Large Language Models (LLMs) offer significant potential for clinical symptom extraction, but their deployment in healthcare settings is constrained by privacy concerns, computational limitations, and operational costs. This study investigates the optimization of compact LLMs for cancer toxicity symptom extraction using a novel iterative refinement approach. We employ a student-teacher architecture, utilizing Zephyr-7b-beta and Phi3-mini-128 as student models and GPT-4o as the teacher, to dynamically select between prompt refinement, Retrieval-Augmented Generation (RAG), and fine-tuning strategies. Our experiments on 294 clinical notes covering 12 post-radiotherapy toxicity symptoms demonstrate the effectiveness of this approach. The RAG method proved most efficient, improving average accuracy scores from 0.32 to 0.73 for Zephyr-7b-beta and from 0.40 to 0.87 for Phi3-mini-128 during refinement. In the test set, both models showed an approximate 0.20 increase in accuracy across symptoms. Notably, this improvement was achieved at a cost 45 times lower than GPT-4o for Zephyr and 79 times lower for Phi-3. These results highlight the potential of iterative refinement techniques in enhancing the capabilities of compact LLMs for clinical applications, offering a balance between performance, cost-effectiveness, and privacy preservation in healthcare settings.
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Endovascular interventions are a life-saving treatment for many diseases, yet suffer from drawbacks such as radiation exposure and potential scarcity of proficient physicians. Robotic assistance during these interventions could be a promising support towards these problems. Research focusing on autonomous endovascular interventions utilizing artificial intelligence-based methodologies is gaining popularity. However, variability in assessment environments hinders the ability to compare and contrast the efficacy of different approaches, primarily due to each study employing a unique evaluation framework. In this study, we present deep reinforcement learning-based autonomous endovascular device navigation on three distinct digital benchmark interventions: BasicWireNav, ArchVariety, and DualDeviceNav. The benchmark interventions were implemented with our modular simulation framework stEVE (simulated EndoVascular Environment). Autonomous controllers were trained solely in simulation and evaluated in simulation and on physical test benches with camera and fluoroscopy feedback. Autonomous control for BasicWireNav and ArchVariety reached high success rates and was successfully transferred from the simulated training environment to the physical test benches, while autonomous control for DualDeviceNav reached a moderate success rate. The experiments demonstrate the feasibility of stEVE and its potential for transferring controllers trained in simulation to real-world scenarios. Nevertheless, they also reveal areas that offer opportunities for future research. This study demonstrates the transferability of autonomous controllers from simulation to the real world in endovascular navigation and lowers the entry barriers and increases the comparability of research on endovascular assistance systems by providing open-source training scripts, benchmarks and the stEVE framework.
Robotic surgery has reached a high level of maturity and has become an integral part of standard surgical care. However, existing surgeon consoles are bulky, take up valuable space in the operating room, make surgical team coordination challenging, and their proprietary nature makes it difficult to take advantage of recent technological advances, especially in virtual and augmented reality. One potential area for further improvement is the integration of modern sensory gloves into robotic platforms, allowing surgeons to control robotic arms intuitively with their hand movements. We propose one such system that combines an HTC Vive tracker, a Manus Meta Prime 3 XR sensory glove, and SCOPEYE wireless smart glasses. The system controls one arm of a da Vinci surgical robot. In addition to moving the arm, the surgeon can use fingers to control the end-effector of the surgical instrument. Hand gestures are used to implement clutching and similar functions. In particular, we introduce clutching of the instrument orientation, a functionality unavailable in the da Vinci system. The vibrotactile elements of the glove are used to provide feedback to the user when gesture commands are invoked. A qualitative and quantitative evaluation has been conducted that compares the current device with the dVRK console. The system is shown to have excellent tracking accuracy, and the new interface allows surgeons to perform common surgical training tasks with minimal practice efficiently.
Internet-of-Things (IoT) devices, ranging from smart home assistants to health devices, are pervasive: Forecasts estimate their number to reach 29 billion by 2030. Understanding the security of their machine-to-machine communication is crucial. Prior work focused on identifying devices' vulnerabilities or proposed protocol-specific solutions. Instead, we investigate the security of backends speaking IoT protocols, that is, the backbone of the IoT ecosystem. We focus on three real-world protocols for our large-scale analysis: MQTT, CoAP, and XMPP. We gather a dataset of over 337,000 backends, augment it with geographical and provider data, and perform non-invasive active measurements to investigate three major security threats: information leakage, weak authentication, and denial of service. Our results provide quantitative evidence of a problematic immaturity in the IoT ecosystem. Among other issues, we find that 9.44% backends expose information, 30.38% CoAP-speaking backends are vulnerable to denial of service attacks, and 99.84% of MQTT- and XMPP-speaking backends use insecure transport protocols (only 0.16% adopt TLS, of which 70.93% adopt a vulnerable version).
Recent advances in generative models for medical imaging have shown promise in representing multiple modalities. However, the variability in modality availability across datasets limits the general applicability of the synthetic data they produce. To address this, we present a novel physics-informed generative model capable of synthesizing a variable number of brain MRI modalities, including those not present in the original dataset. Our approach utilizes latent diffusion models and a two-step generative process: first, unobserved physical tissue property maps are synthesized using a latent diffusion model, and then these maps are combined with a physical signal model to generate the final MRI scan. Our experiments demonstrate the efficacy of this approach in generating unseen MR contrasts and preserving physical plausibility. Furthermore, we validate the distributions of generated tissue properties by comparing them to those measured in real brain tissue.
