Daily Papers

Reliability in multi-agent systems (MAS) built on large language models is increasingly limited by cognitive failures rather than infrastructure faults. Existing observability tools describe failures but do not quantify how quickly distributed reasoning recovers once coherence is lost. We introduce MTTR-A (Mean Time-to-Recovery for Agentic Systems), a runtime reliability metric that measures cognitive recovery latency in MAS. MTTR-A adapts classical dependability theory to agentic orchestration, capturing the time required to detect reasoning drift and restore coherent operation. We further define complementary metrics, including MTBF and a normalized recovery ratio (NRR), and establish theoretical bounds linking recovery latency to long-run cognitive uptime. Using a LangGraph-based benchmark with simulated drift and reflex recovery, we empirically demonstrate measurable recovery behavior across multiple reflex strategies. This work establishes a quantitative foundation for runtime cognitive dependability in distributed agentic systems.

Large Language Model (LLM) serving systems remain fundamentally fragile, where frequent hardware faults in hyperscale clusters trigger disproportionate service outages in the software stack. Current recovery mechanisms are prohibitively slow, often requiring up to 10 minutes to reinitialize resources and reload massive model weights. We introduce KevlarFlow, a fault tolerant serving architecture designed to bridge the gap between hardware unreliability and service availability. KevlarFlow leverages 1) decoupled model parallelism initialization, 2) dynamic traffic rerouting, and 3) background KV cache replication to maintain high throughput during partial failures. Our evaluation demonstrates that KevlarFlow reduces mean-time-to-recovery (MTTR) by 20x and, under failure conditions, improves average latency by 3.1x, 99th percentile (p99) latency by 2.8x, average time-to-first-token (TTFT) by 378.9x, and p99 TTFT by 574.6x with negligible runtime overhead in comparison to state-of-the-art LLM serving systems.

Large-scale LLM pretraining now runs across 10^5--10^6 accelerators, making failures routine and elasticity mandatory. We posit that an elastic-native training system must jointly deliver (i) parameter consistency, (ii) low mean time to recovery (MTTR), (iii) high post-change throughput, and (iv) computation consistency. No prior system achieves all four simultaneously. To achieve these goals, we present ElasWave, which delivers per-step fault tolerance via multi-dimensional scheduling across graph, dataflow, DVFS, and RNG. ElasWave reshapes and reshards micro-batches while preserving the global batch size and gradient scale. It performs online pipeline resharding with asynchronous parameter migration and interleaves ZeRO partitions, reducing parameter recovery processes to disjoint rank-to-rank transfers. It further leverages DVFS to absorb pipeline bubbles and reshards RNG to keep computation consistency. Together, a dynamic communicator enables in-place communication group edits, while per-step in-memory snapshots support online verification and redistribution. We evaluate ElasWave on 96 NPUs and benchmark it against state-of-the-art baselines: throughput improves by 1.35times over ReCycle and 1.60times over TorchFT; communicator recovery completes within one second (up to 82times/3.6times faster than full/partial rebuilds); migration MTTR drops by as much as 51%; and convergence deviation is reduced by approximately 78%.

Time series forecasting (TSF) remains a challenging and largely unsolved problem in machine learning, despite significant recent efforts leveraging Large Language Models (LLMs), which predominantly rely on Transformer architectures. Empirical evidence consistently shows that even powerful Transformers often fail to outperform much simpler models, e.g., linear models, on TSF tasks; however, a rigorous theoretical understanding of this phenomenon remains limited. In this paper, we provide a theoretical analysis of Transformers' limitations for TSF through the lens of In-Context Learning (ICL) theory. Specifically, under AR(p) data, we establish that: (1) Linear Self-Attention (LSA) models cannot achieve lower expected MSE than classical linear models for in-context forecasting; (2) as the context length approaches to infinity, LSA asymptotically recovers the optimal linear predictor; and (3) under Chain-of-Thought (CoT) style inference, predictions collapse to the mean exponentially. We empirically validate these findings through carefully designed experiments. Our theory not only sheds light on several previously underexplored phenomena but also offers practical insights for designing more effective forecasting architectures. We hope our work encourages the broader research community to revisit the fundamental theoretical limitations of TSF and to critically evaluate the direct application of increasingly sophisticated architectures without deeper scrutiny.

