The sentence-level framework defines extractive summarization as an individual sentence selection problem, determining whether each sentence in a document should be included in the summary. However, the sentence-level framework often produces summaries that contain only general sentences or repeat important but similar sentences (Narayan et al., 2018b; Zhong et al., 2020). The summary-level framework overcomes this limitation by defining extractive summarization as a summary ranking problem rather than a sentence selection problem. The main idea of the summary-level framework is to generate a set of candidate summaries consisting of different sentences, and then rank them to select the best summary. By considering sentence composition at the entire summary level rather than sentence by sentence, this approach enables each sentence in the summary to convey different, specific information (Narayan et al., 2018b; Zhong et al., 2020). Previous work in both frameworks has primarily focused on improving which sentences to include in the summary, or in other words, sentence inclusion. However, to the best of our knowledge, the importance of sentence order in summaries has not been highlighted since the era of graph-based extractive summarization (Mihalcea and Ta-rau, 2004; Erkan and Radev, 2004). The sentence order of a text plays a crucial role not only in readability but also in its meaning (Yin et al., 2019; Lo-geswaran et al., 2018). Table 1 illustrates how the arXiv:2502.16180v1

Lower-Limb Fractures (LLF) are a major health concern for older adults, often leading to reduced mobility and prolonged recovery, potentially impairing daily activities and independence. During recovery, older adults frequently face social isolation and functional decline, complicating rehabilitation and adversely affecting physical and mental health. Multi-modal sensor platforms that continuously collect data and analyze it using machine-learning algorithms can remotely monitor this population and infer health outcomes. They can also alert clinicians to individuals at risk of isolation and decline. This paper presents a new publicly available multi-modal sensor dataset, MAISON-LLF, collected from older adults recovering from LLF in community settings. The dataset includes data from smartphone and smartwatch sensors, motion detectors, sleep-tracking mattresses, and clinical questionnaires on isolation and decline. The dataset was collected from ten older adults living alone at home for eight weeks each, totaling 560 days of 24-hour sensor data. For technical validation, supervised machine-learning and deep-learning models were developed using the sensor and clinical questionnaire data, providing a foundational comparison for the research community.

In the era of Large Language Models (LLMs), given their remarkable text understanding and generation abilities, there is an unprecedented opportunity to develop new, LLM-based methods for trustworthy medical knowledge synthesis, extraction and summarization. This paper focuses on the problem of Pharmacovigilance (PhV), where the significance and challenges lie in identifying Adverse Drug Events (ADEs) from diverse text sources, such as medical literature, clinical notes, and drug labels. Unfortunately, this task is hindered by factors including variations in the terminologies of drugs and outcomes, and ADE descriptions often being buried in large amounts of narrative text. We present MALADE, the first effective collaborative multi-agent system powered by LLM with Retrieval Augmented Generation for ADE extraction from drug label data. This technique involves augmenting a query to an LLM with relevant information extracted from text resources, and instructing the LLM to compose a response consistent with the augmented data. MALADE is a general LLM-agnostic architecture, and its unique capabilities are: (1) leveraging a variety of external sources, such as medical literature, drug labels, and FDA tools (e.g., OpenFDA drug information API), (2) extracting drug-outcome association in a structured format along with the strength of the association, and (3) providing explanations for established associations. Instantiated with GPT-4 Turbo or GPT-4o, and FDA drug label data, MALADE demonstrates its efficacy with an Area Under ROC Curve of 0.90 against the OMOP Ground Truth table of ADEs. Our implementation leverages the Langroid multi-agent LLM framework and can be found at https://github.com/jihyechoi77/malade.

Center for Biocomputing and Digital Health, Institute of Computing and Cybersystems, and Health Research Institute, Michigan Technological University, Houghton, MI 49931 # Anjum Shaik and Kristoffer Larsen contribute equally. Abstract Page ABSTRACT Hip fractures present a significant healthcare challenge, especially within aging populations, where they are often caused by falls. These fractures lead to substantial morbidity and mortality, emphasizing the need for timely surgical intervention. Despite advancements in medical care, hip fractures impose a significant burden on individuals and healthcare systems. This paper focuses on the prediction of hip fracture risk in older and middle-aged adults, where falls and compromised bone quality are predominant factors. We propose a novel staged model that combines advanced imaging and clinical data to improve predictive performance. By using convolutional neural networks (CNNs) to extract features from hip DXA images, along with clinical variables, shape measurements, and texture features, our method provides a comprehensive framework for assessing fracture risk. The study cohort included 547 patients, with 94 experiencing hip fracture. A staged machine learning-based model was developed using two ensemble models: Ensemble 1 (clinical variables only) and Ensemble 2 (clinical variables and DXA imaging features). This staged approach used uncertainty quantification from Ensemble 1 to decide if DXA features are necessary for further prediction. Ensemble 2 exhibited the highest performance, achieving an Area Under the Curve (AUC) of 0.9541, an accuracy of 0.9195, a sensitivity of 0.8078, and a specificity of 0.9427.

