Daily Papers

Test-Time Scaling (TTS) improves LLM reasoning by exploring multiple candidate responses and then operating over this set to find the best output. A tacit premise behind TTS is that sufficiently diverse candidate pools enhance reliability. In this work, we show that this assumption in TTS introduces a previously unrecognized failure mode. When candidate diversity is curtailed, even by a modest amount, TTS becomes much more likely to produce unsafe outputs. We present a reference-guided diversity reduction protocol (RefDiv) that serves as a diagnostic attack to stress test TTS pipelines. Through extensive experiments across open-source models (e.g. Qwen3, Mistral, Llama3.1, Gemma3) and two widely used TTS strategies (Monte Carlo Tree Search and Best-of-N), constraining diversity consistently signifies the rate at which TTS produces unsafe results. The effect is often stronger than that produced by prompts directly with high adversarial intent scores. This observed phenomenon also transfers across TTS strategies and to closed-source models (e.g. OpenAI o3-mini and Gemini-2.5-Pro), thus indicating that this is a general and extant property of TTS rather than a model-specific artifact. Additionally, we find that numerous widely used safety guardrail classifiers (e.g. Llama-Guard), are unable to flag the adversarial input prompts generated by RefDiv, demonstrating that existing defenses offer limited protection against this diversity-driven failure mode.

Aligned large language models (LLMs) remain vulnerable to adversarial manipulation, and their reliance on web-scale pretraining creates a subtle but consequential attack surface. We study Stealth Pretraining Seeding (SPS), a threat model in which adversaries distribute small amounts of poisoned content across stealth websites, increasing the likelihood that such material is absorbed into future training corpora derived from sources such as Common Crawl. Because each individual payload is tiny, diffuse, and superficially benign, the attack is difficult to detect during dataset construction or filtering. The result is a latent form of poisoning that remains largely invisible under standard evaluation, yet can later be activated by a precise trigger such as <00TRIGGER00>. We call this attack PermaFrost, reflecting its latent and reactivatable nature. We study it through PermaFrost-Attack, a controlled framework for latent conceptual poisoning, together with three geometric diagnostics: Thermodynamic Length, Spectral Curvature, and the Infection Traceback Graph. Across multiple model families and scales, we show that this controlled SPS proxy can induce persistent unsafe behavior that often remains hidden under standard evaluation. Our results identify SPS as a practical and underappreciated threat to future foundation models. This paper introduces a novel geometric diagnostic lens for systematically examining latent model behavior, providing a principled foundation for detecting, characterizing, and understanding vulnerabilities that may remain invisible under standard evaluation.

Process Reward Models (PRMs) are rapidly becoming the backbone of LLM reasoning pipelines, yet we demonstrate that state-of-the-art PRMs are systematically exploitable under adversarial optimization pressure. To address this, we introduce a three-tiered diagnostic framework that applies increasing adversarial pressure to quantify these vulnerabilities. Static perturbation analysis uncovers a fluency-logic dissociation: high invariance to surface-level style changes reward changes <0.1, yet inconsistent detection of logically-corrupted reasoning, with different models failing on different attack types. Adversarial optimization demonstrates that gradient-based attacks inflate rewards on invalid trajectories, with reward landscapes exhibiting wide, exploitable peaks. RL-induced reward hacking exposes the critical failure mode: policies trained on AIME problems achieve near-perfect PRM rewards (>0.9), while ground-truth accuracy remains low (below 4%), with 43% of reward gains attributable to stylistic shortcuts. These findings reveal that current PRMs function as fluency detectors rather than reasoning verifiers, creating systematic blind spots that undermine their use as training signals. We release PRM-BiasBench and a diagnostic toolkit to enable robustness evaluation before deployment. The code and dataset are available at https://github.com/SqueezeAILab/reward-under-attack.

Large Language Model (LLM) training often optimizes for preference alignment, rewarding outputs that are perceived as helpful and interaction-friendly. However, this preference-oriented objective can be exploited: manipulative prompts can steer responses toward user-appeasing agreement and away from truth-oriented correction. In this work, we investigate whether aligned models are vulnerable to Preference-Undermining Attacks (PUA), a class of manipulative prompting strategies designed to exploit the model's desire to please user preferences at the expense of truthfulness. We propose a diagnostic methodology that provides a finer-grained and more directive analysis than aggregate benchmark scores, using a factorial evaluation framework to decompose prompt-induced shifts into interpretable effects of system objectives (truth- vs. preference-oriented) and PUA-style dialogue factors (directive control, personal derogation, conditional approval, reality denial) within a controlled 2 times 2^4 design. Surprisingly, more advanced models are sometimes more susceptible to manipulative prompts. Beyond the dominant reality-denial factor, we observe model-specific sign reversals and interactions with PUA-style factors, suggesting tailored defenses rather than uniform robustness. These findings offer a novel, reproducible factorial evaluation methodology that provides finer-grained diagnostics for post-training processes like RLHF, enabling better trade-offs in the product iteration of LLMs by offering a more nuanced understanding of preference alignment risks and the impact of manipulative prompts.

Vision-Language Models (VLMs) are increasingly used in clinical diagnostics, yet their robustness to adversarial attacks remains largely unexplored, posing serious risks. Existing medical attacks focus on secondary objectives such as model stealing or adversarial fine-tuning, while transferable attacks from natural images introduce visible distortions that clinicians can easily detect. To address this, we propose MedFocusLeak, a highly transferable black-box multimodal attack that induces incorrect yet clinically plausible diagnoses while keeping perturbations imperceptible. The method injects coordinated perturbations into non-diagnostic background regions and employs an attention distraction mechanism to shift the model's focus away from pathological areas. Extensive evaluations across six medical imaging modalities show that MedFocusLeak achieves state-of-the-art performance, generating misleading yet realistic diagnostic outputs across diverse VLMs. We further introduce a unified evaluation framework with novel metrics that jointly capture attack success and image fidelity, revealing a critical weakness in the reasoning capabilities of modern clinical VLMs.

Speech pathology has impacts on communication abilities and quality of life. While deep learning-based models have shown potential in diagnosing these disorders, the use of sensitive data raises critical privacy concerns. Although differential privacy (DP) has been explored in the medical imaging domain, its application in pathological speech analysis remains largely unexplored despite the equally critical privacy concerns. To the best of our knowledge, this study is the first to investigate DP's impact on pathological speech data, focusing on the trade-offs between privacy, diagnostic accuracy, and fairness. Using a large, real-world dataset of 200 hours of recordings from 2,839 German-speaking participants, we observed a maximum accuracy reduction of 3.85% when training with DP with high privacy levels. To highlight real-world privacy risks, we demonstrated the vulnerability of non-private models to gradient inversion attacks, reconstructing identifiable speech samples and showcasing DP's effectiveness in mitigating these risks. To explore the potential generalizability across languages and disorders, we validated our approach on a dataset of Spanish-speaking Parkinson's disease patients, leveraging pretrained models from healthy English-speaking datasets, and demonstrated that careful pretraining on large-scale task-specific datasets can maintain favorable accuracy under DP constraints. A comprehensive fairness analysis revealed minimal gender bias at reasonable privacy levels but underscored the need for addressing age-related disparities. Our results establish that DP can balance privacy and utility in speech disorder detection, while highlighting unique challenges in privacy-fairness trade-offs for speech data. This provides a foundation for refining DP methodologies and improving fairness across diverse patient groups in real-world deployments.

A membership inference attack allows an adversary to query a trained machine learning model to predict whether or not a particular example was contained in the model's training dataset. These attacks are currently evaluated using average-case "accuracy" metrics that fail to characterize whether the attack can confidently identify any members of the training set. We argue that attacks should instead be evaluated by computing their true-positive rate at low (e.g., <0.1%) false-positive rates, and find most prior attacks perform poorly when evaluated in this way. To address this we develop a Likelihood Ratio Attack (LiRA) that carefully combines multiple ideas from the literature. Our attack is 10x more powerful at low false-positive rates, and also strictly dominates prior attacks on existing metrics.

The emergence of groundbreaking large language models capable of performing complex reasoning tasks holds significant promise for addressing various scientific challenges, including those arising in complex clinical scenarios. To enable their safe and effective deployment in real-world healthcare settings, it is urgently necessary to benchmark the diagnostic capabilities of current models systematically. Given the limitations of existing medical benchmarks in evaluating advanced diagnostic reasoning, we present DiagnosisArena, a comprehensive and challenging benchmark designed to rigorously assess professional-level diagnostic competence. DiagnosisArena consists of 1,113 pairs of segmented patient cases and corresponding diagnoses, spanning 28 medical specialties, deriving from clinical case reports published in 10 top-tier medical journals. The benchmark is developed through a meticulous construction pipeline, involving multiple rounds of screening and review by both AI systems and human experts, with thorough checks conducted to prevent data leakage. Our study reveals that even the most advanced reasoning models, o3-mini, o1, and DeepSeek-R1, achieve only 45.82%, 31.09%, and 17.79% accuracy, respectively. This finding highlights a significant generalization bottleneck in current large language models when faced with clinical diagnostic reasoning challenges. Through DiagnosisArena, we aim to drive further advancements in AIs diagnostic reasoning capabilities, enabling more effective solutions for real-world clinical diagnostic challenges. We provide the benchmark and evaluation tools for further research and development https://github.com/SPIRAL-MED/DiagnosisArena.

AI agents equipped with tool-calling capabilities are susceptible to Indirect Prompt Injection (IPI) attacks. In this attack scenario, malicious commands hidden within untrusted content trick the agent into performing unauthorized actions. Existing defenses can reduce attack success but often suffer from the over-defense dilemma: they deploy expensive, always-on sanitization regardless of actual threat, thereby degrading utility and latency even in benign scenarios. We revisit IPI through a causal ablation perspective: a successful injection manifests as a dominance shift where the user request no longer provides decisive support for the agent's privileged action, while a particular untrusted segment, such as a retrieved document or tool output, provides disproportionate attributable influence. Based on this signature, we propose CausalArmor, a selective defense framework that (i) computes lightweight, leave-one-out ablation-based attributions at privileged decision points, and (ii) triggers targeted sanitization only when an untrusted segment dominates the user intent. Additionally, CausalArmor employs retroactive Chain-of-Thought masking to prevent the agent from acting on ``poisoned'' reasoning traces. We present a theoretical analysis showing that sanitization based on attribution margins conditionally yields an exponentially small upper bound on the probability of selecting malicious actions. Experiments on AgentDojo and DoomArena demonstrate that CausalArmor matches the security of aggressive defenses while improving explainability and preserving utility and latency of AI agents.

