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Medical Reasoning in the Era of LLMs: A Systematic Review of Enhancement Techniques and Applications

The proliferation of Large Language Models (LLMs) in medicine has enabled impressive capabilities, yet a critical gap remains in their ability to perform systematic, transparent, and verifiable reasoning, a cornerstone of clinical practice. This has catalyzed a shift from single-step answer generation to the development of LLMs explicitly designed for medical reasoning. This paper provides the first systematic review of this emerging field. We propose a taxonomy of reasoning enhancement techniques, categorized into training-time strategies (e.g., supervised fine-tuning, reinforcement learning) and test-time mechanisms (e.g., prompt engineering, multi-agent systems). We analyze how these techniques are applied across different data modalities (text, image, code) and in key clinical applications such as diagnosis, education, and treatment planning. Furthermore, we survey the evolution of evaluation benchmarks from simple accuracy metrics to sophisticated assessments of reasoning quality and visual interpretability. Based on an analysis of 60 seminal studies from 2022-2025, we conclude by identifying critical challenges, including the faithfulness-plausibility gap and the need for native multimodal reasoning, and outlining future directions toward building efficient, robust, and sociotechnically responsible medical AI.

cs.CL

Tri-PvP: Exposing Modality Bias in Omni-Modal Large Language Models through Perceptual-Propositional Evidence Conflicts

Omni-modal large language models (OLLMs) jointly process vision, audio, and text, yet their modality bias under cross-modal conflict remains underexplored. Existing benchmarks conflate two distinct forms of evidence within a single modality: perceptual signals (e.g., a photograph or recording of a dog) and propositional signals (e.g., the declarative claim "this is a dog"), such that any measured modality bias is inherently confounded with evidence-form bias, precluding clean attribution to either source. To address this, we introduce Tri-PvP, an 8,000-sample tri-modal conflict benchmark crossing vision, audio, and text, where vision and audio each take perceptual or propositional form. Evaluating five OLLMs, we find robust visual bias across most models and evidence-type conditions. Crucially, we reveal a systematic asymmetry in evidence-form bias: models exhibit a stronger bias toward perceptual signal in vision but propositional in audio. Further analyses via layer-wise linear probing and contrastive decoding reveal that modality bias is already linearly decodable from early representation layers and can only be partially mitigated, calling for mitigation strategies beyond surface-level interventions.

cs.CL

SCDF: A Speaker Characteristics DeepFake Speech Dataset for Bias Analysis

Despite growing attention to deepfake speech detection, the aspects of bias and fairness remain underexplored in the speech domain. To address this gap, we introduce the Speaker Characteristics Deepfake (SCDF) dataset: a novel, richly annotated resource enabling systematic evaluation of demographic biases in deepfake speech detection. SCDF contains over 237,000 utterances in a balanced representation of both male and female speakers spanning five languages and a wide age range. We evaluate several state-of-the-art detectors and show that speaker characteristics significantly influence detection performance, revealing disparities across sex, language, age, and synthesizer type. These findings highlight the need for bias-aware development and provide a foundation for building non-discriminatory deepfake detection systems aligned with ethical and regulatory standards.

cs.SD

RoboTrustBench: Benchmarking the Trustworthiness of Video World Models for Robotic Manipulation

Video world models are increasingly used in robotic manipulation, yet existing benchmarks mostly evaluate them under valid, feasible, and safe instructions. We introduce RoboTrustBench, a benchmark for evaluating the trustworthiness of video world models under four scenarios: Normal, Constraint-Sensitive, Counterfactual, and Adversarial. Built from real-world DROID episodes, RoboTrustBench contains 1,207 expert-validated instruction-image pairs and a six-dimensional evaluation protocol with 13 fine-grained criteria. Evaluating seven representative video world models with human and MLLM assessment, we find that current models often generate visually coherent videos, but struggle with constraint reasoning, counterfactual grounding, physical interaction, and unsafe-instruction suppression. These results show that visual quality and surface-level instruction following are insufficient for trustworthy robotic video world modeling.

