Clinical reasoning in medicine is a hypothesis-driven process where physicians refine diagnoses from limited information through targeted history, physical examination, and diagnostic investigations. In contrast, current medical benchmarks for large language models (LLMs) primarily assess knowledge recall through single-turn questions, where complete clinical information is provided upfront. To address this gap, we introduce VivaBench, a multi-turn benchmark that evaluates sequential clinical reasoning in LLM agents. Our dataset comprises 1152 physiciancurated clinical vignettes structured as interactive scenarios that simulate a viva voce examination in medical training, requiring agents to actively probe for relevant findings, select appropriate investigations, and synthesize information across multiple steps to reach a diagnosis. We evaluated several state-of-the-art LLMs and found that while models demonstrate competence in diagnosing conditions within well-described clinical presentations, their performance degrades significantly when required to navigate diagnostic uncertainty. Our analysis identified several failure modes that mirror common issues in clinical practice, including: (1) fixation on initial hypotheses, (2) excessive investigation ordering, (3) premature diagnostic closure, and (4) missing critical conditions. These patterns reveal fundamental limitations in how current LLMs manage uncertainty and gather information sequentially. Through VivaBench, we provide a standardized benchmark for evaluating conversational medical AI systems for real-world clinical decision support. Beyond medical applications, we contribute to the larger corpus of research on agentic AI by demonstrating how sequential reasoning trajectories can diverge in complex decision-making environments.

Large language models (LLMs) have achieved significant performance progress in various natural language processing applications. However, LLMs still struggle to meet the strict requirements for accuracy and reliability in the medical field and face many challenges in clinical applications. Existing clinical diagnostic evaluation benchmarks for evaluating medical agents powered by LLMs have severe limitations. Firstly, most existing medical evaluation benchmarks face the risk of data leakage or contamination.

Patent examination remains an ongoing challenge in the NLP literature even after the advent of large language models (LLMs), as it requires an extensive yet nuanced human judgment on whether a submitted claim meets the statutory standards of novelty and non-obviousness against previously granted claims--prior art--in expert domains. Previous NLP studies have approached this challenge as a prediction task (e.g., forecasting grant outcomes) with high-level proxies such as similarity metrics or classifiers trained on historical labels. However, this approach often overlooks the step-by-step evaluations that examiners must make with profound information, including rationales for the decisions provided in office actions documents, which also makes it harder to measure the current state of techniques in patent review processes. To fill this gap, we construct PANORAMA, a dataset of 8,143 U.S. patent examination records that preserves the full decision trails, including original applications, all cited references, Non-Final Rejections, and Notices of Allowance. Also, PANORAMA decomposes the trails into sequential benchmarks that emulate patent professionals' patent review processes and allow researchers to examine large language models' capabilities at each step of them. Our findings indicate that, although LLMs are relatively effective at retrieving relevant prior art and pinpointing the pertinent paragraphs, they struggle to assess the novelty and non-obviousness of patent claims. We discuss these results and argue that advancing NLP, including LLMs, in the patent domain requires a deeper understanding of real-world patent examination.

Clinical reasoning in medicine is a hypothesis-driven process where physicians refine diagnoses from limited information through targeted history, physical examination, and diagnostic investigations. In contrast, current medical benchmarks for large language models (LLMs) primarily assess knowledge recall through single-turn questions, where complete clinical information is provided upfront. To address this gap, we introduce VivaBench, a multi-turn benchmark that evaluates sequential clinical reasoning in LLM agents. Our dataset consists of 1762 physician-curated clinical vignettes structured as interactive scenarios that simulate a $ \textit{viva voce}$ (oral) examination in medical training, requiring agents to actively probe for relevant findings, select appropriate investigations, and synthesize information across multiple steps to reach a diagnosis. While current LLMs demonstrate competence in diagnosing conditions from well-described clinical presentations, their performance degrades significantly when required to navigate iterative diagnostic reasoning under uncertainty in our evaluation. Our analysis identified several failure modes that mirror common cognitive errors in clinical practice, including: (1) fixation on initial hypotheses, (2) inappropriate investigation ordering, (3) premature diagnostic closure, and (4) failing to screen for critical conditions. These patterns reveal fundamental limitations in how current LLMs reason and make decisions under uncertainty. Through VivaBench, we provide a standardized benchmark for evaluating conversational medical AI systems for real-world clinical decision support. Beyond medical applications, we contribute to the larger corpus of research on agentic AI by demonstrating how sequential reasoning trajectories can diverge in complex decision-making environments.

