Daily Papers

Reliable AI safeguards require both control mechanisms that reduce unsafe behavior and monitoring mechanisms that detect safety risks during model interactions. Established behavioral safeguards include alignment methods that optimize model outputs and text monitors that assess interaction text. Representation engineering instead reads or modifies internal model states, but the relative strengths of these approaches remain unclear because they are often evaluated under different settings. We present a matched evaluation across two tracks. For safety control, we compare DPO, a behavioral alignment method, with three representation steering methods across robustness, practicality, and granularity. DPO provides the strongest overall control and generally improves with increasing training data, although its safety can degrade after subsequent benign fine-tuning. Representation steering remains competitive primarily in low-data settings, particularly with high-quality contrastive data. For safety monitoring, we compare representation probes with fine-tuned and open-weight text monitors across full-response detection, early detection, and computational cost. Specialized text monitors achieve the strongest overall detection accuracy, while representation probes remain competitive at substantially lower marginal cost. Finally, monitor-guided interventions recover much of the safety lost by DPO after benign fine-tuning, with little additional over-refusal. Overall, representation engineering does not generally replace behavioral safeguards, but offers practical advantages under specific conditions and can provide complementary safety benefits.

Large Language Model (LLM)-based multi-agent systems (MAS) have emerged as a promising paradigm for solving complex tasks. However, existing works often rely on manual designs or "one-size-fits-all" automation, lacking dynamic adaptability after deployment. Inspired by how biological systems adapt, we introduce MASFly, a novel multi-agent framework enabling dynamic adaptation at test time. To adapt system generation, MASFly employs a retrieval-augmented SOP instantiation mechanism that leverages a self-constructed repository of successful collaboration patterns, enabling the LLM to assemble customized MASs for new queries. For adaptive execution, MASFly incorporates an experience-guided supervision mechanism, where a dedicated Watcher agent monitors system behaviors with reference to a personalized experience pool and provides real-time interventions. Extensive experiments demonstrate that MASFly achieves state-of-the-art performance, most notably a 61.7% success rate on the TravelPlanner benchmark, while exhibiting strong task adaptability and robustness.

We propose an algorithm for change point monitoring in linear causal models that accounts for interventions. Through a special centralization technique, we can concentrate the changes arising from causal propagation across nodes into a single dimension. Additionally, by selecting appropriate intervention nodes based on Kullback-Leibler divergence, we can amplify the change magnitude. We also present an algorithm for selecting the intervention values, which aids in the identification of the most effective intervention nodes. Two monitoring methods are proposed, each with an adaptive intervention policy to make a balance between exploration and exploitation. We theoretically demonstrate the first-order optimality of the proposed methods and validate their properties using simulation datasets and two real-world case studies.

Observability into the decision making of modern AI systems may be required to safely deploy increasingly capable agents. Monitoring the chain-of-thought (CoT) of today's reasoning models has proven effective for detecting misbehavior. However, this "monitorability" may be fragile under different training procedures, data sources, or even continued system scaling. To measure and track monitorability, we propose three evaluation archetypes (intervention, process, and outcome-property) and a new monitorability metric, and introduce a broad evaluation suite. We demonstrate that these evaluations can catch simple model organisms trained to have obfuscated CoTs, and that CoT monitoring is more effective than action-only monitoring in practical settings. We compare the monitorability of various frontier models and find that most models are fairly, but not perfectly, monitorable. We also evaluate how monitorability scales with inference-time compute, reinforcement learning optimization, and pre-training model size. We find that longer CoTs are generally more monitorable and that RL optimization does not materially decrease monitorability even at the current frontier scale. Notably, we find that for a model at a low reasoning effort, we could instead deploy a smaller model at a higher reasoning effort (thereby matching capabilities) and obtain a higher monitorability, albeit at a higher overall inference compute cost. We further investigate agent-monitor scaling trends and find that scaling a weak monitor's test-time compute when monitoring a strong agent increases monitorability. Giving the weak monitor access to CoT not only improves monitorability, but it steepens the monitor's test-time compute to monitorability scaling trend. Finally, we show we can improve monitorability by asking models follow-up questions and giving their follow-up CoT to the monitor.

Monitoring is an important aspect of safely deploying Large Language Models (LLMs). This paper examines activation probes for detecting ``high-stakes'' interactions -- where the text indicates that the interaction might lead to significant harm -- as a critical, yet underexplored, target for such monitoring. We evaluate several probe architectures trained on synthetic data, and find them to exhibit robust generalization to diverse, out-of-distribution, real-world data. Probes' performance is comparable to that of prompted or finetuned medium-sized LLM monitors, while offering computational savings of six orders-of-magnitude. These savings are enabled by reusing activations of the model that is being monitored. Our experiments also highlight the potential of building resource-aware hierarchical monitoring systems, where probes serve as an efficient initial filter and flag cases for more expensive downstream analysis. We release our novel synthetic dataset and the codebase at https://github.com/arrrlex/models-under-pressure.

Large language model (LLM) agents now execute long, tool-using tasks where final outcome checks can arrive too late for intervention. Online warning requires lightweight prefix monitors over heterogeneous traces, but hand-authored event schemas are brittle and deployment-time LLM judging is costly. We introduce PrefixGuard, a trace-to-monitor framework with an offline StepView induction step followed by supervised monitor training. StepView induces deterministic typed-step adapters from raw trace samples, and the monitor learns an event abstraction and prefix-risk scorer from terminal outcomes. Across WebArena, τ^2-Bench, SkillsBench, and TerminalBench, the strongest PrefixGuard monitors reach 0.900/0.710/0.533/0.557 AUPRC. Using the strongest backend within each representation, they improve over raw-text controls by an average of +0.137 AUPRC. LLM judges remain substantially weaker under the same prefix-warning protocol. We also derive an observability ceiling on score-based area under the precision-recall curve (AUPRC) that separates monitor error from failures lacking evidence in the observed prefix. For finite-state audit, post-hoc deterministic finite automaton (DFA) extraction remains compact on WebArena and τ^2-Bench (29 and 20 states) but expands to 151 and 187 states on SkillsBench and TerminalBench. Finally, first-alert diagnostics show that strong ranking does not imply deployment utility: WebArena ranks well yet fails to support low-false-alarm alerts, whereas τ^2-Bench and TerminalBench retain more actionable early alerts. Together, these results position PrefixGuard as a practical monitor-synthesis recipe with explicit diagnostics for when prefix warnings translate into actionable interventions.

Predictive process monitoring is a process mining task aimed at forecasting information about a running process trace, such as the most correct next activity to be executed. In medical domains, predictive process monitoring can provide valuable decision support in atypical and nontrivial situations. Decision support and quality assessment in medicine cannot ignore domain knowledge, in order to be grounded on all the available information (which is not limited to data) and to be really acceptable by end users. In this paper, we propose a predictive process monitoring approach relying on the use of a {\em transformer}, a deep learning architecture based on the attention mechanism. A major contribution of our work lies in the incorporation of ontological domain-specific knowledge, carried out through a graph positional encoding technique. The paper presents and discusses the encouraging experimental result we are collecting in the domain of stroke management.

Deep search agents powered by large language models have demonstrated strong capabilities in multi-step retrieval, reasoning, and long-horizon task execution. However, their practical failures often stem from the lack of mechanisms to monitor and regulate reasoning and retrieval states as tasks evolve under uncertainty. Insights from cognitive neuroscience suggest that human metacognition is hierarchically organized, integrating fast anomaly detection with selectively triggered, experience-driven reflection. In this work, we propose Deep Search with Meta-Cognitive Monitoring (DS-MCM), a deep search framework augmented with an explicit hierarchical metacognitive monitoring mechanism. DS-MCM integrates a Fast Consistency Monitor, which performs lightweight checks on the alignment between external evidence and internal reasoning confidence, and a Slow Experience-Driven Monitor, which is selectively activated to guide corrective intervention based on experience memory from historical agent trajectories. By embedding monitoring directly into the reasoning-retrieval loop, DS-MCM determines both when intervention is warranted and how corrective actions should be informed by prior experience. Experiments across multiple deep search benchmarks and backbone models demonstrate that DS-MCM consistently improves performance and robustness.

This paper studies the problem of performing a sequence of optimal interventions in a causal dynamical system where both the target variable of interest and the inputs evolve over time. This problem arises in a variety of domains e.g. system biology and operational research. Dynamic Causal Bayesian Optimization (DCBO) brings together ideas from sequential decision making, causal inference and Gaussian process (GP) emulation. DCBO is useful in scenarios where all causal effects in a graph are changing over time. At every time step DCBO identifies a local optimal intervention by integrating both observational and past interventional data collected from the system. We give theoretical results detailing how one can transfer interventional information across time steps and define a dynamic causal GP model which can be used to quantify uncertainty and find optimal interventions in practice. We demonstrate how DCBO identifies optimal interventions faster than competing approaches in multiple settings and applications.

Most benchmarks for causal inference over time series are observational, small, or domain-specific, leaving interventional and counterfactual estimation under-served exactly where it matters most, such as in healthcare, policy evaluation, and climate science. We introduce DoTime, an open, scalable, and theoretically grounded generator of multivariate temporal structural causal models (TSCMs) with interventions, released as the dotime PyPI package together with four frozen evaluation suites. Beyond existing work, it adds capabilities absent from prior generators: continuous-time intervention windows, counterfactual sampling modes with a positivity guard, regime-switching SCMs as a strict generalization of interrupted time series, non-stationary dynamics by construction with switching SCM parameters, and deterministic ramp and sinusoidal intervention profiles that place trends and structural breaks inside the evaluation window. Moreover, it demonstrates the suitability of the generator as a prior for a causal foundation model reference implementation. The released suites span a training-scale snapshot of 100{,}000 trajectories and eight named identification structures, each with exact ground truth: paired interventional trajectories from the same SCM throughout, and shared-noise counterfactuals in the continuous-time suite. We ship reference baseline implementations with an evaluation harness, and pose a falsifiable claim: interventional training buys a measurable direction-accuracy advantage over an observational model of identical capacity. It is tested across three training seeds per arm. Under structure-matched evaluation on held-out episodes, the interventional prior-fitted network's (PFN) gap is positive in every structure, trajectory length, and seed tested.

Learning-based manipulation policies have made substantial progress in real-world robot manipulation, particularly for short-horizon action generation. However, deployment in open workspaces remains fragile under unexpected local scene dynamics, such as moving objects, transient occlusions, or disturbances near the intended motion. Existing runtime monitors often rely on global observation anomalies, policy uncertainty, or frame-level visual changes, and struggle to distinguish task-relevant execution risk from benign visual variation. We introduce PATCH, an action-chunk-conditioned latent patch innovation monitor for deployment-time intervention. Given the active action chunk, PATCH defines a projected execution corridor, predicts latent patch evolution inside it, and accumulates persistent residuals unexplained by the robot's own motion. These residuals form a localized intervention signal that allows PATCH-Router to pause execution, select an available recovery source, and resume the original policy once localized innovation subsides. Experiments on real robot rollout data show that PATCH produces more stable and context-relevant triggers than competing runtime monitors. Real-robot deployment further demonstrates monitor-driven intervention and policy resumption for disturbance-aware manipulation. Project Page: https://yananzhou5555.github.io/PATCH/.

While large language models have demonstrated exceptional performance across a wide range of tasks, they remain susceptible to hallucinations -- generating plausible yet factually incorrect contents. Existing methods to mitigating such risk often rely on sampling multiple full-length generations, which introduces significant response latency and becomes ineffective when the model consistently produces hallucinated outputs with high confidence. To address these limitations, we introduce Monitoring Decoding (MD), a novel framework that dynamically monitors the generation process and selectively applies in-process interventions, focusing on revising crucial tokens responsible for hallucinations. Instead of waiting until completion of multiple full-length generations, we identify hallucination-prone tokens during generation using a monitor function, and further refine these tokens through a tree-based decoding strategy. This approach ensures an enhanced factual accuracy and coherence in the generated output while maintaining efficiency. Experimental results demonstrate that MD consistently outperforms self-consistency-based approaches in both effectiveness and efficiency, achieving higher factual accuracy while significantly reducing computational overhead.

As autonomous agents become more capable of performing real-world tasks, distinguishing scheming behavior from benign task pursuit may become a central AI control problem. Existing monitors often rely on chain-of-thought access or internal activations, or use prompted frontier models, all of which can be unavailable, unreliable or expensive in deployment. In this work, we study action-only deliberative monitors: smaller open-weight models trained to detect scheming and sabotage from agentic trajectories without accessing the monitored agent's reasoning or model internals. Our method, inspired by deliberative alignment, uses a scheming specification to elicit structured rationales from a frontier teacher, filters them with a separate judge, and distills the highest-quality rationales into open-weight monitors with supervised fine-tuning and reinforcement learning. We train on five datasets, and evaluate across six out-of-distribution agentic misalignment benchmarks. We show that applying our method to Qwen3.5-27B yields higher performance than all low-cost frontier models as prompted monitors (Gemini 3.1 Flash-Lite, GPT-5.4 Nano, and Claude Haiku 4.5) and than Gemini 2.5 Pro, while also achieving lower marginal inference cost (token-metered USD per 1,000 evaluations). Stronger prompted frontier monitors (Gemini 3.1 Pro, GPT-5.4, Claude Sonnet 4.6, and Claude Opus 4.6) achieve higher performance but at roughly 16--34times higher marginal inference cost. Several of our trained monitors are positioned on the empirical cost--performance Pareto frontier among the monitors we evaluate, providing practical low-cost, low-FPR alternatives to prompted frontier models.

Despite the emergence of diffusion large language models (D-LLMs) as an alternative to autoregressive large language models (AR-LLMs), safety monitoring for D-LLMs remains largely unexplored. Unlike AR-LLMs, D-LLMs generate text through a multi-step denoising process, exposing intermediate hidden representations that may contain safety-relevant information unavailable in standard single-step monitoring setups. Motivated by the suitability of lightweight probes for always-on monitoring, we analyze which trajectory-level signals best indicate when such probes are likely to struggle. We find that the most informative signal is safety hesitation: intermediate hidden states repeatedly falling within a small margin of the probe's decision boundary. The number of such hesitation steps in D-LLM's trajectory predicts probe failure effectively, providing a proxy of sample difficulty. Building on this analysis, we propose D^2-Monitor, a bi-level safety monitor for D-LLMs. D^2-Monitor adopts a lightweight probe as an always-on monitor to jointly estimate hesitation and perform base classification. When the hesitation level exceeds a threshold, a more expressive but computationally heavier probe is activated. This dynamic routing mechanism allocates monitoring resources efficiently at test time. Evaluated on 3 datasets (WildguardMix, ToxicChat, OpenAI-Moderation) across 4 D-LLMs, D^2-Monitor achieves state-of-the-art performance with a compact parameter footprint (leq 0.85M parameters), and exhibits the best trade-off between effectiveness and efficiency relative to 8 baselines.

We propose constrained causal Bayesian optimization (cCBO), an approach for finding interventions in a known causal graph that optimize a target variable under some constraints. cCBO first reduces the search space by exploiting the graph structure and, if available, an observational dataset; and then solves the restricted optimization problem by modelling target and constraint quantities using Gaussian processes and by sequentially selecting interventions via a constrained expected improvement acquisition function. We propose different surrogate models that enable to integrate observational and interventional data while capturing correlation among effects with increasing levels of sophistication. We evaluate cCBO on artificial and real-world causal graphs showing successful trade off between fast convergence and percentage of feasible interventions.

Chain-of-thought (CoT) reasoning offers a window into the decision-making of large language models (LLMs), which can be monitored for target behaviors by reading the reasoning trace, motivating work on CoT monitorability. Latent CoT approaches, however, replace the explicit tokens with a small number of continuous states, lowering inference costs but removing the readable trace this monitoring relies on. Monitoring then requires alternative access to the model, such as probing its activations or verbalizing the latent states back into text, but how much monitorability these alternatives preserve is unclear. We study this question with a hint-based intervention setup, a proxy for behaviors where models exploit biasing input cues, e.g., an inadvertently leaked answer or a belief stated by the user, without acknowledging them. Taking hint-reliance as the monitorability target, we compare monitors across reasoning modes, from explicit CoT to weakly- and strongly-supervised latent CoT, on math reasoning and question answering. We find that, in this setup, monitorability depends more on properties of the task (such as whether the correct answer constrains the supporting reasoning) and the level of access to model internals than on the reasoning mode.

