Daily Papers

The rise of Software Engineering (SE) agents, i.e., LLM-based agents that can understand large codebases and carry out engineering tasks with limited human intervention, has been marked by rapid advances and adoption, but little is known about how developers build these systems in practice: existing studies mine repositories or examine deployment, but few investigate how SE agents are constructed. Through semi-structured interviews with 20 practitioners from 12 organizations and an online survey of 80 practitioners, this paper is the first to study how SE processes are changing in the development of SE agents and what challenges developers face. We find that as implementation becomes cheaper, bottlenecks shift rather than disappear: long-standing non-coding work such as requirements, coordination, review, and deployment becomes more visible, while reviewing and evaluating agent output becomes new and central. We characterize a seven-stage workflow and a shift toward evaluation-driven development, in which evaluation steers iteration and specifications become versioned artifacts read by both humans and agents. We further identify six challenges that teams face, together with the practices they adopt to address them, including unreliable evaluation signals, comprehension debt as code outpaces understanding, and behavioral changes introduced by provider-side model updates.

Backward compatibility of model predictions is a desired property when updating a machine learning driven application. It allows to seamlessly improve the underlying model without introducing regression bugs. In classification tasks these bugs occur in the form of negative flips. This means an instance that was correctly classified by the old model is now classified incorrectly by the updated model. This has direct negative impact on the user experience of such systems e.g. a frequently used voice assistant query is suddenly misclassified. A common reason to update the model is when new training data becomes available and needs to be incorporated. Simply retraining the model with the updated data introduces the unwanted negative flips. We study the problem of regression during data updates and propose Backward Compatible Weight Interpolation (BCWI). This method interpolates between the weights of the old and new model and we show in extensive experiments that it reduces negative flips without sacrificing the improved accuracy of the new model. BCWI is straight forward to implement and does not increase inference cost. We also explore the use of importance weighting during interpolation and averaging the weights of multiple new models in order to further reduce negative flips.

We propose patching for large language models (LLMs) like software versions, a lightweight and modular approach for addressing safety vulnerabilities. While vendors release improved LLM versions, major releases are costly, infrequent, and difficult to tailor to customer needs, leaving released models with known safety gaps. Unlike full-model fine-tuning or major version updates, our method enables rapid remediation by prepending a compact, learnable prefix to an existing model. This "patch" introduces only 0.003% additional parameters, yet reliably steers model behavior toward that of a safer reference model. Across three critical domains (toxicity mitigation, bias reduction, and harmfulness refusal) policy patches achieve safety improvements comparable to next-generation safety-aligned models while preserving fluency. Our results demonstrate that LLMs can be "patched" much like software, offering vendors and practitioners a practical mechanism for distributing scalable, efficient, and composable safety updates between major model releases.

Large Language Models (LLMs) are frequently updated due to data or architecture changes to improve their performance. When updating models, developers often focus on increasing overall performance metrics with less emphasis on being compatible with previous model versions. However, users often build a mental model of the functionality and capabilities of a particular machine learning model they are interacting with. They have to adapt their mental model with every update -- a draining task that can lead to user dissatisfaction. In practice, fine-tuned downstream task adapters rely on pretrained LLM base models. When these base models are updated, these user-facing downstream task models experience instance regression or negative flips -- previously correct instances are now predicted incorrectly. This happens even when the downstream task training procedures remain identical. Our work aims to provide seamless model updates to a user in two ways. First, we provide evaluation metrics for a notion of compatibility to prior model versions, specifically for generative tasks but also applicable for discriminative tasks. We observe regression and inconsistencies between different model versions on a diverse set of tasks and model updates. Second, we propose a training strategy to minimize the number of inconsistencies in model updates, involving training of a compatibility model that can enhance task fine-tuned language models. We reduce negative flips -- instances where a prior model version was correct, but a new model incorrect -- by up to 40% from Llama 1 to Llama 2.

The proliferation of Machine Learning (ML) models and their open-source implementations has transformed Artificial Intelligence research and applications. Platforms like Hugging Face (HF) enable the development, sharing, and deployment of these models, fostering an evolving ecosystem. While previous studies have examined aspects of models hosted on platforms like HF, a comprehensive longitudinal study of how these models change remains underexplored. This study addresses this gap by utilizing both repository mining and longitudinal analysis methods to examine over 200,000 commits and 1,200 releases from over 50,000 models on HF. We replicate and extend an ML change taxonomy for classifying commits and utilize Bayesian networks to uncover patterns in commit and release activities over time. Our findings indicate that commit activities align with established data science methodologies, such as CRISP-DM, emphasizing iterative refinement and continuous improvement. Additionally, release patterns tend to consolidate significant updates, particularly in documentation, distinguishing between granular changes and milestone-based releases. Furthermore, projects with higher popularity prioritize infrastructure enhancements early in their lifecycle, and those with intensive collaboration practices exhibit improved documentation standards. These and other insights enhance the understanding of model changes on community platforms and provide valuable guidance for best practices in model maintenance.

The ubiquity of large-scale Pre-Trained Models (PTMs) is on the rise, sparking interest in model hubs, and dedicated platforms for hosting PTMs. Despite this trend, a comprehensive exploration of the challenges that users encounter and how the community leverages PTMs remains lacking. To address this gap, we conducted an extensive mixed-methods empirical study by focusing on discussion forums and the model hub of HuggingFace, the largest public model hub. Based on our qualitative analysis, we present a taxonomy of the challenges and benefits associated with PTM reuse within this community. We then conduct a quantitative study to track model-type trends and model documentation evolution over time. Our findings highlight prevalent challenges such as limited guidance for beginner users, struggles with model output comprehensibility in training or inference, and a lack of model understanding. We also identified interesting trends among models where some models maintain high upload rates despite a decline in topics related to them. Additionally, we found that despite the introduction of model documentation tools, its quantity has not increased over time, leading to difficulties in model comprehension and selection among users. Our study sheds light on new challenges in reusing PTMs that were not reported before and we provide recommendations for various stakeholders involved in PTM reuse.

Large Language Models (LLMs) have become central in academia and industry, raising concerns about privacy, transparency, and misuse. A key issue is the trustworthiness of proprietary models, with open-sourcing often proposed as a solution. However, open-sourcing presents challenges, including potential misuse, financial disincentives, and intellectual property concerns. Proprietary models, backed by private sector resources, are better positioned for return on investment. There are also other approaches that lie somewhere on the spectrum between completely open-source and proprietary. These can largely be categorised into open-source usage limitations protected by licensing, partially open-source (open weights) models, hybrid approaches where obsolete model versions are open-sourced, while competitive versions with market value remain proprietary. Currently, discussions on where on the spectrum future models should fall on remains unbacked and mostly opinionated where industry leaders are weighing in on the discussion. In this paper, we present a data-driven approach by compiling data on open-source development of LLMs, and their contributions in terms of improvements, modifications, and methods. Our goal is to avoid supporting either extreme but rather present data that will support future discussions both by industry experts as well as policy makers. Our findings indicate that open-source contributions can enhance model performance, with trends such as reduced model size and manageable accuracy loss. We also identify positive community engagement patterns and architectures that benefit most from open contributions.

The proliferation of open Pre-trained Language Models (PTLMs) on model registry platforms like Hugging Face (HF) presents both opportunities and challenges for companies building products around them. Similar to traditional software dependencies, PTLMs continue to evolve after a release. However, the current state of release practices of PTLMs on model registry platforms are plagued by a variety of inconsistencies, such as ambiguous naming conventions and inaccessible model training documentation. Given the knowledge gap on current PTLM release practices, our empirical study uses a mixed-methods approach to analyze the releases of 52,227 PTLMs on the most well-known model registry, HF. Our results reveal 148 different naming practices for PTLM releases, with 40.87% of changes to model weight files not represented in the adopted name-based versioning practice or their documentation. In addition, we identified that the 52,227 PTLMs are derived from only 299 different base models (the modified original models used to create 52,227 PTLMs), with Fine-tuning and Quantization being the most prevalent modification methods applied to these base models. Significant gaps in release transparency, in terms of training dataset specifications and model card availability, still exist, highlighting the need for standardized documentation. While we identified a model naming practice explicitly differentiating between major and minor PTLM releases, we did not find any significant difference in the types of changes that went into either type of releases, suggesting that major/minor version numbers for PTLMs often are chosen arbitrarily. Our findings provide valuable insights to improve PTLM release practices, nudging the field towards more formal semantic versioning practices.

Application Programming Interfaces (APIs) facilitate the integration of third-party dependencies within the code of client applications. However, changes to an API, such as deprecation, modification of parameter names or types, or complete replacement with a new API, can break existing client code. These changes are called breaking dependency updates; It is often tedious for API users to identify the cause of these breaks and update their code accordingly. In this paper, we explore the use of Large Language Models (LLMs) to automate client code updates in response to breaking dependency updates. We evaluate our approach on the BUMP dataset, a benchmark for breaking dependency updates in Java projects. Our approach leverages LLMs with advanced prompts, including information from the build process and from the breaking dependency analysis. We assess effectiveness at three granularity levels: at the build level, the file level, and the individual compilation error level. We experiment with five LLMs: Google Gemini-2.0 Flash, OpenAI GPT4o-mini, OpenAI o3-mini, Alibaba Qwen2.5-32b-instruct, and DeepSeek V3. Our results show that LLMs can automatically repair breaking updates. Among the considered models, OpenAI's o3-mini is the best, able to completely fix 27% of the builds when using prompts that include contextual information such as the buggy line, API differences, error messages, and step-by-step reasoning instructions. Also, it fixes 78% of the individual compilation errors. Overall, our findings demonstrate the potential for LLMs to fix compilation errors due to breaking dependency updates, supporting developers in their efforts to stay up-to-date with changes in their dependencies.

Large pre-trained models decay over long-term deployment as input distributions shift, user requirements change, or crucial knowledge gaps are discovered. Recently, model editors have been proposed to modify a model's behavior by adjusting its weights during deployment. However, when editing the same model multiple times, these approaches quickly decay a model's performance on upstream data and forget how to fix previous errors. We propose and study a novel Lifelong Model Editing setting, where streaming errors are identified for a deployed model and we update the model to correct its predictions without influencing unrelated inputs without access to training edits, exogenous datasets, or any upstream data for the edited model. To approach this problem, we introduce General Retrieval Adaptors for Continual Editing, or GRACE, which learns to cache a chosen layer's activations in an adaptive codebook as edits stream in, leaving original model weights frozen. GRACE can thus edit models thousands of times in a row using only streaming errors, without influencing unrelated inputs. Experimentally, we show that GRACE improves over recent alternatives and generalizes to unseen inputs. Our code is available at https://www.github.com/thartvigsen/grace.

Federated learning algorithms, such as FedAvg, are negatively affected by data heterogeneity and partial client participation. To mitigate the latter problem, global variance reduction methods, like FedVARP, leverage stale model updates for non-participating clients. These methods are effective under homogeneous client participation. Yet, this paper shows that, when some clients participate much less than others, aggregating updates with different levels of staleness can detrimentally affect the training process. Motivated by this observation, we introduce FedStale, a novel algorithm that updates the global model in each round through a convex combination of "fresh" updates from participating clients and "stale" updates from non-participating ones. By adjusting the weight in the convex combination, FedStale interpolates between FedAvg, which only uses fresh updates, and FedVARP, which treats fresh and stale updates equally. Our analysis of FedStale convergence yields the following novel findings: i) it integrates and extends previous FedAvg and FedVARP analyses to heterogeneous client participation; ii) it underscores how the least participating client influences convergence error; iii) it provides practical guidelines to best exploit stale updates, showing that their usefulness diminishes as data heterogeneity decreases and participation heterogeneity increases. Extensive experiments featuring diverse levels of client data and participation heterogeneity not only confirm these findings but also show that FedStale outperforms both FedAvg and FedVARP in many settings.

As large language models (LLMs) increasingly shape the AI landscape, fine-tuning pretrained models has become more popular than in the pre-LLM era for achieving optimal performance in domain-specific tasks. However, pretrained LLMs such as ChatGPT are periodically evolved, i.e., model parameters are frequently updated), making it challenging for downstream users with limited resources to keep up with fine-tuning the newest LLMs for their domain application. Even though fine-tuning costs have nowadays been reduced thanks to the innovations of parameter-efficient fine-tuning such as LoRA, not all downstream users have adequate computing for frequent personalization. Moreover, access to fine-tuning datasets, particularly in sensitive domains such as healthcare, could be time-restrictive, making it crucial to retain the knowledge encoded in earlier fine-tuned rounds for future adaptation. In this paper, we present PortLLM, a training-free framework that (i) creates an initial lightweight model update patch to capture domain-specific knowledge, and (ii) allows a subsequent seamless plugging for the continual personalization of evolved LLM at minimal cost. Our extensive experiments cover seven representative datasets, from easier question-answering tasks {BoolQ, SST2} to harder reasoning tasks {WinoGrande, GSM8K}, and models including {Mistral-7B, Llama2, Llama3.1, and Gemma2}, validating the portability of our designed model patches and showcasing the effectiveness of our proposed framework. For instance, PortLLM achieves comparable performance to LoRA fine-tuning with reductions of up to 12.2x in GPU memory usage. Finally, we provide theoretical justifications to understand the portability of our model update patches, which offers new insights into the theoretical dimension of LLMs' personalization.

As the capabilities of Large Language Models (LLMs) in healthcare and medicine continue to advance, there is a growing need for competitive open-source models that can safeguard public interest. With the increasing availability of highly competitive open base models, the impact of continued pre-training is increasingly uncertain. In this work, we explore the role of instruct tuning, model merging, alignment, red teaming and advanced inference schemes, as means to improve current open models. To that end, we introduce the Aloe family, a set of open medical LLMs highly competitive within its scale range. Aloe models are trained on the current best base models (Mistral, LLaMA 3), using a new custom dataset which combines public data sources improved with synthetic Chain of Thought (CoT). Aloe models undergo an alignment phase, becoming one of the first few policy-aligned open healthcare LLM using Direct Preference Optimization, setting a new standard for ethical performance in healthcare LLMs. Model evaluation expands to include various bias and toxicity datasets, a dedicated red teaming effort, and a much-needed risk assessment for healthcare LLMs. Finally, to explore the limits of current LLMs in inference, we study several advanced prompt engineering strategies to boost performance across benchmarks, yielding state-of-the-art results for open healthcare 7B LLMs, unprecedented at this scale.

The factuality of large language model (LLMs) tends to decay over time since events posterior to their training are "unknown" to them. One way to keep models up-to-date could be factual update: the task of inserting, replacing, or removing certain simple (atomic) facts within the model. To study this task, we present WikiFactDiff, a dataset that describes the evolution of factual knowledge between two dates as a collection of simple facts divided into three categories: new, obsolete, and static. We describe several update scenarios arising from various combinations of these three types of basic update. The facts are represented by subject-relation-object triples; indeed, WikiFactDiff was constructed by comparing the state of the Wikidata knowledge base at 4 January 2021 and 27 February 2023. Those fact are accompanied by verbalization templates and cloze tests that enable running update algorithms and their evaluation metrics. Contrary to other datasets, such as zsRE and CounterFact, WikiFactDiff constitutes a realistic update setting that involves various update scenarios, including replacements, archival, and new entity insertions. We also present an evaluation of existing update algorithms on WikiFactDiff.

Self-evolving LLM-based agents improve mainly by changing their agent harness: the structured execution layer around a base model, including prompts, memory, tools, middleware, runtime state, and the model-tool interaction loop. Existing evaluations often reduce this process to isolated task scores or a single sequential curve, obscuring whether an update produces reusable improvement, overfits recent tasks, increases cost, or harms older behavior. We introduce SEAGym, an evaluation environment for measuring agent harness updates across training, validation, test, replay, and cost records. SEAGym turns Harbor-compatible benchmarks into dynamic self-evolution task sources with train batches, frozen update-validation, held-out ID and OOD transfer views, replay diagnostics, and saved snapshot and metric records. Instantiating SEAGym on Terminal-Bench 2.0 and HLE, we compare ACE, TF-GRPO, and AHE under a shared epoch/batch protocol. The results show that these evaluation views provide complementary signals about the evolution process: frequent updates may fail to improve held-out performance, useful intermediate snapshots may collapse later, and source diversity and model backend can affect harness reliability.

