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.

The CSS was accompanied by a natural language explanation of the scores. The LLM judge role used GPT-4.0 by OpenAI. Evaluation by Human Experts Each encounter pair in which the top diagnosis of AI and clinician did not match was evaluated by a board-certified physician with access to medical reference material. Blinding the physician to the origin of the documentation proved impractical, as the AI-based notes were highly consistent and thus easily recognized within a few pairs. The physician was asked to determine the cause of the disagreement between the documents, whether AI or the physician was more likely to be correct, whether it was not possible to determine which diagnosis was more appropriate, and whether the diagnoses did, in fact, match. Similarity and Style Metrics To evaluate how similar-or different the AI-generated (Doctronic) and clinician-generated SOAP notes were, we followed a two-step process. First, we assessed surface-level textual similarity using three standard statistical metrics: (1) TF IDF cosine similarity, which transforms each note into a weighted term-frequency vector and measures the cosine of the angle between them to capture word-frequency alignment; (2) the Jaccard index, which is the ratio of the intersection to the union of lowercased token sets, ranging from 0 (no overlap) to 1 (identical token sets); and (3) the Levenshtein ratio, a normalized edit-distance score based on character-level insertions, deletions, and substitutions that quantifies textual similarity on a 0-1 scale. These analyses demonstrated only minimal alignment in phrasing, formatting, and vocabulary. Then, to probe contextual and semantic similarity, we generated embeddings for each note using OpenAI's text embedding 3 small model and two versions of Biobert,

Root Cause Analysis (RCA) in mobile networks remains a challenging task due to the need for interpretability, domain expertise, and causal reasoning. In this work, we propose a lightweight framework that leverages Large Language Models (LLMs) for RCA. To do so, we introduce TeleLogs, a curated dataset of annotated troubleshooting problems designed to benchmark RCA capabilities. Our evaluation reveals that existing open-source reasoning LLMs struggle with these problems, underscoring the need for domain-specific adaptation. To address this issue, we propose a two-stage training methodology that combines supervised fine-tuning with reinforcement learning to improve the accuracy and reasoning quality of LLMs. The proposed approach fine-tunes a series of RCA models to integrate domain knowledge and generate structured, multi-step diagnostic explanations, improving both interpretability and effectiveness. Extensive experiments across multiple LLM sizes show significant performance gains over state-of-the-art reasoning and non-reasoning models, including strong generalization to randomized test variants. These results demonstrate the promise of domain-adapted, reasoning-enhanced LLMs for practical and explainable RCA in network operation and management.

We develop a criterion to certify whether causal effects are identifiable in linear structural equation models with latent variables. Linear structural equation models correspond to directed graphs whose nodes represent the random variables of interest and whose edges are weighted with linear coefficients that correspond to direct causal effects. In contrast to previous identification methods, we do not restrict ourselves to settings where the latent variables constitute independent latent factors (i.e., to source nodes in the graphical representation of the model). Our novel latent-subgraph criterion is a purely graphical condition that is sufficient for identifiability of causal effects by rational formulas in the covariance matrix. To check the latent-subgraph criterion, we provide a sound and complete algorithm that operates by solving an integer linear program. While it targets effects involving observed variables, our new criterion is also useful for identifying effects between latent variables, as it allows one to transform the given model into a simpler measurement model for which other existing tools become applicable.