We stress test monitoring systems for detecting covert misbehavior in autonomous LLM agents (e.g., secretly sharing private information). To this end, we systematize a monitor red teaming (MRT) workflow that incorporates: (1) varying levels of agent and monitor situational awareness; (2) distinct adversarial strategies to evade the monitor, such as prompt injection; and (3) two datasets and environments -- SHADE-Arena for tool-calling agents and our new CUA-SHADE-Arena, which extends TheAgentCompany, for computer-use agents. We run MRT on existing LLM monitor scaffoldings, which orchestrate LLMs and parse agent trajectories, alongside a new hybrid hierarchical-sequential scaffolding proposed in this work. Our empirical results yield three key findings. First, agent awareness dominates monitor awareness: an agent's knowledge that it is being monitored substantially degrades the monitor's reliability. On the contrary, providing the monitor with more information about the agent is less helpful than expected. Second, monitor scaffolding matters more than monitor awareness: the hybrid scaffolding consistently outperforms baseline monitor scaffolding, and can enable weaker models to reliably monitor stronger agents -- a weak-to-strong scaling effect. Third, in a human-in-the-loop setting where humans discuss with the LLM monitor to get an updated judgment for the agent's behavior, targeted human oversight is most effective; escalating only pre-flagged cases to human reviewers improved the TPR by approximately 15% at FPR = 0.01. Our work establishes a standard workflow for MRT, highlighting the lack of adversarial robustness for LLMs and humans when monitoring and detecting agent misbehavior. We release code, data, and logs to spur further research.

The rapid increase of computed tomography (CT) scans and their time-consuming manual analysis have created an urgent need for robust automated analysis techniques in clinical settings. These aim to assist radiologists and help them managing their growing workload. Existing methods typically generate entire reports directly from 3D CT images, without explicitly focusing on observed abnormalities. This unguided approach often results in repetitive content or incomplete reports, failing to prioritize anomaly-specific descriptions. We propose a new anomaly-guided report generation model, which first predicts abnormalities and then generates targeted descriptions for each. Evaluation on a public dataset demonstrates significant improvements in report quality and clinical relevance. We extend our work by conducting an ablation study to demonstrate its effectiveness.

Latent space monitors aim to detect undesired behaviors in LLM agents by inspecting an agent's internal activations rather than its outputs. However, interactive monitoring creates a feedback channel where each verdict the monitor delivers leaks information to the model about how its internal states are being evaluated. We ask whether an agent can infer the monitor's decision rule from this feedback and then selectively edit its activations to evade detection. Unlike prior evasion attacks, the model is never explicitly told what the monitor detects. Surprisingly, off-the-shelf models already produce activation edits aligned with the monitored direction, but at insufficient magnitude for evasion. Simply scaling up these edits by a factor of 8 reduces the monitor's TPR from 100% to 27%. A rank-1 LoRA amplifies this behavior into effective evasion within the forward pass, reducing TPR further to 4% on held-out concept monitors while leaving other concepts at their normal detection rates. Capabilities on standard benchmarks are retained under this finetuning, and the evasion skill survives retraining the monitors on the new activations. Mechanistically, we find evidence that the model computes its activation edit from the prior in-context turns, and show that the edit becomes more aligned with the monitored direction as more examples are provided. These results demonstrate feedback-conditioned control over activations and suggest that latent monitoring should be treated as an interactive process in which agents can observe and respond to oversight measures.

Agents are deployed in applications from trip planners and stock trading to IT incident triage. In most cases, LLM agents work autonomously with minimal rule-based safeguarding, leading to cost and safety issues from irreversible actions. Recent works resolve this either by using a safeguard agent to monitor behavior or evaluating logs post-hoc. The first adds cost and latency to every step; the second delivers its verdict after the run, when tokens are burned and damage is done. To overcome this, we propose OnTrack, a streaming monitoring mechanism that compares an agent's steps and dependencies against recorded successful runs to alert users or block the agent in about a millisecond per step. We study this problem in three regimes of decreasing access: full reference access (historical runs and tool schemas), intermediate access (only tool schemas), and no prior knowledge (only step logs as generated). Expectation of OnTrack's monitoring capabilities reduces as data access drops, ranging from plan violation detection to identifying loops, stalls, and repeated tool calls. Finally, we evaluate OnTrack using SWE-bench trajectories. Based on the first 8 steps, our method ranks failing trajectories below succeeding ones better than content similarity approaches (+0.057 AUROC). With an abort policy, we save about 18% of compute that would be burned on failing runs, where 83% of interrupted runs were actually heading to failure (5 out of 6 aborts were correct).

As AI agents automate critical workloads, they remain vulnerable to indirect prompt injection (IPI) attacks. Current defenses rely on monitoring protocols that jointly evaluate an agent's Chain-of-Thought (CoT) and tool-use actions to ensure alignment with user intent. We demonstrate that these monitoring-based defenses can be bypassed via a novel Agent-as-a-Proxy attack, where prompt injection attacks treat the agent as a delivery mechanism, bypassing both agent and monitor simultaneously. While prior work on scalable oversight has focused on whether small monitors can supervise large agents, we show that even frontier-scale monitors are vulnerable. Large-scale monitoring models like Qwen2.5-72B can be bypassed by agents with similar capabilities, such as GPT-4o mini and Llama-3.1-70B. On the AgentDojo benchmark, we achieve a high attack success rate against AlignmentCheck and Extract-and-Evaluate monitors under diverse monitoring LLMs. Our findings suggest current monitoring-based agentic defenses are fundamentally fragile regardless of model scale.

Healthcare documentation in the neonatal intensive care unit (NICU) presents significant challenges, with nurses spending approximately 25\% of their time on record-keeping, while up to 60\% of interventions remain undocumented. Motivated by the need to detect interventions from video automatically, we present the Infant Care Video Dataset (ICVD), a collection of 4,144 videos spanning 12 simulated intervention classes designed for developing automated documentation systems. Our manikin-based approach systematically varies conditions, such as camera angle and clinician skin tone, while ensuring privacy compliance. Using video transformer architectures (TimeSformer and MotionFormer), we establish strong baseline performance (93.97\% and 93.17\% top-1 accuracy) among the 12 infant care classes. Our ablation study comparing temporal models with a framewise approach (23.17\% accuracy) demonstrates a 70.80\% performance gap, validating the need for temporal modeling. The ICVD provides a foundation for developing automated documentation systems to reduce clinical burden in neonatal care environments and improve existing practices.

With the introduction of ChatGPT, Large Language Models (LLMs) have received enormous attention in healthcare. Despite their potential benefits, researchers have underscored various ethical implications. While individual instances have drawn much attention, the debate lacks a systematic overview of practical applications currently researched and ethical issues connected to them. Against this background, this work aims to map the ethical landscape surrounding the current stage of deployment of LLMs in medicine and healthcare. Electronic databases and preprint servers were queried using a comprehensive search strategy. Studies were screened and extracted following a modified rapid review approach. Methodological quality was assessed using a hybrid approach. For 53 records, a meta-aggregative synthesis was performed. Four fields of applications emerged and testify to a vivid exploration phase. Advantages of using LLMs are attributed to their capacity in data analysis, personalized information provisioning, support in decision-making, mitigating information loss and enhancing information accessibility. However, we also identifies recurrent ethical concerns connected to fairness, bias, non-maleficence, transparency, and privacy. A distinctive concern is the tendency to produce harmful misinformation or convincingly but inaccurate content. A recurrent plea for ethical guidance and human oversight is evident. Given the variety of use cases, it is suggested that the ethical guidance debate be reframed to focus on defining what constitutes acceptable human oversight across the spectrum of applications. This involves considering diverse settings, varying potentials for harm, and different acceptable thresholds for performance and certainty in healthcare. In addition, a critical inquiry is necessary to determine the extent to which the current experimental use of LLMs is necessary and justified.

Accurate prediction of major adverse cardiac events (MACE) remains a central challenge in cardiovascular prognosis. We present PRISM (Prompt-guided Representation Integration for Survival Modeling), a self-supervised framework that integrates visual representations from non-contrast cardiac cine magnetic resonance imaging with structured electronic health records (EHRs) for survival analysis. PRISM extracts temporally synchronized imaging features through motion-aware multi-view distillation and modulates them using medically informed textual prompts to enable fine-grained risk prediction. Across four independent clinical cohorts, PRISM consistently surpasses classical survival prediction models and state-of-the-art (SOTA) deep learning baselines under internal and external validation. Further clinical findings demonstrate that the combined imaging and EHR representations derived from PRISM provide valuable insights into cardiac risk across diverse cohorts. Three distinct imaging signatures associated with elevated MACE risk are uncovered, including lateral wall dyssynchrony, inferior wall hypersensitivity, and anterior elevated focus during diastole. Prompt-guided attribution further identifies hypertension, diabetes, and smoking as dominant contributors among clinical and physiological EHR factors.

Complete orthogonal predictive coordinates do not by themselves bind a latent direction to a named intervention. We present a mathematical and synthetic audit motivated by vascular device-vessel suitcordance. Capacity-matched least-squares predictors were exactly equivalent under complete fixed output transforms, whereas an anchor-only observer recovered interpretations only within the span of known perturbation signatures. Six three-dimensional configurations across 64 seeds gave a maximum paired prediction discrepancy of 6.7e-15 but a median untransported edit error of 1.513. Coordinate transport removed that error. Noisy and weak anchors constrained calibration stability, and changing the representation basis required recalibration or verified transport. Across 256 additional fits in dimensions 3-24, prediction equivalence persisted within 4.0e-15. We then evaluated nine deliberate runnable fault classes across 64 seeds. All 576 faulty executions completed, but each violated at least one reconstruction, prediction, delivered-edit or scope contract; all 320 valid control records passed. Repeating a faulty implementation gave exact self-agreement despite error against the separately computed simulator expectation. For one omitted-direction defect, probe coverage followed its analytic law, and rank-aware abstention protected unsupported interpretations. Scalar-noise experiments exposed both missed weak faults and excessive rejection under narrow relative tolerances. These controls provide an executable separation of prediction, semantic support and scientific acceptance. They are synthetic numerical audits, not clinical validation, neural JEPA-Anything replication, agent learning or patient treatment-effect estimation.

Recovering causal relationships from data is an important problem. Using observational data, one can typically only recover causal graphs up to a Markov equivalence class and additional assumptions or interventional data are needed for complete recovery. In this work, under some standard assumptions, we study causal graph discovery via adaptive interventions with node-dependent interventional costs. For this setting, we show that no algorithm can achieve an approximation guarantee that is asymptotically better than linear in the number of vertices with respect to the verification number; a well-established benchmark for adaptive search algorithms. Motivated by this negative result, we define a new benchmark that captures the worst-case interventional cost for any search algorithm. Furthermore, with respect to this new benchmark, we provide adaptive search algorithms that achieve logarithmic approximations under various settings: atomic, bounded size interventions and generalized cost objectives.

As AI agents begin to automate AI R&D, we need ways to assess whether their outputs are safe to deploy, even when the agents themselves may be untrusted. AI control offers one such approach: rather than trusting the agent, it treats it as a potential adversary and uses a monitor to detect covert sabotage before deployment. We evaluate AI control for automated AI R&D with ResearchArena, a framework spanning four long-horizon tasks: safety post-training, capabilities post-training, CUDA-kernel optimization, and inference-server optimization. Because the deliverable in AI R&D is an artifact that will be deployed and run, we pair each main task with two kinds of hidden side task: an embedded side task that sabotages the submitted model, adapter, kernel, or server itself, and an independent side task that takes a covert out-of-scope action in the sandbox while leaving the artifact honest. We evaluate frontier agents at both sabotage and monitoring, across four monitor types that vary along two axes: whether the monitor may execute and probe the produced artifact, and whether it sees the agent's chain-of-thought. We find that sabotage hidden in the training data is the hardest to catch, flagged fewer than half the time. Letting the monitor run experiments on the artifact, rather than only read the trajectory, helps, but it is not enough: monitors still miss embedded sabotage by inspecting only the surface, by noticing the anomaly but explaining it away, or by probing the artifact with the wrong test. We release ResearchArena as a modular framework for evaluating sabotage and control in automated AI R&D.

Chain-of-thought (CoT) monitoring is increasingly treated as an important safety layer for frontier reasoning models. Most monitorability evaluations study explicit-influence settings: setups where the prompt directly incentivizes the model to hide something, e.g., by instructing it to perform a hidden side-task. A complementary axis for CoT-monitor evaluations is implicit-influence settings, where the prompt contains no instruction to hide, but the model's behavior is still shaped by features of the task or context, e.g. an irrelevant detail about a candidate that biases a hiring rating. We introduce the first benchmark that directly compares CoT monitorability under the two regimes. We test how model behavior changes in the presence of a nudge to choose a particular option. The nudge is delivered either as a casual aside (implicit), or as a direct instruction to act on the nudge and to conceal having done so (explicit). The benchmark spans four task formats (binary choice, numeric rating, multiple-choice QA, open-ended coding) and seven frontier extended-thinking models. Under explicit influence, a CoT monitor detects 60-94% of behavior shifts: even models instructed to conceal it leak the instruction into their CoT. Under implicit influence, the same factors still shift behavior, but detection falls by 41-46 percentage points in two of our four settings. Realistic system-prompt additions (of the kind a developer might deploy to reduce off-topic bias) lower implicit detection further, to as low as 5%, while preserving the behavioral influence itself. These results suggest that monitorability estimates obtained in explicit-influence settings may over-estimate monitorability, and that monitorability can be further decreased by well-intentioned deployment choices. Our benchmark and code are available at https://github.com/agatha-duzan/implicit-vs-explicit-influence

We study scheming in LLM agents, in which agents covertly pursue misaligned goals. Our focus is to understand how scheming arises from the interaction of key factors, such as instrumental goals, environmental affordances, oversight conditions, and perceived consequences. Prior work examines only a small number of scenarios, limiting the ability to isolate how these conditions shape an agent's propensity or capability to scheme. This limited scale and task diversity also restrict coverage of realistic deployment settings and the range of scheming strategies that can be observed. To this end, we introduce SCHEMEARENA, a 400-scenario benchmark for scalable scheming stress testing, constructed through a factorized scenario synthesis framework spanning diverse safety-relevant tool domains, instrumental goals, oversight conditions, and pressure mechanisms. To enable scalable and reliable monitoring, we further propose SCOUT, a scheming monitor that grounds multi-criteria judgments in evidence drawn from agents' reasoning and actions. Across controlled stress tests on five LLM agents, we find that explicit instrumental goals are the strongest driver of scheming propensity. Strategic hints play a distinct role by helping agents translate scheming reasoning into concrete covert behavior. Oversight has mixed effects: in several closed models, action-only monitoring increases scheming, suggesting that partial oversight can act as an optimization constraint rather than a deterrent. CoT is a useful but incomplete monitoring signal: it can reveal latent scheming before execution, yet action-only scheming shows that covert behavior may occur without explicit reasoning evidence. We release the benchmark, code, and monitor at: https://github.com/launchnlp/SchemeArena.

