--We introduce PRISM (Predictive Reasoning in Sequential Medicine), a transformer-based architecture designed to model the sequential progression of clinical decision-making processes. Unlike traditional approaches that rely on isolated diagnostic classification, PRISM frames clinical trajectories as tokenized sequences of events -- including diagnostic tests, laboratory results, and diagnoses -- and learns to predict the most probable next steps in the patient diagnostic journey. Leveraging a large custom clinical vocabulary and an autoregressive training objective, PRISM demonstrates the ability to capture complex dependencies across longitudinal patient timelines. Experimental results show substantial improvements over random baselines in next-token prediction tasks, with generated sequences reflecting realistic diagnostic pathways, laboratory result progressions, and clinician ordering behaviors. These findings highlight the feasibility of applying generative language modeling techniques to structured medical event data, enabling applications in clinical decision support, simulation, and education. PRISM establishes a foundation for future advancements in sequence-based healthcare modeling, bridging the gap between machine learning architectures and real-world diagnostic reasoning. Accurate and timely clinical decision-making is fundamental to high-quality patient care.

Troubleshooting performance problems of large model training (LMT) is immensely challenging, due to unprecedented scales of modern GPU clusters, the complexity of software-hardware interactions, and the data intensity of the training process. Existing troubleshooting approaches designed for traditional distributed systems or datacenter networks fall short and can hardly apply to real-world training systems. In this paper, we present PerfTracker, the first online troubleshooting system utilizing fine-grained profiling, to diagnose performance issues of large-scale model training in production. PerfTracker can diagnose performance issues rooted in both hardware (e.g., GPUs and their interconnects) and software (e.g., Python functions and GPU operations). It scales to LMT on modern GPU clusters. PerfTracker effectively summarizes runtime behavior patterns of fine-grained LMT functions via online profiling, and leverages differential observability to localize the root cause with minimal production impact. PerfTracker has been deployed as a production service for large-scale GPU clusters of O(10, 000) GPUs (product homepage https://help.aliyun.com/zh/pai/user-guide/perftracker-online-performance-analysis-diagnostic-tool). It has been used to diagnose a variety of difficult performance issues.

Diagnostic processes for complex cyber-physical systems often require extensive prior knowledge in the form of detailed system models or comprehensive training data. However, obtaining such information poses a significant challenge. To address this issue, we present a new diagnostic approach that operates with minimal prior knowledge, requiring only a basic understanding of subsystem relationships and data from nominal operations. Our method combines a neural network-based symptom generator, which employs subsystem-level anomaly detection, with a new graph diagnosis algorithm that leverages minimal causal relationship information between subsystems-information that is typically available in practice. Our experiments with fully controllable simulated datasets show that our method includes the true causal component in its diagnosis set for 82 p.c. of all cases while effectively reducing the search space in 73 p.c. of the scenarios. Additional tests on the real-world Secure Water Treatment dataset showcase the approach's potential for practical scenarios. Our results thus highlight our approach's potential for practical applications with large and complex cyber-physical systems where limited prior knowledge is available.

The application of machine learning (ML) algorithms in the intelligent diagnosis of three-phase engines has the potential to significantly enhance diagnostic performance and accuracy. Traditional methods largely rely on signature analysis, which, despite being a standard practice, can benefit from the integration of advanced ML techniques. In our study, we innovate by combining ML algorithms with a novel unsupervised anomaly generation methodology that takes into account the engine physics model. We propose Signature-Guided Data Augmentation (SGDA), an unsupervised framework that synthesizes physically plausible faults directly in the frequency domain of healthy current signals. Guided by Motor Current Signature Analysis, SGDA creates diverse and realistic anomalies without resorting to computationally intensive simulations. This hybrid approach leverages the strengths of both supervised ML and unsupervised signature analysis, achieving superior diagnostic accuracy and reliability along with wide industrial application. The findings highlight the potential of our approach to contribute significantly to the field of engine diagnostics, offering a robust and efficient solution for real-world applications.

