Daily Papers

We perform a missing, reproducible evaluation of all publicly available GPT-4 family models concerning the Document Understanding field, where it is frequently required to comprehend text spacial arrangement and visual clues in addition to textual semantics. Benchmark results indicate that though it is hard to achieve satisfactory results with text-only models, GPT-4 Vision Turbo performs well when one provides both text recognized by an external OCR engine and document images on the input. Evaluation is followed by analyses that suggest possible contamination of textual GPT-4 models and indicate the significant performance drop for lengthy documents.

Multimodal large language models (MLLMs), built on large-scale pre-trained vision towers and language models, have shown great capabilities in multimodal understanding. However, most existing MLLMs are trained on single-turn vision question-answering tasks, which do not accurately reflect real-world human conversations. In this paper, we introduce MMDiag, a multi-turn multimodal dialogue dataset. This dataset is collaboratively generated through deliberately designed rules and GPT assistance, featuring strong correlations between questions, between questions and images, and among different image regions; thus aligning more closely with real-world scenarios. MMDiag serves as a strong benchmark for multi-turn multimodal dialogue learning and brings more challenges to the grounding and reasoning capabilities of MLLMs. Further, inspired by human vision processing, we present DiagNote, an MLLM equipped with multimodal grounding and reasoning capabilities. DiagNote consists of two modules (Deliberate and Gaze) interacting with each other to perform Chain-of-Thought and annotations respectively, throughout multi-turn dialogues. We empirically demonstrate the advantages of DiagNote in both grounding and jointly processing and reasoning with vision and language information over existing MLLMs.

Clinical notes contain rich data, which is unexploited in predictive modeling compared to structured data. In this work, we developed a new text representation Clinical XLNet for clinical notes which also leverages the temporal information of the sequence of the notes. We evaluated our models on prolonged mechanical ventilation prediction problem and our experiments demonstrated that Clinical XLNet outperforms the best baselines consistently.

We introduce the Scratchpad Mechanism, a novel addition to the sequence-to-sequence (seq2seq) neural network architecture and demonstrate its effectiveness in improving the overall fluency of seq2seq models for natural language generation tasks. By enabling the decoder at each time step to write to all of the encoder output layers, Scratchpad can employ the encoder as a "scratchpad" memory to keep track of what has been generated so far and thereby guide future generation. We evaluate Scratchpad in the context of three well-studied natural language generation tasks --- Machine Translation, Question Generation, and Text Summarization --- and obtain state-of-the-art or comparable performance on standard datasets for each task. Qualitative assessments in the form of human judgements (question generation), attention visualization (MT), and sample output (summarization) provide further evidence of the ability of Scratchpad to generate fluent and expressive output.

Clinical notes contain information about patients that goes beyond structured data like lab values and medications. However, clinical notes have been underused relative to structured data, because notes are high-dimensional and sparse. This work develops and evaluates representations of clinical notes using bidirectional transformers (ClinicalBERT). ClinicalBERT uncovers high-quality relationships between medical concepts as judged by humans. ClinicalBert outperforms baselines on 30-day hospital readmission prediction using both discharge summaries and the first few days of notes in the intensive care unit. Code and model parameters are available.

Two commonly-employed strategies to combat the rise of misinformation on social media are (i) fact-checking by professional organisations and (ii) community moderation by platform users. Policy changes by Twitter/X and, more recently, Meta, signal a shift away from partnerships with fact-checking organisations and towards an increased reliance on crowdsourced community notes. However, the extent and nature of dependencies between fact-checking and helpful community notes remain unclear. To address these questions, we use language models to annotate a large corpus of Twitter/X community notes with attributes such as topic, cited sources, and whether they refute claims tied to broader misinformation narratives. Our analysis reveals that community notes cite fact-checking sources up to five times more than previously reported. Fact-checking is especially crucial for notes on posts linked to broader narratives, which are twice as likely to reference fact-checking sources compared to other sources. In conclusion, our results show that successful community moderation heavily relies on professional fact-checking.

A crucial step within secondary analysis of electronic health records (EHRs) is to identify the patient cohort under investigation. While EHRs contain medical billing codes that aim to represent the conditions and treatments patients may have, much of the information is only present in the patient notes. Therefore, it is critical to develop robust algorithms to infer patients' conditions and treatments from their written notes. In this paper, we introduce a dataset for patient phenotyping, a task that is defined as the identification of whether a patient has a given medical condition (also referred to as clinical indication or phenotype) based on their patient note. Nursing Progress Notes and Discharge Summaries from the Intensive Care Unit of a large tertiary care hospital were manually annotated for the presence of several high-context phenotypes relevant to treatment and risk of re-hospitalization. This dataset contains 1102 Discharge Summaries and 1000 Nursing Progress Notes. Each Discharge Summary and Progress Note has been annotated by at least two expert human annotators (one clinical researcher and one resident physician). Annotated phenotypes include treatment non-adherence, chronic pain, advanced/metastatic cancer, as well as 10 other phenotypes. This dataset can be utilized for academic and industrial research in medicine and computer science, particularly within the field of medical natural language processing.

Objective: Patient notes in electronic health records (EHRs) may contain critical information for medical investigations. However, the vast majority of medical investigators can only access de-identified notes, in order to protect the confidentiality of patients. In the United States, the Health Insurance Portability and Accountability Act (HIPAA) defines 18 types of protected health information (PHI) that needs to be removed to de-identify patient notes. Manual de-identification is impractical given the size of EHR databases, the limited number of researchers with access to the non-de-identified notes, and the frequent mistakes of human annotators. A reliable automated de-identification system would consequently be of high value. Materials and Methods: We introduce the first de-identification system based on artificial neural networks (ANNs), which requires no handcrafted features or rules, unlike existing systems. We compare the performance of the system with state-of-the-art systems on two datasets: the i2b2 2014 de-identification challenge dataset, which is the largest publicly available de-identification dataset, and the MIMIC de-identification dataset, which we assembled and is twice as large as the i2b2 2014 dataset. Results: Our ANN model outperforms the state-of-the-art systems. It yields an F1-score of 97.85 on the i2b2 2014 dataset, with a recall 97.38 and a precision of 97.32, and an F1-score of 99.23 on the MIMIC de-identification dataset, with a recall 99.25 and a precision of 99.06. Conclusion: Our findings support the use of ANNs for de-identification of patient notes, as they show better performance than previously published systems while requiring no feature engineering.

BACKGROUND: Radiology reports are typically written in a free-text format, making clinical information difficult to extract and use. Recently the adoption of structured reporting (SR) has been recommended by various medical societies thanks to the advantages it offers, e.g. standardization, completeness and information retrieval. We propose a pipeline to extract information from free-text radiology reports, that fits with the items of the reference SR registry proposed by a national society of interventional and medical radiology, focusing on CT staging of patients with lymphoma. METHODS: Our work aims to leverage the potential of Natural Language Processing (NLP) and Transformer-based models to deal with automatic SR registry filling. With the availability of 174 radiology reports, we investigate a rule-free generative Question Answering approach based on a domain-specific version of T5 (IT5). Two strategies (batch-truncation and ex-post combination) are implemented to comply with the model's context length limitations. Performance is evaluated in terms of strict accuracy, F1, and format accuracy, and compared with the widely used GPT-3.5 Large Language Model. A 5-point Likert scale questionnaire is used to collect human-expert feedback on the similarity between medical annotations and generated answers. RESULTS: The combination of fine-tuning and batch splitting allows IT5 to achieve notable results; it performs on par with GPT-3.5 albeit its size being a thousand times smaller in terms of parameters. Human-based assessment scores show a high correlation (Spearman's correlation coefficients>0.88, p-values<0.001) with AI performance metrics (F1) and confirm the superior ability of LLMs (i.e., GPT-3.5, 175B of parameters) in generating plausible human-like statements.

In this work, we introduce Multiple Embedding Model for EHR (MEME), an approach that views Electronic Health Records (EHR) as multimodal data. This approach incorporates "pseudo-notes", textual representations of tabular EHR concepts such as diagnoses and medications, and allows us to effectively employ Large Language Models (LLMs) for EHR representation. This framework also adopts a multimodal approach, embedding each EHR modality separately. We demonstrate the effectiveness of MEME by applying it to several tasks within the Emergency Department across multiple hospital systems. Our findings show that MEME surpasses the performance of both single modality embedding methods and traditional machine learning approaches. However, we also observe notable limitations in generalizability across hospital institutions for all tested models.