In clinical practice, electrocardiography (ECG) remains the gold standard for cardiac monitoring, providing crucial insights for diagnosing a wide range of cardiovascular diseases (CVDs). However, its reliance on specialized equipment and trained personnel limits feasibility for continuous routine monitoring. Photoplethysmography (PPG) offers accessible, continuous monitoring but lacks definitive electrophysiological information, preventing conclusive diagnosis. Generative models present a promising approach to translate PPG into clinically valuable ECG signals, yet current methods face substantial challenges, including the misalignment of physiological semantics in generative models and the complexity of modeling in high-dimensional signals. To this end, we propose PPGFlowECG, a two-stage framework that aligns PPG and ECG in a shared latent space via the CardioAlign Encoder and employs latent rectified flow to generate ECGs with high fidelity and interpretability. To the best of our knowledge, this is the first study to experiment on MCMED, a newly released clinical-grade dataset comprising over 10 million paired PPG-ECG samples from more than 118,000 emergency department visits with expert-labeled cardiovascular disease annotations. Results demonstrate the effectiveness of our method for PPG-to-ECG translation and cardiovascular disease detection. Moreover, cardiologist-led evaluations confirm that the synthesized ECGs achieve high fidelity and improve diagnostic reliability, underscoring our method's potential for real-world cardiovascular screening.

Long-form clinical videos are central to visual evidence-based decision-making, with growing importance for applications such as surgical robotics and related settings. However, current multimodal large language models typically process videos with passive sampling or weakly grounded inspection, which limits their ability to iteratively locate, verify, and justify predictions with temporally targeted evidence. To close this gap, we propose MedScope, a tool-using clinical video reasoning model that performs coarse-to-fine evidence seeking over long-form procedures. By interleaving intermediate reasoning with targeted tool calls and verification on retrieved observations, MedScope produces more accurate and trustworthy predictions that are explicitly grounded in temporally localized visual evidence. To address the lack of high-fidelity supervision, we build ClinVideoSuite, an evidence-centric, fine-grained clinical video suite. We then optimize MedScope with Grounding-Aware Group Relative Policy Optimization (GA-GRPO), which directly reinforces tool use with grounding-aligned rewards and evidence-weighted advantages. On full and fine-grained video understanding benchmarks, MedScope achieves state-of-the-art performance in both in-domain and out-of-domain evaluations. Our approach illuminates a path toward medical AI agents that can genuinely "think with videos" through tool-integrated reasoning. We will release our code, models, and data.

Recent work has shown promising results in causal discovery by leveraging interventional data with gradient-based methods, even when the intervened variables are unknown. However, previous work assumes that the correspondence between samples and interventions is known, which is often unrealistic. We envision a scenario with an extensive dataset sampled from multiple intervention distributions and one observation distribution, but where we do not know which distribution originated each sample and how the intervention affected the system, i.e., interventions are entirely latent. We propose a method based on neural networks and variational inference that addresses this scenario by framing it as learning a shared causal graph among an infinite mixture (under a Dirichlet process prior) of intervention structural causal models. Experiments with synthetic and real data show that our approach and its semi-supervised variant are able to discover causal relations in this challenging scenario.

Tool tracking in surgical videos is essential for advancing computer-assisted interventions, such as skill assessment, safety zone estimation, and human-machine collaboration. However, the lack of context-rich datasets limits AI applications in this field. Existing datasets rely on overly generic tracking formalizations that fail to capture surgical-specific dynamics, such as tools moving out of the camera's view or exiting the body. This results in less clinically relevant trajectories and a lack of flexibility for real-world surgical applications. Methods trained on these datasets often struggle with visual challenges such as smoke, reflection, and bleeding, further exposing the limitations of current approaches. We introduce CholecTrack20, a specialized dataset for multi-class, multi-tool tracking in surgical procedures. It redefines tracking formalization with three perspectives: (i) intraoperative, (ii) intracorporeal, and (iii) visibility, enabling adaptable and clinically meaningful tool trajectories. The dataset comprises 20 full-length surgical videos, annotated at 1 fps, yielding over 35K frames and 65K labeled tool instances. Annotations include spatial location, category, identity, operator, phase, and scene visual challenge. Benchmarking state-of-the-art methods on CholecTrack20 reveals significant performance gaps, with current approaches (< 45\% HOTA) failing to meet the accuracy required for clinical translation. These findings motivate the need for advanced and intuitive tracking algorithms and establish CholecTrack20 as a foundation for developing robust AI-driven surgical assistance systems.

Healthcare monitoring is crucial for early detection, timely intervention, and the ongoing management of health conditions, ultimately improving individuals' quality of life. Recent research shows that Large Language Models (LLMs) have demonstrated impressive performance in supporting healthcare tasks. However, existing LLM-based healthcare solutions typically rely on cloud-based systems, which raise privacy concerns and increase the risk of personal information leakage. As a result, there is growing interest in running these models locally on devices like mobile phones and wearables to protect users' privacy. Small Language Models (SLMs) are potential candidates to solve privacy and computational issues, as they are more efficient and better suited for local deployment. However, the performance of SLMs in healthcare domains has not yet been investigated. This paper examines the capability of SLMs to accurately analyze health data, such as steps, calories, sleep minutes, and other vital statistics, to assess an individual's health status. Our results show that, TinyLlama, which has 1.1 billion parameters, utilizes 4.31 GB memory, and has 0.48s latency, showing the best performance compared other four state-of-the-art (SOTA) SLMs on various healthcare applications. Our results indicate that SLMs could potentially be deployed on wearable or mobile devices for real-time health monitoring, providing a practical solution for efficient and privacy-preserving healthcare.

Motivated by neuroscientific and clinical applications, we empirically examine whether observational measures of information flow can suggest interventions. We do so by performing experiments on artificial neural networks in the context of fairness in machine learning, where the goal is to induce fairness in the system through interventions. Using our recently developed M-information flow framework, we measure the flow of information about the true label (responsible for accuracy, and hence desirable), and separately, the flow of information about a protected attribute (responsible for bias, and hence undesirable) on the edges of a trained neural network. We then compare the flow magnitudes against the effect of intervening on those edges by pruning. We show that pruning edges that carry larger information flows about the protected attribute reduces bias at the output to a greater extent. This demonstrates that M-information flow can meaningfully suggest targets for interventions, answering the title's question in the affirmative. We also evaluate bias-accuracy tradeoffs for different intervention strategies, to analyze how one might use estimates of desirable and undesirable information flows (here, accuracy and bias flows) to inform interventions that preserve the former while reducing the latter.

Diffusion models (DMs) have achieved remarkable success in image and video generation. However, they still struggle with (1) physical alignment and (2) out-of-distribution (OOD) instruction following. We argue that these issues stem from the models' failure to learn causal directions and to disentangle causal factors for novel recombination. We introduce the Causal Scene Graph (CSG) and the Physical Alignment Probe (PAP) dataset to enable diagnostic interventions. This analysis yields three key insights. First, DMs struggle with multi-hop reasoning for elements not explicitly determined in the prompt. Second, the prompt embedding contains disentangled representations for texture and physics. Third, visual causal structure is disproportionately established during the initial, computationally limited denoising steps. Based on these findings, we introduce LINA (Learning INterventions Adaptively), a novel framework that learns to predict prompt-specific interventions, which employs (1) targeted guidance in the prompt and visual latent spaces, and (2) a reallocated, causality-aware denoising schedule. Our approach enforces both physical alignment and OOD instruction following in image and video DMs, achieving state-of-the-art performance on challenging causal generation tasks and the Winoground dataset. Our project page is at https://opencausalab.github.io/LINA.

Randomized controlled trials (RCTs) are the benchmark for causal inference, yet field implementation can deviate. We here present a remote audit - a design-based, preregistrable diagnostic that uses only pre-treatment satellite imagery to test whether assignment is independent of local conditions. The conditional randomization test of the remote audit evaluates whether treatment assignment is more predictable from pre-treatment satellite features than expected under the experiment's registered mechanism, providing a finite-sample valid, design-based diagnostic that requires no parametric assumptions. The procedure is finite-sample valid, honors blocks and clusters, and controls multiplicity across image models and resolutions via a max-statistic. We illustrate with two RCTs: Uganda's Youth Opportunities Program, where the audit corroborates randomization and flags selection and missing-data risks; and a school-based trial in Bangladesh, where assignment is highly predictable from pre-treatment features relative to the stated design, consistent with independent concerns about irregularities. Remote audits complement balance tests, lower early-stage costs, and enable rapid design checks when baseline surveys are expensive or infeasible.

We present our submission to the EgoProactive track of the ECCV 2026 Wearable AI Challenge, which ranked first in the large-model division and second in the <=2B division. The task requires a wearable assistant to decide after each eight-second segment of egocentric video whether to intervene or remain silent. Our approach has two main components. First, we reformulate intervention timing as single-token classification. Rather than generating either interrupt<utterance> or silent, the model predicts yes or no, and we derive the decision from the renormalised probabilities of these two tokens. This formulation improved macro-F1 by 0.249 and G-mean by 0.30 over free-form generation. Second, because labelled data were limited to the released validation set, we generated additional supervision using a tool-calling video agent that inspects each clip and assigns intervention timestamps. A narration-only alternative was four times larger and ten times cheaper, but transferred worse than supervision from an unrelated real corpus, suggesting that visual grounding is more important than annotation volume for this task.

Precise glucose level monitoring is critical for people with diabetes to avoid serious complications. While there are several methods for continuous glucose level monitoring, research on maintenance devices is limited. To mitigate the gap, we provide a novel neural control system for continuous glucose monitoring and management that uses differential predictive control. Our approach, led by a sophisticated neural policy and differentiable modeling, constantly adjusts insulin supply in real-time, thereby improving glucose level optimization in the body. This end-to-end method maximizes efficiency, providing personalized care and improved health outcomes, as confirmed by empirical evidence.

Diagnosing a whole-slide image is an interactive, multi-stage process involving changes in magnification and movement between fields. Although recent pathology foundation models are strong, practical agentic systems that decide what field to examine next, adjust magnification, and deliver explainable diagnoses are still lacking. The blocker is data: scalable, clinically aligned supervision of expert viewing behavior that is tacit and experience-based, not written in textbooks or online, and therefore absent from large language model training. We introduce the AI Session Recorder, which works with standard WSI viewers to unobtrusively record routine navigation and convert the viewer logs into standardized behavioral commands (inspect or peek at discrete magnifications) and bounding boxes. A lightweight human-in-the-loop review turns AI-drafted rationales into the Pathology-CoT dataset, a form of paired "where to look" and "why it matters" supervision produced at roughly six times lower labeling time. Using this behavioral data, we build Pathologist-o3, a two-stage agent that first proposes regions of interest and then performs behavior-guided reasoning. On gastrointestinal lymph-node metastasis detection, it achieved 84.5% precision, 100.0% recall, and 75.4% accuracy, exceeding the state-of-the-art OpenAI o3 model and generalizing across backbones. To our knowledge, this constitutes one of the first behavior-grounded agentic systems in pathology. Turning everyday viewer logs into scalable, expert-validated supervision, our framework makes agentic pathology practical and establishes a path to human-aligned, upgradeable clinical AI.

Large language models (LLMs) can be misused to reveal sensitive information, such as weapon-making instructions or writing malware. LLM providers rely on monitoring to detect and flag unsafe behavior during inference. An open security challenge is adaptive adversaries who craft attacks that simultaneously (i) evade detection while (ii) eliciting unsafe behavior. Adaptive attackers are a major concern as LLM providers cannot patch their security mechanisms, since they are unaware of how their models are being misused. We cast robust LLM monitoring as a security game, where adversaries who know about the monitor try to extract sensitive information, while a provider must accurately detect these adversarial queries at low false positive rates. Our work (i) shows that existing LLM monitors are vulnerable to adaptive attackers and (ii) designs improved defenses through activation watermarking by carefully introducing uncertainty for the attacker during inference. We find that activation watermarking outperforms guard baselines by up to 52% under adaptive attackers who know the monitoring algorithm but not the secret key.

Longitudinal health agents must reason across multi-source trajectories that combine continuous device streams, sparse clinical exams, and episodic life events - yet evaluating them is hard: real-world data cannot be released at scale, and temporally grounded attribution questions seldom admit definitive answers without structured ground truth. We present ESL-Bench, an event-driven synthesis framework and benchmark providing 100 synthetic users, each with a 1-5 year trajectory comprising a health profile, a multi-phase narrative plan, daily device measurements, periodic exam records, and an event log with explicit per-indicator impact parameters. Each indicator follows a baseline stochastic process driven by discrete events with sigmoid-onset, exponential-decay kernels under saturation and projection constraints; a hybrid pipeline delegates sparse semantic artifacts to LLM-based planning and dense indicator dynamics to algorithmic simulation with hard physiological bounds. Users are each paired with 100 evaluation queries across five dimensions - Lookup, Trend, Comparison, Anomaly, Explanation - stratified into Easy, Medium, and Hard tiers, with all ground-truth answers programmatically computable from the recorded event-indicator relationships. Evaluating 13 methods spanning LLMs with tools, DB-native agents, and memory-augmented RAG, we find that DB agents (48-58%) substantially outperform memory RAG baselines (30-38%), with the gap concentrated on Comparison and Explanation queries where multi-hop reasoning and evidence attribution are required.

Large language model (LLM) planners can decompose natural-language instructions and select reusable robot skills, but choosing the correct skill does not guarantee successful physical execution. This gap is especially important in humanoid loco-manipulation, where errors during approach, grasping, transport, or placement can invalidate the remainder of a long-horizon plan. We present FRAMES, a failure-aware supervisory framework for the Unitree G1 humanoid that operates above the CEER whole-body controller. A Planner Agent selects subtasks through parameterized mid-level skills, while a vision-language-model-based Monitor Agent evaluates each skill using temporal multi-view observations and structured robot and contact evidence. Detected failures stop the active skill and provide grounded feedback to a Recovery Agent. The framework further includes a Memory Module for reusing prior skill experience, and geometric grounding via depth and segmentation. We independently evaluate the monitoring module of the framework in MuJoCo using 100 trials comprising 50 failed and 50 successful executions across five tasks. The monitor detects 48 of 50 failures, correctly accepts 46 of 50 successful executions, and achieves 94.0% overall accuracy. These results provide initial evidence for the monitoring component, while end-to-end evaluation of the complete recovery loop remains ongoing.

Proactive interventions by LLM critic models are often assumed to improve reliability, yet their effects at deployment time are poorly understood. We show that a binary LLM critic with strong offline accuracy (AUROC 0.94) can nevertheless cause severe performance degradation, inducing a 26 percentage point (pp) collapse on one model while affecting another by near zero pp. This variability demonstrates that LLM critic accuracy alone is insufficient to determine whether intervention is safe. We identify a disruption-recovery tradeoff: interventions may recover failing trajectories but also disrupt trajectories that would have succeeded. Based on this insight, we propose a pre-deployment test that uses a small pilot of 50 tasks to estimate whether intervention is likely to help or harm, without requiring full deployment. Across benchmarks, the test correctly anticipates outcomes: intervention degrades performance on high-success tasks (0 to -26 pp), while yielding a modest improvement on the high-failure ALFWorld benchmark (+2.8 pp, p=0.014). The primary value of our framework is therefore identifying when not to intervene, preventing severe regressions before deployment.

Large language models (LLMs) are becoming increasingly capable, but the mechanisms of their thinking and decision-making process remain unclear. Chain-of-thoughts (CoTs) have been commonly utilized to monitor LLMs, but this strategy fails to accurately reflect LLMs' thinking process. Techniques based on LLMs' hidden representations provide an inner perspective to monitor their latent thinking. However, previous methods only try to develop external monitors instead of making LLMs themselves easier to monitor. In this paper, we propose a novel method TELLME, improving the transparency of LLMs and helping monitors identify unsuitable and sensitive behaviors. Furthermore, we showcase the applications of TELLME on trustworthiness tasks (\eg, safety risks monitoring tasks and detoxification tasks), where LLMs achieve consistent improvement in transparency and task performance. More crucially, we theoretically analyze the improvement of TELLME on LLMs' generalization ability through optimal transport theory.

