Automated seizure detection is of great importance to epilepsy diagnosis and treatment.

The low-resource label analysis and representation visualization further illustrate the effectiveness of our pre-training strategy.

Despite their successes in vision and language, foundation models have stumbled in pathology, revealing low accuracy, instability, and heavy computational demands. These shortcomings stem not from tuning problems but from deeper conceptual mismatches: dense embeddings cannot represent the combinatorial richness of tissue, and current architectures inherit flaws in self-supervision, patch design, and noise-fragile pretraining. Biological complexity and limited domain innovation further widen the gap. The evidence is clear--pathology requires models explicitly designed for biological images rather than adaptations of large-scale natural-image methods whose assumptions do not hold for tissue.

Retrieval-Augmented Generation (RAG) integrates non-parametric knowledge into Large Language Models (LLMs), typically from unstructured texts and structured graphs. While recent progress has advanced text-based RAG to multi-turn reasoning through Reinforcement Learning (RL), extending these advances to hybrid retrieval introduces additional challenges. Existing graph-based or hybrid systems typically depend on fixed or handcrafted retrieval pipelines, lacking the ability to integrate supplementary evidence as reasoning unfolds. Besides, while graph evidence provides relational structures crucial for multi-hop reasoning, it is substantially more expensive to retrieve. To address these limitations, we introduce \model{}, an RL-based framework that enables LLMs to perform multi-turn and adaptive graph-text hybrid RAG. \model{} jointly optimizes the entire generation process via RL, allowing the model to learn when to reason, what to retrieve from either texts or graphs, and when to produce final answers, all within a unified generation policy. To guide this learning process, we design a two-stage training framework that accounts for both task outcome and retrieval efficiency, enabling the model to exploit hybrid evidence while avoiding unnecessary retrieval overhead. Experimental results across five question answering benchmarks demonstrate that \model{} significantly outperforms existing RAG baselines, highlighting the benefits of end-to-end RL in supporting adaptive and efficient retrieval for complex reasoning.

Despite high performance on clinical benchmarks, large language models may reach correct conclusions through faulty reasoning, a failure mode with safety implications for oncology decision support that is not captured by accuracy-based evaluation. In this two-cohort retrospective study, we developed a hierarchical taxonomy of reasoning errors from GPT-4 chain-of-thought responses to real oncology notes and tested its clinical relevance. Using breast and pancreatic cancer notes from the CORAL dataset, we annotated 600 reasoning traces to define a three-tier taxonomy mapping computational failures to cognitive bias frameworks. We validated the taxonomy on 822 responses from prostate cancer consult notes spanning localized through metastatic disease, simulating extraction, analysis, and clinical recommendation tasks. Reasoning errors occurred in 23 percent of interpretations and dominated overall errors, with confirmation bias and anchoring bias most common. Reasoning failures were associated with guideline-discordant and potentially harmful recommendations, particularly in advanced disease management. Automated evaluators using state-of-the-art language models detected error presence but could not reliably classify subtypes. These findings show that large language models may provide fluent but clinically unsafe recommendations when reasoning is flawed. The taxonomy provides a generalizable framework for evaluating and improving reasoning fidelity before clinical deployment.

This paper presents a probabilistic-graphical model that can be used to infer characteristics of instantaneous brain activity by jointly analyzing spatial and temporal dependencies observed in electroencephalograms (EEG). Specifically, we describe a factor-graph-based model with customized factor-functions defined based on domain knowledge, to infer pathologic brain activity with the goal of identifying seizure-generating brain regions in epilepsy patients. We utilize an inference technique based on the graph-cut algorithm to exactly solve graph inference in polynomial time. We validate the model by using clinically collected intracranial EEG data from 29 epilepsy patients to show that the model correctly identifies seizure-generating brain regions. Our results indicate that our model outperforms two conventional approaches used for seizure-onset localization (5-7% better AUC: 0.72, 0.67, 0.65) and that the proposed inference technique provides 3-10% gain in AUC ( 0.72, 0.62, 0.69) compared to sampling-based alternatives.

Large Language Models (LLMs) exhibit impressive capabilities, but remain susceptible to a growing spectrum of safety risks, including jailbreaks, toxic content, hallucinations, and bias. Existing defenses often address only a single threat type or resort to rigid outright rejection, sacrificing user experience and failing to generalize across diverse and novel attacks. This paper introduces Adversarial Scenario Extrapolation (ASE), a novel inference-time computation framework that leverages Chain-of-Thought (CoT) reasoning to simultaneously enhance LLM robustness and seamlessness. ASE guides the LLM through a self-generative process of contemplating potential adversarial scenarios and formulating defensive strategies before generating a response to the user query. Comprehensive evaluation on four adversarial benchmarks with four latest LLMs shows that ASE achieves near-zero jailbreak attack success rates and minimal toxicity, while slashing outright rejections to <4%. ASE outperforms six state-of-the-art defenses in robustness-seamlessness trade-offs, with 92-99% accuracy on adversarial Q&A and 4-10x lower bias scores. By transforming adversarial perception into an intrinsic cognitive process, ASE sets a new paradigm for secure and natural human-AI interaction.

