healthcare data teams

Abstract: Recurrent Transformers reusing their weights rather than stacking $L$ distinct layers are becoming widely adopted due to their parameter efficiency [1,2,3]. However, the exact representational and dynamical differences between looped and stacked architectures remain uncharacterized. This paper presents a controlled study on the example of bViT model [1] applying one weight-tied block $L$ times. We train two models: bViT and standard ViT [4] on 12-lead electrocardiogram (ECG) classification tasks from the PTB-XL dataset under identical training protocols. Despite an $8.9\times$ parameter reduction, bViT achieves accuracy parity with ViT. Geometric similarity metrics demonstrate that both architectures construct comparable latent representations in an equivalent canonical order. Crucially, their dynamics differ: bViT exhibits smaller step sizes and inter-patient sensitivity, as well as near-neutral behavior away from the data manifold, whereas ViT exhibits collapsing dimensionality of representations and out-of-distribution feature expansion.

Abstract: Memory-augmented and tool-using agents expose exact private values when remote LLMs process retrieved memory, tool actions, and intermediate observations. One-way masking limits direct exposure but removes values needed for trusted execution and can leak them through later observations. We propose Trustworthy Virtual Memory (TVM), a closed-loop runtime that keeps exact-value state local while presenting a protected view to the remote model. Within this single runtime, Rule-TVM replaces whole protected fields with locally recoverable handles, and Semantic-TVM instead replaces only sensitive spans predicted by a trusted local model, preserving surrounding task-relevant context. On Memory-EHR and Memory-RAP across two providers, span-level projection recovers most of the EHR utility lost under whole-field replacement (Task Success 84.17% vs. 52.33% on DeepSeek) while measured exposure stays low and workflows remain executable.

Abstract: Early detection of cognitive decline from speech offers a scalable and non-invasive alternative to conventional clinical assessment. Verbal fluency tasks are particularly informative, but most automated approaches aggregate features across an entire recording, overlooking temporal speech dynamics. We propose the Cognitive Instability-Aware Cross-Modal Attention Network (CCMAN), a transfer learning framework that learns task-agnostic cognitive speech representations from multiple memory-probing tasks before fine-tuning on a minute-long semantic and phonemic verbal fluency task. CCMAN integrates semantic, acoustic, and linguistic information through bidirectional cross-attention, gated multimodal fusion, and transformer-based temporal modelling to derive interpretable biomarkers of cognitive decline. Experiments were conducted on 165.44 hours of speech from 843 participants (498 healthy controls, 245 with mild cognitive impairment, and 100 with dementia). CCMAN achieved Macro-F1 scores of 0.81 and 0.59 for binary and multiclass semantic fluency classification, and 0.77 and 0.53 for phonemic fluency, consistently outperforming strong static and temporal baselines. Statistical analyses showed that semantic drift variance and pause variance, but not mean semantic drift, were significantly elevated in both MCI and dementia relative to healthy controls, while pause duration increased progressively over the task with the steepest slope in dementia, supporting global and progressive temporal speech instability as interpretable biomarkers. Evaluation on the independent PROCESS-2 benchmark further demonstrated the generalisability of the proposed framework, improving the baseline Macro-F1 by up to 9%. These findings support temporal speech instability as a dynamic speech biomarker for robust, interpretable, and generalisable early detection of cognitive decline.