cs.CV

When Robots Mishear Us: Mapping the Safety Risks of Voice-Controlled Embodied AI

We investigate whether automatic speech recognition (ASR) errors in user input can lead to unsafe outputs from Embodied AI (EAI) models. We find that ASR errors can lead to harmful instructions being accepted and executed by EAI models, thereby reducing safety. We simulate ASR errors and combine them with existing safety benchmarks (SafeAgentBench and POEX) to evaluate how different errors affect embodied AI safety. We find that some of them preserve semantic structure but increase harmful ambiguity, while others weaken the model refusal behaviour and allow unsafe plans to be generated and executed. We show that in some cases automatic correction of ASR errors can reduce the risk, but this is not always effective. Overall, we show that ASR errors lead to significant safety risks for embodied AI.

cs.AI

Quantum Computing: Lecture Notes

This is a set of lecture notes suitable for a Master's course on quantum computation and information from the perspective of theoretical computer science. The first version was written in 2011, with many extensions and improvements in subsequent years. The first 10 chapters cover the circuit model and the main quantum algorithms (Deutsch-Jozsa, Simon, Shor, Hidden Subgroup Problem, Grover, quantum walks, Hamiltonian simulation and HHL). They are followed by 4 chapters about complexity, 4 chapters about distributed ("Alice and Bob") settings, a chapter about quantum machine learning, one about stabilizer states and Clifford circuits, and a final chapter about quantum error correction. Appendices A and B give a brief introduction to the required linear algebra and some other mathematical and computer science background. All chapters come with exercises, with some hints provided in Appendix C.

quant-ph

Efficient and Microphone-Fault-Tolerant 3D Sound Source Localization

Sound source localization (SSL) is a critical technology for determining the position of sound sources in complex environments. However, existing methods face challenges such as high computational costs and precise calibration requirements, limiting their deployment in dynamic or resource-constrained environments. This paper introduces a novel 3D SSL framework, which uses sparse cross-attention, pretraining, and adaptive signal coherence metrics, to achieve accurate and computationally efficient localization with fewer input microphones. The framework also supports operational microphones at unknown positions: their recordings remain available and are used to estimate both source and microphone positions. Preliminary experiments demonstrate its scalability for multi-source localization without requiring additional hardware. This work advances SSL by balancing the model's performance and efficiency and improving its robustness for real-world scenarios.

cs.SD

CompanionSim: Synthetic Data for Evaluating Anthropomorphism in Human-AI Relationships

Many people now see AI systems as not just productivity tools but as social companions. Researchers are eager to study the consequences of AI companionship behaviors, such as validation, which evoke trust, empathy, and attachment in human-human interaction. However, human-AI interaction data is limited and unreliable, slowing research progress. We scale small amounts of real-world data by simulating multi-turn human-chatbot dialogue across a range of chatbot behaviors and use cases. We release CompanionSim: a simulation framework with 2,240 simulated human-chatbot conversations representing 16 chatbot behaviors across seven use cases. Human participants annotated the simulated conversations and real-world conversations in two experiments probing perceptions of companionship behaviors. We conducted Study 1 with a U.S. representative sample ($N_{1}~=~628$) and Study 2 across the U.S., U.K., India, and Nigeria ($N_{2}~=~3,646$). Surprisingly, we find that companionship behaviors reduced likability, humanlikeness, and trust in AI chatbots. These effects were larger in particular subgroups: women and older participants saw companionship chatbots as less likable, humanlike, and trustworthy. We encourage researchers to leverage real-world and synthetic data together to study the differential impacts of AI companions and to create benchmark evaluations of AI chatbots.

cs.CY

RAFM-SER++: A Lightweight Multimodal Emotion Recognition Framework for Real-Time Behavioral Monitoring in Surveillance Systems