--Intelligent fault diagnosis (IFD) plays a crucial role in ensuring the safe operation of industrial machinery and improving production efficiency. However, traditional supervised deep learning methods require a large amount of training data and labels, which are often located in different clients. Additionally, the cost of data labeling is high, making labels difficult to acquire. Meanwhile, differences in data distribution among clients may also hinder the model's performance. T o tackle these challenges, this paper proposes a semi-supervised federated learning framework, SSFL-DCSL, which integrates dual contrastive loss and soft labeling to address data and label scarcity for distributed clients with few labeled samples while safeguarding user privacy. It enables representation learning using unlabeled data on the client side and facilitates joint learning among clients through prototypes, thereby achieving mutual knowledge sharing and preventing local model divergence. Specifically, first, a sample weighting function based on the Laplace distribution is designed to alleviate bias caused by low confidence in pseudo labels during the semi-supervised training process. Second, a dual contrastive loss is introduced to mitigate model divergence caused by different data distributions, comprising local contrastive loss and global contrastive loss. Third, local prototypes are aggregated on the server with weighted averaging and updated with momentum to share knowledge among clients. T o evaluate the proposed SSFL-DCSL framework, experiments are conducted on two publicly available datasets and a dataset collected on motors from the factory. In the most challenging task, where only 10% of the data are labeled, the proposed SSFL-DCSL can improve accuracy by 1.15% to 7.85% over state-of-the-art methods. Dai and Z. Mei are with the School of Electronic and Optical Engineering, Nanjing University of Science and Technology, Nanjing 210094, China (e-mail: { yajiao.dai, J. Li and S. Jin are with the School of Information Science and Engineering, Southeast University, Nanjing, 210096, China (e-mail: jun.li, jinshi@seu.edu.cn).

Many critical decision-making tasks are now delegated to machine-learned models, and it is imperative that their decisions are trustworthy and reliable, and their outputs are consistent across similar inputs. We identify a new source of unreliable behaviors-called glitches-which may significantly impair the reliability of AI models having steep decision boundaries. Roughly speaking, glitches are small neighborhoods in the input space where the model's output abruptly oscillates with respect to small changes in the input. We provide a formal definition of glitches, and use well-known models and datasets from the literature to demonstrate that they have widespread existence and argue they usually indicate potential model inconsistencies in the neighborhood of where they are found. We proceed to the algorithmic search of glitches for widely used gradient-boosted decision tree (GBDT) models. We prove that the problem of detecting glitches is NP-complete for tree ensembles, already for trees of depth 4. Our glitch-search algorithm for GBDT models uses an MILP encoding of the problem, and its effectiveness and computational feasibility are demonstrated on a set of widely used GBDT benchmarks taken from the literature.

Recent work has demonstrated the promise of conversational AI systems for diagnostic dialogue. However, real-world assurance of patient safety means that providing individual diagnoses and treatment plans is considered a regulated activity by licensed professionals. Furthermore, physicians commonly oversee other team members in such activities, including nurse practitioners (NPs) or physician assistants/associates (PAs). Inspired by this, we propose a framework for effective, asynchronous oversight of the Articulate Medical Intelligence Explorer (AMIE) AI system. We propose guardrailed-AMIE (g-AMIE), a multi-agent system that performs history taking within guardrails, abstaining from individualized medical advice. Afterwards, g-AMIE conveys assessments to an overseeing primary care physician (PCP) in a clinician cockpit interface. The PCP provides oversight and retains accountability of the clinical decision. This effectively decouples oversight from intake and can thus happen asynchronously. In a randomized, blinded virtual Objective Structured Clinical Examination (OSCE) of text consultations with asynchronous oversight, we compared g-AMIE to NPs/PAs or a group of PCPs under the same guardrails. Across 60 scenarios, g-AMIE outperformed both groups in performing high-quality intake, summarizing cases, and proposing diagnoses and management plans for the overseeing PCP to review. This resulted in higher quality composite decisions. PCP oversight of g-AMIE was also more time-efficient than standalone PCP consultations in prior work. While our study does not replicate existing clinical practices and likely underestimates clinicians' capabilities, our results demonstrate the promise of asynchronous oversight as a feasible paradigm for diagnostic AI systems to operate under expert human oversight for enhancing real-world care.