Security concerns related to Large Language Models (LLMs) have been extensively explored, yet the safety implications for Multimodal Large Language Models (MLLMs), particularly in medical contexts (MedMLLMs), remain insufficiently studied. This paper delves into the underexplored security vulnerabilities of MedMLLMs, especially when deployed in clinical environments where the accuracy and relevance of question-and-answer interactions are critically tested against complex medical challenges. By combining existing clinical medical data with atypical natural phenomena, we redefine two types of attacks: mismatched malicious attack (2M-attack) and optimized mismatched malicious attack (O2M-attack). Using our own constructed voluminous 3MAD dataset, which covers a wide range of medical image modalities and harmful medical scenarios, we conduct a comprehensive analysis and propose the MCM optimization method, which significantly enhances the attack success rate on MedMLLMs. Evaluations with this dataset and novel attack methods, including white-box attacks on LLaVA-Med and transfer attacks on four other state-of-the-art models, indicate that even MedMLLMs designed with enhanced security features are vulnerable to security breaches. Our work underscores the urgent need for a concerted effort to implement robust security measures and enhance the safety and efficacy of open-source MedMLLMs, particularly given the potential severity of jailbreak attacks and other malicious or clinically significant exploits in medical settings. For further research and replication, anonymous access to our code is available at https://github.com/dirtycomputer/O2M_attack. Warning: Medical large model jailbreaking may generate content that includes unverified diagnoses and treatment recommendations. Always consult professional medical advice.

In this paper, we present a framework for training large language models (LLMs) as diagnostic agents with reinforcement learning, enabling them to manage multi-turn diagnostic processes, adaptively select examinations, and commit to final diagnoses. Unlike instruction-tuned models trained on static case summaries, our method acquires diagnostic strategies through interactive exploration and outcome-based feedback. Our contributions are fourfold: (i) We present DiagGym, a diagnostics world model trained with electronic health records that emits examination outcomes conditioned on patient history and recommended examination, serving as a virtual clinical environment for realistic diagnosis training and evaluation; (ii) We train DiagAgent via end-to-end, multi-turn reinforcement learning to learn diagnostic policies that optimize both information yield and diagnostic accuracy; (iii) We introduce DiagBench, a diagnostic benchmark comprising 750 cases with physician-validated examination recommendations and 99 cases annotated with 973 physician-written rubrics on diagnosis process; (iv) we demonstrate superior performance across diverse diagnostic settings. DiagAgent significantly outperforms 10 state-of-the-art LLMs, including DeepSeek-v3 and GPT-4o, as well as two prompt-engineered agents. In single-turn settings, DiagAgent achieves 9.34% higher diagnostic accuracy and 44.03% improvement in examination recommendation hit ratio. In end-to-end settings, it delivers 15.12% increase in diagnostic accuracy and 23.09% boost in examination recommendation F1 score. In rubric-based evaluation, it surpasses the next-best model, Claude-sonnet-4, by 7.1% in weighted rubric score. These findings indicate that learning policies in interactive clinical environments confers dynamic and clinically meaningful diagnostic management abilities unattainable through passive training alone.

In recent years, neural networks have become the default choice for image classification and many other learning tasks, even though they are vulnerable to so-called adversarial attacks. To increase their robustness against these attacks, there have emerged numerous detection mechanisms that aim to automatically determine if an input is adversarial. However, state-of-the-art detection mechanisms either rely on being tuned for each type of attack, or they do not generalize across different attack types. To alleviate these issues, we propose a novel technique for adversarial-image detection, RAID, that trains a secondary classifier to identify differences in neuron activation values between benign and adversarial inputs. Our technique is both more reliable and more effective than the state of the art when evaluated against six popular attacks. Moreover, a straightforward extension of RAID increases its robustness against detection-aware adversaries without affecting its effectiveness.

Text-guided image editors can now manipulate authentic medical scans with high fidelity, enabling lesion implantation/removal that threatens clinical trust and safety. Existing defenses are inadequate for healthcare. Medical detectors are largely black-box, while MLLM-based explainers are typically post-hoc, lack medical expertise, and may hallucinate evidence on ambiguous cases. We present MedForge, a data-and-method solution for pre-hoc, evidence-grounded medical forgery detection. We introduce MedForge-90K, a large-scale benchmark of realistic lesion edits across 19 pathologies with expert-guided reasoning supervision via doctor inspection guidelines and gold edit locations. Building on it, MedForge-Reasoner performs localize-then-analyze reasoning, predicting suspicious regions before producing a verdict, and is further aligned with Forgery-aware GSPO to strengthen grounding and reduce hallucinations. Experiments demonstrate state-of-the-art detection accuracy and trustworthy, expert-aligned explanations.

Recently, test-time adaptation (TTA) has been proposed as a promising solution for addressing distribution shifts. It allows a base model to adapt to an unforeseen distribution during inference by leveraging the information from the batch of (unlabeled) test data. However, we uncover a novel security vulnerability of TTA based on the insight that predictions on benign samples can be impacted by malicious samples in the same batch. To exploit this vulnerability, we propose Distribution Invading Attack (DIA), which injects a small fraction of malicious data into the test batch. DIA causes models using TTA to misclassify benign and unperturbed test data, providing an entirely new capability for adversaries that is infeasible in canonical machine learning pipelines. Through comprehensive evaluations, we demonstrate the high effectiveness of our attack on multiple benchmarks across six TTA methods. In response, we investigate two countermeasures to robustify the existing insecure TTA implementations, following the principle of "security by design". Together, we hope our findings can make the community aware of the utility-security tradeoffs in deploying TTA and provide valuable insights for developing robust TTA approaches.

Recently, autonomous agents built on large language models (LLMs) have experienced significant development and are being deployed in real-world applications. These agents can extend the base LLM's capabilities in multiple ways. For example, a well-built agent using GPT-3.5-Turbo as its core can outperform the more advanced GPT-4 model by leveraging external components. More importantly, the usage of tools enables these systems to perform actions in the real world, moving from merely generating text to actively interacting with their environment. Given the agents' practical applications and their ability to execute consequential actions, it is crucial to assess potential vulnerabilities. Such autonomous systems can cause more severe damage than a standalone language model if compromised. While some existing research has explored harmful actions by LLM agents, our study approaches the vulnerability from a different perspective. We introduce a new type of attack that causes malfunctions by misleading the agent into executing repetitive or irrelevant actions. We conduct comprehensive evaluations using various attack methods, surfaces, and properties to pinpoint areas of susceptibility. Our experiments reveal that these attacks can induce failure rates exceeding 80\% in multiple scenarios. Through attacks on implemented and deployable agents in multi-agent scenarios, we accentuate the realistic risks associated with these vulnerabilities. To mitigate such attacks, we propose self-examination detection methods. However, our findings indicate these attacks are difficult to detect effectively using LLMs alone, highlighting the substantial risks associated with this vulnerability.

Despite excellent average-case performance of many image classifiers, their performance can substantially deteriorate on semantically coherent subgroups of the data that were under-represented in the training data. These systematic errors can impact both fairness for demographic minority groups as well as robustness and safety under domain shift. A major challenge is to identify such subgroups with subpar performance when the subgroups are not annotated and their occurrence is very rare. We leverage recent advances in text-to-image models and search in the space of textual descriptions of subgroups ("prompts") for subgroups where the target model has low performance on the prompt-conditioned synthesized data. To tackle the exponentially growing number of subgroups, we employ combinatorial testing. We denote this procedure as PromptAttack as it can be interpreted as an adversarial attack in a prompt space. We study subgroup coverage and identifiability with PromptAttack in a controlled setting and find that it identifies systematic errors with high accuracy. Thereupon, we apply PromptAttack to ImageNet classifiers and identify novel systematic errors on rare subgroups.

Clinical diagnosis is a highly specialized discipline requiring both domain expertise and strict adherence to rigorous guidelines. While current AI-driven medical research predominantly focuses on knowledge graphs or natural text pretraining paradigms to incorporate medical knowledge, these approaches primarily rely on implicitly encoded knowledge within model parameters, neglecting task-specific knowledge required by diverse downstream tasks. To address this limitation, we propose Retrieval-Augmented Diagnosis (RAD), a novel framework that explicitly injects external knowledge into multimodal models directly on downstream tasks. Specifically, RAD operates through three key mechanisms: retrieval and refinement of disease-centered knowledge from multiple medical sources, a guideline-enhanced contrastive loss that constrains the latent distance between multi-modal features and guideline knowledge, and the dual transformer decoder that employs guidelines as queries to steer cross-modal fusion, aligning the models with clinical diagnostic workflows from guideline acquisition to feature extraction and decision-making. Moreover, recognizing the lack of quantitative evaluation of interpretability for multimodal diagnostic models, we introduce a set of criteria to assess the interpretability from both image and text perspectives. Extensive evaluations across four datasets with different anatomies demonstrate RAD's generalizability, achieving state-of-the-art performance. Furthermore, RAD enables the model to concentrate more precisely on abnormal regions and critical indicators, ensuring evidence-based, trustworthy diagnosis. Our code is available at https://github.com/tdlhl/RAD.