Test-time scaling evaluates reasoning LLMs by sampling multiple outputs per prompt, but ranking models in this regime remains underexplored. We formalize dense benchmark ranking under test-time scaling and introduce Scorio, a library that implements statistical ranking methods such as paired-comparison models, item response theory (IRT) models, voting rules, and graph- and spectral-based methods. Across 20 reasoning models on four Olympiad-style math benchmarks (AIME'24, AIME'25, HMMT'25, and BrUMO'25; up to N=80 trials), most full-trial rankings agree closely with the Bayesian gold standard Bayes_{U}@80 (mean Kendall's τ_b = 0.93--0.95), and 19--34 methods recover exactly the same ordering. In the single-trial regime, the best methods reach τ_b approx 0.86. Using greedy decoding as an empirical prior (Bayes_{R_0}@N) reduces variance at N=1 by 16--52%, but can bias rankings when greedy and stochastic sampling disagree. These results identify reliable ranking methods for both high- and low-budget test-time scaling. We release Scorio as an open-source library at https://github.com/mohsenhariri/scorio.

We present a self-supervised, time-to-event (TTE) foundation model called MOTOR (Many Outcome Time Oriented Representations) which is pretrained on timestamped sequences of events in electronic health records (EHR) and health insurance claims. TTE models are used for estimating the probability distribution of the time until a specific event occurs, which is an important task in medical settings. TTE models provide many advantages over classification using fixed time horizons, including naturally handling censored observations, but are challenging to train with limited labeled data. MOTOR addresses this challenge by pretraining on up to 55M patient records (9B clinical events). We evaluate MOTOR's transfer learning performance on 19 tasks, across 3 patient databases (a private EHR system, MIMIC-IV, and Merative claims data). Task-specific models adapted from MOTOR improve time-dependent C statistics by 4.6% over state-of-the-art, improve label efficiency by up to 95% ,and are more robust to temporal distributional shifts. We further evaluate cross-site portability by adapting our MOTOR foundation model for six prediction tasks on the MIMIC-IV dataset, where it outperforms all baselines. MOTOR is the first foundation model for medical TTE predictions and we release a 143M parameter pretrained model for research use at [redacted URL].

Survival analysis, or time-to-event modelling, is a classical statistical problem that has garnered a lot of interest for its practical use in epidemiology, demographics or actuarial sciences. Recent advances on the subject from the point of view of machine learning have been concerned with precise per-individual predictions instead of population studies, driven by the rise of individualized medicine. We introduce here a conditional normalizing flow based estimate of the time-to-event density as a way to model highly flexible and individualized conditional survival distributions. We use a novel hierarchical formulation of normalizing flows to enable efficient fitting of flexible conditional distributions without overfitting and show how the normalizing flow formulation can be efficiently adapted to the censored setting. We experimentally validate the proposed approach on a synthetic dataset as well as four open medical datasets and an example of a common financial problem.

Objective: Forecasting epileptic seizures can reduce uncertainty for patients and allow preventative actions. While many models can predict the occurrence of seizures from features of the EEG, few models incorporate changes in features over time. Long Short-Term Memory (LSTM) neural networks are a machine learning architecture that can display temporal dynamics due to the recurrent connections. In this paper, we used LSTMs to monitor changes in EEG features over time to improve the accuracy of seizure forecasts and to alter the time window of the forecast. Methods: Long-term intracranial EEG recordings from eight patients from the NeuroVista dataset were used. A Fourier transform of 1-minute segments of EEG was fed into a Convolutional Neural Network (CNN). The outputs from the CNN were input to three different LSTM models at different time intervals: 1 minute, 1 hour and 1 day. The LSTM model outputs were used to predict seizure onset within a time window. The prediction and start of the time window were separated by the same length of time as the window. Window sizes tested included 2, 4, 10, 20 and 40 minutes. Results and Conclusion: Our model forecast seizure onsets well above a random predictor. Compared to other models using the same dataset, our model performed better for some patients and worse for others. Monitoring the change in EEG features over time allowed our model to produce good results over a range of different window sizes, which is an improvement on previous models and raises the possibility of altering the forecast to meet individual patient needs. Furthermore, a window size of 40 minutes provides a potential intervention time of 40 minutes, which is the first time an intervention time of more than 5 minutes have been forecast using long-term EEG recordings.