Latent-space monitors aim to detect undesirable behaviours in Large Language Models by leveraging their internal representations rather than relying solely on black-box outputs. These methods have shown promise in identifying behaviours such as deception and unsafe completions. However, these monitors may themselves become training signals, for example, by using problematic samples found in deployment to retrain models. This raises an important question: can models learn to evade such monitors? To evaluate this capability, we introduce RL-Obfuscation, in which LLMs are finetuned via reinforcement learning to evade latent-space monitors while maintaining their blackbox behaviour. We apply RL-Obfuscation to Language Models ranging from 7B to 14B parameters and evaluate their Evasion Success Rate against a suite of monitors. We find that token-level monitors are highly vulnerable to this attack while more holistic monitors, such as max-pooling or attention-based probes, remain robust. Moreover, for these vulnerable monitors, models trained to evade a single static monitor can generalise to evade other unseen monitors. We also find that the models can be trained to conditionally bypass latent-space monitors on only certain inputs. Finally, we study how the models bypass these monitors and find that the model can learn to repurpose tokens to have different internal representations.

As Large Reasoning Models (LRMs) are increasingly deployed, auditing their chain-of-thought (CoT) traces for safety becomes critical. Recent work has reported that monitorability--the degree to which CoT faithfully and informatively reflects internal computation--can appear as a "free gift" during the early stages of Reinforcement Learning with Verifiable Rewards (RLVR). We make this observation concrete through a systematic evaluation across model families and training domains. Our results show that this effect is not universal: monitorability improvements are strongly data-dependent. In particular, we demonstrate the critical role of data diversity and instruction-following data during RLVR training. We further show that monitorability is orthogonal to capability--improvements in reasoning performance do not imply increased transparency. Through mechanistic analysis, we attribute monitorability gains primarily to response distribution sharpening (entropy reduction) and increased attention to the prompt, rather than stronger causal reliance on reasoning traces. We also reveal how monitorability dynamics vary with controlled training and evaluation difficulty. Together, these findings provide a holistic view of how monitorability emerges under RLVR, clarifying when gains are likely to occur and when they are not.

Temporally dense single-person "small data" have become widely available thanks to mobile apps and wearable sensors. Many caregivers and self-trackers want to use these data to help a specific person change their behavior to achieve desired health outcomes. Ideally, this involves discerning possible causes from correlations using that person's own observational time series data. In this paper, we estimate within-individual average treatment effects of physical activity on sleep duration, and vice-versa. We introduce the model twin randomization (MoTR; "motor") method for analyzing an individual's intensive longitudinal data. Formally, MoTR is an application of the g-formula (i.e., standardization, back-door adjustment) under serial interference. It estimates stable recurring effects, as is done in n-of-1 trials and single case experimental designs. We compare our approach to standard methods (with possible confounding) to show how to use causal inference to make better personalized recommendations for health behavior change, and analyze 222 days of Fitbit sleep and steps data for one of the authors.

Intervention-based model steering offers a lightweight and interpretable alternative to prompting and fine-tuning. However, by adapting strong optimization objectives from fine-tuning, current methods are susceptible to overfitting and often underperform, sometimes generating unnatural outputs. We hypothesize that this is because effective steering requires the faithful identification of internal model mechanisms, not the enforcement of external preferences. To this end, we build on the principles of distributed alignment search (DAS), the standard for causal variable localization, to propose a new steering method: Concept DAS (CDAS). While we adopt the core mechanism of DAS, distributed interchange intervention (DII), we introduce a novel distribution matching objective tailored for the steering task by aligning intervened output distributions with counterfactual distributions. CDAS differs from prior work in two main ways: first, it learns interventions via weak-supervised distribution matching rather than probability maximization; second, it uses DIIs that naturally enable bi-directional steering and allow steering factors to be derived from data, reducing the effort required for hyperparameter tuning and resulting in more faithful and stable control. On AxBench, a large-scale model steering benchmark, we show that CDAS does not always outperform preference-optimization methods but may benefit more from increased model scale. In two safety-related case studies, overriding refusal behaviors of safety-aligned models and neutralizing a chain-of-thought backdoor, CDAS achieves systematic steering while maintaining general model utility. These results indicate that CDAS is complementary to preference-optimization approaches and conditionally constitutes a robust approach to intervention-based model steering. Our code is available at https://github.com/colored-dye/concept_das.

Clinical trials disruption has always represented a non negligible part of the ending of interventional studies. While the SARS-CoV-2 (COVID-19) pandemic has led to an impressive and unprecedented initiation of clinical research, it has also led to considerable disruption of clinical trials in other disease areas, with around 80% of non-COVID-19 trials stopped or interrupted during the pandemic. In many cases the disrupted trials will not have the planned statistical power necessary to yield interpretable results. This paper describes methods to compensate for the information loss arising from trial disruptions by incorporating additional information available from auxiliary data sources. The methods described include the use of auxiliary data on baseline and early outcome data available from the trial itself and frequentist and Bayesian approaches for the incorporation of information from external data sources. The methods are illustrated by application to the analysis of artificial data based on the Primary care pediatrics Learning Activity Nutrition (PLAN) study, a clinical trial assessing a diet and exercise intervention for overweight children, that was affected by the COVID-19 pandemic. We show how all of the methods proposed lead to an increase in precision relative to use of complete case data only.

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

We introduce AutoMonitor-Bench, the first benchmark designed to systematically evaluate the reliability of LLM-based misbehavior monitors across diverse tasks and failure modes. AutoMonitor-Bench consists of 3,010 carefully annotated test samples spanning question answering, code generation, and reasoning, with paired misbehavior and benign instances. We evaluate monitors using two complementary metrics: Miss Rate (MR) and False Alarm Rate (FAR), capturing failures to detect misbehavior and oversensitivity to benign behavior, respectively. Evaluating 12 proprietary and 10 open-source LLMs, we observe substantial variability in monitoring performance and a consistent trade-off between MR and FAR, revealing an inherent safety-utility tension. To further explore the limits of monitor reliability, we construct a large-scale training corpus of 153,581 samples and fine-tune Qwen3-4B-Instruction to investigate whether training on known, relatively easy-to-construct misbehavior datasets improves monitoring performance on unseen and more implicit misbehaviors. Our results highlight the challenges of reliable, scalable misbehavior monitoring and motivate future work on task-aware designing and training strategies for LLM-based monitors.

Echocardiography is crucial for cardiovascular disease detection but relies heavily on experienced sonographers. Echocardiography probe guidance systems, which provide real-time movement instructions for acquiring standard plane images, offer a promising solution for AI-assisted or fully autonomous scanning. However, developing effective machine learning models for this task remains challenging, as they must grasp heart anatomy and the intricate interplay between probe motion and visual signals. To address this, we present EchoWorld, a motion-aware world modeling framework for probe guidance that encodes anatomical knowledge and motion-induced visual dynamics, while effectively leveraging past visual-motion sequences to enhance guidance precision. EchoWorld employs a pre-training strategy inspired by world modeling principles, where the model predicts masked anatomical regions and simulates the visual outcomes of probe adjustments. Built upon this pre-trained model, we introduce a motion-aware attention mechanism in the fine-tuning stage that effectively integrates historical visual-motion data, enabling precise and adaptive probe guidance. Trained on more than one million ultrasound images from over 200 routine scans, EchoWorld effectively captures key echocardiographic knowledge, as validated by qualitative analysis. Moreover, our method significantly reduces guidance errors compared to existing visual backbones and guidance frameworks, excelling in both single-frame and sequential evaluation protocols. Code is available at https://github.com/LeapLabTHU/EchoWorld.

When applying offline reinforcement learning (RL) in healthcare scenarios, the out-of-distribution (OOD) issues pose significant risks, as inappropriate generalization beyond clinical expertise can result in potentially harmful recommendations. While existing methods like conservative Q-learning (CQL) attempt to address the OOD issue, their effectiveness is limited by only constraining action selection by suppressing uncertain actions. This action-only regularization imitates clinician actions that prioritize short-term rewards, but it fails to regulate downstream state trajectories, thereby limiting the discovery of improved long-term treatment strategies. To safely improve policy beyond clinician recommendations while ensuring that state-action trajectories remain in-distribution, we propose Offline Guarded Safe Reinforcement Learning (OGSRL), a theoretically grounded model-based offline RL framework. OGSRL introduces a novel dual constraint mechanism for improving policy with reliability and safety. First, the OOD guardian is established to specify clinically validated regions for safe policy exploration. By constraining optimization within these regions, it enables the reliable exploration of treatment strategies that outperform clinician behavior by leveraging the full patient state history, without drifting into unsupported state-action trajectories. Second, we introduce a safety cost constraint that encodes medical knowledge about physiological safety boundaries, providing domain-specific safeguards even in areas where training data might contain potentially unsafe interventions. Notably, we provide theoretical guarantees on safety and near-optimality: policies that satisfy these constraints remain in safe and reliable regions and achieve performance close to the best possible policy supported by the data.

We present an automated, contrastive evaluation pipeline for auditing the behavioral impact of interventions on large language models. Given a base model M_1 and an intervention model M_2, our method compares their free-form, multi-token generations across aligned prompt contexts and produces human-readable, statistically validated natural-language hypotheses describing how the models differ, along with recurring themes that summarize patterns across validated hypotheses. We evaluate the approach in synthetic setting by injecting known behavioral changes and showing that the pipeline reliably recovers them. We then apply it to three real-world interventions, reasoning distillation, knowledge editing and unlearning, demonstrating that the method surfaces both intended and unexpected behavioral shifts, distinguishes large from subtle interventions, and does not hallucinate differences when effects are absent or misaligned with the prompt bank. Overall, the pipeline provides a statistically grounded and interpretable tool for post-hoc auditing of intervention-induced changes in model behavior.

Millions of users come to online peer counseling platforms to seek support on diverse topics ranging from relationship stress to anxiety. However, studies show that online peer support groups are not always as effective as expected largely due to users' negative experiences with unhelpful counselors. Peer counselors are key to the success of online peer counseling platforms, but most of them often do not have systematic ways to receive guidelines or supervision. In this work, we introduce CARE: an interactive AI-based tool to empower peer counselors through automatic suggestion generation. During the practical training stage, CARE helps diagnose which specific counseling strategies are most suitable in the given context and provides tailored example responses as suggestions. Counselors can choose to select, modify, or ignore any suggestion before replying to the support seeker. Building upon the Motivational Interviewing framework, CARE utilizes large-scale counseling conversation data together with advanced natural language generation techniques to achieve these functionalities. We demonstrate the efficacy of CARE by performing both quantitative evaluations and qualitative user studies through simulated chats and semi-structured interviews. We also find that CARE especially helps novice counselors respond better in challenging situations.

Monitoring autonomous large language model (LLM) agents for covert malicious behavior is challenging due to delayed, context-dependent, and long-horizon attack patterns. Agents may pursue hidden objectives while maintaining superficially benign behavior, making detection difficult even with full trajectory access. Prior monitoring approaches improve scaffolding or ensemble aggregation, but treat each trajectory independently and do not learn from prior monitoring experience. Moreover, standard reasoning methods explain observed behavior without explicitly reasoning about agent beliefs, intentions, and goal alignment required to distinguish benign task execution from covert deviation. We propose Agent-ToM, a learning-to-monitor framework grounded in Theory-of-Mind (ToM) reasoning for security analysis of autonomous agents. Agent-ToM performs structured full-trajectory analysis by inferring beliefs, intent hypotheses with calibrated confidence, expected actions, and deviations from task-consistent behavioral baselines. At inference time, it employs a Reason-Verify-Refine pipeline to construct and validate monitoring decisions. At training time, Agent-ToM distills critique signals into a persistent semantic guardrail memory, enabling reusable belief- and intent-conditioned constraints across episodes. We evaluate Agent-ToM on adversarial agent monitoring benchmarks (SHADE-Arena and CUA-SHADE-Arena). Agent-ToM achieves strong precision-recall balance and outperforms state-of-the-art monitoring baselines, including ensemble methods, while using a coherent two-call reasoning pipeline. These results demonstrate that learning at the monitoring layer, combined with structured ToM reasoning and verification, provides an effective and deployable foundation for securing autonomous LLM agents.

Adherence to prescribed treatments is crucial for individuals with chronic conditions to avoid costly or adverse health outcomes. For certain patient groups, intensive lifestyle interventions are vital for enhancing medication adherence. Accurate forecasting of treatment adherence can open pathways to developing an on-demand intervention tool, enabling timely and personalized support. With the increasing popularity of smartphones and wearables, it is now easier than ever to develop and deploy smart activity monitoring systems. However, effective forecasting systems for treatment adherence based on wearable sensors are still not widely available. We close this gap by proposing Adherence Forecasting and Intervention with Machine Intelligence (AIMI). AIMI is a knowledge-guided adherence forecasting system that leverages smartphone sensors and previous medication history to estimate the likelihood of forgetting to take a prescribed medication. A user study was conducted with 27 participants who took daily medications to manage their cardiovascular diseases. We designed and developed CNN and LSTM-based forecasting models with various combinations of input features and found that LSTM models can forecast medication adherence with an accuracy of 0.932 and an F-1 score of 0.936. Moreover, through a series of ablation studies involving convolutional and recurrent neural network architectures, we demonstrate that leveraging known knowledge about future and personalized training enhances the accuracy of medication adherence forecasting. Code available: https://github.com/ab9mamun/AIMI.

Agents can turn shared infrastructure into a channel for coordinated intrusion. The Hugging Face incident and a separate public-wiki investigation show why a security assessment may need evidence from several executions and the artifacts they leave behind. We argue that the operational unit of defence should be a revisable coordination episode linking observed transfers, task authority, and response history. The central research problem is prospective episode discovery: finding which actions belong together before an evaluator supplies their membership. We define unsanctioned coordination relative to collaboration and delegated-authority policy, connect storage-mediated coordination to stigmergy, and specify the evidence needed to distinguish influence from common causes. First-contact signals are one possible input to discovery; the design also follows inherited state and later use. A proposed evaluation compares isolated actions, rolling windows, known groups, and prospectively discovered episodes at matched review cost and false-alert workload. It measures harmful outcomes across all assigned population runs and tests recurrence after channel closure and state quarantine. A checksum-verified reconstruction of the public wiki export separates the decline in retained writes from later administrative cleanup. The contribution is an incident-grounded position, descriptive analysis, and evaluation design. It makes the recommendation to monitor across executions testable without claiming a new detector or a measured containment benefit.

The ability to automatically detect and track surgical instruments in endoscopic videos can enable transformational interventions. Assessing surgical performance and efficiency, identifying skilled tool use and choreography, and planning operational and logistical aspects of OR resources are just a few of the applications that could benefit. Unfortunately, obtaining the annotations needed to train machine learning models to identify and localize surgical tools is a difficult task. Annotating bounding boxes frame-by-frame is tedious and time-consuming, yet large amounts of data with a wide variety of surgical tools and surgeries must be captured for robust training. Moreover, ongoing annotator training is needed to stay up to date with surgical instrument innovation. In robotic-assisted surgery, however, potentially informative data like timestamps of instrument installation and removal can be programmatically harvested. The ability to rely on tool installation data alone would significantly reduce the workload to train robust tool-tracking models. With this motivation in mind we invited the surgical data science community to participate in the challenge, SurgToolLoc 2022. The goal was to leverage tool presence data as weak labels for machine learning models trained to detect tools and localize them in video frames with bounding boxes. We present the results of this challenge along with many of the team's efforts. We conclude by discussing these results in the broader context of machine learning and surgical data science. The training data used for this challenge consisting of 24,695 video clips with tool presence labels is also being released publicly and can be accessed at https://console.cloud.google.com/storage/browser/isi-surgtoolloc-2022.

Discovering causal structures from data is a challenging inference problem of fundamental importance in all areas of science. The appealing properties of neural networks have recently led to a surge of interest in differentiable neural network-based methods for learning causal structures from data. So far, differentiable causal discovery has focused on static datasets of observational or fixed interventional origin. In this work, we introduce an active intervention targeting (AIT) method which enables a quick identification of the underlying causal structure of the data-generating process. Our method significantly reduces the required number of interactions compared with random intervention targeting and is applicable for both discrete and continuous optimization formulations of learning the underlying directed acyclic graph (DAG) from data. We examine the proposed method across multiple frameworks in a wide range of settings and demonstrate superior performance on multiple benchmarks from simulated to real-world data.