Recent multimodal Speech Emotion Recognition (SER) systems achieve high accuracy through interaction-heavy cross-modal transformers, but their computational cost limits deployment in latency-sensitive and resource-constrained surveillance systems. To address this challenge, we propose RAFM_SER++, a lightweight multimodal SER framework featuring an asymmetric Residual Attention Fusion Mechanism (RAFM). Rather than relying on computationally expensive bidirectional interactions, RAFM injects affective speech cues into semantic text representations through a one-directional residual attention pathway. Combined with a BYOL-inspired cross-modal alignment objective and attention-guided pooling, the proposed framework improves multimodal representation learning while maintaining low computational overhead. Experiments on the IEMOCAP and ESD benchmarks demonstrate that RAFM_SER++ consistently outperforms the HuBERT-Base baseline and achieves a superior accuracy-efficiency trade-off compared with the state-of-the-art MemoCMT. Specifically, RAFM_SER++ reduces trainable parameters by more than 60%, achieves faster inference (79.60 it/s), and attains BACC scores of 81.10% on IEMOCAP and 95.39% on ESD. These results indicate that lightweight asymmetric multimodal fusion is an effective alternative to interaction-heavy cross-modal transformers for real-time surveillance applications.

cs.AI

TASTE: Throughput-Aware Batch Size Tuning for On-Device Edge Learning

The rise of privacy-preserving artificial intelligence (AI) has shifted the focus of model adaptation and personalization towards on-device learning, where deep learning models are finetuned directly on edge hardware using local user data. However, this shift requires optimization of deep learning training on resource-constrained hardware to maximize throughput while maintaining predictive accuracy. This paper introduces a novel technique for on-device model training that incorporates an efficient Bayesian optimization-based batch size tuning approach to maximize hardware throughput. To evaluate the impact of this hyperparameter on the learning dynamics, we investigated two distinct paradigms: standard supervised learning (SL) and online continual learning (CL). Experimental results across various edge devices demonstrate a throughput ceiling, beyond which increasing the batch size yields no additional throughput gains. The proposed tuning approach identifies the optimal batch size, which, when combined with gradient accumulation and linear learning rate scaling, achieves up to a 2X increase in training throughput on platforms such as Raspberry Pi 4 compared to maximum batch sizes, without compromising model accuracy. Furthermore, in the CL paradigm, we demonstrate that optimal batch sizes maintain the stability-plasticity balance required for incremental learning, effectively mitigating catastrophic forgetting while maximizing computational efficiency on edge-hardware.

cs.LG

LLM-Driven Autonomous Vehicles Inherit Human Driver Biases in Pedestrian Yielding: Results and Implications From A New Benchmark

Public trust in Autonomous Vehicles (AVs) may depend not only on technical success but also on the fairness of their decision making. While a recent trend in AV research involves using general purpose "common sense" models to guide AV decision making, the degree to which these inherit human biases in driving is still understudied. Given that psychology studies have shown human driver biases exist, such as lower pedestrian-yielding rates to Black pedestrians in the US, we argue that analyses of model bias should also be part of AV evaluation. Concretely, in this paper we propose two new bias testing methodologies for Large Language Models (LLMs) and Visual-Language Models (VLMs)-"All Else Being Equal" tests and "Self-Consistency" tests-in order to assess bias in pedestrian-yielding decisions. Our findings show that both LLMs and VLMs make yielding decisions which are influenced by pedestrian gender, ethnicity, religion, disability, age, skin tone and socio-economic status. While the type and degree of bias is different from model to model, we highlight common patterns-and raise questions about the "common sense" model paradigm, particularly the need to either revise the paradigm or address issues of downstream bias.

cs.AI

Deep Optimizer States: Towards Scalable Training of Transformer Models Using Interleaved Offloading

