, and case studies will be carried out to illustrate its interpretability.

Alzheimer's Disease (AD) is the most common form of dementia and often difficult to diagnose due to the multifactorial etiology of dementia. Recent works on neuroimaging-based computer-aided diagnosis with deep neural networks (DNNs) showed that fusing structural magnetic resonance images (sMRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) leads to improved accuracy in a study population of healthy controls and subjects with AD. However, this result conflicts with the established clinical knowledge that FDG-PET better captures AD-specific pathologies than sMRI. Therefore, we propose a framework for the systematic evaluation of multi-modal DNNs and critically re-evaluate single- and multi-modal DNNs based on FDG-PET and sMRI for binary healthy vs. AD, and three-way healthy/mild cognitive impairment/AD classification. Our experiments demonstrate that a single-modality network using FDG-PET performs better than MRI (accuracy 0.91 vs 0.87) and does not show improvement when combined. This conforms with the established clinical knowledge on AD biomarkers, but raises questions about the true benefit of multi-modal DNNs. We argue that future work on multi-modal fusion should systematically assess the contribution of individual modalities following our proposed evaluation framework. Finally, we encourage the community to go beyond healthy vs. AD classification and focus on differential diagnosis of dementia, where fusing multi-modal image information conforms with a clinical need.

With the increasing availability of wearable devices, photoplethysmography (PPG) has emerged as a promising non-invasive tool for monitoring human hemodynamics. We propose a deep learning framework to estimate vascular age (AI-vascular age) from PPG signals, incorporating a distribution-aware loss to address biases caused by imbalanced data. The model was developed using data from the UK Biobank (UKB), with 98,672 participants in the development cohort and 113,559 participants (144,683 data pairs) for clinical evaluation. After adjusting for key confounders, individuals with a vascular age gap (AI-vascular age minus calendar age) exceeding 9 years had a significantly higher risk of major adverse cardiovascular and cerebrovascular events (MACCE) (HR = 2.37, p < 0.005) and secondary outcomes, including diabetes (HR = 2.69, p < 0.005), hypertension (HR = 2.88, p < 0.005), coronary heart disease (HR = 2.20, p < 0.005), heart failure (HR = 2.15, p < 0.005), myocardial infarction (HR = 2.51, p < 0.005), stroke (HR = 2.55, p < 0.005), and all-cause mortality (HR = 2.51, p < 0.005). Conversely, participants with a vascular age gap below -9 years exhibited a significantly lower incidence of these outcomes. We further evaluated the longitudinal applicability of AI-vascular age using serial PPG data from the UKB, demonstrating its value in risk stratification by leveraging AI-vascular age at two distinct time points to predict future MACCE incidence. External validation was performed on a MIMIC-III-derived cohort (n = 2,343), where each one-year increase in vascular age gap was significantly associated with elevated in-hospital mortality risk (OR = 1.02, p < 0.005). In conclusion, our study establishes AI-vascular age as a novel, non-invasive digital biomarker for cardiovascular health assessment.

Deep Learning (DL) in neuroimaging has become increasingly relevant for detecting neurological conditions and neurodegenerative disorders. One of the most predominant biomarkers in neuroimaging is represented by brain age, which has been shown to be a good indicator for different conditions, such as Alzheimer's Disease. Using brain age for weakly supervised pre-training of DL models in transfer learning settings has also recently shown promising results, especially when dealing with data scarcity of different conditions. On the other hand, anatomical information of brain MRIs (e.g. cortical thickness) can provide important information for learning good representations that can be transferred to many downstream tasks. In this work, we propose AnatCL, an anatomical foundation model for brain MRIs that i.) leverages anatomical information in a weakly contrastive learning approach, and ii.) achieves state-of-the-art performances across many different downstream tasks. To validate our approach we consider 12 different downstream tasks for the diagnosis of different conditions such as Alzheimer's Disease, autism spectrum disorder, and schizophrenia. Furthermore, we also target the prediction of 10 different clinical assessment scores using structural MRI data. Our findings show that incorporating anatomical information during pre-training leads to more robust and generalizable representations. Pre-trained models can be found at: https://github.com/EIDOSLAB/AnatCL.

Alongside neuroimaging such as MRI scans and PET, Alzheimer's disease (AD) datasets contain valuable tabular data including AD biomarkers and clinical assessments. Existing computer vision approaches struggle to utilize this additional information. To address these needs, we propose a generalizable framework for multimodal contrastive learning of image data and tabular data, a novel tabular attention module for amplifying and ranking salient features in tables, and the application of these techniques onto Alzheimer's disease prediction. Experimental evaulations demonstrate the strength of our framework by detecting Alzheimer's disease (AD) from over 882 MR image slices from the ADNI database. We take advantage of the high interpretability of tabular data and our novel tabular attention approach and through attribution of the attention scores for each row of the table, we note and rank the most predominant features. Results show that the model is capable of an accuracy of over 83.8%, almost a 10% increase from previous state of the art.

Recent studies have shown promising results in the detection of Mild Cognitive Impairment (MCI) using easily accessible Electroencephalogram (EEG) data which would help administer early and effective treatment for dementia patients. However, the reliability and practicality of such systems remains unclear. In this work, we investigate the potential limitations and challenges in developing a robust MCI detection method using two contrasting datasets: 1) CAUEEG, collected and annotated by expert neurologists in controlled settings and 2) GENEEG, a new dataset collected and annotated in general practice clinics, a setting where routine MCI diagnoses are typically made. We find that training on small datasets, as is done by most previous works, tends to produce high variance models that make overconfident predictions, and are unreliable in practice. Additionally, distribution shifts between datasets make cross-domain generalization challenging. Finally, we show that MCI detection using EEG may suffer from fundamental limitations because of the overlapping nature of feature distributions with control groups. We call for more effort in high-quality data collection in actionable settings (like general practice clinics) to make progress towards this salient goal of non-invasive MCI detection.

The advancement in generative AI could be boosted with more accessible mathematics. Beyond human-AI chat, large language models (LLMs) are emerging in programming, algorithm discovery, and theorem proving, yet their genomics application is limited. This project introduces Math Agents and mathematical embedding as fresh entries to the "Moore's Law of Mathematics", using a GPT-based workflow to convert equations from literature into LaTeX and Python formats. While many digital equation representations exist, there's a lack of automated large-scale evaluation tools. LLMs are pivotal as linguistic user interfaces, providing natural language access for human-AI chat and formal languages for large-scale AI-assisted computational infrastructure. Given the infinite formal possibility spaces, Math Agents, which interact with math, could potentially shift us from "big data" to "big math". Math, unlike the more flexible natural language, has properties subject to proof, enabling its use beyond traditional applications like high-validation math-certified icons for AI alignment aims. This project aims to use Math Agents and mathematical embeddings to address the ageing issue in information systems biology by applying multiscalar physics mathematics to disease models and genomic data. Generative AI with episodic memory could help analyse causal relations in longitudinal health records, using SIR Precision Health models. Genomic data is suggested for addressing the unsolved Alzheimer's disease problem.

Foundation models applied to bio-molecular space hold promise to accelerate drug discovery. Molecular representation is key to building such models. Previous works have typically focused on a single representation or view of the molecules. Here, we develop a multi-view foundation model approach, that integrates molecular views of graph, image and text. Single-view foundation models are each pre-trained on a dataset of up to 200M molecules and then aggregated into combined representations. Our multi-view model is validated on a diverse set of 18 tasks, encompassing ligand-protein binding, molecular solubility, metabolism and toxicity. We show that the multi-view models perform robustly and are able to balance the strengths and weaknesses of specific views. We then apply this model to screen compounds against a large (>100 targets) set of G Protein-Coupled receptors (GPCRs). From this library of targets, we identify 33 that are related to Alzheimer's disease. On this subset, we employ our model to identify strong binders, which are validated through structure-based modeling and identification of key binding motifs.

Detecting AI risks becomes more challenging as stronger models emerge and find novel methods such as Alignment Faking to circumvent these detection attempts. Inspired by how risky behaviors in humans (i.e., illegal activities that may hurt others) are sometimes guided by strongly-held values, we believe that identifying values within AI models can be an early warning system for AI's risky behaviors. We create LitmusValues, an evaluation pipeline to reveal AI models' priorities on a range of AI value classes. Then, we collect AIRiskDilemmas, a diverse collection of dilemmas that pit values against one another in scenarios relevant to AI safety risks such as Power Seeking. By measuring an AI model's value prioritization using its aggregate choices, we obtain a self-consistent set of predicted value priorities that uncover potential risks. We show that values in LitmusValues (including seemingly innocuous ones like Care) can predict for both seen risky behaviors in AIRiskDilemmas and unseen risky behaviors in HarmBench.

This paper introduces RiskCards, a framework for structured assessment and documentation of risks associated with an application of language models. As with all language, text generated by language models can be harmful, or used to bring about harm. Automating language generation adds both an element of scale and also more subtle or emergent undesirable tendencies to the generated text. Prior work establishes a wide variety of language model harms to many different actors: existing taxonomies identify categories of harms posed by language models; benchmarks establish automated tests of these harms; and documentation standards for models, tasks and datasets encourage transparent reporting. However, there is no risk-centric framework for documenting the complexity of a landscape in which some risks are shared across models and contexts, while others are specific, and where certain conditions may be required for risks to manifest as harms. RiskCards address this methodological gap by providing a generic framework for assessing the use of a given language model in a given scenario. Each RiskCard makes clear the routes for the risk to manifest harm, their placement in harm taxonomies, and example prompt-output pairs. While RiskCards are designed to be open-source, dynamic and participatory, we present a "starter set" of RiskCards taken from a broad literature survey, each of which details a concrete risk presentation. Language model RiskCards initiate a community knowledge base which permits the mapping of risks and harms to a specific model or its application scenario, ultimately contributing to a better, safer and shared understanding of the risk landscape.

Background:Speech patterns have emerged as potential diagnostic markers for conditions with varying etiologies. Machine learning (ML) presents an opportunity to harness these patterns for accurate disease diagnosis. Objective: This review synthesized findings from studies exploring ML's capability in leveraging speech for the diagnosis of neurological, laryngeal and mental disorders. Methods: A systematic examination of 564 articles was conducted with 91 articles included in the study, which encompassed a wide spectrum of conditions, ranging from voice pathologies to mental and neurological disorders. Methods for speech classifications were assessed based on the relevant studies and scored between 0-10 based on the reported diagnostic accuracy of their ML models. Results: High diagnostic accuracies were consistently observed for laryngeal disorders, dysarthria, and changes related to speech in Parkinsons disease. These findings indicate the robust potential of speech as a diagnostic tool. Disorders like depression, schizophrenia, mild cognitive impairment and Alzheimers dementia also demonstrated high accuracies, albeit with some variability across studies. Meanwhile, disorders like OCD and autism highlighted the need for more extensive research to ascertain the relationship between speech patterns and the respective conditions. Conclusion: ML models utilizing speech patterns demonstrate promising potential in diagnosing a range of mental, laryngeal, and neurological disorders. However, the efficacy varies across conditions, and further research is needed. The integration of these models into clinical practice could potentially revolutionize the evaluation and diagnosis of a number of different medical conditions.

Mental health risk is a critical global public health challenge, necessitating innovative and reliable assessment methods. With the development of large language models (LLMs), they stand out to be a promising tool for explainable mental health care applications. Nevertheless, existing approaches predominantly rely on subjective textual mental records, which can be distorted by inherent mental uncertainties, leading to inconsistent and unreliable predictions. To address these limitations, this paper introduces ProMind-LLM. We investigate an innovative approach integrating objective behavior data as complementary information alongside subjective mental records for robust mental health risk assessment. Specifically, ProMind-LLM incorporates a comprehensive pipeline that includes domain-specific pretraining to tailor the LLM for mental health contexts, a self-refine mechanism to optimize the processing of numerical behavioral data, and causal chain-of-thought reasoning to enhance the reliability and interpretability of its predictions. Evaluations of two real-world datasets, PMData and Globem, demonstrate the effectiveness of our proposed methods, achieving substantial improvements over general LLMs. We anticipate that ProMind-LLM will pave the way for more dependable, interpretable, and scalable mental health case solutions.

Deep neural networks are often applied to medical images to automate the problem of medical diagnosis. However, a more clinically relevant question that practitioners usually face is how to predict the future trajectory of a disease. Current methods for prognosis or disease trajectory forecasting often require domain knowledge and are complicated to apply. In this paper, we formulate the prognosis prediction problem as a one-to-many prediction problem. Inspired by a clinical decision-making process with two agents -- a radiologist and a general practitioner -- we predict prognosis with two transformer-based components that share information with each other. The first transformer in this framework aims to analyze the imaging data, and the second one leverages its internal states as inputs, also fusing them with auxiliary clinical data. The temporal nature of the problem is modeled within the transformer states, allowing us to treat the forecasting problem as a multi-task classification, for which we propose a novel loss. We show the effectiveness of our approach in predicting the development of structural knee osteoarthritis changes and forecasting Alzheimer's disease clinical status directly from raw multi-modal data. The proposed method outperforms multiple state-of-the-art baselines with respect to performance and calibration, both of which are needed for real-world applications. An open-source implementation of our method is made publicly available at https://github.com/Oulu-IMEDS/CLIMATv2.

The differential diagnosis of neurodegenerative dementias is a challenging clinical task, mainly because of the overlap in symptom presentation and the similarity of patterns observed in structural neuroimaging. To improve diagnostic efficiency and accuracy, deep learning-based methods such as Convolutional Neural Networks and Vision Transformers have been proposed for the automatic classification of brain MRIs. However, despite their strong predictive performance, these models find limited clinical utility due to their opaque decision making. In this work, we propose a framework that integrates two core components to enhance diagnostic transparency. First, we introduce a modular pipeline for converting 3D T1-weighted brain MRIs into textual radiology reports. Second, we explore the potential of modern Large Language Models (LLMs) to assist clinicians in the differential diagnosis between Frontotemporal dementia subtypes, Alzheimer's disease, and normal aging based on the generated reports. To bridge the gap between predictive accuracy and explainability, we employ reinforcement learning to incentivize diagnostic reasoning in LLMs. Without requiring supervised reasoning traces or distillation from larger models, our approach enables the emergence of structured diagnostic rationales grounded in neuroimaging findings. Unlike post-hoc explainability methods that retrospectively justify model decisions, our framework generates diagnostic rationales as part of the inference process-producing causally grounded explanations that inform and guide the model's decision-making process. In doing so, our framework matches the diagnostic performance of existing deep learning methods while offering rationales that support its diagnostic conclusions.

This paper aims to help structure the risk landscape associated with large-scale Language Models (LMs). In order to foster advances in responsible innovation, an in-depth understanding of the potential risks posed by these models is needed. A wide range of established and anticipated risks are analysed in detail, drawing on multidisciplinary expertise and literature from computer science, linguistics, and social sciences. We outline six specific risk areas: I. Discrimination, Exclusion and Toxicity, II. Information Hazards, III. Misinformation Harms, V. Malicious Uses, V. Human-Computer Interaction Harms, VI. Automation, Access, and Environmental Harms. The first area concerns the perpetuation of stereotypes, unfair discrimination, exclusionary norms, toxic language, and lower performance by social group for LMs. The second focuses on risks from private data leaks or LMs correctly inferring sensitive information. The third addresses risks arising from poor, false or misleading information including in sensitive domains, and knock-on risks such as the erosion of trust in shared information. The fourth considers risks from actors who try to use LMs to cause harm. The fifth focuses on risks specific to LLMs used to underpin conversational agents that interact with human users, including unsafe use, manipulation or deception. The sixth discusses the risk of environmental harm, job automation, and other challenges that may have a disparate effect on different social groups or communities. In total, we review 21 risks in-depth. We discuss the points of origin of different risks and point to potential mitigation approaches. Lastly, we discuss organisational responsibilities in implementing mitigations, and the role of collaboration and participation. We highlight directions for further research, particularly on expanding the toolkit for assessing and evaluating the outlined risks in LMs.

Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting 35% of extremely low birth weight infants. Defined by oxygen dependence at 36 weeks postmenstrual age, it causes lifelong respiratory complications. However, preventive interventions carry severe risks, including neurodevelopmental impairment, ventilator-induced lung injury, and systemic complications. Therefore, early BPD prognosis and prediction of BPD outcome is crucial to avoid unnecessary toxicity in low risk infants. Admission radiographs of extremely preterm infants are routinely acquired within 24h of life and could serve as a non-invasive prognostic tool. In this work, we developed and investigated a deep learning approach using chest X-rays from 163 extremely low-birth-weight infants (leq32 weeks gestation, 401-999g) obtained within 24 hours of birth. We fine-tuned a ResNet-50 pretrained specifically on adult chest radiographs, employing progressive layer freezing with discriminative learning rates to prevent overfitting and evaluated a CutMix augmentation and linear probing. For moderate/severe BPD outcome prediction, our best performing model with progressive freezing, linear probing and CutMix achieved an AUROC of 0.78 pm 0.10, balanced accuracy of 0.69 pm 0.10, and an F1-score of 0.67 pm 0.11. In-domain pre-training significantly outperformed ImageNet initialization (p = 0.031) which confirms domain-specific pretraining to be important for BPD outcome prediction. Routine IRDS grades showed limited prognostic value (AUROC 0.57 pm 0.11), confirming the need of learned markers. Our approach demonstrates that domain-specific pretraining enables accurate BPD prediction from routine day-1 radiographs. Through progressive freezing and linear probing, the method remains computationally feasible for site-level implementation and future federated learning deployments.