This tutorial note summarizes the presentation on ``Large Multimodal Models: Towards Building and Surpassing Multimodal GPT-4'', a part of CVPR 2023 tutorial on ``Recent Advances in Vision Foundation Models''. The tutorial consists of three parts. We first introduce the background on recent GPT-like large models for vision-and-language modeling to motivate the research in instruction-tuned large multimodal models (LMMs). As a pre-requisite, we describe the basics of instruction-tuning in large language models, which is further extended to the multimodal space. Lastly, we illustrate how to build the minimum prototype of multimodal GPT-4 like models with the open-source resource, and review the recently emerged topics.

Recent developments in representational learning for information retrieval can be organized in a conceptual framework that establishes two pairs of contrasts: sparse vs. dense representations and unsupervised vs. learned representations. Sparse learned representations can further be decomposed into expansion and term weighting components. This framework allows us to understand the relationship between recently proposed techniques such as DPR, ANCE, DeepCT, DeepImpact, and COIL, and furthermore, gaps revealed by our analysis point to "low hanging fruit" in terms of techniques that have yet to be explored. We present a novel technique dubbed "uniCOIL", a simple extension of COIL that achieves to our knowledge the current state-of-the-art in sparse retrieval on the popular MS MARCO passage ranking dataset. Our implementation using the Anserini IR toolkit is built on the Lucene search library and thus fully compatible with standard inverted indexes.

Following each patient visit, physicians draft long semi-structured clinical summaries called SOAP notes. While invaluable to clinicians and researchers, creating digital SOAP notes is burdensome, contributing to physician burnout. In this paper, we introduce the first complete pipelines to leverage deep summarization models to generate these notes based on transcripts of conversations between physicians and patients. After exploring a spectrum of methods across the extractive-abstractive spectrum, we propose Cluster2Sent, an algorithm that (i) extracts important utterances relevant to each summary section; (ii) clusters together related utterances; and then (iii) generates one summary sentence per cluster. Cluster2Sent outperforms its purely abstractive counterpart by 8 ROUGE-1 points, and produces significantly more factual and coherent sentences as assessed by expert human evaluators. For reproducibility, we demonstrate similar benefits on the publicly available AMI dataset. Our results speak to the benefits of structuring summaries into sections and annotating supporting evidence when constructing summarization corpora.

Electronic Health Records (EHRs) are integral for storing comprehensive patient medical records, combining structured data (e.g., medications) with detailed clinical notes (e.g., physician notes). These elements are essential for straightforward data retrieval and provide deep, contextual insights into patient care. However, they often suffer from discrepancies due to unintuitive EHR system designs and human errors, posing serious risks to patient safety. To address this, we developed EHRCon, a new dataset and task specifically designed to ensure data consistency between structured tables and unstructured notes in EHRs. EHRCon was crafted in collaboration with healthcare professionals using the MIMIC-III EHR dataset, and includes manual annotations of 3,943 entities across 105 clinical notes checked against database entries for consistency. EHRCon has two versions, one using the original MIMIC-III schema, and another using the OMOP CDM schema, in order to increase its applicability and generalizability. Furthermore, leveraging the capabilities of large language models, we introduce CheckEHR, a novel framework for verifying the consistency between clinical notes and database tables. CheckEHR utilizes an eight-stage process and shows promising results in both few-shot and zero-shot settings. The code is available at https://github.com/dustn1259/EHRCon.

The detailed clinical records drafted by doctors after each patient's visit are crucial for medical practitioners and researchers. Automating the creation of these notes with language models can reduce the workload of doctors. However, training such models can be difficult due to the limited public availability of conversations between patients and doctors. In this paper, we introduce NoteChat, a cooperative multi-agent framework leveraging Large Language Models (LLMs) for generating synthetic doctor-patient conversations conditioned on clinical notes. NoteChat consists of Planning, Roleplay, and Polish modules. We provide a comprehensive automatic and human evaluation of NoteChat, comparing it with state-of-the-art models, including OpenAI's ChatGPT and GPT-4. Results demonstrate that NoteChat facilitates high-quality synthetic doctor-patient conversations, underscoring the untapped potential of LLMs in healthcare. This work represents the first instance of multiple LLMs cooperating to complete a doctor-patient conversation conditioned on clinical notes, offering promising avenues for the intersection of AI and healthcare

Large language models have been shown to struggle with limited context memory and multi-step reasoning. We propose a simple method for solving both of these problems by allowing the model to take Self-Notes. Unlike recent scratchpad approaches, the model can deviate from the input context at any time to explicitly think. This allows the model to recall information and perform reasoning on the fly as it reads the context, thus extending its memory and enabling multi-step reasoning. Our experiments on multiple tasks demonstrate that our method can successfully generalize to longer and more complicated instances from their training setup by taking Self-Notes at inference time.

The development of large language models tailored for handling patients' clinical notes is often hindered by the limited accessibility and usability of these notes due to strict privacy regulations. To address these challenges, we first create synthetic large-scale clinical notes using publicly available case reports extracted from biomedical literature. We then use these synthetic notes to train our specialized clinical large language model, Asclepius. While Asclepius is trained on synthetic data, we assess its potential performance in real-world applications by evaluating it using real clinical notes. We benchmark Asclepius against several other large language models, including GPT-3.5-turbo and other open-source alternatives. To further validate our approach using synthetic notes, we also compare Asclepius with its variants trained on real clinical notes. Our findings convincingly demonstrate that synthetic clinical notes can serve as viable substitutes for real ones when constructing high-performing clinical language models. This conclusion is supported by detailed evaluations conducted by both GPT-4 and medical professionals. All resources including weights, codes, and data used in the development of Asclepius are made publicly accessible for future research.

Predicting disease trajectories from electronic health records (EHRs) is a complex task due to major challenges such as data non-stationarity, high granularity of medical codes, and integration of multimodal data. EHRs contain both structured data, such as diagnostic codes, and unstructured data, such as clinical notes, which hold essential information often overlooked. Current models, primarily based on structured data, struggle to capture the complete medical context of patients, resulting in a loss of valuable information. To address this issue, we propose an approach that integrates unstructured clinical notes into transformer-based deep learning models for sequential disease prediction. This integration enriches the representation of patients' medical histories, thereby improving the accuracy of diagnosis predictions. Experiments on MIMIC-IV datasets demonstrate that the proposed approach outperforms traditional models relying solely on structured data.

In this paper we present a hybrid method for the automatic detection of dermatological pathologies in medical reports. We use a large language model combined with medical ontologies to predict, given a first appointment or follow-up medical report, the pathology a person may suffer from. The results show that teaching the model to learn the type, severity and location on the body of a dermatological pathology, as well as in which order it has to learn these three features, significantly increases its accuracy. The article presents the demonstration of state-of-the-art results for classification of medical texts with a precision of 0.84, micro and macro F1-score of 0.82 and 0.75, and makes both the method and the data set used available to the community.

Automatically summarizing patients' main problems from daily progress notes using natural language processing methods helps to battle against information and cognitive overload in hospital settings and potentially assists providers with computerized diagnostic decision support. Problem list summarization requires a model to understand, abstract, and generate clinical documentation. In this work, we propose a new NLP task that aims to generate a list of problems in a patient's daily care plan using input from the provider's progress notes during hospitalization. We investigate the performance of T5 and BART, two state-of-the-art seq2seq transformer architectures, in solving this problem. We provide a corpus built on top of progress notes from publicly available electronic health record progress notes in the Medical Information Mart for Intensive Care (MIMIC)-III. T5 and BART are trained on general domain text, and we experiment with a data augmentation method and a domain adaptation pre-training method to increase exposure to medical vocabulary and knowledge. Evaluation methods include ROUGE, BERTScore, cosine similarity on sentence embedding, and F-score on medical concepts. Results show that T5 with domain adaptive pre-training achieves significant performance gains compared to a rule-based system and general domain pre-trained language models, indicating a promising direction for tackling the problem summarization task.