Transformers and large language models~(LLMs) have seen rapid adoption in all domains. Their sizes have exploded to hundreds of billions of parameters and keep increasing. Under these circumstances, the training of transformers is very expensive and often hits a ``memory wall'', i.e., even when using 3D parallelism (pipeline, tensor, data) and aggregating the memory of many GPUs, it is still not enough to hold the necessary data structures (model parameters, optimizer state, gradients, activations) in GPU memory. To compensate, state-of-the-art approaches offload the optimizer state, at least partially, to the host memory and perform hybrid CPU-GPU computations. However, the management of the combined host-GPU memory is often suboptimal and results in poor overlapping between data movements and computations. This leads to missed opportunities to simultaneously leverage the interconnect bandwidth and computational capabilities of CPUs and GPUs. In this paper, we leverage a key observation that the interleaving of the forward, backward, and update phases generates fluctuations in the GPU memory utilization, which can be exploited to dynamically move a part of the optimizer state between the host and the GPU memory at each iteration. To this end, we design and implement Deep Optimizer States, a novel technique to split the LLM into subgroups, whose update phase is scheduled on either the CPU or the GPU based on our proposed performance model that addresses the trade-off between data movement cost, acceleration on the GPUs vs the CPUs, and competition for shared resources. We integrate our approach with DeepSpeed and demonstrate 2.5$\times$ faster iterations over state-of-the-art approaches using extensive experiments.

cs.LG

Characterising Global Platforms: Centralised, Decentralised, Federated, and Grassroots

Global digital platforms are distributed systems designed to serve entire populations, with some already serving billions of people. Here we propose atomic transactions-based multiagent transition systems and protocols as a formal framework to study them; introduce essential agents---minimal sets of agents the removal of which makes communication impossible; and show that the cardinality of essential agents partitions all global platforms into four classes: 1. Centralised (Facebook) -- one (the server) 2. Decentralised (Bitcoin) -- finite >1 (bootstrap nodes) 3. Federated (Mastodon) -- infinite but not universal (all servers) 4. Grassroots (Scuttlebutt) -- universal (all agents but one) Our illustrative formal example is a global social network, for which we provide centralised, decentralised, federated, and grassroots specifications via multiagent atomic transactions, and prove they all satisfy the same basic correctness properties, yet have different sets of essential agents as expected. We discuss informally additional global platforms---currencies, "sharing economy" apps, AI, and more. This work provides the first mathematical framework for classifying any global platform---existing or imagined---by providing a multiagent atomic-transactions specification of it and determining the cardinality of the minimal set of essential agents in the ensuing multiagent protocol. It thus provides a unifying mathematical approach for the study of global digital platforms, perhaps the most important class of distributed systems today.

cs.DC

Efficient Constant Optimization for Symbolic Regression with GPU-Accelerated Tree-Based Genetic Programming

Constant optimization refines the numerical coefficients of candidate expressions in tree-based genetic programming for symbolic regression. But its per-generation cost has led modern GPU-accelerated frameworks to omit it or restrict it to lightweight forms. We present a GPU-resident, batched Levenberg--Marquardt solver that optimizes constants across a structurally heterogeneous population of expression trees using a fixed number of population-wide CUDA launches per iteration. Reverse-mode automatic differentiation assembles the per-tree Jacobian in one backward sweep, making the dominant per-iteration cost independent of the number of constants per tree, and a double-precision delivery guard guarantees that returned constants are never worse than their initial values. On early-generation populations, the solver sustains up to $5.1{\times}10^{5}$ trees per second on an NVIDIA A100; at a GPU-saturated benchmark configuration it delivers roughly $9.9{\times}$ the throughput of Operon running on a 64-core EPYC 7763, while matching fp64-reference quality. Integrated in-process into EvoGP, the solver enables end-to-end search to recover governing equations on $10$ of $18$ constructed problems versus 0 for stock EvoGP. Our code is at https://github.com/TensorConv/CuSR.

cs.NE

RAGMark: A Comprehensive Framework for Benchmarking Retrieval-Augmented Generation Systems