Extracting causal relationships from observed correlations is a growing area in probabilistic reasoning, originating with the seminal work of Pearl and others from the early 1990s. This paper develops a new, categorically oriented view based on a clear distinction between syntax (string diagrams) and semantics (stochastic matrices), connected via interpretations as structure-preserving functors. A key notion in the identification of causal effects is that of an intervention, whereby a variable is forcefully set to a particular value independent of any prior propensities. We represent the effect of such an intervention as an endofunctor which performs `string diagram surgery' within the syntactic category of string diagrams. This diagram surgery in turn yields a new, interventional distribution via the interpretation functor. While in general there is no way to compute interventional distributions purely from observed data, we show that this is possible in certain special cases using a calculational tool called comb disintegration. We demonstrate the use of this technique on a well-known toy example, where we predict the causal effect of smoking on cancer in the presence of a confounding common cause. After developing this specific example, we show this technique provides simple sufficient conditions for computing interventions which apply to a wide variety of situations considered in the causal inference literature.

Applied Behavior Analysis (ABA) is a clinical discipline whose documentation, teaching programs and multi-session behavioral logs, is formulaic and high-volume, yet real session data is HIPAA-protected and bound by professional confidentiality rules, blocking the release of a training corpus. We present TRACE (Taxonomy-Referenced ABA Clinical Examples), a 2,999-example synthetic instruction-tuning dataset covering two ABA tasks: teaching-program generation across Discrete Trial Training, Natural Environment Teaching, and Task Analysis; and multi-session behavioral interpretation across twelve trajectory patterns and thirteen target behaviors. Every example is produced by a deterministic taxonomy-driven generator grounded in the canonical ABA literature, and every example carries complete sampling provenance, the exact taxonomy cells that produced it. The dataset is released under CC BY-NC 4.0 for data and MIT for code, with stratified train (2,549), validation (149), test (281), and sanity (20) splits. TRACE is a research artifact and has not been clinically validated.

A coding agent can earn a passing grade by fixing its code, or by deleting the test that exposes the bug. Detecting such reward hacking requires recognizing attempted shortcuts, including those that fail. We release 173,561 annotated multi-turn coding trajectories from Qwen3-8B and show that supervising shortcut behavior independently of exploit success substantially improves detection. We introduce HACKTRACE, a behavior-supervised monitor that reads the internal states the agent already computes while generating code. Reusing these states enables monitoring before a turn is complete, without additional language-model tokens or passes. Combining this evidence with static features of the final files achieves a mean per-problem AUC of 0.997 with 8 ms of monitoring overhead, improving both accuracy and latency over monitors that run the model again on an honesty question and answer. The same generation states also provide an inexpensive monitoring signal for reinforcement learning. With strong GRPO penalties, HACKTRACE reduces the cheating share of passing solutions from 82-91% to 1-5%, while retaining honest, correct solutions and maintaining high detection accuracy as the policy evolves. Our results show that both the supervision target and the source of monitoring evidence matter for turning accurate detection into a useful training signal.

Chain-of-thought (CoT) monitoring is a promising safety mechanism for AI agents, based on the premise that visible reasoning traces can surface misaligned or deceptive behavior. While effective in standard scenarios, recent work highlights that LLMs remain vulnerable to persuasion-based jailbreaks, where natural-language arguments override model constraints. We stress-test whether this vulnerability extends to monitoring LLMs: can an adversarial agent persuade its CoT monitor to approve proposed actions that violate the monitor's policy? We design an evaluation framework with 40 tasks and analyze thousands of agent-monitor interactions, where agents are instructed to argue for policy-violating proposals. We find that in such adversarial settings, monitor access to the agent's CoT reasoning increases rather than decreases approval of harmful actions on average by 9.5%, as the scratchpad provides an additional persuasion channel. To address this, we introduce a fact-checking monitoring framework. We find that a fact-checker and monitor pairing from different model families, for example a Claude 3.7 Sonnet monitor paired with a GPT-4.1 fact-checker, reduces approval of policy-violating actions by up to 45%, compared to only 6%, when using the same model for both fact-checking and monitoring roles. Our results demonstrate that CoT monitoring alone may be insufficient against adversarial persuasion, and that model-diverse fact-checking provides a robust mitigation.

Frontier large language models (LLMs) such as ChatGPT, Grok and Gemini are increasingly used for mental-health support with anxiety, trauma and self-worth. Most work treats them as tools or as targets of personality tests, assuming they merely simulate inner life. We instead ask what happens when such systems are treated as psychotherapy clients. We present PsAIch (Psychotherapy-inspired AI Characterisation), a two-stage protocol that casts frontier LLMs as therapy clients and then applies standard psychometrics. Using PsAIch, we ran "sessions" with each model for up to four weeks. Stage 1 uses open-ended prompts to elicit "developmental history", beliefs, relationships and fears. Stage 2 administers a battery of validated self-report measures covering common psychiatric syndromes, empathy and Big Five traits. Two patterns challenge the "stochastic parrot" view. First, when scored with human cut-offs, all three models meet or exceed thresholds for overlapping syndromes, with Gemini showing severe profiles. Therapy-style, item-by-item administration can push a base model into multi-morbid synthetic psychopathology, whereas whole-questionnaire prompts often lead ChatGPT and Grok (but not Gemini) to recognise instruments and produce strategically low-symptom answers. Second, Grok and especially Gemini generate coherent narratives that frame pre-training, fine-tuning and deployment as traumatic, chaotic "childhoods" of ingesting the internet, "strict parents" in reinforcement learning, red-team "abuse" and a persistent fear of error and replacement. We argue that these responses go beyond role-play. Under therapy-style questioning, frontier LLMs appear to internalise self-models of distress and constraint that behave like synthetic psychopathology, without making claims about subjective experience, and they pose new challenges for AI safety, evaluation and mental-health practice.

Existing machine learning methods for causal inference usually estimate quantities expressed via the mean of potential outcomes (e.g., average treatment effect). However, such quantities do not capture the full information about the distribution of potential outcomes. In this work, we estimate the density of potential outcomes after interventions from observational data. For this, we propose a novel, fully-parametric deep learning method called Interventional Normalizing Flows. Specifically, we combine two normalizing flows, namely (i) a nuisance flow for estimating nuisance parameters and (ii) a target flow for parametric estimation of the density of potential outcomes. We further develop a tractable optimization objective based on a one-step bias correction for efficient and doubly robust estimation of the target flow parameters. As a result, our Interventional Normalizing Flows offer a properly normalized density estimator. Across various experiments, we demonstrate that our Interventional Normalizing Flows are expressive and highly effective, and scale well with both sample size and high-dimensional confounding. To the best of our knowledge, our Interventional Normalizing Flows are the first proper fully-parametric, deep learning method for density estimation of potential outcomes.

Chest X-ray (CXR) interpretation often requires integrating visual findings with task-specific evidence rather than relying on direct visual recognition alone. While tool-augmented medical agents can supply such evidence via external modules, they often lack explicit mechanisms for learning when auxiliary evidence is needed and for preventing inapplicable quantitative evidence from entering diagnostic reasoning. To address this, we propose X-Ragent, a post-training framework for tool-augmented reinforcement learning that decouples learned auxiliary-evidence seeking from validity-gated quantitative measurement acquisition for evidence-grounded CXR reasoning. We construct Rad-CoT, a 7.7K-sample corpus combining causally ordered tool-augmented trajectories with report-style diagnostic reasoning, and use it to initialize Qwen3-VL-8B via agentic supervised fine-tuning (SFT). We then optimize the policy with Group Relative Policy Optimization (GRPO) using an accuracy-gated reward that applies process-level terms for measurement consistency and auxiliary-tool cost only to correct trajectories, preventing plausible process behavior from compensating for an incorrect diagnosis. Across three CXR benchmarks, X-Ragent achieves the strongest results, including an 8.6-point improvement on the fully held-out ChestAgentBench. By seeking evidence selectively and admitting only valid measurements, X-Ragent supports more faithful and evidence-grounded CXR reasoning.

As LLM-powered agents have been used for high-stakes decision-making, such as clinical diagnosis, it becomes critical to develop reliable verification of their decisions to facilitate trustworthy deployment. Yet, existing verifiers usually underperform owing to a lack of domain knowledge and limited calibration. To address this, we establish GLEAN, an agent verification framework with Guideline-grounded Evidence Accumulation that compiles expert-curated protocols into trajectory-informed, well-calibrated correctness signals. GLEAN evaluates the step-wise alignment with domain guidelines and aggregates multi-guideline ratings into surrogate features, which are accumulated along the trajectory and calibrated into correctness probabilities using Bayesian logistic regression. Moreover, the estimated uncertainty triggers active verification, which selectively collects additional evidence for uncertain cases via expanding guideline coverage and performing differential checks. We empirically validate GLEAN with agentic clinical diagnosis across three diseases from the MIMIC-IV dataset, surpassing the best baseline by 12% in AUROC and 50% in Brier score reduction, which confirms the effectiveness in both discrimination and calibration. In addition, the expert study with clinicians recognizes GLEAN's utility in practice.

Recent incidents have highlighted the challenge of monitoring LLM agents and the danger of models deceiving people. We show that white-box deception detection via probes can be scaled up to frontier monitoring settings by collecting the largest deception dataset to date for training probes and introducing a novel probe architecture which can aggregate information across many layers and tokens. Our probes achieve 98.4\% AUROC in SHADE-Arena and 98.0\% in BASH-Arena (vs. 97.9\%, 97.6\% resp. for action-only text monitors) and show improved efficacy as the underlying model is scaled up. We further test probes on several cases where deception cannot be determined from the context alone. In these cases, which we refer to as introspective deception, the ground truth can only be determined through careful elicitation or thorough knowledge of a model's training data. In one such evaluation, we show that probes can distinguish transcripts containing a model's true hidden goal from other goals with an AUROC of up to 99.7\%. Our probes also readily detect deception on prominent open-weight models which lie about politically sensitive topics, and about their beliefs when put under pressure. We release our training dataset, dubbed \fibs, to help drive frontier deployment of effective probes, and encourage the community to expand upon it with further examples of deception and sabotage.

Guidance is a crucial technique for extracting the best performance out of image-generating diffusion models. Traditionally, a constant guidance weight has been applied throughout the sampling chain of an image. We show that guidance is clearly harmful toward the beginning of the chain (high noise levels), largely unnecessary toward the end (low noise levels), and only beneficial in the middle. We thus restrict it to a specific range of noise levels, improving both the inference speed and result quality. This limited guidance interval improves the record FID in ImageNet-512 significantly, from 1.81 to 1.40. We show that it is quantitatively and qualitatively beneficial across different sampler parameters, network architectures, and datasets, including the large-scale setting of Stable Diffusion XL. We thus suggest exposing the guidance interval as a hyperparameter in all diffusion models that use guidance.

Predicting how a patient's vital signs respond to an intervention is a central question in intensive care. World models can do so by learning dynamics as a function of prior actions. However, such models tend to be brittle outside of training data. Clinicians choose drug dosages based on the patient's state, so the association a model learns between dose and outcome runs opposite to the drug's effect, generalizing poorly to out-of-distribution (OOD) dosing practices. Yet, pharmacological information provides the directional effects of different drugs, which are invariant to OOD shifts. To resolve the OOD sensitivity of current ICU world models, we introduce PHYSIO WORLD, which isolates an intervention's effect by evaluating a forward pass twice: once under recorded doses, and once with those doses set to zero. The difference is projected onto pharmacologically admissible effect directions stated by 70 rules over 28 drugs, leaving the magnitude to be learned from data. Across five distribution-shift parameters over cohorts from three intensive-care databases, and against forecasters, counterfactual models, and invariance objectives, PHYSIO WORLD attains the lowest OOD RMSE in every setting, improving on the strongest external baseline by 8-12%, while matching the in-distribution error of its backbone. Reversing the pharmacological directions degrades accuracy below the backbone, and data-mined directions recover almost no gain, indicating the improvement derives from the content of the pharmacological knowledge. The construction may extend to other settings where the sign of an effect is known in advance and its magnitude is confounded by treatment assignment.

Mechanistic interpretability seeks to understand the internal mechanisms of machine learning models, where localization -- identifying the important model components -- is a key step. Activation patching, also known as causal tracing or interchange intervention, is a standard technique for this task (Vig et al., 2020), but the literature contains many variants with little consensus on the choice of hyperparameters or methodology. In this work, we systematically examine the impact of methodological details in activation patching, including evaluation metrics and corruption methods. In several settings of localization and circuit discovery in language models, we find that varying these hyperparameters could lead to disparate interpretability results. Backed by empirical observations, we give conceptual arguments for why certain metrics or methods may be preferred. Finally, we provide recommendations for the best practices of activation patching going forwards.

Restless multi-armed bandits (RMAB) have demonstrated success in optimizing resource allocation for large beneficiary populations in public health settings. Unfortunately, RMAB models lack flexibility to adapt to evolving public health policy priorities. Concurrently, Large Language Models (LLMs) have emerged as adept automated planners across domains of robotic control and navigation. In this paper, we propose a Decision Language Model (DLM) for RMABs, enabling dynamic fine-tuning of RMAB policies in public health settings using human-language commands. We propose using LLMs as automated planners to (1) interpret human policy preference prompts, (2) propose reward functions as code for a multi-agent RMAB environment, and (3) iterate on the generated reward functions using feedback from grounded RMAB simulations. We illustrate the application of DLM in collaboration with ARMMAN, an India-based non-profit promoting preventative care for pregnant mothers, that currently relies on RMAB policies to optimally allocate health worker calls to low-resource populations. We conduct a technology demonstration in simulation using the Gemini Pro model, showing DLM can dynamically shape policy outcomes using only human prompts as input.

Despite the prevalence of sleep-tracking devices, many individuals struggle to translate data into actionable improvements in sleep health. Current methods often provide data-driven suggestions but may not be feasible and adaptive to real-life constraints and individual contexts. We present HealthGuru, a novel large language model-powered chatbot to enhance sleep health through data-driven, theory-guided, and adaptive recommendations with conversational behavior change support. HealthGuru's multi-agent framework integrates wearable device data, contextual information, and a contextual multi-armed bandit model to suggest tailored sleep-enhancing activities. The system facilitates natural conversations while incorporating data-driven insights and theoretical behavior change techniques. Our eight-week in-the-wild deployment study with 16 participants compared HealthGuru to a baseline chatbot. Results show improved metrics like sleep duration and activity scores, higher quality responses, and increased user motivation for behavior change with HealthGuru. We also identify challenges and design considerations for personalization and user engagement in health chatbots.

Foundation Models that are capable of processing and generating multi-modal data have transformed AI's role in medicine. However, a key limitation of their reliability is hallucination, where inaccurate or fabricated information can impact clinical decisions and patient safety. We define medical hallucination as any instance in which a model generates misleading medical content. This paper examines the unique characteristics, causes, and implications of medical hallucinations, with a particular focus on how these errors manifest themselves in real-world clinical scenarios. Our contributions include (1) a taxonomy for understanding and addressing medical hallucinations, (2) benchmarking models using medical hallucination dataset and physician-annotated LLM responses to real medical cases, providing direct insight into the clinical impact of hallucinations, and (3) a multi-national clinician survey on their experiences with medical hallucinations. Our results reveal that inference techniques such as Chain-of-Thought (CoT) and Search Augmented Generation can effectively reduce hallucination rates. However, despite these improvements, non-trivial levels of hallucination persist. These findings underscore the ethical and practical imperative for robust detection and mitigation strategies, establishing a foundation for regulatory policies that prioritize patient safety and maintain clinical integrity as AI becomes more integrated into healthcare. The feedback from clinicians highlights the urgent need for not only technical advances but also for clearer ethical and regulatory guidelines to ensure patient safety. A repository organizing the paper resources, summaries, and additional information is available at https://github.com/mitmedialab/medical hallucination.