Causal Discovery plays a pivotal role in revealing relationships among observed variables, particularly in the temporal setup. While the majority of CD methods rely on synthetic data for evaluation, and recently for training, these fall short in accurately mirroring real-world scenarios; an effect even more evident in temporal data. Generation techniques depending on simplified assumptions on causal structure, effects and time, limit the quality and diversity of the simulated data. In this work, we introduce Temporal Causal-based Simulation (TCS), a robust framework for generating realistic time-series data and their associated temporal causal graphs. The approach is structured in three phases: estimating the true lagged causal structure of the data, approximating the functional dependencies between variables and learning the noise distribution of the corresponding causal model, each part of which can be explicitly tailored based on data assumptions and characteristics. Through an extensive evaluation process, we highlight that single detection methods for generated data discrimination prove inadequate, accentuating it as a multifaceted challenge. For this, we detail a Min-max optimization phase that draws on AutoML techniques. Our contributions include a flexible, model-agnostic pipeline for generating realistic temporal causal data, a thorough evaluation setup which enhances the validity of the generated datasets and insights into the challenges posed by realistic data generation. Through experiments involving not only real but also semi-synthetic and purely synthetic datasets, we demonstrate that while sampling realistic causal data remains a complex task, our method enriches the domain of generating sensible causal-based temporal data.

Medical audio signals, such as heart and lung sounds, play a crucial role in clinical diagnosis. However, analyzing these signals remains challenging: traditional methods rely on handcrafted features or supervised deep learning models that demand extensive labeled datasets, limiting their scalability and applicability. To address these issues, we propose CaReAQA, an audio-language model that integrates a foundation audio model with the reasoning capabilities of large language models, enabling clinically relevant, open-ended diagnostic responses. Alongside CaReAQA, we introduce CaReSound, a benchmark dataset of annotated medical audio recordings enriched with metadata and paired question-answer examples, intended to drive progress in diagnostic reasoning research. Evaluation results show that CaReAQA achieves 86.2% accuracy on open-ended diagnostic reasoning tasks, outperforming baseline models. It also generalizes well to closed-ended classification tasks, achieving an average accuracy of 56.9% on unseen datasets. Our findings show how audio-language integration and reasoning advances medical diagnostics, enabling efficient AI systems for clinical decision support.

Healthcare decision-making represents one of the most challenging domains for Artificial Intelligence (AI), requiring the integration of diverse knowledge sources, complex reasoning, and various external analytical tools. Current AI systems often rely on either task-specific models, which offer limited adaptability, or general language models without grounding with specialized external knowledge and tools. We introduce MedOrch, a novel framework that orchestrates multiple specialized tools and reasoning agents to provide comprehensive medical decision support. MedOrch employs a modular, agent-based architecture that facilitates the flexible integration of domain-specific tools without altering the core system. Furthermore, it ensures transparent and traceable reasoning processes, enabling clinicians to meticulously verify each intermediate step underlying the system's recommendations. We evaluate MedOrch across three distinct medical applications: Alzheimer's disease diagnosis, chest X-ray interpretation, and medical visual question answering, using authentic clinical datasets. The results demonstrate MedOrch's competitive performance across these diverse medical tasks. Notably, in Alzheimer's disease diagnosis, MedOrch achieves an accuracy of 93.26%, surpassing the state-of-the-art baseline by over four percentage points. For predicting Alzheimer's disease progression, it attains a 50.35% accuracy, marking a significant improvement. In chest X-ray analysis, MedOrch exhibits superior performance with a Macro AUC of 61.2% and a Macro F1-score of 25.5%. Moreover, in complex multimodal visual question answering (Image+Table), MedOrch achieves an accuracy of 54.47%. These findings underscore MedOrch's potential to advance healthcare AI by enabling reasoning-driven tool utilization for multimodal medical data processing and supporting intricate cognitive tasks in clinical decision-making.

Weaknesses: * From the theoretical analysis, the main weakness might be the analysis on pure continuous features. Nowadays, it is very unlikely to have this scenario in the most challenging machine learning problems. Thus, the theoretical implications can be limited due to this. From the empirical evaluations, I am curious to know why the method was only compared to a very old algorithm such as CART. Is it the only reasonable algorithm out there for decision trees that can be comparable to the method proposed?

The paper provides an analysis of the combinatorial properties of classes of decision trees. The reviewers found the results to be valuable, both from a theoretical perspective (novel approach in the proofs), and from a practical perspective (leading to an SRM approach to pruning).

Large language models (LLMs) have recently showcased remarkable capabilities, spanning a wide range of tasks and applications, including those in the medical domain. Models like GPT-4 excel in medical question answering but may face challenges in the lack of interpretability when handling complex tasks in real clinical settings. We thus introduce the diagnostic reasoning dataset for clinical notes (DiReCT), aiming at evaluating the reasoning ability and interpretability of LLMs compared to human doctors. It contains 511 clinical notes, each meticulously annotated by physicians, detailing the diagnostic reasoning process from observations in a clinical note to the final diagnosis. Additionally, a diagnostic knowledge graph is provided to offer essential knowledge for reasoning, which may not be covered in the training data of existing LLMs.