Objective: Data unavailability has been one of the biggest barriers in clinical natural language processing. This paper is aimed at providing a large-scale and publicly available patient note dataset, named PMC-Patients, with relevant articles and similar patients annotations. The ultimate goal of PMC-Patients is to facilitate the development of retrieval-based clinical decision support systems. Materials and Methods: To collect PMC-Patients, we extract patient notes from case reports in PubMed Central by recognizing certain section patterns. Patient-article relevance and patient-patient similarity are annotated by citation relationships in PubMed. In addition, we perform three tasks with PMC-Patients to demonstrate its utility in providing clinical decision support for a given patient, including (1) classifying whether another patient is similar, (2) retrieving similar patients in PMC-Patients, and (3) retrieving relevant articles in PubMed. Results: We collect and release PMC-Patients under the CC BY-NC-SA license, which becomes the largest publicly available patient note dataset so far. PMC-Patients contains 167k patient notes that are annotated with 3.1M relevant articles and 293k similar patients. Qualitative and quantitative analyses reveal the high quality and richness of our dataset. Experiments show that classifying the similarity of patient pairs is relatively easy, but it is hard to retrieve similar patients or relevant articles for a given patient from a large set of candidates. Conclusion: We present PMC-Patients, a large-scale dataset of patient notes with high quality, easy access, diverse conditions, and rich annotations. The proposed dataset can also serve as a hard benchmark for evaluating retrieval-based clinical decision support systems.

Understanding causal narratives communicated in clinical notes can help make strides towards personalized healthcare. Extracted causal information from clinical notes can be combined with structured EHR data such as patients' demographics, diagnoses, and medications. This will enhance healthcare providers' ability to identify aspects of a patient's story communicated in the clinical notes and help make more informed decisions. In this work, we propose annotation guidelines, develop an annotated corpus and provide baseline scores to identify types and direction of causal relations between a pair of biomedical concepts in clinical notes; communicated implicitly or explicitly, identified either in a single sentence or across multiple sentences. We annotate a total of 2714 de-identified examples sampled from the 2018 n2c2 shared task dataset and train four different language model based architectures. Annotation based on our guidelines achieved a high inter-annotator agreement i.e. Fleiss' kappa (kappa) score of 0.72, and our model for identification of causal relations achieved a macro F1 score of 0.56 on the test data. The high inter-annotator agreement for clinical text shows the quality of our annotation guidelines while the provided baseline F1 score sets the direction for future research towards understanding narratives in clinical texts.

Objective: Using natural language processing (NLP) to find sentences that state treatment plans in a clinical note, would automate plan extraction and would further enable their use in tools that help providers and care managers. However, as in the most NLP tasks on clinical text, creating gold standard to train and test NLP models is tedious and expensive. Fortuitously, sometimes but not always clinical notes contain sections with a heading that identifies the section as a plan. Leveraging contents of such labeled sections as a noisy training data, we assessed accuracy of NLP models trained with the data. Methods: We used common variations of plan headings and rule-based heuristics to find plan sections with headings in clinical notes, and we extracted sentences from them and formed a noisy training data of plan sentences. We trained Support Vector Machine (SVM) and Convolutional Neural Network (CNN) models with the data. We measured accuracy of the trained models on the noisy dataset using ten-fold cross validation and separately on a set-aside manually annotated dataset. Results: About 13% of 117,730 clinical notes contained treatment plans sections with recognizable headings in the 1001 longitudinal patient records that were obtained from Cleveland Clinic under an IRB approval. We were able to extract and create a noisy training data of 13,492 plan sentences from the clinical notes. CNN achieved best F measures, 0.91 and 0.97 in the cross-validation and set-aside evaluation experiments respectively. SVM slightly underperformed with F measures of 0.89 and 0.96 in the same experiments. Conclusion: Our study showed that the training supervised learning models using noisy plan sentences was effective in identifying them in all clinical notes. More broadly, sections with informal headings in clinical notes can be a good source for generating effective training data.

Generative models in vision have seen rapid progress due to algorithmic improvements and the availability of high-quality image datasets. In this paper, we offer contributions in both these areas to enable similar progress in audio modeling. First, we detail a powerful new WaveNet-style autoencoder model that conditions an autoregressive decoder on temporal codes learned from the raw audio waveform. Second, we introduce NSynth, a large-scale and high-quality dataset of musical notes that is an order of magnitude larger than comparable public datasets. Using NSynth, we demonstrate improved qualitative and quantitative performance of the WaveNet autoencoder over a well-tuned spectral autoencoder baseline. Finally, we show that the model learns a manifold of embeddings that allows for morphing between instruments, meaningfully interpolating in timbre to create new types of sounds that are realistic and expressive.

Several studies showed that Large Language Models (LLMs) can answer medical questions correctly, even outperforming the average human score in some medical exams. However, to our knowledge, no study has been conducted to assess the ability of language models to validate existing or generated medical text for correctness and consistency. In this paper, we introduce MEDEC (https://github.com/abachaa/MEDEC), the first publicly available benchmark for medical error detection and correction in clinical notes, covering five types of errors (Diagnosis, Management, Treatment, Pharmacotherapy, and Causal Organism). MEDEC consists of 3,848 clinical texts, including 488 clinical notes from three US hospital systems that were not previously seen by any LLM. The dataset has been used for the MEDIQA-CORR shared task to evaluate seventeen participating systems [Ben Abacha et al., 2024]. In this paper, we describe the data creation methods and we evaluate recent LLMs (e.g., o1-preview, GPT-4, Claude 3.5 Sonnet, and Gemini 2.0 Flash) for the tasks of detecting and correcting medical errors requiring both medical knowledge and reasoning capabilities. We also conducted a comparative study where two medical doctors performed the same task on the MEDEC test set. The results showed that MEDEC is a sufficiently challenging benchmark to assess the ability of models to validate existing or generated notes and to correct medical errors. We also found that although recent LLMs have a good performance in error detection and correction, they are still outperformed by medical doctors in these tasks. We discuss the potential factors behind this gap, the insights from our experiments, the limitations of current evaluation metrics, and share potential pointers for future research.

The advancement of natural language processing (NLP) systems in healthcare hinges on language model ability to interpret the intricate information contained within clinical notes. This process often requires integrating information from various time points in a patient's medical history. However, most earlier clinical language models were pretrained with a context length limited to roughly one clinical document. In this study, We introduce ClinicalMamba, a specialized version of the Mamba language model, pretrained on a vast corpus of longitudinal clinical notes to address the unique linguistic characteristics and information processing needs of the medical domain. ClinicalMamba, with 130 million and 2.8 billion parameters, demonstrates a superior performance in modeling clinical language across extended text lengths compared to Mamba and clinical Llama. With few-shot learning, ClinicalMamba achieves notable benchmarks in speed and accuracy, outperforming existing clinical language models and general domain large models like GPT-4 in longitudinal clinical notes information extraction tasks.

Social and behavioral determinants of health (SDOH) play a significant role in shaping health outcomes, and extracting these determinants from clinical notes is a first step to help healthcare providers systematically identify opportunities to provide appropriate care and address disparities. Progress on using NLP methods for this task has been hindered by the lack of high-quality publicly available labeled data, largely due to the privacy and regulatory constraints on the use of real patients' information. This paper introduces a new dataset, SDOH-NLI, that is based on publicly available notes and which we release publicly. We formulate SDOH extraction as a natural language inference (NLI) task, and provide binary textual entailment labels obtained from human raters for a cross product of a set of social history snippets as premises and SDOH factors as hypotheses. Our dataset differs from standard NLI benchmarks in that our premises and hypotheses are obtained independently. We evaluate both "off-the-shelf" entailment models as well as models fine-tuned on our data, and highlight the ways in which our dataset appears more challenging than commonly used NLI datasets.

Continuity of care is crucial to ensuring positive health outcomes for patients discharged from an inpatient hospital setting, and improved information sharing can help. To share information, caregivers write discharge notes containing action items to share with patients and their future caregivers, but these action items are easily lost due to the lengthiness of the documents. In this work, we describe our creation of a dataset of clinical action items annotated over MIMIC-III, the largest publicly available dataset of real clinical notes. This dataset, which we call CLIP, is annotated by physicians and covers 718 documents representing 100K sentences. We describe the task of extracting the action items from these documents as multi-aspect extractive summarization, with each aspect representing a type of action to be taken. We evaluate several machine learning models on this task, and show that the best models exploit in-domain language model pre-training on 59K unannotated documents, and incorporate context from neighboring sentences. We also propose an approach to pre-training data selection that allows us to explore the trade-off between size and domain-specificity of pre-training datasets for this task.