Bone segmentation is an essential step for the preoperative planning of fracture trauma surgery. The automated segmentation of fractured bone from computed tomography (CT) scans remains challenging, due to the large differences of fractures in position and morphology, and also the inherent anatomical characteristics of different bone structures. To alleviate these issues, we propose a cross-scale attention mechanism as well as a surface supervision strategy for fractured bone segmentation in CT. Specifically, a cross-scale attention mechanism is introduced to effectively aggregate the features among different scales to provide more powerful fracture representation. Moreover, a surface supervision strategy is employed, which explicitly constrains the network to pay more attention to the bone boundary. The efficacy of the proposed method is evaluated on a public dataset containing CT scans with hip fractures. The evaluation metrics are Dice similarity coefficient (DSC), average symmetric surface distance (ASSD), and Hausdorff distance (95HD). The proposed method achieves an average DSC of 93.36%, ASSD of 0.85mm, 95HD of 7.51mm. Our method offers an effective fracture segmentation approach for the pelvic CT examinations, and has the potential to be used for improving the segmentation performance of other types of fractures.

Hip fracture risk assessment is an important but challenging task. Quantitative CT-based patient specific finite element analysis (FEA) computes the force (fracture load) to break the proximal femur in a particular loading condition. It provides different structural information about the proximal femur that can influence a subject overall fracture risk. To obtain a more robust measure of fracture risk, we used principal component analysis (PCA) to develop a global FEA computed fracture risk index that incorporates the FEA-computed yield and ultimate failure loads and energies to failure in four loading conditions (single-limb stance and impact from a fall onto the posterior, posterolateral, and lateral aspects of the greater trochanter) of 110 hip fracture subjects and 235 age and sex matched control subjects from the AGES-Reykjavik study. We found that the first PC (PC1) of the FE parameters was the only significant predictor of hip fracture. Using a logistic regression model, we determined if prediction performance for hip fracture using PC1 differed from that using FE parameters combined by stratified random resampling with respect to hip fracture status. The results showed that the average of the area under the receive operating characteristic curve (AUC) using PC1 was always higher than that using all FE parameters combined in the male subjects. The AUC of PC1 and AUC of the FE parameters combined were not significantly different than that in the female subjects or in all subjects

Deep-learning approaches based on convolutional neural networks (CNNs) are gaining interest in the medical imaging field. We evaluated the diagnostic performance of a CNN to discriminate femoral neck fractures, trochanteric fractures, and non-fracture using antero-posterior (AP) and lateral hip radiographs. Patients and methods -- 1,703 plain hip AP radiographs and 1,220 plain hip lateral radiographs were included in the total dataset. The CNN made the diagnosis based on: (1) AP radiographs alone, (2) lateral radiographs alone, or (3) both AP and lateral radiographs combined. The diagnostic performance of the CNN was measured by the accuracy, recall, precision, and F1 score.

Current approaches to explaining the decisions of deep learning systems for medical tasks have focused on visualising the elements that have contributed to each decision. We argue that such approaches are not enough to "open the black box" of medical decision making systems because they are missing a key component that has been used as a standard communication tool between doctors for centuries: language. We propose a model-agnostic interpretability method that involves training a simple recurrent neural network model to produce descriptive sentences to clarify the decision of deep learning classifiers. We test our method on the task of detecting hip fractures from frontal pelvic x-rays. This process requires minimal additional labelling despite producing text containing elements that the original deep learning classification model was not specifically trained to detect. The experimental results show that: 1) the sentences produced by our method consistently contain the desired information, 2) the generated sentences are preferred by doctors compared to current tools that create saliency maps, and 3) the combination of visualisations and generated text is better than either alone.

Predictive analytics have proved promising capabilities and opportunities to many aspects of healthcare practice. Data-driven insights can provide an important part of the solution for curbing rising costs and improving care quality. The paper implements machine learning techniques in an attempt to support decision making in relation to elderly healthcare in Ireland, with a particular focus on hip fracture care. We adopt a combination of unsupervised and supervised learning for predicting patient outcomes. Initially, elderly patients are grouped based on the similarity of age, length of stay (LOS) and elapsed time to surgery. Using the K-Means algorithm, our clustering experiments suggest the presence of three coherent clusters of patients. Subsequently, the discovered clusters are utilised to train prediction models that address a particular cluster of patients individually. In particular, two machine learning models are trained for every cluster of patients in order to predict the inpatient LOS, and discharge destination. The developed models are claimed to make predictions with relatively high accuracy. Furthermore, the potential usefulness of the clustering-guided approach of prediction is discussed in general.