arXiv subjects

Mengling Feng

Publications and source records attributed to Mengling Feng.

At least 37 records · Page 2Linked to original sources

arXiv2026

medR: Reward Engineering for Clinical Offline Reinforcement Learning via Tri-Drive Potential Functions

Reinforcement Learning (RL) offers a powerful framework for optimizing dynamic treatment regimes (DTRs). However, clinical RL is fundamentally bottlenecked by reward engineering: the challenge of defining signals that safely and effectively guide policy learning in complex, sparse offline environments. Existing approaches often rely on manual heuristics that fail to generalize across diverse pathologies. To address this, we propose an automated pipeline leveraging Large Language Models (LLMs) for offline reward design and verification. We formulate the reward function using potential functions consisted of three core components: survival, confidence, and competence. We further introduce quantitative metrics to rigorously evaluate and select the optimal reward structure prior to deployment. By integrating LLM-driven domain knowledge, our framework automates the design of reward functions for specific diseases while significantly enhancing the performance of the resulting policies.

cs.LG↗

arXiv2026

S3-CoT: Self-Sampled Succinct Reasoning Enables Efficient Chain-of-Thought LLMs

Large language models (LLMs) equipped with chain-of-thought (CoT) achieve strong performance and offer a window into LLM behavior. However, recent evidence suggests that improvements in CoT capabilities often come with redundant reasoning processes, motivating a key question: Can LLMs acquire a fast-thinking mode analogous to human System 1 reasoning? To explore this, our study presents a self-sampling framework based on activation steering for efficient CoT learning. Our method can induce style-aligned and variable-length reasoning traces from target LLMs themselves without any teacher guidance, thereby alleviating a central bottleneck of SFT-based methods-the scarcity of high-quality supervision data. Using filtered data by gold answers, we perform SFT for efficient CoT learning with (i) a human-like dual-cognitive system, and (ii) a progressive compression curriculum. Furthermore, we explore a self-evolution regime in which SFT is driven solely by prediction-consistent data of variable-length variants, eliminating the need for gold answers. Extensive experiments on math benchmarks, together with cross-domain generalization tests in medicine, show that our method yields stable improvements for both general and R1-style LLMs. Our data and model checkpoints can be found at https://github.com/DYR1/S3-CoT.

cs.CL↗

arXiv2026

A Survey of Quantized Graph Representation Learning: Connecting Graph Structures with Large Language Models

Recent years have witnessed rapid advances in graph representation learning, with the continuous embedding approach emerging as the dominant paradigm. However, such methods encounter issues regarding parameter efficiency, interpretability, and robustness. Thus, Quantized Graph Representation (QGR) learning has recently gained increasing interest, which represents the graph structure with discrete codes instead of conventional continuous embeddings. Given its analogous representation form to natural language, QGR also possesses the capability to seamlessly integrate graph structures with large language models (LLMs). As this emerging paradigm is still in its infancy yet holds significant promise, we undertake this thorough survey to promote its rapid future prosperity. We first present the background of the general quantization methods and their merits. Moreover, we provide an in-depth demonstration of current QGR studies from the perspectives of quantized strategies, training objectives, distinctive designs, knowledge graph quantization, and applications. We further explore the strategies for code dependence learning and integration with LLMs. At last, we give discussions and conclude future directions, aiming to provide a comprehensive picture of QGR and inspire future research.

cs.LG↗

arXiv2025

medDreamer: Model-Based Reinforcement Learning with Latent Imagination on Complex EHRs for Clinical Decision Support

Timely and personalized treatment decisions are essential across a wide range of healthcare settings where patient responses can vary significantly and evolve over time. Clinical data used to support these treatment decisions are often irregularly sampled, where missing data frequencies may implicitly convey information about the patient's condition. Existing Reinforcement Learning (RL) based clinical decision support systems often ignore the missing patterns and distort them with coarse discretization and simple imputation. They are also predominantly model-free and largely depend on retrospective data, which could lead to insufficient exploration and bias by historical behaviors. To address these limitations, we propose medDreamer, a novel model-based reinforcement learning framework for personalized treatment recommendation. medDreamer contains a world model with an Adaptive Feature Integration module that simulates latent patient states from irregular data and a two-phase policy trained on a hybrid of real and imagined trajectories. This enables learning optimal policies that go beyond the sub-optimality of historical clinical decisions, while remaining close to real clinical data. We evaluate medDreamer on both sepsis and mechanical ventilation treatment tasks using two large-scale Electronic Health Records (EHRs) datasets. Comprehensive evaluations show that medDreamer significantly outperforms model-free and model-based baselines in both clinical outcomes and off-policy metrics.