--Novel AI-based arc fault diagnosis models have demonstrated outstanding performance in terms of classification accuracy. However, an inherent problem is whether these models can actually be trusted to find arc faults. In this light, this work proposes a soft evaluation indicator that explains the outputs of arc fault diagnosis models, by defining the the correct explanation of arc faults and leveraging Explainable Artificial Intelligence and real arc fault experiments. Meanwhile, a lightweight balanced neural network is proposed to guarantee competitive accuracy and soft feature extraction score. In our experiments, several traditional machine learning methods and deep learning methods across two arc fault datasets with different sample times and noise levels are utilized to test the effectiveness of the soft evaluation indicator . Through this approach, the arc fault diagnosis models are easy to understand and trust, allowing practitioners to make informed and trustworthy decisions. ITH the deepening of the electrification of buildings and transportation, arc faults have become an essential problem in power systems, since they can ignite surrounding materials, leading to fires that often go undetected [1] and posing serious threats to people and property [2]. Meanwhile, the arc faults will reduce the current of the circuit, which causes the conventional over-current and leakage current protection devices to fail to detect the fault [3]. Therefore, many recent studies have designed many arc fault detection or classification methods to warn of the occurrence of arc faults in advance and avoid the tragedy of fire.

The diagnosis of oral diseases presents a problematic clinical challenge, characterized by a wide spectrum of pathologies with overlapping symptomatology. To address this, we developed Clinical Semantic Intelligence (CSI), a novel artificial intelligence framework that diagnoses 118 different oral diseases by computationally modeling the cognitive processes of an expert clinician. Our core hypothesis is that moving beyond simple pattern matching to emulate expert reasoning is critical to building clinically useful diagnostic aids. CSI's architecture integrates a fine-tuned multimodal CLIP model with a specialized ChatGLM-6B language model. This system executes a Hierarchical Diagnostic Reasoning Tree (HDRT), a structured framework that distills the systematic, multi-step logic of differential diagnosis. The framework operates in two modes: a Fast Mode for rapid screening and a Standard Mode that leverages the full HDRT for an interactive and in-depth diagnostic workup. To train and validate our system, we curated a primary dataset of 4,310 images, supplemented by an external hold-out set of 176 images for final validation. A clinically-informed augmentation strategy expanded our training data to over 30,000 image-text pairs. On a 431-image internal test set, CSI's Fast Mode achieved an accuracy of 73.4%, which increased to 89.5% with the HDRT-driven Standard Mode. The performance gain is directly attributable to the hierarchical reasoning process. Herein, we detail the architectural philosophy, development, and rigorous evaluation of the CSI framework.

Fu are with the School of Computing and Augmented Intelligence, Arizona State University, Tempe, Arizona, USA. Abstract --The escalating threat of cyberattacks on real-time critical infrastructures poses significant risks to public safety, necessitating detection methods that can effectively capture complex system interdependencies and adapt to evolving attack patterns. Traditional real-time anomaly detection techniques often produce excessive false positives due to their statistical sensitivity to high data variability and class imbalance. T o address these limitations, recent research has explored modeling causal relationships among system components. However, prior work predominantly focuses on offline causal graph-based approaches that require static historical data and fail to generalize to real-time settings. These methods are fundamentally constrained by: (1) their inability to adapt to dynamic shifts in data distribution without retraining, and (2) the risk of catastrophic forgetting when lacking timely supervision in live systems. T o overcome these challenges, we propose INCADET, a novel framework for incremental causal graph learning tailored to real-time cyberat-tack detection. The framework comprises three modules: 1) Early Symptom Detection: Detects transitions in system status using divergence in edge-weight distributions across sequential causal graphs. Extensive experiments on real-world critical infrastructure datasets demonstrate that INCADET achieves superior accuracy, robustness, and adaptability compared to both static causal and deep temporal baselines in evolving attack scenarios. In real-world critical public infrastructures, adversarial cy-berattacks emerge incrementally, evolving from subtle data perturbations to complex intrusions that trigger delayed, cascading disruptions across interconnected nodes, complicating detection and mitigation.