Sepsis is a life-threatening host response to infection associated with high mortality, morbidity, and health costs. Its management is highly time-sensitive since each hour of delayed treatment increases mortality due to irreversible organ damage. Meanwhile, despite decades of clinical research, robust biomarkers for sepsis are missing. Therefore, detecting sepsis early by utilizing the affluence of high-resolution intensive care records has become a challenging machine learning problem. Recent advances in deep learning and data mining promise to deliver a powerful set of tools to efficiently address this task. This empirical study proposes two novel approaches for the early detection of sepsis: a deep learning model and a lazy learner based on time series distances. Our deep learning model employs a temporal convolutional network that is embedded in a Multi-task Gaussian Process Adapter framework, making it directly applicable to irregularly-spaced time series data. Our lazy learner, by contrast, is an ensemble approach that employs dynamic time warping. We frame the timely detection of sepsis as a supervised time series classification task. For this, we derive the most recent sepsis definition in an hourly resolution to provide the first fully accessible early sepsis detection environment. Seven hours before sepsis onset, our methods improve area under the precision--recall curve from 0.25 to 0.35/0.40 over the state of the art. This demonstrates that they are well-suited for detecting sepsis in the crucial earlier stages when management is most effective.

The ability to measure and track the speed and trajectory of a community's post-disaster recovery is essential to inform resource allocation and prioritization. The current survey-based approaches to examining community recovery, however, have significant lags and put the burden of data collection on affected people. Also, the existing literature lacks quantitative measures for important milestones to inform the assessment of recovery trajectory. Recognizing these gaps, this study uses location-based data related to visitation patterns and credit card transactions to specify critical recovery milestones related to population activity recovery. Using data from 2017 Hurricane Harvey in Harris County (Texas), the study specifies four critical post-disaster recovery milestones and calculates quantitative measurements of the length of time between the end of a hazard event and when the spatial areas (census tracts) reached these milestones based on fluctuations in visits to essential and non-essential facilities, and essential and non-essential credit card transactions. Accordingly, an integrated recovery metric is created for an overall measurement of each spatial area's recovery progression. Exploratory statistical analyses were conducted to examine whether variations in community recovery progression in achieving the critical milestones is correlated to its flood status, socioeconomic characteristics, and demographic composition. Finally, the extent of spatial inequality is examined. The results show the presence of moderate spatial inequality in population activity recovery in Hurricane Harvey, based upon which the inequality of recovery is measured. Results of this study can benefit post-disaster recovery resource allocation as well as improve community resilience towards future natural hazards.

Lung cancer patients frequently experience breakthrough pain episodes, with up to 91% requiring timely intervention. To enable proactive pain management, we propose a hybrid machine learning and large language model pipeline that predicts pain episodes within 48 and 72 hours of hospitalization using both structured and unstructured electronic health record data. A retrospective cohort of 266 inpatients was analyzed, with features including demographics, tumor stage, vital signs, and WHO-tiered analgesic use. The machine learning module captured temporal medication trends, while the large language model interpreted ambiguous dosing records and free-text clinical notes. Integrating these modalities improved sensitivity and interpretability. Our framework achieved an accuracy of 0.874 (48h) and 0.917 (72h), with an improvement in sensitivity of 8.6% and 10.4% due to the augmentation of large language model. This hybrid approach offers a clinically interpretable and scalable tool for early pain episode forecasting, with potential to enhance treatment precision and optimize resource allocation in oncology care.

