arXiv subjects

Hong Yu

Publications and source records attributed to Hong Yu.

At least 37 records · Page 2Linked to original sources

arXiv2026

TAO-Attack: Toward Advanced Optimization-Based Jailbreak Attacks for Large Language Models

Large language models (LLMs) have achieved remarkable success across diverse applications but remain vulnerable to jailbreak attacks, where attackers craft prompts that bypass safety alignment and elicit unsafe responses. Among existing approaches, optimization-based attacks have shown strong effectiveness, yet current methods often suffer from frequent refusals, pseudo-harmful outputs, and inefficient token-level updates. In this work, we propose TAO-Attack, a new optimization-based jailbreak method. TAO-Attack employs a two-stage loss function: the first stage suppresses refusals to ensure the model continues harmful prefixes, while the second stage penalizes pseudo-harmful outputs and encourages the model toward more harmful completions. In addition, we design a direction-priority token optimization (DPTO) strategy that improves efficiency by aligning candidates with the gradient direction before considering update magnitude. Extensive experiments on multiple LLMs demonstrate that TAO-Attack consistently outperforms state-of-the-art methods, achieving higher attack success rates and even reaching 100\% in certain scenarios.

cs.CL↗

arXiv2026

TARSE: Test-Time Adaptation via Retrieval of Skills and Experience for Reasoning Agents

Complex clinical decision making often fails not because a model lacks facts, but because it cannot reliably select and apply the right procedural knowledge and the right prior example at the right reasoning step. We frame clinical question answering as an agent problem with two explicit, retrievable resources: skills, reusable clinical procedures such as guidelines, protocols, and pharmacologic mechanisms; and experience, verified reasoning trajectories from previously solved cases (e.g., chain-of-thought solutions and their step-level decompositions). At test time, the agent retrieves both relevant skills and experiences from curated libraries and performs lightweight test-time adaptation to align the language model's intermediate reasoning with clinically valid logic. Concretely, we build (i) a skills library from guideline-style documents organized as executable decision rules, (ii) an experience library of exemplar clinical reasoning chains indexed by step-level transitions, and (iii) a step-aware retriever that selects the most useful skill and experience items for the current case. We then adapt the model on the retrieved items to reduce instance-step misalignment and to prevent reasoning from drifting toward unsupported shortcuts. Experiments on medical question-answering benchmarks show consistent gains over strong medical RAG baselines and prompting-only reasoning methods. Our results suggest that explicitly separating and retrieving clinical skills and experience, and then aligning the model at test time, is a practical approach to more reliable medical agents.

cs.IR↗

arXiv2026

FinSight-Net:A Physics-Aware Decoupled Network with Frequency-Domain Compensation for Underwater Fish Detection in Smart Aquaculture

Underwater fish detection (UFD) is a core capability for smart aquaculture and marine ecological monitoring. While recent detectors improve accuracy by stacking feature extractors or introducing heavy attention modules, they often incur substantial computational overhead and, more importantly, neglect the physics that fundamentally limits UFD: wavelength-dependent absorption and turbidity-induced scattering significantly degrade contrast, blur fine structures, and introduce backscattering noise, leading to unreliable localization and recognition. To address these challenges, we propose FinSight-Net, an efficient and physics-aware detection framework tailored for complex aquaculture environments. FinSight-Net introduces a Multi-Scale Decoupled Dual-Stream Processing (MS-DDSP) bottleneck that explicitly targets frequency-specific information loss via heterogeneous convolutional branches, suppressing backscattering artifacts while compensating distorted biological cues through scale-aware and channel-weighted pathways. We further design an Efficient Path Aggregation FPN (EPA-FPN) as a detail-filling mechanism: it restores high-frequency spatial information typically attenuated in deep layers by establishing long-range skip connections and pruning redundant fusion routes, enabling robust detection of non-rigid fish targets under severe blur and turbidity. Extensive experiments on DeepFish, AquaFishSet, and our challenging UW-BlurredFish benchmark demonstrate that FinSight-Net achieves state-of-the-art performance. In particular, on UW-BlurredFish, FinSight-Net reaches 92.8% mAP, outperforming YOLOv11s by 4.8% while reducing parameters by 29.0%, providing a strong and lightweight solution for real-time automated monitoring in smart aquaculture.