Tumor documentation in Germany is largely done manually, requiring reading patient records and entering data into structured databases. Large language models (LLMs) could potentially enhance this process by improving efficiency and reliability. This evaluation tests eleven different open source LLMs with sizes ranging from 1-70 billion model parameters on three basic tasks of the tumor documentation process: identifying tumor diagnoses, assigning ICD-10 codes, and extracting the date of first diagnosis. For evaluating the LLMs on these tasks, a dataset of annotated text snippets based on anonymized doctors' notes from urology was prepared. Different prompting strategies were used to investigate the effect of the number of examples in few-shot prompting and to explore the capabilities of the LLMs in general. The models Llama 3.1 8B, Mistral 7B, and Mistral NeMo 12 B performed comparably well in the tasks. Models with less extensive training data or having fewer than 7 billion parameters showed notably lower performance, while larger models did not display performance gains. Examples from a different medical domain than urology could also improve the outcome in few-shot prompting, which demonstrates the ability of LLMs to handle tasks needed for tumor documentation. Open source LLMs show a strong potential for automating tumor documentation. Models from 7-12 billion parameters could offer an optimal balance between performance and resource efficiency. With tailored fine-tuning and well-designed prompting, these models might become important tools for clinical documentation in the future. The code for the evaluation is available from https://github.com/stefan-m-lenz/UroLlmEval. We also release the dataset as a new valuable resource that addresses the shortage of authentic and easily accessible benchmarks in German-language medical NLP.

Video has become a popular media form for information sharing and consumption. However, taking notes while watching a video requires significant time and effort. To address this, we propose a novel interactive system, NoTeeline, for taking real-time, personalized notes. NoTeeline lets users quickly jot down keypoints (micronotes), which are automatically expanded into full-fledged notes that capture the content of the user's micronotes and are consistent with the user's writing style. In a within-subjects study (N=12), we found that NoTeeline helps users create high-quality notes that capture the essence of their micronotes with a higher factual correctness (93.2%) while accurately reflecting their writing style. While using NoTeeline, participants experienced significantly reduced mental effort, captured satisfactory notes while writing 47% less text, and completed notetaking with 43.9% less time compared to a manual notetaking baseline.

Accurate diagnostic coding of medical notes is crucial for enhancing patient care, medical research, and error-free billing in healthcare organizations. Manual coding is a time-consuming task for providers, and diagnostic codes often exhibit low sensitivity and specificity, whereas the free text in medical notes can be a more precise description of a patients status. Thus, accurate automated diagnostic coding of medical notes has become critical for a learning healthcare system. Recent developments in long-document transformer architectures have enabled attention-based deep-learning models to adjudicate medical notes. In addition, contrastive loss functions have been used to jointly pre-train large language and image models with noisy labels. To further improve the automated adjudication of medical notes, we developed an approach based on i) models for ICD-10 diagnostic code sequences using a large real-world data set, ii) large language models for medical notes, and iii) contrastive pre-training to build an integrated model of both ICD-10 diagnostic codes and corresponding medical text. We demonstrate that a contrastive approach for pre-training improves performance over prior state-of-the-art models for the MIMIC-III-50, MIMIC-III-rare50, and MIMIC-III-full diagnostic coding tasks.

Large Language Models (LLMs) have demonstrated exceptional text understanding. Existing works explore their application in text embedding tasks. However, there are few works utilizing LLMs to assist multimodal representation tasks. In this work, we investigate the potential of LLMs to enhance multimodal representation in multimodal item-to-item (I2I) recommendations. One feasible method is the transfer of Multimodal Large Language Models (MLLMs) for representation tasks. However, pre-training MLLMs usually requires collecting high-quality, web-scale multimodal data, resulting in complex training procedures and high costs. This leads the community to rely heavily on open-source MLLMs, hindering customized training for representation scenarios. Therefore, we aim to design an end-to-end training method that customizes the integration of any existing LLMs and vision encoders to construct efficient multimodal representation models. Preliminary experiments show that fine-tuned LLMs in this end-to-end method tend to overlook image content. To overcome this challenge, we propose a novel training framework, NoteLLM-2, specifically designed for multimodal representation. We propose two ways to enhance the focus on visual information. The first method is based on the prompt viewpoint, which separates multimodal content into visual content and textual content. NoteLLM-2 adopts the multimodal In-Content Learning method to teach LLMs to focus on both modalities and aggregate key information. The second method is from the model architecture, utilizing a late fusion mechanism to directly fuse visual information into textual information. Extensive experiments have been conducted to validate the effectiveness of our method.

The discharge summary is a one of critical documents in the patient journey, encompassing all events experienced during hospitalization, including multiple visits, medications, tests, surgery/procedures, and admissions/discharge. Providing a summary of the patient's progress is crucial, as it significantly influences future care and planning. Consequently, clinicians face the laborious and resource-intensive task of manually collecting, organizing, and combining all the necessary data for a discharge summary. Therefore, we propose "NOTE", which stands for "Notable generation Of patient Text summaries through an Efficient approach based on direct preference optimization". NOTE is based on Medical Information Mart for Intensive Care- III dataset and summarizes a single hospitalization of a patient. Patient events are sequentially combined and used to generate a discharge summary for each hospitalization. In the present circumstances, large language models' application programming interfaces (LLMs' APIs) are widely available, but importing and exporting medical data presents significant challenges due to privacy protection policies in healthcare institutions. Moreover, to ensure optimal performance, it is essential to implement a lightweight model for internal server or program within the hospital. Therefore, we utilized DPO and parameter efficient fine tuning (PEFT) techniques to apply a fine-tuning method that guarantees superior performance. To demonstrate the practical application of the developed NOTE, we provide a webpage-based demonstration software. In the future, we will aim to deploy the software available for actual use by clinicians in hospital. NOTE can be utilized to generate various summaries not only discharge summaries but also throughout a patient's journey, thereby alleviating the labor-intensive workload of clinicians and aiming for increased efficiency.

We introduce the first Natural Office Talkers in Settings of Far-field Audio Recordings (``NOTSOFAR-1'') Challenge alongside datasets and baseline system. The challenge focuses on distant speaker diarization and automatic speech recognition (DASR) in far-field meeting scenarios, with single-channel and known-geometry multi-channel tracks, and serves as a launch platform for two new datasets: First, a benchmarking dataset of 315 meetings, averaging 6 minutes each, capturing a broad spectrum of real-world acoustic conditions and conversational dynamics. It is recorded across 30 conference rooms, featuring 4-8 attendees and a total of 35 unique speakers. Second, a 1000-hour simulated training dataset, synthesized with enhanced authenticity for real-world generalization, incorporating 15,000 real acoustic transfer functions. The tasks focus on single-device DASR, where multi-channel devices always share the same known geometry. This is aligned with common setups in actual conference rooms, and avoids technical complexities associated with multi-device tasks. It also allows for the development of geometry-specific solutions. The NOTSOFAR-1 Challenge aims to advance research in the field of distant conversational speech recognition, providing key resources to unlock the potential of data-driven methods, which we believe are currently constrained by the absence of comprehensive high-quality training and benchmarking datasets.

It is demonstrated that self-diffusion and shear viscosity data for the TIP4P/Ice water model reported recently [L. Baran, W. Rzysko and L. MacDowell, J. Chem. Phys. {\bf 158}, 064503 (2023)] obey the microscopic version of the Stokes-Einstein relation without the hydrodynamic diameter.

How can we better organize code in computational notebooks? Notebooks have become a popular tool among data scientists, as they seamlessly weave text and code together, supporting users to rapidly iterate and document code experiments. However, it is often challenging to organize code in notebooks, partially because there is a mismatch between the linear presentation of code and the non-linear process of exploratory data analysis. We present StickyLand, a notebook extension for empowering users to freely organize their code in non-linear ways. With sticky cells that are always shown on the screen, users can quickly access their notes, instantly observe experiment results, and easily build interactive dashboards that support complex visual analytics. Case studies highlight how our tool can enhance notebook users's productivity and identify opportunities for future notebook designs. StickyLand is available at https://github.com/xiaohk/stickyland.