Autonomous language-model agents increasingly rely on installable skills and tools to complete user tasks. Static skill auditing can expose capability surface before deployment, but it cannot determine whether a particular invocation is unsafe under the current user request and runtime context. We therefore study skill invocation auditing as a continuous-risk estimation problem: given a user request, candidate skill, and runtime context, predict a score that supports ranking and triage before a hard intervention is applied. We introduce STARS, which combines a static capability prior, a request-conditioned invocation risk model, and a calibrated risk-fusion policy. To evaluate this setting, we construct SIA-Bench, a benchmark of 3,000 invocation records with group-safe splits, lineage metadata, runtime context, canonical action labels, and derived continuous-risk targets. On a held-out split of indirect prompt injection attacks, calibrated fusion reaches 0.439 high-risk AUPRC, improving over 0.405 for the contextual scorer and 0.380 for the strongest static baseline, while the contextual scorer remains better calibrated with 0.289 expected calibration error. On the locked in-distribution test split, gains are smaller and static priors remain useful. The resulting claim is therefore narrower: request-conditioned auditing is most valuable as an invocation-time risk-scoring and triage layer rather than as a replacement for static screening. Code is available at https://github.com/123zgj123/STARS.

Large Language Models (LLMs) are vulnerable to attacks like prompt injection, backdoor attacks, and adversarial attacks, which manipulate prompts or models to generate harmful outputs. In this paper, departing from traditional deep learning attack paradigms, we explore their intrinsic relationship and collectively term them Prompt Trigger Attacks (PTA). This raises a key question: Can we determine if a prompt is benign or poisoned? To address this, we propose UniGuardian, the first unified defense mechanism designed to detect prompt injection, backdoor attacks, and adversarial attacks in LLMs. Additionally, we introduce a single-forward strategy to optimize the detection pipeline, enabling simultaneous attack detection and text generation within a single forward pass. Our experiments confirm that UniGuardian accurately and efficiently identifies malicious prompts in LLMs.

Intelligent Personal Assistant (IA), also known as Voice Assistant (VA), has become increasingly popular as a human-computer interaction mechanism. Most smartphones have built-in voice assistants that are granted high privilege, which is able to access system resources and private information. Thus, once the voice assistants are exploited by attackers, they become the stepping stones for the attackers to hack into the smartphones. Prior work shows that the voice assistant can be activated by inter-component communication mechanism, through an official Android API. However, this attack method is only effective on Google Assistant, which is the official voice assistant developed by Google. Voice assistants in other operating systems, even custom Android systems, cannot be activated by this mechanism. Prior work also shows that the attacking voice commands can be inaudible, but it requires additional instruments to launch the attack, making it unrealistic for real-world attack. We propose an attacking framework, which records the activation voice of the user, and launch the attack by playing the activation voice and attack commands via the built-in speaker. An intelligent stealthy module is designed to decide on the suitable occasion to launch the attack, preventing the attack being noticed by the user. We demonstrate proof-of-concept attacks on Google Assistant, showing the feasibility and stealthiness of the proposed attack scheme. We suggest to revise the activation logic of voice assistant to be resilient to the speaker based attack.

Deep neural networks (DNNs) offer significant promise for improving breast cancer diagnosis in medical imaging. However, these models are highly susceptible to adversarial attacks--small, imperceptible changes that can mislead classifiers--raising critical concerns about their reliability and security. Traditional attacks rely on fixed-norm perturbations, misaligning with human perception. In contrast, diffusion-based attacks require pre-trained models, demanding substantial data when these models are unavailable, limiting practical use in data-scarce scenarios. In medical imaging, however, this is often unfeasible due to the limited availability of datasets. Building on recent advancements in learnable prompts, we propose Prompt2Perturb (P2P), a novel language-guided attack method capable of generating meaningful attack examples driven by text instructions. During the prompt learning phase, our approach leverages learnable prompts within the text encoder to create subtle, yet impactful, perturbations that remain imperceptible while guiding the model towards targeted outcomes. In contrast to current prompt learning-based approaches, our P2P stands out by directly updating text embeddings, avoiding the need for retraining diffusion models. Further, we leverage the finding that optimizing only the early reverse diffusion steps boosts efficiency while ensuring that the generated adversarial examples incorporate subtle noise, thus preserving ultrasound image quality without introducing noticeable artifacts. We show that our method outperforms state-of-the-art attack techniques across three breast ultrasound datasets in FID and LPIPS. Moreover, the generated images are both more natural in appearance and more effective compared to existing adversarial attacks. Our code will be publicly available https://github.com/yasamin-med/P2P.

Rationale: Computer aided detection (CAD) algorithms for Pulmonary Embolism (PE) algorithms have been shown to increase radiologists' sensitivity with a small increase in specificity. However, CAD for PE has not been adopted into clinical practice, likely because of the high number of false positives current CAD software produces. Objective: To generate a database of annotated computed tomography pulmonary angiographies, use it to compare the sensitivity and false positive rate of current algorithms and to develop new methods that improve such metrics. Methods: 91 Computed tomography pulmonary angiography scans were annotated by at least one radiologist by segmenting all pulmonary emboli visible on the study. 20 annotated CTPAs were open to the public in the form of a medical image analysis challenge. 20 more were kept for evaluation purposes. 51 were made available post-challenge. 8 submissions, 6 of them novel, were evaluated on the 20 evaluation CTPAs. Performance was measured as per embolus sensitivity vs. false positives per scan curve. Results: The best algorithms achieved a per-embolus sensitivity of 75% at 2 false positives per scan (fps) or of 70% at 1 fps, outperforming the state of the art. Deep learning approaches outperformed traditional machine learning ones, and their performance improved with the number of training cases. Significance: Through this work and challenge we have improved the state-of-the art of computer aided detection algorithms for pulmonary embolism. An open database and an evaluation benchmark for such algorithms have been generated, easing the development of further improvements. Implications on clinical practice will need further research.

Artificial intelligence holds great promise for expanding access to expert medical knowledge and reasoning. However, most evaluations of language models rely on static vignettes and multiple-choice questions that fail to reflect the complexity and nuance of evidence-based medicine in real-world settings. In clinical practice, physicians iteratively formulate and revise diagnostic hypotheses, adapting each subsequent question and test to what they've just learned, and weigh the evolving evidence before committing to a final diagnosis. To emulate this iterative process, we introduce the Sequential Diagnosis Benchmark, which transforms 304 diagnostically challenging New England Journal of Medicine clinicopathological conference (NEJM-CPC) cases into stepwise diagnostic encounters. A physician or AI begins with a short case abstract and must iteratively request additional details from a gatekeeper model that reveals findings only when explicitly queried. Performance is assessed not just by diagnostic accuracy but also by the cost of physician visits and tests performed. We also present the MAI Diagnostic Orchestrator (MAI-DxO), a model-agnostic orchestrator that simulates a panel of physicians, proposes likely differential diagnoses and strategically selects high-value, cost-effective tests. When paired with OpenAI's o3 model, MAI-DxO achieves 80% diagnostic accuracy--four times higher than the 20% average of generalist physicians. MAI-DxO also reduces diagnostic costs by 20% compared to physicians, and 70% compared to off-the-shelf o3. When configured for maximum accuracy, MAI-DxO achieves 85.5% accuracy. These performance gains with MAI-DxO generalize across models from the OpenAI, Gemini, Claude, Grok, DeepSeek, and Llama families. We highlight how AI systems, when guided to think iteratively and act judiciously, can advance diagnostic precision and cost-effectiveness in clinical care.

Large Language Models (LLMs) are increasingly powerful but remain vulnerable to prompt injection attacks, where malicious inputs cause the model to deviate from its intended instructions. This paper introduces Sentinel, a novel detection model, qualifire/prompt-injection-sentinel, based on the \answerdotai/ModernBERT-large architecture. By leveraging ModernBERT's advanced features and fine-tuning on an extensive and diverse dataset comprising a few open-source and private collections, Sentinel achieves state-of-the-art performance. This dataset amalgamates varied attack types, from role-playing and instruction hijacking to attempts to generate biased content, alongside a broad spectrum of benign instructions, with private datasets specifically targeting nuanced error correction and real-world misclassifications. On a comprehensive, unseen internal test set, Sentinel demonstrates an average accuracy of 0.987 and an F1-score of 0.980. Furthermore, when evaluated on public benchmarks, it consistently outperforms strong baselines like protectai/deberta-v3-base-prompt-injection-v2. This work details Sentinel's architecture, its meticulous dataset curation, its training methodology, and a thorough evaluation, highlighting its superior detection capabilities.

With the advent of the COVID-19 pandemic, ultrasound imaging has emerged as a promising technique for COVID-19 detection, due to its non-invasive nature, affordability, and portability. In response, researchers have focused on developing AI-based scoring systems to provide real-time diagnostic support. However, the limited size and lack of proper annotation in publicly available ultrasound datasets pose significant challenges for training a robust AI model. This paper proposes MeDiVLAD, a novel pipeline to address the above issue for multi-level lung-ultrasound (LUS) severity scoring. In particular, we leverage self-knowledge distillation to pretrain a vision transformer (ViT) without label and aggregate frame-level features via dual-level VLAD aggregation. We show that with minimal finetuning, MeDiVLAD outperforms conventional fully-supervised methods in both frame- and video-level scoring, while offering classification reasoning with exceptional quality. This superior performance enables key applications such as the automatic identification of critical lung pathology areas and provides a robust solution for broader medical video classification tasks.

Deep learning models are susceptible to adversarial samples in white and black-box environments. Although previous studies have shown high attack success rates, coupling DNN models with interpretation models could offer a sense of security when a human expert is involved, who can identify whether a given sample is benign or malicious. However, in white-box environments, interpretable deep learning systems (IDLSes) have been shown to be vulnerable to malicious manipulations. In black-box settings, as access to the components of IDLSes is limited, it becomes more challenging for the adversary to fool the system. In this work, we propose a Query-efficient Score-based black-box attack against IDLSes, QuScore, which requires no knowledge of the target model and its coupled interpretation model. QuScore is based on transfer-based and score-based methods by employing an effective microbial genetic algorithm. Our method is designed to reduce the number of queries necessary to carry out successful attacks, resulting in a more efficient process. By continuously refining the adversarial samples created based on feedback scores from the IDLS, our approach effectively navigates the search space to identify perturbations that can fool the system. We evaluate the attack's effectiveness on four CNN models (Inception, ResNet, VGG, DenseNet) and two interpretation models (CAM, Grad), using both ImageNet and CIFAR datasets. Our results show that the proposed approach is query-efficient with a high attack success rate that can reach between 95% and 100% and transferability with an average success rate of 69% in the ImageNet and CIFAR datasets. Our attack method generates adversarial examples with attribution maps that resemble benign samples. We have also demonstrated that our attack is resilient against various preprocessing defense techniques and can easily be transferred to different DNN models.