cs.CV↗

arXiv2026

Predicting first-episode homelessness among US Veterans using longitudinal EHR data: time-varying models and social risk factors

Homelessness among US veterans remains a critical public health challenge, yet risk prediction offers a pathway for proactive intervention. In this retrospective prognostic study, we analyzed electronic health record (EHR) data from 4,276,403 Veterans Affairs patients during a 2016 observation period to predict first-episode homelessness occurring 3-12 months later in 2017 (prevalence: 0.32-1.19%). We constructed static and time-varying EHR representations, utilizing clinician-informed logic to model the persistence of clinical conditions and social risks over time. We then compared the performance of classical machine learning, transformer-based masked language models, and fine-tuned large language models (LLMs). We demonstrate that incorporating social and behavioral factors into longitudinal models improved precision-recall area under the curve (PR-AUC) by 15-30%. In the top 1% risk tier, models yielded positive predictive values ranging from 3.93-4.72% at 3 months, 7.39-8.30% at 6 months, 9.84-11.41% at 9 months, and 11.65-13.80% at 12 months across model architectures. Large language models underperformed encoder-based models on discrimination but showed smaller performance disparities across racial groups. These results demonstrate that longitudinal, socially informed EHR modeling concentrates homelessness risk into actionable strata, enabling targeted and data-informed prevention strategies for at-risk veterans.

cs.CL↗

arXiv2026

Knowing When to Abstain: Medical LLMs Under Clinical Uncertainty

Current evaluation of large language models (LLMs) overwhelmingly prioritizes accuracy; however, in real-world and safety-critical applications, the ability to abstain when uncertain is equally vital for trustworthy deployment. We introduce MedAbstain, a unified benchmark and evaluation protocol for abstention in medical multiple-choice question answering (MCQA) -- a discrete-choice setting that generalizes to agentic action selection -- integrating conformal prediction, adversarial question perturbations, and explicit abstention options. Our systematic evaluation of both open- and closed-source LLMs reveals that even state-of-the-art, high-accuracy models often fail to abstain with uncertain. Notably, providing explicit abstention options consistently increases model uncertainty and safer abstention, far more than input perturbations, while scaling model size or advanced prompting brings little improvement. These findings highlight the central role of abstention mechanisms for trustworthy LLM deployment and offer practical guidance for improving safety in high-stakes applications.

cs.CL↗

arXiv2025

PRIME: Planning and Retrieval-Integrated Memory for Enhanced Reasoning

Inspired by the dual-process theory of human cognition from \textit{Thinking, Fast and Slow}, we introduce \textbf{PRIME} (Planning and Retrieval-Integrated Memory for Enhanced Reasoning), a multi-agent reasoning framework that dynamically integrates \textbf{System 1} (fast, intuitive thinking) and \textbf{System 2} (slow, deliberate thinking). PRIME first employs a Quick Thinking Agent (System 1) to generate a rapid answer; if uncertainty is detected, it then triggers a structured System 2 reasoning pipeline composed of specialized agents for \textit{planning}, \textit{hypothesis generation}, \textit{retrieval}, \textit{information integration}, and \textit{decision-making}. This multi-agent design faithfully mimics human cognitive processes and enhances both efficiency and accuracy. Experimental results with LLaMA 3 models demonstrate that PRIME enables open-source LLMs to perform competitively with state-of-the-art closed-source models like GPT-4 and GPT-4o on benchmarks requiring multi-hop and knowledge-grounded reasoning. This research establishes PRIME as a scalable solution for improving LLMs in domains requiring complex, knowledge-intensive reasoning.

cs.AI↗

arXiv2025

TS-P$^2$CL: Plug-and-Play Dual Contrastive Learning for Vision-Guided Medical Time Series Classification