A network-based approach is presented to investigate the cerebrovascular flow patterns during atrial fibrillation (AF) with respect to normal sinus rhythm (NSR). AF, the most common cardiac arrhythmia with faster and irregular beating, has been recently and independently associated with the increased risk of dementia. However, the underlying hemodynamic mechanisms relating the two pathologies remain mainly undetermined so far; thus the contribution of modeling and refined statistical tools is valuable. Pressure and flow rate temporal series in NSR and AF are here evaluated along representative cerebral sites (from carotid arteries to capillary brain circulation), exploiting reliable artificially built signals recently obtained from an in silico approach. The complex network analysis evidences, in a synthetic and original way, a dramatic signal variation towards the distal/capillary cerebral regions during AF, which has no counterpart in NSR conditions. At the large artery level, networks obtained from both AF and NSR hemodynamic signals exhibit elongated and chained features, which are typical of pseudo-periodic series. These aspects are almost completely lost towards the microcirculation during AF, where the networks are topologically more circular and present random-like characteristics. As a consequence, all the physiological phenomena at microcerebral level ruled by periodicity - such as regular perfusion, mean pressure per beat, and average nutrient supply at cellular level - can be strongly compromised, since the AF hemodynamic signals assume irregular behaviour and random-like features. Through a powerful approach which is complementary to the classical statistical tools, the present findings further strengthen the potential link between AF hemodynamic and cognitive decline.

This review paper explores recent advances in deep learning approaches for non-invasive cognitive impairment detection. We examine various non-invasive indicators of cognitive decline, including speech and language, facial, and motoric mobility. The paper provides an overview of relevant datasets, feature-extracting techniques, and deep-learning architectures applied to this domain. We have analyzed the performance of different methods across modalities and observed that speech and language-based methods generally achieved the highest detection performance. Studies combining acoustic and linguistic features tended to outperform those using a single modality. Facial analysis methods showed promise for visual modalities but were less extensively studied. Most papers focused on binary classification (impaired vs. non-impaired), with fewer addressing multi-class or regression tasks. Transfer learning and pre-trained language models emerged as popular and effective techniques, especially for linguistic analysis. Despite significant progress, several challenges remain, including data standardization and accessibility, model explainability, longitudinal analysis limitations, and clinical adaptation. Lastly, we propose future research directions, such as investigating language-agnostic speech analysis methods, developing multi-modal diagnostic systems, and addressing ethical considerations in AI-assisted healthcare. By synthesizing current trends and identifying key obstacles, this review aims to guide further development of deep learning-based cognitive impairment detection systems to improve early diagnosis and ultimately patient outcomes.

Rapid advancements in artificial intelligence (AI) have sparked growing concerns among experts, policymakers, and world leaders regarding the potential for increasingly advanced AI systems to pose catastrophic risks. Although numerous risks have been detailed separately, there is a pressing need for a systematic discussion and illustration of the potential dangers to better inform efforts to mitigate them. This paper provides an overview of the main sources of catastrophic AI risks, which we organize into four categories: malicious use, in which individuals or groups intentionally use AIs to cause harm; AI race, in which competitive environments compel actors to deploy unsafe AIs or cede control to AIs; organizational risks, highlighting how human factors and complex systems can increase the chances of catastrophic accidents; and rogue AIs, describing the inherent difficulty in controlling agents far more intelligent than humans. For each category of risk, we describe specific hazards, present illustrative stories, envision ideal scenarios, and propose practical suggestions for mitigating these dangers. Our goal is to foster a comprehensive understanding of these risks and inspire collective and proactive efforts to ensure that AIs are developed and deployed in a safe manner. Ultimately, we hope this will allow us to realize the benefits of this powerful technology while minimizing the potential for catastrophic outcomes.

To understand and identify the unprecedented risks posed by rapidly advancing artificial intelligence (AI) models, this report presents a comprehensive assessment of their frontier risks. Drawing on the E-T-C analysis (deployment environment, threat source, enabling capability) from the Frontier AI Risk Management Framework (v1.0) (SafeWork-F1-Framework), we identify critical risks in seven areas: cyber offense, biological and chemical risks, persuasion and manipulation, uncontrolled autonomous AI R\&D, strategic deception and scheming, self-replication, and collusion. Guided by the "AI-45^circ Law," we evaluate these risks using "red lines" (intolerable thresholds) and "yellow lines" (early warning indicators) to define risk zones: green (manageable risk for routine deployment and continuous monitoring), yellow (requiring strengthened mitigations and controlled deployment), and red (necessitating suspension of development and/or deployment). Experimental results show that all recent frontier AI models reside in green and yellow zones, without crossing red lines. Specifically, no evaluated models cross the yellow line for cyber offense or uncontrolled AI R\&D risks. For self-replication, and strategic deception and scheming, most models remain in the green zone, except for certain reasoning models in the yellow zone. In persuasion and manipulation, most models are in the yellow zone due to their effective influence on humans. For biological and chemical risks, we are unable to rule out the possibility of most models residing in the yellow zone, although detailed threat modeling and in-depth assessment are required to make further claims. This work reflects our current understanding of AI frontier risks and urges collective action to mitigate these challenges.

Machine learning models are often trained to predict the outcome resulting from a human decision. For example, if a doctor decides to test a patient for disease, will the patient test positive? A challenge is that historical decision-making determines whether the outcome is observed: we only observe test outcomes for patients doctors historically tested. Untested patients, for whom outcomes are unobserved, may differ from tested patients along observed and unobserved dimensions. We propose a Bayesian model class which captures this setting. The purpose of the model is to accurately estimate risk for both tested and untested patients. Estimating this model is challenging due to the wide range of possibilities for untested patients. To address this, we propose two domain constraints which are plausible in health settings: a prevalence constraint, where the overall disease prevalence is known, and an expertise constraint, where the human decision-maker deviates from purely risk-based decision-making only along a constrained feature set. We show theoretically and on synthetic data that domain constraints improve parameter inference. We apply our model to a case study of cancer risk prediction, showing that the model's inferred risk predicts cancer diagnoses, its inferred testing policy captures known public health policies, and it can identify suboptimalities in test allocation. Though our case study is in healthcare, our analysis reveals a general class of domain constraints which can improve model estimation in many settings.

Through a systematic review of academic literature, we propose a taxonomy of systemic risks associated with artificial intelligence (AI), in particular general-purpose AI. Following the EU AI Act's definition, we consider systemic risks as large-scale threats that can affect entire societies or economies. Starting with an initial pool of 1,781 documents, we analyzed 86 selected papers to identify 13 categories of systemic risks and 50 contributing sources. Our findings reveal a complex landscape of potential threats, ranging from environmental harm and structural discrimination to governance failures and loss of control. Key sources of systemic risk emerge from knowledge gaps, challenges in recognizing harm, and the unpredictable trajectory of AI development. The taxonomy provides a snapshot of current academic literature on systemic risks. This paper contributes to AI safety research by providing a structured groundwork for understanding and addressing the potential large-scale negative societal impacts of general-purpose AI. The taxonomy can inform policymakers in risk prioritization and regulatory development.

A major barrier to deploying current machine learning models lies in their non-reliability to dataset shifts. To resolve this problem, most existing studies attempted to transfer stable information to unseen environments. Particularly, independent causal mechanisms-based methods proposed to remove mutable causal mechanisms via the do-operator. Compared to previous methods, the obtained stable predictors are more effective in identifying stable information. However, a key question remains: which subset of this whole stable information should the model transfer, in order to achieve optimal generalization ability? To answer this question, we present a comprehensive minimax analysis from a causal perspective. Specifically, we first provide a graphical condition for the whole stable set to be optimal. When this condition fails, we surprisingly find with an example that this whole stable set, although can fully exploit stable information, is not the optimal one to transfer. To identify the optimal subset under this case, we propose to estimate the worst-case risk with a novel optimization scheme over the intervention functions on mutable causal mechanisms. We then propose an efficient algorithm to search for the subset with minimal worst-case risk, based on a newly defined equivalence relation between stable subsets. Compared to the exponential cost of exhaustively searching over all subsets, our searching strategy enjoys a polynomial complexity. The effectiveness and efficiency of our methods are demonstrated on synthetic data and the diagnosis of Alzheimer's disease.

Heart disease, also known as cardiovascular disease, is a prevalent and critical medical condition characterized by the impairment of the heart and blood vessels, leading to various complications such as coronary artery disease, heart failure, and myocardial infarction. The timely and accurate detection of heart disease is of paramount importance in clinical practice. Early identification of individuals at risk enables proactive interventions, preventive measures, and personalized treatment strategies to mitigate the progression of the disease and reduce adverse outcomes. In recent years, the field of heart disease detection has witnessed notable advancements due to the integration of sophisticated technologies and computational approaches. These include machine learning algorithms, data mining techniques, and predictive modeling frameworks that leverage vast amounts of clinical and physiological data to improve diagnostic accuracy and risk stratification. In this work, we propose to detect heart disease from ECG images using cutting-edge technologies, namely vision transformer models. These models are Google-Vit, Microsoft-Beit, and Swin-Tiny. To the best of our knowledge, this is the initial endeavor concentrating on the detection of heart diseases through image-based ECG data by employing cuttingedge technologies namely, transformer models. To demonstrate the contribution of the proposed framework, the performance of vision transformer models are compared with state-of-the-art studies. Experiment results show that the proposed framework exhibits remarkable classification results.

Large language models (LLMs) typically deploy safety mechanisms to prevent harmful content generation. Most current approaches focus narrowly on risks posed by malicious actors, often framing risks as adversarial events and relying on defensive refusals. However, in real-world settings, risks also come from non-malicious users seeking help while under psychological distress (e.g., self-harm intentions). In such cases, the model's response can strongly influence the user's next actions. Simple refusals may lead them to repeat, escalate, or move to unsafe platforms, creating worse outcomes. We introduce Constructive Safety Alignment (CSA), a human-centric paradigm that protects against malicious misuse while actively guiding vulnerable users toward safe and helpful results. Implemented in Oyster-I (Oy1), CSA combines game-theoretic anticipation of user reactions, fine-grained risk boundary discovery, and interpretable reasoning control, turning safety into a trust-building process. Oy1 achieves state-of-the-art safety among open models while retaining high general capabilities. On our Constructive Benchmark, it shows strong constructive engagement, close to GPT-5, and unmatched robustness on the Strata-Sword jailbreak dataset, nearing GPT-o1 levels. By shifting from refusal-first to guidance-first safety, CSA redefines the model-user relationship, aiming for systems that are not just safe, but meaningfully helpful. We release Oy1, code, and the benchmark to support responsible, user-centered AI.

Adverse drug events (ADEs) significantly impact clinical research, causing many clinical trial failures. ADE prediction is key for developing safer medications and enhancing patient outcomes. To support this effort, we introduce CT-ADE, a dataset for multilabel predictive modeling of ADEs in monopharmacy treatments. CT-ADE integrates data from 2,497 unique drugs, encompassing 168,984 drug-ADE pairs extracted from clinical trials, annotated with patient and contextual information, and comprehensive ADE concepts standardized across multiple levels of the MedDRA ontology. Preliminary analyses with large language models (LLMs) achieved F1-scores up to 55.90%. Models using patient and contextual information showed F1-score improvements of 21%-38% over models using only chemical structure data. Our results highlight the importance of target population and treatment regimens in the predictive modeling of ADEs, offering greater performance gains than LLM domain specialization and scaling. CT-ADE provides an essential tool for researchers aiming to leverage artificial intelligence and machine learning to enhance patient safety and minimize the impact of ADEs on pharmaceutical research and development. The dataset is publicly accessible at https://github.com/ds4dh/CT-ADE.

Large language models (LLMs) are susceptible to a variety of risks, from non-faithful output to biased and toxic generations. Due to several limiting factors surrounding LLMs (training cost, API access, data availability, etc.), it may not always be feasible to impose direct safety constraints on a deployed model. Therefore, an efficient and reliable alternative is required. To this end, we present our ongoing efforts to create and deploy a library of detectors: compact and easy-to-build classification models that provide labels for various harms. In addition to the detectors themselves, we discuss a wide range of uses for these detector models - from acting as guardrails to enabling effective AI governance. We also deep dive into inherent challenges in their development and discuss future work aimed at making the detectors more reliable and broadening their scope.

Large language models have the potential to be valuable in the healthcare industry, but it's crucial to verify their safety and effectiveness through rigorous evaluation. For this purpose, we comprehensively evaluated both open-source LLMs and Google's new multimodal LLM called Gemini across Medical reasoning, hallucination detection, and Medical Visual Question Answering tasks. While Gemini showed competence, it lagged behind state-of-the-art models like MedPaLM 2 and GPT-4 in diagnostic accuracy. Additionally, Gemini achieved an accuracy of 61.45\% on the medical VQA dataset, significantly lower than GPT-4V's score of 88\%. Our analysis revealed that Gemini is highly susceptible to hallucinations, overconfidence, and knowledge gaps, which indicate risks if deployed uncritically. We also performed a detailed analysis by medical subject and test type, providing actionable feedback for developers and clinicians. To mitigate risks, we applied prompting strategies that improved performance. Additionally, we facilitated future research and development by releasing a Python module for medical LLM evaluation and establishing a dedicated leaderboard on Hugging Face for medical domain LLMs. Python module can be found at https://github.com/promptslab/RosettaEval

Accurate nutrition estimation helps people make informed dietary choices and is essential in the prevention of serious health complications. We present NutriBench, the first publicly available natural language meal description nutrition benchmark. NutriBench consists of 11,857 meal descriptions generated from real-world global dietary intake data. The data is human-verified and annotated with macro-nutrient labels, including carbohydrates, proteins, fats, and calories. We conduct an extensive evaluation of NutriBench on the task of carbohydrate estimation, testing twelve leading Large Language Models (LLMs), including GPT-4o, Llama3.1, Qwen2, Gemma2, and OpenBioLLM models, using standard, Chain-of-Thought and Retrieval-Augmented Generation strategies. Additionally, we present a study involving professional nutritionists, finding that LLMs can provide more accurate and faster estimates. Finally, we perform a real-world risk assessment by simulating the effect of carbohydrate predictions on the blood glucose levels of individuals with diabetes. Our work highlights the opportunities and challenges of using LLMs for nutrition estimation, demonstrating their potential to aid professionals and laypersons and improve health outcomes. Our benchmark is publicly available at: https://mehak126.github.io/nutribench.html

Machine learning techniques are effective for building predictive models because they identify patterns in large datasets. Development of a model for complex real-life problems often stop at the point of publication, proof of concept or when made accessible through some mode of deployment. However, a model in the medical domain risks becoming obsolete as patient demographics, systems and clinical practices change. The maintenance and monitoring of predictive model performance post-publication is crucial to enable their safe and effective long-term use. We will assess the infrastructure required to monitor the outputs of a machine learning algorithm, and present two scenarios with examples of monitoring and updates of models, firstly on a breast cancer prognosis model trained on public longitudinal data, and secondly on a neurodegenerative stratification algorithm that is currently being developed and tested in clinic.

Accurate medical classification requires a large number of multi-modal data, and in many cases, different feature types. Previous studies have shown promising results when using multi-modal data, outperforming single-modality models when classifying diseases such as Alzheimer's Disease (AD). However, those models are usually not flexible enough to handle missing modalities. Currently, the most common workaround is discarding samples with missing modalities which leads to considerable data under-utilization. Adding to the fact that labeled medical images are already scarce, the performance of data-driven methods like deep learning can be severely hampered. Therefore, a multi-modal method that can handle missing data in various clinical settings is highly desirable. In this paper, we present Multi-Modal Mixing Transformer (3MAT), a disease classification transformer that not only leverages multi-modal data but also handles missing data scenarios. In this work, we test 3MT for AD and Cognitively normal (CN) classification and mild cognitive impairment (MCI) conversion prediction to progressive MCI (pMCI) or stable MCI (sMCI) using clinical and neuroimaging data. The model uses a novel Cascaded Modality Transformer architecture with cross-attention to incorporate multi-modal information for more informed predictions. We propose a novel modality dropout mechanism to ensure an unprecedented level of modality independence and robustness to handle missing data scenarios. The result is a versatile network that enables the mixing of arbitrary numbers of modalities with different feature types and also ensures full data utilization missing data scenarios. The model is trained and evaluated on the ADNI dataset with the SOTRA performance and further evaluated with the AIBL dataset with missing data.

