Matthew Thompson

Sihang Zeng, Matthew Thompson, Ruth Etzioni et al.

Modeling patient trajectories from longitudinal electronic health records (EHRs) requires reasoning over sparse, noisy, and long-context multimodal sequences. Existing LLM-based multi-agent systems address context length but process patients in isolation, failing to mirror how clinicians leverage accumulated experience from similar prior cases. We present Traj-Evolve, a self-evolving multi-agent system with two complementary evolving mechanisms. First, an Experience Pool (ExPool) acts as a non-parametric memory, indexing rejection-sampled reasoning traces to retrieve similar patients as few-shot contexts. Second, multi-agent reinforcement learning (MARL) via reward-ranked fine-tuning parametrically optimizes inter-agent and agent-memory collaboration. A leave-one-out cross-retrieval strategy unifies the two, aligning training- and inference-time behavior under retrieval augmentation. On a lung cancer prediction task utilizing up to five years of multimodal EHRs, Traj-Evolve outperforms 9 strong baselines on the overall population and a challenging never-smoker population. Analysis of the evolving dynamics highlights three key findings: (1) expanding the ExPool shifts optimal retrieval from diverse to specific samples; (2) under MARL, the manager agent's prediction loss converges quickly while the worker agents' temporal reasoning continues to benefit from more verified patients; and (3) the two mechanisms are complementary on the predicted risk, where ExPool improves specificity while MARL improves sensitivity.

Rory Sayres, Kejia Chen, Ayush Jain et al.

Patient-managed Personal Health Records (PHRs) promises to empower patients to better understand their health; but information in the record is complex, potentially hindering insights. In this study, we assess the potential of large language models (LLMs, Gemini 3.0 Flash) to provide helpful answers to user health queries, when provided clinical data from PHRs as context. A total of 2,257 user queries were drawn from 3 different distributions to represent patient questions: shorter web search queries, longer questions derived from templates of chatbot conversations, and questions patients asked to their healthcare team (patient calls). Queries were matched with de-identified PHRs (from a pool of 1,945). Gemini responses were generated (1) without PHR context; (2) with a basic summary of demographics, conditions, and medications; (3) with full, extensive clinical notes. For evaluation, we leveraged an existing rating framework (SHARP), and developed a new framework for specific error modes when interpreting PHRs. Evaluation was performed using autoraters for the full set, and with clinician ratings for a subset (n=95), with both sets of raters knowing the full PHR context. We see significant improvements in the helpfulness of answers to all question types with PHR data (p < 0.001, paired t-test). We also observe potential gains in safety, accuracy, relevance and personalization of answers. Our PHR evaluation framework further identifies gaps in LLM understanding of particular aspects of complex PHRs, such as temporal disorientation, and rare but meaningful confabulations. These results suggest potential for PHR data to help people with a wide range of user needs; and provide a framework for monitoring for gaps in LLM answers based on PHR context. This study motivates further work to assess and realize potential benefits to users from understanding their health records.

Jenna Kline, Maksim Kholiavchenko, Samuel Stevens et al.

A comprehensive understanding of animal behavior ecology depends on scalable approaches to quantify and interpret complex, multidimensional behavioral patterns. Traditional field observations are often limited in scope, time-consuming, and labor-intensive, hindering the assessment of behavioral responses across landscapes. To address this, we present kabr-tools (Kenyan Animal Behavior Recognition Tools), an open-source package for automated multi-species behavioral monitoring. This framework integrates drone-based video with machine learning systems to extract behavioral, social, and spatial metrics from wildlife footage. Our pipeline leverages object detection, tracking, and behavioral classification systems to generate key metrics, including time budgets, behavioral transitions, social interactions, habitat associations, and group composition dynamics. Compared to ground-based methods, drone-based observations significantly improved behavioral granularity, reducing visibility loss by 15% and capturing more transitions with higher accuracy and continuity. We validate kabr-tools through three case studies, analyzing 969 behavioral sequences, surpassing the capacity of traditional methods for data capture and annotation. We found that, like Plains zebras, vigilance in Grevy's zebras decreases with herd size, but, unlike Plains zebras, habitat has a negligible impact. Plains and Grevy's zebras exhibit strong behavioral inertia, with rare transitions to alert behaviors and observed spatial segregation between Grevy's zebras, Plains zebras, and giraffes in mixed-species herds. By enabling automated behavioral monitoring at scale, kabr-tools offers a powerful tool for ecosystem-wide studies, advancing conservation, biodiversity research, and ecological monitoring.

Peng Cao, Zhijian Yang, Tennison Liu et al.