Medical time series (MedTS) classification is pivotal for intelligent healthcare, yet its efficacy is severely limited by poor cross-subject generation due to the profound cross-individual heterogeneity. Despite advances in architectural innovations and transfer learning techniques, current methods remain constrained by modality-specific inductive biases that limit their ability to learn universally invariant representations. To overcome this, we propose TS-P$^2$CL, a novel plug-and-play framework that leverages the universal pattern recognition capabilities of pre-trained vision models. We introduce a vision-guided paradigm that transforms 1D physiological signals into 2D pseudo-images, establishing a bridge to the visual domain. This transformation enables implicit access to rich semantic priors learned from natural images. Within this unified space, we employ a dual-contrastive learning strategy: intra-modal consistency enforces temporal coherence, while cross-modal alignment aligns time-series dynamics with visual semantics, thereby mitigating individual-specific biases and learning robust, domain-invariant features. Extensive experiments on six MedTS datasets demonstrate that TS-P$^2$CL consistently outperforms fourteen methods in both subject-dependent and subject-independent settings.

cs.CV↗

arXiv2025

Exploiting Tree Structure for Credit Assignment in RL Training of LLMs

Reinforcement learning improves LLM reasoning, yet sparse delayed reward over long sequences makes token-level credit assignment the key bottleneck. We study the verifiable-reward setting, where the final answer is checkable and multiple responses can be drawn per prompt. Reasoning tasks in math and medical QA align with this setup, where only a few decision tokens significantly impact the outcome. PPO offers token-level advantages with a learned value model, but it is complex to train both the actor and critic models simultaneously, and it is not easily generalizable, as the token-level values from the critic model can make training prone to overfitting. GRPO is critic-free and supports verifiable rewards, but spreads a single sequence-level return across tokens and ignores branching. We introduce \textbf{Prefix-to-Tree (P2T)}, a simple procedure that converts a group of responses into a prefix tree and computes \emph{nonparametric} prefix values $V(s)$ by aggregating descendant outcomes. Built on P2T, we propose \textbf{TEMPO} (\emph{\textbf{T}ree-\textbf{E}stimated \textbf{M}ean Prefix Value for \textbf{P}olicy \textbf{O}ptimization}), a critic-free algorithm that augments the group-relative outcome signal of GRPO with \emph{branch-gated} temporal-difference corrections derived from the tree. At non-branch tokens, the temporal-difference (TD) term is zero, so TEMPO reduces to GRPO; at branching tokens, it supplies precise token-level credit without a learned value network or extra judges/teachers. On Qwen3-1.7B/4B, TEMPO outperforms PPO and GRPO on in-distribution (MATH, MedQA) and out-of-distribution (GSM-HARD, AMC23, MedMCQA, MMLU-Medical) benchmarks, and reaches higher validation accuracy with roughly the same wall-clock time.

cs.CL↗

arXiv2025

From Scores to Steps: Diagnosing and Improving LLM Performance in Evidence-Based Medical Calculations

Large language models (LLMs) have demonstrated promising performance on medical benchmarks; however, their ability to perform medical calculations, a crucial aspect of clinical decision-making, remains underexplored and poorly evaluated. Existing benchmarks often assess only the final answer with a wide numerical tolerance, overlooking systematic reasoning failures and potentially causing serious clinical misjudgments. In this work, we revisit medical calculation evaluation with a stronger focus on clinical trustworthiness. First, we clean and restructure the MedCalc-Bench dataset and propose a new step-by-step evaluation pipeline that independently assesses formula selection, entity extraction, and arithmetic computation. Under this granular framework, the accuracy of GPT-4o drops from 62.7% to 43.6%, revealing errors masked by prior evaluations. Second, we introduce an automatic error analysis framework that generates structured attribution for each failure mode. Human evaluation confirms its alignment with expert judgment, enabling scalable and explainable diagnostics. Finally, we propose a modular agentic pipeline, MedRaC, that combines retrieval-augmented generation and Python-based code execution. Without any fine-tuning, MedRaC improves the accuracy of different LLMs from 16.35% up to 53.19%. Our work highlights the limitations of current benchmark practices and proposes a more clinically faithful methodology. By enabling transparent and transferable reasoning evaluation, we move closer to making LLM-based systems trustworthy for real-world medical applications.