Jupyter notebooks facilitate the bundling of executable code with its documentation and output in one interactive environment, and they represent a popular mechanism to document and share computational workflows. The reproducibility of computational aspects of research is a key component of scientific reproducibility but has not yet been assessed at scale for Jupyter notebooks associated with biomedical publications. We address computational reproducibility at two levels: First, using fully automated workflows, we analyzed the computational reproducibility of Jupyter notebooks related to publications indexed in PubMed Central. We identified such notebooks by mining the articles full text, locating them on GitHub and re-running them in an environment as close to the original as possible. We documented reproduction success and exceptions and explored relationships between notebook reproducibility and variables related to the notebooks or publications. Second, this study represents a reproducibility attempt in and of itself, using essentially the same methodology twice on PubMed Central over two years. Out of 27271 notebooks from 2660 GitHub repositories associated with 3467 articles, 22578 notebooks were written in Python, including 15817 that had their dependencies declared in standard requirement files and that we attempted to re-run automatically. For 10388 of these, all declared dependencies could be installed successfully, and we re-ran them to assess reproducibility. Of these, 1203 notebooks ran through without any errors, including 879 that produced results identical to those reported in the original notebook and 324 for which our results differed from the originally reported ones. Running the other notebooks resulted in exceptions. We zoom in on common problems, highlight trends and discuss potential improvements to Jupyter-related workflows associated with biomedical publications.

Recent immense breakthroughs in generative models such as in GPT4 have precipitated re-imagined ubiquitous usage of these models in all applications. One area that can benefit by improvements in artificial intelligence (AI) is healthcare. The note generation task from doctor-patient encounters, and its associated electronic medical record documentation, is one of the most arduous time-consuming tasks for physicians. It is also a natural prime potential beneficiary to advances in generative models. However with such advances, benchmarking is more critical than ever. Whether studying model weaknesses or developing new evaluation metrics, shared open datasets are an imperative part of understanding the current state-of-the-art. Unfortunately as clinic encounter conversations are not routinely recorded and are difficult to ethically share due to patient confidentiality, there are no sufficiently large clinic dialogue-note datasets to benchmark this task. Here we present the Ambient Clinical Intelligence Benchmark (ACI-BENCH) corpus, the largest dataset to date tackling the problem of AI-assisted note generation from visit dialogue. We also present the benchmark performances of several common state-of-the-art approaches.

Effective traffic prediction is a cornerstone of intelligent transportation systems, enabling precise forecasts of traffic flow, speed, and congestion. While traditional spatio-temporal graph neural networks (ST-GNNs) have achieved notable success in short-term traffic forecasting, their performance in long-term predictions remains limited. This challenge arises from over-squashing problem, where bottlenecks and limited receptive fields restrict information flow and hinder the modeling of global dependencies. To address these challenges, this study introduces a novel framework that incorporates virtual nodes, which are additional nodes added to the graph and connected to existing nodes, in order to aggregate information across the entire graph within a single GNN layer. Our proposed model incorporates virtual nodes by constructing a semi-adaptive adjacency matrix. This matrix integrates distance-based and adaptive adjacency matrices, allowing the model to leverage geographical information while also learning task-specific features from data. Experimental results demonstrate that the inclusion of virtual nodes significantly enhances long-term prediction accuracy while also improving layer-wise sensitivity to mitigate the over-squashing problem. Virtual nodes also offer enhanced explainability by focusing on key intersections and high-traffic areas, as shown by the visualization of their adjacency matrix weights on road network heat maps. Our advanced approach enhances the understanding and management of urban traffic systems, making it particularly well-suited for real-world applications.

This paper presents a novel framework for enhancing reasoning capabilities in large language models (LLMs) by leveraging iterative reasoning and feedback-driven methodologies. Building on the limitations identified in the SimpleBench benchmark, a dataset designed to evaluate logical coherence and real-world reasoning, we propose a multi-step prompting strategy coupled with global consistency checks to improve model accuracy and robustness. Through comparative analysis of state-of-the-art models, including Claude 3 Opus, Claude 3.5, GPT- 4o, and o1-preview, we demonstrate that iterative reasoning significantly enhances model performance, with improvements observed in both standard accuracy metrics (AVG@5) and a newly introduced metric, Extreme Averaging (EAG@5). Our results reveal model-specific strengths: Claude excels in maintaining logical consistency, while GPT-4o exhibits exploratory creativity but struggles with ambiguous prompts. By analyzing case studies and identifying gaps in spatial and temporal reasoning, we highlight areas for further refinement. The findings underscore the potential of structured reasoning frameworks to address inherent model limitations, irrespective of pretraining methodologies. This study lays the groundwork for integrating dynamic feedback mechanisms, adaptive restart strategies, and diverse evaluation metrics to advance LLM reasoning capabilities across complex and multi-domain problem spaces.

Dark matter, one of the fundamental components of the universe, has remained mysterious in modern cosmology and particle physics, and hence, this field is of utmost importance at present moment. One of the foundational questions in this direction is the origin of dark matter which directly links with its creation. In the present article we study the gravitational production of dark matter in two distinct contexts: firstly, when reheating occurs through the gravitational particle production, and secondly, when it is driven by the inflaton's decay. We establish a connection between the reheating temperature and the mass of dark matter, and from the reheating bounds, we determine the range of viable dark matter mass values.

Purpose: In radiology, large language models (LLMs), including ChatGPT, have recently gained attention, and their utility is being rapidly evaluated. However, concerns have emerged regarding their reliability in clinical applications due to limitations such as hallucinations and insufficient referencing. To address these issues, we focus on the latest technology, retrieval-augmented generation (RAG), which enables LLMs to reference reliable external knowledge (REK). Specifically, this study examines the utility and reliability of a recently released RAG-equipped LLM (RAG-LLM), NotebookLM, for staging lung cancer. Materials and methods: We summarized the current lung cancer staging guideline in Japan and provided this as REK to NotebookLM. We then tasked NotebookLM with staging 100 fictional lung cancer cases based on CT findings and evaluated its accuracy. For comparison, we performed the same task using a gold-standard LLM, GPT-4 Omni (GPT-4o), both with and without the REK. Results: NotebookLM achieved 86% diagnostic accuracy in the lung cancer staging experiment, outperforming GPT-4o, which recorded 39% accuracy with the REK and 25% without it. Moreover, NotebookLM demonstrated 95% accuracy in searching reference locations within the REK. Conclusion: NotebookLM successfully performed lung cancer staging by utilizing the REK, demonstrating superior performance compared to GPT-4o. Additionally, it provided highly accurate reference locations within the REK, allowing radiologists to efficiently evaluate the reliability of NotebookLM's responses and detect possible hallucinations. Overall, this study highlights the potential of NotebookLM, a RAG-LLM, in image diagnosis.

LoRA (Low-Rank Adaptation) has emerged as a preferred method for efficiently adapting Large Language Models (LLMs) with remarkable simplicity and efficacy. This note extends the original LoRA paper by offering new perspectives that were not initially discussed and presents a series of insights for deploying LoRA at scale. Without introducing new experiments, we aim to improve the understanding and application of LoRA.

Recently, an intriguing class of non-convex optimization problems has emerged in the context of learning directed acyclic graphs (DAGs). These problems involve minimizing a given loss or score function, subject to a non-convex continuous constraint that penalizes the presence of cycles in a graph. In this work, we delve into the optimization challenges associated with this class of non-convex programs. To address these challenges, we propose a bi-level algorithm that leverages the non-convex constraint in a novel way. The outer level of the algorithm optimizes over topological orders by iteratively swapping pairs of nodes within the topological order of a DAG. A key innovation of our approach is the development of an effective method for generating a set of candidate swapping pairs for each iteration. At the inner level, given a topological order, we utilize off-the-shelf solvers that can handle linear constraints. The key advantage of our proposed algorithm is that it is guaranteed to find a local minimum or a KKT point under weaker conditions compared to previous work and finds solutions with lower scores. Extensive experiments demonstrate that our method outperforms state-of-the-art approaches in terms of achieving a better score. Additionally, our method can also be used as a post-processing algorithm to significantly improve the score of other algorithms. Code implementing the proposed method is available at https://github.com/duntrain/topo.