The successes of foundation models such as ChatGPT and AlphaFold have spurred significant interest in building similar models for electronic medical records (EMRs) to improve patient care and hospital operations. However, recent hype has obscured critical gaps in our understanding of these models' capabilities. We review over 80 foundation models trained on non-imaging EMR data (i.e. clinical text and/or structured data) and create a taxonomy delineating their architectures, training data, and potential use cases. We find that most models are trained on small, narrowly-scoped clinical datasets (e.g. MIMIC-III) or broad, public biomedical corpora (e.g. PubMed) and are evaluated on tasks that do not provide meaningful insights on their usefulness to health systems. In light of these findings, we propose an improved evaluation framework for measuring the benefits of clinical foundation models that is more closely grounded to metrics that matter in healthcare.

Asynchronous reinforcement learning improves rollout throughput for large language model agents by decoupling sample generation from policy optimization, but it also introduces a critical failure mode for PPO-style off-policy correction. In heterogeneous training systems, the total importance ratio should ideally be decomposed into two semantically distinct factors: a training--inference discrepancy term that aligns inference-side and training-side distributions at the same behavior-policy version, and a policy-staleness term that constrains the update from the historical policy to the current policy. We show that practical asynchronous pipelines with delayed updates and partial rollouts often lose the required historical training-side logits, or old logits. This missing-old-logit problem entangles discrepancy repair with staleness correction, breaks the intended semantics of decoupled correction, and makes clipping and masking thresholds interact undesirably. To address this issue, we study both exact and approximate correction routes. We propose three exact old-logit acquisition strategies: snapshot-based version tracking, a dedicated old-logit model, and synchronization via partial rollout interruption, and compare their system trade-offs. From the perspective of approximate correction, we focus on preserving the benefits of decoupled correction through a more appropriate approximate policy when exact old logits cannot be recovered at low cost, without incurring extra system overhead. Following this analysis, we adopt a revised PPO-EWMA method, which achieves significant gains in both training speed and optimization performance. Code at https://github.com/millioniron/ROLL.

Med42-v2 introduces a suite of clinical large language models (LLMs) designed to address the limitations of generic models in healthcare settings. These models are built on Llama3 architecture and fine-tuned using specialized clinical data. They underwent multi-stage preference alignment to effectively respond to natural prompts. While generic models are often preference-aligned to avoid answering clinical queries as a precaution, Med42-v2 is specifically trained to overcome this limitation, enabling its use in clinical settings. Med42-v2 models demonstrate superior performance compared to the original Llama3 models in both 8B and 70B parameter configurations and GPT-4 across various medical benchmarks. These LLMs are developed to understand clinical queries, perform reasoning tasks, and provide valuable assistance in clinical environments. The models are now publicly available at https://huggingface.co/m42-health{https://huggingface.co/m42-health}.

Purpose: With advancements in Large Language Models (LLMs) for healthcare, the need arises for competitive open-source models to protect the public interest. This work contributes to the field of open medical LLMs by optimizing key stages of data preprocessing and training, while showing how to improve model safety (through DPO) and efficacy (through RAG). The evaluation methodology used, which includes four different types of tests, defines a new standard for the field. The resultant models, shown to be competitive with the best private alternatives, are released with a permisive license. Methods: Building on top of strong base models like Llama 3.1 and Qwen 2.5, Aloe Beta uses a custom dataset to enhance public data with synthetic Chain of Thought examples. The models undergo alignment with Direct Preference Optimization, emphasizing ethical and policy-aligned performance in the presence of jailbreaking attacks. Evaluation includes close-ended, open-ended, safety and human assessments, to maximize the reliability of results. Results: Recommendations are made across the entire pipeline, backed by the solid performance of the Aloe Family. These models deliver competitive performance across healthcare benchmarks and medical fields, and are often preferred by healthcare professionals. On bias and toxicity, the Aloe Beta models significantly improve safety, showing resilience to unseen jailbreaking attacks. For a responsible release, a detailed risk assessment specific to healthcare is attached to the Aloe Family models. Conclusion: The Aloe Beta models, and the recipe that leads to them, are a significant contribution to the open-source medical LLM field, offering top-of-the-line performance while maintaining high ethical requirements. This work sets a new standard for developing and reporting aligned LLMs in healthcare.

The advent of foundation models (FMs) as an emerging suite of AI techniques has struck a wave of opportunities in computational healthcare. The interactive nature of these models, guided by pre-training data and human instructions, has ignited a data-centric AI paradigm that emphasizes better data characterization, quality, and scale. In healthcare AI, obtaining and processing high-quality clinical data records has been a longstanding challenge, ranging from data quantity, annotation, patient privacy, and ethics. In this survey, we investigate a wide range of data-centric approaches in the FM era (from model pre-training to inference) towards improving the healthcare workflow. We discuss key perspectives in AI security, assessment, and alignment with human values. Finally, we offer a promising outlook of FM-based analytics to enhance the performance of patient outcome and clinical workflow in the evolving landscape of healthcare and medicine. We provide an up-to-date list of healthcare-related foundation models and datasets at https://github.com/Yunkun-Zhang/Data-Centric-FM-Healthcare .

Clinical decision support systems (CDSS) require scrutable, auditable pipelines that enable rigorous, reproducible validation. Yet current LLM-based CDSS remain largely opaque. Most "open" models are open-weight only, releasing parameters while withholding the data provenance, curation procedures, and generation pipelines that determine model behavior. Fully Open (FO) models, which expose the complete training stack end-to-end, do not currently exist in medicine. We introduce Fully Open Meditron, the first fully open pipeline for building LLM-CDSS, comprising a clinician-audited training corpus, a reproducible data construction and training framework, and a use-aligned evaluation protocol. The corpus unifies eight public medical QA datasets into a normalized conversational format and expands coverage with three clinician-vetted synthetic extensions: exam-style QA, guideline-grounded QA derived from 46,469 clinical practice guidelines, and clinical vignettes. The pipeline enforces system-wide decontamination, gold-label resampling of teacher generations, and end-to-end validation by a four-physician panel. We evaluate using an LLM-as-a-judge protocol over expert-written clinical vignettes, calibrated against 204 human raters. We apply the recipe to five FO base models (Apertus-70B/8B-Instruct, OLMo-2-32B-SFT, EuroLLM-22B/9B-Instruct). All MeditronFO variants are preferred over their bases. Apertus-70B-MeditronFO improves +6.6 points over its base (47.2% to 53.8%) on aggregate medical benchmarks, establishing a new FO SoTA. Gemma-3-27B-MeditronFO is preferred over MedGemma in 58.6% of LLM-as-a-judge comparisons and outperforms it on HealthBench (58% vs 55.9%). These results show that fully open pipelines can achieve state-of-the-art domain-specific performance without sacrificing auditability or reproducibility.

The technical report introduces O1-CODER, an attempt to replicate OpenAI's o1 model with a focus on coding tasks. It integrates reinforcement learning (RL) and Monte Carlo Tree Search (MCTS) to enhance the model's System-2 thinking capabilities. The framework includes training a Test Case Generator (TCG) for standardized code testing, using MCTS to generate code data with reasoning processes, and iteratively fine-tuning the policy model to initially produce pseudocode, followed by the generation of the full code. The report also addresses the opportunities and challenges in deploying o1-like models in real-world applications, suggesting transitioning to the System-2 paradigm and highlighting the imperative for environment state updates. Updated model progress and experimental results will be reported in subsequent versions. All source code, curated datasets, as well as the derived models will be disclosed at https://github.com/ADaM-BJTU/O1-CODER .

Large language models (LLMs) are increasingly used in healthcare, but their reliability is heavily influenced by user-driven factors such as question phrasing and the completeness of clinical information. In this study, we examined how misinformation framing, source authority, model persona, and omission of key clinical details affect the diagnostic accuracy and reliability of LLM outputs. We conducted two experiments: one introducing misleading external opinions with varying assertiveness (perturbation test), and another removing specific categories of patient information (ablation test). Using public datasets (MedQA and Medbullets), we evaluated proprietary models (GPT-4o, Claude 3.5 Sonnet, Claude 3.5 Haiku, Gemini 1.5 Pro, Gemini 1.5 Flash) and open-source models (LLaMA 3 8B, LLaMA 3 Med42 8B, DeepSeek R1 8B). All models were vulnerable to user-driven misinformation, with proprietary models especially affected by definitive and authoritative language. Assertive tone had the greatest negative impact on accuracy. In the ablation test, omitting physical exam findings and lab results caused the most significant performance drop. Although proprietary models had higher baseline accuracy, their performance declined sharply under misinformation. These results highlight the need for well-structured prompts and complete clinical context. Users should avoid authoritative framing of misinformation and provide full clinical details, especially for complex cases.

The advancement in healthcare has shifted focus toward patient-centric approaches, particularly in self-care and patient education, facilitated by access to Electronic Health Records (EHR). However, medical jargon in EHRs poses significant challenges in patient comprehension. To address this, we introduce a new task of automatically generating lay definitions, aiming to simplify complex medical terms into patient-friendly lay language. We first created the README dataset, an extensive collection of over 50,000 unique (medical term, lay definition) pairs and 300,000 mentions, each offering context-aware lay definitions manually annotated by domain experts. We have also engineered a data-centric Human-AI pipeline that synergizes data filtering, augmentation, and selection to improve data quality. We then used README as the training data for models and leveraged a Retrieval-Augmented Generation method to reduce hallucinations and improve the quality of model outputs. Our extensive automatic and human evaluations demonstrate that open-source mobile-friendly models, when fine-tuned with high-quality data, are capable of matching or even surpassing the performance of state-of-the-art closed-source large language models like ChatGPT. This research represents a significant stride in closing the knowledge gap in patient education and advancing patient-centric healthcare solutions.

The integration of Large Language Models (LLMs) into healthcare promises to transform medical diagnostics, research, and patient care. Yet, the progression of medical LLMs faces obstacles such as complex training requirements, rigorous evaluation demands, and the dominance of proprietary models that restrict academic exploration. Transparent, comprehensive access to LLM resources is essential for advancing the field, fostering reproducibility, and encouraging innovation in healthcare AI. We present Hippocrates, an open-source LLM framework specifically developed for the medical domain. In stark contrast to previous efforts, it offers unrestricted access to its training datasets, codebase, checkpoints, and evaluation protocols. This open approach is designed to stimulate collaborative research, allowing the community to build upon, refine, and rigorously evaluate medical LLMs within a transparent ecosystem. Also, we introduce Hippo, a family of 7B models tailored for the medical domain, fine-tuned from Mistral and LLaMA2 through continual pre-training, instruction tuning, and reinforcement learning from human and AI feedback. Our models outperform existing open medical LLMs models by a large-margin, even surpassing models with 70B parameters. Through Hippocrates, we aspire to unlock the full potential of LLMs not just to advance medical knowledge and patient care but also to democratize the benefits of AI research in healthcare, making them available across the globe.

In many machine learning for healthcare tasks, standard datasets are constructed by amassing data across many, often fundamentally dissimilar, sources. But when does adding more data help, and when does it hinder progress on desired model outcomes in real-world settings? We identify this situation as the Data Addition Dilemma, demonstrating that adding training data in this multi-source scaling context can at times result in reduced overall accuracy, uncertain fairness outcomes, and reduced worst-subgroup performance. We find that this possibly arises from an empirically observed trade-off between model performance improvements due to data scaling and model deterioration from distribution shift. We thus establish baseline strategies for navigating this dilemma, introducing distribution shift heuristics to guide decision-making on which data sources to add in data scaling, in order to yield the expected model performance improvements. We conclude with a discussion of the required considerations for data collection and suggestions for studying data composition and scale in the age of increasingly larger models.

Online updating of time series forecasting models aims to address the concept drifting problem by efficiently updating forecasting models based on streaming data. Many algorithms are designed for online time series forecasting, with some exploiting cross-variable dependency while others assume independence among variables. Given every data assumption has its own pros and cons in online time series modeling, we propose Online ensembling Network (OneNet). It dynamically updates and combines two models, with one focusing on modeling the dependency across the time dimension and the other on cross-variate dependency. Our method incorporates a reinforcement learning-based approach into the traditional online convex programming framework, allowing for the linear combination of the two models with dynamically adjusted weights. OneNet addresses the main shortcoming of classical online learning methods that tend to be slow in adapting to the concept drift. Empirical results show that OneNet reduces online forecasting error by more than 50% compared to the State-Of-The-Art (SOTA) method. The code is available at https://github.com/yfzhang114/OneNet.

Hugging Face (HF) has established itself as a crucial platform for the development and sharing of machine learning (ML) models. This repository mining study, which delves into more than 380,000 models using data gathered via the HF Hub API, aims to explore the community engagement, evolution, and maintenance around models hosted on HF, aspects that have yet to be comprehensively explored in the literature. We first examine the overall growth and popularity of HF, uncovering trends in ML domains, framework usage, authors grouping and the evolution of tags and datasets used. Through text analysis of model card descriptions, we also seek to identify prevalent themes and insights within the developer community. Our investigation further extends to the maintenance aspects of models, where we evaluate the maintenance status of ML models, classify commit messages into various categories (corrective, perfective, and adaptive), analyze the evolution across development stages of commits metrics and introduce a new classification system that estimates the maintenance status of models based on multiple attributes. This study aims to provide valuable insights about ML model maintenance and evolution that could inform future model development strategies on platforms like HF.

Many LLM-based open-ended search systems freeze the foundation model that proposes improvements to existing solutions, which may bottleneck long-run progress. Recent work has explored updating the proposal model at test time [arXiv:2511.23473], but the update strategy is still typically hand-specified. Therefore, this study investigated whether an LLM can use task feedback to decide how it should update its weights. For tractability, we focused on the simpler case where there is only one round of self-improvement, and restricted the update operator to self-supervised next token prediction (NTP), leaving the model freedom in choosing its training data and key NTP hyperparameters. Using the Self-Adapting Language Models (SEAL) [arXiv:2506.10943] framework as a testbed, we relaxed its fixed human template constraint and allowed the model to generate its own self-edit templates, thereby giving it more control over its training data and hyperparameters. Two variants were studied, differing in whether template generation was conditioned on a lightweight archive of past templates. In SEAL's Single-Passage Knowledge Incorporation setting with Qwen3-8B on SQuAD [arXiv:1606.05250], the no-archive variant performed comparably to the weaker "Implications" baseline, while the archive variant outperformed "Implications" and approached the strongest human-designed "Rewrite" baseline without surpassing it. Further analysis of collapse in the model's exploration revealed that a naive archive can confer some short-term robustness but can also accelerate homogenization, suggesting that explicit novelty pressure may be required to consistently advance beyond carefully optimized human strategies. Our code is available at https://github.com/cheongalc/search-self-edit-strategies .

Transformers have significantly advanced the modeling of Electronic Health Records (EHR), yet their deployment in real-world healthcare is limited by several key challenges. Firstly, the quadratic computational cost and insufficient context length of these models pose significant obstacles for hospitals in processing the extensive medical histories typical in EHR data. Additionally, existing models employ separate finetuning for each clinical task, complicating maintenance in healthcare environments. Moreover, these models focus exclusively on either clinical prediction or EHR forecasting, lacking the flexibility to perform well across both. To overcome these limitations, we introduce EHRMamba, a robust foundation model built on the Mamba architecture. EHRMamba can process sequences up to four times longer than previous models due to its linear computational cost. We also introduce a novel approach to Multitask Prompted Finetuning (MTF) for EHR data, which enables EHRMamba to simultaneously learn multiple clinical tasks in a single finetuning phase, significantly enhancing deployment and cross-task generalization. Furthermore, our model leverages the HL7 FHIR data standard to simplify integration into existing hospital systems. Alongside EHRMamba, we open-source Odyssey, a toolkit designed to support the development and deployment of EHR foundation models, with an emphasis on data standardization and interpretability. Our evaluations on the MIMIC-IV dataset demonstrate that EHRMamba advances state-of-the-art performance across 6 major clinical tasks and excels in EHR forecasting, marking a significant leap forward in the field.

