Towards a Virtual Neuroscientist: Autonomous Neuroimaging Analysis via Multi-Agent Collaboration

Transforming neuroimaging data into clinically actionable biomarkers is a knowledge-intensive and labor-intensive process. Standardized workflows such as fMRIPrep have improved robustness and efficiency, but they are statically configured and cannot reason about downstream objectives, deliberate over alternative strategies, or close the loop between intermediate evidence and subsequent decisions in the way a human researcher would. This lack of closed-loop adaptation often leaves domain experts trapped in a cycle of manual trial-and-error to tune parameters and remediate pipeline failures, severely constraining the scalability of clinical biomarker development. To bridge this gap, we introduce NIAgent, a multi-agent system for autonomous end-to-end neuroimaging analysis. Unlike conventional flat tool-calling agents, NIAgent adopts a code-centric execution paradigm where specialist agents collaboratively synthesize and optimize executable programs over composable domain-specific primitives. This design enables robust, long-horizon workflow construction that adapts dynamically to runtime observations. Furthermore, we propose a hierarchical verification framework for autonomous quality control, integrating cohort-level metric screening with agentic visual inspection to drive evidence-grounded workflow remediation. Experiments on ADHD-200 and ADNI demonstrate that NIAgent outperforms standard workflow-based baselines in predictive performance while exhibiting sophisticated agentic behaviors, including strategy exploration and adaptive refinement.

LEAD: Length-Efficient Adaptive and Dynamic Reasoning for Large Language Models

Large reasoning models, such as OpenAI o1 and DeepSeek-R1, tend to become increasingly verbose as their reasoning capabilities improve. These inflated Chain-of-Thought (CoT) trajectories often exceed what the underlying problems require, wasting compute, latency, and context budgets. While introducing length-based efficiency rewards during reinforcement learning offers a natural remedy, existing methods struggle with two fundamental challenges: the optimal balance between correctness and efficiency is non-stationary throughout training, and intrinsic reasoning budgets vary drastically across problems. Relying on static reward weights and global length constraints inevitably forces a compromise between degraded accuracy and unrealized compression. To overcome these limitations, we propose LEAD (Length-Efficient Adaptive and Dynamic reasoning), a method that replaces static heuristics with online, self-adaptive mechanisms. LEAD dynamically calibrates the correctness-efficiency trade-off at each step using a Potential-Scaled Instability, directing optimization capacity to the most informative learning signal. Furthermore, it estimates an adaptive per-problem target length online based on the model's own correct rollouts, applying a symmetric efficiency reward that penalizes both overthinking and over-compression. Evaluated on five mathematical reasoning benchmarks, LEAD achieves the highest accuracy and Accuracy-Efficiency Score among RL-trained efficient-reasoning methods while producing substantially shorter outputs than the base model.

EviCare: Enhancing Diagnosis Prediction with Deep Model-Guided Evidence for In-Context Reasoning

Recent advances in large language models (LLMs) have enabled promising progress in diagnosis prediction from electronic health records (EHRs). However, existing LLM-based approaches tend to overfit to historically observed diagnoses, often overlooking novel yet clinically important conditions that are critical for early intervention. To address this, we propose EviCare, an in-context reasoning framework that integrates deep model guidance into LLM-based diagnosis prediction. Rather than prompting LLMs directly with raw EHR inputs, EviCare performs (1) deep model inference for candidate selection, (2) evidential prioritization for set-based EHRs, and (3) relational evidence construction for novel diagnosis prediction. These signals are then composed into an adaptive in-context prompt to guide LLM reasoning in an accurate and interpretable manner. Extensive experiments on two real-world EHR benchmarks (MIMIC-III and MIMIC-IV) demonstrate that EviCare achieves significant performance gains, which consistently outperforms both LLM-only and deep model-only baselines by an average of 20.65\% across precision and accuracy metrics. The improvements are particularly notable in challenging novel diagnosis prediction, yielding average improvements of 30.97\%.

Reinforcement Learning with LLM-Guided Action Spaces for Synthesizable Lead Optimization

Lead optimization in drug discovery requires improving therapeutic properties while ensuring that proposed molecular modifications correspond to feasible synthetic routes. Existing approaches either prioritize property scores without enforcing synthesizability, or rely on expensive enumeration over large reaction networks, while direct application of Large Language Models (LLMs) frequently produces chemically invalid structures. We introduce MolReAct, a framework that formulates lead optimization as a Markov Decision Process over a synthesis-constrained action space defined by validated reaction templates. A tool-augmented LLM agent serves as a dynamic reaction environment that invokes specialized chemical analysis tools to identify reactive sites and propose chemically grounded transformations from matched templates. A policy model trained via Group Relative Policy Optimization (GRPO) selects among these constrained actions to maximize long-term oracle reward across multi-step reaction trajectories. A SMILES-based caching mechanism further reduces end-to-end optimization time by approximately 43%. Across 13 property optimization tasks from the Therapeutic Data Commons and one structure-based docking task, MolReAct achieves an average Top-10 score of 0.563, outperforming the strongest synthesizable baseline by 10.4% in relative improvement, and attains the best sample efficiency on 10 of 14 tasks. Ablations confirm that both tool-augmented reaction proposals and trajectory-level policy optimization contribute complementary gains. By grounding every step in validated reaction templates, MolReAct produces molecules that are property-improved and each accompanied by an explicit synthetic pathway.