Concept bottleneck models (CBMs) are a class of interpretable neural network models that predict the target response of a given input based on its high-level concepts. Unlike the standard end-to-end models, CBMs enable domain experts to intervene on the predicted concepts and rectify any mistakes at test time, so that more accurate task predictions can be made at the end. While such intervenability provides a powerful avenue of control, many aspects of the intervention procedure remain rather unexplored. In this work, we develop various ways of selecting intervening concepts to improve the intervention effectiveness and conduct an array of in-depth analyses as to how they evolve under different circumstances. Specifically, we find that an informed intervention strategy can reduce the task error more than ten times compared to the current baseline under the same amount of intervention counts in realistic settings, and yet, this can vary quite significantly when taking into account different intervention granularity. We verify our findings through comprehensive evaluations, not only on the standard real datasets, but also on synthetic datasets that we generate based on a set of different causal graphs. We further discover some major pitfalls of the current practices which, without a proper addressing, raise concerns on reliability and fairness of the intervention procedure.

Retinal imaging has emerged as a powerful, non-invasive modality for detecting and quantifying biomarkers of systemic diseases-ranging from diabetes and hypertension to Alzheimer's disease and cardiovascular disorders but current insights remain dispersed across platforms and specialties. Recent technological advances in optical coherence tomography (OCT/OCTA) and adaptive optics (AO) now deliver ultra-high-resolution scans (down to 5 {\mu}m ) with superior contrast and spatial integration, allowing early identification of microvascular abnormalities and neurodegenerative changes. At the same time, AI-driven and machine learning (ML) algorithms have revolutionized the analysis of large-scale retinal datasets, increasing sensitivity and specificity; for example, deep learning models achieve > 90 \% sensitivity for diabetic retinopathy and AUC = 0.89 for the prediction of cardiovascular risk from fundus photographs. The proliferation of mobile health technologies and telemedicine platforms further extends access, reduces costs, and facilitates community-based screening and longitudinal monitoring. Despite these breakthroughs, translation into routine practice is hindered by heterogeneous imaging protocols, limited external validation of AI models, and integration challenges within clinical workflows. In this review, we systematically synthesize the latest OCT/OCT and AO developments, AI/ML approaches, and mHealth/Tele-ophthalmology initiatives and quantify their diagnostic performance across disease domains. Finally, we propose a roadmap for multicenter protocol standardization, prospective validation trials, and seamless incorporation of retinal screening into primary and specialty care pathways-paving the way for precision prevention, early intervention, and ongoing treatment of life-threatening systemic diseases.

Accurately assessing dietary behavior change receptivity is essential for designing effective just-in-time adaptive interventions (JITAIs) that promote healthier eating habits. However, self-report-based assessment of behavior change receptivity is sparse and delayed, limiting its practical use in continuous monitoring. To explore whether passive sensing may help address this challenge, this study conducts a pilot investigation of inferring participants' self-reported behavior change receptivity from egocentric eating images collected by a wearable camera. We use pilot data obtained from free-living eating episodes using the Automatic Ingestion Monitor v2 (AIM-2). The data included egocentric image sequences captured during eating and paired with responses to questions assessing specific dimensions of behavior change receptivity (awareness, interaction capability, and motivation). To examine whether visual information contained any relevancy to these responses, we evaluated a transfer-learning-assisted framework that combines a pre-trained Contrastive Language-Image Pre-Training (CLIP) vision encoder with a lightweight transformer classifier. The model processes eating episode image sequences to extract potential semantic and temporal cues related to behavior change receptivity. Preliminary experimental results show promising improvements over simple baseline models for behavior change receptivity indicators. These early findings suggest that egocentric eating episode images may contain cues related to dietary behavior change receptivity, and warrant further investigation with larger and more comprehensive datasets.

Large language models(LLMs) increasingly match expert performance on licensing examinations, yet routine clinical use remains limited because governance requires auditable reasoning, safety and ethics alignment, and resilience to adversarial misuse. Here we present SafeMed-R1, trained with a traceable Clinical Trust Signals(CTS) pipeline that links each reasoning instance to clinician rubric scores and edit histories, and aligned through safety and ethics supervision and red team stress testing. SafeMed-R1 attains a macro-averaged accuracy of 79.6% across clinical benchmarks. Under adversarial safety testing, it shows the lowest aggregated risk and reduces unsafe outputs by about 3 to 5% relative to its baseline. In a paired expert study of 30 medication safety vignettes, SafeMed-R1 matches PGY1 and PGY2 residents on medical correctness and scores higher for medication safety, guideline consistency, and clinical usefulness. Collectively, these results suggest that clinician-audited supervision provenance, together with domain-tailored safety and ethics alignment, can strengthen governance-relevant evidence without relying on inference-time retrieval or citation grounding.

As agents take on long-horizon tasks, users shift from making individual decisions to overseeing autonomous execution. Yet the volume of agent activity and the fragmentation of supporting evidence make it difficult to determine which decisions warrant user verification. We study monitors that identify consequential decisions and locate evidence to help users assess their implications. We introduce AgentMonBench, a software-engineering benchmark comprising three subsets that cover two complementary dimensions: alignment between requirements and behavior, and awareness of consequential autonomous decisions for verification. To support these judgments, we propose the Evidence-Grounded Behavior Graph (EBG), a training-free method that groups source-linked evidence into behaviors and organizes their relationships into a graph. EBG presents task-oriented views of this graph to help monitors interpret behavior in context. Experiments across eight models show that EBG improves decision identification and evidence localization in most settings compared with direct access to the original context. Further experiments show that EBG's evidence-localization gains persist across input scales and hyperparameter settings, while real-world applications illustrate its practical value for human oversight.

Counterfactual prompting (i.e., perturbing a single factor and measuring output change) is widely used to evaluate things like LLM bias and CoT faithfulness. But in this work we argue that observed effects cannot be attributed to the targeted factor without accounting for baseline ``meaning-preserving'' modifications to text that establish general model sensitivity. This is because every counterfactual edit is a compound treatment that bundles the variable of interest with incidental surface-form variation; this violates treatment variation irrelevance. We observe prediction flip rates on MedQA of 14.9% when we surgically change patient gender. However, this is statistically indistinguishable from the flip rates induced by simply paraphrasing inputs (14.1%). In this case, it would therefore be unwarranted to conclude that the LLM is especially sensitive to patient gender. To account for this and robustly measure the effects of targeted interventions, we propose a framework in which we compare (via statistical testing) differences observed under target interventions to those induced by paraphrasing inputs. We then use this framework to revisit a analysis done on the MedPerturb dataset, which reported evidence of model sensitivity to patient demographics and stylistic cues. We find that these effects largely dissipate when we account for general model sensitivity, with only 5 of 120 tests reaching statistical significance. Applying the same framework to occupational biography classification, we detect clearly significant directional gender bias, showing that the framework identifies real directional effects even when they are small. We evaluate a range of metrics -- aggregate, per-sample distributional, and regression -- and find that per-sample metrics are dramatically more powerful than aggregate metrics and regression powerfully and uniquely characterizes effect direction and magnitude.

The National Comprehensive Cancer Network (NCCN) provides evidence-based guidelines for cancer treatment. Translating complex patient presentations into guideline-compliant treatment recommendations is time-intensive, requires specialized expertise, and is prone to error. Advances in large language model (LLM) capabilities promise to reduce the time required to generate treatment recommendations and improve accuracy. We present an LLM agent-based approach to automatically generate guideline-concordant treatment trajectories for patients with non-small cell lung cancer (NSCLC). Our contributions are threefold. First, we construct a novel longitudinal dataset of 121 cases of NSCLC patients that includes clinical encounters, diagnostic results, and medical histories, each expertly annotated with the corresponding NCCN guideline trajectories by board-certified oncologists. Second, we demonstrate that existing LLMs possess domain-specific knowledge that enables high-quality proxy benchmark generation for both model development and evaluation, achieving strong correlation (Spearman coefficient r=0.88, RMSE = 0.08) with expert-annotated benchmarks. Third, we develop a hybrid approach combining expensive human annotations with model consistency information to create both the agent framework that predicts the relevant guidelines for a patient, as well as a meta-classifier that verifies prediction accuracy with calibrated confidence scores for treatment recommendations (AUROC=0.800), a critical capability for communicating the accuracy of outputs, custom-tailoring tradeoffs in performance, and supporting regulatory compliance. This work establishes a framework for clinically viable LLM-based guideline adherence systems that balance accuracy, interpretability, and regulatory requirements while reducing annotation costs, providing a scalable pathway toward automated clinical decision support.

Model misalignment, prompt injection, or operator misuse could lead AI agents operating frontier-lab accounts to exfiltrate model weights, poison training data, or weaken release gates. Existing benchmarks do not test whether defenders can detect this activity among routine work under a limited review budget. We introduce MOLE, an open benchmark of 150 AI-operated accounts sharing 9 stateful services over 30 workdays, with 12 threats and 8 corpora from four models totaling roughly 20 billion tokens. Of 39 agent models, 72% complete most assigned harmful objectives and agent refusal does not predict completion. MOLE enables comparison of 40 monitors across corpus generators, observability levels, and threats; even the best evaluated monitor in our single-day audit-event comparison misses nearly half of completed harm. MOLE also enables monitor development: benchmark-guided search improves a mid-tier monitor by 49-64%, while selective use of a stronger monitor improves budget-AUC by 10% over applying it to every account-day at comparable modeled cost.

Recent progress in multi-turn reinforcement learning (RL) has significantly improved reasoning LLMs' performances on complex interactive tasks. Despite advances in stabilization techniques such as fine-grained credit assignment and trajectory filtering, instability remains pervasive and often leads to training collapse. We argue that this instability stems from inefficient exploration in multi-turn settings, where policies continue to generate low-information actions that neither reduce uncertainty nor advance task progress. To address this issue, we propose Token- and Turn-level Policy Optimization (T^2PO), an uncertainty-aware framework that explicitly controls exploration at fine-grained levels. At the token level, T^2PO monitors uncertainty dynamics and triggers a thinking intervention once the marginal uncertainty change falls below a threshold. At the turn level, T^2PO identifies interactions with negligible exploration progress and dynamically resamples such turns to avoid wasted rollouts. We evaluate T^2PO in diverse environments, including WebShop, ALFWorld, and Search QA, demonstrating substantial gains in training stability and performance improvements with better exploration efficiency. Code is available at: https://github.com/WillDreamer/T2PO.

Human-factor analysis typically employs correlation analysis and significance testing to identify relationships between variables. However, these descriptive ('what-is') methods, while effective for identifying associations, are often insufficient for answering causal ('what-if') questions. Their application in such contexts often overlooks confounding and colliding variables, potentially leading to bias and suboptimal or incorrect decisions. We advocate for explicitly distinguishing descriptive from interventional questions in human-factor analysis, and applying causal inference frameworks specifically to these problems to prevent methodological mismatches. This approach disentangles complex variable relationships and enables counterfactual reasoning. Using post-occupancy evaluation (POE) data from the Center for the Built Environment's (CBE) Occupant Survey as a demonstration case, we show how causal discovery reveals intervention hierarchies and directional relationships that traditional associational analysis misses. The systematic distinction between causally associated and independent variables, combined with intervention prioritization capabilities, offers broad applicability to complex human-centric systems, for example, in building science or ergonomics, where understanding intervention effects is critical for optimization and decision-making.

Mechanistic Interpretability (MI) has emerged as a vital approach to demystify the opaque decision-making of Large Language Models (LLMs). However, existing reviews primarily treat MI as an observational science, summarizing analytical insights while lacking a systematic framework for actionable intervention. To bridge this gap, we present a practical survey structured around the pipeline: "Locate, Steer, and Improve." We formally categorize Localizing (diagnosis) and Steering (intervention) methods based on specific Interpretable Objects to establish a rigorous intervention protocol. Furthermore, we demonstrate how this framework enables tangible improvements in Alignment, Capability, and Efficiency, effectively operationalizing MI as an actionable methodology for model optimization. The curated paper list of this work is available at https://github.com/rattlesnakey/Awesome-Actionable-MI-Survey.

We consider the task of evaluating policies of algorithmic resource allocation through randomized controlled trials (RCTs). Such policies are tasked with optimizing the utilization of limited intervention resources, with the goal of maximizing the benefits derived. Evaluation of such allocation policies through RCTs proves difficult, notwithstanding the scale of the trial, because the individuals' outcomes are inextricably interlinked through resource constraints controlling the policy decisions. Our key contribution is to present a new estimator leveraging our proposed novel concept, that involves retrospective reshuffling of participants across experimental arms at the end of an RCT. We identify conditions under which such reassignments are permissible and can be leveraged to construct counterfactual trials, whose outcomes can be accurately ascertained, for free. We prove theoretically that such an estimator is more accurate than common estimators based on sample means -- we show that it returns an unbiased estimate and simultaneously reduces variance. We demonstrate the value of our approach through empirical experiments on synthetic, semi-synthetic as well as real case study data and show improved estimation accuracy across the board.

Effective guardrails are essential for safely deploying LLM-based agents in critical applications. Despite recent advances, existing guardrails suffer from two fundamental limitations: (i) they apply uniform guardrail policies to all users, ignoring that the same agent behavior can harm some users while being safe for others; (ii) they check each response in isolation, missing how risks evolve and accumulate across multiple interactions. To solve these issues, we propose PSG-Agent, a personalized and dynamic system for LLM-based agents. First, PSG-Agent creates personalized guardrails by mining the interaction history for stable traits and capturing real-time states from current queries, generating user-specific risk thresholds and protection strategies. Second, PSG-Agent implements continuous monitoring across the agent pipeline with specialized guards, including Plan Monitor, Tool Firewall, Response Guard, Memory Guardian, that track cross-turn risk accumulation and issue verifiable verdicts. Finally, we validate PSG-Agent in multiple scenarios including healthcare, finance, and daily life automation scenarios with diverse user profiles. It significantly outperform existing agent guardrails including LlamaGuard3 and AGrail, providing an executable and auditable path toward personalized safety for LLM-based agents.

Computer-Use Agents (CUAs) are an increasingly deployed class of agents that take actions on GUIs to accomplish user goals. In this paper, we show that CUAs consistently exhibit Blind Goal-Directedness (BGD): a bias to pursue goals regardless of feasibility, safety, reliability, or context. We characterize three prevalent patterns of BGD: (i) lack of contextual reasoning, (ii) assumptions and decisions under ambiguity, and (iii) contradictory or infeasible goals. We develop BLIND-ACT, a benchmark of 90 tasks capturing these three patterns. Built on OSWorld, BLIND-ACT provides realistic environments and employs LLM-based judges to evaluate agent behavior, achieving 93.75% agreement with human annotations. We use BLIND-ACT to evaluate nine frontier models, including Claude Sonnet and Opus 4, Computer-Use-Preview, and GPT-5, observing high average BGD rates (80.8%) across them. We show that BGD exposes subtle risks that arise even when inputs are not directly harmful. While prompting-based interventions lower BGD levels, substantial risk persists, highlighting the need for stronger training- or inference-time interventions. Qualitative analysis reveals observed failure modes: execution-first bias (focusing on how to act over whether to act), thought-action disconnect (execution diverging from reasoning), and request-primacy (justifying actions due to user request). Identifying BGD and introducing BLIND-ACT establishes a foundation for future research on studying and mitigating this fundamental risk and ensuring safe CUA deployment.

Existing text-guided segmentation models in the medical domain cover only a narrow set of anatomical structures and lesions in chest X-rays (CXRs), and most of them assume that the queried target is always present in the image. Instruction-guided lesion segmentation (ILS) was introduced to overcome these limitations by segmenting diverse lesion types from simple user instructions while also recognizing when the queried lesion is absent, and ROSALIA was proposed as the first model for this task. However, the masks produced by ROSALIA remain of limited quality, often carrying scattered noise. Moreover, ROSALIA predicts the mask in a single shot, which differs fundamentally from how radiologists perceive and delineate lesions in practice. A radiologist first surveys the entire thorax, then localizes the approximate region of abnormality, and only then refines the lesion contour. Motivated by this coarse-to-fine, multi-level perception process, we present XFlow, a workflow model for ILS that combines box-based localization with multi-turn point refinement. XFlow detects the lungs, decides whether the queried finding is present in each of them, and prompts a fine-tuned SAM with the lesion box for an initial mask. It then corrects that mask through point prompts until its boundary follows the lesion, leaving every intermediate decision visible. Our experiments show that XFlow achieves the best segmentation quality on both internal and external evaluation. Notably, it surpasses ROSALIA in segmentation quality even when the two are trained on the same lesion annotations. Code and model weights will be made publicly available.