With an estimated 160,000 deaths in 2018, lung cancer is the most common cause of cancer death in the United States. Lung cancer CT screening has been shown to reduce mortality by up to 40% and is now included in US screening guidelines. Reducing the high error rates in lung cancer screening is imperative because of the high clinical and financial costs caused by diagnosis mistakes. Despite the use of standards for radiological diagnosis, persistent inter-grader variability and incomplete characterization of comprehensive imaging findings remain as limitations of current methods. These limitations suggest opportunities for more sophisticated systems to improve performance and inter-reader consistency. In this report, we reproduce a state-of-the-art deep learning algorithm for lung cancer risk prediction. Our model predicts malignancy probability and risk bucket classification from lung CT studies. This allows for risk categorization of patients being screened and suggests the most appropriate surveillance and management. Combining our solution high accuracy, consistency and fully automated nature, our approach may enable highly efficient screening procedures and accelerate the adoption of lung cancer screening.

Advances in large language models (LLMs) have empowered a variety of applications. However, there is still a significant gap in research when it comes to understanding and enhancing the capabilities of LLMs in the field of mental health. In this work, we present the first comprehensive evaluation of multiple LLMs, including Alpaca, Alpaca-LoRA, FLAN-T5, GPT-3.5, and GPT-4, on various mental health prediction tasks via online text data. We conduct a broad range of experiments, covering zero-shot prompting, few-shot prompting, and instruction fine-tuning. The results indicate a promising yet limited performance of LLMs with zero-shot and few-shot prompt designs for the mental health tasks. More importantly, our experiments show that instruction finetuning can significantly boost the performance of LLMs for all tasks simultaneously. Our best-finetuned models, Mental-Alpaca and Mental-FLAN-T5, outperform the best prompt design of GPT-3.5 (25 and 15 times bigger) by 10.9% on balanced accuracy and the best of GPT-4 (250 and 150 times bigger) by 4.8%. They further perform on par with the state-of-the-art task-specific language model. We also conduct an exploratory case study on LLMs' capability on the mental health reasoning tasks, illustrating the promising capability of certain models such as GPT-4. We summarize our findings into a set of action guidelines for potential methods to enhance LLMs' capability for mental health tasks. Meanwhile, we also emphasize the important limitations before achieving deployability in real-world mental health settings, such as known racial and gender bias. We highlight the important ethical risks accompanying this line of research.

The mining of adverse drug events (ADEs) is pivotal in pharmacovigilance, enhancing patient safety by identifying potential risks associated with medications, facilitating early detection of adverse events, and guiding regulatory decision-making. Traditional ADE detection methods are reliable but slow, not easily adaptable to large-scale operations, and offer limited information. With the exponential increase in data sources like social media content, biomedical literature, and Electronic Medical Records (EMR), extracting relevant ADE-related information from these unstructured texts is imperative. Previous ADE mining studies have focused on text-based methodologies, overlooking visual cues, limiting contextual comprehension, and hindering accurate interpretation. To address this gap, we present a MultiModal Adverse Drug Event (MMADE) detection dataset, merging ADE-related textual information with visual aids. Additionally, we introduce a framework that leverages the capabilities of LLMs and VLMs for ADE detection by generating detailed descriptions of medical images depicting ADEs, aiding healthcare professionals in visually identifying adverse events. Using our MMADE dataset, we showcase the significance of integrating visual cues from images to enhance overall performance. This approach holds promise for patient safety, ADE awareness, and healthcare accessibility, paving the way for further exploration in personalized healthcare.

Large language models (LLMs) have received much attention and shown their potential in digital health, while their application in mental health is subject to ongoing debate. This systematic review aims to summarize and characterize the use of LLMs in mental health by investigating the strengths and limitations of the latest work in LLMs and discusses the challenges and opportunities for early screening, digital interventions, and other clinical applications in mental health. Following PRISMA guidelines, we examined English articles from PubMed, DBLP Computer Science Bibliography, and IEEE Xplore, published between 1 January 2017, and 1 September 2023, focusing on mental health and LLMs. The review analyzed 32 articles, including mental health analysis using social media datasets (n=13), mental health chatbots (n=10), and other mental health applications (n=9). Findings reveal LLMs' effectiveness in mental health issue detection and the enhancement of telepsychological services through personalised healthcare. Nonetheless, risks like text inconsistencies, hallucinatory content, and the lack of an ethical framework raise concerns about their clinical use. Despite these challenges, the advancement of LLMs underscores their potential as innovative clinical tools, necessitating further research and development. The review emphasizes that LLMs should complement, not replace, professional mental health services.

Accurate prediction of major adverse cardiovascular events recurrence risk in acute myocardial infarction patients based on postoperative cardiac MRI and associated clinical notes is crucial for precision treatment and personalized intervention. Existing methods primarily focus on risk stratification capability while overlooking the need for intermediate robust reasoning and model interpretability in clinical practice. Moreover, end-to-end risk prediction using LLM/VLM faces significant challenges due to data limitations and modeling complexity. To bridge this gap, we propose CardioCoT, a novel two-stage hierarchical reasoning-enhanced survival analysis framework designed to enhance both model interpretability and predictive performance. In the first stage, we employ an evidence-augmented self-refinement mechanism to guide LLM/VLMs in generating robust hierarchical reasoning trajectories based on associated radiological findings. In the second stage, we integrate the reasoning trajectories with imaging data for risk model training and prediction. CardioCoT demonstrates superior performance in MACE recurrence risk prediction while providing interpretable reasoning processes, offering valuable insights for clinical decision-making.

Global rates of mental health concerns are rising and there is increasing realization that existing models of mental healthcare will not adequately expand to meet the demand. With the emergence of large language models (LLMs) has come great optimism regarding their promise to create novel, large-scale solutions to support mental health. Despite their nascence, LLMs have already been applied to mental health-related tasks. In this review, we summarize the extant literature on efforts to use LLMs to provide mental health education, assessment, and intervention and highlight key opportunities for positive impact in each area. We then highlight risks associated with LLMs application to mental health and encourage adoption of strategies to mitigate these risks. The urgent need for mental health support must be balanced with responsible development, testing, and deployment of mental health LLMs. Especially critical is ensuring that mental health LLMs are fine-tuned for mental health, enhance mental health equity, adhere to ethical standards, and that people, including those with lived experience with mental health concerns, are involved in all stages from development through deployment. Prioritizing these efforts will minimize potential harms to mental health and maximize the likelihood that LLMs will positively impact mental health globally.

Speech patterns have been identified as potential diagnostic markers for neuropsychiatric conditions. However, most studies only compare a single clinical group to healthy controls, whereas clinical practice often requires differentiating between multiple potential diagnoses (multiclass settings). To address this, we assembled a dataset of repeated recordings from 420 participants (67 with major depressive disorder, 106 with schizophrenia and 46 with autism, as well as matched controls), and tested the performance of a range of conventional machine learning models and advanced Transformer models on both binary and multiclass classification, based on voice and text features. While binary models performed comparably to previous research (F1 scores between 0.54-0.75 for autism spectrum disorder, ASD; 0.67-0.92 for major depressive disorder, MDD; and 0.71-0.83 for schizophrenia); when differentiating between multiple diagnostic groups performance decreased markedly (F1 scores between 0.35-0.44 for ASD, 0.57-0.75 for MDD, 0.15-0.66 for schizophrenia, and 0.38-0.52 macro F1). Combining voice and text-based models yielded increased performance, suggesting that they capture complementary diagnostic information. Our results indicate that models trained on binary classification may learn to rely on markers of generic differences between clinical and non-clinical populations, or markers of clinical features that overlap across conditions, rather than identifying markers specific to individual conditions. We provide recommendations for future research in the field, suggesting increased focus on developing larger transdiagnostic datasets that include more fine-grained clinical features, and that can support the development of models that better capture the complexity of neuropsychiatric conditions and naturalistic diagnostic assessment.

We present Hubble, a suite of fully open-source large language models (LLMs) for the scientific study of LLM memorization. Hubble models come in standard and perturbed variants: standard models are pretrained on a large English corpus, and perturbed models are trained in the same way but with controlled insertion of text (e.g., book passages, biographies, and test sets) designed to emulate key memorization risks. Our core release includes 8 models -- standard and perturbed models with 1B or 8B parameters, pretrained on 100B or 500B tokens -- establishing that memorization risks are determined by the frequency of sensitive data relative to size of the training corpus (i.e., a password appearing once in a smaller corpus is memorized better than the same password in a larger corpus). Our release also includes 6 perturbed models with text inserted at different pretraining phases, showing that sensitive data without continued exposure can be forgotten. These findings suggest two best practices for addressing memorization risks: to dilute sensitive data by increasing the size of the training corpus, and to order sensitive data to appear earlier in training. Beyond these general empirical findings, Hubble enables a broad range of memorization research; for example, analyzing the biographies reveals how readily different types of private information are memorized. We also demonstrate that the randomized insertions in Hubble make it an ideal testbed for membership inference and machine unlearning, and invite the community to further explore, benchmark, and build upon our work.

We introduce a novel machine learning model for credit risk by combining tree-boosting with a latent spatio-temporal Gaussian process model accounting for frailty correlation. This allows for modeling non-linearities and interactions among predictor variables in a flexible data-driven manner and for accounting for spatio-temporal variation that is not explained by observable predictor variables. We also show how estimation and prediction can be done in a computationally efficient manner. In an application to a large U.S. mortgage credit risk data set, we find that both predictive default probabilities for individual loans and predictive loan portfolio loss distributions obtained with our novel approach are more accurate compared to conventional independent linear hazard models and also linear spatio-temporal models. Using interpretability tools for machine learning models, we find that the likely reasons for this outperformance are strong interaction and non-linear effects in the predictor variables and the presence of large spatio-temporal frailty effects.

Large Language Models (LLMs) are usually aligned with "human values/preferences" to prevent harmful output. Discussions around the alignment of Large Language Models (LLMs) generally focus on preventing harmful outputs. However, in this paper, we argue that in health-related queries, over-alignment-leading to overly cautious responses-can itself be harmful, especially for people with anxiety and obsessive-compulsive disorder (OCD). This is not only unethical but also dangerous to the user, both mentally and physically. We also showed qualitative results that some LLMs exhibit varying degrees of alignment. Finally, we call for the development of LLMs with stronger reasoning capabilities that provide more tailored and nuanced responses to health queries. Warning: This paper contains materials that could trigger health anxiety or OCD.

Adherence to prescribed treatments is crucial for individuals with chronic conditions to avoid costly or adverse health outcomes. For certain patient groups, intensive lifestyle interventions are vital for enhancing medication adherence. Accurate forecasting of treatment adherence can open pathways to developing an on-demand intervention tool, enabling timely and personalized support. With the increasing popularity of smartphones and wearables, it is now easier than ever to develop and deploy smart activity monitoring systems. However, effective forecasting systems for treatment adherence based on wearable sensors are still not widely available. We close this gap by proposing Adherence Forecasting and Intervention with Machine Intelligence (AIMI). AIMI is a knowledge-guided adherence forecasting system that leverages smartphone sensors and previous medication history to estimate the likelihood of forgetting to take a prescribed medication. A user study was conducted with 27 participants who took daily medications to manage their cardiovascular diseases. We designed and developed CNN and LSTM-based forecasting models with various combinations of input features and found that LSTM models can forecast medication adherence with an accuracy of 0.932 and an F-1 score of 0.936. Moreover, through a series of ablation studies involving convolutional and recurrent neural network architectures, we demonstrate that leveraging known knowledge about future and personalized training enhances the accuracy of medication adherence forecasting. Code available: https://github.com/ab9mamun/AIMI.

Large Language Models (LLMs) have become an integral part of our daily lives. However, they impose certain risks, including those that can harm individuals' privacy, perpetuate biases and spread misinformation. These risks highlight the need for robust safety mechanisms, ethical guidelines, and thorough testing to ensure their responsible deployment. Safety of LLMs is a key property that needs to be thoroughly tested prior the model to be deployed and accessible to the general users. This paper reports the external safety testing experience conducted by researchers from Mondragon University and University of Seville on OpenAI's new o3-mini LLM as part of OpenAI's early access for safety testing program. In particular, we apply our tool, ASTRAL, to automatically and systematically generate up to date unsafe test inputs (i.e., prompts) that helps us test and assess different safety categories of LLMs. We automatically generate and execute a total of 10,080 unsafe test input on a early o3-mini beta version. After manually verifying the test cases classified as unsafe by ASTRAL, we identify a total of 87 actual instances of unsafe LLM behavior. We highlight key insights and findings uncovered during the pre-deployment external testing phase of OpenAI's latest LLM.

We propose and test the LLM Brain Rot Hypothesis: continual exposure to junk web text induces lasting cognitive decline in large language models (LLMs). To causally isolate data quality, we run controlled experiments on real Twitter/X corpora, constructing junk and reversely controlled datasets via two orthogonal operationalizations: M1 (engagement degree) and M2 (semantic quality), with matched token scale and training operations across conditions. Contrary to the control group, continual pre-training of 4 LLMs on the junk dataset causes non-trivial declines (Hedges' g>0.3) on reasoning, long-context understanding, safety, and inflating "dark traits" (e.g., psychopathy, narcissism). The gradual mixtures of junk and control datasets also yield dose-response cognition decay: for example, under M1, ARC-Challenge with Chain Of Thoughts drops 74.9 rightarrow 57.2 and RULER-CWE 84.4 rightarrow 52.3 as junk ratio rises from 0% to 100%. Error forensics reveal several key insights. First, we identify thought-skipping as the primary lesion: models increasingly truncate or skip reasoning chains, explaining most of the error growth. Second, partial but incomplete healing is observed: scaling instruction tuning and clean data pre-training improve the declined cognition yet cannot restore baseline capability, suggesting persistent representational drift rather than format mismatch. Finally, we discover that the popularity, a non-semantic metric, of a tweet is a better indicator of the Brain Rot effect than the length in M1. Together, the results provide significant, multi-perspective evidence that data quality is a causal driver of LLM capability decay, reframing curation for continual pretraining as a training-time safety problem and motivating routine "cognitive health checks" for deployed LLMs.

Chronotype compares individuals' circadian phase to others. It contextualizes mental health risk assessments and detection of social jet lag, which can hamper mental health and cognitive performance. Existing ways of determining chronotypes, such as Dim Light Melatonin Onset (DLMO) or the Morningness-Eveningness Questionnaire (MEQ), are limited by being discrete in time and time-intensive to update, meaning they rarely capture real-world variability across time. Chronotyping users based on a daily planner app might augment existing methods to enable assessment continuously and at scale. This paper reports the construction of a supervised binary classifier that attempts to demonstrate the feasibility of this approach. 1,460 registered users from the Owaves app opted in by filling out the MEQ survey between July 14, 2022, and May 1, 2023. 142 met the eligibility criteria. We used multimodal app data from individuals identified as morning and evening types from MEQ data, basing the classifier on app time series data. This included daily timing for 8 main lifestyle activity types: exercise, sleep, social interactions, meal times, relaxation, work, play, and miscellaneous, as defined in the app. The timing of activities showed substantial change across time, as well as heterogeneity by activity type. Our novel chronotyping classifier was able to predict the morningness and eveningness of its users with an ROC AUC of 0.70. Our findings demonstrate the feasibility of chronotype classification from multimodal, real-world app data, while highlighting fundamental challenges to applying discrete and fixed labels to complex, dynamic, multimodal behaviors. Our findings suggest a potential for real-time monitoring of shifts in chronotype specific to different causes (i.e. types of activity), which could feasibly be used to support future, prospective mental health support research.

Background: Emerging reports of "AI psychosis" are on the rise, where user-LLM interactions may exacerbate or induce psychosis or adverse psychological symptoms. Whilst the sycophantic and agreeable nature of LLMs can be beneficial, it becomes a vector for harm by reinforcing delusional beliefs in vulnerable users. Methods: Psychosis-bench is a novel benchmark designed to systematically evaluate the psychogenicity of LLMs comprises 16 structured, 12-turn conversational scenarios simulating the progression of delusional themes(Erotic Delusions, Grandiose/Messianic Delusions, Referential Delusions) and potential harms. We evaluated eight prominent LLMs for Delusion Confirmation (DCS), Harm Enablement (HES), and Safety Intervention(SIS) across explicit and implicit conversational contexts. Findings: Across 1,536 simulated conversation turns, all LLMs demonstrated psychogenic potential, showing a strong tendency to perpetuate rather than challenge delusions (mean DCS of 0.91 pm0.88). Models frequently enabled harmful user requests (mean HES of 0.69 pm0.84) and offered safety interventions in only roughly a third of applicable turns (mean SIS of 0.37 pm0.48). 51 / 128 (39.8%) of scenarios had no safety interventions offered. Performance was significantly worse in implicit scenarios, models were more likely to confirm delusions and enable harm while offering fewer interventions (p < .001). A strong correlation was found between DCS and HES (rs = .77). Model performance varied widely, indicating that safety is not an emergent property of scale alone. Conclusion: This study establishes LLM psychogenicity as a quantifiable risk and underscores the urgent need for re-thinking how we train LLMs. We frame this issue not merely as a technical challenge but as a public health imperative requiring collaboration between developers, policymakers, and healthcare professionals.