Wearable sensors enable the continuous acquisition of high-resolution physiological waveforms, such as photoplethysmography and accelerometry, under free-living conditions. However, inferring health-related phenotypes from these signals presents significant challenges due to high sampling frequencies, multimodal dependencies, and extreme sequence lengths (e.g., weeks of recordings), compounded by a scarcity of ground-truth labels. To address these challenges, existing self-supervised learning (SSL) methodologies typically follow two paradigms: (1) learning rich morphological representations from short waveform segments while collapsing longitudinal dynamics through simple aggregation, or (2) modeling behavioral patterns from coarse, hand-crafted features (e.g. heart rate, step counts) spanning longer horizons but foregoing subtle, predictive signatures in raw waveforms. To bridge this gap, we propose WavesFM, a foundation model utilizing a two-stage SSL framework for longitudinal physiological data. Specifically, we decompose the learning problem into two stages: first, a segment-level encoder is pretrained to extract local embeddings from short waveforms; subsequently, a temporal encoder is trained to model the sequence of these embeddings across a multi-day horizon. This hierarchical approach overcomes the computational complexity of high-resolution, long-sequence data, allowing the overall model to capture both local signal semantics and the complex circadian and inter-day variations governing physiological dynamics. Pretrained on over 6.8M hours (N=324k individuals) of recordings for the first stage and 5.3M hours (N=10k) for the second stage, WavesFM demonstrates superior performance across 58 diverse tasks spanning demographics, lifestyle, health conditions, and medications.

Matthew Thompson

Current approaches to AI coding agents appear to blur the lines between the Large Language Model (LLM) and the agent itself, asking the LLM to make decisions best left to deterministic processes. This leads to systems prone to stochastic failures such as gaming unit tests or hallucinating syntax. Drawing on established software engineering practices that provide deterministic frameworks for managing unpredictable processes, this paper proposes setting the control boundary such that the LLM is treated as a component of the environment environment -- preserving its creative stochasticity -- rather than the decision-making agent. A \textbf{Dual-State Architecture} is formalized, separating workflow state (deterministic control flow) from environment state (stochastic generation). \textbf{Atomic Action Pairs} couple generation with verification as indivisible transactions, where \textbf{Guard Functions} act as sensing actions that project probabilistic outputs onto observable workflow state. The framework is validated on three code generation tasks across 13 LLMs (1.3B--15B parameters). For qualified instruction-following models, task success rates improved by up to 66 percentage points at 1.2--2.1$\times$ baseline computational cost. The results suggest that architectural constraints can substitute for parameter scale in achieving reliable code generation.

Zongliang Ji, Ziyang Zhang, Xincheng Tan et al.

Evidence-based medicine (EBM) is central to high-quality care, but remains difficult to implement in fast-paced primary care settings. Physicians face short consultations, increasing patient loads, and lengthy guideline documents that are impractical to consult in real time. To address this gap, we investigate the feasibility of using large language models (LLMs) as ambient assistants that surface targeted, evidence-based questions during physician-patient encounters. Our study focuses on question generation rather than question answering, with the aim of scaffolding physician reasoning and integrating guideline-based practice into brief consultations. We implemented two prompting strategies, a zero-shot baseline and a multi-stage reasoning variant, using Gemini 2.5 as the backbone model. We evaluated on a benchmark of 80 de-identified transcripts from real clinical encounters, with six experienced physicians contributing over 90 hours of structured review. Results indicate that while general-purpose LLMs are not yet fully reliable, they can produce clinically meaningful and guideline-relevant questions, suggesting significant potential to reduce cognitive burden and make EBM more actionable at the point of care.

Joseph Breda, Fadi Yousif, Beszel Hawkins et al.

Language models excel at diagnostic assessments on currated medical case-studies and vignettes, performing on par with, or better than, clinical professionals. However, existing studies focus on complex scenarios with rich context making it difficult to draw conclusions about how these systems perform for patients reporting symptoms in everyday life. We deployed SymptomAI, a set of conversational AI agents for end-to-end patient interviewing and differential diagnosis (DDx), via the Fitbit app in a study that randomized participants (N=13,917) to interact with five AI agents. This corpus captures diverse communication and a realistic distribution of illnesses from a real world population. A subset of 1,228 participants reported a clinician-provided diagnosis, and 517 of these were further evaluated by a panel of clinicians during over 250 hours of annotation. SymptomAI DDx were significantly more accurate (OR = 2.47, p < 0.001) than those from independent clinicians given the same dialogue in a blinded randomized comparison. Moreover, agentic strategies which conduct a dedicated symptom interview that elicit additional symptom information before providing a diagnosis, perform substantially better than baseline, user-guided conversations (p < 0.001). An auxiliary analysis on 1,509 conversations from a general US population panel validated that these results generalize beyond wearable device users. We used SymptomAI diagnoses as labels for all 13,917 participants to analyze over 500,000 days of wearable metrics across nearly 400 unique conditions. We identified strong associations between acute infections and physiological shifts (e.g., OR > 7 for influenza). While limited by self-reported ground truth, these results demonstrate the benefits of a dedicated and complete symptom interview compared to a user-guided symptom discussion, which is the default of most consumer LLMs.

