Cochlear implants (CI) significantly improve spoken language in children with severe-to-profound sensorineural hearing loss (SNHL), yet outcomes remain more variable than in children with normal hearing. This variability cannot be reliably predicted for individual children using age at implantation or residual hearing. This study aims to compare the accuracy of traditional machine learning (ML) to deep transfer learning (DTL) algorithms to predict post-CI spoken language development of children with bilateral SNHL using a binary classification model of high versus low language improvers. A total of 278 implanted children enrolled from three centers. The accuracy, sensitivity and specificity of prediction models based upon brain neuroanatomic features using traditional ML and DTL learning. DTL prediction models using bilinear attention-based fusion strategy achieved: accuracy of 92.39% (95% CI, 90.70%-94.07%), sensitivity of 91.22% (95% CI, 89.98%-92.47%), specificity of 93.56% (95% CI, 90.91%-96.21%), and area under the curve (AUC) of 0.977 (95% CI, 0.969-0.986). DTL outperformed traditional ML models in all outcome measures. DTL was significantly improved by direct capture of discriminative and task-specific information that are advantages of representation learning enabled by this approach over ML. The results support the feasibility of a single DTL prediction model for language prediction of children served by CI programs worldwide.

Guard models are a critical component of LLM safety, but their sensitivity to superficial linguistic variations remains a key vulnerability. We show that even meaning-preserving paraphrases can cause large fluctuations in safety scores, revealing a lack of semantic grounding. To address this, we introduce a practical, self-supervised framework for improving the semantic robustness of guard models. Our method leverages paraphrase sets to enforce prediction consistency using a novel, skew-aware aggregation strategy for robust target computation. Notably, we find that standard aggregation methods like mean and median can degrade safety, underscoring the need for skew-aware alternatives. We analyze six open-source guard models and show that our approach reduces semantic variability across paraphrases by ~58%, improves benchmark accuracy by ~2.5% on average, and generalizes to unseen stylistic variations. Intriguingly, we discover a bidirectional relationship between model calibration and consistency: our robustness training improves calibration by up to 40%, revealing a fundamental connection between these properties. These results highlight the value of treating semantic consistency as a first-class training objective and provide a scalable recipe for building more reliable guard models.

Large language models (LLMs) are increasingly used to extract structured information from free-text clinical records, but prior work often focuses on single tasks, limited models, and English-language reports. We evaluated 15 open-weight LLMs on pathology and radiology reports across six use cases, colorectal liver metastases, liver tumours, neurodegenerative diseases, soft-tissue tumours, melanomas, and sarcomas, at three institutes in the Netherlands, UK, and Czech Republic. Models included general-purpose and medical-specialised LLMs of various sizes, and six prompting strategies were compared: zero-shot, one-shot, few-shot, chain-of-thought, self-consistency, and prompt graph. Performance was assessed using task-appropriate metrics, with consensus rank aggregation and linear mixed-effects models quantifying variance. Top-ranked models achieved macro-average scores close to inter-rater agreement across tasks. Small-to-medium general-purpose models performed comparably to large models, while tiny and specialised models performed worse. Prompt graph and few-shot prompting improved performance by ~13%. Task-specific factors, including variable complexity and annotation variability, influenced results more than model size or prompting strategy. These findings show that open-weight LLMs can extract structured data from clinical reports across diseases, languages, and institutions, offering a scalable approach for clinical data curation.

When deploying LLMs in agentic architectures requiring real-time decisions under temporal constraints, we assume they reliably determine whether action windows remain open or have closed. This assumption is untested. We characterize temporal constraint processing across eight production-scale models (2.8-8B parameters) using deadline detection tasks, revealing systematic deployment risks: bimodal performance distribution (models achieve either 95% or 50% accuracy), extreme prompt brittleness (30-60 percentage point swings from formatting changes alone), and systematic action bias (100% false positive rates in failing models). Parameter count shows no correlation with capability in this range-a 3.8B model matches 7B models while other 7B models fail completely. Fine-tuning on 200 synthetic examples improves models with partial capability by 12-37 percentage points. We demonstrate that temporal constraint satisfaction cannot be reliably learned through next-token prediction on natural language, even with targeted fine-tuning. This capability requires architectural mechanisms for: (1) continuous temporal state representation, (2) explicit constraint checking separate from linguistic pattern matching, (3) systematic compositional reasoning over temporal relations. Current autoregressive architectures lack these mechanisms. Deploying such systems in time-critical applications without hybrid architectures incorporating symbolic reasoning modules represents unacceptable risk.

Efficient retrieval of external knowledge bases and web pages is crucial for enhancing the reasoning abilities of LLMs. Previous works on training LLMs to leverage external retrievers for solving complex problems have predominantly employed end-to-end reinforcement learning. However, these approaches neglect supervision over the reasoning process, making it difficult to guarantee logical coherence and rigor. To address these limitations, we propose Thinker, a hierarchical thinking model for deep search through multi-turn interaction, making the reasoning process supervisable and verifiable. It decomposes complex problems into independently solvable sub-problems, each dually represented in both natural language and an equivalent logical function to support knowledge base and web searches. Concurrently, dependencies between sub-problems are passed as parameters via these logical functions, enhancing the logical coherence of the problem-solving process. To avoid unnecessary external searches, we perform knowledge boundary determination to check if a sub-problem is within the LLM's intrinsic knowledge, allowing it to answer directly. Experimental results indicate that with as few as several hundred training samples, the performance of Thinker is competitive with established baselines. Furthermore, when scaled to the full training set, Thinker significantly outperforms these methods across various datasets and model sizes. The source code is available at https://github.com/OpenSPG/KAG-Thinker.