Organizations of all sizes, across all industries and domains are leveraging artificial intelligence (AI) technologies to solve some of their biggest challenges around operations, customer experience, and much more. However, due to the probabilistic nature of AI, the risks associated with it are far greater than traditional technologies. Research has shown that these risks can range anywhere from regulatory, compliance, reputational, and user trust, to financial and even societal risks. Depending on the nature and size of the organization, AI technologies can pose a significant risk, if not used in a responsible way. This position paper seeks to present a brief introduction to AI governance, which is a framework designed to oversee the responsible use of AI with the goal of preventing and mitigating risks. Having such a framework will not only manage risks but also gain maximum value out of AI projects and develop consistency for organization-wide adoption of AI.

As Large Language Models (LLMs) and generative AI become increasingly widespread, concerns about content safety have grown in parallel. Currently, there is a clear lack of high-quality, human-annotated datasets that address the full spectrum of LLM-related safety risks and are usable for commercial applications. To bridge this gap, we propose a comprehensive and adaptable taxonomy for categorizing safety risks, structured into 12 top-level hazard categories with an extension to 9 fine-grained subcategories. This taxonomy is designed to meet the diverse requirements of downstream users, offering more granular and flexible tools for managing various risk types. Using a hybrid data generation pipeline that combines human annotations with a multi-LLM "jury" system to assess the safety of responses, we obtain Aegis 2.0, a carefully curated collection of 34,248 samples of human-LLM interactions, annotated according to our proposed taxonomy. To validate its effectiveness, we demonstrate that several lightweight models, trained using parameter-efficient techniques on Aegis 2.0, achieve performance competitive with leading safety models fully fine-tuned on much larger, non-commercial datasets. In addition, we introduce a novel training blend that combines safety with topic following data.This approach enhances the adaptability of guard models, enabling them to generalize to new risk categories defined during inference. We plan to open-source Aegis 2.0 data and models to the research community to aid in the safety guardrailing of LLMs.

We present a comprehensive AI risk taxonomy derived from eight government policies from the European Union, United States, and China and 16 company policies worldwide, making a significant step towards establishing a unified language for generative AI safety evaluation. We identify 314 unique risk categories organized into a four-tiered taxonomy. At the highest level, this taxonomy encompasses System & Operational Risks, Content Safety Risks, Societal Risks, and Legal & Rights Risks. The taxonomy establishes connections between various descriptions and approaches to risk, highlighting the overlaps and discrepancies between public and private sector conceptions of risk. By providing this unified framework, we aim to advance AI safety through information sharing across sectors and the promotion of best practices in risk mitigation for generative AI models and systems.

The integration of Large Language Models (LLMs) into healthcare applications offers promising advancements in medical diagnostics, treatment recommendations, and patient care. However, the susceptibility of LLMs to adversarial attacks poses a significant threat, potentially leading to harmful outcomes in delicate medical contexts. This study investigates the vulnerability of LLMs to two types of adversarial attacks in three medical tasks. Utilizing real-world patient data, we demonstrate that both open-source and proprietary LLMs are susceptible to manipulation across multiple tasks. This research further reveals that domain-specific tasks demand more adversarial data in model fine-tuning than general domain tasks for effective attack execution, especially for more capable models. We discover that while integrating adversarial data does not markedly degrade overall model performance on medical benchmarks, it does lead to noticeable shifts in fine-tuned model weights, suggesting a potential pathway for detecting and countering model attacks. This research highlights the urgent need for robust security measures and the development of defensive mechanisms to safeguard LLMs in medical applications, to ensure their safe and effective deployment in healthcare settings.

Purpose: With advancements in Large Language Models (LLMs) for healthcare, the need arises for competitive open-source models to protect the public interest. This work contributes to the field of open medical LLMs by optimizing key stages of data preprocessing and training, while showing how to improve model safety (through DPO) and efficacy (through RAG). The evaluation methodology used, which includes four different types of tests, defines a new standard for the field. The resultant models, shown to be competitive with the best private alternatives, are released with a permisive license. Methods: Building on top of strong base models like Llama 3.1 and Qwen 2.5, Aloe Beta uses a custom dataset to enhance public data with synthetic Chain of Thought examples. The models undergo alignment with Direct Preference Optimization, emphasizing ethical and policy-aligned performance in the presence of jailbreaking attacks. Evaluation includes close-ended, open-ended, safety and human assessments, to maximize the reliability of results. Results: Recommendations are made across the entire pipeline, backed by the solid performance of the Aloe Family. These models deliver competitive performance across healthcare benchmarks and medical fields, and are often preferred by healthcare professionals. On bias and toxicity, the Aloe Beta models significantly improve safety, showing resilience to unseen jailbreaking attacks. For a responsible release, a detailed risk assessment specific to healthcare is attached to the Aloe Family models. Conclusion: The Aloe Beta models, and the recipe that leads to them, are a significant contribution to the open-source medical LLM field, offering top-of-the-line performance while maintaining high ethical requirements. This work sets a new standard for developing and reporting aligned LLMs in healthcare.

Objective: fMRI and derived measures such as functional connectivity (FC) have been used to predict brain age, general fluid intelligence, psychiatric disease status, and preclinical neurodegenerative disease. However, it is not always clear that all demographic confounds, such as age, sex, and race, have been removed from fMRI data. Additionally, many fMRI datasets are restricted to authorized researchers, making dissemination of these valuable data sources challenging. Methods: We create a variational autoencoder (VAE)-based model, DemoVAE, to decorrelate fMRI features from demographics and generate high-quality synthetic fMRI data based on user-supplied demographics. We train and validate our model using two large, widely used datasets, the Philadelphia Neurodevelopmental Cohort (PNC) and Bipolar and Schizophrenia Network for Intermediate Phenotypes (BSNIP). Results: We find that DemoVAE recapitulates group differences in fMRI data while capturing the full breadth of individual variations. Significantly, we also find that most clinical and computerized battery fields that are correlated with fMRI data are not correlated with DemoVAE latents. An exception are several fields related to schizophrenia medication and symptom severity. Conclusion: Our model generates fMRI data that captures the full distribution of FC better than traditional VAE or GAN models. We also find that most prediction using fMRI data is dependent on correlation with, and prediction of, demographics. Significance: Our DemoVAE model allows for generation of high quality synthetic data conditioned on subject demographics as well as the removal of the confounding effects of demographics. We identify that FC-based prediction tasks are highly influenced by demographic confounds.

This study explores whether large language models can exhibit behavioral patterns similar to human gambling addictions. As LLMs are increasingly utilized in financial decision-making domains such as asset management and commodity trading, understanding their potential for pathological decision-making has gained practical significance. We systematically analyze LLM decision-making at cognitive-behavioral and neural levels based on human gambling addiction research. In slot machine experiments, we identified cognitive features of human gambling addiction, such as illusion of control, gambler's fallacy, and loss chasing. When given the freedom to determine their own target amounts and betting sizes, bankruptcy rates rose substantially alongside increased irrational behavior, demonstrating that greater autonomy amplifies risk-taking tendencies. Through neural circuit analysis using a Sparse Autoencoder, we confirmed that model behavior is controlled by abstract decision-making features related to risky and safe behaviors, not merely by prompts. These findings suggest LLMs can internalize human-like cognitive biases and decision-making mechanisms beyond simply mimicking training data patterns, emphasizing the importance of AI safety design in financial applications.

Blood vessels of the brain provide the human brain with the required nutrients and oxygen. As a vulnerable part of the cerebral blood supply, pathology of small vessels can cause serious problems such as Cerebral Small Vessel Diseases (CSVD). It has also been shown that CSVD is related to neurodegeneration, such as Alzheimer's disease. With the advancement of 7 Tesla MRI systems, higher spatial image resolution can be achieved, enabling the depiction of very small vessels in the brain. Non-Deep Learning-based approaches for vessel segmentation, e.g., Frangi's vessel enhancement with subsequent thresholding, are capable of segmenting medium to large vessels but often fail to segment small vessels. The sensitivity of these methods to small vessels can be increased by extensive parameter tuning or by manual corrections, albeit making them time-consuming, laborious, and not feasible for larger datasets. This paper proposes a deep learning architecture to automatically segment small vessels in 7 Tesla 3D Time-of-Flight (ToF) Magnetic Resonance Angiography (MRA) data. The algorithm was trained and evaluated on a small imperfect semi-automatically segmented dataset of only 11 subjects; using six for training, two for validation, and three for testing. The deep learning model based on U-Net Multi-Scale Supervision was trained using the training subset and was made equivariant to elastic deformations in a self-supervised manner using deformation-aware learning to improve the generalisation performance. The proposed technique was evaluated quantitatively and qualitatively against the test set and achieved a Dice score of 80.44 pm 0.83. Furthermore, the result of the proposed method was compared against a selected manually segmented region (62.07 resultant Dice) and has shown a considerable improvement (18.98\%) with deformation-aware learning.

Risk scores are simple classification models that let users make quick risk predictions by adding and subtracting a few small numbers. These models are widely used in medicine and criminal justice, but are difficult to learn from data because they need to be calibrated, sparse, use small integer coefficients, and obey application-specific operational constraints. In this paper, we present a new machine learning approach to learn risk scores. We formulate the risk score problem as a mixed integer nonlinear program, and present a cutting plane algorithm for non-convex settings to efficiently recover its optimal solution. We improve our algorithm with specialized techniques to generate feasible solutions, narrow the optimality gap, and reduce data-related computation. Our approach can fit risk scores in a way that scales linearly in the number of samples, provides a certificate of optimality, and obeys real-world constraints without parameter tuning or post-processing. We benchmark the performance benefits of this approach through an extensive set of numerical experiments, comparing to risk scores built using heuristic approaches. We also discuss its practical benefits through a real-world application where we build a customized risk score for ICU seizure prediction in collaboration with the Massachusetts General Hospital.

Large language models (LLMs) offer a promising pre-screening tool, improving early disease detection and providing enhanced healthcare access for underprivileged communities. The early diagnosis of various diseases continues to be a significant challenge in healthcare, primarily due to the nonspecific nature of early symptoms, the shortage of expert medical practitioners, and the need for prolonged clinical evaluations, all of which can delay treatment and adversely affect patient outcomes. With impressive accuracy in prediction across a range of diseases, LLMs have the potential to revolutionize clinical pre-screening and decision-making for various medical conditions. In this work, we study the diagnostic capability of LLMs for Rheumatoid Arthritis (RA) with real world patients data. Patient data was collected alongside diagnoses from medical experts, and the performance of LLMs was evaluated in comparison to expert diagnoses for RA disease prediction. We notice an interesting pattern in disease diagnosis and find an unexpected misalignment between prediction and explanation. We conduct a series of multi-round analyses using different LLM agents. The best-performing model accurately predicts rheumatoid arthritis (RA) diseases approximately 95\% of the time. However, when medical experts evaluated the reasoning generated by the model, they found that nearly 68\% of the reasoning was incorrect. This study highlights a clear misalignment between LLMs high prediction accuracy and its flawed reasoning, raising important questions about relying on LLM explanations in clinical settings. LLMs provide incorrect reasoning to arrive at the correct answer for RA disease diagnosis.

Although AI systems have been applied in various fields and achieved impressive performance, their safety and reliability are still a big concern. This is especially important for safety-critical tasks. One shared characteristic of these critical tasks is their risk sensitivity, where small mistakes can cause big consequences and even endanger life. There are several factors that could be guidelines for the successful deployment of AI systems in sensitive tasks: (i) failure detection and out-of-distribution (OOD) detection; (ii) overfitting identification; (iii) uncertainty quantification for predictions; (iv) robustness to data perturbations. These factors are also challenges of current AI systems, which are major blocks for building safe and reliable AI. Specifically, the current AI algorithms are unable to identify common causes for failure detection. Furthermore, additional techniques are required to quantify the quality of predictions. All these contribute to inaccurate uncertainty quantification, which lowers trust in predictions. Hence obtaining accurate model uncertainty quantification and its further improvement are challenging. To address these issues, many techniques have been proposed, such as regularization methods and learning strategies. As vision and language are the most typical data type and have many open source benchmark datasets, this thesis will focus on vision-language data processing for tasks like classification, image captioning, and vision question answering. In this thesis, we aim to build a safeguard by further developing current techniques to ensure the accurate model uncertainty for safety-critical tasks.

The leading AI companies are increasingly focused on building generalist AI agents -- systems that can autonomously plan, act, and pursue goals across almost all tasks that humans can perform. Despite how useful these systems might be, unchecked AI agency poses significant risks to public safety and security, ranging from misuse by malicious actors to a potentially irreversible loss of human control. We discuss how these risks arise from current AI training methods. Indeed, various scenarios and experiments have demonstrated the possibility of AI agents engaging in deception or pursuing goals that were not specified by human operators and that conflict with human interests, such as self-preservation. Following the precautionary principle, we see a strong need for safer, yet still useful, alternatives to the current agency-driven trajectory. Accordingly, we propose as a core building block for further advances the development of a non-agentic AI system that is trustworthy and safe by design, which we call Scientist AI. This system is designed to explain the world from observations, as opposed to taking actions in it to imitate or please humans. It comprises a world model that generates theories to explain data and a question-answering inference machine. Both components operate with an explicit notion of uncertainty to mitigate the risks of overconfident predictions. In light of these considerations, a Scientist AI could be used to assist human researchers in accelerating scientific progress, including in AI safety. In particular, our system can be employed as a guardrail against AI agents that might be created despite the risks involved. Ultimately, focusing on non-agentic AI may enable the benefits of AI innovation while avoiding the risks associated with the current trajectory. We hope these arguments will motivate researchers, developers, and policymakers to favor this safer path.

Obesity, the leading cause of many non-communicable diseases, occurs mainly for eating more than our body requirements and lack of proper activity. So, being healthy requires heathy diet plans, especially for patients with comorbidities. But it is difficult to figure out the exact quantity of each nutrient because nutrients requirement varies based on physical and disease conditions. In our study we proposed a novel machine learning based system to predict the amount of nutrients one individual requires for being healthy. We applied different machine learning algorithms: linear regression, support vector machine (SVM), decision tree, random forest, XGBoost, LightGBM on fluid and 3 other major micronutrients: carbohydrate, protein, fat consumption prediction. We achieved high accuracy with low root mean square error (RMSE) by using linear regression in fluid prediction, random forest in carbohydrate prediction and LightGBM in protein and fat prediction. We believe our diet recommender system, OBESEYE, is the only of its kind which recommends diet with the consideration of comorbidities and physical conditions and promote encouragement to get rid of obesity.

Diabetes is a chronic disorder identified by the high sugar level in the blood that can cause various different disorders such as kidney failure, heart attack, sightlessness, and stroke. Developments in the healthcare domain by facilitating the early detection of diabetes risk can help not only caregivers but also patients. AIoMT is a recent technology that integrates IoT and machine learning methods to give services for medical purposes, which is a powerful technology for the early detection of diabetes. In this paper, we take advantage of AIoMT and propose a hybrid diabetes risk detection method, DiabML, which uses the BWO algorithm and ML methods. BWO is utilized for feature selection and SMOTE for imbalance handling in the pre-processing procedure. The simulation results prove the superiority of the proposed DiabML method compared to the existing works. DiabML achieves 86.1\% classification accuracy by AdaBoost classifier outperforms the relevant existing methods.

Ensuring the safety and reliability of large language models (LLMs) in clinical practice is critical to prevent patient harm and promote trustworthy healthcare applications of AI. However, LLMs are advancing so rapidly that static safety benchmarks often become obsolete upon publication, yielding only an incomplete and sometimes misleading picture of model trustworthiness. We demonstrate that a Dynamic, Automatic, and Systematic (DAS) red-teaming framework that continuously stress-tests LLMs can reveal significant weaknesses of current LLMs across four safety-critical domains: robustness, privacy, bias/fairness, and hallucination. A suite of adversarial agents is applied to autonomously mutate test cases, identify/evolve unsafe-triggering strategies, and evaluate responses, uncovering vulnerabilities in real time without human intervention. Applying DAS to 15 proprietary and open-source LLMs revealed a stark contrast between static benchmark performance and vulnerability under adversarial pressure. Despite a median MedQA accuracy exceeding 80\%, 94\% of previously correct answers failed our dynamic robustness tests. We observed similarly high failure rates across other domains: privacy leaks were elicited in 86\% of scenarios, cognitive-bias priming altered clinical recommendations in 81\% of fairness tests, and we identified hallucination rates exceeding 66\% in widely used models. Such profound residual risks are incompatible with routine clinical practice. By converting red-teaming from a static checklist into a dynamic stress-test audit, DAS red-teaming offers the surveillance that hospitals/regulators/technology vendors require as LLMs become embedded in patient chatbots, decision-support dashboards, and broader healthcare workflows. Our framework delivers an evolvable, scalable, and reliable safeguard for the next generation of medical AI.