Dialogue to Question Generation for Evidence-based Medical Guideline Agent Development

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

LLM-MINE: Large Language Model based Alzheimer's Disease and Related Dementias Phenotypes Mining from Clinical Notes

Accurate extraction of Alzheimer's Disease and Related Dementias (ADRD) phenotypes from electronic health records (EHR) is critical for early-stage detection and disease staging. However, this information is usually embedded in unstructured textual data rather than tabular data, making it difficult to be extracted accurately. We therefore propose LLM-MINE, a Large Language Model-based phenotype mining framework for automatic extraction of ADRD phenotypes from clinical notes. Using two expert-defined phenotype lists, we evaluate the extracted phenotypes by examining their statistical significance across cohorts and their utility for unsupervised disease staging. Chi-square analyses confirm statistically significant phenotype differences across cohorts, with memory impairment being the strongest discriminator. Few-shot prompting with the combined phenotype lists achieves the best clustering performance (ARI=0.290, NMI=0.232), substantially outperforming biomedical NER and dictionary-based baselines. Our results demonstrate that LLM-based phenotype extraction is a promising tool for discovering clinically meaningful ADRD signals from unstructured notes.

ECG-MoE: Mixture-of-Expert Electrocardiogram Foundation Model

Electrocardiography (ECG) analysis is crucial for cardiac diagnosis, yet existing foundation models often fail to capture the periodicity and diverse features required for varied clinical tasks. We propose ECG-MoE, a hybrid architecture that integrates multi-model temporal features with a cardiac period-aware expert module. Our approach uses a dual-path Mixture-of-Experts to separately model beat-level morphology and rhythm, combined with a hierarchical fusion network using LoRA for efficient inference. Evaluated on five public clinical tasks, ECG-MoE achieves state-of-the-art performance with 40% faster inference than multi-task baselines.

MIRAGE: Knowledge Graph-Guided Cross-Cohort MRI Synthesis for Alzheimer's Disease Prediction

Reliable Alzheimer's disease (AD) diagnosis increasingly relies on multimodal assessments combining structural Magnetic Resonance Imaging (MRI) and Electronic Health Records (EHR). However, deploying these models is bottlenecked by modality missingness, as MRI scans are expensive and frequently unavailable in many patient cohorts. Furthermore, synthesizing de novo 3D anatomical scans from sparse, high-dimensional tabular records is technically challenging and poses severe clinical risks. To address this, we introduce MIRAGE, a novel framework that reframes the missing-MRI problem as an anatomy-guided cross-modal latent distillation task. First, MIRAGE leverages a Biomedical Knowledge Graph (KG) and Graph Attention Networks to map heterogeneous EHR variables into a unified embedding space that can be propagated from cohorts with real MRIs to cohorts without them. To bridge the semantic gap and enforce physical spatial awareness, we employ a frozen pre-trained 3D U-Net decoder strictly as an auxiliary regularization engine. Supported by a novel cohort-aggregated skip feature compensation strategy, this decoder acts as a rigorous structural penalty, forcing 1D latent representations to encode biologically plausible, macro-level pathological semantics. By exclusively utilizing this distilled "diagnostic-surrogate" representation during inference, MIRAGE completely bypasses computationally expensive 3D voxel reconstruction. Experiments demonstrate that our framework successfully bridges the missing-modality gap, improving the AD classification rate by 13% compared to unimodal baselines in cohorts without real MRIs.

Position: General Alignment Has Hit a Ceiling; Edge Alignment Must Be Taken Seriously

Large language models are being deployed in complex socio-technical systems, which exposes limits in current alignment practice. We take the position that the dominant paradigm of General Alignment, which compresses diverse human values into a single scalar reward, reaches a structural ceiling in settings with conflicting values, plural stakeholders, and irreducible uncertainty. These failures follow from the mathematics and incentives of scalarization and lead to \textbf{structural} value flattening, \textbf{normative} representation loss, and \textbf{cognitive} uncertainty blindness. We introduce Edge Alignment as a distinct approach in which systems preserve multi dimensional value structure, support plural and democratic representation, and incorporate epistemic mechanisms for interaction and clarification. To make this approach practical, we propose seven interdependent pillars organized into three phases. We identify key challenges in data collection, training objectives, and evaluation, outlining complementary technical and governance directions. Taken together, these measures reframe alignment as a lifecycle problem of dynamic normative governance rather than as a single instance optimization task.

Traceable Latent Variable Discovery Based on Multi-Agent Collaboration

Revealing the underlying causal mechanisms in the real world is crucial for scientific and technological progress. Despite notable advances in recent decades, the lack of high-quality data and the reliance of traditional causal discovery algorithms (TCDA) on the assumption of no latent confounders, as well as their tendency to overlook the precise semantics of latent variables, have long been major obstacles to the broader application of causal discovery. To address this issue, we propose a novel causal modeling framework, TLVD, which integrates the metadata-based reasoning capabilities of large language models (LLMs) with the data-driven modeling capabilities of TCDA for inferring latent variables and their semantics. Specifically, we first employ a data-driven approach to construct a causal graph that incorporates latent variables. Then, we employ multi-LLM collaboration for latent variable inference, modeling this process as a game with incomplete information and seeking its Bayesian Nash Equilibrium (BNE) to infer the possible specific latent variables. Finally, to validate the inferred latent variables across multiple real-world web-based data sources, we leverage LLMs for evidence exploration to ensure traceability. We comprehensively evaluate TLVD on three de-identified real patient datasets provided by a hospital and two benchmark datasets. Extensive experimental results confirm the effectiveness and reliability of TLVD, with average improvements of 32.67% in Acc, 62.21% in CAcc, and 26.72% in ECit across the five datasets.