Alaa Youssef

Chen Wang, Xunzhuo Liu, Yue Zhu et al.

LLM serving systems process heterogeneous query workloads where different categories exhibit different characteristics. Code queries cluster densely in embedding space while conversational queries distribute sparsely. Content staleness varies from minutes (stock data) to months (code patterns). Query repetition patterns range from power-law (code) to uniform (conversation), producing long tail cache hit rate distributions: high-repetition categories achieve 40-60% hit rates while low-repetition or volatile categories achieve 5-15% hit rates. Vector databases must exclude the long tail because remote search costs (30ms) require 15--20% hit rates to break even, leaving 20-30% of production traffic uncached. Uniform cache policies compound this problem: fixed thresholds cause false positives in dense spaces and miss valid paraphrases in sparse spaces; fixed TTLs waste memory or serve stale data. This paper presents category-aware semantic caching where similarity thresholds, TTLs, and quotas vary by query category. We present a hybrid architecture separating in-memory HNSW search from external document storage, reducing miss cost from 30ms to 2ms. This reduction makes low-hit-rate categories economically viable (break-even at 3-5% versus 15-20%), enabling cache coverage across the entire workload distribution. Adaptive load-based policies extend this framework to respond to downstream model load, dynamically adjusting thresholds and TTLs to reduce traffic to overloaded models by 9-17% in theoretical projections.

Alison Callahan, Duncan McElfresh, Juan M. Banda et al.

The impact of using artificial intelligence (AI) to guide patient care or operational processes is an interplay of the AI model's output, the decision-making protocol based on that output, and the capacity of the stakeholders involved to take the necessary subsequent action. Estimating the effects of this interplay before deployment, and studying it in real time afterwards, are essential to bridge the chasm between AI model development and achievable benefit. To accomplish this, the Data Science team at Stanford Health Care has developed a Testing and Evaluation (T&E) mechanism to identify fair, useful and reliable AI models (FURM) by conducting an ethical review to identify potential value mismatches, simulations to estimate usefulness, financial projections to assess sustainability, as well as analyses to determine IT feasibility, design a deployment strategy, and recommend a prospective monitoring and evaluation plan. We report on FURM assessments done to evaluate six AI guided solutions for potential adoption, spanning clinical and operational settings, each with the potential to impact from several dozen to tens of thousands of patients each year. We describe the assessment process, summarize the six assessments, and share our framework to enable others to conduct similar assessments. Of the six solutions we assessed, two have moved into a planning and implementation phase. Our novel contributions - usefulness estimates by simulation, financial projections to quantify sustainability, and a process to do ethical assessments - as well as their underlying methods and open source tools, are available for other healthcare systems to conduct actionable evaluations of candidate AI solutions.

Ferran Agullo, Joan Oliveras, Chen Wang et al.

With the rapid adoption of Large Language Models (LLMs), LLM-adapters have become increasingly common, providing lightweight specialization of large-scale models. Serving hundreds or thousands of these adapters on a single GPU allows request aggregation, increasing throughput, but may also cause request starvation if GPU memory limits are exceeded. To address this issue, this study focuses on determining the joint configuration of concurrent and parallel adapters that maximizes GPU throughput without inducing starvation, given heterogeneous adapter and traffic properties. We propose a data-driven ML approach leveraging interpretable models to tackle this caching problem and introduce the first Digital Twin capable of reproducing an LLM-adapter serving system, enabling efficient training data generation. Experiments with the vLLM framework and LoRA adapters show that the Digital Twin reproduces throughput within 5.1% of real results, while the ML approach predicts optimal numbers of concurrent and parallel adapters with an error of at most 7.2% under heterogeneous, real-world workloads. The code is publicly available at https://github.com/FerranAgulloLopez/GPULLMAdapterOptimization.

Zhihong Chen, Maya Varma, Justin Xu et al. · mila, oxford

Over 1.4 billion chest X-rays (CXRs) are performed annually due to their cost-effectiveness as an initial diagnostic test. This scale of radiological studies provides a significant opportunity to streamline CXR interpretation and documentation. While foundation models are a promising solution, the lack of publicly available large-scale datasets and benchmarks inhibits their iterative development and real-world evaluation. To overcome these challenges, we constructed a large-scale dataset (CheXinstruct), which we utilized to train a vision-language foundation model (CheXagent). We systematically demonstrated competitive performance across eight distinct task types on our novel evaluation benchmark (CheXbench). Beyond technical validation, we assessed the real-world utility of CheXagent in directly drafting radiology reports. Our clinical assessment with eight radiologists revealed a 36% time saving for residents using CheXagent-drafted reports, while attending radiologists showed no significant time difference editing resident-drafted or CheXagent-drafted reports. The CheXagent-drafted reports improved the writing efficiency of both radiology residents and attending radiologists in 81% and 61% of cases, respectively, without loss of quality. Overall, we demonstrate that CheXagent can effectively perform a variety of CXR interpretation tasks and holds potential to assist radiologists in routine clinical workflows.