We present RAGMark, a modular benchmarking framework for advanced Retrieval-Augmented Generation (RAG) systems targeting small-scale multi-GPU environments. RAGMark evaluates diverse RAG components, including retrievers, vector databases, prompt-processing methods, and generator models, while collecting detailed per-stage metrics such as latency, GPU utilization, memory consumption, power usage, time to first token (TTFT), throughput, and answer quality. The framework is highly extensible, separating RAG stages, timing, and resource monitoring into modular components, and is designed to efficiently sweep large configuration spaces while minimizing repeated model and database initialization overhead. Using RAGMark, we characterize five RAG workloads on open-domain QA datasets across varying retrieval depths, model scales, reranking, compression methods, and vector database configurations. We show that while autoregressive generation dominates latency in naive pipelines, context-reduction techniques shift bottlenecks across compute, memory bandwidth, and preprocessing stages. Reranking and compression produce compounding benefits: reranking reduces compression workload itself, while both jointly reduce prefill and KV-cache traversal costs, lowering energy consumption by up to 66%. We further observe strong cross-stage interactions, where small upstream context reductions cascade through downstream latency, memory traffic, and energy consumption. The RAGMark source code is publicly available at: https://github.com/zferic/RAGMark.

cs.PF

D3ARC: Time-Critical Distributed Disaster Detection for Asynchronous Cooperative Multi-Robot Systems

Climate change is increasing the severity and unpredictability of natural disasters. In time-critical crises such as wildfires, traditional monitoring practices remain limited by coverage, cost, and personnel risk, paving the way for autonomous and adaptive monitoring solutions. Within this context, this paper introduces D3ARC, an asynchronous distributed hierarchical framework for time-aware and reliable wildfire detection. D3ARC integrates multiple robotic agents that cooperate under uncertainty through distributed perception, shared situational awareness and coordinated actions. A remote controller asynchronously decides upon each robot's motion, while each robotic agent senses the environment and decides where and how to execute the wildfire detection. All robotic operations require time, and as time progresses, wildfires continue to spread, reducing the opportunity for early intervention. As such, all agents share a common objective: to detect a wildfire with a certain performance threshold as fast as possible and within a time limit. D3ARC integrates mechanisms for safe navigation, coverage efficiency, cooperation and reliability. It introduces a forward-looking capability that allows agents to anticipate the future by evaluating candidate strategies before execution. The framework is evaluated through realistic robotics simulations, ablation studies, and baseline comparisons, achieving an overall mission success up to 94% with 89.4% detection confidence.

cs.RO

FlatLands: Generative Floormap Completion From a Single Egocentric View

A single egocentric image typically captures only a small portion of the floor, yet a complete metric traversability map of the surroundings would better serve applications such as indoor navigation. We introduce FlatLands, a dataset and benchmark for single-view bird's-eye view (BEV) floor completion. The dataset contains 270,575 observations from 17,656 real metric indoor scenes drawn from six existing datasets, with aligned observation, visibility, validity, and ground-truth BEV maps, and the benchmark includes both in- and out-of-distribution evaluation protocols. We compare training-free approaches, deterministic models, ensembles, and stochastic generative models. Finally, we instantiate the task as an end-to-end monocular RGB-to-floormaps pipeline. FlatLands provides a rigorous testbed for uncertainty-aware indoor mapping and generative completion for embodied navigation.

cs.CV

Robust Multi-Agent LLMs under Byzantine Faults

Large language model (LLM) agents increasingly collaborate over peer-to-peer networks to improve their reliability. However, these same interactions can also introduce vulnerability to unreliable or Byzantine agents that can propagate incorrect information and degrade overall system performance. To address this, we propose Self-Anchored Consensus (SAC), a fully decentralized filter-and-refine protocol in which agents iteratively exchange responses, locally evaluate and filter unreliable messages, and refine their own outputs. We present $(F{+}1)$-robustness conditions on the communication graph that ensure honest agents preserve and propagate reliable information despite Byzantine influence. Experiments across diverse open- and closed-weight LLMs on mathematical and commonsense reasoning benchmarks show that SAC effectively suppresses Byzantine influence and consistently improves performance across diverse communication topologies, whereas prior methods degrade significantly under Byzantine attacks.

cs.MA