Despite decades of clinical research, sepsis remains a global public health crisis with high mortality, and morbidity. Currently, when sepsis is detected and the underlying pathogen is identified, organ damage may have already progressed to irreversible stages. Effective sepsis management is therefore highly time-sensitive. By systematically analysing trends in the plethora of clinical data available in the intensive care unit (ICU), an early prediction of sepsis could lead to earlier pathogen identification, resistance testing, and effective antibiotic and supportive treatment, and thereby become a life-saving measure. Here, we developed and validated a machine learning (ML) system for the prediction of sepsis in the ICU. Our analysis represents the largest multi-national, multi-centre in-ICU study for sepsis prediction using ML to date. Our dataset contains 156,309 unique ICU admissions, which represent a refined and harmonised subset of five large ICU databases originating from three countries. Using the international consensus definition Sepsis-3, we derived hourly-resolved sepsis label annotations, amounting to 26,734 (17.1%) septic stays. We compared our approach, a deep self-attention model, to several clinical baselines as well as ML baselines and performed an extensive internal and external validation within and across databases. On average, our model was able to predict sepsis with an AUROC of 0.847 pm 0.050 (internal out-of sample validation) and 0.761 pm 0.052 (external validation). For a harmonised prevalence of 17%, at 80% recall our model detects septic patients with 39% precision 3.7 hours in advance.

One straightforward metric to evaluate a survival prediction model is based on the Mean Absolute Error (MAE) -- the average of the absolute difference between the time predicted by the model and the true event time, over all subjects. Unfortunately, this is challenging because, in practice, the test set includes (right) censored individuals, meaning we do not know when a censored individual actually experienced the event. In this paper, we explore various metrics to estimate MAE for survival datasets that include (many) censored individuals. Moreover, we introduce a novel and effective approach for generating realistic semi-synthetic survival datasets to facilitate the evaluation of metrics. Our findings, based on the analysis of the semi-synthetic datasets, reveal that our proposed metric (MAE using pseudo-observations) is able to rank models accurately based on their performance, and often closely matches the true MAE -- in particular, is better than several alternative methods.

Urgent care clinics and emergency departments around the world periodically suffer from extended wait times beyond patient expectations due to inadequate staffing levels. These delays have been linked with adverse clinical outcomes. Previous research into forecasting demand this domain has mostly used a collection of statistical techniques, with machine learning approaches only now beginning to emerge in recent literature. The forecasting problem for this domain is difficult and has also been complicated by the COVID-19 pandemic which has introduced an additional complexity to this estimation due to typical demand patterns being disrupted. This study explores the ability of machine learning methods to generate accurate patient presentations at two large urgent care clinics located in Auckland, New Zealand. A number of machine learning algorithms were explored in order to determine the most effective technique for this problem domain, with the task of making forecasts of daily patient demand three months in advance. The study also performed an in-depth analysis into the model behaviour in respect to the exploration of which features are most effective at predicting demand and which features are capable of adaptation to the volatility caused by the COVID-19 pandemic lockdowns. The results showed that ensemble-based methods delivered the most accurate and consistent solutions on average, generating improvements in the range of 23%-27% over the existing in-house methods for estimating the daily demand.

Clinical trials or studies oftentimes require long-term and/or costly follow-up of participants to evaluate a novel treatment/drug/vaccine. There has been increasing interest in the past few decades in using short-term surrogate outcomes as a replacement of the primary outcome i.e., in using the surrogate outcome, which can potentially be observed sooner, to make inference about the treatment effect on the long-term primary outcome. Very few of the available statistical methods to evaluate a surrogate are applicable to settings where both the surrogate and the primary outcome are time-to-event outcomes subject to censoring. Methods that can handle this setting tend to require parametric assumptions or be limited to assessing only the restricted mean survival time. In this paper, we propose a non-parametric approach to evaluate a censored surrogate outcome, such as time to progression, when the primary outcome is also a censored time-to-event outcome, such as time to death, and the treatment effect of interest is the difference in overall survival. Specifically, we define the proportion of the treatment effect on the primary outcome that is explained (PTE) by the censored surrogate outcome in this context, and estimate this proportion by defining and deriving an optimal transformation of the surrogate information. Our approach provides the added advantage of relaxed assumptions to guarantee that the true PTE is within (0,1), along with being model-free. Finite sample performance of our estimators are illustrated via extensive simulation studies and a real data application examining progression-free survival as a surrogate for overall survival for patients with metastatic colorectal cancer.