Magdalini Paschali, Zhihong Chen, Louis Blankemeier et al. · stanford

Recent advances in artificial intelligence have witnessed the emergence of large-scale deep learning models capable of interpreting and generating both textual and imaging data. Such models, typically referred to as foundation models, are trained on extensive corpora of unlabeled data and demonstrate high performance across various tasks. Foundation models have recently received extensive attention from academic, industry, and regulatory bodies. Given the potentially transformative impact that foundation models can have on the field of radiology, this review aims to establish a standardized terminology concerning foundation models, with a specific focus on the requirements of training data, model training paradigms, model capabilities, and evaluation strategies. We further outline potential pathways to facilitate the training of radiology-specific foundation models, with a critical emphasis on elucidating both the benefits and challenges associated with such models. Overall, we envision that this review can unify technical advances and clinical needs in the training of foundation models for radiology in a safe and responsible manner, for ultimately benefiting patients, providers, and radiologists.

Deming Chen, Alaa Youssef, Ruchi Pendse et al.

This white paper, developed through close collaboration between IBM Research and UIUC researchers within the IIDAI Institute, envisions transforming hybrid cloud systems to meet the growing complexity of AI workloads through innovative, full-stack co-design approaches, emphasizing usability, manageability, affordability, adaptability, efficiency, and scalability. By integrating cutting-edge technologies such as generative and agentic AI, cross-layer automation and optimization, unified control plane, and composable and adaptive system architecture, the proposed framework addresses critical challenges in energy efficiency, performance, and cost-effectiveness. Incorporating quantum computing as it matures will enable quantum-accelerated simulations for materials science, climate modeling, and other high-impact domains. Collaborative efforts between academia and industry are central to this vision, driving advancements in foundation models for material design and climate solutions, scalable multimodal data processing, and enhanced physics-based AI emulators for applications like weather forecasting and carbon sequestration. Research priorities include advancing AI agentic systems, LLM as an Abstraction (LLMaaA), AI model optimization and unified abstractions across heterogeneous infrastructure, end-to-end edge-cloud transformation, efficient programming model, middleware and platform, secure infrastructure, application-adaptive cloud systems, and new quantum-classical collaborative workflows. These ideas and solutions encompass both theoretical and practical research questions, requiring coordinated input and support from the research community. This joint initiative aims to establish hybrid clouds as secure, efficient, and sustainable platforms, fostering breakthroughs in AI-driven applications and scientific discovery across academia, industry, and society.

Pol G. Recasens, Yue Zhu, Chen Wang et al.

Large language models (LLMs) have revolutionized the state-of-the-art of many different natural language processing tasks. Although serving LLMs is computationally and memory demanding, the rise of Small Language Models (SLMs) offers new opportunities for resource-constrained users, who now are able to serve small models with cutting-edge performance. In this paper, we present a set of experiments designed to benchmark SLM inference at performance and energy levels. Our analysis provides a new perspective in serving, highlighting that the small memory footprint of SLMs allows for reaching the Pareto-optimal throughput within the resource capacity of a single accelerator. In this regard, we present an initial set of findings demonstrating how model replication can effectively improve resource utilization for serving SLMs.

Yuyin Zhou, Shih-Cheng Huang, Jason Alan Fries et al.

Despite the routine use of electronic health record (EHR) data by radiologists to contextualize clinical history and inform image interpretation, the majority of deep learning architectures for medical imaging are unimodal, i.e., they only learn features from pixel-level information. Recent research revealing how race can be recovered from pixel data alone highlights the potential for serious biases in models which fail to account for demographics and other key patient attributes. Yet the lack of imaging datasets which capture clinical context, inclusive of demographics and longitudinal medical history, has left multimodal medical imaging underexplored. To better assess these challenges, we present RadFusion, a multimodal, benchmark dataset of 1794 patients with corresponding EHR data and high-resolution computed tomography (CT) scans labeled for pulmonary embolism. We evaluate several representative multimodal fusion models and benchmark their fairness properties across protected subgroups, e.g., gender, race/ethnicity, age. Our results suggest that integrating imaging and EHR data can improve classification performance and robustness without introducing large disparities in the true positive rate between population groups.