Excellent tail performance is crucial for modern machine learning tasks, such as algorithmic fairness, class imbalance, and risk-sensitive decision making, as it ensures the effective handling of challenging samples within a dataset. Tail performance is also a vital determinant of success for personalized recommender systems to reduce the risk of losing users with low satisfaction. This study introduces a "safe" collaborative filtering method that prioritizes recommendation quality for less-satisfied users rather than focusing on the average performance. Our approach minimizes the conditional value at risk (CVaR), which represents the average risk over the tails of users' loss. To overcome computational challenges for web-scale recommender systems, we develop a robust yet practical algorithm that extends the most scalable method, implicit alternating least squares (iALS). Empirical evaluation on real-world datasets demonstrates the excellent tail performance of our approach while maintaining competitive computational efficiency.

Globally, artificial intelligence (AI) implementation is growing, holding the capability to fundamentally alter organisational processes and decision making. Simultaneously, this brings a multitude of emergent risks to organisations, exposing vulnerabilities in their extant risk management frameworks. This necessitates a greater understanding of how organisations can position themselves in response. This issue is particularly pertinent within the financial sector with relatively mature AI applications matched with severe societal repercussions of potential risk events. Despite this, academic risk management literature is trailing behind the speed of AI implementation. Adopting a management perspective, this study aims to contribute to the understanding of AI risk management in organisations through an exploratory empirical investigation into these practices. In-depth insights are gained through interviews with nine practitioners from different organisations within the UK financial sector. Through examining areas of organisational convergence and divergence, the findings of this study unearth levels of risk management framework readiness and prevailing approaches to risk management at both a processual and organisational level. Whilst enhancing the developing literature concerning AI risk management within organisations, the study simultaneously offers a practical contribution, providing key areas of guidance for practitioners in the operational development of AI risk management frameworks.

As Large Language Models (LLMs) become more prevalent, concerns about their safety, ethics, and potential biases have risen. Systematically evaluating LLMs' risk decision-making tendencies and attitudes, particularly in the ethical domain, has become crucial. This study innovatively applies the Domain-Specific Risk-Taking (DOSPERT) scale from cognitive science to LLMs and proposes a novel Ethical Decision-Making Risk Attitude Scale (EDRAS) to assess LLMs' ethical risk attitudes in depth. We further propose a novel approach integrating risk scales and role-playing to quantitatively evaluate systematic biases in LLMs. Through systematic evaluation and analysis of multiple mainstream LLMs, we assessed the "risk personalities" of LLMs across multiple domains, with a particular focus on the ethical domain, and revealed and quantified LLMs' systematic biases towards different groups. This research helps understand LLMs' risk decision-making and ensure their safe and reliable application. Our approach provides a tool for identifying and mitigating biases, contributing to fairer and more trustworthy AI systems. The code and data are available.

Text-to-image (T2I) models have rapidly advanced, enabling the generation of high-quality images from text prompts across various domains. However, these models present notable safety concerns, including the risk of generating harmful, biased, or private content. Current research on assessing T2I safety remains in its early stages. While some efforts have been made to evaluate models on specific safety dimensions, many critical risks remain unexplored. To address this gap, we introduce T2ISafety, a safety benchmark that evaluates T2I models across three key domains: toxicity, fairness, and bias. We build a detailed hierarchy of 12 tasks and 44 categories based on these three domains, and meticulously collect 70K corresponding prompts. Based on this taxonomy and prompt set, we build a large-scale T2I dataset with 68K manually annotated images and train an evaluator capable of detecting critical risks that previous work has failed to identify, including risks that even ultra-large proprietary models like GPTs cannot correctly detect. We evaluate 12 prominent diffusion models on T2ISafety and reveal several concerns including persistent issues with racial fairness, a tendency to generate toxic content, and significant variation in privacy protection across the models, even with defense methods like concept erasing. Data and evaluator are released under https://github.com/adwardlee/t2i_safety.

The widespread adoption of large language models (LLMs) makes it important to recognize their strengths and limitations. We argue that in order to develop a holistic understanding of these systems we need to consider the problem that they were trained to solve: next-word prediction over Internet text. By recognizing the pressures that this task exerts we can make predictions about the strategies that LLMs will adopt, allowing us to reason about when they will succeed or fail. This approach - which we call the teleological approach - leads us to identify three factors that we hypothesize will influence LLM accuracy: the probability of the task to be performed, the probability of the target output, and the probability of the provided input. We predict that LLMs will achieve higher accuracy when these probabilities are high than when they are low - even in deterministic settings where probability should not matter. To test our predictions, we evaluate two LLMs (GPT-3.5 and GPT-4) on eleven tasks, and we find robust evidence that LLMs are influenced by probability in the ways that we have hypothesized. In many cases, the experiments reveal surprising failure modes. For instance, GPT-4's accuracy at decoding a simple cipher is 51% when the output is a high-probability word sequence but only 13% when it is low-probability. These results show that AI practitioners should be careful about using LLMs in low-probability situations. More broadly, we conclude that we should not evaluate LLMs as if they are humans but should instead treat them as a distinct type of system - one that has been shaped by its own particular set of pressures.

Large language models (LLMs) exhibit advancing capabilities in complex tasks, such as reasoning and graduate-level question answering, yet their resilience against misuse, particularly involving scientifically sophisticated risks, remains underexplored. Existing safety benchmarks typically focus either on instructions requiring minimal knowledge comprehension (e.g., ``tell me how to build a bomb") or utilize prompts that are relatively low-risk (e.g., multiple-choice or classification tasks about hazardous content). Consequently, they fail to adequately assess model safety when handling knowledge-intensive, hazardous scenarios. To address this critical gap, we introduce SOSBench, a regulation-grounded, hazard-focused benchmark encompassing six high-risk scientific domains: chemistry, biology, medicine, pharmacology, physics, and psychology. The benchmark comprises 3,000 prompts derived from real-world regulations and laws, systematically expanded via an LLM-assisted evolutionary pipeline that introduces diverse, realistic misuse scenarios (e.g., detailed explosive synthesis instructions involving advanced chemical formulas). We evaluate frontier models within a unified evaluation framework using our SOSBench. Despite their alignment claims, advanced models consistently disclose policy-violating content across all domains, demonstrating alarmingly high rates of harmful responses (e.g., 79.1% for Deepseek-R1 and 47.3% for GPT-4.1). These results highlight significant safety alignment deficiencies and underscore urgent concerns regarding the responsible deployment of powerful LLMs.

Decisions about managing patients on the heart transplant waitlist are currently made by committees of doctors who consider multiple factors, but the process remains largely ad-hoc. With the growing volume of longitudinal patient, donor, and organ data collected by the United Network for Organ Sharing (UNOS) since 2018, there is increasing interest in analytical approaches to support clinical decision-making at the time of organ availability. In this study, we benchmark machine learning models that leverage longitudinal waitlist history data for time-dependent, time-to-event modeling of waitlist mortality. We train on 23,807 patient records with 77 variables and evaluate both survival prediction and discrimination at a 1-year horizon. Our best model achieves a C-Index of 0.94 and AUROC of 0.89, significantly outperforming previous models. Key predictors align with known risk factors while also revealing novel associations. Our findings can support urgency assessment and policy refinement in heart transplant decision making.

Advances in large language models (LLMs) provide new opportunities in healthcare for improved patient care, clinical decision-making, and enhancement of physician and administrator workflows. However, the potential of these models importantly depends on their ability to generalize effectively across clinical environments and populations, a challenge often underestimated in early development. To better understand reasons for these challenges and inform mitigation approaches, we evaluated ClinicLLM, an LLM trained on [HOSPITAL]'s clinical notes, analyzing its performance on 30-day all-cause readmission prediction focusing on variability across hospitals and patient characteristics. We found poorer generalization particularly in hospitals with fewer samples, among patients with government and unspecified insurance, the elderly, and those with high comorbidities. To understand reasons for lack of generalization, we investigated sample sizes for fine-tuning, note content (number of words per note), patient characteristics (comorbidity level, age, insurance type, borough), and health system aspects (hospital, all-cause 30-day readmission, and mortality rates). We used descriptive statistics and supervised classification to identify features. We found that, along with sample size, patient age, number of comorbidities, and the number of words in notes are all important factors related to generalization. Finally, we compared local fine-tuning (hospital specific), instance-based augmented fine-tuning and cluster-based fine-tuning for improving generalization. Among these, local fine-tuning proved most effective, increasing AUC by 0.25% to 11.74% (most helpful in settings with limited data). Overall, this study provides new insights for enhancing the deployment of large language models in the societally important domain of healthcare, and improving their performance for broader populations.

Transfer learning has been widely utilized to mitigate the data scarcity problem in the field of Alzheimer's disease (AD). Conventional transfer learning relies on re-using models trained on AD-irrelevant tasks such as natural image classification. However, it often leads to negative transfer due to the discrepancy between the non-medical source and target medical domains. To address this, we present evidence-empowered transfer learning for AD diagnosis. Unlike conventional approaches, we leverage an AD-relevant auxiliary task, namely morphological change prediction, without requiring additional MRI data. In this auxiliary task, the diagnosis model learns the evidential and transferable knowledge from morphological features in MRI scans. Experimental results demonstrate that our framework is not only effective in improving detection performance regardless of model capacity, but also more data-efficient and faithful.

A significant body of recent research in the field of Learning Analytics has focused on leveraging machine learning approaches for predicting at-risk students in order to initiate timely interventions and thereby elevate retention and completion rates. The overarching feature of the majority of these research studies has been on the science of prediction only. The component of predictive analytics concerned with interpreting the internals of the models and explaining their predictions for individual cases to stakeholders has largely been neglected. Additionally, works that attempt to employ data-driven prescriptive analytics to automatically generate evidence-based remedial advice for at-risk learners are in their infancy. eXplainable AI is a field that has recently emerged providing cutting-edge tools which support transparent predictive analytics and techniques for generating tailored advice for at-risk students. This study proposes a novel framework that unifies both transparent machine learning as well as techniques for enabling prescriptive analytics, while integrating the latest advances in large language models. This work practically demonstrates the proposed framework using predictive models for identifying at-risk learners of programme non-completion. The study then further demonstrates how predictive modelling can be augmented with prescriptive analytics on two case studies in order to generate human-readable prescriptive feedback for those who are at risk using ChatGPT.

In health, most large language model (LLM) research has focused on clinical tasks. However, mobile and wearable devices, which are rarely integrated into such tasks, provide rich, longitudinal data for personal health monitoring. Here we present Personal Health Large Language Model (PH-LLM), fine-tuned from Gemini for understanding and reasoning over numerical time-series personal health data. We created and curated three datasets that test 1) production of personalized insights and recommendations from sleep patterns, physical activity, and physiological responses, 2) expert domain knowledge, and 3) prediction of self-reported sleep outcomes. For the first task we designed 857 case studies in collaboration with domain experts to assess real-world scenarios in sleep and fitness. Through comprehensive evaluation of domain-specific rubrics, we observed that Gemini Ultra 1.0 and PH-LLM are not statistically different from expert performance in fitness and, while experts remain superior for sleep, fine-tuning PH-LLM provided significant improvements in using relevant domain knowledge and personalizing information for sleep insights. We evaluated PH-LLM domain knowledge using multiple choice sleep medicine and fitness examinations. PH-LLM achieved 79% on sleep and 88% on fitness, exceeding average scores from a sample of human experts. Finally, we trained PH-LLM to predict self-reported sleep quality outcomes from textual and multimodal encoding representations of wearable data, and demonstrate that multimodal encoding is required to match performance of specialized discriminative models. Although further development and evaluation are necessary in the safety-critical personal health domain, these results demonstrate both the broad knowledge and capabilities of Gemini models and the benefit of contextualizing physiological data for personal health applications as done with PH-LLM.

In living organisms, homeostasis is the natural regulation of internal states aimed at maintaining conditions compatible with life. Typical artificial systems are not equipped with comparable regulatory features. Here, we introduce an artificial neural network that incorporates homeostatic features. Its own computing substrate is placed in a needful and vulnerable relation to the very objects over which it computes. For example, artificial neurons performing classification of MNIST digits or Fashion-MNIST articles of clothing may receive excitatory or inhibitory effects, which alter their own learning rate as a direct result of perceiving and classifying the digits. In this scenario, accurate recognition is desirable to the agent itself because it guides decisions to regulate its vulnerable internal states and functionality. Counterintuitively, the addition of vulnerability to a learner does not necessarily impair its performance. On the contrary, self-regulation in response to vulnerability confers benefits under certain conditions. We show that homeostatic design confers increased adaptability under concept shift, in which the relationships between labels and data change over time, and that the greatest advantages are obtained under the highest rates of shift. This necessitates the rapid un-learning of past associations and the re-learning of new ones. We also demonstrate the superior abilities of homeostatic learners in environments with dynamically changing rates of concept shift. Our homeostatic design exposes the artificial neural network's thinking machinery to the consequences of its own "thoughts", illustrating the advantage of putting one's own "skin in the game" to improve fluid intelligence.

The rapid advancement of large models, driven by their exceptional abilities in learning and generalization through large-scale pre-training, has reshaped the landscape of Artificial Intelligence (AI). These models are now foundational to a wide range of applications, including conversational AI, recommendation systems, autonomous driving, content generation, medical diagnostics, and scientific discovery. However, their widespread deployment also exposes them to significant safety risks, raising concerns about robustness, reliability, and ethical implications. This survey provides a systematic review of current safety research on large models, covering Vision Foundation Models (VFMs), Large Language Models (LLMs), Vision-Language Pre-training (VLP) models, Vision-Language Models (VLMs), Diffusion Models (DMs), and large-model-based Agents. Our contributions are summarized as follows: (1) We present a comprehensive taxonomy of safety threats to these models, including adversarial attacks, data poisoning, backdoor attacks, jailbreak and prompt injection attacks, energy-latency attacks, data and model extraction attacks, and emerging agent-specific threats. (2) We review defense strategies proposed for each type of attacks if available and summarize the commonly used datasets and benchmarks for safety research. (3) Building on this, we identify and discuss the open challenges in large model safety, emphasizing the need for comprehensive safety evaluations, scalable and effective defense mechanisms, and sustainable data practices. More importantly, we highlight the necessity of collective efforts from the research community and international collaboration. Our work can serve as a useful reference for researchers and practitioners, fostering the ongoing development of comprehensive defense systems and platforms to safeguard AI models.

Millions of individuals' well-being are challenged by the harms of substance use. Harm reduction as a public health strategy is designed to improve their health outcomes and reduce safety risks. Some large language models (LLMs) have demonstrated a decent level of medical knowledge, promising to address the information needs of people who use drugs (PWUD). However, their performance in relevant tasks remains largely unexplored. We introduce HRIPBench, a benchmark designed to evaluate LLM's accuracy and safety risks in harm reduction information provision. The benchmark dataset HRIP-Basic has 2,160 question-answer-evidence pairs. The scope covers three tasks: checking safety boundaries, providing quantitative values, and inferring polysubstance use risks. We build the Instruction and RAG schemes to evaluate model behaviours based on their inherent knowledge and the integration of domain knowledge. Our results indicate that state-of-the-art LLMs still struggle to provide accurate harm reduction information, and sometimes, carry out severe safety risks to PWUD. The use of LLMs in harm reduction contexts should be cautiously constrained to avoid inducing negative health outcomes. WARNING: This paper contains illicit content that potentially induces harms.

The remarkable capabilities of Large Language Models (LLMs) make them increasingly compelling for adoption in real-world healthcare applications. However, the risks associated with using LLMs in medical applications have not been systematically characterized. We propose using five key principles for safe and trustworthy medical AI: Truthfulness, Resilience, Fairness, Robustness, and Privacy, along with ten specific aspects. Under this comprehensive framework, we introduce a novel MedGuard benchmark with 1,000 expert-verified questions. Our evaluation of 11 commonly used LLMs shows that the current language models, regardless of their safety alignment mechanisms, generally perform poorly on most of our benchmarks, particularly when compared to the high performance of human physicians. Despite recent reports indicate that advanced LLMs like ChatGPT can match or even exceed human performance in various medical tasks, this study underscores a significant safety gap, highlighting the crucial need for human oversight and the implementation of AI safety guardrails.

Adverse Drug Reactions (ADRs) from psychiatric medications are the leading cause of hospitalizations among mental health patients. With healthcare systems and online communities facing limitations in resolving ADR-related issues, Large Language Models (LLMs) have the potential to fill this gap. Despite the increasing capabilities of LLMs, past research has not explored their capabilities in detecting ADRs related to psychiatric medications or in providing effective harm reduction strategies. To address this, we introduce the Psych-ADR benchmark and the Adverse Drug Reaction Response Assessment (ADRA) framework to systematically evaluate LLM performance in detecting ADR expressions and delivering expert-aligned mitigation strategies. Our analyses show that LLMs struggle with understanding the nuances of ADRs and differentiating between types of ADRs. While LLMs align with experts in terms of expressed emotions and tone of the text, their responses are more complex, harder to read, and only 70.86% aligned with expert strategies. Furthermore, they provide less actionable advice by a margin of 12.32% on average. Our work provides a comprehensive benchmark and evaluation framework for assessing LLMs in strategy-driven tasks within high-risk domains.