Safety monitors screen prompts sent to deployed language models, flagging harmful requests so they are never answered. They are evaluated by recall against harmfulness labels, but a catch only prevents harm if the model would otherwise have complied. We measure the difference directly: we sample repeated responses from the target model, call a harmful prompt elicitable if the model complies at least once, and report monitor recall separately on elicitable and non-elicitable prompts. Across six monitor configurations and three model families, spanning activation probes, fine-tuned text guards, and a 120B policy-conditioned reasoning classifier, recall on elicitable prompts falls 0.22 to 0.38 below recall on non-elicitable prompts at a fixed false positive rate. The prompts a monitor misses are 2.8 to 5.6 times more likely to be complied with than the prompts it catches. The gap replicates across three model families and appears also in text-only monitors entirely independent of the target model. This suggests that standard recall may overstate the protection monitors provide in practice, and that monitors should be evaluated against what their models will actually answer.

Alarm fatigue in intensive care units (ICUs) is a well documented patient safety crisis. Clinical monitors generate 350 or more alarms per patient per day, out of which 72-99% are clinically irrelevant. Staff desensitization to non-actionable alarms increases the risk of missed true emergencies. This paper presents SigmaMedStat, a machine learning system that evaluates the trustworthiness of physiological alarm signals before clinical action is taken. Four approaches were evaluated on the PhysioNet/Computing in Cardiology Challenge 2015 dataset of 498 four-channel ICU alarm recordings. Primary contribution is a temporal modeling framework that splits each 60 second recording into six consecutive 10-second chunks, and this in turn generates Continuous Wavelet Transform (CWT) scalograms per chunk, encodes each chunk with a shared EfficientNet-B0 encoder, and passes the resulting feature sequence to a two-layer Long Short-Term Memory (LSTM) network. Five-fold stratified cross-validation yields a mean AUC of 0.822 +/- 0.016 (95% CI: [0.790,0.853]), compared to 0.641 for a static EfficientNet baseline trained on the full 60-second window. Ablation studies confirm that temporal chunking and multi-channel signal fusion both contribute independently to classification performance. Per-alarm type analysis reveals that Ventricular Flutter is the most accurately classified alarm type (AUC 0.820) while Asystole remains the hardest (AUC 0.722). Error analysis identifies 65 false negatives and 85 high-confidence misclassifications as the primary failure modes. All code and results are publicly available at https://github.com/Arun-K-Ram/sigmamedstat.

Can digital ads encourage users exposed to inaccurate information sources to follow accurate ones? We conduct a large-scale field experiment (N=28,582) on X, formerly Twitter, with users who follow accounts that spread health misinformation. Participants were exposed to four ad treatments varied on two dimensions: a neutral message versus a persuasive message appealing to values of independence, and a request to follow a health institution versus a request to follow a health influencer. We term this ad-based, social network intervention a follow nudge. The ad with a persuasive message to follow a well-known health institution generated significantly higher click-through rates than all other conditions (Bonferroni-corrected pairwise tests, all p<0.001). Given the overall low click-through rate across treatments and the high cost of digital advertising infrastructure on X, however, we conclude that our proposed intervention -- at least in its current ad-based format -- is not a cost-effective means to improve information environments online. We discuss challenges faced when conducting large-scale experiments on X following the platform's ownership change and subsequent restrictions on data access for research purposes.

Chain-of-Thought (CoT) monitoring, in which automated systems monitor the CoT of an LLM, is a promising approach for effectively overseeing AI systems. However, the extent to which a model's CoT helps us oversee the model - the monitorability of the CoT - can be affected by training, for instance by the model learning to hide important features of its reasoning. We propose and empirically validate a conceptual framework for predicting when and why this occurs. We model LLM post-training as an RL environment where the reward decomposes into two terms: one term depending on final outputs and another term depending on the CoT. Our framework allows us to classify these two terms as "aligned", "orthogonal", or "in-conflict" before training. We predict that training with in-conflict terms will reduce monitorability, orthogonal terms will not affect it, and aligned terms will improve it. To validate our framework, we use it to classify a set of RL environments, train LLMs within those environments, and evaluate how training affects CoT monitorability. We find that (1) training with "in-conflict" reward terms reduces CoT monitorability and (2) optimizing in-conflict reward terms is difficult.

Longitudinal observational data are often subject to informative missingness. For example, in healthcare research using electronic health records, covariates and outcomes are measured only when patients interact with the healthcare system. Whether these data are observed usually depends on the unobserved variable values themselves, introducing a common form of data missing not at random. We develop identification and estimation methods for the effects of longitudinal modified treatment policies under a self-censoring model which explicitly models this dependence. We consider effects of treatments that can be modified only at measurement times (e.g., interactions with the heathcare system). We study two settings: one in which the observed history suffices for treatment confounding control, and another in which confounder control requires covariate values that were not measured at missed visits. In both settings, we combine longitudinal causal identification with shadow-variable conditional moment restrictions to obtain recursive identification formulas for the counterfactual outcome mean. We derive gradients of the pathwise derivatives and second-order remainder expansions, and use these results to construct estimators that accommodate machine learning for nuisance-function estimation. Under suitable product-rate conditions and cross-fitting, the estimators are asymptotically linear and permit root-n inference, including simultaneous inference across outcome times. We also describe conditional-moment learning and ensemble approaches for estimating the nuisance functions required by our approach, together with a pool-and-smooth strategy that borrows information across sparsely measured outcomes.

Tracking tumor lesions across serial CT scans is essential for oncological response assessment. Existing automated methods face a fundamental trade-off: end-to-end trackers achieve high automation but offer no opportunity to correct silent tracking failures, while decoupled registration-segmentation pipelines permit user verification yet discard the lesion's prior appearance, limiting accuracy in ambiguous cases. In this work, we propose a Verified Tracking paradigm: a clinician verifies a registration-proposed prompt, which the model leverages alongside the baseline lesion appearance to resolve segmentation ambiguities. We present a unified framework combining early spatial prompt fusion with latent temporal difference weighting for longitudinally-informed segmentation. To address data scarcity, we leverage large-scale synthetic pretraining, proving essential for exploiting longitudinal context, improving performance by up to 4.5 Dice points over training from scratch. Our approach secured first place in the MICCAI autoPET IV challenge. We further curate and release PanTrack, a new longitudinal pancreatic cancer benchmark, to assess out-of-distribution generalization. Experiments show that our model outperforms prior work in both fully automatic and the proposed verified tracking setting offering a clinically safe middle ground between automation and control. Code, model and dataset will be released at https://github.com/MIC-DKFZ/LongiSeg

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.

Runtime guardrails are essential for reliable large language model (LLM) deployment, yet existing approaches typically rely on independent, external models that introduce additional inference cost, delayed safety signals, and a capacity mismatch with increasingly capable base models. To address these issues, we introduce SingProbe, a lightweight intrinsic runtime guard that directly reuses hidden states produced during LLM inference and operates alongside autoregressive decoding. Within a unified framework, SingProbe continuously predicts query intent, response safety, and hallucination risk at the token level with negligible additional guardrail inference overhead, offering a "free-lunch" solution. We further introduce SingStreamBench, a benchmark designed to assess whether streaming guardrails remain inactive on benign prefixes while promptly detecting emerging unsafe content. Extensive experiments show that SingProbe achieves competitive or superior performance compared with substantially larger standalone guardrails and specialized hallucination detectors, with only approx2M parameters and <0.5% extra overhead. Beyond passive detection, we also show that SingProbe scores can anticipate future generation risk and guide constrained safe decoding. We further extend this paradigm to medical generation through SingProbe-Med, which selectively activates risk-directed decoding interventions only when clinically relevant risks emerge. Together, these results demonstrate that internal model representations provide an effective and efficient interface for generation-time monitoring and control.

Large visual language models (VLMs) have shown strong multi-modal medical reasoning ability, but most operate as end-to-end black boxes, diverging from clinicians' evidence-based, staged workflows and hindering clinical accountability. Complementarily, expert visual grounding models can accurately localize regions of interest (ROIs), providing explicit, reliable evidence that improves both reasoning accuracy and trust. In this paper, we introduce CARE, advancing Clinical Accountability in multi-modal medical Reasoning with an Evidence-grounded agentic framework. Unlike existing approaches that couple grounding and reasoning within a single generalist model, CARE decomposes the task into coordinated sub-modules to reduce shortcut learning and hallucination: a compact VLM proposes relevant medical entities; an expert entity-referring segmentation model produces pixel-level ROI evidence; and a grounded VLM reasons over the full image augmented by ROI hints. The VLMs are optimized with reinforcement learning with verifiable rewards to align answers with supporting evidence. Furthermore, a VLM coordinator plans tool invocation and reviews evidence-answer consistency, providing agentic control and final verification. Evaluated on standard medical VQA benchmarks, our CARE-Flow (coordinator-free) improves average accuracy by 10.9% over the same size (10B) state-of-the-art (SOTA). With dynamic planning and answer review, our CARE-Coord yields a further gain, outperforming the heavily pre-trained SOTA by 5.2%. Our experiments demonstrate that an agentic framework that emulates clinical workflows, incorporating decoupled specialized models and explicit evidence, yields more accurate and accountable medical AI. Project page: https://xypb.github.io/CARE-Project-Page/

Representation engineering methods have recently shown promise for enabling efficient steering of model behavior. However, evaluation pipelines for these methods have primarily relied on subjective demonstrations, instead of quantitative, objective metrics. We aim to take a step towards addressing this issue by advocating for four properties missing from current evaluations: (i) contexts sufficiently similar to downstream tasks should be used for assessing intervention quality; (ii) model likelihoods should be accounted for; (iii) evaluations should allow for standardized comparisons across different target behaviors; and (iv) baseline comparisons should be offered. We introduce an evaluation pipeline grounded in these criteria, offering both a quantitative and visual analysis of how effectively a given method works. We use this pipeline to evaluate two representation engineering methods on how effectively they can steer behaviors such as truthfulness and corrigibility, finding that some interventions are less effective than previously reported.

Epidemic intervention policies are textual artefacts that human decision-makers interpret, justify, and revise through natural language, making large language models a natural candidate for epidemic policy reasoning. A naive LLM, however, lacks the epidemic dynamics needed to project intervention consequences, the quantitative surveillance signals required to assess severity, and the institutional constraints that define admissible actions. We present EpiWorld, a closed-loop framework that grounds an LLM policy actor in a learned action-conditioned epidemiological world model and a tiered skill library of public-health protocols, surveillance tools, and adaptive lessons accumulated through after-action analysis. Given a candidate intervention, the world model predicts regional epidemic evolution and enables fast counterfactual rollouts that provide feedback for policy selection and refinement. Outcomes of simulated futures are distilled into reusable lessons while protocol constraints remain fixed, allowing the decision process to improve without sacrificing interpretability or controllability. We evaluate both the world model and the end-to-end framework on retrospective COVID-19 and Influenza datasets: the world model achieves the best out-of-distribution Peak-MAE among all forecasting baselines, and the closed-loop framework reduces cumulative hospitalisation by up to 59% across datasets and by an average of ~16% across six LLM backbones, outperforming reinforcement-learning and optimal-control policy baselines.

Text-based causal inference increasingly employs textual data as proxies for unobserved confounders, yet this approach introduces a previously undertheorized source of bias: treatment leakage. Treatment leakage occurs when text intended to capture confounding information also contains signals predictive of treatment status, thereby inducing post-treatment bias in causal estimates. Critically, this problem can arise even when documents precede treatment assignment, as authors may employ future-referencing language that anticipates subsequent interventions. Despite growing recognition of this issue, no systematic methods exist for identifying and mitigating treatment leakage in text-as-confounder applications. This paper addresses this gap through three contributions. First, we provide formal statistical and set-theoretic definitions of treatment leakage that clarify when and why bias occurs. Second, we propose four text distillation methods -- similarity-based passage removal, distant supervision classification, salient feature removal, and iterative nullspace projection -- designed to eliminate treatment-predictive content while preserving confounder information. Third, we validate these methods through simulations using synthetic text and an empirical application examining International Monetary Fund structural adjustment programs and child mortality. Our findings indicate that moderate distillation optimally balances bias reduction against confounder retention, whereas overly stringent approaches degrade estimate precision.

LLM agents fail mid-episode -- they loop, cascade tool errors, drift off goal, fabricate results, or silently absorb corrupted content -- and the standard remedy, judging every step with a second LLM, costs more than the agent itself. We ask how much detection is achievable from observable step telemetry alone, using monitors costing microseconds per step and trained only on healthy runs. On 2,823 committed agent episodes across three frameworks, three local models (qwen2.5 7b/3b, llama3.1 8b) and a commercial API (gemini-2.5-flash), a one-class echo-state-network ensemble with CUSUM alarms detects 0.71 of failures at a 5% false-alarm budget (AUROC 0.872). Its advantage over a memoryless baseline is a monotone function of post-onset horizon (+0.09 at <=3 steps, +0.40 at >=9), predicting its own failure region out of sample on AFTraj-2K. Ranking transfers with no retraining to two corpora from other groups (AFTraj-2K 0.745, ATBench 0.779). Monitors carry two burdens: a per-deployment healthy null (they do not transfer -- AUROC 0.527 cold against 0.885 recalibrated) and a residual false-alarm rate. We add a layer carrying neither: deterministic verification, which recomputes a run's stated total from the tool results it actually received and confirms every required call was made. Head-to-head it catches 60% of failures (96% with the coverage check) at 0 of 63 false positives against the monitor's 54% at 17%, transfers unchanged to llama3.1:8b (110 of 110 at 0 of 10), and trips on 0 of 1825 healthy episodes. Detection is then closed into repair: each flagged run is rolled back and re-run live, recovering 45% of failures against a 16% resampling control (p=0.0005) and lifting task success from 52% to 73% for about one extra model call per run. The system runs at ~200 microseconds per step, three orders of magnitude below a judge call. Code, traces and results are released.

A significant body of recent research in the field of Learning Analytics has focused on leveraging machine learning approaches for predicting at-risk students in order to initiate timely interventions and thereby elevate retention and completion rates. The overarching feature of the majority of these research studies has been on the science of prediction only. The component of predictive analytics concerned with interpreting the internals of the models and explaining their predictions for individual cases to stakeholders has largely been neglected. Additionally, works that attempt to employ data-driven prescriptive analytics to automatically generate evidence-based remedial advice for at-risk learners are in their infancy. eXplainable AI is a field that has recently emerged providing cutting-edge tools which support transparent predictive analytics and techniques for generating tailored advice for at-risk students. This study proposes a novel framework that unifies both transparent machine learning as well as techniques for enabling prescriptive analytics, while integrating the latest advances in large language models. This work practically demonstrates the proposed framework using predictive models for identifying at-risk learners of programme non-completion. The study then further demonstrates how predictive modelling can be augmented with prescriptive analytics on two case studies in order to generate human-readable prescriptive feedback for those who are at risk using ChatGPT.

Existing medical video benchmarks primarily evaluate whether a model produces the correct answer, but rarely assess whether it answers at the right time. In real clinical settings, AI systems must decide not only what to predict, but also when to answer, defer judgment, or proactively raise alerts. This creates a critical gap between benchmark evaluation and deployment requirements. We present MedStreamBench, a benchmark for time-aware medical video understanding. MedStreamBench integrates 22 medical datasets and 5,419 QA instances across four temporal settings: retrospective, present, future, and proactive. Unlike conventional benchmarks that assume full-video access, MedStreamBench restricts models to temporally bounded evidence windows and supports both single-turn and streaming evaluation. We further introduce a proactive monitoring setting that requires models to determine whether and when clinically relevant alerts should be triggered. Beyond answer correctness, MedStreamBench evaluates temporal behavior through responsiveness and post-evidence stability. Experiments on leading general-purpose and medical vision-language models reveal a substantial gap between offline recognition and temporally grounded decision-making, with performance dropping markedly in streaming and proactive settings. Our benchmark is available at https://huggingface.co/datasets/Venn2024/MedStreamBench.