cs.LG↗

arXiv2025

Robust Multimodal Sentiment Analysis via Double Information Bottleneck

Multimodal sentiment analysis has received significant attention across diverse research domains. Despite advancements in algorithm design, existing approaches suffer from two critical limitations: insufficient learning of noise-contaminated unimodal data, leading to corrupted cross-modal interactions, and inadequate fusion of multimodal representations, resulting in discarding discriminative unimodal information while retaining multimodal redundant information. To address these challenges, this paper proposes a Double Information Bottleneck (DIB) strategy to obtain a powerful, unified compact multimodal representation. Implemented within the framework of low-rank Renyi's entropy functional, DIB offers enhanced robustness against diverse noise sources and computational tractability for high-dimensional data, as compared to the conventional Shannon entropy-based methods. The DIB comprises two key modules: 1) learning a sufficient and compressed representation of individual unimodal data by maximizing the task-relevant information and discarding the superfluous information, and 2) ensuring the discriminative ability of multimodal representation through a novel attention bottleneck fusion mechanism. Consequently, DIB yields a multimodal representation that effectively filters out noisy information from unimodal data while capturing inter-modal complementarity. Extensive experiments on CMU-MOSI, CMU-MOSEI, CH-SIMS, and MVSA-Single validate the effectiveness of our method. The model achieves 47.4% accuracy under the Acc-7 metric on CMU-MOSI and 81.63% F1-score on CH-SIMS, outperforming the second-best baseline by 1.19%. Under noise, it shows only 0.36% and 0.29% performance degradation on CMU-MOSI and CMU-MOSEI respectively.

cs.AI↗

arXiv2025

GEM: Empowering MLLM for Grounded ECG Understanding with Time Series and Images

While recent multimodal large language models (MLLMs) have advanced automated ECG interpretation, they still face two key limitations: (1) insufficient multimodal synergy between time series signals and visual ECG representations, and (2) limited explainability in linking diagnoses to granular waveform evidence. We introduce GEM, the first MLLM unifying ECG time series, 12-lead ECG images and text for grounded and clinician-aligned ECG interpretation. GEM enables feature-grounded analysis, evidence-driven reasoning, and a clinician-like diagnostic process through three core innovations: a dual-encoder framework extracting complementary time series and image features, cross-modal alignment for effective multimodal understanding, and knowledge-guided instruction generation for generating high-granularity grounding data (ECG-Grounding) linking diagnoses to measurable parameters ($e.g.$, QRS/PR Intervals). Additionally, we propose the Grounded ECG Understanding task, a clinically motivated benchmark designed to comprehensively assess the MLLM's capability in grounded ECG understanding. Experimental results on both existing and our proposed benchmarks show GEM significantly improves predictive performance (CSN $7.4\% \uparrow$), explainability ($22.7\% \uparrow$), and grounding ($24.8\% \uparrow$), making it more suitable for real-world clinical applications. GitHub repository: https://github.com/lanxiang1017/GEM.git

cs.CL↗

arXiv2025

Anchoring Refusal Direction: Mitigating Safety Risks in Tuning via Projection Constraint

