Objective: Large Language Models (LLMs) demonstrate significant capabilities in medical text understanding and generation. However, their diagnostic reliability in complex clinical scenarios remains limited. This study aims to enhance LLMs' diagnostic accuracy and clinical reasoning ability. Method: We propose an Etiology-Aware Attention Steering Framework to integrate structured clinical reasoning into LLM-based diagnosis. Specifically, we first construct Clinical Reasoning Scaffolding (CRS) based on authoritative clinical guidelines for three representative acute abdominal emergencies: acute appendicitis, acute pancreatitis, and acute cholecystitis. Next, we develop the Etiology-Aware Head Identification algorithm to pinpoint attention heads crucial for the model's etiology reasoning. To ensure reliable clinical reasoning alignment, we introduce the Reasoning-Guided Parameter-Efficient Fine-tuning that embeds etiological reasoning cues into input representations and steers the selected Etiology-Aware Heads toward critical information through a Reasoning-Guided Loss function. Result: On the Consistent Diagnosis Cohort, our framework improves average diagnostic accuracy by 15.65% and boosts the average Reasoning Focus Score by 31.6% over baselines. External validation on the Discrepant Diagnosis Cohort further confirms its effectiveness in enhancing diagnostic accuracy. Further assessments via Reasoning Attention Frequency indicate that our models exhibit enhanced reliability when faced with real-world complex scenarios. Conclusion: This study presents a practical and effective approach to enhance clinical reasoning in LLM-based diagnosis. By aligning model attention with structured CRS, the proposed framework offers a promising paradigm for building more interpretable and reliable AI diagnostic systems in complex clinical settings.

Graph model generation from natural language description is an important task with many applications in software engineering. With the rise of large language models (LLMs), there is a growing interest in using LLMs for graph model generation. Nevertheless, LLM-based graph model generation typically produces partially correct models that suffer from three main issues: (1) syntax violations: the generated model may not adhere to the syntax defined by its metamodel, (2) constraint inconsistencies: the structure of the model might not conform to some domain-specific constraints, and (3) inaccuracy: due to the inherent uncertainty in LLMs, the models can include inaccurate, hallucinated elements. While the first issue is often addressed through techniques such as constraint decoding or filtering, the latter two remain largely unaddressed. Motivated by recent self-consistency approaches in LLMs, we propose a novel abstraction-concretization framework that enhances the consistency and quality of generated graph models by considering multiple outputs from an LLM. Our approach first constructs a probabilistic partial model that aggregates all candidate outputs and then refines this partial model into the most appropriate concrete model that satisfies all constraints. We evaluate our framework on several popular open-source and closed-source LLMs using diverse datasets for model generation tasks. The results demonstrate that our approach significantly improves both the consistency and quality of the generated graph models.

In recent years, written language, particularly in science and education, has undergone remarkable shifts in word usage. These changes are widely attributed to the growing influence of Large Language Models (LLMs), which frequently rely on a distinct lexical style. Divergences between model output and target audience norms can be viewed as a form of misalignment. While these shifts are often linked to using Artificial Intelligence (AI) directly as a tool to generate text, it remains unclear whether the changes reflect broader changes in the human language system itself. To explore this question, we constructed a dataset of 22.1 million words from unscripted spoken language drawn from conversational science and technology podcasts. We analyzed lexical trends before and after ChatGPT's release in 2022, focusing on commonly LLM-associated words. Our results show a moderate yet significant increase in the usage of these words post-2022, suggesting a convergence between human word choices and LLM-associated patterns. In contrast, baseline synonym words exhibit no significant directional shift. Given the short time frame and the number of words affected, this may indicate the onset of a remarkable shift in language use. Whether this represents natural language change or a novel shift driven by AI exposure remains an open question. Similarly, although the shifts may stem from broader adoption patterns, it may also be that upstream training misalignments ultimately contribute to changes in human language use. These findings parallel ethical concerns that misaligned models may shape social and moral beliefs.

Large Language Models (LLMs) have demonstrated remarkable capabilities, leading to a significant increase in user demand for LLM services. However, cloud-based LLM services often suffer from high latency, unstable responsiveness, and privacy concerns. Therefore, multiple LLMs are usually deployed at the network edge to boost real-time responsiveness and protect data privacy, particularly for many emerging smart mobile and IoT applications. Given the varying response quality and latency of LLM services, a critical issue is how to route user requests from mobile and IoT devices to an appropriate LLM service (i.e., edge LLM expert) to ensure acceptable quality-of-service (QoS). Existing routing algorithms fail to simultaneously address the heterogeneity of LLM services, the interference among requests, and the dynamic workloads necessary for maintaining long-term stable QoS. To meet these challenges, in this paper we propose a novel deep reinforcement learning (DRL)-based QoS-aware LLM routing framework for sustained high-quality LLM services. Due to the dynamic nature of the global state, we propose a dynamic state abstraction technique to compactly represent global state features with a heterogeneous graph attention network (HAN). Additionally, we introduce an action impact estimator and a tailored reward function to guide the DRL agent in maximizing QoS and preventing latency violations. Extensive experiments on both Poisson and real-world workloads demonstrate that our proposed algorithm significantly improves average QoS and computing resource efficiency compared to existing baselines.