Computational notebooks such as Jupyter Notebook have become data scientists' de facto programming environments. Many visualization researchers and practitioners have developed interactive visualization tools that support notebooks. However, little is known about the appropriate design of visual analytics (VA) tools in notebooks. To bridge this critical research gap, we investigate the design strategies in this space by analyzing 159 notebook VA tools and their users' feedback. Our analysis encompasses 62 systems from academic papers and 103 systems sourced from a pool of 55k notebooks containing interactive visualizations that we obtain via scraping 8.6 million notebooks on GitHub. We also examine findings from 15 user studies and user feedback in 379 GitHub issues. Through this work, we identify unique design opportunities and considerations for future notebook VA tools, such as using and manipulating multimodal data in notebooks as well as balancing the degree of visualization-notebook integration. Finally, we develop SuperNOVA, an open-source interactive tool to help researchers explore existing notebook VA tools and search for related work.

Daily progress notes are common types in the electronic health record (EHR) where healthcare providers document the patient's daily progress and treatment plans. The EHR is designed to document all the care provided to patients, but it also enables note bloat with extraneous information that distracts from the diagnoses and treatment plans. Applications of natural language processing (NLP) in the EHR is a growing field with the majority of methods in information extraction. Few tasks use NLP methods for downstream diagnostic decision support. We introduced the 2022 National NLP Clinical Challenge (N2C2) Track 3: Progress Note Understanding - Assessment and Plan Reasoning as one step towards a new suite of tasks. The Assessment and Plan Reasoning task focuses on the most critical components of progress notes, Assessment and Plan subsections where health problems and diagnoses are contained. The goal of the task was to develop and evaluate NLP systems that automatically predict causal relations between the overall status of the patient contained in the Assessment section and its relation to each component of the Plan section which contains the diagnoses and treatment plans. The goal of the task was to identify and prioritize diagnoses as the first steps in diagnostic decision support to find the most relevant information in long documents like daily progress notes. We present the results of 2022 n2c2 Track 3 and provide a description of the data, evaluation, participation and system performance.

Jupyter notebook allows data scientists to write machine learning code together with its documentation in cells. In this paper, we propose a new task of code documentation generation (CDG) for computational notebooks. In contrast to the previous CDG tasks which focus on generating documentation for single code snippets, in a computational notebook, one documentation in a markdown cell often corresponds to multiple code cells, and these code cells have an inherent structure. We proposed a new model (HAConvGNN) that uses a hierarchical attention mechanism to consider the relevant code cells and the relevant code tokens information when generating the documentation. Tested on a new corpus constructed from well-documented Kaggle notebooks, we show that our model outperforms other baseline models.

Deep generative models are powerful tools that have produced impressive results in recent years. These advances have been for the most part empirically driven, making it essential that we use high quality evaluation metrics. In this paper, we provide new insights into the Inception Score, a recently proposed and widely used evaluation metric for generative models, and demonstrate that it fails to provide useful guidance when comparing models. We discuss both suboptimalities of the metric itself and issues with its application. Finally, we call for researchers to be more systematic and careful when evaluating and comparing generative models, as the advancement of the field depends upon it.

Data sharding, a technique for partitioning and distributing data among multiple servers or nodes, offers enhancements in the scalability, performance, and fault tolerance of extensive distributed systems. Nonetheless, this strategy introduces novel challenges, including load balancing among shards, management of node failures and data loss, and adaptation to evolving data and workload patterns. This paper proposes an innovative approach to tackle these challenges by empowering self-healing nodes with adaptive data sharding. Leveraging concepts such as self-replication, fractal regeneration, sentient data sharding, and symbiotic node clusters, our approach establishes a dynamic and resilient data sharding scheme capable of addressing diverse scenarios and meeting varied requirements. Implementation and evaluation of our approach involve a prototype system simulating a large-scale distributed database across various data sharding scenarios. Comparative analyses against existing data sharding techniques highlight the superior scalability, performance, fault tolerance, and adaptability of our approach. Additionally, the paper delves into potential applications and limitations, providing insights into the future research directions that can further advance this innovative approach.

Retrieval-augmented language models (RALMs) represent a substantial advancement in the capabilities of large language models, notably in reducing factual hallucination by leveraging external knowledge sources. However, the reliability of the retrieved information is not always guaranteed. The retrieval of irrelevant data can lead to misguided responses, and potentially causing the model to overlook its inherent knowledge, even when it possesses adequate information to address the query. Moreover, standard RALMs often struggle to assess whether they possess adequate knowledge, both intrinsic and retrieved, to provide an accurate answer. In situations where knowledge is lacking, these systems should ideally respond with "unknown" when the answer is unattainable. In response to these challenges, we introduces Chain-of-Noting (CoN), a novel approach aimed at improving the robustness of RALMs in facing noisy, irrelevant documents and in handling unknown scenarios. The core idea of CoN is to generate sequential reading notes for retrieved documents, enabling a thorough evaluation of their relevance to the given question and integrating this information to formulate the final answer. We employed ChatGPT to create training data for CoN, which was subsequently trained on an LLaMa-2 7B model. Our experiments across four open-domain QA benchmarks show that RALMs equipped with CoN significantly outperform standard RALMs. Notably, CoN achieves an average improvement of +7.9 in EM score given entirely noisy retrieved documents and +10.5 in rejection rates for real-time questions that fall outside the pre-training knowledge scope.

The ability of neural networks to represent more features than neurons makes interpreting them challenging. This phenomenon, known as superposition, has spurred efforts to find architectures that are more interpretable than standard multilayer perceptrons (MLPs) with elementwise activation functions. In this note, I examine bilinear layers, which are a type of MLP layer that are mathematically much easier to analyze while simultaneously performing better than standard MLPs. Although they are nonlinear functions of their input, I demonstrate that bilinear layers can be expressed using only linear operations and third order tensors. We can integrate this expression for bilinear layers into a mathematical framework for transformer circuits, which was previously limited to attention-only transformers. These results suggest that bilinear layers are easier to analyze mathematically than current architectures and thus may lend themselves to deeper safety insights by allowing us to talk more formally about circuits in neural networks. Additionally, bilinear layers may offer an alternative path for mechanistic interpretability through understanding the mechanisms of feature construction instead of enumerating a (potentially exponentially) large number of features in large models.

Electronic Health Records (EHRs) hold immense potential for advancing healthcare, offering rich, longitudinal data that combines structured information with valuable insights from unstructured clinical notes. However, the unstructured nature of clinical text poses significant challenges for secondary applications. Traditional methods for structuring EHR free-text data, such as rule-based systems and multi-stage pipelines, are often limited by their time-consuming configurations and inability to adapt across clinical notes from diverse healthcare settings. Few systems provide a comprehensive attribute extraction for terminologies. While giant large language models (LLMs) like GPT-4 and LLaMA 405B excel at structuring tasks, they are slow, costly, and impractical for large-scale use. To overcome these limitations, we introduce GENIE, a Generative Note Information Extraction system that leverages LLMs to streamline the structuring of unstructured clinical text into usable data with standardized format. GENIE processes entire paragraphs in a single pass, extracting entities, assertion statuses, locations, modifiers, values, and purposes with high accuracy. Its unified, end-to-end approach simplifies workflows, reduces errors, and eliminates the need for extensive manual intervention. Using a robust data preparation pipeline and fine-tuned small scale LLMs, GENIE achieves competitive performance across multiple information extraction tasks, outperforming traditional tools like cTAKES and MetaMap and can handle extra attributes to be extracted. GENIE strongly enhances real-world applicability and scalability in healthcare systems. By open-sourcing the model and test data, we aim to encourage collaboration and drive further advancements in EHR structurization.

Language model training in distributed settings is limited by the communication cost of gradient exchanges. In this short note, we extend recent work from Malladi et al. (2023), using shared randomness to perform distributed fine-tuning with low bandwidth. The method is a natural decentralized extension of memory-efficient Simultaneous Perturbation Stochastic Approximation (SPSA). Each iteration, each machine seeds a Random Number Generator (RNG) to perform local reproducible perturbations on model weights and calculate and exchange scalar projected gradients, which are then used to update each model. By using a (machine, sample) identifier as the random seed, each model can regenerate one another's perturbations. As machines only exchange single-byte projected gradients, this is highly communication efficient. There are also potential privacy benefits, as projected gradients may be calculated on different training data, and models never access the other's data. Our approach not only drastically reduces communication bandwidth requirements but also accommodates dynamic addition or removal of machines during the training process and retains the memory-efficient and inference-only advantages of recent work. We perform proof-of-concept experiments to demonstrate the potential usefulness of this method, building off of rich literature on distributed optimization and memory-efficient training.