Motivation: Emerging drug-drug interaction (DDI) prediction is crucial for new drugs but is hindered by distribution changes between known and new drugs in real-world scenarios. Current evaluation often neglects these changes, relying on unrealistic i.i.d. split due to the absence of drug approval data. Results: We propose DDI-Ben, a benchmarking framework for emerging DDI prediction under distribution changes. DDI-Ben introduces a distribution change simulation framework that leverages distribution changes between drug sets as a surrogate for real-world distribution changes of DDIs, and is compatible with various drug split strategies. Through extensive benchmarking on ten representative methods, we show that most existing approaches suffer substantial performance degradation under distribution changes. Our analysis further indicates that large language model (LLM) based methods and the integration of drug-related textual information offer promising robustness against such degradation. To support future research, we release the benchmark datasets with simulated distribution changes. Overall, DDI-Ben highlights the importance of explicitly addressing distribution changes and provides a foundation for developing more resilient methods for emerging DDI prediction. Availability and implementation: Our code and data are available at https://github.com/LARS-research/DDI-Bench.

Class-Incremental Learning (CIL) requires a learning system to continually learn new classes without forgetting. Despite the strong performance of Pre-Trained Models (PTMs) in CIL, a critical issue persists: learning new classes often results in the overwriting of old ones. Excessive modification of the network causes forgetting, while minimal adjustments lead to an inadequate fit for new classes. As a result, it is desired to figure out a way of efficient model updating without harming former knowledge. In this paper, we propose ExpAndable Subspace Ensemble (EASE) for PTM-based CIL. To enable model updating without conflict, we train a distinct lightweight adapter module for each new task, aiming to create task-specific subspaces. These adapters span a high-dimensional feature space, enabling joint decision-making across multiple subspaces. As data evolves, the expanding subspaces render the old class classifiers incompatible with new-stage spaces. Correspondingly, we design a semantic-guided prototype complement strategy that synthesizes old classes' new features without using any old class instance. Extensive experiments on seven benchmark datasets verify EASE's state-of-the-art performance. Code is available at: https://github.com/sun-hailong/CVPR24-Ease

With the advent of Vision-Language Models (VLMs), medical artificial intelligence (AI) has experienced significant technological progress and paradigm shifts. This survey provides an extensive review of recent advancements in Medical Vision-Language Models (Med-VLMs), which integrate visual and textual data to enhance healthcare outcomes. We discuss the foundational technology behind Med-VLMs, illustrating how general models are adapted for complex medical tasks, and examine their applications in healthcare. The transformative impact of Med-VLMs on clinical practice, education, and patient care is highlighted, alongside challenges such as data scarcity, narrow task generalization, interpretability issues, and ethical concerns like fairness, accountability, and privacy. These limitations are exacerbated by uneven dataset distribution, computational demands, and regulatory hurdles. Rigorous evaluation methods and robust regulatory frameworks are essential for safe integration into healthcare workflows. Future directions include leveraging large-scale, diverse datasets, improving cross-modal generalization, and enhancing interpretability. Innovations like federated learning, lightweight architectures, and Electronic Health Record (EHR) integration are explored as pathways to democratize access and improve clinical relevance. This review aims to provide a comprehensive understanding of Med-VLMs' strengths and limitations, fostering their ethical and balanced adoption in healthcare.

Large Language Models (LLMs) have great potential in the field of health care, yet they face great challenges in adapting to rapidly evolving medical knowledge. This can lead to outdated or contradictory treatment suggestions. This study investigated how LLMs respond to evolving clinical guidelines, focusing on concept drift and internal inconsistencies. We developed the DriftMedQA benchmark to simulate guideline evolution and assessed the temporal reliability of various LLMs. Our evaluation of seven state-of-the-art models across 4,290 scenarios demonstrated difficulties in rejecting outdated recommendations and frequently endorsing conflicting guidance. Additionally, we explored two mitigation strategies: Retrieval-Augmented Generation and preference fine-tuning via Direct Preference Optimization. While each method improved model performance, their combination led to the most consistent and reliable results. These findings underscore the need to improve LLM robustness to temporal shifts to ensure more dependable applications in clinical practice.

Recent advance in deep learning has led to the rapid adoption of machine learning-based NLP models in a wide range of applications. Despite the continuous gain in accuracy, backward compatibility is also an important aspect for industrial applications, yet it received little research attention. Backward compatibility requires that the new model does not regress on cases that were correctly handled by its predecessor. This work studies model update regression in structured prediction tasks. We choose syntactic dependency parsing and conversational semantic parsing as representative examples of structured prediction tasks in NLP. First, we measure and analyze model update regression in different model update settings. Next, we explore and benchmark existing techniques for reducing model update regression including model ensemble and knowledge distillation. We further propose a simple and effective method, Backward-Congruent Re-ranking (BCR), by taking into account the characteristics of structured prediction. Experiments show that BCR can better mitigate model update regression than model ensemble and knowledge distillation approaches.

Healthcare AI agents handle patient consultation, clinical reasoning over text and images, interactive diagnosis, and electronic health record (EHR) tool use, yet specialized agentic models that cover these use cases together remain limited. These capabilities fail in different ways, and a narrow update for one task can degrade another. We present Cura 1T, a healthcare-specialized LLM built on the open-weight Kimi-K2.6 and trained through a human-gated recursive self-improvement (RSI) loop. Specifically, in each round, the RSI harness plans a target capability, trains the model, evaluates benchmark trajectories, and refines the data mixture from observed failures with targeted synthetic and curated examples rather than a single generic medical-data update. Across the healthcare evaluation suite, Cura 1T ranks at or near the top among frontier baselines while remaining competitive on out-of-domain reasoning and agentic benchmarks.

Foundation models are increasingly central to high-stakes AI systems, and governance frameworks now depend on evaluations to assess their risks and capabilities. Although general capability evaluations are widespread, social impact assessments covering bias, fairness, privacy, environmental costs, and labor practices remain uneven across the AI ecosystem. To characterize this landscape, we conduct the first comprehensive analysis of both first-party and third-party social impact evaluation reporting across a wide range of model developers. Our study examines 186 first-party release reports and 183 post-release evaluation sources, and complements this quantitative analysis with interviews of model developers. We find a clear division of evaluation labor: first-party reporting is sparse, often superficial, and has declined over time in key areas such as environmental impact and bias, while third-party evaluators including academic researchers, nonprofits, and independent organizations provide broader and more rigorous coverage of bias, harmful content, and performance disparities. However, this complementarity has limits. Only model developers can authoritatively report on data provenance, content moderation labor, financial costs, and training infrastructure, yet interviews reveal that these disclosures are often deprioritized unless tied to product adoption or regulatory compliance. Our findings indicate that current evaluation practices leave major gaps in assessing AI's societal impacts, highlighting the urgent need for policies that promote developer transparency, strengthen independent evaluation ecosystems, and create shared infrastructure to aggregate and compare third-party evaluations in a consistent and accessible way.

This paper explores the advancements and applications of large-scale models in the medical field, with a particular focus on Medical Large Models (MedLMs). These models, encompassing Large Language Models (LLMs), Vision Models, 3D Large Models, and Multimodal Models, are revolutionizing healthcare by enhancing disease prediction, diagnostic assistance, personalized treatment planning, and drug discovery. The integration of graph neural networks in medical knowledge graphs and drug discovery highlights the potential of Large Graph Models (LGMs) in understanding complex biomedical relationships. The study also emphasizes the transformative role of Vision-Language Models (VLMs) and 3D Large Models in medical image analysis, anatomical modeling, and prosthetic design. Despite the challenges, these technologies are setting new benchmarks in medical innovation, improving diagnostic accuracy, and paving the way for personalized healthcare solutions. This paper aims to provide a comprehensive overview of the current state and future directions of large models in medicine, underscoring their significance in advancing global health.

Deployed LLM agents rely on agentic context, the model-external textual control content assembled by an operational harness. In this work, the mutable component of that context is a persistent system-level instruction that is updated from operational experience while the model, tools, and harness remain fixed. Over long evolution horizons, flat-text maintenance makes verification increasingly difficult as accumulated instructions grow and interact. We propose Graph-Regularized Agentic Context Evolution (GRACE), which maintains the persistent instruction component as a typed semantic graph and validates proposed updates within the local typed neighborhoods of modified nodes. Accepted graph updates are reconstructed as incremental edits to the textual instruction checkpoint used at deployment. We evaluate GRACE within a fixed telecom agent harness derived from τ^2-bench under a controlled distribution-shift protocol. Across five independent replications, GRACE improves strict reliability, measured by pass^3, from the Gemini 2.5 Flash zero-shot value of 0.091 to 0.673pm0.136 at the final checkpoint. This exceeds a Gemini 3.1 Pro zero-shot reference of 0.242 on the same held-out set, while the flat-text HCE baseline finishes at 0.191pm0.051. These results identify two requirements for reliable long-horizon context evolution, a structural substrate that makes verification local and a consolidation mechanism that keeps accumulated instruction content usable.

With the advent of Large Language Models (LLMs), medical artificial intelligence (AI) has experienced substantial technological progress and paradigm shifts, highlighting the potential of LLMs to streamline healthcare delivery and improve patient outcomes. Considering this rapid technical progress, in this survey, we trace the recent advances of Medical Large Language Models (Med-LLMs), including the background, key findings, and mainstream techniques, especially for the evolution from general-purpose models to medical-specialized applications. Firstly, we delve into the foundational technology of Med-LLMs, indicating how general models can be progressively adapted and refined for the complicated medical tasks. Secondly, the wide-ranging applications of Med-LLMs are investigated across various healthcare domains, as well as an up-to-date review of existing Med-LLMs. The transformative impact of these models on daily medical practice is evident through their ability to assist clinicians, educators, and patients. Recognizing the importance of responsible innovation, we discuss the challenges associated with ensuring fairness, accountability, privacy, and robustness. Ethical considerations, rigorous evaluation methodologies, and the establishment of regulatory frameworks are crucial for building trustworthiness in the real-world system. We emphasize the need for ongoing scrutiny and development to maintain high standards of safety and reliability. Finally, we anticipate possible future trajectories for Med-LLMs, identifying key avenues for prudent expansion. By consolidating these insights, our review aims to provide professionals and researchers with a thorough understanding of the strengths and limitations of Med-LLMs, fostering a balanced and ethical approach to their integration into the healthcare ecosystem.

Software languages evolve over time for various reasons, such as the addition of new features. When the language's grammar definition evolves, textual instances that originally conformed to the grammar become outdated. For DSLs in a model-driven engineering context, there exists a plethora of techniques to co-evolve models with the evolving metamodel. However, these techniques are not geared to support DSLs with a textual syntax -- applying them to textual language definitions and instances may lead to the loss of information from the original instances, such as comments and layout information, which are valuable for software comprehension and maintenance. This study explores the potential of Large Language Model (LLM)-based solutions in achieving grammar and instance co-evolution, with attention to their ability to preserve auxiliary information when directly processing textual instances. By applying two advanced language models, Claude-3.5 and GPT-4o, and conducting experiments across seven case languages, we evaluated the feasibility and limitations of this approach. Our results indicate a good ability of the considered LLMs for migrating textual instances in small-scale cases with limited instance size, which are representative of a subset of cases encountered in practice. In addition, we observe significant challenges with the scalability of LLM-based solutions to larger instances, leading to insights that are useful for informing future research.

Recent large language models (LLMs) in the general domain, such as ChatGPT, have shown remarkable success in following instructions and producing human-like responses. However, such language models have not been learned individually and carefully for the medical domain, resulting in poor diagnostic accuracy and inability to give correct recommendations for medical diagnosis, medications, etc. To address this issue, we collected more than 700 diseases and their corresponding symptoms, recommended medications, and required medical tests, and then generated 5K doctor-patient conversations. By fine-tuning models of doctor-patient conversations, these models emerge with great potential to understand patients' needs, provide informed advice, and offer valuable assistance in a variety of medical-related fields. The integration of these advanced language models into healthcare can revolutionize the way healthcare professionals and patients communicate, ultimately improving the overall quality of care and patient outcomes. In addition, we will open all source code, datasets and model weights to advance the further development of dialogue models in the medical field. In addition, the training data, code, and weights of this project are available at: https://github.com/Kent0n-Li/ChatDoctor.

Foundation models (FMs) trained on electronic health records (EHRs) have shown strong performance on a range of clinical prediction tasks. However, adapting these models to local health systems remains challenging due to limited data availability and resource constraints. In this study, we investigated what these models learn and evaluated the transferability of an FM trained on MIMIC-IV to an institutional EHR dataset at the University of Chicago Medical Center. We assessed their ability to identify outlier patients and examined representation-space patient trajectories in relation to future clinical outcomes. We also evaluated the performance of supervised fine-tuned classifiers on both source and target datasets. Our findings offer insights into the adaptability of FMs across different healthcare systems, highlight considerations for their effective implementation, and provide an empirical analysis of the underlying factors that contribute to their predictive performance.

The utilization of large language models (LLMs) in the Healthcare domain has generated both excitement and concern due to their ability to effectively respond to freetext queries with certain professional knowledge. This survey outlines the capabilities of the currently developed LLMs for Healthcare and explicates their development process, with the aim of providing an overview of the development roadmap from traditional Pretrained Language Models (PLMs) to LLMs. Specifically, we first explore the potential of LLMs to enhance the efficiency and effectiveness of various Healthcare applications highlighting both the strengths and limitations. Secondly, we conduct a comparison between the previous PLMs and the latest LLMs, as well as comparing various LLMs with each other. Then we summarize related Healthcare training data, training methods, optimization strategies, and usage. Finally, the unique concerns associated with deploying LLMs in Healthcare settings are investigated, particularly regarding fairness, accountability, transparency and ethics. Our survey provide a comprehensive investigation from perspectives of both computer science and Healthcare specialty. Besides the discussion about Healthcare concerns, we supports the computer science community by compiling a collection of open source resources, such as accessible datasets, the latest methodologies, code implementations, and evaluation benchmarks in the Github. Summarily, we contend that a significant paradigm shift is underway, transitioning from PLMs to LLMs. This shift encompasses a move from discriminative AI approaches to generative AI approaches, as well as a shift from model-centered methodologies to datacentered methodologies.

Ensuring equitable Artificial Intelligence (AI) in healthcare demands systems that make unbiased decisions across all demographic groups, bridging technical innovation with ethical principles. Foundation Models (FMs), trained on vast datasets through self-supervised learning, enable efficient adaptation across medical imaging tasks while reducing dependency on labeled data. These models demonstrate potential for enhancing fairness, though significant challenges remain in achieving consistent performance across demographic groups. Our review indicates that effective bias mitigation in FMs requires systematic interventions throughout all stages of development. While previous approaches focused primarily on model-level bias mitigation, our analysis reveals that fairness in FMs requires integrated interventions throughout the development pipeline, from data documentation to deployment protocols. This comprehensive framework advances current knowledge by demonstrating how systematic bias mitigation, combined with policy engagement, can effectively address both technical and institutional barriers to equitable AI in healthcare. The development of equitable FMs represents a critical step toward democratizing advanced healthcare technologies, particularly for underserved populations and regions with limited medical infrastructure and computational resources.

