Large language models (LLMs) integrated into agent-driven workflows hold immense promise for healthcare, yet a significant gap exists between their potential and practical implementation within clinical settings. To address this, we present a practitioner-oriented field manual for deploying generative agents that use electronic health record (EHR) data. This guide is informed by our experience deploying the "irAE-Agent", an automated system to detect immune-related adverse events from clinical notes at Mass General Brigham, and by structured interviews with 21 clinicians, engineers, and informatics leaders involved in the project. Our analysis reveals a critical misalignment in clinical AI development: less than 20% of our effort was dedicated to prompt engineering and model development, while over 80% was consumed by the sociotechnical work of implementation. We distill this effort into five "heavy lifts": data integration, model validation, ensuring economic value, managing system drift, and governance. By providing actionable solutions for each of these challenges, this field manual shifts the focus from algorithmic development to the essential infrastructure and implementation work required to bridge the "valley of death" and successfully translate generative AI from pilot projects into routine clinical care.

The limited availability of annotated data presents a major challenge for applying deep learning methods to medical image analysis. Few-shot learning methods aim to recognize new classes from only a small number of labeled examples. These methods are typically studied under the standard few-shot learning setting, where all classes in a task are new. However, medical applications such as pathology classification from chest X-rays often require learning new classes while simultaneously leveraging knowledge of previously known ones, a scenario more closely aligned with generalized few-shot classification. Despite its practical relevance, few-shot learning has been scarcely studied in this context. In this work, we present MetaChest, a large-scale dataset of 479,215 chest X-rays collected from four public databases. MetaChest includes a meta-set partition specifically designed for standard few-shot classification, as well as an algorithm for generating multi-label episodes. We conduct extensive experiments evaluating both a standard transfer learning approach and an extension of ProtoNet across a wide range of few-shot multi-label classification tasks. Our results demonstrate that increasing the number of classes per episode and the number of training examples per class improves classification performance. Notably, the transfer learning approach consistently outperforms the ProtoNet extension, despite not being tailored for few-shot learning. We also show that higher-resolution images improve accuracy at the cost of additional computation, while efficient model architectures achieve comparable performance to larger models with significantly reduced resource requirements.

Longitudinal medical visual question answering (Diff-VQA) requires comparing paired studies from different time points and answering questions about clinically meaningful changes. In this setting, the difference signal and the consistency of visual focus across time are more informative than absolute single-image findings. We propose a saliency-guided encoder-decoder for chest X-ray Diff-VQA that turns post-hoc saliency into actionable supervision. The model first performs a lightweight near-identity affine pre-alignment to reduce nuisance motion between visits. It then executes a within-epoch two-step loop: step 1 extracts a medically relevant keyword from the answer and generates keyword-conditioned Grad-CAM on both images to obtain disease-focused saliency; step 2 applies the shared saliency mask to both time points and generates the final answer. This closes the language-vision loop so that the terms that matter also guide where the model looks, enforcing spatially consistent attention on corresponding anatomy. On Medical-Diff-VQA, the approach attains competitive performance on BLEU, ROUGE-L, CIDEr, and METEOR while providing intrinsic interpretability. Notably, the backbone and decoder are general-domain pretrained without radiology-specific pretraining, highlighting practicality and transferability. These results support saliency-conditioned generation with mild pre-alignment as a principled framework for longitudinal reasoning in medical VQA.

Voltage prediction in distribution grids is a critical yet difficult task for maintaining power system stability. Machine learning approaches, particularly Graph Neural Networks (GNNs), offer significant speedups but suffer from poor generalization when trained on limited or incomplete data. In this work, we systematically investigate the role of inductive biases in improving a model's ability to reliably learn power flow. Specifically, we evaluate three physics-informed strategies: (i) power-flow-constrained loss functions, (ii) complex-valued neural networks, and (iii) residual-based task reformulation. Using the ENGAGE dataset, which spans multiple low- and medium-voltage grid configurations, we conduct controlled experiments to isolate the effect of each inductive bias and assess both standard predictive performance and out-of-distribution generalization. Our study provides practical insights into which model assumptions most effectively guide learning for reliable and efficient voltage prediction in modern distribution networks.

3D scene understanding is fundamental for embodied AI and robotics, supporting reliable perception for interaction and navigation. Recent approaches achieve zero-shot, open-vocabulary 3D semantic mapping by assigning embedding vectors to 2D class-agnostic masks generated via vision-language models (VLMs) and projecting these into 3D. However, these methods often produce fragmented masks and inaccurate semantic assignments due to the direct use of raw masks, limiting their effectiveness in complex environments. To address this, we leverage SemanticSAM with progressive granularity refinement to generate more accurate and numerous object-level masks, mitigating the over-segmentation commonly observed in mask generation models such as vanilla SAM, and improving downstream 3D semantic segmentation. To further enhance semantic context, we employ a context-aware CLIP encoding strategy that integrates multiple contextual views of each mask using empirically determined weighting, providing much richer visual context. We evaluate our approach on multiple 3D scene understanding tasks, including 3D semantic segmentation and object retrieval from language queries, across several benchmark datasets. Experimental results demonstrate significant improvements over existing methods, highlighting the effectiveness of our approach.