Abstract: Recent advances in multimodal foundation models have intensified the need to understand how different modalities share, preserve, and complement information. Mutual Information (MI), the Information Bottleneck (IB), and Partial Information Decomposition (PID) provide complementary perspectives, yet existing studies often treat them as isolated tools. This survey presents an information-theoretic perspective connecting these principles as progressively refined views of multimodal information processing: MI characterizes inter-modal dependency, IB explains task-oriented information preservation under compression, and PID decomposes preserved information into redundancy, uniqueness, and synergy. We review 170 recent studies (2018--2026) and 12 foundational works, organizing multimodal learning around four challenges: cross-modal alignment, information-efficient fusion, interaction-type characterization, and scaling to multimodal foundation models. Rather than using application domains as primary taxonomy axes, we interpret healthcare, robotics, recommendation systems, affective computing, and wireless communications as empirical validations of these information principles. Beyond taxonomy, we organize existing multimodal paradigms within a single information-theoretic coordinate system -- the Generalized Multimodal Information Lagrangian -- in which they occupy exact or approximate parameter corners, and whose unoccupied regions name candidate method families the literature has not yet built. We further discuss how emerging multimodal foundation models instantiate these principles at scale and identify open challenges including scalable information estimation in high-dimensional settings, standardized evaluation across information-theoretic methods, combinatorial complexity of multimodal PID, and the transition from post-hoc information analysis toward information-aware multimodal learning.

Abstract: Automated radiology report generation has advanced rapidly in diagnostic accuracy, yet generated reports frequently diverge from the stylistic conventions of authentic radiologist writing in structure, diction, and uncertainty language, a gap which has direct implications for clinician trust and user experience. To address this, we characterize stylistic variation across 2,000 reports from the CheXpert Plus dataset using Bio-ClinicalBERT embeddings, UMAP dimensionality reduction, and HDBSCAN clustering, identifying five distinct reporting patterns differing in pathology focus, narrative structure, and lexical preference. Drawing on these findings, we adapt the inverse constitutional AI framework to derive a style-focused constitution from radiologist-written report pairs without requiring a formal preference dataset. This constitution, encoding conventions of tone, diction, uncertainty calibration, and report structure, is incorporated into the supervised fine-tuning of a MedGemma-4B base model on 25,245 CheXpert Plus training pairs. Constitutional fine-tuning produces a substantial increases in text alignment (BLEU-4: 0.006 to 0.308; ROUGE-L: 0.171 to 0.484) relative to the untuned baseline. These gains show a qualitative shift in structural and lexical alignment rather than marginal improvement, as the baseline model produces near-zero scores due to format mismatch. Overall, we establish corpus-level style characterization and constitutional modeling as an effective and data-efficient strategy for producing radiology reports that conform to authentic radiologist writing conventions.

Abstract: Electronic health records (EHRs) may incompletely capture patient-reported factors associated with opioid use disorder (OUD). We evaluated whether survey data improve prediction of a first recorded OUD diagnosis among 267,747 All of Us participants with documented opioid exposure, including 15,287 OUD cases. We compared EHR-only and EHR+survey models across 6-, 12-, and 24-month look-back windows using logistic regression, random forest, XGBoost, LightGBM, multilayer perceptron, LSTM, GRU, and Transformer. Survey augmentation improved PR-AUC across all 24 model-window combinations by 0.0087-0.0505; the best 24-month LightGBM model improved from 0.6219 to 0.6603. Survey coverage increased with longer windows and differed by OUD status (24 months: 21.7% OUD-positive vs. 60.7% OUD-negative). Permutation analysis ranked survey features as the second most important information domain at 24 months in both evaluated models. Patient-reported data provide complementary predictive signals beyond structured EHRs while highlighting the importance of survey availability.

Abstract: Multivariate time series imputation (MTSI) aims to recover missing values in temporal data composed of multiple interdependent variables. This problem is central to real-world applications such as healthcare monitoring, traffic networks, and energy systems. Recent diffusion-based approaches have shown strong potential for probabilistic imputation by learning to generate missing values through iterative denoising. However, most existing approaches perform diffusion directly in the original data space, requiring the denoising network to simultaneously capture global structure, temporal dynamics, and stochastic variability. This makes the generative task unnecessarily complex, especially when modern deterministic imputers can already provide accurate initial reconstructions. To address this limitation, we propose RDDMPI, a conditional residual diffusion framework that operates directly in residual space. Instead of modeling the full missing signal directly, we reformulate probabilistic imputation as a baseline-residual decomposition, where a pretrained model captures the dominant signal and a diffusion process models the residual uncertainty. To better exploit deterministic guidance, \model{} conditions the reverse denoising process on both the baseline-completed signal and its latent representation, while a reliability-aware conditioning mechanism adaptively controls the influence of baseline information during residual generation. This formulation simplifies the diffusion learning objective, enabling it to focus on structured correction terms rather than reconstructing the full signal. Experiments on multiple benchmark datasets demonstrate that RDDMPI consistently improves both reconstruction accuracy and uncertainty quantification.