Instruction Fine-Tuning (IFT) has been widely adopted as an effective post-training strategy to enhance various abilities of Large Language Models (LLMs). However, prior studies have shown that IFT can significantly compromise LLMs' safety, particularly their ability to refuse malicious instructions, raising significant concerns. Recent research into the internal mechanisms of LLMs has identified the refusal direction (r-direction) in the hidden states, which plays a pivotal role in governing refusal behavior. Building on this insight, our study reveals that the r-direction tends to drift during training, which we identify as one of the causes of the associated safety risks. To mitigate such drift, our proposed ProCon method introduces a projection-constrained loss term that regularizes the projection magnitude of each training sample's hidden state onto the r-direction. Our initial analysis shows that applying an appropriate constraint can effectively mitigate the refusal direction drift and associated safety risks, but remains limited by overall performance barriers. To overcome this barrier, informed by our observation of early-stage sharp drift and a data-driven perspective, we introduce a warm-up strategy that emphasizes early-stage strong constraints and broaden the data distribution to strengthen constraint signals, leading to an enhanced ProCon method. Experimental results under various datasets, scenarios, and LLMs demonstrate that our method can significantly mitigate safety risks posed by IFT while preserving task performance gains. Even compared with strong baselines, our method consistently delivers superior overall performance. Crucially, our analysis indicates that ProCon can contribute to stabilizing the r-direction during training, while such an interpretability-driven exploration of LLMs' internal mechanisms lays a solid foundation for future safety research.

cs.CL↗

arXiv2025

Prediction of mortality and resource utilization in critical care: a deep learning approach using multimodal electronic health records with natural language processing techniques

Background Predicting mortality and resource utilization from electronic health records (EHRs) is challenging yet crucial for optimizing patient outcomes and managing costs in intensive care unit (ICU). Existing approaches predominantly focus on structured EHRs, often ignoring the valuable clinical insights in free-text notes. Additionally, the potential of textual information within structured data is not fully leveraged. This study aimed to introduce and assess a deep learning framework using natural language processing techniques that integrates multimodal EHRs to predict mortality and resource utilization in critical care settings. Methods Utilizing two real-world EHR datasets, we developed and evaluated our model on three clinical tasks with leading existing methods. We also performed an ablation study on three key components in our framework: medical prompts, free-texts, and pre-trained sentence encoder. Furthermore, we assessed the model's robustness against the corruption in structured EHRs. Results Our experiments on two real-world datasets across three clinical tasks showed that our proposed model improved performance metrics by 1.6\%/0.8\% on BACC/AUROC for mortality prediction, 0.5%/2.2% on RMSE/MAE for LOS prediction, 10.9%/11.0% on RMSE/MAE for surgical duration estimation compared to the best existing methods. It consistently demonstrated superior performance compared to other baselines across three tasks at different corruption rates. Conclusions The proposed framework is an effective and accurate deep learning approach for predicting mortality and resource utilization in critical care. The study also highlights the success of using prompt learning with a transformer encoder in analyzing multimodal EHRs. Importantly, the model showed strong resilience to data corruption within structured data, especially at high corruption levels.

cs.CL↗

arXiv2025

Beyond Prediction: Reinforcement Learning as the Defining Leap in Healthcare AI

Reinforcement learning (RL) marks a fundamental shift in how artificial intelligence is applied in healthcare. Instead of merely predicting outcomes, RL actively decides interventions with long term goals. Unlike traditional models that operate on fixed associations, RL systems learn through trial, feedback, and long-term reward optimization, introducing transformative possibilities and new risks. From an information fusion lens, healthcare RL typically integrates multi-source signals such as vitals, labs clinical notes, imaging and device telemetry using temporal and decision-level mechanisms. These systems can operate within centralized, federated, or edge architectures to meet real-time clinical constraints, and naturally span data, features and decision fusion levels. This survey explore RL's rise in healthcare as more than a set of tools, rather a shift toward agentive intelligence in clinical environments. We first structure the landscape of RL techniques including model-based and model-free methods, offline and batch-constrained approaches, and emerging strategies for reward specification and uncertainty calibration through the lens of healthcare constraints. We then comprehensively analyze RL applications spanning critical care, chronic disease, mental health, diagnostics, and robotic assistance, identifying their trends, gaps, and translational bottlenecks. In contrast to prior reviews, we critically analyze RL's ethical, deployment, and reward design challenges, and synthesize lessons for safe, human-aligned policy learning. This paper serves as both a a technical roadmap and a critical reflection of RL's emerging transformative role in healthcare AI not as prediction machinery, but as agentive clinical intelligence.

cs.LG↗

arXiv2025

Advancing Multi-Organ Disease Care: A Hierarchical Multi-Agent Reinforcement Learning Framework