The proliferation of Large Language Models (LLMs) accessed via black-box APIs introduces a significant trust challenge: users pay for services based on advertised model capabilities (e.g., size, performance), but providers may covertly substitute the specified model with a cheaper, lower-quality alternative to reduce operational costs. This lack of transparency undermines fairness, erodes trust, and complicates reliable benchmarking. Detecting such substitutions is difficult due to the black-box nature, typically limiting interaction to input-output queries. This paper formalizes the problem of model substitution detection in LLM APIs. We systematically evaluate existing verification techniques, including output-based statistical tests, benchmark evaluations, and log probability analysis, under various realistic attack scenarios like model quantization, randomized substitution, and benchmark evasion. Our findings reveal the limitations of methods relying solely on text outputs, especially against subtle or adaptive attacks. While log probability analysis offers stronger guarantees when available, its accessibility is often limited. We conclude by discussing the potential of hardware-based solutions like Trusted Execution Environments (TEEs) as a pathway towards provable model integrity, highlighting the trade-offs between security, performance, and provider adoption. Code is available at https://github.com/sunblaze-ucb/llm-api-audit

We formulate the predicted-updates dynamic model, one of the first beyond-worst-case models for dynamic algorithms, which generalizes a large set of well-studied dynamic models including the offline dynamic, incremental, and decremental models to the fully dynamic setting when given predictions about the update times of the elements. In the most basic form of our model, we receive a set of predicted update times for all of the updates that occur over the event horizon. We give a novel framework that "lifts" offline divide-and-conquer algorithms into the fully dynamic setting with little overhead. Using this, we are able to interpolate between the offline and fully dynamic settings; when the ell_1 error of the prediction is linear in the number of updates, we achieve the offline runtime of the algorithm (up to poly log n factors). Provided a fully dynamic backstop algorithm, our algorithm will never do worse than the backstop algorithm regardless of the prediction error. Furthermore, our framework achieves a smooth linear trade-off between ell_1 error in the predictions and runtime. These correspond to the desiderata of consistency, robustness, and graceful degradation of the algorithms-with-predictions literature. We further extend our techniques to incremental and decremental settings, transforming algorithms in these settings when given predictions of only the deletion and insertion times, respectively. Our framework is general, and we apply it to obtain improved efficiency bounds over the state-of-the-art dynamic algorithms for a variety of problems including triconnectivity, planar digraph all pairs shortest paths, k-edge connectivity, and others, for prediction error of reasonable magnitude.

Since 2019, the Hugging Face Model Hub has been the primary global platform for sharing open weight AI models. By releasing a dataset of the complete history of weekly model downloads (June 2020-August 2025) alongside model metadata, we provide the most rigorous examination to-date of concentration dynamics and evolving characteristics in the open model economy. Our analysis spans 851,000 models, over 200 aggregated attributes per model, and 2.2B downloads. We document a fundamental rebalancing of economic power: US open-weight industry dominance by Google, Meta, and OpenAI has declined sharply in favor of unaffiliated developers, community organizations, and, as of 2025, Chinese industry, with DeepSeek and Qwen models potentially heralding a new consolidation of market power. We identify statistically significant shifts in model properties, a 17X increase in average model size, rapid growth in multimodal generation (3.4X), quantization (5X), and mixture-of-experts architectures (7X), alongside concerning declines in data transparency, with open weights models surpassing truly open source models for the first time in 2025. We expose a new layer of developer intermediaries that has emerged, focused on quantizing and adapting base models for both efficiency and artistic expression. To enable continued research and oversight, we release the complete dataset with an interactive dashboard for real-time monitoring of concentration dynamics and evolving properties in the open model economy.

The rapid development of Large Language Models (LLMs) for healthcare applications has spurred calls for holistic evaluation beyond frequently-cited benchmarks like USMLE, to better reflect real-world performance. While real-world assessments are valuable indicators of utility, they often lag behind the pace of LLM evolution, likely rendering findings obsolete upon deployment. This temporal disconnect necessitates a comprehensive upfront evaluation that can guide model selection for specific clinical applications. We introduce MEDIC, a framework assessing LLMs across five critical dimensions of clinical competence: medical reasoning, ethics and bias, data and language understanding, in-context learning, and clinical safety. MEDIC features a novel cross-examination framework quantifying LLM performance across areas like coverage and hallucination detection, without requiring reference outputs. We apply MEDIC to evaluate LLMs on medical question-answering, safety, summarization, note generation, and other tasks. Our results show performance disparities across model sizes, baseline vs medically finetuned models, and have implications on model selection for applications requiring specific model strengths, such as low hallucination or lower cost of inference. MEDIC's multifaceted evaluation reveals these performance trade-offs, bridging the gap between theoretical capabilities and practical implementation in healthcare settings, ensuring that the most promising models are identified and adapted for diverse healthcare applications.

Large language models (LLMs) show promise in medical diagnosis, but real-world deployment remains challenging due to high-stakes clinical decisions and imperfect reasoning reliability. As a result, careful inspection of model behavior is essential for assessing whether diagnostic reasoning is reliable and clinically grounded. However, debugging medical LLMs remains difficult. First, developers often lack sufficient medical domain expertise to interpret model errors in clinically meaningful terms. Second, models can fail across a large and diverse set of instances involving different input types, tasks, and reasoning steps, making it challenging for developers to prioritize which errors deserve focused inspection. Third, developers struggle to identify recurring error patterns across cases, as existing debugging practices are largely instance-centric and rely on manual inspection of isolated failures. To address these challenges, we present VeriLLMed, a visual analytics system that integrates external biomedical knowledge to audit and debug medical LLM diagnostic reasoning. VeriLLMed transforms model outputs into comparable reasoning paths, constructs knowledge graph-grounded reference paths, and identifies three recurring classes of diagnosis errors: relation errors, branch errors, and missing errors. Case studies and expert evaluation demonstrate that VeriLLMed helps developers identify clinically implausible reasoning and generate actionable insights that can inform the improvement of medical LLMs.

Multimodal foundation models serve numerous applications at the intersection of vision and language. Still, despite being pretrained on extensive data, they become outdated over time. To keep models updated, research into continual pretraining mainly explores scenarios with either (1) infrequent, indiscriminate updates on large-scale new data, or (2) frequent, sample-level updates. However, practical model deployment often operates in the gap between these two limit cases, as real-world applications often demand adaptation to specific subdomains, tasks or concepts -- spread over the entire, varying life cycle of a model. In this work, we complement current perspectives on continual pretraining through a research test bed as well as provide comprehensive guidance for effective continual model updates in such scenarios. We first introduce FoMo-in-Flux, a continual multimodal pretraining benchmark with realistic compute constraints and practical deployment requirements, constructed over 63 datasets with diverse visual and semantic coverage. Using FoMo-in-Flux, we explore the complex landscape of practical continual pretraining through multiple perspectives: (1) A data-centric investigation of data mixtures and stream orderings that emulate real-world deployment situations, (2) a method-centric investigation ranging from simple fine-tuning and traditional continual learning strategies to parameter-efficient updates and model merging, (3) meta learning rate schedules and mechanistic design choices, and (4) the influence of model and compute scaling. Together, our insights provide a practitioner's guide to continual multimodal pretraining for real-world deployment. Our benchmark and code is here: https://github.com/ExplainableML/fomo_in_flux.

Large language models (LLMs) are increasingly being used to synthesize and reason about source code. However, the static nature of these models' knowledge does not reflect the fact that libraries and API functions they invoke are continuously evolving, with functionality being added or changing. While numerous benchmarks evaluate how LLMs can generate code, no prior work has studied how an LLMs' knowledge about code API functions can be updated. To fill this gap, we present CodeUpdateArena, a benchmark for knowledge editing in the code domain. An instance in our benchmark consists of a synthetic API function update paired with a program synthesis example that uses the updated functionality; our goal is to update an LLM to be able to solve this program synthesis example without providing documentation of the update at inference time. Compared to knowledge editing for facts encoded in text, success here is more challenging: a code LLM must correctly reason about the semantics of the modified function rather than just reproduce its syntax. Our dataset is constructed by first prompting GPT-4 to generate atomic and executable function updates. Then, for each update, we generate program synthesis examples whose code solutions are prone to use the update. Our benchmark covers updates of various types to 54 functions from seven diverse Python packages, with a total of 670 program synthesis examples. Our experiments show that prepending documentation of the update to open-source code LLMs (i.e., DeepSeek, CodeLlama) does not allow them to incorporate changes for problem solving, and existing knowledge editing techniques also have substantial room for improvement. We hope our benchmark will inspire new methods for knowledge updating in code LLMs.

Large Language Models (LLMs) are emerging as transformative tools for software vulnerability detection, addressing critical challenges in the security domain. Traditional methods, such as static and dynamic analysis, often falter due to inefficiencies, high false positive rates, and the growing complexity of modern software systems. By leveraging their ability to analyze code structures, identify patterns, and generate repair suggestions, LLMs, exemplified by models like GPT, BERT, and CodeBERT, present a novel and scalable approach to mitigating vulnerabilities. This paper provides a detailed survey of LLMs in vulnerability detection. It examines key aspects, including model architectures, application methods, target languages, fine-tuning strategies, datasets, and evaluation metrics. We also analyze the scope of current research problems, highlighting the strengths and weaknesses of existing approaches. Further, we address challenges such as cross-language vulnerability detection, multimodal data integration, and repository-level analysis. Based on these findings, we propose solutions for issues like dataset scalability, model interpretability, and applications in low-resource scenarios. Our contributions are threefold: (1) a systematic review of how LLMs are applied in vulnerability detection; (2) an analysis of shared patterns and differences across studies, with a unified framework for understanding the field; and (3) a summary of key challenges and future research directions. This work provides valuable insights for advancing LLM-based vulnerability detection. We also maintain and regularly update latest selected paper on https://github.com/OwenSanzas/LLM-For-Vulnerability-Detection

Machine learning techniques are effective for building predictive models because they identify patterns in large datasets. Development of a model for complex real-life problems often stop at the point of publication, proof of concept or when made accessible through some mode of deployment. However, a model in the medical domain risks becoming obsolete as patient demographics, systems and clinical practices change. The maintenance and monitoring of predictive model performance post-publication is crucial to enable their safe and effective long-term use. We will assess the infrastructure required to monitor the outputs of a machine learning algorithm, and present two scenarios with examples of monitoring and updates of models, firstly on a breast cancer prognosis model trained on public longitudinal data, and secondly on a neurodegenerative stratification algorithm that is currently being developed and tested in clinic.

Large language models (LLMs) integrated into agent-driven workflows hold immense promise for healthcare, yet a significant gap exists between their potential and practical implementation within clinical settings. To address this, we present a practitioner-oriented field manual for deploying generative agents that use electronic health record (EHR) data. This guide is informed by our experience deploying the "irAE-Agent", an automated system to detect immune-related adverse events from clinical notes at Mass General Brigham, and by structured interviews with 21 clinicians, engineers, and informatics leaders involved in the project. Our analysis reveals a critical misalignment in clinical AI development: less than 20% of our effort was dedicated to prompt engineering and model development, while over 80% was consumed by the sociotechnical work of implementation. We distill this effort into five "heavy lifts": data integration, model validation, ensuring economic value, managing system drift, and governance. By providing actionable solutions for each of these challenges, this field manual shifts the focus from algorithmic development to the essential infrastructure and implementation work required to bridge the "valley of death" and successfully translate generative AI from pilot projects into routine clinical care.

Public health reasoning requires population level inference grounded in scientific evidence, expert consensus, and safety constraints. However, it remains underexplored as a structured machine learning problem with limited supervised signals and benchmarks. We introduce GlobalHealthAtlas, a large scale multilingual dataset of 280,210 instances spanning 15 public health domains and 17 languages. We further propose a large language model (LLM) assisted construction and quality control pipeline with retrieval, deduplication, evidence grounding checks, and label validation to improve consistency at scale. Finally, we present a domain aligned evaluator distilled from high confidence judgments of diverse LLMs to assess outputs along six dimensions: Accuracy, Reasoning, Completeness, Consensus Alignment, Terminology Norms, and Insightfulness. Together, these contributions enable reproducible training and evaluation of LLMs for safety critical public health reasoning beyond conventional QA benchmarks. We publicly release project codebase, evaluator, and model at:: https://github.com/Jan8217/GlobalHealthAtlas, https://huggingface.co/aerovane0/GlobalHealthAtlas_Public_Evaluator and https://huggingface.co/aerovane0/GlobalHealthAtlas_Public_Model

The scale of large pre-trained models (PTMs) poses significant challenges in adapting to downstream tasks due to the high optimization overhead and storage costs associated with full-parameter fine-tuning. To address this, many studies explore parameter-efficient tuning methods, also framed as "delta tuning", which updates only a small subset of parameters, known as "delta modules", while keeping the backbone model's parameters fixed. However, the practicality and flexibility of delta tuning have been limited due to existing implementations that directly modify the code of the backbone PTMs and hard-code specific delta tuning methods for each PTM. In this paper, we present OpenDelta, an open-source library that overcomes these limitations by providing a plug-and-play implementation of various delta tuning methods. Our novel techniques eliminate the need to modify the backbone PTMs' code, making OpenDelta compatible with different, even novel PTMs. OpenDelta is designed to be simple, modular, and extensible, providing a comprehensive platform for researchers and practitioners to adapt large PTMs efficiently.

Machine learning models in modern mass-market applications are often updated over time. One of the foremost challenges faced is that, despite increasing overall performance, these updates may flip specific model predictions in unpredictable ways. In practice, researchers quantify the number of unstable predictions between models pre and post update -- i.e., predictive churn. In this paper, we study this effect through the lens of predictive multiplicity -- i.e., the prevalence of conflicting predictions over the set of near-optimal models (the Rashomon set). We show how traditional measures of predictive multiplicity can be used to examine expected churn over this set of prospective models -- i.e., the set of models that may be used to replace a baseline model in deployment. We present theoretical results on the expected churn between models within the Rashomon set from different perspectives. And we characterize expected churn over model updates via the Rashomon set, pairing our analysis with empirical results on real-world datasets -- showing how our approach can be used to better anticipate, reduce, and avoid churn in consumer-facing applications. Further, we show that our approach is useful even for models enhanced with uncertainty awareness.

The Model Context Protocol (MCP), introduced by Anthropic in November 2024, defines a standardized interface for connecting large language models (LLMs) to external tools, data sources, and services. Within months of release, hundreds of community-built MCP servers appeared on GitHub, but no software-maintenance literature has yet described how the ecosystem is being structured in production. This industry experience paper catalogues five recurring MCP server architectural patterns observed across an enumerated corpus of fifteen independently developed servers (five production servers from the ANSYR voice AI platform plus ten public servers from the official MCP registry): Resource Gateway, Tool Orchestrator, Stateful Session Server, Proxy Aggregator, and Domain-Specific Adapter. Each pattern is described in the structured form of Gamma et al.: context, problem, solution, and consequences. We also document four anti-patterns and a set of cross-cutting concerns around authentication, versioning, and observability. The quantitative evaluation contributes three measurements: inter-rater reliability of the taxonomy across two independent LLM raters on 54 held-out servers (Cohen's kappa = 0.76), which also localizes three pattern-boundary ambiguities; transport overhead measured end-to-end on loopback and modeled for cross-host paths; and a tool-count study showing tool-selection accuracy drops below 90% between 10 and 15 tools per context for Claude Haiku 4.5 and between 20 and 30 tools for Sonnet 4. Code, corpus, and prompts are released as a replication package.

Continual post-training aims to extend large language models (LLMs) with new knowledge, skills, and behaviors, yet it remains unclear when sequential updates enable capability transfer and when they cause catastrophic forgetting. Existing methods mitigate forgetting through sequential fine-tuning, replay, regularization, or model merging, but offer limited criteria for determining when incorporating new updates is beneficial or harmful. In this work, we study LLM continual post-training through three questions: What drives forgetting? When do sequentially acquired capabilities transfer or interfere? How can compatibility be used to control update integration? We address these questions through task geometry: we represent each post-training task by its parameter update and study the covariance geometry induced by the update. Our central finding is that: forgetting can be considered as a state-relative update-integration failure, it arises when the covariance geometries induced by tasks misalign with the geometry of the evolving model state. Sequential updates transfer when they remain compatible with the model state shaped by previous updates, and interfere when state-relative geometry conflict becomes high. Motivated by this finding, we propose Geometry-Conflict Wasserstein Merging (GCWM), a data-free update-integration method that constructs a shared Wasserstein metric via Gaussian Wasserstein barycenters and uses geometry conflict to gate geometry-aware correction. Across Qwen3 0.6B--14B on domain-continual and capability-continual settings, GCWM consistently outperforms data-free baselines, improving retention and final performance without replay data. These results identify geometry conflict as both an explanatory signal for forgetting and a practical control signal for LLM continual post-training.