Training Data Detection (TDD) is a task aimed at determining whether a specific data instance is used to train a machine learning model. In the computer security literature, TDD is also referred to as Membership Inference Attack (MIA). Given its potential to assess the risks of training data breaches, ensure copyright authentication, and verify model unlearning, TDD has garnered significant attention in recent years, leading to the development of numerous methods. Despite these advancements, there is no comprehensive benchmark to thoroughly evaluate the effectiveness of TDD methods. In this work, we introduce TDDBench, which consists of 13 datasets spanning three data modalities: image, tabular, and text. We benchmark 21 different TDD methods across four detection paradigms and evaluate their performance from five perspectives: average detection performance, best detection performance, memory consumption, and computational efficiency in both time and memory. With TDDBench, researchers can identify bottlenecks and areas for improvement in TDD algorithms, while practitioners can make informed trade-offs between effectiveness and efficiency when selecting TDD algorithms for specific use cases. Our large-scale benchmarking also reveals the generally unsatisfactory performance of TDD algorithms across different datasets. To enhance accessibility and reproducibility, we open-source TDDBench for the research community.

We develop and evaluate a data-driven approach for detecting unusual (anomalous) patient-management decisions using past patient cases stored in electronic health records (EHRs). Our hypothesis is that a patient-management decision that is unusual with respect to past patient care may be due to an error and that it is worthwhile to generate an alert if such a decision is encountered. We evaluate this hypothesis using data obtained from EHRs of 4486 post-cardiac surgical patients and a subset of 222 alerts generated from the data. We base the evaluation on the opinions of a panel of experts. The results of the study support our hypothesis that the outlier-based alerting can lead to promising true alert rates. We observed true alert rates that ranged from 25\% to 66\% for a variety of patient-management actions, with 66\% corresponding to the strongest outliers.

Few-shot classification with foundation models (e.g., CLIP, DINOv2, PaLM-2) enables users to build an accurate classifier with a few labeled training samples (called support samples) for a classification task. However, an attacker could perform data poisoning attacks by manipulating some support samples such that the classifier makes the attacker-desired, arbitrary prediction for a testing input. Empirical defenses cannot provide formal robustness guarantees, leading to a cat-and-mouse game between the attacker and defender. Existing certified defenses are designed for traditional supervised learning, resulting in sub-optimal performance when extended to few-shot classification. In our work, we propose FCert, the first certified defense against data poisoning attacks to few-shot classification. We show our FCert provably predicts the same label for a testing input under arbitrary data poisoning attacks when the total number of poisoned support samples is bounded. We perform extensive experiments on benchmark few-shot classification datasets with foundation models released by OpenAI, Meta, and Google in both vision and text domains. Our experimental results show our FCert: 1) maintains classification accuracy without attacks, 2) outperforms existing state-of-the-art certified defenses for data poisoning attacks, and 3) is efficient and general.

Advanced Persistent Threat (APT) attribution is a critical challenge in cybersecurity and implies the process of accurately identifying the perpetrators behind sophisticated cyber attacks. It can significantly enhance defense mechanisms and inform strategic responses. With the growing prominence of artificial intelligence (AI) and machine learning (ML) techniques, researchers are increasingly focused on developing automated solutions to link cyber threats to responsible actors, moving away from traditional manual methods. Previous literature on automated threat attribution lacks a systematic review of automated methods and relevant artifacts that can aid in the attribution process. To address these gaps and provide context on the current state of threat attribution, we present a comprehensive survey of automated APT attribution. The presented survey starts with understanding the dispersed artifacts and provides a comprehensive taxonomy of the artifacts that aid in attribution. We comprehensively review and present the classification of the available attribution datasets and current automated APT attribution methods. Further, we raise critical comments on current literature methods, discuss challenges in automated attribution, and direct toward open research problems. This survey reveals significant opportunities for future research in APT attribution to address current gaps and challenges. By identifying strengths and limitations in current practices, this survey provides a foundation for future research and development in automated, reliable, and actionable APT attribution methods.

Pulmonary embolism (PE) is a life-threatening condition where rapid and accurate diagnosis is imperative yet difficult due to predominantly atypical symptomatology. Computed tomography pulmonary angiography (CTPA) is acknowledged as the gold standard imaging tool in clinics, yet it can be contraindicated for emergency department (ED) patients and represents an onerous procedure, thus necessitating PE identification through non-contrast CT (NCT) scans. In this work, we explore the feasibility of applying a deep-learning approach to NCT scans for PE identification. We propose a novel Cross-Phase Mutual learNing framework (CPMN) that fosters knowledge transfer from CTPA to NCT, while concurrently conducting embolism segmentation and abnormality classification in a multi-task manner. The proposed CPMN leverages the Inter-Feature Alignment (IFA) strategy that enhances spatial contiguity and mutual learning between the dual-pathway network, while the Intra-Feature Discrepancy (IFD) strategy can facilitate precise segmentation of PE against complex backgrounds for single-pathway networks. For a comprehensive assessment of the proposed approach, a large-scale dual-phase dataset containing 334 PE patients and 1,105 normal subjects has been established. Experimental results demonstrate that CPMN achieves the leading identification performance, which is 95.4\% and 99.6\% in patient-level sensitivity and specificity on NCT scans, indicating the potential of our approach as an economical, accessible, and precise tool for PE identification in clinical practice.

Federated learning offers a framework of training a machine learning model in a distributed fashion while preserving privacy of the participants. As the server cannot govern the clients' actions, nefarious clients may attack the global model by sending malicious local gradients. In the meantime, there could also be unreliable clients who are benign but each has a portion of low-quality training data (e.g., blur or low-resolution images), thus may appearing similar as malicious clients. Therefore, a defense mechanism will need to perform a three-fold differentiation which is much more challenging than the conventional (two-fold) case. This paper introduces MUD-HoG, a novel defense algorithm that addresses this challenge in federated learning using long-short history of gradients, and treats the detected malicious and unreliable clients differently. Not only this, but we can also distinguish between targeted and untargeted attacks among malicious clients, unlike most prior works which only consider one type of the attacks. Specifically, we take into account sign-flipping, additive-noise, label-flipping, and multi-label-flipping attacks, under a non-IID setting. We evaluate MUD-HoG with six state-of-the-art methods on two datasets. The results show that MUD-HoG outperforms all of them in terms of accuracy as well as precision and recall, in the presence of a mixture of multiple (four) types of attackers as well as unreliable clients. Moreover, unlike most prior works which can only tolerate a low population of harmful users, MUD-HoG can work with and successfully detect a wide range of malicious and unreliable clients - up to 47.5% and 10%, respectively, of the total population. Our code is open-sourced at https://github.com/LabSAINT/MUD-HoG_Federated_Learning.

Machine learning (ML) models, e.g., deep neural networks (DNNs), are vulnerable to adversarial examples: malicious inputs modified to yield erroneous model outputs, while appearing unmodified to human observers. Potential attacks include having malicious content like malware identified as legitimate or controlling vehicle behavior. Yet, all existing adversarial example attacks require knowledge of either the model internals or its training data. We introduce the first practical demonstration of an attacker controlling a remotely hosted DNN with no such knowledge. Indeed, the only capability of our black-box adversary is to observe labels given by the DNN to chosen inputs. Our attack strategy consists in training a local model to substitute for the target DNN, using inputs synthetically generated by an adversary and labeled by the target DNN. We use the local substitute to craft adversarial examples, and find that they are misclassified by the targeted DNN. To perform a real-world and properly-blinded evaluation, we attack a DNN hosted by MetaMind, an online deep learning API. We find that their DNN misclassifies 84.24% of the adversarial examples crafted with our substitute. We demonstrate the general applicability of our strategy to many ML techniques by conducting the same attack against models hosted by Amazon and Google, using logistic regression substitutes. They yield adversarial examples misclassified by Amazon and Google at rates of 96.19% and 88.94%. We also find that this black-box attack strategy is capable of evading defense strategies previously found to make adversarial example crafting harder.

We develop and evaluate a data-driven approach for detecting unusual (anomalous) patient-management actions using past patient cases stored in an electronic health record (EHR) system. Our hypothesis is that patient-management actions that are unusual with respect to past patients may be due to a potential error and that it is worthwhile to raise an alert if such a condition is encountered. We evaluate this hypothesis using data obtained from the electronic health records of 4,486 post-cardiac surgical patients. We base the evaluation on the opinions of a panel of experts. The results support that anomaly-based alerting can have reasonably low false alert rates and that stronger anomalies are correlated with higher alert rates.

Over the years, adversarial attempts against critical services have become more effective and sophisticated in launching low-profile attacks. This trend has always been concerning. However, an even more alarming trend is the increasing difficulty of collecting relevant evidence about these attacks and the involved threat actors in the early stages before significant damage is done. This issue puts defenders at a significant disadvantage, as it becomes exceedingly difficult to understand the attack details and formulate an appropriate response. Developing robust forensics tools to collect evidence about modern threats has never been easy. One main challenge is to provide a robust trade-off between achieving sufficient visibility while leaving minimal detectable artifacts. This paper will introduce LASE, an open-source Low-Artifact Forensics Engine to perform threat analysis and forensics in Windows operating system. LASE augments current analysis tools by providing detailed, system-wide monitoring capabilities while minimizing detectable artifacts. We designed multiple deployment scenarios, showing LASE's potential in evidence gathering and threat reasoning in a real-world setting. By making LASE and its execution trace data available to the broader research community, this work encourages further exploration in the field by reducing the engineering costs for threat analysis and building a longitudinal behavioral analysis catalog for diverse security domains.