cs.CL↗

arXiv2025

DischargeSim: A Simulation Benchmark for Educational Doctor-Patient Communication at Discharge

Discharge communication is a critical yet underexplored component of patient care, where the goal shifts from diagnosis to education. While recent large language model (LLM) benchmarks emphasize in-visit diagnostic reasoning, they fail to evaluate models' ability to support patients after the visit. We introduce DischargeSim, a novel benchmark that evaluates LLMs on their ability to act as personalized discharge educators. DischargeSim simulates post-visit, multi-turn conversations between LLM-driven DoctorAgents and PatientAgents with diverse psychosocial profiles (e.g., health literacy, education, emotion). Interactions are structured across six clinically grounded discharge topics and assessed along three axes: (1) dialogue quality via automatic and LLM-as-judge evaluation, (2) personalized document generation including free-text summaries and structured AHRQ checklists, and (3) patient comprehension through a downstream multiple-choice exam. Experiments across 18 LLMs reveal significant gaps in discharge education capability, with performance varying widely across patient profiles. Notably, model size does not always yield better education outcomes, highlighting trade-offs in strategy use and content prioritization. DischargeSim offers a first step toward benchmarking LLMs in post-visit clinical education and promoting equitable, personalized patient support.

cs.CL↗

arXiv2025

Chatbot To Help Patients Understand Their Health

Patients must possess the knowledge necessary to actively participate in their care. We present NoteAid-Chatbot, a conversational AI that promotes patient understanding via a novel 'learning as conversation' framework, built on a multi-agent large language model (LLM) and reinforcement learning (RL) setup without human-labeled data. NoteAid-Chatbot was built on a lightweight LLaMA 3.2 3B model trained in two stages: initial supervised fine-tuning on conversational data synthetically generated using medical conversation strategies, followed by RL with rewards derived from patient understanding assessments in simulated hospital discharge scenarios. Our evaluation, which includes comprehensive human-aligned assessments and case studies, demonstrates that NoteAid-Chatbot exhibits key emergent behaviors critical for patient education, such as clarity, relevance, and structured dialogue, even though it received no explicit supervision for these attributes. Our results show that even simple Proximal Policy Optimization (PPO)-based reward modeling can successfully train lightweight, domain-specific chatbots to handle multi-turn interactions, incorporate diverse educational strategies, and meet nuanced communication objectives. Our Turing test demonstrates that NoteAid-Chatbot surpasses non-expert human. Although our current focus is on healthcare, the framework we present illustrates the feasibility and promise of applying low-cost, PPO-based RL to realistic, open-ended conversational domains, broadening the applicability of RL-based alignment methods.

cs.AI↗

arXiv2025

DualAlign: Generating Clinically Grounded Synthetic Data

Synthetic clinical data are increasingly important for advancing AI in healthcare, given strict privacy constraints on real-world EHRs, limited availability of annotated rare-condition data, and systemic biases in observational datasets. While large language models (LLMs) can generate fluent clinical text, producing synthetic data that is both realistic and clinically meaningful remains challenging. We introduce DualAlign, a framework that enhances statistical fidelity and clinical plausibility through dual alignment: (1) statistical alignment, which conditions generation on patient demographics and risk factors; and (2) semantic alignment, which incorporates real-world symptom trajectories to guide content generation. Using Alzheimer's disease (AD) as a case study, DualAlign produces context-grounded symptom-level sentences that better reflect real-world clinical documentation. Fine-tuning an LLaMA 3.1-8B model with a combination of DualAlign-generated and human-annotated data yields substantial performance gains over models trained on gold data alone or unguided synthetic baselines. While DualAlign does not fully capture longitudinal complexity, it offers a practical approach for generating clinically grounded, privacy-preserving synthetic data to support low-resource clinical text analysis.