Abstract: Healthcare systems, mental health, and public well-being are increasingly affected by cyberbullying and harmful online interactions. This paper presents CareGuard, an early-warning framework designed to support healthcare-driven mental health protection and proactive online safety through the detection of cyberbullying-related content using advanced natural language processing techniques. CareGuard integrates zero-shot semantic labeling with fine-tuned transformer-based models, including BERT, DistilBERT, and RoBERTa, to enable robust and context-aware classification across sensitive cyberbullying categories. To improve efficiency and reduce unnecessary computation in healthcare-oriented monitoring settings, the framework incorporates an emotion-aware filtering mechanism alongside cosine similarity-based semantic screening, allowing the system to focus on semantically relevant and emotionally salient content. Experimental results on benchmark datasets demonstrate that CareGuard effectively balances detection accuracy and computational efficiency, highlighting its potential for scalable deployment in healthcare systems, mental health monitoring, and online safety applications.

Abstract: A wrong number is worse than no answer. Across factuality-critical domains -- audience metrics, scheduling and rights in media; dosages and lab values in healthcare; figures and citations in finance and legal -- a confident but fabricated value is more damaging than an honest admission of uncertainty. Yet this is the dominant failure mode we observe on small local language models: even when correct evidence is present in context, models fabricate plausible numbers and timestamps. Recent work characterizes a real limit of this regime: below 7B parameters, the bottleneck of retrieval-augmented generation (RAG) is not retrieval quality but context utilization. We present Noesis, the deterministic-first query plane of the Noesis architecture, which makes every deterministic judgment before generation. Its mechanisms follow from the ingestion architecture (subject of a separate patent application): (a) a producer-side fact layer rendering precomputed metric facts verbatim without ranking; (b) positional addressing with deterministic cross-source alignment, resolved ahead of query time at zero LLM cost; (c) provenance scoping as an attribution constraint with multi-tier named-reference routing; and (d) two-tier context with model-triggered verbatim hydration. Across four ablations, a 2B model reaches parity with a 35B model on factual integrity (exact values in all runs; zero confabulated numbers on absent-entity traps); structured retrieval beats flat RAG by +11.4 points at 2B; skeleton-only context preserves quantitative answers at 20-30% smaller prompts; and hydration recovers verbatim narrative in ~8s versus ~29s. Two properties matter for regulated domains: each query resolves in a single generation call, and every reported value is traceable to its exact source and position by construction.

Abstract: Asynchronous federated learning improves scalability by updating the global model from a server-side buffer of client updates as they arrive, rather than waiting for all selected clients to finish. While efficient, this arrival-driven aggregation can silently distort representation learning under heterogeneous participation. We identify silent rarity failure, a hidden failure mode in which clients holding rare labels contribute too weakly to the global model even though its overall accuracy appears largely unaffected. This failure arises from two coupled effects: rare-label clients may submit updates less frequently when they are slower or less available, creating participation bias; and once their updates enter the buffer, standard asynchronous aggregation assigns them no compensating influence, creating aggregation bias. We propose FedRAW, a fully server-side aggregation method that preserves rare-label influence without changing local training, client objectives, or communication protocols. FedRAW combines client-level update deduplication, which prevents frequently arriving clients from repeatedly dominating the update buffer, with rare-label-aware weighting, which increases the influence of clients carrying low-coverage labels. We formalize silent rarity failure through participation and aggregation bias, and show that FedRAW increases rare-label client influence over uniform aggregation while preserving convergence. Across EMNIST Balanced, CIFAR-10, HAM10000, and ISIC-2019, FedRAW improves rarelabel accuracy while preserving comparable global accuracy and adding negligible server-side computation.