Federated learning (FL) collaboratively trains artificial intelligence (AI) models to ensure user data privacy. Sharing only model updates generated from local training on client data with the server enhances user data privacy. However, model performance may suffer due to data and system heterogeneity among clients in FL scenarios. Previous studies have proposed model optimization, fine-tuning, and personalization to achieve improved model performance. Despite these efforts, models resulting from FL scenarios often exhibit catastrophic forgetting, which increases the communication and computational costs of clients for model optimization and raises energy consumption. To address these challenges, we propose a reference model-based fine-tuning method for federated learning that overcomes catastrophic forgetting in each round. Our method is derived from Bayesian parameter-efficient transfer learning and includes an proximal term. It employs a reference model that incorporates previous model parameters and reviews previous global features in the model optimization step to mitigate catastrophic forgetting. As a result, our method achieves higher model performance and lower communication and computational costs for clients than existing methods.

LLMs have become increasingly capable at accomplishing a range of specialized-tasks and can be utilized to expand equitable access to medical knowledge. Most medical LLMs have involved extensive fine-tuning, leveraging specialized medical data and significant, thus costly, amounts of computational power. Many of the top performing LLMs are proprietary and their access is limited to very few research groups. However, open-source (OS) models represent a key area of growth for medical LLMs due to significant improvements in performance and an inherent ability to provide the transparency and compliance required in healthcare. We present OpenMedLM, a prompting platform which delivers state-of-the-art (SOTA) performance for OS LLMs on medical benchmarks. We evaluated a range of OS foundation LLMs (7B-70B) on four medical benchmarks (MedQA, MedMCQA, PubMedQA, MMLU medical-subset). We employed a series of prompting strategies, including zero-shot, few-shot, chain-of-thought (random selection and kNN selection), and ensemble/self-consistency voting. We found that OpenMedLM delivers OS SOTA results on three common medical LLM benchmarks, surpassing the previous best performing OS models that leveraged computationally costly extensive fine-tuning. The model delivers a 72.6% accuracy on the MedQA benchmark, outperforming the previous SOTA by 2.4%, and achieves 81.7% accuracy on the MMLU medical-subset, establishing itself as the first OS LLM to surpass 80% accuracy on this benchmark. Our results highlight medical-specific emergent properties in OS LLMs which have not yet been documented to date elsewhere, and showcase the benefits of further leveraging prompt engineering to improve the performance of accessible LLMs for medical applications.

While the general machine learning (ML) community has benefited from public datasets, tasks, and models, the progress of ML in healthcare has been hampered by a lack of such shared assets. The success of foundation models creates new challenges for healthcare ML by requiring access to shared pretrained models to validate performance benefits. We help address these challenges through three contributions. First, we publish a new dataset, EHRSHOT, which contains deidentified structured data from the electronic health records (EHRs) of 6,739 patients from Stanford Medicine. Unlike MIMIC-III/IV and other popular EHR datasets, EHRSHOT is longitudinal and not restricted to ICU/ED patients. Second, we publish the weights of CLMBR-T-base, a 141M parameter clinical foundation model pretrained on the structured EHR data of 2.57M patients. We are one of the first to fully release such a model for coded EHR data; in contrast, most prior models released for clinical data (e.g. GatorTron, ClinicalBERT) only work with unstructured text and cannot process the rich, structured data within an EHR. We provide an end-to-end pipeline for the community to validate and build upon its performance. Third, we define 15 few-shot clinical prediction tasks, enabling evaluation of foundation models on benefits such as sample efficiency and task adaptation. Our model and dataset are available via a research data use agreement from the Stanford AIMI Center. Code to reproduce our results are available at our Github repo: https://github.com/som-shahlab/ehrshot-benchmark

We present a comprehensive adoption snapshot of the leading open language models and who is building them, focusing on the ~1.5K mainline open models from the likes of Alibaba's Qwen, DeepSeek, Meta's Llama, that are the foundation of an ecosystem crucial to researchers, entrepreneurs, and policy advisors. We document a clear trend where Chinese models overtook their counterparts built in the U.S. in the summer of 2025 and subsequently widened the gap over their western counterparts. We study a mix of Hugging Face downloads and model derivatives, inference market share, performance metrics and more to make a comprehensive picture of the ecosystem.

Generative models have demonstrated considerable potential in software engineering, particularly in tasks such as code generation and debugging. However, their utilization in the domain of code documentation generation remains underexplored. To this end, we introduce RepoAgent, a large language model powered open-source framework aimed at proactively generating, maintaining, and updating code documentation. Through both qualitative and quantitative evaluations, we have validated the effectiveness of our approach, showing that RepoAgent excels in generating high-quality repository-level documentation. The code and results are publicly accessible at https://github.com/OpenBMB/RepoAgent.

Residual connections are pivotal for deep neural networks, enabling greater depth by mitigating vanishing gradients. However, in standard residual updates, the module's output is directly added to the input stream. This can lead to updates that predominantly reinforce or modulate the existing stream direction, potentially underutilizing the module's capacity for learning entirely novel features. In this work, we introduce Orthogonal Residual Update: we decompose the module's output relative to the input stream and add only the component orthogonal to this stream. This design aims to guide modules to contribute primarily new representational directions, fostering richer feature learning while promoting more efficient training. We demonstrate that our orthogonal update strategy improves generalization accuracy and training stability across diverse architectures (ResNetV2, Vision Transformers) and datasets (CIFARs, TinyImageNet, ImageNet-1k), achieving, for instance, a +4.3\%p top-1 accuracy gain for ViT-B on ImageNet-1k.

Large language models are increasingly capable of synthesizing executable frontend projects, yet existing benchmarks still treat web generation as a static evaluation problem. We argue that frontend artifacts demand a different paradigm: they are interactive rather than static, admit diverse yet equally valid implementations, and evolve faster than rigid pipelines can accommodate. To address these gaps, we present LiveEvalBench, an automated framework that reformulates web-generation evaluation as an agentic, adaptive, and extensible process. LiveEvalBench instantiates evaluation as a collaborative review workflow, in which a Build Engineer, a Code Engineer, and a UI Tester collectively gather evidence across the full lifecycle of a frontend project, from deployment and code inspection to browser-based interaction. To handle implementation diversity, an adaptive protocol couples shared rubrics for cross-model comparability with implementation-grounded criteria tailored to each artifact. The framework further supports incremental integration of new evaluator roles and assessment dimensions without pipeline redesign. Experiments across diverse real-world web-generation scenarios show that LiveEvalBench aligns closely with human expert judgment and provides fine-grained insights into frontier models' web generation capabilities. Code is available at https://github.com/wyysteelhead/LiveEvalBench

The scaling laws and extraordinary performance of large foundation models motivate the development and utilization of such models in biomedicine. However, despite early promising results on some biomedical benchmarks, there are still major challenges that need to be addressed before these models can be used in real-world clinics. Frontier general-domain models such as GPT-4V still have significant performance gaps in multimodal biomedical applications. More importantly, less-acknowledged pragmatic issues, including accessibility, model cost, and tedious manual evaluation make it hard for clinicians to use state-of-the-art large models directly on private patient data. Here, we explore training open-source small multimodal models (SMMs) to bridge competency gaps for unmet clinical needs in radiology. To maximize data efficiency, we adopt a modular approach by incorporating state-of-the-art pre-trained models for image and text modalities, and focusing on training a lightweight adapter to ground each modality to the text embedding space, as exemplified by LLaVA-Med. For training, we assemble a large dataset of over 697 thousand radiology image-text pairs. For evaluation, we propose CheXprompt, a GPT-4-based metric for factuality evaluation, and demonstrate its parity with expert evaluation. For best practice, we conduct a systematic ablation study on various choices in data engineering and multimodal training. The resulting LlaVA-Rad (7B) model attains state-of-the-art results on standard radiology tasks such as report generation and cross-modal retrieval, even outperforming much larger models such as GPT-4V and Med-PaLM M (84B). The inference of LlaVA-Rad is fast and can be performed on a single V100 GPU in private settings, offering a promising state-of-the-art tool for real-world clinical applications.

LLMs hold great promise for healthcare applications, but the rapid evolution of medical knowledge and errors in training data often cause them to generate outdated or inaccurate information, limiting their applicability in high-stakes clinical practice. Model editing has emerged as a potential remedy without full retraining. While parameter-based editing often compromises locality and is thus ill-suited for the medical domain, retrieval-based editing offers a more viable alternative. However, it still faces two critical challenges: (1) representation overlap within the medical knowledge space often causes inaccurate retrieval and reduces editing accuracy; (2) existing methods are restricted to single-sample edits, while batch-editing remains largely unexplored despite its importance for real-world medical applications. To address these challenges, we first construct MedVersa, an enhanced benchmark with broader coverage of medical subjects, designed to evaluate both single and batch edits under strict locality constraints. We then propose MedREK, a retrieval-based editing framework that integrates a shared query-key module for precise matching with an attention-based prompt encoder for informative guidance. Experimental results on various medical benchmarks demonstrate that our MedREK achieves superior performance across different core metrics and provides the first validated solution for batch-editing in medical LLMs. Our code and dataset are available at https://github.com/mylittleriver/MedREK.

Foundation model development attracts a rapidly expanding body of contributors, scientists, and applications. To help shape responsible development practices, we introduce the Foundation Model Development Cheatsheet: a growing collection of 250+ tools and resources spanning text, vision, and speech modalities. We draw on a large body of prior work to survey resources (e.g. software, documentation, frameworks, guides, and practical tools) that support informed data selection, processing, and understanding, precise and limitation-aware artifact documentation, efficient model training, advance awareness of the environmental impact from training, careful model evaluation of capabilities, risks, and claims, as well as responsible model release, licensing and deployment practices. We hope this curated collection of resources helps guide more responsible development. The process of curating this list, enabled us to review the AI development ecosystem, revealing what tools are critically missing, misused, or over-used in existing practices. We find that (i) tools for data sourcing, model evaluation, and monitoring are critically under-serving ethical and real-world needs, (ii) evaluations for model safety, capabilities, and environmental impact all lack reproducibility and transparency, (iii) text and particularly English-centric analyses continue to dominate over multilingual and multi-modal analyses, and (iv) evaluation of systems, rather than just models, is needed so that capabilities and impact are assessed in context.

As real-world knowledge evolves, the information embedded within large language models (LLMs) can become outdated, inadequate, or erroneous. Model editing has emerged as a prominent approach for updating LLMs' knowledge with minimal computational costs and parameter changes. This approach typically identifies and adjusts specific model parameters associated with newly acquired knowledge. However, existing methods often underestimate the adverse effects that parameter modifications can have on broadly distributed knowledge. More critically, post-edit LLMs frequently struggle with multi-hop reasoning and continuous knowledge updates. Although various studies have discussed these shortcomings, there is a lack of comprehensive evaluation. In this paper, we provide an evaluation of ten model editing methods along four dimensions: reliability, generalization, locality, and portability. Results confirm that all ten popular model editing methods show significant shortcomings across multiple dimensions, suggesting model editing is less promising. We then propose a straightforward method called Selective Contextual Reasoning (SCR), for knowledge updating. SCR does not modify model parameters but harnesses LLM's inherent contextual reasoning capabilities utilizing the updated knowledge pieces. Under SCR, an LLM first assesses whether an incoming query falls within the scope of an external knowledge base. If it does, the relevant external knowledge texts are contextualized to enhance reasoning; otherwise, the query is answered directly. We evaluate SCR against the ten model editing methods on two counterfactual datasets with three backbone LLMs. Empirical results confirm the effectiveness and efficiency of contextual reasoning for knowledge updating.

Social determinants of health (SDoH) have an important impact on patient outcomes but are incompletely collected from the electronic health records (EHR). This study researched the ability of large language models to extract SDoH from free text in EHRs, where they are most commonly documented, and explored the role of synthetic clinical text for improving the extraction of these scarcely documented, yet extremely valuable, clinical data. 800 patient notes were annotated for SDoH categories, and several transformer-based models were evaluated. The study also experimented with synthetic data generation and assessed for algorithmic bias. Our best-performing models were fine-tuned Flan-T5 XL (macro-F1 0.71) for any SDoH, and Flan-T5 XXL (macro-F1 0.70). The benefit of augmenting fine-tuning with synthetic data varied across model architecture and size, with smaller Flan-T5 models (base and large) showing the greatest improvements in performance (delta F1 +0.12 to +0.23). Model performance was similar on the in-hospital system dataset but worse on the MIMIC-III dataset. Our best-performing fine-tuned models outperformed zero- and few-shot performance of ChatGPT-family models for both tasks. These fine-tuned models were less likely than ChatGPT to change their prediction when race/ethnicity and gender descriptors were added to the text, suggesting less algorithmic bias (p<0.05). At the patient-level, our models identified 93.8% of patients with adverse SDoH, while ICD-10 codes captured 2.0%. Our method can effectively extracted SDoH information from clinic notes, performing better compare to GPT zero- and few-shot settings. These models could enhance real-world evidence on SDoH and aid in identifying patients needing social support.

Large language models (LLMs) have reshaped the landscape of program synthesis. However, contemporary LLM-based code completion systems often hallucinate broken code because they lack appropriate context, particularly when working with definitions not in the training data nor near the cursor. This paper demonstrates that tight integration with the type and binding structure of a language, as exposed by its language server, can address this contextualization problem in a token-efficient manner. In short, we contend that AIs need IDEs, too! In particular, we integrate LLM code generation into the Hazel live program sketching environment. The Hazel Language Server identifies the type and typing context of the hole being filled, even in the presence of errors, ensuring that a meaningful program sketch is always available. This allows prompting with codebase-wide contextual information not lexically local to the cursor, nor necessarily in the same file, but that is likely to be semantically local to the developer's goal. Completions synthesized by the LLM are then iteratively refined via further dialog with the language server. To evaluate these techniques, we introduce MVUBench, a dataset of model-view-update (MVU) web applications. These applications serve as challenge problems due to their reliance on application-specific data structures. We find that contextualization with type definitions is particularly impactful. After introducing our ideas in the context of Hazel we duplicate our techniques and port MVUBench to TypeScript in order to validate the applicability of these methods to higher-resource languages. Finally, we outline ChatLSP, a conservative extension to the Language Server Protocol (LSP) that language servers can implement to expose capabilities that AI code completion systems of various designs can use to incorporate static context when generating prompts for an LLM.

Large language models (LLMs) hold great promise in summarizing medical evidence. Most recent studies focus on the application of proprietary LLMs. Using proprietary LLMs introduces multiple risk factors, including a lack of transparency and vendor dependency. While open-source LLMs allow better transparency and customization, their performance falls short compared to proprietary ones. In this study, we investigated to what extent fine-tuning open-source LLMs can further improve their performance in summarizing medical evidence. Utilizing a benchmark dataset, MedReview, consisting of 8,161 pairs of systematic reviews and summaries, we fine-tuned three broadly-used, open-sourced LLMs, namely PRIMERA, LongT5, and Llama-2. Overall, the fine-tuned LLMs obtained an increase of 9.89 in ROUGE-L (95% confidence interval: 8.94-10.81), 13.21 in METEOR score (95% confidence interval: 12.05-14.37), and 15.82 in CHRF score (95% confidence interval: 13.89-16.44). The performance of fine-tuned LongT5 is close to GPT-3.5 with zero-shot settings. Furthermore, smaller fine-tuned models sometimes even demonstrated superior performance compared to larger zero-shot models. The above trends of improvement were also manifested in both human and GPT4-simulated evaluations. Our results can be applied to guide model selection for tasks demanding particular domain knowledge, such as medical evidence summarization.

