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Evaluating Strategies for Synthesizing Clinical Notes for Medical Multimodal AI

arXiv.org Artificial Intelligence

Multimodal (MM) learning is emerging as a promising paradigm in biomedical artificial intelligence (AI) applications, integrating complementary modality, which highlight different aspects of patient health. The scarcity of large heterogeneous biomedical MM data has restrained the development of robust models for medical AI applications. In the dermatology domain, for instance, skin lesion datasets typically include only images linked to minimal metadata describing the condition, thereby limiting the benefits of MM data integration for reliable and generalizable predictions. Recent advances in Large Language Models (LLMs) enable the synthesis of textual description of image findings, potentially allowing the combination of image and text representations. However, LLMs are not specifically trained for use in the medical domain, and their naive inclusion has raised concerns about the risk of hallucinations in clinically relevant contexts. This work investigates strategies for generating synthetic textual clinical notes, in terms of prompt design and medical metadata inclusion, and evaluates their impact on MM architectures toward enhancing performance in classification and cross-modal retrieval tasks. Experiments across several heterogeneous dermatology datasets demonstrate that synthetic clinical notes not only enhance classification performance, particularly under domain shift, but also unlock cross-modal retrieval capabilities, a downstream task that is not explicitly optimized during training.


Tacit Bidder-Side Collusion: Artificial Intelligence in Dynamic Auctions

arXiv.org Artificial Intelligence

We study whether large language models acting as autonomous bidders can tacitly collude by coordinating when to accept platform posted payouts in repeated Dutch auctions, without any communication. We present a minimal repeated auction model that yields a simple incentive compatibility condition and a closed form threshold for sustainable collusion for subgame-perfect Nash equilibria. In controlled simulations with multiple language models, we observe systematic supra-competitive prices in small auction settings and a return to competitive behavior as the number of bidders in the market increases, consistent with the theoretical model. We also find LLMs use various mechanisms to facilitate tacit coordination, such as focal point acceptance timing versus patient strategies that track the theoretical incentives. The results provide, to our knowledge, the first evidence of bidder side tacit collusion by LLMs and show that market structure levers can be more effective than capability limits for mitigation.


Reducing research bureaucracy in UK higher education: Can generative AI assist with the internal evaluation of quality?

arXiv.org Artificial Intelligence

This paper examines the potential for generative artificial intelligence (GenAI) to assist with internal review processes for research quality evaluations in UK higher education and particularly in preparation for the Research Excellence Framework (REF). Using the lens of function substitution in the Viable Systems Model, we present an experimental methodology using ChatGPT to score and rank business and management papers from REF 2021 submissions, "reverse engineering" the assessment by comparing AI-generated scores with known institutional results. Through rigourous testing of 822 papers across 11 institutions, we established scoring boundaries that aligned with reported REF outcomes: 49% between 1* and 2*, 59% between 2* and 3*, and 69% between 3* and 4*. The results demonstrate that AI can provide consistent evaluations that help identify borderline evaluation cases requiring additional human scrutiny while reducing the substantial resource burden of traditional internal review processes. We argue for application through a nuanced hybrid approach that maintains academic integrity while addressing the multi-million pound costs associated with research evaluation bureaucracy. While acknowledging these limitations including potential AI biases, the research presents a promising framework for more efficient, consistent evaluations that could transform current approaches to research assessment.


Factors That Support Grounded Responses in LLM Conversations: A Rapid Review

arXiv.org Artificial Intelligence

Large language models (LLMs) may generate outputs that are misaligned with user intent, lack contextual grounding, or exhibit hallucinations during conversation, which compromises the reliability of LLM-based applications. This review aimed to identify and analyze techniques that align LLM responses with conversational goals, ensure grounding, and reduce hallucination and topic drift. We conducted a Rapid Review guided by the PRISMA framework and the PICO strategy to structure the search, filtering, and selection processes. The alignment strategies identified were categorized according to the LLM lifecycle phase in which they operate: inference-time, post-training, and reinforcement learning-based methods. Among these, inference-time approaches emerged as particularly efficient, aligning outputs without retraining while supporting user intent, contextual grounding, and hallucination mitigation. The reviewed techniques provided structured mechanisms for improving the quality and reliability of LLM responses across key alignment objectives.