Lower-Limb Fractures (LLF) are a major health concern for older adults, often leading to reduced mobility and prolonged recovery, potentially impairing daily activities and independence. During recovery, older adults frequently face social isolation and functional decline, complicating rehabilitation and adversely affecting physical and mental health. Multi-modal sensor platforms that continuously collect data and analyze it using machine-learning algorithms can remotely monitor this population and infer health outcomes. They can also alert clinicians to individuals at risk of isolation and decline. This paper presents a new publicly available multi-modal sensor dataset, MAISON-LLF, collected from older adults recovering from LLF in community settings. The dataset includes data from smartphone and smartwatch sensors, motion detectors, sleep-tracking mattresses, and clinical questionnaires on isolation and decline. The dataset was collected from ten older adults living alone at home for eight weeks each, totaling 560 days of 24-hour sensor data. For technical validation, supervised machine-learning and deep-learning models were developed using the sensor and clinical questionnaire data, providing a foundational comparison for the research community.

With the volatile and complex nature of financial data influenced by external factors, forecasting the stock market is challenging. Traditional models such as ARIMA and GARCH perform well with linear data but struggle with non-linear dependencies. Machine learning and deep learning models, particularly Long Short-Term Memory (LSTM) networks, address these challenges by capturing intricate patterns and long-term dependencies. This report compares ARIMA and LSTM models in predicting the S&P 500 index, a major financial benchmark. Using historical price data and technical indicators, we evaluated these models using Mean Absolute Error (MAE) and Root Mean Squared Error (RMSE). The ARIMA model showed reasonable performance with an MAE of 462.1, RMSE of 614, and 89.8 percent accuracy, effectively capturing short-term trends but limited by its linear assumptions. The LSTM model, leveraging sequential processing capabilities, outperformed ARIMA with an MAE of 369.32, RMSE of 412.84, and 92.46 percent accuracy, capturing both short- and long-term dependencies. Notably, the LSTM model without additional features performed best, achieving an MAE of 175.9, RMSE of 207.34, and 96.41 percent accuracy, showcasing its ability to handle market data efficiently. Accurately predicting stock movements is crucial for investment strategies, risk assessments, and market stability. Our findings confirm the potential of deep learning models in handling volatile financial data compared to traditional ones. The results highlight the effectiveness of LSTM and suggest avenues for further improvements. This study provides insights into financial forecasting, offering a comparative analysis of ARIMA and LSTM while outlining their strengths and limitations.

This study explores the potential of utilizing administrative claims data, combined with advanced machine learning and deep learning techniques, to predict the progression of Chronic Kidney Disease (CKD) to End-Stage Renal Disease (ESRD). We analyze a comprehensive, 10-year dataset provided by a major health insurance organization to develop prediction models for multiple observation windows using traditional machine learning methods such as Random Forest and XGBoost as well as deep learning approaches such as Long Short-Term Memory (LSTM) networks. Our findings demonstrate that the LSTM model, particularly with a 24-month observation window, exhibits superior performance in predicting ESRD progression, outperforming existing models in the literature. We further apply SHapley Additive exPlanations (SHAP) analysis to enhance interpretability, providing insights into the impact of individual features on predictions at the individual patient level. This study underscores the value of leveraging administrative claims data for CKD management and predicting ESRD progression.