How can we develop visual analytics (VA) tools that can be easily adopted? Visualization researchers have developed a large number of web-based VA tools to help data scientists in a wide range of tasks. However, adopting these standalone systems can be challenging, as they require data scientists to create new workflows to streamline the VA processes. Recent surveys suggest computational notebooks have been dominating data scientists' analytical workflows, as these notebooks seamlessly combine text, code, and visualization, allowing users to rapidly iterate code experiments. To help visualization researchers develop VA tools that can be easily integrated into existing data science workflows, we present NOVA, a simple and flexible method to adapt web-based VA systems for notebooks. We provide detailed examples of using this method with diverse web development technologies and different types of computational notebooks. Deployed application examples highlight that NOVA is easy to adopt, and data scientists appreciate in-notebook VA. NOVA is available at https://github.com/poloclub/nova.

As lung cancer evolves, the presence of enlarged and potentially malignant lymph nodes must be assessed to properly estimate disease progression and select the best treatment strategy. Following the clinical guidelines, estimation of short-axis diameter and mediastinum station are paramount for correct diagnosis. A method for accurate and automatic segmentation is hence decisive for quantitatively describing lymph nodes. In this study, the use of 3D convolutional neural networks, either through slab-wise schemes or the leveraging of downsampled entire volumes, is investigated. Furthermore, the potential impact from simple ensemble strategies is considered. As lymph nodes have similar attenuation values to nearby anatomical structures, we suggest using the knowledge of other organs as prior information to guide the segmentation task. To assess the segmentation and instance detection performances, a 5-fold cross-validation strategy was followed over a dataset of 120 contrast-enhanced CT volumes. For the 1178 lymph nodes with a short-axis diameter geq10 mm, our best performing approach reached a patient-wise recall of 92%, a false positive per patient ratio of 5, and a segmentation overlap of 80.5%. The method performs similarly well across all stations. Fusing a slab-wise and a full volume approach within an ensemble scheme generated the best performances. The anatomical priors guiding strategy is promising, yet a larger set than four organs appears needed to generate an optimal benefit. A larger dataset is also mandatory, given the wide range of expressions a lymph node can exhibit (i.e., shape, location, and attenuation), and contrast uptake variations.

Turing machine and decision tree have developed independently for a long time. With the recent development of differentiable models, there is an intersection between them. Neural turing machine(NTM) opens door for the memory network. It use differentiable attention mechanism to read/write external memory bank. Differentiable forest brings differentiable properties to classical decision tree. In this short note, we show the deep connection between these two models. That is: differentiable forest is a special case of NTM. Differentiable forest is actually decision tree based neural turing machine. Based on this deep connection, we propose a response augmented differential forest (RaDF). The controller of RaDF is differentiable forest, the external memory of RaDF are response vectors which would be read/write by leaf nodes.

We describe the 2020 edition of the DeepMind Kinetics human action dataset, which replenishes and extends the Kinetics-700 dataset. In this new version, there are at least 700 video clips from different YouTube videos for each of the 700 classes. This paper details the changes introduced for this new release of the dataset and includes a comprehensive set of statistics as well as baseline results using the I3D network.

Summaries generated from medical conversations can improve recall and understanding of care plans for patients and reduce documentation burden for doctors. Recent advancements in automatic speech recognition (ASR) and natural language understanding (NLU) offer potential solutions to generate these summaries automatically, but rigorous quantitative baselines for benchmarking research in this domain are lacking. In this paper, we bridge this gap for two tasks: classifying utterances from medical conversations according to (i) the SOAP section and (ii) the speaker role. Both are fundamental building blocks along the path towards an end-to-end, automated SOAP note for medical conversations. We provide details on a dataset that contains human and ASR transcriptions of medical conversations and corresponding machine learning optimized SOAP notes. We then present a systematic analysis in which we adapt an existing deep learning architecture to the two aforementioned tasks. The results suggest that modelling context in a hierarchical manner, which captures both word and utterance level context, yields substantial improvements on both classification tasks. Additionally, we develop and analyze a modular method for adapting our model to ASR output.

Retrieval-Augmented Generation (RAG) mitigates issues of the factual errors and hallucinated outputs generated by Large Language Models (LLMs) in open-domain question-answering tasks (OpenQA) via introducing external knowledge. For complex QA, however, existing RAG methods use LLMs to actively predict retrieval timing and directly use the retrieved information for generation, regardless of whether the retrieval timing accurately reflects the actual information needs, or sufficiently considers prior retrieved knowledge, which may result in insufficient information gathering and interaction, yielding low-quality answers. To address these, we propose a generic RAG approach called Adaptive Note-Enhanced RAG (Adaptive-Note) for complex QA tasks, which includes the iterative information collector, adaptive memory reviewer, and task-oriented generator, while following a new Retriever-and-Memory paradigm. Specifically, Adaptive-Note introduces an overarching view of knowledge growth, iteratively gathering new information in the form of notes and updating them into the existing optimal knowledge structure, enhancing high-quality knowledge interactions. In addition, we employ an adaptive, note-based stop-exploration strategy to decide "what to retrieve and when to stop" to encourage sufficient knowledge exploration. We conduct extensive experiments on five complex QA datasets, and the results demonstrate the superiority and effectiveness of our method and its components. The code and data are at https://github.com/thunlp/Adaptive-Note.

In this paper, we propose a novel centralized Asynchronous Federated Learning (FL) framework, FAVANO, for training Deep Neural Networks (DNNs) in resource-constrained environments. Despite its popularity, ``classical'' federated learning faces the increasingly difficult task of scaling synchronous communication over large wireless networks. Moreover, clients typically have different computing resources and therefore computing speed, which can lead to a significant bias (in favor of ``fast'' clients) when the updates are asynchronous. Therefore, practical deployment of FL requires to handle users with strongly varying computing speed in communication/resource constrained setting. We provide convergence guarantees for FAVANO in a smooth, non-convex environment and carefully compare the obtained convergence guarantees with existing bounds, when they are available. Experimental results show that the FAVANO algorithm outperforms current methods on standard benchmarks.

Current graph neural networks (GNNs) that tackle node classification on graphs tend to only focus on nodewise scores and are solely evaluated by nodewise metrics. This limits uncertainty estimation on graphs since nodewise marginals do not fully characterize the joint distribution given the graph structure. In this work, we propose novel edgewise metrics, namely the edgewise expected calibration error (ECE) and the agree/disagree ECEs, which provide criteria for uncertainty estimation on graphs beyond the nodewise setting. Our experiments demonstrate that the proposed edgewise metrics can complement the nodewise results and yield additional insights. Moreover, we show that GNN models which consider the structured prediction problem on graphs tend to have better uncertainty estimations, which illustrates the benefit of going beyond the nodewise setting.

The Guzheng is a kind of traditional Chinese instruments with diverse playing techniques. Instrument playing techniques (IPT) play an important role in musical performance. However, most of the existing works for IPT detection show low efficiency for variable-length audio and provide no assurance in the generalization as they rely on a single sound bank for training and testing. In this study, we propose an end-to-end Guzheng playing technique detection system using Fully Convolutional Networks that can be applied to variable-length audio. Because each Guzheng playing technique is applied to a note, a dedicated onset detector is trained to divide an audio into several notes and its predictions are fused with frame-wise IPT predictions. During fusion, we add the IPT predictions frame by frame inside each note and get the IPT with the highest probability within each note as the final output of that note. We create a new dataset named GZ_IsoTech from multiple sound banks and real-world recordings for Guzheng performance analysis. Our approach achieves 87.97% in frame-level accuracy and 80.76% in note-level F1-score, outperforming existing works by a large margin, which indicates the effectiveness of our proposed method in IPT detection.