LLMs for Low-Resource Dialect Translation Using Context-Aware Prompting: A Case Study on Sylheti

arXiv.org Artificial Intelligence

Large Language Models (LLMs) have demonstrated strong translation abilities through prompting, even without task-specific training. However, their effectiveness in dialectal and low-resource contexts remains underexplored. This study presents the first systematic investigation of LLM-based machine translation (MT) for Sylheti, a dialect of Bangla that is itself low-resource. We evaluate five advanced LLMs (GPT-4.1, GPT-4.1, LLaMA 4, Grok 3, and DeepSeek V3.2) across both translation directions (Bangla $\Leftrightarrow$ Sylheti), and find that these models struggle with dialect-specific vocabulary. To address this, we introduce Sylheti-CAP (Context-Aware Prompting), a three-step framework that embeds a linguistic rulebook, a dictionary (2{,}260 core vocabulary items and idioms), and an authenticity check directly into prompts. Extensive experiments show that Sylheti-CAP consistently improves translation quality across models and prompting strategies. Both automatic metrics and human evaluations confirm its effectiveness, while qualitative analysis reveals notable reductions in hallucinations, ambiguities, and awkward phrasing, establishing Sylheti-CAP as a scalable solution for dialectal and low-resource MT. Dataset link: \href{https://github.com/TabiaTanzin/LLMs-for-Low-Resource-Dialect-Translation-Using-Context-Aware-Prompting-A-Case-Study-on-Sylheti.git}{https://github.com/TabiaTanzin/LLMs-for-Low-Resource-Dialect-Translation-Using-Context-Aware-Prompting-A-Case-Study-on-Sylheti.git}


Orchestrating Dual-Boundaries: An Arithmetic Intensity Inspired Acceleration Framework for Diffusion Language Models

arXiv.org Artificial Intelligence

Diffusion-based large language models (dLLMs) have recently gained significant attention for their exceptional performance and inherent potential for parallel decoding. Existing frameworks further enhance its inference efficiency by enabling KV caching. However, its bidirectional attention mechanism necessitates periodic cache refreshes that interleave prefill and decoding phases, both contributing substantial inference cost and constraining achievable speedup. Inspired by the heterogeneous arithmetic intensity of the prefill and decoding phases, we propose ODB-dLLM, a framework that orchestrates dual-boundaries to accelerate dLLM inference. In the prefill phase, we find that the predefined fixed response length introduces heavy yet redundant computational overhead, which affects efficiency. To alleviate this, ODB-dLLM incorporates an adaptive length prediction mechanism that progressively reduces prefill overhead and unnecessary computation. In the decoding phase, we analyze the computational characteristics of dLLMs and propose a dLLM-specific jump-share speculative decoding method to enhance efficiency by reducing the number of decoding iterations. Experimental results demonstrate that ODB-dLLM achieves 46-162x and 2.63-6.30x speedups over the baseline dLLM and Fast-dLLM, respectively, while simultaneously mitigating the accuracy degradation in existing acceleration frameworks.


A Longitudinal Measurement of Privacy Policy Evolution for Large Language Models

arXiv.org Artificial Intelligence

Large language model (LLM) services have been rapidly integrated into people's daily lives as chatbots and agentic systems. They are nourished by collecting rich streams of data, raising privacy concerns around excessive collection of sensitive personal information. Privacy policies are the fundamental mechanism for informing users about data practices in modern information privacy paradigm. Although traditional web and mobile policies are well studied, the privacy policies of LLM providers, their LLM-specific content, and their evolution over time remain largely underexplored. In this paper, we present the first longitudinal empirical study of privacy policies for mainstream LLM providers worldwide. We curate a chronological dataset of 74 historical privacy policies and 115 supplemental privacy documents from 11 LLM providers across 5 countries up to August 2025, and extract over 3,000 sentence-level edits between consecutive policy versions. We compare LLM privacy policies to those of other software formats, propose a taxonomy tailored to LLM privacy policies, annotate policy edits and align them with a timeline of key LLM ecosystem events. Results show they are substantially longer, demand college-level reading ability, and remain highly vague. Our taxonomy analysis reveals patterns in how providers disclose LLM-specific practices and highlights regional disparities in coverage. Policy edits are concentrated in first-party data collection and international/specific-audience sections, and that product releases and regulatory actions are the primary drivers, shedding light on the status quo and the evolution of LLM privacy policies.