Longitudinal multimodal data, including electronic health records (EHR) and sequential chest X-rays (CXRs), is critical for modeling disease progression, yet remains underutilized due to two key challenges: (1) redundancy in consecutive CXR sequences, where static anatomical regions dominate over clinically-meaningful dynamics, and (2) temporal misalignment between sparse, irregular imaging and continuous EHR data. We introduce DiPro, a novel framework that addresses these challenges through region-aware disentanglement and multi-timescale alignment. First, we disentangle static (anatomy) and dynamic (pathology progression) features in sequential CXRs, prioritizing disease-relevant changes. Second, we hierarchically align these static and dynamic CXR features with asynchronous EHR data via local (pairwise interval-level) and global (full-sequence) synchronization to model coherent progression pathways. Extensive experiments on the MIMIC dataset demonstrate that DiPro could effectively extract temporal clinical dynamics and achieve state-of-the-art performance on both disease progression identification and general ICU prediction tasks.

Fine-tuning large language models (LLMs) for telecom tasks and datasets is a common practice to adapt general-purpose models to the telecom domain. However, little attention has been paid to how this process may compromise model safety. Recent research has shown that even benign fine-tuning can degrade the safety alignment of LLMs, causing them to respond to harmful or unethical user queries. In this paper, we investigate this issue for telecom-tuned LLMs using three representative datasets featured by the GenAINet initiative. We show that safety degradation persists even for structured and seemingly harmless datasets such as 3GPP standards and tabular records, indicating that telecom-specific data is not immune to safety erosion during fine-tuning. We further extend our analysis to publicly available Telecom LLMs trained via continual pre-training, revealing that safety alignment is often severely lacking, primarily due to the omission of safety-focused instruction tuning. To address these issues in both fine-tuned and pre-trained models, we conduct extensive experiments and evaluate three safety realignment defenses (SafeInstruct, SafeLoRA, and SafeMERGE) using established red-teaming benchmarks. The results show that, across all settings, the proposed defenses can effectively restore safety after harmful degradation without compromising downstream task performance, leading to Safe teleCOMMunication (SafeCOMM) models. In a nutshell, our work serves as a diagnostic study and practical guide for safety realignment in telecom-tuned LLMs, and emphasizes the importance of safety-aware instruction and fine-tuning for real-world deployments of Telecom LLMs.

Large language models (LLMs) hold great promise for medical applications and are evolving rapidly, with new models being released at an accelerated pace. However, current evaluations of LLMs in clinical contexts remain limited. Most existing benchmarks rely on medical exam-style questions or PubMed-derived text, failing to capture the complexity of real-world electronic health record (EHR) data. Others focus narrowly on specific application scenarios, limiting their generalizability across broader clinical use. To address this gap, we present BRIDGE, a comprehensive multilingual benchmark comprising 87 tasks sourced from real-world clinical data sources across nine languages. We systematically evaluated 52 state-of-the-art LLMs (including DeepSeek-R1, GPT-4o, Gemini, and Llama 4) under various inference strategies. With a total of 13,572 experiments, our results reveal substantial performance variation across model sizes, languages, natural language processing tasks, and clinical specialties. Notably, we demonstrate that open-source LLMs can achieve performance comparable to proprietary models, while medically fine-tuned LLMs based on older architectures often underperform versus updated general-purpose models. The BRIDGE and its corresponding leaderboard serve as a foundational resource and a unique reference for the development and evaluation of new LLMs in real-world clinical text understanding.

Modern software projects depend on third-party libraries that evolve continuously, introducing breaking API changes that prevent client code from compiling after a dependency update. When the same library update breaks multiple projects, existing repair approaches generate project-specific patches that cannot be reused, requiring each affected project to be repaired independently. We present BigBag, an agentic framework that generates fixing transformations: structured, executable programs that encode the repair logic at the API level and transfer to any client broken by the same update. We evaluate BigBag on 157 compilation failure breaking dependency updates from the BUMP benchmark, across eight configurations combining four large language models and two AST transformation engines (Spoon and JavaParser). The best configuration achieves a compilable transformation rate of 94.3% and a fix rate of 78.6%. Generated transformations transfer across projects, achieving a cross-project fix rate of 33.3% overall and 80% or above for breaking updates where all clients invoke the affected API element uniformly. These results show that agentic generation of reusable fixing transformations is a viable approach to scalable repair of breaking updates.

Large language models (LLMs) are increasingly embedded in open-source software (OSS) ecosystems, creating complex interactions among natural language prompts, probabilistic model outputs, and execution-capable components. However, it remains unclear whether traditional vulnerability disclosure frameworks adequately capture these model-mediated risks. To investigate this, we analyze 295 GitHub Security Advisories published between January 2025 and January 2026 that reference LLM-related components, and we manually annotate a sample of 100 advisories using the OWASP Top 10 for LLM Applications 2025. We find no evidence of new implementation-level weakness classes specific to LLM systems. Most advisories map to established CWEs, particularly injection and deserialization weaknesses. At the same time, the OWASP-based analysis reveals recurring architectural risk patterns, especially Supply Chain, Excessive Agency, and Prompt Injection, which often co-occur across multiple stages of execution. These results suggest that existing advisory metadata captures code-level defects but underrepresents model-mediated exposure. We conclude that combining the CWE and OWASP perspectives provides a more complete and necessary view of vulnerabilities in LLM-integrated systems.

This paper introduces Patched Round-Trip Correctness (Patched RTC), a novel evaluation technique for Large Language Models (LLMs) applied to diverse software development tasks, particularly focusing on "outer loop" activities such as bug fixing, code review, and documentation updates. Patched RTC extends the original Round-Trip Correctness method to work with any LLM and downstream task, offering a self-evaluating framework that measures consistency and robustness of model responses without human intervention. The study demonstrates a correlation between Patched RTC scores and task-specific accuracy metrics, presenting it as an alternative to the LLM-as-Judge paradigm for open-domain task evaluation. We implement Patched RTC in an open-source framework called patchwork, allowing for transparent evaluation during inference across various patchflows. Experiments comparing GPT-3.5 and GPT-4 models across different software development tasks reveal that Patched RTC effectively distinguishes model performance and task difficulty. The paper also explores the impact of consistency prompts on improving model accuracy, suggesting that Patched RTC can guide prompt refinement and model selection for complex software development workflows.

Although Foundation Models (FMs), such as GPT-4, are increasingly used in domains like finance and software engineering, reliance on textual interfaces limits these models' real-world interaction. To address this, FM providers introduced tool calling-triggering a proliferation of frameworks with distinct tool interfaces. In late 2024, Anthropic introduced the Model Context Protocol (MCP) to standardize this tool ecosystem, which has become the de facto standard with over eight million weekly SDK downloads. Despite its adoption, MCP's AI-driven, non-deterministic control flow introduces new risks to sustainability, security, and maintainability, warranting closer examination. Towards this end, we present the first large-scale empirical study of MCP servers. Using state-of-the-art health metrics and a hybrid analysis pipeline, combining a general-purpose static analysis tool with an MCP-specific scanner, we evaluate 1,899 open-source MCP servers to assess their health, security, and maintainability. Despite MCP servers demonstrating strong health metrics, we identify eight distinct vulnerabilities - only three overlapping with traditional software vulnerabilities. Additionally, 7.2% of servers contain general vulnerabilities and 5.5% exhibit MCP-specific tool poisoning. Regarding maintainability, while 66% exhibit code smells, 14.4% contain nine bug patterns overlapping with traditional open-source software projects. These findings highlight the need for MCP-specific vulnerability detection techniques while reaffirming the value of traditional analysis and refactoring practices.

Financial institutions deploy Large Language Models (LLMs) for reconciliations, regulatory reporting, and client communications, but nondeterministic outputs (output drift) undermine auditability and trust. We quantify drift across five model architectures (7B-120B parameters) on regulated financial tasks, revealing a stark inverse relationship: smaller models (Granite-3-8B, Qwen2.5-7B) achieve 100% output consistency at T=0.0, while GPT-OSS-120B exhibits only 12.5% consistency (95% CI: 3.5-36.0%) regardless of configuration (p<0.0001, Fisher's exact test). This finding challenges conventional assumptions that larger models are universally superior for production deployment. Our contributions include: (i) a finance-calibrated deterministic test harness combining greedy decoding (T=0.0), fixed seeds, and SEC 10-K structure-aware retrieval ordering; (ii) task-specific invariant checking for RAG, JSON, and SQL outputs using finance-calibrated materiality thresholds (plus or minus 5%) and SEC citation validation; (iii) a three-tier model classification system enabling risk-appropriate deployment decisions; and (iv) an audit-ready attestation system with dual-provider validation. We evaluated five models (Qwen2.5-7B via Ollama, Granite-3-8B via IBM watsonx.ai, Llama-3.3-70B, Mistral-Medium-2505, and GPT-OSS-120B) across three regulated financial tasks. Across 480 runs (n=16 per condition), structured tasks (SQL) remain stable even at T=0.2, while RAG tasks show drift (25-75%), revealing task-dependent sensitivity. Cross-provider validation confirms deterministic behavior transfers between local and cloud deployments. We map our framework to Financial Stability Board (FSB), Bank for International Settlements (BIS), and Commodity Futures Trading Commission (CFTC) requirements, demonstrating practical pathways for compliance-ready AI deployments.

Model merging refers to the process of integrating multiple distinct models into a unified model that preserves and combines the strengths and capabilities of the individual models. Most existing approaches rely on task vectors to combine models, typically under the assumption that model parameters are accessible. However, for extremely large language models (LLMs) such as GPT-4, which are often provided solely as black-box services through API interfaces (Language-Model-as-a-Service), model weights are not available to end users. This presents a significant challenge, which we refer to as black-box model merging (BMM) with massive LLMs. To address this challenge, we propose a derivative-free optimization framework based on the evolutionary algorithm (Evo-Merging) that enables effective model merging using only inference-time API queries. Our method consists of two key components: (1) sparsity-based denoising, designed to identify and filter out irrelevant or redundant information across models, and (2) sign-aware scaling, which dynamically computes optimal combination weights for the relevant models based on their performance. We also provide a formal justification, along with a theoretical analysis, for our asymmetric sparsification. Extensive experimental evaluations demonstrate that our approach achieves state-of-the-art results on a range of tasks, significantly outperforming existing strong baselines.

Despite the proven effectiveness of Transformer neural networks across multiple domains, their performance with Electronic Health Records (EHR) can be nuanced. The unique, multidimensional sequential nature of EHR data can sometimes make even simple linear models with carefully engineered features more competitive. Thus, the advantages of Transformers, such as efficient transfer learning and improved scalability are not always fully exploited in EHR applications. Addressing these challenges, we introduce SANSformer, an attention-free sequential model designed with specific inductive biases to cater for the unique characteristics of EHR data. In this work, we aim to forecast the demand for healthcare services, by predicting the number of patient visits to healthcare facilities. The challenge amplifies when dealing with divergent patient subgroups, like those with rare diseases, which are characterized by unique health trajectories and are typically smaller in size. To address this, we employ a self-supervised pretraining strategy, Generative Summary Pretraining (GSP), which predicts future summary statistics based on past health records of a patient. Our models are pretrained on a health registry of nearly one million patients, then fine-tuned for specific subgroup prediction tasks, showcasing the potential to handle the multifaceted nature of EHR data. In evaluation, SANSformer consistently surpasses robust EHR baselines, with our GSP pretraining method notably amplifying model performance, particularly within smaller patient subgroups. Our results illuminate the promising potential of tailored attention-free models and self-supervised pretraining in refining healthcare utilization predictions across various patient demographics.

We introduce SoftTiger, a clinical large language model (CLaM) designed as a foundation model for healthcare workflows. The narrative and unstructured nature of clinical notes is a major obstacle for healthcare intelligentization. We address a critical problem of structuring clinical notes into clinical data, according to international interoperability standards. We collect and annotate data for three subtasks, namely, international patient summary, clinical impression and medical encounter. We then supervised fine-tuned a state-of-the-art LLM using public and credentialed clinical data. The training is orchestrated in a way that the target model can first support basic clinical tasks such as abbreviation expansion and temporal information extraction, and then learn to perform more complex downstream clinical tasks. Moreover, we address several modeling challenges in the healthcare context, e.g., extra long context window. Our blind pairwise evaluation shows that SoftTiger outperforms other popular open-source models and GPT-3.5, comparable to Gemini-pro, with a mild gap from GPT-4. We believe that LLMs may become a step-stone towards healthcare digitalization and democratization. Therefore, we publicly release SoftTiger models at scales of 13 billion and 70 billion parameters, as well as datasets and code for our innovative scalable evaluation, hopefully, making a significant contribution to the healthcare industry.

We study the code generation behavior of instruction-tuned models built on top of code pre-trained language models when they could access an auxiliary function to implement a function. We design several ways to provide auxiliary functions to the models by adding them to the query or providing a response prefix to incorporate the ability to utilize auxiliary functions with the instruction-following capability. Our experimental results show the effectiveness of combining the base models' auxiliary function utilization ability with the instruction following ability. In particular, the performance of adopting our approaches with the open-sourced language models surpasses that of the recent powerful proprietary language models, i.e., gpt-4o.

The recent surge in Time Series Foundation Models has rapidly advanced the field, yet the heterogeneous training setups across studies make it difficult to attribute improvements to architectural innovations versus data engineering. In this work, we investigate the potential of a standard patch Transformer, demonstrating that this generic architecture achieves state-of-the-art zero-shot forecasting performance using a straightforward training protocol. We conduct a comprehensive ablation study that covers model scaling, data composition, and training techniques to isolate the essential ingredients for high performance. Our findings identify the key drivers of performance, while confirming that the generic architecture itself demonstrates excellent scalability. By strictly controlling these variables, we provide comprehensive empirical results on model scaling across multiple dimensions. We release our open-source model and detailed findings to establish a transparent, reproducible baseline for future research.

Asynchronous reinforcement learning improves throughput by decoupling rollout generation from optimization, but staleness is an inevitable byproduct compounded by policy lag, engine delays, and mixture-of-experts routing. From a trust-region perspective, this mismatch is critical: training-inference divergence governs approximation error in finite-horizon bounds, whereas PPO clipping only gates sampled outward updates, acting as a sampled surrogate rather than a full-policy constraint. As a result, high-staleness updates remain weakly controlled in the asynchronous regime where stale rollouts matter most. We introduce the Staleness-Adaptive Trust Region (SAT), which uses the detached sampled log-ratio as a practical staleness proxy, identifies high-mismatch tails within each batch via staleness-based kernel scaling, and contracts only the sign-selected endpoint of the nominal PPO interval. This preserves baseline behavior on ordinary tokens while enforcing more conservative updates on newly intercepted outward bands. We prove local interval containment and pointwise pessimism relative to PPO, showing how the adaptive rule reshapes update geometry under heterogeneous staleness. We evaluate SAT in a decoupled asynchronous RL setup built on Qwen3-30B-A3B-Base, using SGLang as the inference engine and Megatron for training. In this setting, SAT-GSPO w/ R3 achieves the best observed AIME24 avg@8, reaching 35.83 at lag 1 and 34.79 at lag 8, while SAT-GSPO reaches 34.17 at lag 1. Adaptive clipping and routing replay act as complementary stabilizers targeting mismatch tails and routing inconsistency, respectively. Overall, aligning clip intervals with staleness heterogeneity effectively stabilizes asynchronous RL.

