arXiv subjects

Tonmoy Monsoor

Publications and source records attributed to Tonmoy Monsoor.

5 recordsLinked to original sources

arXiv2026

Teaching LLMs to Recommend and Defer in Underrepresented Epilepsy Care

Specialist epilepsy expertise is scarce in resource-constrained settings. Clinical decision-support systems must adapt to local prescribing practices and recognize when specialist review is needed. We study pediatric epilepsy care in Uganda, predicting anti-seizure medication regimens from longitudinal clinic notes. General-purpose language models achieve non-trivial agreement with physician prescriptions, but neurologists' review reveals Western prescribing defaults that do not account for local practices. We introduce MANANA, a non-parametric prompt-learning framework that learns local prescribing guidance from a small patient-level training set. MANANA turns prescription errors into auditable prompt memory, with 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. The learned prompt trajectory also provides a basis for estimating uncertainty. Bayesian prompt averaging (BPA) combines predictions across this trajectory to produce prescription likelihoods and a deferral signal. Using the same MANANA-Multi trajectory, BPA improves top-1 physician-regimen agreement from 66% to 70% on Cohort A and from 73% to 75% on Cohort B while preserving top-3 coverage. On Cohort B, its most confident half of cases achieves 95% precision, and its most confident quarter achieves 99% precision, supporting deferral of lower-confidence cases for specialist review. These results suggest a path toward locally adapted clinical LLM systems that learn from limited site-specific data and focus scarce specialist attention on uncertain cases.

cs.LG↗

arXiv2026

Omni-iEEG Planner: an open-source Python platform integrating multimodal neuroimaging and intracranial EEG data for epilepsy surgery research

Multimodal intracranial EEG (iEEG) research for epilepsy surgery combines anatomical and functional imaging, implanted electrode locations, interictal biomarkers, and functional mapping--outputs produced by different applications and reconciled by hand before they can be viewed on the same anatomy. Omni-iEEG Planner is an open-source Python platform that brings these inputs into one patient coordinate frame for research data analysis. The workflow starts from the preoperative T1-weighted MRI, from which FreeSurfer provides the cortical surface and anatomical labels; CT, PET and diffusion MRI are then co-registered to that reference, electrode contacts are detected automatically on the postimplantation CT and reviewed by the analyst, and tractography is reconstructed within the application. Channel-indexed results computed outside the platform, such as high-frequency oscillation counts from pyHFO or time-resolved gamma responses, are projected onto the contacts and the cortical surface with their source units preserved, and interictal and functional evidence remain separate layers. We describe the design and demonstrate representative workflows on de-identified patient data. The platform is not proposed as a method for every laboratory; it is a worked example of how one research group combined multimodal integration with an AI-assisted iEEG analysis tool, pyHFO, in a single open environment that others can adapt to their own pipelines. The design will accommodate further evidence types--model-derived contact scores, virtual implantation and hypothetical resection studies, group-level analyses--as they are implemented. The software is released under the MIT license for research and educational use, not clinical decision-making.

physics.med-ph↗

arXiv2026

Seizure-Semiology-Suite (S3): A Clinically Multimodal Dataset, Benchmark, and Models for Seizure Semiology Understanding

While Multimodal Large Language Models (MLLMs) have demonstrated remarkable proficiency in general video understanding, their capacity to interpret involuntary, and spatio-temporally evolving pathologic motor behaviors such as seizure semiology remains largely untested. To address this gap, we introduce Seizure-Semiology-Suite, a clinically grounded dataset and benchmark for fine-grained, structured seizure semiology understanding. The dataset includes 438 seizure videos annotated with over 35,000 dense labels covering 20 ILAE-defined semiological features. Building on this dataset, we propose a seven-task hierarchical benchmark that systematically evaluates MLLMs from low-level visual perception to temporal sequencing, narrative report generation, and seizure diagnosis. To enable clinically meaningful evaluation of generated reports, we further introduce the Report Quality Index for Seizure Semiology (Seizure-RQI). Extensive baselines across 11 open-weight MLLMs reveal systematic weaknesses in laterality reasoning, temporal localization, symptom sequencing, and clinically faithful reporting. We show that seizure-specific fine-tuning substantially improves performance across tasks, and that a two-stage neuro-symbolic framework achieves an F1 score of 0.96 on epileptic versus non-epileptic seizure classification. Seizure-Semiology-Suite establishes a rigorous benchmark for evaluating multimodal models in safety-critical medical video understanding and guides the development of clinically reliable, domain-adaptive multimodal intelligence.

cs.CV↗

arXiv2026

An Exterior Method for Nonnegative Matrix Factorization

Nonnegative matrix factorization (NMF) seeks a low-rank approximation $X \approx UV^T$ with nonnegative factors and is commonly solved using interior methods that enforce feasibility throughout optimization. We show that such constraint-driven approaches can impede progress in the nonconvex landscape, leading to slow convergence or convergence to suboptimal stationary points. We propose an exterior framework for NMF (eNMF) that separates low-rank approximation from nonnegativity enforcement. Our method initializes from the optimal unconstrained factorization and introduces a rotation procedure that maps unconstrained factors to an exterior point closest to the nonnegative orthant. This viewpoint yields an algorithmic framework in which simple iterative updates converge to KKT-satisfying stationary points on the boundary of the positive orthant. The exterior formulation also enables a geometric interpretation of NMF solutions, clarifying equivalence classes of factorizations under permutation and orthogonal transformations. An intriguing numerical result, involving 400 NMF experiments across both real and synthetic datasets, show that in 99% of the cases, different algorithms tend to converge towards equivalent factor matrices. We benchmark eNMF against 9 state-of-the-art NMF algorithms with 9 initialization schemes across 3 real-world and 2 synthetic datasets. eNMF consistently outperforms all 81 competitors, achieving up to 30% lower reconstruction error under equal-time settings and up to 150% speedup under equal-error settings. The downstream experiments further demonstrate substantial performance gains in audio processing and recommendation tasks, corroborating the practical benefits of the proposed exterior optimization framework. Code is available at https://github.com/roychowdhuryresearch/eNMF

cs.LG↗

arXiv2026

Can Multimodal Large Language Models Understand Pathologic Movements? A Pilot Study on Seizure Semiology

Multimodal Large Language Models (MLLMs) have demonstrated robust capabilities in recognizing everyday human activities, yet their potential for analyzing clinically significant involuntary movements in neurological disorders remains largely unexplored. This pilot study evaluates the capability of MLLMs for automated recognition of pathological movements in seizure videos. We assessed the zero-shot performance of state-of-the-art MLLMs on 20 ILAE-defined semiological features across 90 clinical seizure recordings. MLLMs outperformed fine-tuned Convolutional Neural Network (CNN) and Vision Transformer (ViT) baseline models on 13 of 18 features without task-specific training, demonstrating particular strength in recognizing salient postural and contextual features while struggling with subtle, high-frequency movements. Feature-targeted signal enhancement (facial cropping, pose estimation, audio denoising) improved performance on 10 of 20 features. Expert evaluation showed that 94.3 percent of MLLM-generated explanations for correctly predicted cases achieved at least 60 percent faithfulness scores, aligning with epileptologist reasoning. These findings demonstrate the potential of adapting general-purpose MLLMs for specialized clinical video analysis through targeted preprocessing strategies, offering a path toward interpretable, efficient diagnostic assistance. Our code is publicly available at https://github.com/LinaZhangUCLA/PathMotionMLLM.

cs.CV↗