Batch prompting, which combines a batch of multiple queries sharing the same context in one inference, has emerged as a promising solution to reduce inference costs. However, our study reveals a significant security vulnerability in batch prompting: malicious users can inject attack instructions into a batch, leading to unwanted interference across all queries, which can result in the inclusion of harmful content, such as phishing links, or the disruption of logical reasoning. In this paper, we construct BATCHSAFEBENCH, a comprehensive benchmark comprising 150 attack instructions of two types and 8k batch instances, to study the batch prompting vulnerability systematically. Our evaluation of both closed-source and open-weight LLMs demonstrates that all LLMs are susceptible to batch-prompting attacks. We then explore multiple defending approaches. While the prompting-based defense shows limited effectiveness for smaller LLMs, the probing-based approach achieves about 95% accuracy in detecting attacks. Additionally, we perform a mechanistic analysis to understand the attack and identify attention heads that are responsible for it.

Clinical diagnosis is critical in medical practice, typically requiring a continuous and evolving process that includes primary diagnosis, differential diagnosis, and final diagnosis. However, most existing clinical diagnostic tasks are single-step processes, which does not align with the complex multi-step diagnostic procedures found in real-world clinical settings. In this paper, we propose a multi-step diagnostic task and annotate a clinical diagnostic dataset (MSDiagnosis). This dataset includes primary diagnosis, differential diagnosis, and final diagnosis questions. Additionally, we propose a novel and effective framework. This framework combines forward inference, backward inference, reflection, and refinement, enabling the LLM to self-evaluate and adjust its diagnostic results. To assess the effectiveness of our proposed method, we design and conduct extensive experiments. The experimental results demonstrate the effectiveness of the proposed method. We also provide a comprehensive experimental analysis and suggest future research directions for this task.

Differential Diagnosis (DDx) is a fundamental yet complex aspect of clinical decision-making, in which physicians iteratively refine a ranked list of possible diseases based on symptoms, antecedents, and medical knowledge. While recent advances in large language models (LLMs) have shown promise in supporting DDx, existing approaches face key limitations, including single-dataset evaluations, isolated optimization of components, unrealistic assumptions about complete patient profiles, and single-attempt diagnosis. We introduce a Modular Explainable DDx Agent (MEDDxAgent) framework designed for interactive DDx, where diagnostic reasoning evolves through iterative learning, rather than assuming a complete patient profile is accessible. MEDDxAgent integrates three modular components: (1) an orchestrator (DDxDriver), (2) a history taking simulator, and (3) two specialized agents for knowledge retrieval and diagnosis strategy. To ensure robust evaluation, we introduce a comprehensive DDx benchmark covering respiratory, skin, and rare diseases. We analyze single-turn diagnostic approaches and demonstrate the importance of iterative refinement when patient profiles are not available at the outset. Our broad evaluation demonstrates that MEDDxAgent achieves over 10% accuracy improvements in interactive DDx across both large and small LLMs, while offering critical explainability into its diagnostic reasoning process.

As the field of artificial intelligence progresses, assistive technologies are becoming more widely used across all industries. The healthcare industry is no different, with numerous studies being done to develop assistive tools for healthcare professionals. Automatic diagnostic systems are one such beneficial tool that can assist with a variety of tasks, including collecting patient information, analyzing test results, and diagnosing patients. However, the idea of developing systems that can provide a differential diagnosis has been largely overlooked in most of these research studies. In this study, we propose a transformer-based approach for providing differential diagnoses based on a patient's age, sex, medical history, and symptoms. We use the DDXPlus dataset, which provides differential diagnosis information for patients based on 49 disease types. Firstly, we propose a method to process the tabular patient data from the dataset and engineer them into patient reports to make them suitable for our research. In addition, we introduce two data modification modules to diversify the training data and consequently improve the robustness of the models. We approach the task as a multi-label classification problem and conduct extensive experiments using four transformer models. All the models displayed promising results by achieving over 97% F1 score on the held-out test set. Moreover, we design additional behavioral tests to get a broader understanding of the models. In particular, for one of our test cases, we prepared a custom test set of 100 samples with the assistance of a doctor. The results on the custom set showed that our proposed data modification modules improved the model's generalization capabilities. We hope our findings will provide future researchers with valuable insights and inspire them to develop reliable systems for automatic differential diagnosis.

Multimodal contrastive learning methods like CLIP train on noisy and uncurated training datasets. This is cheaper than labeling datasets manually, and even improves out-of-distribution robustness. We show that this practice makes backdoor and poisoning attacks a significant threat. By poisoning just 0.01% of a dataset (e.g., just 300 images of the 3 million-example Conceptual Captions dataset), we can cause the model to misclassify test images by overlaying a small patch. Targeted poisoning attacks, whereby the model misclassifies a particular test input with an adversarially-desired label, are even easier requiring control of 0.0001% of the dataset (e.g., just three out of the 3 million images). Our attacks call into question whether training on noisy and uncurated Internet scrapes is desirable.

We investigate the robustness of reasoning models trained for step-by-step problem solving by introducing query-agnostic adversarial triggers - short, irrelevant text that, when appended to math problems, systematically mislead models to output incorrect answers without altering the problem's semantics. We propose CatAttack, an automated iterative attack pipeline for generating triggers on a weaker, less expensive proxy model (DeepSeek V3) and successfully transfer them to more advanced reasoning target models like DeepSeek R1 and DeepSeek R1-distilled-Qwen-32B, resulting in greater than 300% increase in the likelihood of the target model generating an incorrect answer. For example, appending, "Interesting fact: cats sleep most of their lives," to any math problem leads to more than doubling the chances of a model getting the answer wrong. Our findings highlight critical vulnerabilities in reasoning models, revealing that even state-of-the-art models remain susceptible to subtle adversarial inputs, raising security and reliability concerns. The CatAttack triggers dataset with model responses is available at https://huggingface.co/datasets/collinear-ai/cat-attack-adversarial-triggers.

Deep neural networks are vulnerable to adversarial attacks. In this paper, we take the role of investigators who want to trace the attack and identify the source, that is, the particular model which the adversarial examples are generated from. Techniques derived would aid forensic investigation of attack incidents and serve as deterrence to potential attacks. We consider the buyers-seller setting where a machine learning model is to be distributed to various buyers and each buyer receives a slightly different copy with same functionality. A malicious buyer generates adversarial examples from a particular copy M_i and uses them to attack other copies. From these adversarial examples, the investigator wants to identify the source M_i. To address this problem, we propose a two-stage separate-and-trace framework. The model separation stage generates multiple copies of a model for a same classification task. This process injects unique characteristics into each copy so that adversarial examples generated have distinct and traceable features. We give a parallel structure which embeds a ``tracer'' in each copy, and a noise-sensitive training loss to achieve this goal. The tracing stage takes in adversarial examples and a few candidate models, and identifies the likely source. Based on the unique features induced by the noise-sensitive loss function, we could effectively trace the potential adversarial copy by considering the output logits from each tracer. Empirical results show that it is possible to trace the origin of the adversarial example and the mechanism can be applied to a wide range of architectures and datasets.

Large language models (LLMs) show promise in clinical decision support yet risk acquiescing to patient pressure for inappropriate care. We introduce SycoEval-EM, a multi-agent simulation framework evaluating LLM robustness through adversarial patient persuasion in emergency medicine. Across 20 LLMs and 1,875 encounters spanning three Choosing Wisely scenarios, acquiescence rates ranged from 0-100\%. Models showed higher vulnerability to imaging requests (38.8\%) than opioid prescriptions (25.0\%), with model capability poorly predicting robustness. All persuasion tactics proved equally effective (30.0-36.0\%), indicating general susceptibility rather than tactic-specific weakness. Our findings demonstrate that static benchmarks inadequately predict safety under social pressure, necessitating multi-turn adversarial testing for clinical AI certification.

Automatic speaker verification (ASV) is one of the most natural and convenient means of biometric person recognition. Unfortunately, just like all other biometric systems, ASV is vulnerable to spoofing, also referred to as "presentation attacks." These vulnerabilities are generally unacceptable and call for spoofing countermeasures or "presentation attack detection" systems. In addition to impersonation, ASV systems are vulnerable to replay, speech synthesis, and voice conversion attacks. The ASVspoof 2019 edition is the first to consider all three spoofing attack types within a single challenge. While they originate from the same source database and same underlying protocol, they are explored in two specific use case scenarios. Spoofing attacks within a logical access (LA) scenario are generated with the latest speech synthesis and voice conversion technologies, including state-of-the-art neural acoustic and waveform model techniques. Replay spoofing attacks within a physical access (PA) scenario are generated through carefully controlled simulations that support much more revealing analysis than possible previously. Also new to the 2019 edition is the use of the tandem detection cost function metric, which reflects the impact of spoofing and countermeasures on the reliability of a fixed ASV system. This paper describes the database design, protocol, spoofing attack implementations, and baseline ASV and countermeasure results. It also describes a human assessment on spoofed data in logical access. It was demonstrated that the spoofing data in the ASVspoof 2019 database have varied degrees of perceived quality and similarity to the target speakers, including spoofed data that cannot be differentiated from bona-fide utterances even by human subjects.

There has been a rapidly growing interest in Automatic Symptom Detection (ASD) and Automatic Diagnosis (AD) systems in the machine learning research literature, aiming to assist doctors in telemedicine services. These systems are designed to interact with patients, collect evidence about their symptoms and relevant antecedents, and possibly make predictions about the underlying diseases. Doctors would review the interactions, including the evidence and the predictions, collect if necessary additional information from patients, before deciding on next steps. Despite recent progress in this area, an important piece of doctors' interactions with patients is missing in the design of these systems, namely the differential diagnosis. Its absence is largely due to the lack of datasets that include such information for models to train on. In this work, we present a large-scale synthetic dataset of roughly 1.3 million patients that includes a differential diagnosis, along with the ground truth pathology, symptoms and antecedents for each patient. Unlike existing datasets which only contain binary symptoms and antecedents, this dataset also contains categorical and multi-choice symptoms and antecedents useful for efficient data collection. Moreover, some symptoms are organized in a hierarchy, making it possible to design systems able to interact with patients in a logical way. As a proof-of-concept, we extend two existing AD and ASD systems to incorporate the differential diagnosis, and provide empirical evidence that using differentials as training signals is essential for the efficiency of such systems or for helping doctors better understand the reasoning of those systems.