cs.LG↗

arXiv2025

MedCOD: Enhancing English-to-Spanish Medical Translation of Large Language Models Using Enriched Chain-of-Dictionary Framework

We present MedCOD (Medical Chain-of-Dictionary), a hybrid framework designed to improve English-to-Spanish medical translation by integrating domain-specific structured knowledge into large language models (LLMs). MedCOD integrates domain-specific knowledge from both the Unified Medical Language System (UMLS) and the LLM-as-Knowledge-Base (LLM-KB) paradigm to enhance structured prompting and fine-tuning. We constructed a parallel corpus of 2,999 English-Spanish MedlinePlus articles and a 100-sentence test set annotated with structured medical contexts. Four open-source LLMs (Phi-4, Qwen2.5-14B, Qwen2.5-7B, and LLaMA-3.1-8B) were evaluated using structured prompts that incorporated multilingual variants, medical synonyms, and UMLS-derived definitions, combined with LoRA-based fine-tuning. Experimental results demonstrate that MedCOD significantly improves translation quality across all models. For example, Phi-4 with MedCOD and fine-tuning achieved BLEU 44.23, chrF++ 28.91, and COMET 0.863, surpassing strong baseline models like GPT-4o and GPT-4o-mini. Ablation studies confirm that both MedCOD prompting and model adaptation independently contribute to performance gains, with their combination yielding the highest improvements. These findings highlight the potential of structured knowledge integration to enhance LLMs for medical translation tasks.

cs.CL↗

arXiv2025

ChatCLIDS: Simulating Persuasive AI Dialogues to Promote Closed-Loop Insulin Adoption in Type 1 Diabetes Care

Real-world adoption of closed-loop insulin delivery systems (CLIDS) in type 1 diabetes remains low, driven not by technical failure, but by diverse behavioral, psychosocial, and social barriers. We introduce ChatCLIDS, the first benchmark to rigorously evaluate LLM-driven persuasive dialogue for health behavior change. Our framework features a library of expert-validated virtual patients, each with clinically grounded, heterogeneous profiles and realistic adoption barriers, and simulates multi-turn interactions with nurse agents equipped with a diverse set of evidence-based persuasive strategies. ChatCLIDS uniquely supports longitudinal counseling and adversarial social influence scenarios, enabling robust, multi-dimensional evaluation. Our findings reveal that while larger and more reflective LLMs adapt strategies over time, all models struggle to overcome resistance, especially under realistic social pressure. These results highlight critical limitations of current LLMs for behavior change, and offer a high-fidelity, scalable testbed for advancing trustworthy persuasive AI in healthcare and beyond.

cs.AI↗

arXiv2025

ChatThero: An LLM-Supported Chatbot for Behavior Change and Therapeutic Support in Addiction Recovery

Substance use disorders (SUDs) affect millions of people, and relapses are common, requiring multi-session treatments. Access to care is limited, which contributes to the challenge of recovery support. We present \textbf{ChatThero}, an innovative low-cost, multi-session, stressor-aware, and memory-persistent autonomous \emph{language agent} designed to facilitate long-term behavior change and therapeutic support in addiction recovery. Unlike existing work that mostly finetuned large language models (LLMs) on patient-therapist conversation data, ChatThero was trained in a multi-agent simulated environment that mirrors real therapy. We created anonymized patient profiles from recovery communities (e.g., Reddit). We classify patients as \texttt{easy}, \texttt{medium}, and \texttt{difficult}, three scales representing their resistance to recovery. We created an external environment by introducing stressors (e.g., social determinants of health) to simulate real-world situations. We dynamically inject clinically-grounded therapeutic strategies (motivational interview and cognitive behavioral therapy). Our evaluation, conducted by both human (blinded clinicians) and LLM-as-Judge, shows that ChatThero is superior in empathy and clinical relevance. We show that stressor simulation improves robustness of ChatThero. Explicit stressors increase relapse-like setbacks, matching real-world patterns. We evaluate ChatThero with behavioral change metrics. On a 1--5 scale, ChatThero raises \texttt{motivation} by $+1.71$ points (from $2.39$ to $4.10$) and \texttt{confidence} by $+1.67$ points (from $1.52$ to $3.19$), substantially outperforming GPT-5. On \texttt{difficult} patients, ChatThero reaches the success milestone with $26\%$ fewer turns than GPT-5.