Alyson East, Elizabeth G. Campolongo, Luke Meyers et al.

1) Biological collections house millions of specimens with digital images increasingly available through open-access platforms. However, most imaging protocols were developed for human interpretation without considering automated analysis requirements. As computer vision applications revolutionize taxonomic identification and trait extraction, a critical gap exists between current digitization practices and computational analysis needs. This review provides the first comprehensive practical framework for optimizing biological specimen imaging for computer vision applications. 2) Through interdisciplinary collaboration between taxonomists, collection managers, ecologists, and computer scientists, we synthesized evidence-based recommendations addressing fundamental computer vision concepts and practical imaging considerations. We provide immediately actionable implementation guidance while identifying critical areas requiring community standards development. 3) Our framework encompasses ten interconnected considerations for optimizing image capture for computer vision-powered taxonomic identification and trait extraction. We translate these into practical implementation checklists, equipment selection guidelines, and a roadmap for community standards development including filename conventions, pixel density requirements, and cross-institutional protocols. 4)By bridging biological and computational disciplines, this approach unlocks automated analysis potential for millions of existing specimens and guides future digitization efforts toward unprecedented analytical capabilities.

Sihang Zeng, Yujuan Fu, Sitong Zhou et al. · uw

Large language models (LLMs) offer a generalizable approach for modeling patient trajectories, but suffer from the long and noisy nature of electronic health records (EHR) data in temporal reasoning. To address these challenges, we introduce Traj-CoA, a multi-agent system involving chain-of-agents for patient trajectory modeling. Traj-CoA employs a chain of worker agents to process EHR data in manageable chunks sequentially, distilling critical events into a shared long-term memory module, EHRMem, to reduce noise and preserve a comprehensive timeline. A final manager agent synthesizes the worker agents' summary and the extracted timeline in EHRMem to make predictions. In a zero-shot one-year lung cancer risk prediction task based on five-year EHR data, Traj-CoA outperforms baselines of four categories. Analysis reveals that Traj-CoA exhibits clinically aligned temporal reasoning, establishing it as a promisingly robust and generalizable approach for modeling complex patient trajectories.

Elzbieta Gruzewska, Pooja Rao, Sebastien Baur et al.

Radar technology presents untapped potential for continuous, contactless, and passive heart rate monitoring via consumer electronics like mobile phones. However the variety of available radar systems and lack of standardization means that a large new paired dataset collection is required for each radar system. This study demonstrates transfer learning between frequency-modulated continuous wave (FMCW) and impulse-radio ultra-wideband (IR-UWB) radar systems, both increasingly integrated into consumer devices. FMCW radar utilizes a continuous chirp, while IR-UWB radar employs short pulses. Our mm-wave FMCW radar operated at 60 GHz with a 5.5 GHz bandwidth (2.7 cm resolution, 3 receiving antennas [Rx]), and our IR-UWB radar at 8 GHz with a 500 MHz bandwidth (30 cm resolution, 2 Rx). Using a novel 2D+1D ResNet architecture we achieved a mean absolute error (MAE) of 0.85 bpm and a mean absolute percentage error (MAPE) of 1.42% for heart rate monitoring with FMCW radar (N=119 participants, an average of 8 hours per participant). This model maintained performance (under 5 MAE/10% MAPE) across various body positions and heart rate ranges, with a 98.9% recall. We then fine-tuned a variant of this model, trained on single-antenna and single-range bin FMCW data, using a small (N=376, avg 6 minutes per participant) IR-UWB dataset. This transfer learning approach yielded a model with MAE 4.1 bpm and MAPE 6.3% (97.5% recall), a 25% MAE reduction over the IR-UWB baseline. This demonstration of transfer learning between radar systems for heart rate monitoring has the potential to accelerate its introduction into existing consumer devices.

Kevin Lybarger, Mari Ostendorf, Matthew Thompson et al.

Coronavirus disease 2019 (COVID-19) is a global pandemic. Although much has been learned about the novel coronavirus since its emergence, there are many open questions related to tracking its spread, describing symptomology, predicting the severity of infection, and forecasting healthcare utilization. Free-text clinical notes contain critical information for resolving these questions. Data-driven, automatic information extraction models are needed to use this text-encoded information in large-scale studies. This work presents a new clinical corpus, referred to as the COVID-19 Annotated Clinical Text (CACT) Corpus, which comprises 1,472 notes with detailed annotations characterizing COVID-19 diagnoses, testing, and clinical presentation. We introduce a span-based event extraction model that jointly extracts all annotated phenomena, achieving high performance in identifying COVID-19 and symptom events with associated assertion values (0.83-0.97 F1 for events and 0.73-0.79 F1 for assertions). In a secondary use application, we explored the prediction of COVID-19 test results using structured patient data (e.g. vital signs and laboratory results) and automatically extracted symptom information. The automatically extracted symptoms improve prediction performance, beyond structured data alone.