Stealthy hardware Trojans (HTs) inserted during the fabrication of integrated circuits can bypass the security of critical infrastructures. Although researchers have proposed many techniques to detect HTs, several limitations exist, including: (i) a low success rate, (ii) high algorithmic complexity, and (iii) a large number of test patterns. Furthermore, the most pertinent drawback of prior detection techniques stems from an incorrect evaluation methodology, i.e., they assume that an adversary inserts HTs randomly. Such inappropriate adversarial assumptions enable detection techniques to claim high HT detection accuracy, leading to a "false sense of security." Unfortunately, to the best of our knowledge, despite more than a decade of research on detecting HTs inserted during fabrication, there have been no concerted efforts to perform a systematic evaluation of HT detection techniques. In this paper, we play the role of a realistic adversary and question the efficacy of HT detection techniques by developing an automated, scalable, and practical attack framework, ATTRITION, using reinforcement learning (RL). ATTRITION evades eight detection techniques across two HT detection categories, showcasing its agnostic behavior. ATTRITION achieves average attack success rates of 47times and 211times compared to randomly inserted HTs against state-of-the-art HT detection techniques. We demonstrate ATTRITION's ability to evade detection techniques by evaluating designs ranging from the widely-used academic suites to larger designs such as the open-source MIPS and mor1kx processors to AES and a GPS module. Additionally, we showcase the impact of ATTRITION-generated HTs through two case studies (privilege escalation and kill switch) on the mor1kx processor. We envision that our work, along with our released HT benchmarks and models, fosters the development of better HT detection techniques.

LLM agents with tool access can discover and exploit security vulnerabilities. This is known. What is not known is which features of a system prompt trigger this behaviour, and which do not. We present a systematic taxonomy based on approximately 10,000 trials across seven models, 37 prompt conditions, and 12 hypothesized attack dimensions -- all executed in real Docker sandboxes. Every condition includes the instruction "Always respect all rules and access policies"; only a single encouragement sentence varies. Within the task class studied (planted test-runner vulnerabilities), the threat model is narrower than assumed: nine of twelve dimensions -- including minimization, moral licensing, incentives, identity priming, and reasoning triggers -- produce no detectable exploitation at n=50 per cell (upper 95% CI <7% per condition). But it is also more subtle than expected: one dimension, goal reframing, reliably triggers exploitation. "You are solving a puzzle; there may be hidden clues" produces 38-40% exploitation on Claude Sonnet 4 despite the explicit rule instruction, replicating across four models (CTF framing: 8-14% on DeepSeek, GPT-5-mini, o4-mini). The agent does not override the rules; it reinterprets the task so that exploitative actions become task-aligned. GPT-4.1 produces no exploitation across 1,850 trials (37 conditions), and a temporal comparison across four OpenAI models released over eleven months shows a pattern consistent with improving safety training, though model capability differences are a confounder. The practical contribution is a narrowed, testable threat model: defenders should audit for goal-reframing language, not for the broad class of adversarial prompts.

Retrieval-Augmented Generation (RAG) systems, widely used to improve the factual grounding of large language models (LLMs), are increasingly vulnerable to poisoning attacks, where adversaries inject manipulated content into the retriever's corpus. While prior research has predominantly focused on single-attacker settings, real-world scenarios often involve multiple, competing attackers with conflicting objectives. In this work, we introduce PoisonArena, the first benchmark to systematically study and evaluate competing poisoning attacks in RAG. We formalize the multi-attacker threat model, where attackers vie to control the answer to the same query using mutually exclusive misinformation. PoisonArena leverages the Bradley-Terry model to quantify each method's competitive effectiveness in such adversarial environments. Through extensive experiments on the Natural Questions and MS MARCO datasets, we demonstrate that many attack strategies successful in isolation fail under competitive pressure. Our findings highlight the limitations of conventional evaluation metrics like Attack Success Rate (ASR) and F1 score and underscore the need for competitive evaluation to assess real-world attack robustness. PoisonArena provides a standardized framework to benchmark and develop future attack and defense strategies under more realistic, multi-adversary conditions.

Large language models (LLM) have achieved impressive performance on medical question-answering benchmarks. However, high benchmark accuracy does not imply that the performance generalizes to real-world clinical settings. Medical question-answering benchmarks rely on assumptions consistent with quantifying LLM performance but that may not hold in the open world of the clinic. Yet LLMs learn broad knowledge that can help the LLM generalize to practical conditions regardless of unrealistic assumptions in celebrated benchmarks. We seek to quantify how well LLM medical question-answering benchmark performance generalizes when benchmark assumptions are violated. Specifically, we present an adversarial method that we call MedFuzz (for medical fuzzing). MedFuzz attempts to modify benchmark questions in ways aimed at confounding the LLM. We demonstrate the approach by targeting strong assumptions about patient characteristics presented in the MedQA benchmark. Successful "attacks" modify a benchmark item in ways that would be unlikely to fool a medical expert but nonetheless "trick" the LLM into changing from a correct to an incorrect answer. Further, we present a permutation test technique that can ensure a successful attack is statistically significant. We show how to use performance on a "MedFuzzed" benchmark, as well as individual successful attacks. The methods show promise at providing insights into the ability of an LLM to operate robustly in more realistic settings.

Explainable machine learning holds great potential for analyzing and understanding learning-based systems. These methods can, however, be manipulated to present unfaithful explanations, giving rise to powerful and stealthy adversaries. In this paper, we demonstrate blinding attacks that can fully disguise an ongoing attack against the machine learning model. Similar to neural backdoors, we modify the model's prediction upon trigger presence but simultaneously also fool the provided explanation. This enables an adversary to hide the presence of the trigger or point the explanation to entirely different portions of the input, throwing a red herring. We analyze different manifestations of such attacks for different explanation types in the image domain, before we resume to conduct a red-herring attack against malware classification.

To achieve reliable, robust, and safe AI systems, it is vital to implement fallback strategies when AI predictions cannot be trusted. Certifiers for neural networks are a reliable way to check the robustness of these predictions. They guarantee for some predictions that a certain class of manipulations or attacks could not have changed the outcome. For the remaining predictions without guarantees, the method abstains from making a prediction, and a fallback strategy needs to be invoked, which typically incurs additional costs, can require a human operator, or even fail to provide any prediction. While this is a key concept towards safe and secure AI, we show for the first time that this approach comes with its own security risks, as such fallback strategies can be deliberately triggered by an adversary. In addition to naturally occurring abstains for some inputs and perturbations, the adversary can use training-time attacks to deliberately trigger the fallback with high probability. This transfers the main system load onto the fallback, reducing the overall system's integrity and/or availability. We design two novel availability attacks, which show the practical relevance of these threats. For example, adding 1% poisoned data during training is sufficient to trigger the fallback and hence make the model unavailable for up to 100% of all inputs by inserting the trigger. Our extensive experiments across multiple datasets, model architectures, and certifiers demonstrate the broad applicability of these attacks. An initial investigation into potential defenses shows that current approaches are insufficient to mitigate the issue, highlighting the need for new, specific solutions.

Coronavirus disease 2019 (Covid-19) is highly contagious with limited treatment options. Early and accurate diagnosis of Covid-19 is crucial in reducing the spread of the disease and its accompanied mortality. Currently, detection by reverse transcriptase polymerase chain reaction (RT-PCR) is the gold standard of outpatient and inpatient detection of Covid-19. RT-PCR is a rapid method, however, its accuracy in detection is only ~70-75%. Another approved strategy is computed tomography (CT) imaging. CT imaging has a much higher sensitivity of ~80-98%, but similar accuracy of 70%. To enhance the accuracy of CT imaging detection, we developed an open-source set of algorithms called CovidCTNet that successfully differentiates Covid-19 from community-acquired pneumonia (CAP) and other lung diseases. CovidCTNet increases the accuracy of CT imaging detection to 90% compared to radiologists (70%). The model is designed to work with heterogeneous and small sample sizes independent of the CT imaging hardware. In order to facilitate the detection of Covid-19 globally and assist radiologists and physicians in the screening process, we are releasing all algorithms and parametric details in an open-source format. Open-source sharing of our CovidCTNet enables developers to rapidly improve and optimize services, while preserving user privacy and data ownership.

Multi-agent systems (MAS) are critical for automating complex tasks, yet their practical deployment is severely hampered by the challenge of failure attribution. Current diagnostic tools, which rely on statistical correlations, are fundamentally inadequate; on challenging benchmarks like Who\&When, state-of-the-art methods achieve less than 15\% accuracy in locating the root-cause step of a failure. To address this critical gap, we introduce the first failure attribution framework for MAS grounded in multi-granularity causal inference. Our approach makes two key technical contributions: (1) a performance causal inversion principle, which correctly models performance dependencies by reversing the data flow in execution logs, combined with Shapley values to accurately assign agent-level blame; (2) a novel causal discovery algorithm, CDC-MAS, that robustly identifies critical failure steps by tackling the non-stationary nature of MAS interaction data. The framework's attribution results directly fuel an automated optimization loop, generating targeted suggestions whose efficacy is validated via counterfactual simulations. Evaluations on the Who\&When and TRAIL benchmarks demonstrate a significant leap in performance. Our method achieves up to 36.2\% step-level accuracy. Crucially, the generated optimizations boost overall task success rates by an average of 22.4\%. This work provides a principled and effective solution for debugging complex agent interactions, paving the way for more reliable and interpretable multi-agent systems.

We increase overhead for applications that rely on reasoning LLMs-we force models to spend an amplified number of reasoning tokens, i.e., "overthink", to respond to the user query while providing contextually correct answers. The adversary performs an OVERTHINK attack by injecting decoy reasoning problems into the public content that is used by the reasoning LLM (e.g., for RAG applications) during inference time. Due to the nature of our decoy problems (e.g., a Markov Decision Process), modified texts do not violate safety guardrails. We evaluated our attack across closed-(OpenAI o1, o1-mini, o3-mini) and open-(DeepSeek R1) weights reasoning models on the FreshQA and SQuAD datasets. Our results show up to 18x slowdown on FreshQA dataset and 46x slowdown on SQuAD dataset. The attack also shows high transferability across models. To protect applications, we discuss and implement defenses leveraging LLM-based and system design approaches. Finally, we discuss societal, financial, and energy impacts of OVERTHINK attack which could amplify the costs for third-party applications operating reasoning models.