Medication reconciliation at clinical handoffs is a high-stakes, error-prone process. Large language models are increasingly proposed to assist with this task using FHIR-structured patient records, but a fundamental and largely unstudied variable is how the FHIR data is serialised before being passed to the model. We present the first systematic comparison of four FHIR serialisation strategies (Raw JSON, Markdown Table, Clinical Narrative, and Chronological Timeline) across five open-weight models (Phi-3.5-mini, Mistral-7B, BioMistral-7B, Llama-3.1-8B, Llama-3.3-70B) on a controlled benchmark of 200 synthetic patients, totalling 4,000 inference runs. We find that serialisation strategy has a large, statistically significant effect on performance for models up to 8B parameters: Clinical Narrative outperforms Raw JSON by up to 19 F1 points for Mistral-7B (r = 0.617, p < 10^{-10}). This advantage reverses at 70B, where Raw JSON achieves the best mean F1 of 0.9956. In all 20 model and strategy combinations, mean precision exceeds mean recall: omission is the dominant failure mode, with models more often missing an active medication than fabricating one, which changes how clinical safety auditing priorities should be set. Smaller models plateau at roughly 7-10 concurrent active medications, leaving polypharmacy patients, the patients most at risk from reconciliation errors, systematically underserved. BioMistral-7B, a domain-pretrained model without instruction tuning, produces zero usable output in all conditions, showing that domain pretraining alone is not sufficient for structured extraction. These results offer practical, evidence-based format recommendations for clinical LLM deployment: Clinical Narrative for models up to 8B, Raw JSON for 70B and above. The complete pipeline is reproducible on open-source tools running on an AWS g6e.xlarge instance (NVIDIA L40S, 48 GB VRAM).

Compared with full client participation, partial client participation is a more practical scenario in federated learning, but it may amplify some challenges in federated learning, such as data heterogeneity. The lack of inactive clients' updates in partial client participation makes it more likely for the model aggregation to deviate from the aggregation based on full client participation. Training with large batches on individual clients is proposed to address data heterogeneity in general, but their effectiveness under partial client participation is not clear. Motivated by these challenges, we propose to develop a novel federated learning framework, referred to as FedAMD, for partial client participation. The core idea is anchor sampling, which separates partial participants into anchor and miner groups. Each client in the anchor group aims at the local bullseye with the gradient computation using a large batch. Guided by the bullseyes, clients in the miner group steer multiple near-optimal local updates using small batches and update the global model. By integrating the results of the two groups, FedAMD is able to accelerate the training process and improve the model performance. Measured by epsilon-approximation and compared to the state-of-the-art methods, FedAMD achieves the convergence by up to O(1/epsilon) fewer communication rounds under non-convex objectives. Empirical studies on real-world datasets validate the effectiveness of FedAMD and demonstrate the superiority of the proposed algorithm: Not only does it considerably save computation and communication costs, but also the test accuracy significantly improves.

Foundation Models (FMs) trained on Electronic Health Records (EHRs) have achieved state-of-the-art results on numerous clinical prediction tasks. However, most existing EHR FMs have context windows of <1k tokens. This prevents them from modeling full patient EHRs which can exceed 10k's of events. Recent advancements in subquadratic long-context architectures (e.g., Mamba) offer a promising solution. However, their application to EHR data has not been well-studied. We address this gap by presenting the first systematic evaluation of the effect of context length on modeling EHR data. We find that longer context models improve predictive performance -- our Mamba-based model surpasses the prior state-of-the-art on 9/14 tasks on the EHRSHOT prediction benchmark. For clinical applications, however, model performance alone is insufficient -- robustness to the unique properties of EHR is crucial. Thus, we also evaluate models across three previously underexplored properties of EHR data: (1) the prevalence of "copy-forwarded" diagnoses which creates artificial repetition of tokens within EHR sequences; (2) the irregular time intervals between EHR events which can lead to a wide range of timespans within a context window; and (3) the natural increase in disease complexity over time which makes later tokens in the EHR harder to predict than earlier ones. Stratifying our EHRSHOT results, we find that higher levels of each property correlate negatively with model performance, but that longer context models are more robust to more extreme levels of these properties. Our work highlights the potential for using long-context architectures to model EHR data, and offers a case study for identifying new challenges in modeling sequential data motivated by domains outside of natural language. We release our models and code at: https://github.com/som-shahlab/long_context_clues

To continuously improve quality and reflect changes in data, machine learning applications have to regularly retrain and update their core models. We show that a differential analysis of language model snapshots before and after an update can reveal a surprising amount of detailed information about changes in the training data. We propose two new metrics---differential score and differential rank---for analyzing the leakage due to updates of natural language models. We perform leakage analysis using these metrics across models trained on several different datasets using different methods and configurations. We discuss the privacy implications of our findings, propose mitigation strategies and evaluate their effect.

Large Language Models (LLMs) heavily rely on high-quality training data, making data valuation crucial for optimizing model performance, especially when working within a limited budget. In this work, we aim to offer a third-party data valuation approach that benefits both data providers and model developers. We introduce a linearized future influence kernel (LinFiK), which assesses the value of individual data samples in improving LLM performance during training. We further propose ALinFiK, a learning strategy to approximate LinFiK, enabling scalable data valuation. Our comprehensive evaluations demonstrate that this approach surpasses existing baselines in effectiveness and efficiency, demonstrating significant scalability advantages as LLM parameters increase.

Large language models can generate plausible quantum code, but it is unclear whether they can reliably target the specific software development kit (SDK) version requested by the user. We study this problem as API drift and introduce quantum-api-drift, a benchmark for measuring version fidelity, defined here as execution success on the requested SDK version, cross-version compatibility, failure modes, and documentation-guided repair in LLM-generated quantum SDK code. We instantiate the benchmark with Qiskit, a representative quantum SDK that underwent substantial interface changes across v0.43, v1.3, and v2.0. We evaluate 17 models on 50 tasks with 3 samples per prompt, yielding 450 generated samples and 1,350 executions per model. Sixteen models are tested in a matched REST API setting with a 1024-token output cap, while GPT-5.4 (Codex CLI) is reported separately as a reference configuration. Across the 16 matched REST models, diagonal Pass@1 ranges from 0.02 to 0.85. Claude Opus 4.7 is strongest on v0.43 and v2.0, while Grok 4.20 is strongest on v1.3 at 0.513. Error profiles differ systematically by model strength: weaker models fail mainly with broken imports, while stronger models more often reach deprecation-level failures. Documentation-guided repair succeeds for 0.19 to 0.59 of repair attempts overall and is consistently much more effective for migration to v2.0 than to v1.3. The benchmark artifacts are publicly available at https://github.com/arasyi/quantum-api-drift. These results show that version alignment is a distinct evaluation axis for quantum code generation and that API drift remains only partly recoverable even with migration guidance.

Clinical trial matching is the task of identifying trials for which patients may be potentially eligible. Typically, this task is labor-intensive and requires detailed verification of patient electronic health records (EHRs) against the stringent inclusion and exclusion criteria of clinical trials. This process is manual, time-intensive, and challenging to scale up, resulting in many patients missing out on potential therapeutic options. Recent advancements in Large Language Models (LLMs) have made automating patient-trial matching possible, as shown in multiple concurrent research studies. However, the current approaches are confined to constrained, often synthetic datasets that do not adequately mirror the complexities encountered in real-world medical data. In this study, we present the first, end-to-end large-scale empirical evaluation of clinical trial matching using real-world EHRs. Our study showcases the capability of LLMs to accurately match patients with appropriate clinical trials. We perform experiments with proprietary LLMs, including GPT-4 and GPT-3.5, as well as our custom fine-tuned model called OncoLLM and show that OncoLLM, despite its significantly smaller size, not only outperforms GPT-3.5 but also matches the performance of qualified medical doctors. All experiments were carried out on real-world EHRs that include clinical notes and available clinical trials from a single cancer center in the United States.

As innovation in deep learning continues, many engineers seek to adopt Pre-Trained Models (PTMs) as components in computer systems. Researchers publish PTMs, which engineers adapt for quality or performance prior to deployment. PTM authors should choose appropriate names for their PTMs, which would facilitate model discovery and reuse. However, prior research has reported that model names are not always well chosen - and are sometimes erroneous. The naming for PTM packages has not been systematically studied. In this paper, we frame and conduct the first empirical investigation of PTM naming practices in the Hugging Face PTM registry. We initiated our study with a survey of 108 Hugging Face users to understand the practices in PTM naming. From our survey analysis, we highlight discrepancies from traditional software package naming, and present findings on naming practices. Our findings indicate there is a great mismatch between engineers' preferences and practical practices of PTM naming. We also present practices on detecting naming anomalies and introduce a novel automated DNN ARchitecture Assessment technique (DARA), capable of detecting PTM naming anomalies. We envision future works on leveraging meta-features of PTMs to improve model reuse and trustworthiness.

Despite the ability to train capable LLMs, the methodology for maintaining their relevancy and rectifying errors remains elusive. To this end, the past few years have witnessed a surge in techniques for editing LLMs, the objective of which is to efficiently alter the behavior of LLMs within a specific domain without negatively impacting performance across other inputs. This paper embarks on a deep exploration of the problems, methods, and opportunities related to model editing for LLMs. In particular, we provide an exhaustive overview of the task definition and challenges associated with model editing, along with an in-depth empirical analysis of the most progressive methods currently at our disposal. We also build a new benchmark dataset to facilitate a more robust evaluation and pinpoint enduring issues intrinsic to existing techniques. Our objective is to provide valuable insights into the effectiveness and feasibility of each editing technique, thereby assisting the community in making informed decisions on the selection of the most appropriate method for a specific task or context. Code and datasets are available at https://github.com/zjunlp/EasyEdit.

Behavior of deep neural networks can be inconsistent between different versions. Regressions during model update are a common cause of concern that often over-weigh the benefits in accuracy or efficiency gain. This work focuses on quantifying, reducing and analyzing regression errors in the NLP model updates. Using negative flip rate as regression measure, we show that regression has a prevalent presence across tasks in the GLUE benchmark. We formulate the regression-free model updates into a constrained optimization problem, and further reduce it into a relaxed form which can be approximately optimized through knowledge distillation training method. We empirically analyze how model ensemble reduces regression. Finally, we conduct CheckList behavioral testing to understand the distribution of regressions across linguistic phenomena, and the efficacy of ensemble and distillation methods.

Foundation models are routinely fine-tuned for use in particular domains, yet safety assessments are typically conducted only on base models, implicitly assuming that safety properties persist through downstream adaptation. We test this assumption by analyzing the safety behavior of 100 models, including widely deployed fine-tunes in the medical and legal domains as well as controlled adaptations of open foundation models alongside their bases. Across general-purpose and domain-specific safety benchmarks, we find that benign fine-tuning induces large, heterogeneous, and often contradictory changes in measured safety: models frequently improve on some instruments while degrading on others, with substantial disagreement across evaluations. These results show that safety behavior is not stable under ordinary downstream adaptation, raising critical questions about governance and deployment practices centered on base-model evaluations. Without explicit re-evaluation of fine-tuned models in deployment-relevant contexts, such approaches fall short of adequately managing downstream risk, overlooking practical sources of harm -- failures that are especially consequential in high-stakes settings and challenge current accountability paradigms.

Parallel coding agents can independently produce locally valid changes while still interfering at integration time, expanding beyond planned scope, or relying on premises invalidated by concurrent work. Existing responses emphasize communication, isolated workspaces, late merge-time repair, continuous supervision, or post-hoc runtime recovery. This paper presents Claim Plane, a model-agnostic coordination architecture that treats concurrent software change as a pre-write admission problem. Before implementation, each worker declares a versioned ChangeIntent containing an exact base commit, typed resources, dependencies, and operations marked as committed or contingent. A deterministic control plane atomically admits compatible intents, constrains same-file parallelism to declared regions, serializes unresolved overlap, tracks dependency invalidation, and fails closed on ambiguous authority. During execution, a contingent mutation does not reserve write ownership initially; the first attempted mutation triggers atomic scope promotion and re-admission against the current active set. Brokered execution binds capabilities to intent versions, leases, OS-level worktree locks, monotonic fencing tokens, and Git-tree provenance, while integration verifies immutable patches and evidence. A preliminary six-pair CooperBench mechanism check is reported only as feasibility evidence: static Claim Plane achieved 6/6 pair passes with full serialization, while dynamic scope retained parallel admission on half of the pairs, performed seven successful scope promotions, and failed closed on two undeclared mutations. The sample is intentionally too small for comparative claims. We argue that separating probabilistic planning from deterministic authority provides a foundation for a future learned semantic-dependency model and frontier-model escalation only on unresolved cases.

Since the COVID-19 pandemic, clinicians have seen a large and sustained influx in patient portal messages, significantly contributing to clinician burnout. To the best of our knowledge, there are no large-scale public patient portal messages corpora researchers can use to build tools to optimize clinician portal workflows. Informed by our ongoing work with a regional hospital, this study introduces an LLM-powered framework for configurable and realistic patient portal message generation. Our approach leverages few-shot grounded text generation, requiring only a small number of de-identified patient portal messages to help LLMs better match the true style and tone of real data. Clinical experts in our team deem this framework as HIPAA-friendly, unlike existing privacy-preserving approaches to synthetic text generation which cannot guarantee all sensitive attributes will be protected. Through extensive quantitative and human evaluation, we show that our framework produces data of higher quality than comparable generation methods as well as all related datasets. We believe this work provides a path forward for (i) the release of large-scale synthetic patient message datasets that are stylistically similar to ground-truth samples and (ii) HIPAA-friendly data generation which requires minimal human de-identification efforts.

In this study, we provide solutions to two practical yet overlooked scenarios in federated learning for electronic health records (EHRs): firstly, we introduce EHRFL, a framework that facilitates federated learning across healthcare institutions with distinct medical coding systems and database schemas using text-based linearization of EHRs. Secondly, we focus on a scenario where a single healthcare institution initiates federated learning to build a model tailored for itself, in which the number of clients must be optimized in order to reduce expenses incurred by the host. For selecting participating clients, we present a novel precision-based method, leveraging data latents to identify suitable participants for the institution. Our empirical results show that EHRFL effectively enables federated learning across hospitals with different EHR systems. Furthermore, our results demonstrate the efficacy of our precision-based method in selecting reduced number of participating clients without compromising model performance, resulting in lower operational costs when constructing institution-specific models. We believe this work lays a foundation for the broader adoption of federated learning on EHRs.

Advances in large language models (LLMs) provide new opportunities in healthcare for improved patient care, clinical decision-making, and enhancement of physician and administrator workflows. However, the potential of these models importantly depends on their ability to generalize effectively across clinical environments and populations, a challenge often underestimated in early development. To better understand reasons for these challenges and inform mitigation approaches, we evaluated ClinicLLM, an LLM trained on [HOSPITAL]'s clinical notes, analyzing its performance on 30-day all-cause readmission prediction focusing on variability across hospitals and patient characteristics. We found poorer generalization particularly in hospitals with fewer samples, among patients with government and unspecified insurance, the elderly, and those with high comorbidities. To understand reasons for lack of generalization, we investigated sample sizes for fine-tuning, note content (number of words per note), patient characteristics (comorbidity level, age, insurance type, borough), and health system aspects (hospital, all-cause 30-day readmission, and mortality rates). We used descriptive statistics and supervised classification to identify features. We found that, along with sample size, patient age, number of comorbidities, and the number of words in notes are all important factors related to generalization. Finally, we compared local fine-tuning (hospital specific), instance-based augmented fine-tuning and cluster-based fine-tuning for improving generalization. Among these, local fine-tuning proved most effective, increasing AUC by 0.25% to 11.74% (most helpful in settings with limited data). Overall, this study provides new insights for enhancing the deployment of large language models in the societally important domain of healthcare, and improving their performance for broader populations.

As a promising approach to deal with distributed data, Federated Learning (FL) achieves major advancements in recent years. FL enables collaborative model training by exploiting the raw data dispersed in multiple edge devices. However, the data is generally non-independent and identically distributed, i.e., statistical heterogeneity, and the edge devices significantly differ in terms of both computation and communication capacity, i.e., system heterogeneity. The statistical heterogeneity leads to severe accuracy degradation while the system heterogeneity significantly prolongs the training process. In order to address the heterogeneity issue, we propose an Asynchronous Staleness-aware Model Update FL framework, i.e., FedASMU, with two novel methods. First, we propose an asynchronous FL system model with a dynamical model aggregation method between updated local models and the global model on the server for superior accuracy and high efficiency. Then, we propose an adaptive local model adjustment method by aggregating the fresh global model with local models on devices to further improve the accuracy. Extensive experimentation with 6 models and 5 public datasets demonstrates that FedASMU significantly outperforms baseline approaches in terms of accuracy (0.60% to 23.90% higher) and efficiency (3.54% to 97.98% faster).

