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Refine Medical Diagnosis Using Generation Augmented Retrieval and Clinical Practice Guidelines
Li, Wenhao, Zhang, Hongkuan, Zhang, Hongwei, Li, Zhengxu, Dong, Zengjie, Chen, Yafan, Bidargaddi, Niranjan, Liu, Hong
-- Current medical language models, adapted from large language models (LLMs), typically predict ICD code - based diagnosis from electronic health records (EHRs) because these labels are readily available. However, ICD codes do not capture the nuanced, context - rich reasoning clinicians use for diagnosis. Clinicians synthesize diverse patient data and reference clinical practice guidelines (CPGs) to make evidence - based decisions. This misalignment limits the clinical utility of existing models. We introduce GARMLE - G, a Generation - Augmented Retrieval framework that grounds medical language model outp uts in authoritative CPGs. Unlike conventional Retrieval - Augmented Generation based approaches, GARMLE - G enables hallucination - free outputs by directly retrieving authoritative guideline content without relying on model - generated text. It (1) integrates LLM predictions with EHR data to create semantically rich queries, (2) retrieves relevant CPG knowledge snippets via embedding similarity, and (3) fuses guideline content with model output to generate clinically aligned recommendations. A prototype system for hypertension diagnosis was developed and evaluated on multiple metrics, demonstrating superior retrieval precision, semantic relevance, and clinical guideline adherence compared to RAG - based baselines, while maintaining a lightweight architecture suitable for localized healthcare deployment. This work provides a scalable, low - cost, and hallucination - free method for grounding medical language models in evidence - based clinical practice, with strong potential for broader clinical deployment. The research reported in this paper is financially supported by the National Natural Science Foundation of China (62276156), the project of Shandong Provincial Natural Science Foundation (ZR2024LZH005), the Taishan Scholar Program of Shandong Province of China (No.tsq nz20240809), and the Excellent Youth Foundation of Shandong Natural Science Foundation (2024HWYQ - 055). Wenhao Li is with Shandong Normal University, Jinan, China, 250358 (email: lwh@sdnu.edu.cn) Hongkuan Zhang is with Shandong Normal University, Jinan, China, 250358 (email: 2024217028@stu.sdnu.edu.cn) In the healthcare sector, language models and related tools, such as ChatGPT and ClinicalBERT, have been increasingly applied across multiple scenarios, including disease prediction, clinical decision support, patient interaction, drug discovery, and personalized medicine, significantly driving innovation and transformation in medical technology [1, 2] . As a fundamental task in healthcare, disease diagnosis refers to the process by which health professionals identify the most likely disease or disorder causing a patient's symptoms [3] .
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Scaling Internal-State Policy-Gradient Methods for POMDPs
Aberdeen, Douglas, Baxter, Jonathan
Policy-gradient methods have received increased attention recently as a mechanism for learning to act in partially observable environments. They have shown promise for problems admitting memoryless policies but have been less successful when memory is required. In this paper we develop several improved algorithms for learning policies with memory in an infinite-horizon setting -- directly when a known model of the environment is available, and via simulation otherwise. We compare these algorithms on some large POMDPs, including noisy robot navigation and multi-agent problems.
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NAS-LoRA: Empowering Parameter-Efficient Fine-Tuning for Visual Foundation Models with Searchable Adaptation
Chen, Renqi, Su, Haoyang, Tang, Shixiang
The Segment Anything Model (SAM) has emerged as a powerful visual foundation model for image segmentation. However, adapting SAM to specific downstream tasks, such as medical and agricultural imaging, remains a significant challenge. To address this, Low-Rank Adaptation (LoRA) and its variants have been widely employed to enhancing SAM's adaptation performance on diverse domains. Despite advancements, a critical question arises: can we integrate inductive bias into the model? This is particularly relevant since the Transformer encoder in SAM inherently lacks spatial priors within image patches, potentially hindering the acquisition of high-level semantic information. In this paper, we propose NAS-LoRA, a new Parameter-Efficient Fine-Tuning (PEFT) method designed to bridge the semantic gap between pre-trained SAM and specialized domains. Specifically, NAS-LoRA incorporates a lightweight Neural Architecture Search (NAS) block between the encoder and decoder components of LoRA to dynamically optimize the prior knowledge integrated into weight updates. Furthermore, we propose a stage-wise optimization strategy to help the ViT encoder balance weight updates and architectural adjustments, facilitating the gradual learning of high-level semantic information. V arious Experiments demonstrate our NAS-LoRA improves existing PEFT methods, while reducing training cost by 24.14% without increasing inference cost, highlighting the potential of NAS in enhancing PEFT for visual foundation models.
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Forecasting India's Demographic Transition Under Fertility Policy Scenarios Using hybrid LSTM-PINN Model
Khanra, Subarna, Kukreja, Vijay Kumar, Bala, Indu
Demographic forecasting remains a fundamental challenge for policy planning in rapidly evolving nations such as India, where fertility transitions, policy interventions, and age structured dynamics interact in complex ways. In this study, we present a hybrid modelling framework that integrates policy-aware fertility functions into a Physics-Informed Neural Network (PINN) enhanced with Long Short-Term Memory (LSTM) networks to capture physical constraints and temporal dependencies in population dynamics. The model is applied to India's age structured population from 2024 to 2054 under three fertility-policy scenarios: continuation of current fertility decline, stricter population control, and relaxed fertility promotion. The governing transport-reaction partial differential equation is formulated with India-specific demographic indicators, including age-specific fertility and mortality rates. PINNs embed the core population equation and policy-driven fertility changes, while LSTM layers improve long-term forecasting across decades. Results show that fertility policies substantially shape future age distribution, dependency ratios, and workforce size. Stricter controls intensify ageing and reduce labour force participation, whereas relaxed policies support workforce growth but increase population pressure. Our findings suggest that the hybrid LSTM-PINN is an effective approach for demographic forecasting, offering accuracy with interpretability. Beyond methodological novelty, this work provides actionable insights for India's demographic policy debates, highlighting the need for balanced fertility interventions to ensure sustainable socio-economic development.
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