Yang Ren

Anran Li, Yuanyuan Chen, Wenjun Long et al.

Large language models (LLMs) have demonstrated strong performance on medical benchmarks, including question answering and diagnosis. To enable their use in clinical settings, LLMs are typically further adapted through continued pretraining or post-training using clinical data. However, most medical LLMs are trained on data from a single institution, which faces limitations in generalizability and safety in heterogeneous systems. Federated learning (FL) is a promising solution for enabling collaborative model development across healthcare institutions. Yet applying FL to LLMs in medicine remains fundamentally limited. First, conventional FL requires transmitting the full model during each communication round, which becomes impractical for multi-billion-parameter LLMs given the limited computational resources. Second, many FL algorithms implicitly assume data homogeneity, whereas real-world clinical data are highly heterogeneous across patients, diseases, and institutional practices. We introduce the model-agnostic and parameter-efficient federated learning framework for adapting LLMs to medical applications. Fed-MedLoRA transmits only low-rank adapter parameters, reducing communication and computation overhead, while Fed-MedLoRA+ further incorporates adaptive, data-aware aggregation to improve convergence under cross-site heterogeneity. We apply the framework to clinical information extraction (IE), which transforms patient narratives into structured medical entities and relations. Accuracy was assessed across five patient cohorts through comparisons with BERT models, and LLaMA-3 and DeepSeek-R1, GPT-4o models. Evaluation settings included (1) in-domain training and testing, (2) external validation on independent cohorts, and (3) a low-resource new-site adaptation scenario using real-world clinical notes from the Yale New Haven Health System.

Rui Zhu, Weiheng Bai, Qiushi Wu et al.

Reinforcement Learning (RL) has emerged as a crucial paradigm for unlocking the advanced reasoning capabilities of Large Language Models (LLMs), encompassing frameworks like RLHF and RLAIF. Regardless of the specific optimization algorithm (e.g., PPO, GRPO, or Online DPO), online RL inherently requires an exploratory trajectory generation (rollout) phase. However, for long-context reasoning tasks, this rollout phase imposes a severe ``memory wall'' due to the exorbitant Key-Value (KV) cache footprint. While applying KV cache compression during rollouts mitigates this memory overhead, it induces a critical off-policy bias. Although modern KV compression is often nearly lossless during standard inference, even minuscule approximation errors are drastically amplified by the inherent instability of RL optimization. Specifically, the sampler generates responses under a sparse context, whereas the learner updates parameters using the full, dense context. Existing statistical solutions, such as importance reweighting, struggle to correct this magnified bias, suffering from high gradient variance and severe sample inefficiency.

Sai Krishna Revanth Vuruma, Dezhi Wu, Saborny Sen Gupta et al.

The widespread adoption of social media platforms globally not only enhances users' connectivity and communication but also emerges as a vital channel for the dissemination of health-related information, thereby establishing social media data as an invaluable organic data resource for public health research. The surge in popularity of vaping or e-cigarette use in the United States and other countries has caused an outbreak of e-cigarette and vaping use-associated lung injury (EVALI), leading to hospitalizations and fatalities in 2019, highlighting the urgency to comprehend vaping behaviors and develop effective strategies for cession. In this study, we extracted a sample dataset from one vaping sub-community on Reddit to analyze users' quit vaping intentions. Leveraging large language models including both the latest GPT-4 and traditional BERT-based language models for sentence-level quit-vaping intention prediction tasks, this study compares the outcomes of these models against human annotations. Notably, when compared to human evaluators, GPT-4 model demonstrates superior consistency in adhering to annotation guidelines and processes, showcasing advanced capabilities to detect nuanced user quit-vaping intentions that human evaluators might overlook. These preliminary findings emphasize the potential of GPT-4 in enhancing the accuracy and reliability of social media data analysis, especially in identifying subtle users' intentions that may elude human detection.

Kriti Bhattarai, Vipina K. Keloth, Donald Wright et al.

Objective: Large language models (LLMs) are increasingly applied in biomedical settings, and existing benchmark datasets have played an important role in supporting model development and evaluation. However, these benchmarks often have limitations. Many rely on static or outdated datasets that fail to capture the dynamic, context-rich, and high-stakes nature of biomedical knowledge. They also carry increasing risk of data leakage due to overlap with model pretraining corpora and often overlook critical dimensions such as robustness to linguistic variation and potential demographic biases. Materials and Methods: To address these gaps, we introduce BioPulse-QA, a benchmark that evaluates LLMs on answering questions from newly published biomedical documents including drug labels, trial protocols, and clinical guidelines. BioPulse-QA includes 2,280 expert-verified question answering (QA) pairs and perturbed variants, covering both extractive and abstractive formats. We evaluate four LLMs - GPT-4o, GPT-o1, Gemini-2.0-Flash, and LLaMA-3.1 8B Instruct - released prior to the publication dates of the benchmark documents. Results: GPT-o1 achieves the highest relaxed F1 score (0.92), followed by Gemini-2.0-Flash (0.90) on drug labels. Clinical trials are the most challenging source, with extractive F1 scores as low as 0.36. Discussion and Conclusion: Performance differences are larger for paraphrasing than for typographical errors, while bias testing shows negligible differences. BioPulse-QA provides a scalable and clinically relevant framework for evaluating biomedical LLMs.