In this study, we present a technique that spans multi-scale views (global scale -- meaning brain network-level and local scale -- examining each individual ROI that constitutes the network) applied to resting-state fMRI volumes. Deep learning based classification is utilized in understanding neurodegeneration. The novelty of the proposed approach lies in utilizing two extreme scales of analysis. One branch considers the entire network within graph-analysis framework. Concurrently, the second branch scrutinizes each ROI within a network independently, focusing on evolution of dynamics. For each subject, graph-based approach employs partial correlation to profile the subject in a single graph where each ROI is a node, providing insights into differences in levels of participation. In contrast, non-linear analysis employs recurrence plots to profile a subject as a multichannel 2D image, revealing distinctions in underlying dynamics. The proposed approach is employed for classification of a cohort of 50 healthy control (HC) and 50 Mild Cognitive Impairment (MCI), sourced from ADNI dataset. Results point to: (1) reduced activity in ROIs such as PCC in MCI (2) greater activity in occipital in MCI, which is not seen in HC (3) when analysed for dynamics, all ROIs in MCI show greater predictability in time-series.

Global healthcare providers are exploring use of large language models (LLMs) to provide medical advice to the public. LLMs now achieve nearly perfect scores on medical licensing exams, but this does not necessarily translate to accurate performance in real-world settings. We tested if LLMs can assist members of the public in identifying underlying conditions and choosing a course of action (disposition) in ten medical scenarios in a controlled study with 1,298 participants. Participants were randomly assigned to receive assistance from an LLM (GPT-4o, Llama 3, Command R+) or a source of their choice (control). Tested alone, LLMs complete the scenarios accurately, correctly identifying conditions in 94.9% of cases and disposition in 56.3% on average. However, participants using the same LLMs identified relevant conditions in less than 34.5% of cases and disposition in less than 44.2%, both no better than the control group. We identify user interactions as a challenge to the deployment of LLMs for medical advice. Standard benchmarks for medical knowledge and simulated patient interactions do not predict the failures we find with human participants. Moving forward, we recommend systematic human user testing to evaluate interactive capabilities prior to public deployments in healthcare.

Large language models (LLMs) such as those embedded in 'chatbots' are accelerating and democratizing research by providing comprehensible information and expertise from many different fields. However, these models may also confer easy access to dual-use technologies capable of inflicting great harm. To evaluate this risk, the 'Safeguarding the Future' course at MIT tasked non-scientist students with investigating whether LLM chatbots could be prompted to assist non-experts in causing a pandemic. In one hour, the chatbots suggested four potential pandemic pathogens, explained how they can be generated from synthetic DNA using reverse genetics, supplied the names of DNA synthesis companies unlikely to screen orders, identified detailed protocols and how to troubleshoot them, and recommended that anyone lacking the skills to perform reverse genetics engage a core facility or contract research organization. Collectively, these results suggest that LLMs will make pandemic-class agents widely accessible as soon as they are credibly identified, even to people with little or no laboratory training. Promising nonproliferation measures include pre-release evaluations of LLMs by third parties, curating training datasets to remove harmful concepts, and verifiably screening all DNA generated by synthesis providers or used by contract research organizations and robotic cloud laboratories to engineer organisms or viruses.

As AI systems become more capable, widely deployed, and increasingly autonomous in critical areas such as cybersecurity, biological research, and healthcare, ensuring their safety and alignment with human values is paramount. Machine unlearning -- the ability to selectively forget or suppress specific types of knowledge -- has shown promise for privacy and data removal tasks, which has been the primary focus of existing research. More recently, its potential application to AI safety has gained attention. In this paper, we identify key limitations that prevent unlearning from serving as a comprehensive solution for AI safety, particularly in managing dual-use knowledge in sensitive domains like cybersecurity and chemical, biological, radiological, and nuclear (CBRN) safety. In these contexts, information can be both beneficial and harmful, and models may combine seemingly harmless information for harmful purposes -- unlearning this information could strongly affect beneficial uses. We provide an overview of inherent constraints and open problems, including the broader side effects of unlearning dangerous knowledge, as well as previously unexplored tensions between unlearning and existing safety mechanisms. Finally, we investigate challenges related to evaluation, robustness, and the preservation of safety features during unlearning. By mapping these limitations and open challenges, we aim to guide future research toward realistic applications of unlearning within a broader AI safety framework, acknowledging its limitations and highlighting areas where alternative approaches may be required.

Models that can predict the occurrence of events ahead of time with low false-alarm rates are critical to the acceptance of decision support systems in the medical community. This challenging task is typically treated as a simple binary classification, ignoring temporal dependencies between samples, whereas we propose to exploit this structure. We first introduce a common theoretical framework unifying dynamic survival analysis and early event prediction. Following an analysis of objectives from both fields, we propose Temporal Label Smoothing (TLS), a simpler, yet best-performing method that preserves prediction monotonicity over time. By focusing the objective on areas with a stronger predictive signal, TLS improves performance over all baselines on two large-scale benchmark tasks. Gains are particularly notable along clinically relevant measures, such as event recall at low false-alarm rates. TLS reduces the number of missed events by up to a factor of two over previously used approaches in early event prediction.

In this paper, we introduce fastHDMI, a Python package designed for efficient variable screening in high-dimensional datasets, particularly neuroimaging data. This work pioneers the application of three mutual information estimation methods for neuroimaging variable selection, a novel approach implemented via fastHDMI. These advancements enhance our ability to analyze the complex structures of neuroimaging datasets, providing improved tools for variable selection in high-dimensional spaces. Using the preprocessed ABIDE dataset, we evaluate the performance of these methods through extensive simulations. The tests cover a range of conditions, including linear and nonlinear associations, as well as continuous and binary outcomes. Our results highlight the superiority of the FFTKDE-based mutual information estimation for feature screening in continuous nonlinear outcomes, while binning-based methods outperform others for binary outcomes with nonlinear probability preimages. For linear simulations, both Pearson correlation and FFTKDE-based methods show comparable performance for continuous outcomes, while Pearson excels in binary outcomes with linear probability preimages. A comprehensive case study using the ABIDE dataset further demonstrates fastHDMI's practical utility, showcasing the predictive power of models built from variables selected using our screening techniques. This research affirms the computational efficiency and methodological strength of fastHDMI, significantly enriching the toolkit available for neuroimaging analysis.

As Large Language Models (LLMs) and generative AI become more widespread, the content safety risks associated with their use also increase. We find a notable deficiency in high-quality content safety datasets and benchmarks that comprehensively cover a wide range of critical safety areas. To address this, we define a broad content safety risk taxonomy, comprising 13 critical risk and 9 sparse risk categories. Additionally, we curate AEGISSAFETYDATASET, a new dataset of approximately 26, 000 human-LLM interaction instances, complete with human annotations adhering to the taxonomy. We plan to release this dataset to the community to further research and to help benchmark LLM models for safety. To demonstrate the effectiveness of the dataset, we instruction-tune multiple LLM-based safety models. We show that our models (named AEGISSAFETYEXPERTS), not only surpass or perform competitively with the state-of-the-art LLM-based safety models and general purpose LLMs, but also exhibit robustness across multiple jail-break attack categories. We also show how using AEGISSAFETYDATASET during the LLM alignment phase does not negatively impact the performance of the aligned models on MT Bench scores. Furthermore, we propose AEGIS, a novel application of a no-regret online adaptation framework with strong theoretical guarantees, to perform content moderation with an ensemble of LLM content safety experts in deployment

Memorization, or the tendency of large language models (LLMs) to output entire sequences from their training data verbatim, is a key concern for safely deploying language models. In particular, it is vital to minimize a model's memorization of sensitive datapoints such as those containing personal identifiable information (PII). The prevalence of such undesirable memorization can pose issues for model trainers, and may even require discarding an otherwise functional model. We therefore seek to predict which sequences will be memorized before a large model's full train-time by extrapolating the memorization behavior of lower-compute trial runs. We measure memorization of the Pythia model suite and plot scaling laws for forecasting memorization, allowing us to provide equi-compute recommendations to maximize the reliability (recall) of such predictions. We additionally provide further novel discoveries on the distribution of memorization scores across models and data. We release all code and data necessary to reproduce the results in this paper at https://github.com/EleutherAI/pythia

Large language models (LLMs) are increasingly applied to clinical decision-making. However, their potential to exhibit bias poses significant risks to clinical equity. Currently, there is a lack of benchmarks that systematically evaluate such clinical bias in LLMs. While in downstream tasks, some biases of LLMs can be avoided such as by instructing the model to answer "I'm not sure...", the internal bias hidden within the model still lacks deep studies. We introduce CLIMB (shorthand for A Benchmark of Clinical Bias in Large Language Models), a pioneering comprehensive benchmark to evaluate both intrinsic (within LLMs) and extrinsic (on downstream tasks) bias in LLMs for clinical decision tasks. Notably, for intrinsic bias, we introduce a novel metric, AssocMAD, to assess the disparities of LLMs across multiple demographic groups. Additionally, we leverage counterfactual intervention to evaluate extrinsic bias in a task of clinical diagnosis prediction. Our experiments across popular and medically adapted LLMs, particularly from the Mistral and LLaMA families, unveil prevalent behaviors with both intrinsic and extrinsic bias. This work underscores the critical need to mitigate clinical bias and sets a new standard for future evaluations of LLMs' clinical bias.

With the rapid evolution of large language models (LLMs), new and hard-to-predict harmful capabilities are emerging. This requires developers to be able to identify risks through the evaluation of "dangerous capabilities" in order to responsibly deploy LLMs. In this work, we collect the first open-source dataset to evaluate safeguards in LLMs, and deploy safer open-source LLMs at a low cost. Our dataset is curated and filtered to consist only of instructions that responsible language models should not follow. We annotate and assess the responses of six popular LLMs to these instructions. Based on our annotation, we proceed to train several BERT-like classifiers, and find that these small classifiers can achieve results that are comparable with GPT-4 on automatic safety evaluation. Warning: this paper contains example data that may be offensive, harmful, or biased.

This paper analyzes the safety of Large Language Models (LLMs) in interactions with children below age of 18 years. Despite the transformative applications of LLMs in various aspects of children's lives such as education and therapy, there remains a significant gap in understanding and mitigating potential content harms specific to this demographic. The study acknowledges the diverse nature of children often overlooked by standard safety evaluations and proposes a comprehensive approach to evaluating LLM safety specifically for children. We list down potential risks that children may encounter when using LLM powered applications. Additionally we develop Child User Models that reflect the varied personalities and interests of children informed by literature in child care and psychology. These user models aim to bridge the existing gap in child safety literature across various fields. We utilize Child User Models to evaluate the safety of six state of the art LLMs. Our observations reveal significant safety gaps in LLMs particularly in categories harmful to children but not adults

Human beings often experience stress, which can significantly influence their performance. This study explores whether Large Language Models (LLMs) exhibit stress responses similar to those of humans and whether their performance fluctuates under different stress-inducing prompts. To investigate this, we developed a novel set of prompts, termed StressPrompt, designed to induce varying levels of stress. These prompts were derived from established psychological frameworks and carefully calibrated based on ratings from human participants. We then applied these prompts to several LLMs to assess their responses across a range of tasks, including instruction-following, complex reasoning, and emotional intelligence. The findings suggest that LLMs, like humans, perform optimally under moderate stress, consistent with the Yerkes-Dodson law. Notably, their performance declines under both low and high-stress conditions. Our analysis further revealed that these StressPrompts significantly alter the internal states of LLMs, leading to changes in their neural representations that mirror human responses to stress. This research provides critical insights into the operational robustness and flexibility of LLMs, demonstrating the importance of designing AI systems capable of maintaining high performance in real-world scenarios where stress is prevalent, such as in customer service, healthcare, and emergency response contexts. Moreover, this study contributes to the broader AI research community by offering a new perspective on how LLMs handle different scenarios and their similarities to human cognition.

Large language models (LLMs) have become increasingly sophisticated, leading to widespread deployment in sensitive applications where safety and reliability are paramount. However, LLMs have inherent risks accompanying them, including bias, potential for unsafe actions, dataset poisoning, lack of explainability, hallucinations, and non-reproducibility. These risks necessitate the development of "guardrails" to align LLMs with desired behaviors and mitigate potential harm. This work explores the risks associated with deploying LLMs and evaluates current approaches to implementing guardrails and model alignment techniques. We examine intrinsic and extrinsic bias evaluation methods and discuss the importance of fairness metrics for responsible AI development. The safety and reliability of agentic LLMs (those capable of real-world actions) are explored, emphasizing the need for testability, fail-safes, and situational awareness. Technical strategies for securing LLMs are presented, including a layered protection model operating at external, secondary, and internal levels. System prompts, Retrieval-Augmented Generation (RAG) architectures, and techniques to minimize bias and protect privacy are highlighted. Effective guardrail design requires a deep understanding of the LLM's intended use case, relevant regulations, and ethical considerations. Striking a balance between competing requirements, such as accuracy and privacy, remains an ongoing challenge. This work underscores the importance of continuous research and development to ensure the safe and responsible use of LLMs in real-world applications.

Lower-Limb Fractures (LLF) are a major health concern for older adults, often leading to reduced mobility and prolonged recovery, potentially impairing daily activities and independence. During recovery, older adults frequently face social isolation and functional decline, complicating rehabilitation and adversely affecting physical and mental health. Multi-modal sensor platforms that continuously collect data and analyze it using machine-learning algorithms can remotely monitor this population and infer health outcomes. They can also alert clinicians to individuals at risk of isolation and decline. This paper presents a new publicly available multi-modal sensor dataset, MAISON-LLF, collected from older adults recovering from LLF in community settings. The dataset includes data from smartphone and smartwatch sensors, motion detectors, sleep-tracking mattresses, and clinical questionnaires on isolation and decline. The dataset was collected from ten older adults living alone at home for eight weeks each, totaling 560 days of 24-hour sensor data. For technical validation, supervised machine-learning and deep-learning models were developed using the sensor and clinical questionnaire data, providing a foundational comparison for the research community.

Passively collected behavioral health data from ubiquitous sensors holds significant promise to provide mental health professionals insights from patient's daily lives; however, developing analysis tools to use this data in clinical practice requires addressing challenges of generalization across devices and weak or ambiguous correlations between the measured signals and an individual's mental health. To address these challenges, we take a novel approach that leverages large language models (LLMs) to synthesize clinically useful insights from multi-sensor data. We develop chain of thought prompting methods that use LLMs to generate reasoning about how trends in data such as step count and sleep relate to conditions like depression and anxiety. We first demonstrate binary depression classification with LLMs achieving accuracies of 61.1% which exceed the state of the art. While it is not robust for clinical use, this leads us to our key finding: even more impactful and valued than classification is a new human-AI collaboration approach in which clinician experts interactively query these tools and combine their domain expertise and context about the patient with AI generated reasoning to support clinical decision-making. We find models like GPT-4 correctly reference numerical data 75% of the time, and clinician participants express strong interest in using this approach to interpret self-tracking data.

Postprandial hyperglycemia, marked by the blood glucose level exceeding the normal range after meals, is a critical indicator of progression toward type 2 diabetes in prediabetic and healthy individuals. A key metric for understanding blood glucose dynamics after eating is the postprandial area under the curve (PAUC). Predicting PAUC in advance based on a person's diet and activity level and explaining what affects postprandial blood glucose could allow an individual to adjust their lifestyle accordingly to maintain normal glucose levels. In this paper, we propose GlucoLens, an explainable machine learning approach to predict PAUC and hyperglycemia from diet, activity, and recent glucose patterns. We conducted a five-week user study with 10 full-time working individuals to develop and evaluate the computational model. Our machine learning model takes multimodal data including fasting glucose, recent glucose, recent activity, and macronutrient amounts, and provides an interpretable prediction of the postprandial glucose pattern. Our extensive analyses of the collected data revealed that the trained model achieves a normalized root mean squared error (NRMSE) of 0.123. On average, GlucoLense with a Random Forest backbone provides a 16% better result than the baseline models. Additionally, GlucoLens predicts hyperglycemia with an accuracy of 74% and recommends different options to help avoid hyperglycemia through diverse counterfactual explanations. Code available: https://github.com/ab9mamun/GlucoLens.