In healthcare, multi-organ system diseases pose unique and significant challenges as they impact multiple physiological systems concurrently, demanding complex and coordinated treatment strategies. Despite recent advancements in the AI based clinical decision support systems, these solutions only focus on individual organ systems, failing to account for complex interdependencies between them. This narrow focus greatly hinders their effectiveness in recommending holistic and clinically actionable treatments in the real world setting. To address this critical gap, we propose a novel Hierarchical Multi-Agent Reinforcement Learning (HMARL) framework. Our architecture deploys specialized and dedicated agents for each organ system and facilitates inter-agent communication to enable synergistic decision-making across organ systems. Furthermore, we introduce a dual-layer state representation technique that contextualizes patient conditions at both global and organ-specific levels, improving the accuracy and relevance of treatment decisions. We evaluate our HMARL solution on the task of sepsis management, a common and critical multi-organ disease, using both qualitative and quantitative metrics. Our method learns effective, clinically aligned treatment policies that considerably improve patient survival. We believe this framework represents a significant advancement in clinical decision support systems, introducing the first RL solution explicitly designed for multi-organ treatment recommendations. Our solution moves beyond prevailing simplified, single-organ models that fall short in addressing the complexity of multi-organ diseases.

cs.AI↗

arXiv2025

MEETI: A Multimodal ECG Dataset from MIMIC-IV-ECG with Signals, Images, Features and Interpretations

Electrocardiogram (ECG) plays a foundational role in modern cardiovascular care, enabling non-invasive diagnosis of arrhythmias, myocardial ischemia, and conduction disorders. While machine learning has achieved expert-level performance in ECG interpretation, the development of clinically deployable multimodal AI systems remains constrained, primarily due to the lack of publicly available datasets that simultaneously incorporate raw signals, diagnostic images, and interpretation text. Most existing ECG datasets provide only single-modality data or, at most, dual modalities, making it difficult to build models that can understand and integrate diverse ECG information in real-world settings. To address this gap, we introduce MEETI (MIMIC-IV-Ext ECG-Text-Image), the first large-scale ECG dataset that synchronizes raw waveform data, high-resolution plotted images, and detailed textual interpretations generated by large language models. In addition, MEETI includes beat-level quantitative ECG parameters extracted from each lead, offering structured parameters that support fine-grained analysis and model interpretability. Each MEETI record is aligned across four components: (1) the raw ECG waveform, (2) the corresponding plotted image, (3) extracted feature parameters, and (4) detailed interpretation text. This alignment is achieved using consistent, unique identifiers. This unified structure supports transformer-based multimodal learning and supports fine-grained, interpretable reasoning about cardiac health. By bridging the gap between traditional signal analysis, image-based interpretation, and language-driven understanding, MEETI established a robust foundation for the next generation of explainable, multimodal cardiovascular AI. It offers the research community a comprehensive benchmark for developing and evaluating ECG-based AI systems.

eess.SP↗

arXiv2025

Towards Unified Neurosymbolic Reasoning on Knowledge Graphs

Knowledge Graph (KG) reasoning has received significant attention in the fields of artificial intelligence and knowledge engineering, owing to its ability to autonomously deduce new knowledge and consequently enhance the availability and precision of downstream applications. However, current methods predominantly concentrate on a single form of neural or symbolic reasoning, failing to effectively integrate the inherent strengths of both approaches. Furthermore, the current prevalent methods primarily focus on addressing a single reasoning scenario, presenting limitations in meeting the diverse demands of real-world reasoning tasks. Unifying the neural and symbolic methods, as well as diverse reasoning scenarios in one model is challenging as there is a natural representation gap between symbolic rules and neural networks, and diverse scenarios exhibit distinct knowledge structures and specific reasoning objectives. To address these issues, we propose a unified neurosymbolic reasoning framework, namely Tunsr, for KG reasoning. Tunsr first introduces a consistent structure of reasoning graph that starts from the query entity and constantly expands subsequent nodes by iteratively searching posterior neighbors. Based on it, a forward logic message-passing mechanism is proposed to update both the propositional representations and attentions, as well as first-order logic (FOL) representations and attentions of each node. In this way, Tunsr conducts the transformation of merging multiple rules by merging possible relations at each step. Finally, the FARI algorithm is proposed to induce FOL rules by constantly performing attention calculations over the reasoning graph. Extensive experimental results on 19 datasets of four reasoning scenarios (transductive, inductive, interpolation, and extrapolation) demonstrate the effectiveness of Tunsr.