Tables have gained significant attention in large language models (LLMs) and multimodal large language models (MLLMs) due to their complex and flexible structure. Unlike linear text inputs, tables are two-dimensional, encompassing formats that range from well-structured database tables to complex, multi-layered spreadsheets, each with different purposes. This diversity in format and purpose has led to the development of specialized methods and tasks, instead of universal approaches, making navigation of table understanding tasks challenging. To address these challenges, this paper introduces key concepts through a taxonomy of tabular input representations and an introduction of table understanding tasks. We highlight several critical gaps in the field that indicate the need for further research: (1) the predominance of retrieval-focused tasks that require minimal reasoning beyond mathematical and logical operations; (2) significant challenges faced by models when processing complex table structures, large-scale tables, length context, or multi-table scenarios; and (3) the limited generalization of models across different tabular representations and formats.

--Large Language Models (LLMs), such as Generative Pre-trained Transformers (GPTs) are revolutionizing the generation of human-like text, producing contextually relevant and syntactically correct content. Despite challenges like biases and hallucinations, these Artificial Intelligence (AI) models excel in tasks, such as content creation, translation, and code generation. Fine-tuning and novel architectures, such as Mixture of Experts (MoE), address these issues. Over the past two years, numerous open-source foundational and fine-tuned models have been introduced, complicating the selection of the optimal LLM for researchers and companies regarding licensing and hardware requirements. T o navigate the rapidly evolving LLM landscape and facilitate LLM selection, we present a comparative list of foundational and domain-specific models, focusing on features, such as release year, licensing, and hardware requirements. This list is published on GitLab and will be continuously updated.

Clinical decision-making relies on the integrated analysis of medical images and the associated clinical reports. While Vision-Language Models (VLMs) can offer a unified framework for such tasks, they can exhibit strong biases toward one modality, frequently overlooking critical visual cues in favor of textual information. In this work, we introduce Selective Modality Shifting (SMS), a perturbation-based approach to quantify a model's reliance on each modality in binary classification tasks. By systematically swapping images or text between samples with opposing labels, we expose modality-specific biases. We assess six open-source VLMs--four generalist models and two fine-tuned for medical data-- on two medical imaging datasets with distinct modalities: MIMIC-CXR (chest X-ray) and FairVLMed (scanning laser ophthalmoscopy). By assessing model performance and the calibration of every model in both unperturbed and perturbed settings, we reveal a marked dependency on text input, which persists despite the presence of complementary visual information. We also perform a qualitative attention-based analysis which further confirms that image content is often overshadowed by text details. Our findings highlight the importance of designing and evaluating multimodal medical models that genuinely integrate visual and textual cues, rather than relying on single-modality signals.

Humans can be notoriously imperfect evaluators. They are often biased, unreliable, and unfit to define "ground truth." Yet, given the surging need to produce large amounts of training data in educational applications using AI, traditional inter-rater reliability (IRR) metrics like Cohen's kappa remain central to validating labeled data. IRR remains a cornerstone of many machine learning pipelines for educational data. Take, for example, the classification of tutors' moves in dialogues or labeling open responses in machine-graded assessments. This position paper argues that overreliance on human IRR as a gatekeeper for annotation quality hampers progress in classifying data in ways that are valid and predictive in relation to improving learning. To address this issue, we highlight five examples of complementary evaluation methods, such as multi-label annotation schemes, expert-based approaches, and close-the-loop validity. We argue that these approaches are in a better position to produce training data and subsequent models that produce improved student learning and more actionable insights than IRR approaches alone. We also emphasize the importance of external validity, for example, by establishing a procedure of validating tutor moves and demonstrating that it works across many categories of tutor actions (e.g., providing hints). We call on the field to rethink annotation quality and ground truth--prioritizing validity and educational impact over consensus alone.

The uptake of Artificial Intelligence (AI) impacts the way we work, interact, do business, and conduct research. However, organizations struggle to apply AI successfully in industrial settings where the focus is on end-to-end operational processes. Here, we consider generative, predictive, and prescriptive AI and elaborate on the challenges of diagnosing and improving such processes. We show that AI needs to be grounded using Object-Centric Process Mining (OCPM). Process-related data are structured and organization-specific and, unlike text, processes are often highly dynamic. OCPM is the missing link connecting data and processes and enables different forms of AI. We use the term Process Intelligence (PI) to refer to the amalgamation of process-centric data-driven techniques able to deal with a variety of object and event types, enabling AI in an organizational context. This paper explains why AI requires PI to improve operational processes and highlights opportunities for successfully combining OCPM and generative, predictive, and prescriptive AI.

Federated fine-tuning enables Large Language Models (LLMs) to adapt to downstream tasks while preserving data privacy, but its resource-intensive nature limits deployment on edge devices. In this paper, we introduce Developmental Federated Tuning (DevFT), a resource-efficient approach inspired by cognitive development that progressively builds a powerful LLM from a compact foundation. DevFT decomposes the fine-tuning process into developmental stages, each optimizing submodels with increasing parameter capacity. Knowledge from earlier stages transfers to subsequent submodels, providing optimized initialization parameters that prevent convergence to local minima and accelerate training. This paradigm mirrors human learning, gradually constructing comprehensive knowledge structure while refining existing skills. To efficiently build stage-specific submodels, DevFT introduces deconfliction-guided layer grouping and differential-based layer fusion to distill essential information and construct representative layers. Evaluations across multiple benchmarks demonstrate that DevFT significantly outperforms state-of-the-art methods, achieving up to 4.59$\times$ faster convergence, 10.67$\times$ reduction in communication overhead, and 9.07% average performance improvement, while maintaining compatibility with existing approaches.