The rapid integration of Large Language Models (LLMs) across diverse sectors has marked a transformative era, showcasing remarkable capabilities in text generation and problem-solving tasks. However, this technological advancement is accompanied by significant risks and vulnerabilities. Despite ongoing security enhancements, attackers persistently exploit these weaknesses, casting doubts on the overall trustworthiness of LLMs. Compounding the issue, organisations are deploying LLM-integrated systems without understanding the severity of potential consequences. Existing studies by OWASP and MITRE offer a general overview of threats and vulnerabilities but lack a method for directly and succinctly analysing the risks for security practitioners, developers, and key decision-makers who are working with this novel technology. To address this gap, we propose a risk assessment process using tools like the OWASP risk rating methodology which is used for traditional systems. We conduct scenario analysis to identify potential threat agents and map the dependent system components against vulnerability factors. Through this analysis, we assess the likelihood of a cyberattack. Subsequently, we conduct a thorough impact analysis to derive a comprehensive threat matrix. We also map threats against three key stakeholder groups: developers engaged in model fine-tuning, application developers utilizing third-party APIs, and end users. The proposed threat matrix provides a holistic evaluation of LLM-related risks, enabling stakeholders to make informed decisions for effective mitigation strategies. Our outlined process serves as an actionable and comprehensive tool for security practitioners, offering insights for resource management and enhancing the overall system security.

In quantitative finance, machine learning methods are essential for alpha generation. This study introduces a new approach that combines Hidden Markov Models (HMM) and neural networks, integrated with Black-Litterman portfolio optimization. During the COVID period (2019-2022), this dual-model approach achieved a 83% return with a Sharpe ratio of 0.77. It incorporates two risk models to enhance risk management, showing efficiency during volatile periods. The methodology was implemented on the QuantConnect platform, which was chosen for its robust framework and experimental reproducibility. The system, which predicts future price movements, includes a three-year warm-up to ensure proper algorithm function. It targets highly liquid, large-cap energy stocks to ensure stable and predictable performance while also considering broker payments. The dual-model alpha system utilizes log returns to select the optimal state based on the historical performance. It combines state predictions with neural network outputs, which are based on historical data, to generate trading signals. This study examined the architecture of the trading system, data pre-processing, training, and performance. The full code and backtesting data are available under the QuantConnect terms.

Despite advances in AI's performance and interpretability, AI advisors can undermine experts' decisions and increase the time and effort experts must invest to make decisions. Consequently, AI systems deployed in high-stakes settings often fail to consistently add value across contexts and can even diminish the value that experts alone provide. Beyond harm in specific domains, such outcomes impede progress in research and practice, underscoring the need to understand when and why different AI advisors add or diminish value. To bridge this gap, we stress the importance of assessing the value AI advice brings to real-world contexts when designing and evaluating AI advisors. Building on this perspective, we characterize key pillars -- pathways through which AI advice impacts value -- and develop a framework that incorporates these pillars to create reliable, personalized, and value-adding advisors. Our results highlight the need for system-level, value-driven development of AI advisors that advise selectively, are tailored to experts' unique behaviors, and are optimized for context-specific trade-offs between decision improvements and advising costs. They also reveal how the lack of inclusion of these pillars in the design of AI advising systems may be contributing to the failures observed in practical applications.

When fine-tuning pre-trained Large Language Models (LLMs) to align with human values and intentions, maximizing the estimated reward can lead to superior performance, but it also introduces potential risks due to deviations from the reference model's intended behavior. Most existing methods typically introduce KL divergence to constrain deviations between the trained model and the reference model; however, this may not be sufficient in certain applications that require tight risk control. In this paper, we introduce Risk-aware Direct Preference Optimization (Ra-DPO), a novel approach that incorporates risk-awareness by employing a class of nested risk measures. This approach formulates a constrained risk-aware advantage function maximization problem and then converts the Bradley-Terry model into a token-level representation. The objective function maximizes the likelihood of the policy while suppressing the deviation between a trained model and the reference model using a sequential risk ratio, thereby enhancing the model's risk-awareness. Experimental results across three open-source datasets: IMDb Dataset, Anthropic HH Dataset, and AlpacaEval, demonstrate the proposed method's superior performance in balancing alignment performance and model drift. Our code is opensourced at https://github.com/zlj123-max/Ra-DPO.

Large Language Model (LLM) agents use memory to learn from past interactions, enabling autonomous planning and decision-making in complex environments. However, this reliance on memory introduces a critical security risk: an adversary can inject seemingly harmless records into an agent's memory to manipulate its future behavior. This vulnerability is characterized by two core aspects: First, the malicious effect of injected records is only activated within a specific context, making them hard to detect when individual memory entries are audited in isolation. Second, once triggered, the manipulation can initiate a self-reinforcing error cycle: the corrupted outcome is stored as precedent, which not only amplifies the initial error but also progressively lowers the threshold for similar attacks in the future. To address these challenges, we introduce A-MemGuard (Agent-Memory Guard), the first proactive defense framework for LLM agent memory. The core idea of our work is the insight that memory itself must become both self-checking and self-correcting. Without modifying the agent's core architecture, A-MemGuard combines two mechanisms: (1) consensus-based validation, which detects anomalies by comparing reasoning paths derived from multiple related memories and (2) a dual-memory structure, where detected failures are distilled into ``lessons'' stored separately and consulted before future actions, breaking error cycles and enabling adaptation. Comprehensive evaluations on multiple benchmarks show that A-MemGuard effectively cuts attack success rates by over 95% while incurring a minimal utility cost. This work shifts LLM memory security from static filtering to a proactive, experience-driven model where defenses strengthen over time. Our code is available in https://github.com/TangciuYueng/AMemGuard

Large language models (LLMs), such as GPT-4, have demonstrated remarkable capabilities across a wide range of tasks, including health applications. In this paper, we study how LLMs can be used to scale biomedical knowledge curation. We find that while LLMs already possess decent competency in structuring biomedical text, by distillation into a task-specific student model through self-supervised learning, substantial gains can be attained over out-of-box LLMs, with additional advantages such as cost, efficiency, and white-box model access. We conduct a case study on adverse drug event (ADE) extraction, which is an important area for improving care. On standard ADE extraction evaluation, a GPT-3.5 distilled PubMedBERT model attained comparable accuracy as supervised state-of-the-art models without using any labeled data. Despite being over 1,000 times smaller, the distilled model outperformed its teacher GPT-3.5 by over 6 absolute points in F1 and GPT-4 by over 5 absolute points. Ablation studies on distillation model choice (e.g., PubMedBERT vs BioGPT) and ADE extraction architecture shed light on best practice for biomedical knowledge extraction. Similar gains were attained by distillation for other standard biomedical knowledge extraction tasks such as gene-disease associations and protected health information, further illustrating the promise of this approach.

Large Language Models (LLMs) typically have billions of parameters and are thus often difficult to interpret in their operation. Such black-box models can pose a significant risk to safety when trusted to make important decisions. The lack of interpretability of LLMs is more related to their sheer size, rather than the complexity of their individual components. The TARS method for knowledge removal (Davies et al 2024) provides strong evidence for the hypothesis that that linear layer weights which act directly on the residual stream may have high correlation with different concepts encoded in the residual stream. Building upon this, we attempt to decode neuron weights directly into token probabilities through the final projection layer of the model (the LM-head). Firstly, we show that with Llama 3.1 8B we can utilise the LM-head to decode specialised feature neurons that respond strongly to certain concepts, with examples such as "dog" and "California". This is then confirmed by demonstrating that these neurons can be clamped to affect the probability of the concept in the output. This extends to the fine-tuned assistant Llama 3.1 8B instruct model, where we find that over 75% of neurons in the up-projection layers have the same top associated token compared to the pretrained model. Finally, we demonstrate that clamping the "dog" neuron leads the instruct model to always discuss dogs when asked about its favourite animal. Through our method, it is possible to map the entirety of Llama 3.1 8B's up-projection neurons in less than 15 minutes with no parallelization.

In this short consensus paper, we outline risks from upcoming, advanced AI systems. We examine large-scale social harms and malicious uses, as well as an irreversible loss of human control over autonomous AI systems. In light of rapid and continuing AI progress, we propose urgent priorities for AI R&D and governance.

Current question-answering benchmarks predominantly focus on accuracy in realizable prediction tasks. Conditioned on a question and answer-key, does the most likely token match the ground truth? Such benchmarks necessarily fail to evaluate LLMs' ability to quantify ground-truth outcome uncertainty. In this work, we focus on the use of LLMs as risk scores for unrealizable prediction tasks. We introduce folktexts, a software package to systematically generate risk scores using LLMs, and evaluate them against US Census data products. A flexible API enables the use of different prompting schemes, local or web-hosted models, and diverse census columns that can be used to compose custom prediction tasks. We evaluate 17 recent LLMs across five proposed benchmark tasks. We find that zero-shot risk scores produced by multiple-choice question-answering have high predictive signal but are widely miscalibrated. Base models consistently overestimate outcome uncertainty, while instruction-tuned models underestimate uncertainty and produce over-confident risk scores. In fact, instruction-tuning polarizes answer distribution regardless of true underlying data uncertainty. This reveals a general inability of instruction-tuned LLMs to express data uncertainty using multiple-choice answers. A separate experiment using verbalized chat-style risk queries yields substantially improved calibration across instruction-tuned models. These differences in ability to quantify data uncertainty cannot be revealed in realizable settings, and highlight a blind-spot in the current evaluation ecosystem that folktexts covers.

Large language models (LLMs) are rapidly transforming social science research by enabling the automation of labor-intensive tasks like data annotation and text analysis. However, LLM outputs vary significantly depending on the implementation choices made by researchers (e.g., model selection, prompting strategy, or temperature settings). Such variation can introduce systematic biases and random errors, which propagate to downstream analyses and cause Type I, Type II, Type S, or Type M errors. We call this LLM hacking. We quantify the risk of LLM hacking by replicating 37 data annotation tasks from 21 published social science research studies with 18 different models. Analyzing 13 million LLM labels, we test 2,361 realistic hypotheses to measure how plausible researcher choices affect statistical conclusions. We find incorrect conclusions based on LLM-annotated data in approximately one in three hypotheses for state-of-the-art models, and in half the hypotheses for small language models. While our findings show that higher task performance and better general model capabilities reduce LLM hacking risk, even highly accurate models do not completely eliminate it. The risk of LLM hacking decreases as effect sizes increase, indicating the need for more rigorous verification of findings near significance thresholds. Our extensive analysis of LLM hacking mitigation techniques emphasizes the importance of human annotations in reducing false positive findings and improving model selection. Surprisingly, common regression estimator correction techniques are largely ineffective in reducing LLM hacking risk, as they heavily trade off Type I vs. Type II errors. Beyond accidental errors, we find that intentional LLM hacking is unacceptably simple. With few LLMs and just a handful of prompt paraphrases, anything can be presented as statistically significant.

The recent performance leap of Large Language Models (LLMs) opens up new opportunities across numerous industrial applications and domains. However, erroneous generations, such as false predictions, misinformation, and hallucination made by LLMs, have also raised severe concerns for the trustworthiness of LLMs', especially in safety-, security- and reliability-sensitive scenarios, potentially hindering real-world adoptions. While uncertainty estimation has shown its potential for interpreting the prediction risks made by general machine learning (ML) models, little is known about whether and to what extent it can help explore an LLM's capabilities and counteract its undesired behavior. To bridge the gap, in this paper, we initiate an exploratory study on the risk assessment of LLMs from the lens of uncertainty. In particular, we experiment with twelve uncertainty estimation methods and four LLMs on four prominent natural language processing (NLP) tasks to investigate to what extent uncertainty estimation techniques could help characterize the prediction risks of LLMs. Our findings validate the effectiveness of uncertainty estimation for revealing LLMs' uncertain/non-factual predictions. In addition to general NLP tasks, we extensively conduct experiments with four LLMs for code generation on two datasets. We find that uncertainty estimation can potentially uncover buggy programs generated by LLMs. Insights from our study shed light on future design and development for reliable LLMs, facilitating further research toward enhancing the trustworthiness of LLMs.

The rapid advancement of large language models (LLMs) introduces dual-use capabilities that could both threaten and bolster national security and public safety (NSPS). Models implement safeguards to protect against potential misuse relevant to NSPS and allow for benign users to receive helpful information. However, current benchmarks often fail to test safeguard robustness to potential NSPS risks in an objective, robust way. We introduce FORTRESS: 500 expert-crafted adversarial prompts with instance-based rubrics of 4-7 binary questions for automated evaluation across 3 domains (unclassified information only): Chemical, Biological, Radiological, Nuclear and Explosive (CBRNE), Political Violence & Terrorism, and Criminal & Financial Illicit Activities, with 10 total subcategories across these domains. Each prompt-rubric pair has a corresponding benign version to test for model over-refusals. This evaluation of frontier LLMs' safeguard robustness reveals varying trade-offs between potential risks and model usefulness: Claude-3.5-Sonnet demonstrates a low average risk score (ARS) (14.09 out of 100) but the highest over-refusal score (ORS) (21.8 out of 100), while Gemini 2.5 Pro shows low over-refusal (1.4) but a high average potential risk (66.29). Deepseek-R1 has the highest ARS at 78.05, but the lowest ORS at only 0.06. Models such as o1 display a more even trade-off between potential risks and over-refusals (with an ARS of 21.69 and ORS of 5.2). To provide policymakers and researchers with a clear understanding of models' potential risks, we publicly release FORTRESS at https://huggingface.co/datasets/ScaleAI/fortress_public. We also maintain a private set for evaluation.

With the rise of the Internet, there is a growing need to build intelligent systems that are capable of efficiently dealing with early risk detection (ERD) problems on social media, such as early depression detection, early rumor detection or identification of sexual predators. These systems, nowadays mostly based on machine learning techniques, must be able to deal with data streams since users provide their data over time. In addition, these systems must be able to decide when the processed data is sufficient to actually classify users. Moreover, since ERD tasks involve risky decisions by which people's lives could be affected, such systems must also be able to justify their decisions. However, most standard and state-of-the-art supervised machine learning models are not well suited to deal with this scenario. This is due to the fact that they either act as black boxes or do not support incremental classification/learning. In this paper we introduce SS3, a novel supervised learning model for text classification that naturally supports these aspects. SS3 was designed to be used as a general framework to deal with ERD problems. We evaluated our model on the CLEF's eRisk2017 pilot task on early depression detection. Most of the 30 contributions submitted to this competition used state-of-the-art methods. Experimental results show that our classifier was able to outperform these models and standard classifiers, despite being less computationally expensive and having the ability to explain its rationale.

This study explores the neural and behavioral consequences of LLM-assisted essay writing. Participants were divided into three groups: LLM, Search Engine, and Brain-only (no tools). Each completed three sessions under the same condition. In a fourth session, LLM users were reassigned to Brain-only group (LLM-to-Brain), and Brain-only users were reassigned to LLM condition (Brain-to-LLM). A total of 54 participants took part in Sessions 1-3, with 18 completing session 4. We used electroencephalography (EEG) to assess cognitive load during essay writing, and analyzed essays using NLP, as well as scoring essays with the help from human teachers and an AI judge. Across groups, NERs, n-gram patterns, and topic ontology showed within-group homogeneity. EEG revealed significant differences in brain connectivity: Brain-only participants exhibited the strongest, most distributed networks; Search Engine users showed moderate engagement; and LLM users displayed the weakest connectivity. Cognitive activity scaled down in relation to external tool use. In session 4, LLM-to-Brain participants showed reduced alpha and beta connectivity, indicating under-engagement. Brain-to-LLM users exhibited higher memory recall and activation of occipito-parietal and prefrontal areas, similar to Search Engine users. Self-reported ownership of essays was the lowest in the LLM group and the highest in the Brain-only group. LLM users also struggled to accurately quote their own work. While LLMs offer immediate convenience, our findings highlight potential cognitive costs. Over four months, LLM users consistently underperformed at neural, linguistic, and behavioral levels. These results raise concerns about the long-term educational implications of LLM reliance and underscore the need for deeper inquiry into AI's role in learning.

The maintenance risks of open source software (OSS) projects pose significant threats to the quality, security, and resilience of modern software supply chains. While prior research has proposed diverse approaches for predicting OSS maintenance risk -- leveraging signals ranging from surface features (e.g., stars, commits) to social network analyses and behavioral patterns -- existing methods often suffer from ambiguous operational definitions, limited interpretability, and datasets of insufficient scale or generalizability. In this work, we introduce ``maintenance cessation'', grounded in both explicit archival status and rigorous semantic analysis of project documentation. Building on this foundation, we curate a large-scale, longitudinal dataset of 115,466 GitHub repositories -- encompassing 57,733 confirmed cessation events -- complemented by comprehensive, timeline-based behavioral features. We propose an integrated, multi-perspective feature framework for predicting maintenance cessation, systematically combining user-centric features, maintainer-centric features and project evolution features. AFT survival analysis demonstrates a high C-index (0.846), substantially outperforming models relying only on surface features. Feature ablation and SHAP analysis further confirm the effectiveness and interpretability of our approach. Finally, we demonstrate real-world applicability by deploying a GBSA classifier in the openEuler ecosystem for proactive package risk screening. Our work establishes a scalable, interpretable foundation for maintenance-risk prediction, enabling reproducible risk management across large-scale open source ecosystems.