cs.AI↗

arXiv2025

No More Sliding Window: Efficient 3D Medical Image Segmentation with Differentiable Top-k Patch Sampling

3D models surpass 2D models in CT/MRI segmentation by effectively capturing inter-slice relationships. However, the added depth dimension substantially increases memory consumption. While patch-based training alleviates memory constraints, it significantly slows down the inference speed due to the sliding window (SW) approach. We propose No-More-Sliding-Window (NMSW), a novel end-to-end trainable framework that enhances the efficiency of generic 3D segmentation backbone during an inference step by eliminating the need for SW. NMSW employs a differentiable Top-k module to selectively sample only the most relevant patches, thereby minimizing redundant computations. When patch-level predictions are insufficient, the framework intelligently leverages coarse global predictions to refine results. Evaluated across 3 tasks using 3 segmentation backbones, NMSW achieves competitive accuracy compared to SW inference while significantly reducing computational complexity by 91% (88.0 to 8.00 TMACs). Moreover, it delivers a 9.1x faster inference on the H100 GPU (99.0 to 8.3 sec) and a 11.1x faster inference on the Xeon Gold CPU (2110 to 189 sec). NMSW is model-agnostic, further boosting efficiency when integrated with any existing efficient segmentation backbones. The code is avaialble: https://github.com/Youngseok0001/open_nmsw.

eess.IV↗

arXiv2025

ST-USleepNet: A Spatial-Temporal Coupling Prominence Network for Multi-Channel Sleep Staging

Sleep staging is critical to assess sleep quality and diagnose disorders. Despite advancements in artificial intelligence enabling automated sleep staging, significant challenges remain: (1) Simultaneously extracting prominent temporal and spatial sleep features from multi-channel raw signals, including characteristic sleep waveforms and salient spatial brain networks. (2) Capturing the spatial-temporal coupling patterns essential for accurate sleep staging. To address these challenges, we propose a novel framework named ST-USleepNet, comprising a spatial-temporal graph construction module (ST) and a U-shaped sleep network (USleepNet). The ST module converts raw signals into a spatial-temporal graph based on signal similarity, temporal, and spatial relationships to model spatial-temporal coupling patterns. The USleepNet employs a U-shaped structure for both the temporal and spatial streams, mirroring its original use in image segmentation to isolate significant targets. Applied to raw sleep signals and graph data from the ST module, USleepNet effectively segments these inputs, simultaneously extracting prominent temporal and spatial sleep features. Testing on three datasets demonstrates that ST-USleepNet outperforms existing baselines, and model visualizations confirm its efficacy in extracting prominent sleep features and temporal-spatial coupling patterns across various sleep stages. The code is available at https://github.com/Majy-Yuji/ST-USleepNet.

q-bio.NC↗

arXiv2025

DivScore: Zero-Shot Detection of LLM-Generated Text in Specialized Domains

Detecting LLM-generated text in specialized and high-stakes domains like medicine and law is crucial for combating misinformation and ensuring authenticity. However, current zero-shot detectors, while effective on general text, often fail when applied to specialized content due to domain shift. We provide a theoretical analysis showing this failure is fundamentally linked to the KL divergence between human, detector, and source text distributions. To address this, we propose DivScore, a zero-shot detection framework using normalized entropy-based scoring and domain knowledge distillation to robustly identify LLM-generated text in specialized domains. We also release a domain-specific benchmark for LLM-generated text detection in the medical and legal domains. Experiments on our benchmark show that DivScore consistently outperforms state-of-the-art detectors, with 14.4% higher AUROC and 64.0% higher recall (0.1% false positive rate threshold). In adversarial settings, DivScore demonstrates superior robustness than other baselines, achieving on average 22.8% advantage in AUROC and 29.5% in recall. Code and data are publicly available.