Foundation models (FMs) promise to generalize medical imaging, but their effectiveness varies. It remains unclear how pre-training domain (medical vs. general), paradigm (e.g., text-guided), and architecture influence embedding quality, hindering the selection of optimal encoders for specific radiology tasks. To address this, we evaluate vision encoders from eight medical and general-domain FMs for chest X-ray analysis. We benchmark classification (pneumothorax, cardiomegaly) and segmentation (pneumothorax, cardiac boundary) using linear probing and fine-tuning. Our results show that domain-specific pre-training provides a significant advantage; medical FMs consistently outperformed general-domain models in linear probing, establishing superior initial feature quality. However, feature utility is highly task-dependent. Pre-trained embeddings were strong for global classification and segmenting salient anatomy (e.g., heart). In contrast, for segmenting complex, subtle pathologies (e.g., pneumothorax), all FMs performed poorly without significant fine-tuning, revealing a critical gap in localizing subtle disease. Subgroup analysis showed FMs use confounding shortcuts (e.g., chest tubes for pneumothorax) for classification, a strategy that fails for precise segmentation. We also found that expensive text-image alignment is not a prerequisite; image-only (RAD-DINO) and label-supervised (Ark+) FMs were among top performers. Notably, a supervised, end-to-end baseline remained highly competitive, matching or exceeding the best FMs on segmentation tasks. These findings show that while medical pre-training is beneficial, architectural choices (e.g., multi-scale) are critical, and pre-trained features are not universally effective, especially for complex localization tasks where supervised models remain a strong alternative.

Contrastive Language-Image Pre-training (CLIP) models have demonstrated superior performance across various visual tasks including medical image classification. However, fairness concerns, including demographic biases, have received limited attention for CLIP models. This oversight leads to critical issues, particularly those related to race and gender, resulting in disparities in diagnostic outcomes and reduced reliability for underrepresented groups. To address these challenges, we introduce AdFair-CLIP, a novel framework employing adversarial feature intervention to suppress sensitive attributes, thereby mitigating spurious correlations and improving prediction fairness. We conduct comprehensive experiments on chest X-ray (CXR) datasets, and show that AdFair-CLIP significantly enhances both fairness and diagnostic accuracy, while maintaining robust generalization in zero-shot and few-shot scenarios. These results establish new benchmarks for fairness-aware learning in CLIP-based medical diagnostic models, particularly for CXR analysis.

Large Language Models (LLMs) are increasingly demonstrating the potential to reach human-level performance in generating clinical summaries from patient-clinician conversations. However, these summaries often focus on patients' biology rather than their preferences, values, wishes, and concerns. To achieve patient-centered care, we propose a new standard for Artificial Intelligence (AI) clinical summarization tasks: Patient-Centered Summaries (PCS). Our objective was to develop a framework to generate PCS that capture patient values and ensure clinical utility and to assess whether current open-source LLMs can achieve human-level performance in this task. We used a mixed-methods process. Two Patient and Public Involvement groups (10 patients and 8 clinicians) in the United Kingdom participated in semi-structured interviews exploring what personal and contextual information should be included in clinical summaries and how it should be structured for clinical use. Findings informed annotation guidelines used by eight clinicians to create gold-standard PCS from 88 atrial fibrillation consultations. Sixteen consultations were used to refine a prompt aligned with the guidelines. Five open-source LLMs (Llama-3.2-3B, Llama-3.1-8B, Mistral-8B, Gemma-3-4B, and Qwen3-8B) generated summaries for 72 consultations using zero-shot and few-shot prompting, evaluated with ROUGE-L, BERTScore, and qualitative metrics. Patients emphasized lifestyle routines, social support, recent stressors, and care values. Clinicians sought concise functional, psychosocial, and emotional context. The best zero-shot performance was achieved by Mistral-8B (ROUGE-L 0.189) and Llama-3.1-8B (BERTScore 0.673); the best few-shot by Llama-3.1-8B (ROUGE-L 0.206, BERTScore 0.683). Completeness and fluency were similar between experts and models, while correctness and patient-centeredness favored human PCS.