Automatic Music Transcription (AMT) has been recognized as a key enabling technology with a wide range of applications. Given the task's complexity, best results have typically been reported for systems focusing on specific settings, e.g. instrument-specific systems tend to yield improved results over instrument-agnostic methods. Similarly, higher accuracy can be obtained when only estimating frame-wise f_0 values and neglecting the harder note event detection. Despite their high accuracy, such specialized systems often cannot be deployed in the real-world. Storage and network constraints prohibit the use of multiple specialized models, while memory and run-time constraints limit their complexity. In this paper, we propose a lightweight neural network for musical instrument transcription, which supports polyphonic outputs and generalizes to a wide variety of instruments (including vocals). Our model is trained to jointly predict frame-wise onsets, multipitch and note activations, and we experimentally show that this multi-output structure improves the resulting frame-level note accuracy. Despite its simplicity, benchmark results show our system's note estimation to be substantially better than a comparable baseline, and its frame-level accuracy to be only marginally below those of specialized state-of-the-art AMT systems. With this work we hope to encourage the community to further investigate low-resource, instrument-agnostic AMT systems.

Recent advances in large language models have led to renewed interest in natural language processing in healthcare using the free text of clinical notes. One distinguishing characteristic of clinical notes is their long time span over multiple long documents. The unique structure of clinical notes creates a new design choice: when the context length for a language model predictor is limited, which part of clinical notes should we choose as the input? Existing studies either choose the inputs with domain knowledge or simply truncate them. We propose a framework to analyze the sections with high predictive power. Using MIMIC-III, we show that: 1) predictive power distribution is different between nursing notes and discharge notes and 2) combining different types of notes could improve performance when the context length is large. Our findings suggest that a carefully selected sampling function could enable more efficient information extraction from clinical notes.

The way in which data are shared can affect their utility and reusability. Here, we demonstrate how data that we had previously shared in bulk can be mobilized further through a knowledge graph that allows for much more granular exploration and interrogation. The original dataset is about the computational reproducibility of GitHub-hosted Jupyter notebooks associated with biomedical publications. It contains rich metadata about the publications, associated GitHub repositories and Jupyter notebooks, and the notebooks' reproducibility. We took this dataset, converted it into semantic triples and loaded these into a triple store to create a knowledge graph, FAIR Jupyter, that we made accessible via a web service. This enables granular data exploration and analysis through queries that can be tailored to specific use cases. Such queries may provide details about any of the variables from the original dataset, highlight relationships between them or combine some of the graph's content with materials from corresponding external resources. We provide a collection of example queries addressing a range of use cases in research and education. We also outline how sets of such queries can be used to profile specific content types, either individually or by class. We conclude by discussing how such a semantically enhanced sharing of complex datasets can both enhance their FAIRness, i.e., their findability, accessibility, interoperability, and reusability, and help identify and communicate best practices, particularly with regards to data quality, standardization, automation and reproducibility.

This paper presents UMASS_BioNLP team participation in the MEDIQA-Chat 2023 shared task for Task-A and Task-C. We focus especially on Task-C and propose a novel LLMs cooperation system named a doctor-patient loop to generate high-quality conversation data sets. The experiment results demonstrate that our approaches yield reasonable performance as evaluated by automatic metrics such as ROUGE, medical concept recall, BLEU, and Self-BLEU. Furthermore, we conducted a comparative analysis between our proposed method and ChatGPT and GPT-4. This analysis also investigates the potential of utilizing cooperation LLMs to generate high-quality datasets.

Existing synthetic datasets (FigureQA, DVQA) for reasoning over plots do not contain variability in data labels, real-valued data, or complex reasoning questions. Consequently, proposed models for these datasets do not fully address the challenge of reasoning over plots. In particular, they assume that the answer comes either from a small fixed size vocabulary or from a bounding box within the image. However, in practice, this is an unrealistic assumption because many questions require reasoning and thus have real-valued answers which appear neither in a small fixed size vocabulary nor in the image. In this work, we aim to bridge this gap between existing datasets and real-world plots. Specifically, we propose PlotQA with 28.9 million question-answer pairs over 224,377 plots on data from real-world sources and questions based on crowd-sourced question templates. Further, 80.76% of the out-of-vocabulary (OOV) questions in PlotQA have answers that are not in a fixed vocabulary. Analysis of existing models on PlotQA reveals that they cannot deal with OOV questions: their overall accuracy on our dataset is in single digits. This is not surprising given that these models were not designed for such questions. As a step towards a more holistic model which can address fixed vocabulary as well as OOV questions, we propose a hybrid approach: Specific questions are answered by choosing the answer from a fixed vocabulary or by extracting it from a predicted bounding box in the plot, while other questions are answered with a table question-answering engine which is fed with a structured table generated by detecting visual elements from the image. On the existing DVQA dataset, our model has an accuracy of 58%, significantly improving on the highest reported accuracy of 46%. On PlotQA, our model has an accuracy of 22.52%, which is significantly better than state of the art models.

Large language models have become one of the most commonly deployed NLP inventions. In the past half-decade, their integration into core natural language processing tools has dramatically increased the performance of such tools, and they have entered the public discourse surrounding artificial intelligence. Consequently, it is important for both developers and researchers alike to understand the mathematical foundations of large language models, as well as how to implement them. These notes are the accompaniment to the theoretical portion of the ETH Z\"urich course on large language models, covering what constitutes a language model from a formal, theoretical perspective.

Clinical notes in Electronic Health Records (EHR) present rich documented information of patients to inference phenotype for disease diagnosis and study patient characteristics for cohort selection. Unsupervised user embedding aims to encode patients into fixed-length vectors without human supervisions. Medical concepts extracted from the clinical notes contain rich connections between patients and their clinical categories. However, existing unsupervised approaches of user embeddings from clinical notes do not explicitly incorporate medical concepts. In this study, we propose a concept-aware unsupervised user embedding that jointly leverages text documents and medical concepts from two clinical corpora, MIMIC-III and Diabetes. We evaluate user embeddings on both extrinsic and intrinsic tasks, including phenotype classification, in-hospital mortality prediction, patient retrieval, and patient relatedness. Experiments on the two clinical corpora show our approach exceeds unsupervised baselines, and incorporating medical concepts can significantly improve the baseline performance.

Patient notes contain a wealth of information of potentially great interest to medical investigators. However, to protect patients' privacy, Protected Health Information (PHI) must be removed from the patient notes before they can be legally released, a process known as patient note de-identification. The main objective for a de-identification system is to have the highest possible recall. Recently, the first neural-network-based de-identification system has been proposed, yielding state-of-the-art results. Unlike other systems, it does not rely on human-engineered features, which allows it to be quickly deployed, but does not leverage knowledge from human experts or from electronic health records (EHRs). In this work, we explore a method to incorporate human-engineered features as well as features derived from EHRs to a neural-network-based de-identification system. Our results show that the addition of features, especially the EHR-derived features, further improves the state-of-the-art in patient note de-identification, including for some of the most sensitive PHI types such as patient names. Since in a real-life setting patient notes typically come with EHRs, we recommend developers of de-identification systems to leverage the information EHRs contain.

Specialised pre-trained language models are becoming more frequent in NLP since they can potentially outperform models trained on generic texts. BioBERT and BioClinicalBERT are two examples of such models that have shown promise in medical NLP tasks. Many of these models are overparametrised and resource-intensive, but thanks to techniques like Knowledge Distillation (KD), it is possible to create smaller versions that perform almost as well as their larger counterparts. In this work, we specifically focus on development of compact language models for processing clinical texts (i.e. progress notes, discharge summaries etc). We developed a number of efficient lightweight clinical transformers using knowledge distillation and continual learning, with the number of parameters ranging from 15 million to 65 million. These models performed comparably to larger models such as BioBERT and ClinicalBioBERT and significantly outperformed other compact models trained on general or biomedical data. Our extensive evaluation was done across several standard datasets and covered a wide range of clinical text-mining tasks, including Natural Language Inference, Relation Extraction, Named Entity Recognition, and Sequence Classification. To our knowledge, this is the first comprehensive study specifically focused on creating efficient and compact transformers for clinical NLP tasks. The models and code used in this study can be found on our Huggingface profile at https://huggingface.co/nlpie and Github page at https://github.com/nlpie-research/Lightweight-Clinical-Transformers, respectively, promoting reproducibility of our results.

We here summarize our experience running a challenge with open data for musical genre recognition. Those notes motivate the task and the challenge design, show some statistics about the submissions, and present the results.