We examine the use of a novel variant of Physics-Informed Neural Networks to predict cosmological parameters from recent supernovae and baryon acoustic oscillations (BAO) datasets. Our machine learning framework generates uncertainty estimates for target variables and the inferred unknown parameters of the underlying PDE descriptions. Built upon a hybrid of the principles of Evidential Deep Learning, Physics-Informed Neural Networks, Bayesian Neural Networks and Gaussian Processes, our model enables learning of the posterior distribution of the unknown PDE parameters through standard gradient-descent based training. We apply our model to an up-to-date BAO dataset (Bousis et al. 2024) calibrated with the CMB-inferred sound horizon, and the Pantheon$+$ Sne Ia distances (Scolnic et al. 2018), examining the relative effectiveness and mutual consistency among the standard $Λ$CDM, $w$CDM and $Λ_s$CDM models. Unlike previous results arising from the standard approach of minimizing an appropriate $χ^2$ function, the posterior distributions for parameters in various models trained purely on Pantheon$+$ data were found to be largely contained within the $2σ$ contours of their counterparts trained on BAO data. Their posterior medians for $h_0$ were within about $2σ$ of one another, indicating that our machine learning-guided approach provides a different measure of the Hubble tension.

Large Language Model (LLM) agents excel at multi-step, tool-augmented tasks. However, smart homes introduce distinct challenges, requiring agents to handle latent user intents, temporal dependencies, device constraints, scheduling, and more. The main bottlenecks for developing smart home agents with such capabilities include the lack of a realistic simulation environment where agents can interact with devices and observe the results, as well as a challenging benchmark to evaluate them. To address this, we introduce $\textbf{SimuHome}$, a time-accelerated home environment that simulates smart devices, supports API calls, and reflects changes in environmental variables. By building the simulator on the Matter protocol, the global industry standard for smart home communication, SimuHome provides a high-fidelity environment, and agents validated in SimuHome can be deployed on real Matter-compliant devices with minimal adaptation. We provide a challenging benchmark of 600 episodes across twelve user query types that require the aforementioned capabilities. Our evaluation of 16 agents under a unified ReAct framework reveals distinct capabilities and limitations across models. Models under 7B parameters exhibited negligible performance across all query types. Even GPT-4.1, the best-performing standard model, struggled with implicit intent inference, state verification, and particularly temporal scheduling. While reasoning models such as GPT-5.1 consistently outperformed standard models on every query type, they required over three times the average inference time, which can be prohibitive for real-time smart home applications. This highlights a critical trade-off between task performance and real-world practicality.

Procedural Content Generation (PCG) techniques enable automatic creation of diverse and complex environments. While PCG facilitates more efficient content creation, ensuring consistently high-quality, industry-standard content remains a significant challenge. In this research, we propose a method to identify and repair unstable levels generated by existing PCG models. We use Angry Birds as a case study, demonstrating our method on game levels produced by established PCG approaches. Our method leverages object segmentation and visual analysis of level images to detect structural gaps and perform targeted repairs. We evaluate multiple object segmentation models and select the most effective one as the basis for our repair pipeline. Experimental results show that our method improves the stability and playability of AI-generated levels. Although our evaluation is specific to Angry Birds, our image-based approach is designed to be applicable to a wide range of 2D games with similar level structures.

Tool agents interact with users through multi-turn dialogues to accomplish various tasks. Recent studies have adopted user simulation methods to develop these agents in multi-turn settings. However, existing user simulators tend to be agent-friendly, exhibiting only cooperative behaviors, which fails to train and test agents against non-collaborative users in the real world. To address this, we propose a novel user simulator architecture that simulates four categories of non-collaborative behaviors: requesting unavailable services, digressing into tangential conversations, expressing impatience, and providing incomplete utterances. Our user simulator can simulate challenging and natural non-collaborative behaviors while reliably delivering all intents and information necessary to accomplish the task. Our experiments on MultiWOZ and $τ$-bench reveal significant performance degradation in state-of-the-art tool agents when encountering non-collaborative users. We provide detailed analyses of agents' weaknesses under each non-collaborative condition, such as escalated hallucinations and dialogue breakdowns. Ultimately, we contribute an easily extensible user simulation framework to help the research community develop tool agents and preemptively diagnose them under challenging real-world conditions within their own services.

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