cs.AI↗

arXiv2025

The Anatomy of a Personal Health Agent

Health is a fundamental pillar of human wellness, and the rapid advancements in large language models (LLMs) have driven the development of a new generation of health agents. However, the application of health agents to fulfill the diverse needs of individuals in daily non-clinical settings is underexplored. In this work, we aim to build a comprehensive personal health agent that is able to reason about multimodal data from everyday consumer wellness devices and common personal health records, and provide personalized health recommendations. To understand end-users' needs when interacting with such an assistant, we conducted an in-depth analysis of web search and health forum queries, alongside qualitative insights from users and health experts gathered through a user-centered design process. Based on these findings, we identified three major categories of consumer health needs, each of which is supported by a specialist sub-agent: (1) a data science agent that analyzes personal time-series wearable and health record data, (2) a health domain expert agent that integrates users' health and contextual data to generate accurate, personalized insights, and (3) a health coach agent that synthesizes data insights, guiding users using a specified psychological strategy and tracking users' progress. Furthermore, we propose and develop the Personal Health Agent (PHA), a multi-agent framework that enables dynamic, personalized interactions to address individual health needs. To evaluate each sub-agent and the multi-agent system, we conducted automated and human evaluations across 10 benchmark tasks, involving more than 7,000 annotations and 1,100 hours of effort from health experts and end-users. Our work represents the most comprehensive evaluation of a health agent to date and establishes a strong foundation towards the futuristic vision of a personal health agent accessible to everyone.

cs.AI↗

arXiv2025

A New NMT Model for Translating Clinical Texts from English to Spanish

Translating electronic health record (EHR) narratives from English to Spanish is a clinically important yet challenging task due to the lack of a parallel-aligned corpus and the abundant unknown words contained. To address such challenges, we propose \textbf{NOOV} (for No OOV), a new neural machine translation (NMT) system that requires little in-domain parallel-aligned corpus for training. NOOV integrates a bilingual lexicon automatically learned from parallel-aligned corpora and a phrase look-up table extracted from a large biomedical knowledge resource, to alleviate both the unknown word problem and the word-repeat challenge in NMT, enhancing better phrase generation of NMT systems. Evaluation shows that NOOV is able to generate better translation of EHR with improvement in both accuracy and fluency.

cs.CL↗

arXiv2025

MedReadCtrl: Personalizing medical text generation with readability-controlled instruction learning

Generative AI has demonstrated strong potential in healthcare, from clinical decision support to patient-facing chatbots that improve outcomes. A critical challenge for deployment is effective human-AI communication, where content must be both personalized and understandable. We introduce MedReadCtrl, a readability-controlled instruction tuning framework that enables LLMs to adjust output complexity without compromising meaning. Evaluations of nine datasets and three tasks across medical and general domains show that MedReadCtrl achieves significantly lower readability instruction-following errors than GPT-4 (e.g., 1.39 vs. 1.59 on ReadMe, p<0.001) and delivers substantial gains on unseen clinical tasks (e.g., +14.7 ROUGE-L, +6.18 SARI on MTSamples). Experts consistently preferred MedReadCtrl (71.7% vs. 23.3%), especially at low literacy levels. These gains reflect MedReadCtrl's ability to restructure clinical content into accessible, readability-aligned language while preserving medical intent, offering a scalable solution to support patient education and expand equitable access to AI-enabled care.

cs.CL↗