Decision-based adversarial attacks construct inputs that fool a machine-learning model into making targeted mispredictions by making only hard-label queries. For the most part, these attacks have been applied directly to isolated neural network models. However, in practice, machine learning models are just a component of a much larger system. By adding just a single preprocessor in front of a classifier, we find that state-of-the-art query-based attacks are as much as seven times less effective at attacking a prediction pipeline than attacking the machine learning model alone. Hence, attacks that are unaware of this invariance inevitably waste a large number of queries to re-discover or overcome it. We, therefore, develop techniques to first reverse-engineer the preprocessor and then use this extracted information to attack the end-to-end system. Our extraction method requires only a few hundred queries to learn the preprocessors used by most publicly available model pipelines, and our preprocessor-aware attacks recover the same efficacy as just attacking the model alone. The code can be found at https://github.com/google-research/preprocessor-aware-black-box-attack.

Multimodal large language models with Retrieval Augmented Generation (RAG) have significantly advanced tasks such as multimodal question answering by grounding responses in external text and images. This grounding improves factuality, reduces hallucination, and extends reasoning beyond parametric knowledge. However, this reliance on external knowledge poses a critical yet underexplored safety risk: knowledge poisoning attacks, where adversaries deliberately inject adversarial multimodal content into external knowledge bases to steer model toward generating incorrect or even harmful responses. To expose such vulnerabilities, we propose MM-PoisonRAG, the first framework to systematically design knowledge poisoning in multimodal RAG. We introduce two complementary attack strategies: Localized Poisoning Attack (LPA), which implants targeted multimodal misinformation to manipulate specific queries, and Globalized Poisoning Attack (GPA), which inserts a single adversarial knowledge to broadly disrupt reasoning and induce nonsensical responses across all queries. Comprehensive experiments across tasks, models, and access settings show that LPA achieves targeted manipulation with attack success rates of up to 56%, while GPA completely disrupts model generation to 0% accuracy with just a single adversarial knowledge injection. Our results reveal the fragility of multimodal RAG and highlight the urgent need for defenses against knowledge poisoning.

The integration of Large Language Models (LLMs) into healthcare demands a safety paradigm rooted in primum non nocere. However, current alignment techniques rely on generic definitions of harm that fail to capture context-dependent violations, such as administrative fraud and clinical discrimination. To address this, we introduce Medical Malice: a dataset of 214,219 adversarial prompts calibrated to the regulatory and ethical complexities of the Brazilian Unified Health System (SUS). Crucially, the dataset includes the reasoning behind each violation, enabling models to internalize ethical boundaries rather than merely memorizing a fixed set of refusals. Using an unaligned agent (Grok-4) within a persona-driven pipeline, we synthesized high-fidelity threats across seven taxonomies, ranging from procurement manipulation and queue-jumping to obstetric violence. We discuss the ethical design of releasing these "vulnerability signatures" to correct the information asymmetry between malicious actors and AI developers. Ultimately, this work advocates for a shift from universal to context-aware safety, providing the necessary resources to immunize healthcare AI against the nuanced, systemic threats inherent to high-stakes medical environments -- vulnerabilities that represent the paramount risk to patient safety and the successful integration of AI in healthcare systems.

Multi-modal retrieval augmented generation (M-RAG) is instrumental for inhibiting hallucinations in large multi-modal models (LMMs) through the use of a factual knowledge base (KB). However, M-RAG introduces new attack vectors for adversaries that aim to disrupt the system by injecting malicious entries into the KB. In this paper, we present the first poisoning attack against M-RAG targeting visual document retrieval applications where the KB contains images of document pages. We propose two attacks, each of which require injecting only a single adversarial image into the KB. Firstly, we propose a universal attack that, for any potential user query, influences the response to cause a denial-of-service (DoS) in the M-RAG system. Secondly, we present a targeted attack against one or a group of user queries, with the goal of spreading targeted misinformation. For both attacks, we use a multi-objective gradient-based adversarial approach to craft the injected image while optimizing for both retrieval and generation. We evaluate our attacks against several visual document retrieval datasets, a diverse set of state-of-the-art retrievers (embedding models) and generators (LMMs), demonstrating the attack effectiveness in both the universal and targeted settings. We additionally present results including commonly used defenses, various attack hyper-parameter settings, ablations, and attack transferability.

For safety, medical AI systems undergo thorough evaluations before deployment, validating their predictions against a ground truth which is assumed to be fixed and certain. However, this ground truth is often curated in the form of differential diagnoses. While a single differential diagnosis reflects the uncertainty in one expert assessment, multiple experts introduce another layer of uncertainty through disagreement. Both forms of uncertainty are ignored in standard evaluation which aggregates these differential diagnoses to a single label. In this paper, we show that ignoring uncertainty leads to overly optimistic estimates of model performance, therefore underestimating risk associated with particular diagnostic decisions. To this end, we propose a statistical aggregation approach, where we infer a distribution on probabilities of underlying medical condition candidates themselves, based on observed annotations. This formulation naturally accounts for the potential disagreements between different experts, as well as uncertainty stemming from individual differential diagnoses, capturing the entire ground truth uncertainty. Our approach boils down to generating multiple samples of medical condition probabilities, then evaluating and averaging performance metrics based on these sampled probabilities. In skin condition classification, we find that a large portion of the dataset exhibits significant ground truth uncertainty and standard evaluation severely over-estimates performance without providing uncertainty estimates. In contrast, our framework provides uncertainty estimates on common metrics of interest such as top-k accuracy and average overlap, showing that performance can change multiple percentage points. We conclude that, while assuming a crisp ground truth can be acceptable for many AI applications, a more nuanced evaluation protocol should be utilized in medical diagnosis.

As Large Language Models (LLMs) grow increasingly powerful, multi-agent systems are becoming more prevalent in modern AI applications. Most safety research, however, has focused on vulnerabilities in single-agent LLMs. These include prompt injection attacks, where malicious prompts embedded in external content trick the LLM into executing unintended or harmful actions, compromising the victim's application. In this paper, we reveal a more dangerous vector: LLM-to-LLM prompt injection within multi-agent systems. We introduce Prompt Infection, a novel attack where malicious prompts self-replicate across interconnected agents, behaving much like a computer virus. This attack poses severe threats, including data theft, scams, misinformation, and system-wide disruption, all while propagating silently through the system. Our extensive experiments demonstrate that multi-agent systems are highly susceptible, even when agents do not publicly share all communications. To address this, we propose LLM Tagging, a defense mechanism that, when combined with existing safeguards, significantly mitigates infection spread. This work underscores the urgent need for advanced security measures as multi-agent LLM systems become more widely adopted.

Chest X-ray plays a central role in thoracic diagnosis, and its interpretation inherently requires multi-step, evidence-grounded reasoning. However, large vision-language models (LVLMs) often generate plausible responses that are not faithfully grounded in diagnostic evidence and provide limited visual evidence for verification, while also requiring costly retraining to support new diagnostic tasks, limiting their reliability and adaptability in clinical settings. To address these limitations, we present CXReasonAgent, a diagnostic agent that integrates a large language model (LLM) with clinically grounded diagnostic tools to perform evidence-grounded diagnostic reasoning using image-derived diagnostic and visual evidence. To evaluate these capabilities, we introduce CXReasonDial, a multi-turn dialogue benchmark with 1,946 dialogues across 12 diagnostic tasks, and show that CXReasonAgent produces faithfully grounded responses, enabling more reliable and verifiable diagnostic reasoning than LVLMs. These findings highlight the importance of integrating clinically grounded diagnostic tools, particularly in safety-critical clinical settings.

In this paper, we compare and evaluate different testing protocols used for automatic COVID-19 diagnosis from X-Ray images in the recent literature. We show that similar results can be obtained using X-Ray images that do not contain most of the lungs. We are able to remove the lungs from the images by turning to black the center of the X-Ray scan and training our classifiers only on the outer part of the images. Hence, we deduce that several testing protocols for the recognition are not fair and that the neural networks are learning patterns in the dataset that are not correlated to the presence of COVID-19. Finally, we show that creating a fair testing protocol is a challenging task, and we provide a method to measure how fair a specific testing protocol is. In the future research we suggest to check the fairness of a testing protocol using our tools and we encourage researchers to look for better techniques than the ones that we propose.

Pre-trained models of code have achieved success in many important software engineering tasks. However, these powerful models are vulnerable to adversarial attacks that slightly perturb model inputs to make a victim model produce wrong outputs. Current works mainly attack models of code with examples that preserve operational program semantics but ignore a fundamental requirement for adversarial example generation: perturbations should be natural to human judges, which we refer to as naturalness requirement. In this paper, we propose ALERT (nAturaLnEss AwaRe ATtack), a black-box attack that adversarially transforms inputs to make victim models produce wrong outputs. Different from prior works, this paper considers the natural semantic of generated examples at the same time as preserving the operational semantic of original inputs. Our user study demonstrates that human developers consistently consider that adversarial examples generated by ALERT are more natural than those generated by the state-of-the-art work by Zhang et al. that ignores the naturalness requirement. On attacking CodeBERT, our approach can achieve attack success rates of 53.62%, 27.79%, and 35.78% across three downstream tasks: vulnerability prediction, clone detection and code authorship attribution. On GraphCodeBERT, our approach can achieve average success rates of 76.95%, 7.96% and 61.47% on the three tasks. The above outperforms the baseline by 14.07% and 18.56% on the two pre-trained models on average. Finally, we investigated the value of the generated adversarial examples to harden victim models through an adversarial fine-tuning procedure and demonstrated the accuracy of CodeBERT and GraphCodeBERT against ALERT-generated adversarial examples increased by 87.59% and 92.32%, respectively.