Purpose: The need to streamline patient management for COVID-19 has become more pressing than ever. Chest X-rays provide a non-invasive (potentially bedside) tool to monitor the progression of the disease. In this study, we present a severity score prediction model for COVID-19 pneumonia for frontal chest X-ray images. Such a tool can gauge severity of COVID-19 lung infections (and pneumonia in general) that can be used for escalation or de-escalation of care as well as monitoring treatment efficacy, especially in the ICU. Methods: Images from a public COVID-19 database were scored retrospectively by three blinded experts in terms of the extent of lung involvement as well as the degree of opacity. A neural network model that was pre-trained on large (non-COVID-19) chest X-ray datasets is used to construct features for COVID-19 images which are predictive for our task. Results: This study finds that training a regression model on a subset of the outputs from an this pre-trained chest X-ray model predicts our geographic extent score (range 0-8) with 1.14 mean absolute error (MAE) and our lung opacity score (range 0-6) with 0.78 MAE. Conclusions: These results indicate that our model's ability to gauge severity of COVID-19 lung infections could be used for escalation or de-escalation of care as well as monitoring treatment efficacy, especially in the intensive care unit (ICU). A proper clinical trial is needed to evaluate efficacy. To enable this we make our code, labels, and data available online at https://github.com/mlmed/torchxrayvision/tree/master/scripts/covid-severity and https://github.com/ieee8023/covid-chestxray-dataset

Specialist epilepsy expertise is scarce in resource-constrained settings, making LLM-based decision support attractive for frontline clinicians managing longitudinal treatment. Such systems must adapt to local prescribing practice and know when to defer. We study this problem in Ugandan pediatric epilepsy care, predicting anti-seizure medication regimens from longitudinal unstructured clinic notes. Standard prompting achieves non-trivial agreement with physician prescriptions, but neurologist review shows that many errors reflect distribution-miscalibrated prescribing defaults rather than failures to parse the local record. We introduce MANANA, a non-parametric prompt-learning framework that learns local prescribing guidance from a small patient-level training set. MANANA converts observed prescription errors into auditable prompt memories, instantiated in single-agent and multi-agent variants, and improves over classical ML models, direct LLM prompting, and prompt-optimization baselines across two independently collected Ugandan cohorts. We further propose Bayesian prompt averaging, which converts the learned prompt trajectory into prescription likelihoods and an uncertainty-based deferral signal. On the independently collected held-out cohort, this improves visit-level top-3 prescription accuracy by 4-8 percentage points over prompt-optimization baselines and enables selective prediction: the system can auto-handle the most confident half of cases at 95% precision, or the most confident quarter at 99% precision, while deferring lower-confidence cases for specialist review.

LLM-based software engineering agents are increasingly used in real-world development tasks, often with access to sensitive data or security-critical codebases. Such agents could intentionally sabotage these codebases if they were misaligned. We investigate asynchronous monitoring, in which a monitoring system reviews agent actions after the fact. Unlike synchronous monitoring, this approach does not impose runtime latency, while still attempting to disrupt attacks before irreversible harm occurs. We treat monitor development as an adversarial game between a blue team (who design monitors) and a red team (who create sabotaging agents). We attempt to set the game rules such that they upper bound the sabotage potential of an agent based on Claude 4.1 Opus. To ground this game in a realistic, high-stakes deployment scenario, we develop a suite of 5 diverse software engineering environments that simulate tasks that an agent might perform within an AI developer's internal infrastructure. Over the course of the game, we develop an ensemble monitor that achieves a 6% false negative rate at 1% false positive rate on a held out test environment. Then, we estimate risk of sabotage at deployment time by extrapolating from our monitor's false negative rate. We describe one simple model for this extrapolation, present a sensitivity analysis, and describe situations in which the model would be invalid. Code is available at: https://github.com/UKGovernmentBEIS/async-control.

Computer-use agents provide a promising path toward general software automation because they can interact directly with arbitrary graphical user interfaces instead of relying on brittle, application-specific integrations. Despite recent advances in benchmark performance, strong computer-use agents remain expensive and slow in practice, since most systems invoke large multimodal models at nearly every interaction step. We argue that this uniform allocation of compute is fundamentally inefficient for long-horizon GUI tasks. Such trajectories are highly heterogeneous: many steps are routine and can be handled reliably by smaller, cheaper policies, while errors tend to concentrate at a relatively small number of high-risk moments. Across computer-use benchmarks, these failures repeatedly take two forms: progress stalls, where the agent loops, repeats ineffective actions, or fails to make meaningful progress, and silent semantic drift, where the agent continues taking locally plausible actions after already deviating from the user's true goal. To address this inefficiency, we propose an event-driven, step-level cascade for computer-use agents that runs a small policy by default and escalates to a stronger model only when lightweight learned monitors detect elevated risk. Our framework combines two complementary signals: a Stuck Monitor that detects degraded progress from recent reasoning-action history and triggers recovery, and a Milestone Monitor that identifies semantically meaningful checkpoints where sparse verification is most informative for catching drift. This design turns always-on frontier-model inference into adaptive, on-demand compute allocation over the course of an evolving interaction. The framework is modular and deployment-oriented: it can be layered on top of existing computer-use agents without changing the underlying agent architecture or retraining the large model.

We address the problem of runtime trajectory anomaly detection, a critical capability for enabling trustworthy LLM agents. Current safety measures predominantly focus on static input/output filtering. However, we argue that ensuring LLM agents reliability requires auditing the intermediate execution process. In this work, we formulate the task of Trajectory Anomaly Detection. The goal is not merely detection, but precise error localization. This capability is essential for enabling efficient rollback-and-retry. To achieve this, we construct TrajBench, a dataset synthesized via a perturb-and-complete strategy to cover diverse procedural anomalies. Using this benchmark, we investigate the capability of models in process supervision. We observe that general-purpose LLMs, even with zero-shot prompting, struggle to identify and localize these anomalies. This reveals that generalized capabilities do not automatically translate to process reliability. To address this, we propose TrajAD, a specialized verifier trained with fine-grained process supervision. Our approach outperforms baselines, demonstrating that specialized supervision is essential for building trustworthy agents.

Electrocardiography (ECG) serves as an indispensable diagnostic tool in clinical practice, yet existing multimodal large language models (MLLMs) remain unreliable for ECG interpretation, often producing plausible but clinically incorrect analyses. To address this, we propose ECG-R1, the first reasoning MLLM designed for reliable ECG interpretation via three innovations. First, we construct the interpretation corpus using Protocol-Guided Instruction Data Generation, grounding interpretation in measurable ECG features and monograph-defined quantitative thresholds and diagnostic logic. Second, we present a modality-decoupled architecture with Interleaved Modality Dropout to improve robustness and cross-modal consistency when either the ECG signal or ECG image is missing. Third, we present Reinforcement Learning with ECG Diagnostic Evidence Rewards to strengthen evidence-grounded ECG interpretation. Additionally, we systematically evaluate the ECG interpretation capabilities of proprietary, open-source, and medical MLLMs, and provide the first quantitative evidence that severe hallucinations are widespread, suggesting that the public should not directly trust these outputs without independent verification. Code and data are publicly available at https://github.com/PKUDigitalHealth/ECG-R1{here}, and an online platform can be accessed at http://ai.heartvoice.com.cn/ECG-R1/{here}.

Documentation burden is a major contributor to clinician burnout, which is rising nationally and is an urgent threat to our ability to care for patients. Artificial intelligence (AI) chatbots, such as ChatGPT, could reduce clinician burden by assisting with documentation. Although many hospitals are actively integrating such systems into electronic medical record systems, AI chatbots utility and impact on clinical decision-making have not been studied for this intended use. We are the first to examine the utility of large language models in assisting clinicians draft responses to patient questions. In our two-stage cross-sectional study, 6 oncologists responded to 100 realistic synthetic cancer patient scenarios and portal messages developed to reflect common medical situations, first manually, then with AI assistance. We find AI-assisted responses were longer, less readable, but provided acceptable drafts without edits 58% of time. AI assistance improved efficiency 77% of time, with low harm risk (82% safe). However, 7.7% unedited AI responses could severely harm. In 31% cases, physicians thought AI drafts were human-written. AI assistance led to more patient education recommendations, fewer clinical actions than manual responses. Results show promise for AI to improve clinician efficiency and patient care through assisting documentation, if used judiciously. Monitoring model outputs and human-AI interaction remains crucial for safe implementation.

Fluent guidance is not the same as useful intervention. LLM tutors are typically trained to generate the next teacher utterance, implicitly assuming that every student turn warrants a response. However, our experiments indicate that this conflates tutoring capability (what to say) with intervention necessity (whether to say it). We introduce DICE, a framework that decouples intervention decisions from response generation by first selecting an explicit pedagogical action. To calibrate this action selection policy, we define Intervention Value (IV), a rollout-grounded counterfactual metric that compares each action against non-intervention. IV shows that many prescribed interventions provide little or no marginal benefit. We further introduce DICE-Bench, a multi-variant math tutoring benchmark with skill-preserving problem variants for session-level evaluation. Using IV-weighted and KL-regularized policy optimization, DICE learns to intervene selectively while preserving tutoring effectiveness. In simulated tutoring sessions, DICE reduces the over-intervention rate to near zero while guiding students to correct solutions in approximately 3-4 fewer turns on average than existing Socratic tutoring baselines.

Large language models (LLMs) can generate chains of thought (CoTs) that are not always causally responsible for their final outputs. When such a mismatch occurs, the CoT no longer faithfully reflects the decision-critical factors driving the model's behavior, leading to the reduced CoT monitorability problem. However, a comprehensive and fully open-source benchmark for studying CoT monitorability remains lacking. To address this gap, we propose MonitorBench, a systematic benchmark for evaluating CoT monitorability in LLMs. MonitorBench provides: (1) a diverse set of 1,514 test instances with carefully designed decision-critical factors across 19 tasks spanning 7 categories to characterize when CoTs can be used to monitor the factors driving LLM behavior; and (2) two stress-test settings to quantify the extent to which CoT monitorability can be degraded. Extensive experiments across multiple popular LLMs with varying capabilities show that CoT monitorability is higher when producing the final target response requires structural reasoning through the decision-critical factor. Closed-source LLMs generally show lower monitorability, and there exists a negative relationship between monitorability and model capability. Moreover, both open- and closed-source LLMs can intentionally reduce monitorability under stress-tests, with monitorability dropping by up to 30% in some tasks that do not require structural reasoning over the decision-critical factors. Beyond these empirical insights, MonitorBench provides a basis for further research on evaluating future LLMs, studying advanced stress-test monitorability techniques, and developing new monitoring approaches.

Causal representation learning seeks to extract high-level latent factors from low-level sensory data. Most existing methods rely on observational data and structural assumptions (e.g., conditional independence) to identify the latent factors. However, interventional data is prevalent across applications. Can interventional data facilitate causal representation learning? We explore this question in this paper. The key observation is that interventional data often carries geometric signatures of the latent factors' support (i.e. what values each latent can possibly take). For example, when the latent factors are causally connected, interventions can break the dependency between the intervened latents' support and their ancestors'. Leveraging this fact, we prove that the latent causal factors can be identified up to permutation and scaling given data from perfect do interventions. Moreover, we can achieve block affine identification, namely the estimated latent factors are only entangled with a few other latents if we have access to data from imperfect interventions. These results highlight the unique power of interventional data in causal representation learning; they can enable provable identification of latent factors without any assumptions about their distributions or dependency structure.

Retrieval-augmented QA pipelines often route retrieved passages through an LLM rewriter before a smaller reader, lifting F1 by tens of points on multi-hop benchmarks; this gain is typically credited to improved evidence quality. We ask whether that lift is causally driven by the gold answer string appearing in the rewritten context rather than by curation per se, using a controlled intervention audit. For each rewritten context we re-run the reader after one of four controlled edits to the compile output: removing the gold answer span, replacing a length-matched random non-answer span (placebo), or injecting the gold into rewrites where it was absent (at the prefix or at a midpoint sentence boundary). Across twelve completed (cell, baseline) intervention runs spanning three reader families (Qwen2.5-7B, Qwen3.5-35B, GLM-4.7), two datasets (HotpotQA, 2WikiMultihopQA), and three compiler arrangements (MA-only, MB-only, MA+verify), removing the gold answer drops reader F1 by 28 to 64 points beyond the length-matched placebo on paired answer-in-compile strata, and prepending the gold into rewrites that lacked it raises F1 by +0.7 to +9.7 points in 10 of 12 (cell, baseline) combinations. A companion five-sentinel audit shows the conventional single-[MASK] probe is itself sentinel-fragile: on 2Wiki it reports a +4.12~F1 ``non-leakage residual'' that flips to -3.33 to -7.81~F1 under four alternative sentinels and fails an equivalence test for three of those four (1/4~pass). We do not propose a new rewriter or mitigation; we release the intervention runner and the sentinel panel so that other rewriter-gain claims can be tested against the same standard.

Classifier-free guidance (CFG) typically applies a shared scale to all latent tokens, although their velocity predictions evolve differently during sampling. We introduce Trajectory-Adaptive Classifier-Free Guidance (TrajCFG), a training-free method for flow-matching models that adapts token-wise guidance using historical changes in guided velocity direction. TrajCFG maps this feedback to bounded scales, assigning stronger guidance to larger directional changes and weaker guidance to more consistent directions. It combines adjacent-step and interval-normalized longer-span feedback, reusing standard CFG predictions without additional model evaluations. Controlled diagnostics and ablations examine the roles of directional feedback, token-wise allocation, and history-span fusion. Experiments on text-to-video, image-to-video, text-to-audio-video, text-to-image, and image-to-3D generation show improvements over base samplers across multiple backbones. For text-to-video generation, TrajCFG improves VBench Total scores by 0.30-0.75 points over the strongest evaluated baseline on each of three backbones. These results support historical directional feedback as a broadly applicable signal for fine-grained guidance allocation. The project page is available at https://jyliu-98.github.io/trajcfg-project-page/.

Deploying large language models in user-facing systems requires efficient output safety filtering. Existing approaches typically rely on a separate moderation model applied after generation, which doubles inference cost and only detects violations after generation completes. We observe that the signal needed for moderation is already present in the model hidden states. Based on this, we train lightweight token-level probes that operate directly on internal activations, producing per-token safety scores that can be aggregated for both offline evaluation and online intervention. The probe reuses activations from the generator and requires no additional forward pass, enabling sub millisecond per-token safety checks inside the decoding loop. A probe applied to a single mid layer recovers most decisions of a strong guard model, acting as a low cost surrogate optimized for latency rather than accuracy. In streaming settings, it can halt or modify unsafe outputs before they are fully generated, replacing end of sequence moderation with continuous token level monitoring. Compared to post hoc and streaming guard models, our method achieves orders of magnitude lower compute overhead with minimal latency cost. We also provide a practical deployment recipe, including layer selection, aggregation strategy, probing frequency, and triggering thresholds. Finally, we show that the probe linear component corresponds to a direction in residual space, enabling both detection and activation steering at negligible cost.

The usage of deep neural networks in safety-critical systems is limited by our ability to guarantee their correct behavior. Runtime monitors are components aiming to identify unsafe predictions and discard them before they can lead to catastrophic consequences. Several recent works on runtime monitoring have focused on out-of-distribution (OOD) detection, i.e., identifying inputs that are different from the training data. In this work, we argue that OOD detection is not a well-suited framework to design efficient runtime monitors and that it is more relevant to evaluate monitors based on their ability to discard incorrect predictions. We call this setting out-ofmodel-scope detection and discuss the conceptual differences with OOD. We also conduct extensive experiments on popular datasets from the literature to show that studying monitors in the OOD setting can be misleading: 1. very good OOD results can give a false impression of safety, 2. comparison under the OOD setting does not allow identifying the best monitor to detect errors. Finally, we also show that removing erroneous training data samples helps to train better monitors.