Purpose. Patients with advanced cancer may undergo multiple lines of treatment, switching therapies as their disease progresses. Motivated by a study of metastatic prostate cancer, we develop a microsimulation framework to study therapy sequence. Methods. We propose a discrete-time state transition model to study two lines of anti-cancer therapy. Based on digitized published progression-free survival (PFS) and overall survival (OS) curves, we infer event types (progression or death), and estimate transition probabilities using cumulative incidence functions with competing risks. Our model incorporates within-patient dependence over time, such that response to first-line therapy informs subsequent event probabilities. Parameters governing the degree of within-patient dependence can be used to calibrate the model-based results to those of a target trial. We demonstrate these methods in a study of two therapy sequences for metastatic prostate cancer, where Docetaxel (DCT) and Abiraterone Acetate (AA) are both appropriate for use in either first or second line treatment. We assess costs, Quality-Adjusted Life Years (QALYs) and Incremental Cost Effectiveness Ratio (ICER) for two treatment strategies: DCT then AA vs AA then DCT. Results. Using digitized survival curves from relevant clinical trials, we identified 8.6-13.9% of PFS times that should be categorized as deaths, allowing for estimation of cumulative incidence functions. Models assuming within-patient independence overestimated OS time, corrected with our calibration approach. Correction resulted in meaningful changes in the difference in QALYs between treatment strategies (0.07 vs 0.15) and the ICER (-\76,836/QALY vs -21,030/QALY). Conclusions. Microsimulation models can be successfully used to study cost-effectiveness of therapy sequences, taking care to account correctly for within-patient dependence.

During the radiotherapy treatment of patients with lung cancer, the radiation delivered to healthy tissue around the tumor needs to be minimized, which is difficult because of respiratory motion and the latency of linear accelerator systems. In the proposed study, we first use the Lucas-Kanade pyramidal optical flow algorithm to perform deformable image registration of chest computed tomography scan images of four patients with lung cancer. We then track three internal points close to the lung tumor based on the previously computed deformation field and predict their position with a recurrent neural network (RNN) trained using real-time recurrent learning (RTRL) and gradient clipping. The breathing data is quite regular, sampled at approximately 2.5Hz, and includes artificial drift in the spine direction. The amplitude of the motion of the tracked points ranged from 12.0mm to 22.7mm. Finally, we propose a simple method for recovering and predicting 3D tumor images from the tracked points and the initial tumor image based on a linear correspondence model and Nadaraya-Watson non-linear regression. The root-mean-square error, maximum error, and jitter corresponding to the RNN prediction on the test set were smaller than the same performance measures obtained with linear prediction and least mean squares (LMS). In particular, the maximum prediction error associated with the RNN, equal to 1.51mm, is respectively 16.1% and 5.0% lower than the maximum error associated with linear prediction and LMS. The average prediction time per time step with RTRL is equal to 119ms, which is less than the 400ms marker position sampling time. The tumor position in the predicted images appears visually correct, which is confirmed by the high mean cross-correlation between the original and predicted images, equal to 0.955.

Purpose: Surgical performance depends not only on surgeons' technical skills but also on team communication within and across the different professional groups present during the operation. Therefore, automatically identifying team communication in the OR is crucial for patient safety and advances in the development of computer-assisted surgical workflow analysis and intra-operative support systems. To take the first step, we propose a new task of detecting communication briefings involving all OR team members, i.e. the team Time-out and the StOP?-protocol, by localizing their start and end times in video recordings of surgical operations. Methods: We generate an OR dataset of real surgeries, called Team-OR, with more than one hundred hours of surgical videos captured by the multi-view camera system in the OR. The dataset contains temporal annotations of 33 Time-out and 22 StOP?-protocol activities in total. We then propose a novel group activity detection approach, where we encode both scene context and action features, and use an efficient neural network model to output the results. Results: The experimental results on the Team-OR dataset show that our approach outperforms existing state-of-the-art temporal action detection approaches. It also demonstrates the lack of research on group activities in the OR, proving the significance of our dataset. Conclusion: We investigate the Team Time-Out and the StOP?-protocol in the OR, by presenting the first OR dataset with temporal annotations of group activities protocols, and introducing a novel group activity detection approach that outperforms existing approaches. Code is available at https://github.com/CAMMA-public/Team-OR.

The proper design and architecture of testing of machine learning models, especially in their application to quantitative finance problems, is crucial. The most important in this process is selecting an adequate loss function used for training, validation, estimation purposes, and tuning of hyperparameters. Therefore, in this research, through empirical experiments on equity and cryptocurrency assets, we introduce the Mean Absolute Directional Loss (MADL) function which is more adequate for optimizing forecast-generating models used in algorithmic investment strategies. The MADL function results are compared for Transformer and LSTM models and we show that almost in every case Transformer results are significantly better than those obtained with LSTM.