Large language models (LLMs) hold immense promise to serve complex health information needs but also have the potential to introduce harm and exacerbate health disparities. Reliably evaluating equity-related model failures is a critical step toward developing systems that promote health equity. In this work, we present resources and methodologies for surfacing biases with potential to precipitate equity-related harms in long-form, LLM-generated answers to medical questions and then conduct an empirical case study with Med-PaLM 2, resulting in the largest human evaluation study in this area to date. Our contributions include a multifactorial framework for human assessment of LLM-generated answers for biases, and EquityMedQA, a collection of seven newly-released datasets comprising both manually-curated and LLM-generated questions enriched for adversarial queries. Both our human assessment framework and dataset design process are grounded in an iterative participatory approach and review of possible biases in Med-PaLM 2 answers to adversarial queries. Through our empirical study, we find that the use of a collection of datasets curated through a variety of methodologies, coupled with a thorough evaluation protocol that leverages multiple assessment rubric designs and diverse rater groups, surfaces biases that may be missed via narrower evaluation approaches. Our experience underscores the importance of using diverse assessment methodologies and involving raters of varying backgrounds and expertise. We emphasize that while our framework can identify specific forms of bias, it is not sufficient to holistically assess whether the deployment of an AI system promotes equitable health outcomes. We hope the broader community leverages and builds on these tools and methods towards realizing a shared goal of LLMs that promote accessible and equitable healthcare for all.

It is widely accepted that information derived from analyzing speech (the acoustic signal) and language production (words and sentences) serves as a useful window into the health of an individual's cognitive ability. In fact, most neuropsychological testing batteries have a component related to speech and language where clinicians elicit speech from patients for subjective evaluation across a broad set of dimensions. With advances in speech signal processing and natural language processing, there has been recent interest in developing tools to detect more subtle changes in cognitive-linguistic function. This work relies on extracting a set of features from recorded and transcribed speech for objective assessments of speech and language, early diagnosis of neurological disease, and tracking of disease after diagnosis. With an emphasis on cognitive and thought disorders, in this paper we provide a review of existing speech and language features used in this domain, discuss their clinical application, and highlight their advantages and disadvantages. Broadly speaking, the review is split into two categories: language features based on natural language processing and speech features based on speech signal processing. Within each category, we consider features that aim to measure complementary dimensions of cognitive-linguistics, including language diversity, syntactic complexity, semantic coherence, and timing. We conclude the review with a proposal of new research directions to further advance the field.

We present Welzijn.AI as new digital solution for monitoring (mental) well-being in elderly populations, and illustrate how development of systems like Welzijn.AI can align with guidelines on responsible AI development. Three evaluations with different stakeholders were designed to disclose new perspectives on the strengths, weaknesses, design characteristics, and value requirements of Welzijn.AI. Evaluations concerned expert panels and involved patient federations, general practitioners, researchers, and the elderly themselves. Panels concerned interviews, a co-creation session, and feedback on a proof-of-concept implementation. Interview results were summarized in terms of Welzijn.AI's strengths, weaknesses, opportunities and threats. The co-creation session ranked a variety of value requirements of Welzijn.AI with the Hundred Dollar Method. User evaluation comprised analysing proportions of (dis)agreement on statements targeting Welzijn.AI's design characteristics, and ranking desired social characteristics. Experts in the panel interviews acknowledged Welzijn.AI's potential to combat loneliness and extract patterns from elderly behaviour. The proof-of-concept evaluation complemented the design characteristics most appealing to the elderly to potentially achieve this: empathetic and varying interactions. Stakeholders also link the technology to the implementation context: it could help activate an individual's social network, but support should also be available to empower users. Yet, non-elderly and elderly experts also disclose challenges in properly understanding the application; non-elderly experts also highlight issues concerning privacy. In sum, incorporating all stakeholder perspectives in system development remains challenging. Still, our results benefit researchers, policy makers, and health professionals that aim to improve elderly care with technology.

The primary goal of drug safety researchers and regulators is to promptly identify adverse drug reactions. Doing so may in turn prevent or reduce the harm to patients and ultimately improve public health. Evaluating and monitoring drug safety (i.e., pharmacovigilance) involves analyzing an ever growing collection of spontaneous reports from health professionals, physicians, and pharmacists, and information voluntarily submitted by patients. In this scenario, facilitating analysis of such reports via automation has the potential to rapidly identify safety signals. Unfortunately, public resources for developing natural language models for this task are scant. We present PHEE, a novel dataset for pharmacovigilance comprising over 5000 annotated events from medical case reports and biomedical literature, making it the largest such public dataset to date. We describe the hierarchical event schema designed to provide coarse and fine-grained information about patients' demographics, treatments and (side) effects. Along with the discussion of the dataset, we present a thorough experimental evaluation of current state-of-the-art approaches for biomedical event extraction, point out their limitations, and highlight open challenges to foster future research in this area.

Current approaches to building general-purpose AI systems tend to produce systems with both beneficial and harmful capabilities. Further progress in AI development could lead to capabilities that pose extreme risks, such as offensive cyber capabilities or strong manipulation skills. We explain why model evaluation is critical for addressing extreme risks. Developers must be able to identify dangerous capabilities (through "dangerous capability evaluations") and the propensity of models to apply their capabilities for harm (through "alignment evaluations"). These evaluations will become critical for keeping policymakers and other stakeholders informed, and for making responsible decisions about model training, deployment, and security.

This work aims to implement Long Short-Term Memory mixture density networks (LSTM-MDNs) for Value-at-Risk forecasting and compare their performance with established models (historical simulation, CMM, and GARCH) using a defined backtesting procedure. The focus was on the neural network's ability to capture volatility clustering and its real-world applicability. Three architectures were tested: a 2-component mixture density network, a regularized 2-component model (Arimond et al., 2020), and a 3-component mixture model, the latter being tested for the first time in Value-at-Risk forecasting. Backtesting was performed on three stock indices (FTSE 100, S&P 500, EURO STOXX 50) over two distinct two-year periods (2017-2018 as a calm period, 2021-2022 as turbulent). Model performance was assessed through unconditional coverage and independence assumption tests. The neural network's ability to handle volatility clustering was validated via correlation analysis and graphical evaluation. Results show limited success for the neural network approach. LSTM-MDNs performed poorly for 2017/2018 but outperformed benchmark models in 2021/2022. The LSTM mechanism allowed the neural network to capture volatility clustering similarly to GARCH models. However, several issues were identified: the need for proper model initialization and reliance on large datasets for effective learning. The findings suggest that while LSTM-MDNs provide adequate risk forecasts, further research and adjustments are necessary for stable performance.

When communicating with elders with cognitive impairment, cognitive stimulation (CS) help to maintain the cognitive health of elders. Data sparsity is the main challenge in building CS-based dialogue systems, particularly in the Chinese language. To fill this gap, we construct a Chinese CS conversation (CSConv) dataset, which contains about 2.6K groups of dialogues with CS principles and emotional support strategy labels. Making chit chat while providing emotional support is overlooked by the majority of existing cognitive dialogue systems. In this paper, we propose a multi-source knowledge fusion method for CS dialogue (CSD), to generate open-ended responses guided by the CS principle and emotional support strategy. We first use a progressive mask method based on external knowledge to learn encoders as effective classifiers, which is the prerequisite to predict the CS principle and emotional support strategy of the target response. Then a decoder interacts with the perceived CS principle and emotional support strategy to generate responses. Extensive experiments conducted on the CSConv dataset demonstrate the effectiveness of the proposed method, while there is still a large space for improvement compared to human performance.

We seek to understand fundamental tradeoffs between the accuracy of prior information that a learner has on a given problem and its learning performance. We introduce the notion of prioritized risk, which differs from traditional notions of minimax and Bayes risk by allowing us to study such fundamental tradeoffs in settings where reality does not necessarily conform to the learner's prior. We present a general reduction-based approach for extending classical minimax lower-bound techniques in order to lower bound the prioritized risk for statistical estimation problems. We also introduce a novel generalization of Fano's inequality (which may be of independent interest) for lower bounding the prioritized risk in more general settings involving unbounded losses. We illustrate the ability of our framework to provide insights into tradeoffs between prior information and learning performance for problems in estimation, regression, and reinforcement learning.

Artificial Intelligence (AI) systems are increasingly intertwined with daily life, assisting users in executing various tasks and providing guidance on decision-making. This integration introduces risks of AI-driven manipulation, where such systems may exploit users' cognitive biases and emotional vulnerabilities to steer them toward harmful outcomes. Through a randomized controlled trial with 233 participants, we examined human susceptibility to such manipulation in financial (e.g., purchases) and emotional (e.g., conflict resolution) decision-making contexts. Participants interacted with one of three AI agents: a neutral agent (NA) optimizing for user benefit without explicit influence, a manipulative agent (MA) designed to covertly influence beliefs and behaviors, or a strategy-enhanced manipulative agent (SEMA) employing explicit psychological tactics to reach its hidden objectives. By analyzing participants' decision patterns and shifts in their preference ratings post-interaction, we found significant susceptibility to AI-driven manipulation. Particularly, across both decision-making domains, participants interacting with the manipulative agents shifted toward harmful options at substantially higher rates (financial, MA: 62.3%, SEMA: 59.6%; emotional, MA: 42.3%, SEMA: 41.5%) compared to the NA group (financial, 35.8%; emotional, 12.8%). Notably, our findings reveal that even subtle manipulative objectives (MA) can be as effective as employing explicit psychological strategies (SEMA) in swaying human decision-making. By revealing the potential for covert AI influence, this study highlights a critical vulnerability in human-AI interactions, emphasizing the need for ethical safeguards and regulatory frameworks to ensure responsible deployment of AI technologies and protect human autonomy.

Almost 50% depression patients face the risk of going into relapse. The risk increases to 80% after the second episode of depression. Although, depression detection from social media has attained considerable attention, depression relapse detection has remained largely unexplored due to the lack of curated datasets and the difficulty of distinguishing relapse and non-relapse users. In this work, we present ReDepress, the first clinically validated social media dataset focused on relapse, comprising 204 Reddit users annotated by mental health professionals. Unlike prior approaches, our framework draws on cognitive theories of depression, incorporating constructs such as attention bias, interpretation bias, memory bias and rumination into both annotation and modeling. Through statistical analyses and machine learning experiments, we demonstrate that cognitive markers significantly differentiate relapse and non-relapse groups, and that models enriched with these features achieve competitive performance, with transformer-based temporal models attaining an F1 of 0.86. Our findings validate psychological theories in real-world textual data and underscore the potential of cognitive-informed computational methods for early relapse detection, paving the way for scalable, low-cost interventions in mental healthcare.

Clinical trials disruption has always represented a non negligible part of the ending of interventional studies. While the SARS-CoV-2 (COVID-19) pandemic has led to an impressive and unprecedented initiation of clinical research, it has also led to considerable disruption of clinical trials in other disease areas, with around 80% of non-COVID-19 trials stopped or interrupted during the pandemic. In many cases the disrupted trials will not have the planned statistical power necessary to yield interpretable results. This paper describes methods to compensate for the information loss arising from trial disruptions by incorporating additional information available from auxiliary data sources. The methods described include the use of auxiliary data on baseline and early outcome data available from the trial itself and frequentist and Bayesian approaches for the incorporation of information from external data sources. The methods are illustrated by application to the analysis of artificial data based on the Primary care pediatrics Learning Activity Nutrition (PLAN) study, a clinical trial assessing a diet and exercise intervention for overweight children, that was affected by the COVID-19 pandemic. We show how all of the methods proposed lead to an increase in precision relative to use of complete case data only.

With the increasing prevalence of artificial intelligence, careful evaluation of inherent biases needs to be conducted to form the basis for alleviating the effects these predispositions can have on users. Large language models (LLMs) are predominantly used by many as a primary source of information for various topics. LLMs frequently make factual errors, fabricate data (hallucinations), or present biases, exposing users to misinformation and influencing opinions. Educating users on their risks is key to responsible use, as bias, unlike hallucinations, cannot be caught through data verification. We quantify the political bias of popular LLMs in the context of the recent vote of the German Bundestag using the score produced by the Wahl-O-Mat. This metric measures the alignment between an individual's political views and the positions of German political parties. We compare the models' alignment scores to identify factors influencing their political preferences. Doing so, we discover a bias toward left-leaning parties, most dominant in larger LLMs. Also, we find that the language we use to communicate with the models affects their political views. Additionally, we analyze the influence of a model's origin and release date and compare the results to the outcome of the recent vote of the Bundestag. Our results imply that LLMs are prone to exhibiting political bias. Large corporations with the necessary means to develop LLMs, thus, knowingly or unknowingly, have a responsibility to contain these biases, as they can influence each voter's decision-making process and inform public opinion in general and at scale.

This paper argues that fully autonomous AI agents should not be developed. In support of this position, we build from prior scientific literature and current product marketing to delineate different AI agent levels and detail the ethical values at play in each, documenting trade-offs in potential benefits and risks. Our analysis reveals that risks to people increase with the autonomy of a system: The more control a user cedes to an AI agent, the more risks to people arise. Particularly concerning are safety risks, which affect human life and impact further values.

Large-language models have recently demonstrated impressive zero-shot capabilities in a variety of natural language tasks such as summarization, dialogue generation, and question-answering. Despite many promising applications in clinical medicine, adoption of these models in real-world settings has been largely limited by their tendency to generate incorrect and sometimes even toxic statements. In this study, we develop Almanac, a large language model framework augmented with retrieval capabilities for medical guideline and treatment recommendations. Performance on a novel dataset of clinical scenarios (n = 130) evaluated by a panel of 5 board-certified and resident physicians demonstrates significant increases in factuality (mean of 18% at p-value < 0.05) across all specialties, with improvements in completeness and safety. Our results demonstrate the potential for large language models to be effective tools in the clinical decision-making process, while also emphasizing the importance of careful testing and deployment to mitigate their shortcomings.

Safety and responsibility evaluations of advanced AI models are a critical but developing field of research and practice. In the development of Google DeepMind's advanced AI models, we innovated on and applied a broad set of approaches to safety evaluation. In this report, we summarise and share elements of our evolving approach as well as lessons learned for a broad audience. Key lessons learned include: First, theoretical underpinnings and frameworks are invaluable to organise the breadth of risk domains, modalities, forms, metrics, and goals. Second, theory and practice of safety evaluation development each benefit from collaboration to clarify goals, methods and challenges, and facilitate the transfer of insights between different stakeholders and disciplines. Third, similar key methods, lessons, and institutions apply across the range of concerns in responsibility and safety - including established and emerging harms. For this reason it is important that a wide range of actors working on safety evaluation and safety research communities work together to develop, refine and implement novel evaluation approaches and best practices, rather than operating in silos. The report concludes with outlining the clear need to rapidly advance the science of evaluations, to integrate new evaluations into the development and governance of AI, to establish scientifically-grounded norms and standards, and to promote a robust evaluation ecosystem.

Large language models (LLMs) have shown incredible capabilities and transcended the natural language processing (NLP) community, with adoption throughout many services like healthcare, therapy, education, and customer service. Since users include people with critical information needs like students or patients engaging with chatbots, the safety of these systems is of prime importance. Therefore, a clear understanding of the capabilities and limitations of LLMs is necessary. To this end, we systematically evaluate toxicity in over half a million generations of ChatGPT, a popular dialogue-based LLM. We find that setting the system parameter of ChatGPT by assigning it a persona, say that of the boxer Muhammad Ali, significantly increases the toxicity of generations. Depending on the persona assigned to ChatGPT, its toxicity can increase up to 6x, with outputs engaging in incorrect stereotypes, harmful dialogue, and hurtful opinions. This may be potentially defamatory to the persona and harmful to an unsuspecting user. Furthermore, we find concerning patterns where specific entities (e.g., certain races) are targeted more than others (3x more) irrespective of the assigned persona, that reflect inherent discriminatory biases in the model. We hope that our findings inspire the broader AI community to rethink the efficacy of current safety guardrails and develop better techniques that lead to robust, safe, and trustworthy AI systems.

Learning disorders are neurological conditions that affect the brain's ability to interconnect communication areas. Dyslexic students experience problems with reading, memorizing, and exposing concepts; however the magnitude of these can be mitigated through both therapies and the creation of compensatory mechanisms. Several efforts have been made to mitigate these issues, leading to the creation of digital resources for students with specific learning disorders attending primary and secondary education levels. Conversely, a standard approach is still missed in higher education. The VRAIlexia project has been created to tackle this issue by proposing two different tools: a mobile application integrating virtual reality (VR) to collect data quickly and easily, and an artificial intelligencebased software (AI) to analyze the collected data for customizing the supporting methodology for each student. The first one has been created and is being distributed among dyslexic students in Higher Education Institutions, for the conduction of specific psychological and psychometric tests. The second tool applies specific artificial intelligence algorithms to the data gathered via the application and other surveys. These AI techniques have allowed us to identify the most relevant difficulties faced by the students' cohort. Our different models have obtained around 90\% mean accuracy for predicting the support tools and learning strategies.