Patent examination remains an ongoing challenge in the NLP literature even after the advent of large language models (LLMs), as it requires an extensive yet nuanced human judgment on whether a submitted $\textit{claim}$ meets the statutory standards of $\textit{novelty}$ and $\textit{non-obviousness}$ against previously granted claims--$\textit{prior art}$--in expert domains. Previous NLP studies have approached this challenge as a prediction task (e.g., forecasting grant outcomes) with high-level proxies such as similarity metrics or classifiers trained on historical labels. However, this approach often overlooks the step-by-step evaluations that examiners must make with profound information, including rationales for the decisions provided in $\textit{office actions}$ documents, which also makes it harder to measure the current state of techniques in patent review processes. To fill this gap, we construct PANORAMA, a dataset of 8,143 U.S. patent examination records that preserves the full decision trails, including original applications, all cited references, $\textit{Non-Final Rejections}$, and $\textit{Notices of Allowance}$. Also, PANORAMA decomposes the trails into sequential benchmarks that emulate patent professionals' patent review processes and allow researchers to examine large language models' capabilities at each step of them. Our findings indicate that, although LLMs are relatively effective at retrieving relevant prior art and pinpointing the pertinent paragraphs, they struggle to assess the novelty and non-obviousness of patent claims. We discuss these results and argue that advancing NLP, including LLMs, in the patent domain requires a deeper understanding of real-world patent examination.

In this paper, we address this gap by dividing a typical patient's clinical journey

Online learning to rank (OLTR) plays a critical role in information retrieval and machine learning systems, with a wide range of applications in search engines and content recommenders. However, despite their extensive adoption, the susceptibility of OLTR algorithms to coordinated adversarial attacks remains poorly understood. In this work, we present a novel framework for attacking some of the widely used OLTR algorithms. Our framework is designed to promote a set of target items so that they appear in the list of top-K recommendations for T - o(T) rounds, while simultaneously inducing linear regret in the learning algorithm. We propose two novel attack strategies: CascadeOFA for CascadeUCB1 and PBMOFA for PBM-UCB . We provide theoretical guarantees showing that both strategies require only O(log T) manipulations to succeed. Additionally, we supplement our theoretical analysis with empirical results on real-world data.

Background: Magnetic resonance imaging (MRI) has high sensitivity for breast cancer detection, but interpretation is time-consuming. Artificial intelligence may aid in pre-screening. Purpose: To evaluate the DINOv2-based Medical Slice Transformer (MST) for ruling out significant findings (Breast Imaging Reporting and Data System [BI-RADS] >=4) in contrast-enhanced and non-contrast-enhanced abbreviated breast MRI. Materials and Methods: This institutional review board approved retrospective study included 1,847 single-breast MRI examinations (377 BI-RADS >=4) from an in-house dataset and 924 from an external validation dataset (Duke). Four abbreviated protocols were tested: T1-weighted early subtraction (T1sub), diffusion-weighted imaging with b=1500 s/mm2 (DWI1500), DWI1500+T2-weighted (T2w), and T1sub+T2w. Performance was assessed at 90%, 95%, and 97.5% sensitivity using five-fold cross-validation and area under the receiver operating characteristic curve (AUC) analysis. AUC differences were compared with the DeLong test. False negatives were characterized, and attention maps of true positives were rated in the external dataset. Results: A total of 1,448 female patients (mean age, 49 +/- 12 years) were included. T1sub+T2w achieved an AUC of 0.77 +/- 0.04; DWI1500+T2w, 0.74 +/- 0.04 (p=0.15). At 97.5% sensitivity, T1sub+T2w had the highest specificity (19% +/- 7%), followed by DWI1500+T2w (17% +/- 11%). Missed lesions had a mean diameter <10 mm at 95% and 97.5% thresholds for both T1sub and DWI1500, predominantly non-mass enhancements. External validation yielded an AUC of 0.77, with 88% of attention maps rated good or moderate. Conclusion: At 97.5% sensitivity, the MST framework correctly triaged cases without BI-RADS >=4, achieving 19% specificity for contrast-enhanced and 17% for non-contrast-enhanced MRI. Further research is warranted before clinical implementation.

The advancement of artificial intelligence in oral healthcare relies on the availability of large-scale multimodal datasets that capture the complexity of clinical practice. In this paper, we present a comprehensive multimodal dataset, comprising 8775 dental checkups from 4800 patients collected over eight years (2018-2025), with patients ranging from 10 to 90 years of age. The dataset includes 50000 intraoral images, 8056 radiographs, and detailed textual records, including diagnoses, treatment plans, and follow-up notes. The data were collected under standard ethical guidelines and annotated for benchmarking. To demonstrate its utility, we fine-tuned state-of-the-art large vision-language models, Qwen-VL 3B and 7B, and evaluated them on two tasks: classification of six oro-dental anomalies and generation of complete diagnostic reports from multimodal inputs. We compared the fine-tuned models with their base counterparts and GPT-4o. The fine-tuned models achieved substantial gains over these baselines, validating the dataset and underscoring its effectiveness in advancing AI-driven oro-dental healthcare solutions. The dataset is publicly available, providing an essential resource for future research in AI dentistry.