Medical Malice: A Dataset for Context-Aware Safety in Healthcare LLMs

arXiv.org Artificial Intelligence

The integration of Large Language Models (LLMs) into healthcare demands a safety paradigm rooted in \textit{primum non nocere}. However, current alignment techniques rely on generic definitions of harm that fail to capture context-dependent violations, such as administrative fraud and clinical discrimination. To address this, we introduce Medical Malice: a dataset of 214,219 adversarial prompts calibrated to the regulatory and ethical complexities of the Brazilian Unified Health System (SUS). Crucially, the dataset includes the reasoning behind each violation, enabling models to internalize ethical boundaries rather than merely memorizing a fixed set of refusals. Using an unaligned agent (Grok-4) within a persona-driven pipeline, we synthesized high-fidelity threats across seven taxonomies, ranging from procurement manipulation and queue-jumping to obstetric violence. We discuss the ethical design of releasing these "vulnerability signatures" to correct the information asymmetry between malicious actors and AI developers. Ultimately, this work advocates for a shift from universal to context-aware safety, providing the necessary resources to immunize healthcare AI against the nuanced, systemic threats inherent to high-stakes medical environments -- vulnerabilities that represent the paramount risk to patient safety and the successful integration of AI in healthcare systems.


Dissecting the Ledger: Locating and Suppressing "Liar Circuits" in Financial Large Language Models

arXiv.org Artificial Intelligence

Large Language Models (LLMs) are increasingly deployed in high-stakes financial domains, yet they suffer from specific, reproducible hallucinations when performing arithmetic operations. Current mitigation strategies often treat the model as a black box. In this work, we propose a mechanistic approach to intrinsic hallucination detection. By applying Causal Tracing to the GPT-2 XL architecture on the ConvFinQA benchmark, we identify a dual-stage mechanism for arithmetic reasoning: a distributed computational scratchpad in middle layers (L12-L30) and a decisive aggregation circuit in late layers (specifically Layer 46). We verify this mechanism via an ablation study, demonstrating that suppressing Layer 46 reduces the model's confidence in hallucinatory outputs by 81.8%. Furthermore, we demonstrate that a linear probe trained on this layer generalizes to unseen financial topics with 98% accuracy, suggesting a universal geometry of arithmetic deception.


Extracting Disaster Impacts and Impact Related Locations in Social Media Posts Using Large Language Models

arXiv.org Artificial Intelligence

Large-scale disasters can often result in catastrophic consequences on people and infrastructure. Situation awareness about such disaster impacts generated by authoritative data from in-situ sensors, remote sensing imagery, and/or geographic data is often limited due to atmospheric opacity, satellite revisits, and time limitations. This often results in geo-temporal information gaps. In contrast, impact-related social media posts can act as "geo-sensors" during a disaster, where people describe specific impacts and locations. However, not all locations mentioned in disaster-related social media posts relate to an impact. Only the impacted locations are critical for directing resources effectively. e.g., "The death toll from a fire which ripped through the Greek coastal town of #Mati stood at 80, with dozens of people unaccounted for as forensic experts tried to identify victims who were burned alive #Greecefires #AthensFires #Athens #Greece." contains impacted location "Mati" and non-impacted locations "Greece" and "Athens". This research uses Large Language Models (LLMs) to identify all locations, impacts and impacted locations mentioned in disaster-related social media posts. In the process, LLMs are fine-tuned to identify only impacts and impacted locations (as distinct from other, non-impacted locations), including locations mentioned in informal expressions, abbreviations, and short forms. Our fine-tuned model demonstrates efficacy, achieving an F1-score of 0.69 for impact and 0.74 for impacted location extraction, substantially outperforming the pre-trained baseline. These robust results confirm the potential of fine-tuned language models to offer a scalable solution for timely decision-making in resource allocation, situational awareness, and post-disaster recovery planning for responders.