Confocal laser endomicroscopy (CLE) is a non-invasive, real-time imaging modality that can be used for in-situ, in-vivo imaging and the microstructural analysis of mucous structures. The diagnosis using CLE is, however, complicated by images being hard to interpret for non-experienced physicians. Utilizing machine learning as an augmentative tool would hence be beneficial, but is complicated by the shortage of histopathology-correlated CLE imaging sequences with respect to the plurality of patterns in this domain, leading to overfitting of machine learning models. To overcome this, self-supervised learning (SSL) can be employed on larger unlabeled datasets. CLE is a video-based modality with high inter-frame correlation, leading to a non-stratified data distribution for SSL training. In this work, we propose a filter functionality on CLE video sequences to reduce the dataset redundancy in SSL training and improve SSL training convergence and training efficiency. We use four state-of-the-art baseline networks and a SSL teacher-student network with a vision transformer small backbone for the evaluation. These networks were evaluated on downstream tasks for a sinonasal tumor dataset and a squamous cell carcinoma of the skin dataset. On both datasets, we found the highest test accuracy on the filtered SSL-pretrained model, with 67.48% and 73.52%, both considerably outperforming their non-SSL baselines. Our results show that SSL is an effective method for CLE pretraining. Further, we show that our proposed CLE video filter can be utilized to improve training efficiency in self-supervised scenarios, resulting in a reduction of 67% in training time.

Meeting summarization with large language models (LLMs) remains error-prone, often producing outputs with hallucinations, omissions, and irrelevancies. We present FRAME, a modular pipeline that reframes summarization as a semantic enrichment task. FRAME extracts and scores salient facts, organizes them thematically, and uses these to enrich an outline into an abstractive summary. To personalize summaries, we introduce SCOPE, a reason-out-loud protocol that has the model build a reasoning trace by answering nine questions before content selection. For evaluation, we propose P-MESA, a multi-dimensional, reference-free evaluation framework to assess if a summary fits a target reader. P-MESA reliably identifies error instances, achieving >= 89% balanced accuracy against human annotations and strongly aligns with human severity ratings (r >= 0.70). On QMSum and FAME, FRAME reduces hallucination and omission by 2 out of 5 points (measured with MESA), while SCOPE improves knowledge fit and goal alignment over prompt-only baselines. Our findings advocate for rethinking summarization to improve control, faithfulness, and personalization.

Large Vision-Language Models (LVLMs) excel at captioning, visual question answering, and robotics by combining vision and language, yet they often miss obvious objects or hallucinate nonexistent ones in atypical scenes. W e examine these failures through the lens of uncertainty, focusing on contextual incongruity, where objects appear unexpectedly or fail to appear in expected contexts, and show that such cases increase recognition difficulty for state-of-the-art LVLMs. T o study this regime, we introduce the Object Recognition in Incongruous Context (ORIC) framework, which constructs incongruous object-context pairs through two complementary strategies: (1) LLM-guided sampling to identify hard-to-recognize objects present in the image and (2) CLIP-guided sampling to mine plausible but absent ones. Applied to MSCOCO, ORIC produces ORIC-Bench and ORIC-style training data. Evaluating 18 LVLMs and 2 open-vocabulary detectors reveals substantial performance drops and bias patterns under incongruous contexts. Fine-tuning Qwen3-VL-8B-Instruct with Visual Reinforcement Fine-Tuning on 600 ORIC-style samples improves results on ORIC-Bench, AMBER, and HallusionBench. Overall, we show that contextual incongruity is a key source of uncertainty and provide tools for more reliable LVLMs.

Machine learning models often preserve biases present in training data, leading to unfair treatment of certain minority groups. Despite an array of existing firm-side bias mitigation techniques, they typically incur utility costs and require organizational buy-in. Recognizing that many models rely on user-contributed data, end-users can induce fairness through the framework of Algorithmic Collective Action, where a coordinated minority group strategically relabels its own data to enhance fairness, without altering the firm's training process. We propose three practical, model-agnostic methods to approximate ideal relabeling and validate them on real-world datasets. Our findings show that a subgroup of the minority can substantially reduce unfairness with a small impact on the overall prediction error.

The explainability of deep learning models remains a significant challenge, particularly in the medical domain where interpretable outputs are critical for clinical trust and transparency. Path attribution methods such as Integrated Gradients rely on a baseline representing the absence of relevant features ("missingness"). Commonly used baselines, such as all-zero inputs, are often semantically meaningless, especially in medical contexts. While alternative baseline choices have been explored, existing methods lack a principled approach to dynamically select baselines tailored to each input. In this work, we examine the notion of missingness in the medical context, analyze its implications for baseline selection, and introduce a counterfactual-guided approach to address the limitations of conventional baselines. We argue that a generated counterfactual (i.e. clinically "normal" variation of the pathological input) represents a more accurate representation of a meaningful absence of features. We use a Variational Autoencoder in our implementation, though our concept is model-agnostic and can be applied with any suitable counterfactual method. We evaluate our concept on three distinct medical data sets and empirically demonstrate that counterfactual baselines yield more faithful and medically relevant attributions, outperforming standard baseline choices as well as other related methods.