The Model Context Protocol (MCP) has recently emerged as a standardized interface for connecting language models with external tools and data. As the ecosystem rapidly expands, the lack of a structured, comprehensive view of existing MCP artifacts presents challenges for research. To bridge this gap, we introduce MCPCorpus, a large-scale dataset containing around 14K MCP servers and 300 MCP clients. Each artifact is annotated with 20+ normalized attributes capturing its identity, interface configuration, GitHub activity, and metadata. MCPCorpus provides a reproducible snapshot of the real-world MCP ecosystem, enabling studies of adoption trends, ecosystem health, and implementation diversity. To keep pace with the rapid evolution of the MCP ecosystem, we provide utility tools for automated data synchronization, normalization, and inspection. Furthermore, to support efficient exploration and exploitation, we release a lightweight web-based search interface. MCPCorpus is publicly available at: https://github.com/Snakinya/MCPCorpus.

Pre-trained models (PTMs) are machine learning models that have been trained in advance, often on large-scale data, and can be reused for new tasks, thereby reducing the need for costly training from scratch. Their widespread adoption introduces a new class of software dependency, which we term Software Dependencies 2.0, extending beyond conventional libraries to learned behaviors embodied in trained models and their associated artifacts. The integration of PTMs as software dependencies in real projects remains unclear, potentially threatening maintainability and reliability of modern software systems that increasingly rely on them. Objective: In this study, we investigate Software Dependencies 2.0 in open-source software (OSS) projects by examining the reuse of PTMs, with a focus on how developers manage and integrate these models. Specifically, we seek to understand: (1) how OSS projects structure and document their PTM dependencies; (2) what stages and organizational patterns emerge in the reuse pipelines of PTMs within these projects; and (3) the interactions among PTMs and other learned components across pipeline stages. We conduct a mixed-methods analysis of a statistically significant random sample of 401 GitHub repositories from the PeaTMOSS dataset (28,575 repositories reusing PTMs from Hugging Face and PyTorch Hub). We quantitatively examine PTM reuse by identifying patterns and qualitatively investigate how developers integrate and manage these models in practice.

The rapid development of AI systems has been greatly influenced by the emergence of foundation models. A common approach for targeted problems involves fine-tuning these pre-trained foundation models for specific target tasks, resulting in a rapid spread of models fine-tuned across a diverse array of tasks. This work focuses on the problem of merging multiple fine-tunings of the same foundation model derived from a spectrum of auxiliary tasks. We introduce a new simple method, Model Breadcrumbs, which consists of a sparsely defined set of weights that carve out a trajectory within the weight space of a pre-trained model, enhancing task performance when traversed. These breadcrumbs are constructed by subtracting the weights from a pre-trained model before and after fine-tuning, followed by a sparsification process that eliminates weight outliers and negligible perturbations. Our experiments demonstrate the effectiveness of Model Breadcrumbs to simultaneously improve performance across multiple tasks. This contribution aligns with the evolving paradigm of updatable machine learning, reminiscent of the collaborative principles underlying open-source software development, fostering a community-driven effort to reliably update machine learning models. Our method is shown to be more efficient and unlike previous proposals does not require hyperparameter tuning for each new task added. Through extensive experimentation involving various models, tasks, and modalities we establish that integrating Model Breadcrumbs offers a simple, efficient, and highly effective approach for constructing multi-task models and facilitating updates to foundation models.

We present HealthBench, an open-source benchmark measuring the performance and safety of large language models in healthcare. HealthBench consists of 5,000 multi-turn conversations between a model and an individual user or healthcare professional. Responses are evaluated using conversation-specific rubrics created by 262 physicians. Unlike previous multiple-choice or short-answer benchmarks, HealthBench enables realistic, open-ended evaluation through 48,562 unique rubric criteria spanning several health contexts (e.g., emergencies, transforming clinical data, global health) and behavioral dimensions (e.g., accuracy, instruction following, communication). HealthBench performance over the last two years reflects steady initial progress (compare GPT-3.5 Turbo's 16% to GPT-4o's 32%) and more rapid recent improvements (o3 scores 60%). Smaller models have especially improved: GPT-4.1 nano outperforms GPT-4o and is 25 times cheaper. We additionally release two HealthBench variations: HealthBench Consensus, which includes 34 particularly important dimensions of model behavior validated via physician consensus, and HealthBench Hard, where the current top score is 32%. We hope that HealthBench grounds progress towards model development and applications that benefit human health.

Time series models face significant challenges in scaling to handle large and complex datasets, akin to the scaling achieved by large language models (LLMs). The unique characteristics of time series data and the computational demands of model scaling necessitate innovative approaches. While researchers have explored various architectures such as Transformers, LSTMs, and GRUs to address these challenges, we propose a novel solution using RWKV-7, which incorporates meta-learning into its state update mechanism. By integrating RWKV-7's time mix and channel mix components into the transformer-based time series model Timer, we achieve a substantial performance improvement of approximately 1.13 to 43.3x and a 4.5x reduction in training time with 1/23 parameters, all while utilizing fewer parameters. Our code and model weights are publicly available for further research and development at https://github.com/Alic-Li/BlackGoose_Rimer.

The widespread adoption of cloud-based proprietary large language models (LLMs) has introduced significant challenges, including operational dependencies, privacy concerns, and the necessity of continuous internet connectivity. In this work, we introduce an LLMOps pipeline, "LlamaDuo", for the seamless migration of knowledge and abilities from service-oriented LLMs to smaller, locally manageable models. This pipeline is crucial for ensuring service continuity in the presence of operational failures, strict privacy policies, or offline requirements. Our LlamaDuo involves fine-tuning a small language model against the service LLM using a synthetic dataset generated by the latter. If the performance of the fine-tuned model falls short of expectations, it is enhanced by further fine-tuning with additional similar data created by the service LLM. This iterative process guarantees that the smaller model can eventually match or even surpass the service LLM's capabilities in specific downstream tasks, offering a practical and scalable solution for managing AI deployments in constrained environments. Extensive experiments with leading edge LLMs are conducted to demonstrate the effectiveness, adaptability, and affordability of LlamaDuo across various downstream tasks. Our pipeline implementation is available at https://github.com/deep-diver/llamaduo.

Large Language Models (LLMs) have exhibited exceptional performance in software engineering yet face challenges in adapting to continually evolving code knowledge, particularly regarding the frequent updates of third-party library APIs. This limitation, stemming from static pre-training datasets, often results in non-executable code or implementations with suboptimal safety and efficiency. To this end, this paper introduces CODESYNC, a data engine for identifying outdated code patterns and collecting real-time code knowledge updates from Python third-party libraries. Building upon CODESYNC, we develop CODESYNCBENCH, a comprehensive benchmark for assessing LLMs' ability to stay synchronized with code evolution, which covers real-world updates for 220 APIs from six Python libraries. Our benchmark offers 3,300 test cases across three evaluation tasks and an update-aware instruction tuning dataset consisting of 2,200 training samples. Extensive experiments on 14 state-of-the-art LLMs reveal that they struggle with dynamic code evolution, even with the support of advanced knowledge updating methods (e.g., DPO, ORPO, and SimPO). We believe that our benchmark can offer a strong foundation for the development of more effective methods for real-time code knowledge updating in the future. The experimental code and dataset are publicly available at: https://github.com/Lucky-voyage/Code-Sync.

Although large language models (LLMs) are impressive in solving various tasks, they can quickly be outdated after deployment. Maintaining their up-to-date status is a pressing concern in the current era. This paper provides a comprehensive review of recent advances in aligning LLMs with the ever-changing world knowledge without re-training from scratch. We categorize research works systemically and provide in-depth comparisons and discussion. We also discuss existing challenges and highlight future directions to facilitate research in this field. We release the paper list at https://github.com/hyintell/awesome-refreshing-llms

As Large Language Models (LLMs) are increasingly integrated into software development workflows, their trustworthiness has become a critical concern. However, in dependency recommendation scenarios, the reliability of LLMs is undermined by widespread package hallucinations, where models often recommend hallucinated packages. Recent studies have proposed a range of approaches to mitigate this issue. Nevertheless, existing approaches typically merely reduce hallucination rates rather than eliminate them, leaving persistent software security risks. In this work, we argue that package hallucinations are theoretically preventable based on the key insight that package validity is decidable through finite and enumerable authoritative package lists. Building on this, we propose PackMonitor, the first approach capable of fundamentally eliminating package hallucinations by continuously monitoring the model's decoding process and intervening when necessary. To implement this in practice, PackMonitor addresses three key challenges: (1) determining when to trigger intervention via a Context-Aware Parser that continuously monitors model outputs and selectively activates intervening only during installation command generation; (2) resolving how to intervene by employing a Package-Name Intervenor that strictly limits the decoding space to an authoritative package list; and (3) ensuring monitoring efficiency through a DFA-Caching Mechanism that enables scalability to millions of packages with negligible overhead. Extensive experiments on five widely used LLMs demonstrate that PackMonitor is a training-free, plug-and-play solution that consistently reduces package hallucination rates to zero while maintaining low-latency inference and preserving original model capabilities.

Domain models are central to software engineering, as they enable a shared understanding, guide implementation, and support automated analyses and model-driven development. Yet, despite these benefits, practitioners often skip modeling because it is time-consuming and demands scarce expertise. We address this barrier by investigating whether open-weight large language models, adapted via instruction tuning, can generate high-quality BPMN process models directly from natural language descriptions in a cost-effective and privacy-preserving way. We introduce InstruBPM, a reproducible approach that prepares paired text-diagram data and instruction tunes an open source large language model with parameter-efficient fine-tuning and quantization for on-prem deployment. We evaluate the tuned model through complementary perspectives: (i) text/code similarity using BLEU, ROUGE-L, and METEOR, (ii) structural fidelity using Relative Graph Edit Distance, (iii) guidelines conformance using external tool checks, and (iv) a small expert review. Using a curated subset of a multi-domain BPMN dataset, we compare the tuned model with untuned open-weight baselines and strong proprietary models under consistent prompting regimes. Our compact tuned model outperforms all baselines across sequence and structural metrics while requiring substantially fewer resources; guideline analysis and expert feedback further indicate that the generated diagrams largely follow BPMN best practices and are useful starting points that reduce modeling effort. Overall, instruction tuning improves structural accuracy and robustness compared to untuned baselines and reduces reliance on heavy prompt scaffolding. We publicly share the trained models and scripts to support reproducibility and further research.

Over the past several years, across the globe, there has been an increase in people seeking care in emergency departments (EDs). ED resources, including nurse staffing, are strained by such increases in patient volume. Accurate forecasting of incoming patient volume in emergency departments (ED) is crucial for efficient utilization and allocation of ED resources. Working with a suburban ED in the Pacific Northwest, we developed a tool powered by machine learning models, to forecast ED arrivals and ED patient volume to assist end-users, such as ED nurses, in resource allocation. In this paper, we discuss the results from our predictive models, the challenges, and the learnings from users' experiences with the tool in active clinical deployment in a real world setting.

Recent model editing techniques promise to mitigate the problem of memorizing false or outdated associations during LLM training. However, we show that these techniques can introduce large unwanted side effects which are not detected by existing specificity benchmarks. We extend the existing CounterFact benchmark to include a dynamic component and dub our benchmark CounterFact+. Additionally, we extend the metrics used for measuring specificity by a principled KL divergence-based metric. We use this improved benchmark to evaluate recent model editing techniques and find that they suffer from low specificity. Our findings highlight the need for improved specificity benchmarks that identify and prevent unwanted side effects.

LLMs have long demonstrated remarkable effectiveness in automatic program repair (APR), with OpenAI's ChatGPT being one of the most widely used models in this domain. Through continuous iterations and upgrades of GPT-family models, their performance in fixing bugs has already reached state-of-the-art levels. However, there are few works comparing the effectiveness and variations of different versions of GPT-family models on APR. In this work, inspired by the recent public release of the GPT-o1 models, we conduct the first study to compare the effectiveness of different versions of the GPT-family models in APR. We evaluate the performance of the latest version of the GPT-family models (i.e., O1-preview and O1-mini), GPT-4o, and the historical version of ChatGPT on APR. We conduct an empirical study of the four GPT-family models against other LLMs and APR techniques on the QuixBugs benchmark from multiple evaluation perspectives, including repair success rate, repair cost, response length, and behavior patterns. The results demonstrate that O1's repair capability exceeds that of prior GPT-family models, successfully fixing all 40 bugs in the benchmark. Our work can serve as a foundation for further in-depth exploration of the applications of GPT-family models in APR.

Current transformer language models (LM) are large-scale models with billions of parameters. They have been shown to provide high performances on a variety of tasks but are also prone to shortcut learning and bias. Addressing such incorrect model behavior via parameter adjustments is very costly. This is particularly problematic for updating dynamic concepts, such as moral values, which vary culturally or interpersonally. In this work, we question the current common practice of storing all information in the model parameters and propose the Revision Transformer (RiT) to facilitate easy model updating. The specific combination of a large-scale pre-trained LM that inherently but also diffusely encodes world knowledge with a clear-structured revision engine makes it possible to update the model's knowledge with little effort and the help of user interaction. We exemplify RiT on a moral dataset and simulate user feedback demonstrating strong performance in model revision even with small data. This way, users can easily design a model regarding their preferences, paving the way for more transparent AI models.

Healthcare systems continuously generate vast amounts of electronic health records (EHRs), commonly stored in the Fast Healthcare Interoperability Resources (FHIR) standard. Despite the wealth of information in these records, their complexity and volume make it difficult for users to retrieve and interpret crucial health insights. Recent advances in Large Language Models (LLMs) offer a solution, enabling semantic question answering (QA) over medical data, allowing users to interact with their health records more effectively. However, ensuring privacy and compliance requires edge and private deployments of LLMs. This paper proposes a novel approach to semantic QA over EHRs by first identifying the most relevant FHIR resources for a user query (Task1) and subsequently answering the query based on these resources (Task2). We explore the performance of privately hosted, fine-tuned LLMs, evaluating them against benchmark models such as GPT-4 and GPT-4o. Our results demonstrate that fine-tuned LLMs, while 250x smaller in size, outperform GPT-4 family models by 0.55% in F1 score on Task1 and 42% on Meteor Task in Task2. Additionally, we examine advanced aspects of LLM usage, including sequential fine-tuning, model self-evaluation (narcissistic evaluation), and the impact of training data size on performance. The models and datasets are available here: https://huggingface.co/genloop

As Large Multimodal Models (LMMs) scale up and reinforcement learning (RL) methods mature, LMMs have made notable progress in complex reasoning and decision making. Yet training still relies on static data and fixed recipes, making it difficult to diagnose capability blind spots or provide dynamic, targeted reinforcement. Motivated by findings that test driven error exposure and feedback based correction outperform repetitive practice, we propose Diagnostic-driven Progressive Evolution (DPE), a spiral loop where diagnosis steers data generation and reinforcement, and each iteration re-diagnoses the updated model to drive the next round of targeted improvement. DPE has two key components. First, multiple agents annotate and quality control massive unlabeled multimodal data, using tools such as web search and image editing to produce diverse, realistic samples. Second, DPE attributes failures to specific weaknesses, dynamically adjusts the data mixture, and guides agents to generate weakness focused data for targeted reinforcement. Experiments on Qwen3-VL-8B-Instruct and Qwen2.5-VL-7B-Instruct show stable, continual gains across eleven benchmarks, indicating DPE as a scalable paradigm for continual LMM training under open task distributions. Our code, models, and data are publicly available at https://github.com/hongruijia/DPE.