Natural Language Processing (NLP) techniques have been increasingly integrated into clinical projects to advance clinical decision-making and improve patient outcomes. Such projects benefit from interdisciplinary team collaborations. This paper explores challenges and opportunities using two clinical NLP projects as case studies, where speech-language pathologists (SLPs) and NLP researchers jointly developed technology-based systems to improve clinical workflow. Through semi-structured interviews with five SLPs and four NLP researchers, we collected collaboration practices and challenges. Using Activity Theory as an analytical framework, we examined collaborative activities, challenges, and strategies to bridge interdisciplinary gaps. Our findings revealed significant knowledge boundaries and terminological barriers between SLPs and NLP researchers when both groups relied on clinical data as boundary objects to facilitate collaboration, although this approach has limitations. We highlight the potential opportunities of AI technologies as knowledge brokers to overcome interdisciplinary collaboration challenges.
With the increasing demand for dynamic behaviors in automotive use cases, Software Defined Vehicles (SDVs) have emerged as a promising solution by bringing dynamic onboard service management capabilities. While users may request a wide range of services during vehicle operation, background tasks such as cooperative Vehicle-to-Everything (V2X) services can activate on-the-fly in response to real-time road conditions. In this dynamic environment, the efficient allocation of onboard resources becomes a complex challenge, in order to meet mixed-criticality onboard Quality-of-Service (QoS) network requirements while ensuring an optimal user experience. Additionally, the ever-evolving real-time network connectivity and computational availability conditions further complicate the process. In this context, we present a dynamic resource-based onboard service orchestration algorithm that considers real-time in-vehicle and V2X network health, along with onboard resource constraints, to select degraded modes for onboard applications and maximize user experience. To enable dynamic orchestration, we introduce the concept of Automotive eXperience Integrity Level (AXIL) which expresses a runtime priority for non-safety-critical applications. This algorithm produces near-optimal solutions while significantly reducing execution time compared to straightforward methods as demonstrated by simulation results. With this approach, we aim to enable efficient onboard execution for a user experience-focused service orchestration.
It has been shown that deep neural networks are prone to overfitting on biased training data. Towards addressing this issue, meta-learning employs a meta model for correcting the training bias. Despite the promising performances, super slow training is currently the bottleneck in the meta learning approaches. In this paper, we introduce a novel Faster Meta Update Strategy (FaMUS) to replace the most expensive step in the meta gradient computation with a faster layer-wise approximation. We empirically find that FaMUS yields not only a reasonably accurate but also a low-variance approximation of the meta gradient. We conduct extensive experiments to verify the proposed method on two tasks. We show our method is able to save two-thirds of the training time while still maintaining the comparable or achieving even better generalization performance. In particular, our method achieves the state-of-the-art performance on both synthetic and realistic noisy labels, and obtains promising performance on long-tailed recognition on standard benchmarks.
Human doctors with well-structured medical knowledge can diagnose a disease merely via a few conversations with patients about symptoms. In contrast, existing knowledge-grounded dialogue systems often require a large number of dialogue instances to learn as they fail to capture the correlations between different diseases and neglect the diagnostic experience shared among them. To address this issue, we propose a more natural and practical paradigm, i.e., low-resource medical dialogue generation, which can transfer the diagnostic experience from source diseases to target ones with a handful of data for adaptation. It is capitalized on a commonsense knowledge graph to characterize the prior disease-symptom relations. Besides, we develop a Graph-Evolving Meta-Learning (GEML) framework that learns to evolve the commonsense graph for reasoning disease-symptom correlations in a new disease, which effectively alleviates the needs of a large number of dialogues. More importantly, by dynamically evolving disease-symptom graphs, GEML also well addresses the real-world challenges that the disease-symptom correlations of each disease may vary or evolve along with more diagnostic cases. Extensive experiment results on the CMDD dataset and our newly-collected Chunyu dataset testify the superiority of our approach over state-of-the-art approaches. Besides, our GEML can generate an enriched dialogue-sensitive knowledge graph in an online manner, which could benefit other tasks grounded on knowledge graph.
Few-shot Knowledge Graph (KG) completion is a focus of current research, where each task aims at querying unseen facts of a relation given its few-shot reference entity pairs. Recent attempts solve this problem by learning static representations of entities and references, ignoring their dynamic properties, i.e., entities may exhibit diverse roles within task relations, and references may make different contributions to queries. This work proposes an adaptive attentional network for few-shot KG completion by learning adaptive entity and reference representations. Specifically, entities are modeled by an adaptive neighbor encoder to discern their task-oriented roles, while references are modeled by an adaptive query-aware aggregator to differentiate their contributions. Through the attention mechanism, both entities and references can capture their fine-grained semantic meanings, and thus render more expressive representations. This will be more predictive for knowledge acquisition in the few-shot scenario. Evaluation in link prediction on two public datasets shows that our approach achieves new state-of-the-art results with different few-shot sizes.
Multi-relation Question Answering is a challenging task, due to the requirement of elaborated analysis on questions and reasoning over multiple fact triples in knowledge base. In this paper, we present a novel model called Interpretable Reasoning Network that employs an interpretable, hop-by-hop reasoning process for question answering. The model dynamically decides which part of an input question should be analyzed at each hop; predicts a relation that corresponds to the current parsed results; utilizes the predicted relation to update the question representation and the state of the reasoning process; and then drives the next-hop reasoning. Experiments show that our model yields state-of-the-art results on two datasets. More interestingly, the model can offer traceable and observable intermediate predictions for reasoning analysis and failure diagnosis, thereby allowing manual manipulation in predicting the final answer.
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