cs.CL↗

arXiv2025

BrainPrompt: Multi-Level Brain Prompt Enhancement for Neurological Condition Identification

Neurological conditions, such as Alzheimer's Disease, are challenging to diagnose, particularly in the early stages where symptoms closely resemble healthy controls. Existing brain network analysis methods primarily focus on graph-based models that rely solely on imaging data, which may overlook important non-imaging factors and limit the model's predictive power and interpretability. In this paper, we present BrainPrompt, an innovative framework that enhances Graph Neural Networks (GNNs) by integrating Large Language Models (LLMs) with knowledge-driven prompts, enabling more effective capture of complex, non-imaging information and external knowledge for neurological disease identification. BrainPrompt integrates three types of knowledge-driven prompts: (1) ROI-level prompts to encode the identity and function of each brain region, (2) subject-level prompts that incorporate demographic information, and (3) disease-level prompts to capture the temporal progression of disease. By leveraging these multi-level prompts, BrainPrompt effectively harnesses knowledge-enhanced multi-modal information from LLMs, enhancing the model's capability to predict neurological disease stages and meanwhile offers more interpretable results. We evaluate BrainPrompt on two resting-state functional Magnetic Resonance Imaging (fMRI) datasets from neurological disorders, showing its superiority over state-of-the-art methods. Additionally, a biomarker study demonstrates the framework's ability to extract valuable and interpretable information aligned with domain knowledge in neuroscience. The code is available at https://github.com/AngusMonroe/BrainPrompt

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arXiv2025

P-Transformer: A Prompt-based Multimodal Transformer Architecture For Medical Tabular Data

Medical tabular data, abundant in Electronic Health Records (EHRs), is a valuable resource for diverse medical tasks such as risk prediction. While deep learning approaches, particularly transformer-based models, have shown remarkable performance in tabular data prediction, there are still problems remaining for existing work to be effectively adapted into medical domain, such as ignoring unstructured free-texts and underutilizing the textual information in structured data. To address these issues, we propose PTransformer, a \underline{P}rompt-based multimodal \underline{Transformer} architecture designed specifically for medical tabular data. This framework consists of two critical components: a tabular cell embedding generator and a tabular transformer. The former efficiently encodes diverse modalities from both structured and unstructured tabular data into a harmonized language semantic space with the help of pre-trained sentence encoder and medical prompts. The latter integrates cell representations to generate patient embeddings for various medical tasks. In comprehensive experiments on two real-world datasets for three medical tasks, PTransformer demonstrated the improvements with 10.9%/11.0% on RMSE/MAE, 0.5%/2.2% on RMSE/MAE, and 1.6%/0.8% on BACC/AUROC compared to state-of-the-art (SOTA) baselines in predictability.

cs.CL↗

arXiv2025

From Screens to Scenes: A Survey of Embodied AI in Healthcare

Healthcare systems worldwide face persistent challenges in efficiency, accessibility, and personalization. Powered by modern AI technologies such as multimodal large language models and world models, Embodied AI (EmAI) represents a transformative frontier, offering enhanced autonomy and the ability to interact with the physical world to address these challenges. As an interdisciplinary and rapidly evolving research domain, "EmAI in healthcare" spans diverse fields such as algorithms, robotics, and biomedicine. This complexity underscores the importance of timely reviews and analyses to track advancements, address challenges, and foster cross-disciplinary collaboration. In this paper, we provide a comprehensive overview of the "brain" of EmAI for healthcare, wherein we introduce foundational AI algorithms for perception, actuation, planning, and memory, and focus on presenting the healthcare applications spanning clinical interventions, daily care & companionship, infrastructure support, and biomedical research. Despite its promise, the development of EmAI for healthcare is hindered by critical challenges such as safety concerns, gaps between simulation platforms and real-world applications, the absence of standardized benchmarks, and uneven progress across interdisciplinary domains. We discuss the technical barriers and explore ethical considerations, offering a forward-looking perspective on the future of EmAI in healthcare. A hierarchical framework of intelligent levels for EmAI systems is also introduced to guide further development. By providing systematic insights, this work aims to inspire innovation and practical applications, paving the way for a new era of intelligent, patient-centered healthcare.

cs.AI↗