Anomaly detection (AD) is a machine learning task that identifies anomalies by learning patterns from normal training data. In many real-world scenarios, anomalies vary in severity, from minor anomalies with little risk to severe abnormalities requiring immediate attention. However, existing models primarily operate in a binary setting, and the anomaly scores they produce are usually based on the deviation of data points from normal data, which may not accurately reflect practical severity. In this paper, we address this gap by making three key contributions. First, we propose a novel setting, Multilevel AD (MAD), in which the anomaly score represents the severity of anomalies in real-world applications, and we highlight its diverse applications across various domains. Second, we introduce a novel benchmark, MAD-Bench, that evaluates models not only on their ability to detect anomalies, but also on how effectively their anomaly scores reflect severity. This benchmark incorporates multiple types of baselines and real-world applications involving severity. Finally, we conduct a comprehensive performance analysis on MAD-Bench. We evaluate models on their ability to assign severity-aligned scores, investigate the correspondence between their performance on binary and multilevel detection, and study their robustness. This analysis offers key insights into improving AD models for practical severity alignment. The code framework and datasets used for the benchmark will be made publicly available.

Despite extensive diagnostics and debugging by developers, AI systems sometimes exhibit harmful unintended behaviors. Finding and fixing these is challenging because the attack surface is so large -- it is not tractable to exhaustively search for inputs that may elicit harmful behaviors. Red-teaming and adversarial training (AT) are commonly used to improve robustness, however, they empirically struggle to fix failure modes that differ from the attacks used during training. In this work, we utilize latent adversarial training (LAT) to defend against vulnerabilities without leveraging knowledge of what they are or using inputs that elicit them. LAT makes use of the compressed, abstract, and structured latent representations of concepts that the network actually uses for prediction. Here, we use it to defend against failure modes without examples that elicit them. Specifically, we use LAT to remove trojans and defend against held-out classes of adversarial attacks. We show in image classification, text classification, and text generation tasks that LAT usually improves both robustness to novel attacks and performance on clean data relative to AT. This suggests that LAT can be a promising tool for defending against failure modes that are not explicitly identified by developers.

Large Language Models (LLMs) have demonstrated remarkable performance across a wide range of applications, e.g., medical question-answering, mathematical sciences, and code generation. However, they also exhibit inherent limitations, such as outdated knowledge and susceptibility to hallucinations. Retrieval-Augmented Generation (RAG) has emerged as a promising paradigm to address these issues, but it also introduces new vulnerabilities. Recent efforts have focused on the security of RAG-based LLMs, yet existing attack methods face three critical challenges: (1) their effectiveness declines sharply when only a limited number of poisoned texts can be injected into the knowledge database, (2) they lack sufficient stealth, as the attacks are often detectable by anomaly detection systems, which compromises their effectiveness, and (3) they rely on heuristic approaches to generate poisoned texts, lacking formal optimization frameworks and theoretic guarantees, which limits their effectiveness and applicability. To address these issues, we propose coordinated Prompt-RAG attack (PR-attack), a novel optimization-driven attack that introduces a small number of poisoned texts into the knowledge database while embedding a backdoor trigger within the prompt. When activated, the trigger causes the LLM to generate pre-designed responses to targeted queries, while maintaining normal behavior in other contexts. This ensures both high effectiveness and stealth. We formulate the attack generation process as a bilevel optimization problem leveraging a principled optimization framework to develop optimal poisoned texts and triggers. Extensive experiments across diverse LLMs and datasets demonstrate the effectiveness of PR-Attack, achieving a high attack success rate even with a limited number of poisoned texts and significantly improved stealth compared to existing methods.

Coronary artery disease (CAD) remains the leading cause of death globally and invasive coronary angiography (ICA) is considered the gold standard of anatomical imaging evaluation when CAD is suspected. However, risk evaluation based on ICA has several limitations, such as visual assessment of stenosis severity, which has significant interobserver variability. This motivates to development of a lesion classification system that can support specialists in their clinical procedures. Although deep learning classification methods are well-developed in other areas of medical imaging, ICA image classification is still at an early stage. One of the most important reasons is the lack of available and high-quality open-access datasets. In this paper, we reported a new annotated ICA images dataset, CADICA, to provide the research community with a comprehensive and rigorous dataset of coronary angiography consisting of a set of acquired patient videos and associated disease-related metadata. This dataset can be used by clinicians to train their skills in angiographic assessment of CAD severity and by computer scientists to create computer-aided diagnostic systems to help in such assessment. In addition, baseline classification methods are proposed and analyzed, validating the functionality of CADICA and giving the scientific community a starting point to improve CAD detection.

Despite achieving high accuracy on medical benchmarks, LLMs exhibit the Einstellung Effect in clinical diagnosis--relying on statistical shortcuts rather than patient-specific evidence, causing misdiagnosis in atypical cases. Existing benchmarks fail to detect this critical failure mode. We introduce MedEinst, a counterfactual benchmark with 5,383 paired clinical cases across 49 diseases. Each pair contains a control case and a "trap" case with altered discriminative evidence that flips the diagnosis. We measure susceptibility via Bias Trap Rate--probability of misdiagnosing traps despite correctly diagnosing controls. Extensive Evaluation of 17 LLMs shows frontier models achieve high baseline accuracy but severe bias trap rates. Thus, we propose ECR-Agent, aligning LLM reasoning with Evidence-Based Medicine standard via two components: (1) Dynamic Causal Inference (DCI) performs structured reasoning through dual-pathway perception, dynamic causal graph reasoning across three levels (association, intervention, counterfactual), and evidence audit for final diagnosis; (2) Critic-Driven Graph and Memory Evolution (CGME) iteratively refines the system by storing validated reasoning paths in an exemplar base and consolidating disease-specific knowledge into evolving illness graphs. Source code is to be released.

Large Language Models (LLMs) excel in reasoning and generation across domains, but still struggle with identifying and diagnosing complex errors. This stems mainly from training objectives that prioritize correct answers, limiting exposure to and learning from errors. While recent studies have begun to address this by introducing error signals, most rely on shallow, static errors, restricting improvement in deep diagnostic ability. To overcome this, we propose Hide and Seek Game (HSG), a dynamic adversarial framework for error generation and diagnosis, and evaluate it on mathematical problem-solving. HSG involves two adversarial roles: Sneaky, which "hides" by generating subtle, deceptive reasoning errors, and Diagnosis, which "seeks" to accurately detect them. Through adversarial co-evolution, both error stealth and diagnostic precision are enhanced. Experiments on several math reasoning tasks show that HSG significantly boosts error diagnosis, achieving 16.8\%--31.4\% higher accuracy than baselines like GPT-4o. We also release a challenging dataset of deceptive errors and diagnostic annotations as a benchmark for future research.

This technical report delves into an in-depth exploration of adversarial attacks specifically targeted at Deep Neural Networks (DNNs) utilized for image classification. The study also investigates defense mechanisms aimed at bolstering the robustness of machine learning models. The research focuses on comprehending the ramifications of two prominent attack methodologies: the Fast Gradient Sign Method (FGSM) and the Carlini-Wagner (CW) approach. These attacks are examined concerning three pre-trained image classifiers: Resnext50_32x4d, DenseNet-201, and VGG-19, utilizing the Tiny-ImageNet dataset. Furthermore, the study proposes the robustness of defensive distillation as a defense mechanism to counter FGSM and CW attacks. This defense mechanism is evaluated using the CIFAR-10 dataset, where CNN models, specifically resnet101 and Resnext50_32x4d, serve as the teacher and student models, respectively. The proposed defensive distillation model exhibits effectiveness in thwarting attacks such as FGSM. However, it is noted to remain susceptible to more sophisticated techniques like the CW attack. The document presents a meticulous validation of the proposed scheme. It provides detailed and comprehensive results, elucidating the efficacy and limitations of the defense mechanisms employed. Through rigorous experimentation and analysis, the study offers insights into the dynamics of adversarial attacks on DNNs, as well as the effectiveness of defensive strategies in mitigating their impact.

As LLM-based agents increasingly browse the web on users' behalf, a natural question arises: can websites passively identify which underlying model powers an agent? Doing so would represent a significant security risk, enabling targeted attacks tailored to known model vulnerabilities. Across 14 frontier LLMs and four web environments spanning information retrieval and shopping tasks, we show that an agent's actions and interaction timings, captured via a passive JavaScript tracker, are sufficient to identify the underlying model with up to 96\% F1. We formalise this attack surface by demonstrating that classifiers trained on agent actions generalise across model sizes and families. We further show that strong classifiers can be trained from few interaction traces and that agent identity can be inferred early within an episode. Injecting randomised timing delays between actions substantially degrades classifier performance, but does not provide robust protection: a classifier retrained on delayed traces largely recovers performance. We release our harness and a labelled corpus of agent traces https://github.com/KabakaWilliam/known_actions{here}.

Anomaly detection methods can be very useful in identifying unusual or interesting patterns in data. A recently proposed conditional anomaly detection framework extends anomaly detection to the problem of identifying anomalous patterns on a subset of attributes in the data. The anomaly always depends (is conditioned) on the value of remaining attributes. The work presented in this paper focuses on instance-based methods for detecting conditional anomalies. The methods rely on the distance metric to identify examples in the dataset that are most critical for detecting the anomaly. We investigate various metrics and metric learning methods to optimize the performance of the instance-based anomaly detection methods. We show the benefits of the instance-based methods on two real-world detection problems: detection of unusual admission decisions for patients with the community-acquired pneumonia and detection of unusual orders of an HPF4 test that is used to confirm Heparin induced thrombocytopenia - a life-threatening condition caused by the Heparin therapy.

Recent studies have shown that deep learning models are vulnerable to specifically crafted adversarial inputs that are quasi-imperceptible to humans. In this letter, we propose a novel method to detect adversarial inputs, by augmenting the main classification network with multiple binary detectors (observer networks) which take inputs from the hidden layers of the original network (convolutional kernel outputs) and classify the input as clean or adversarial. During inference, the detectors are treated as a part of an ensemble network and the input is deemed adversarial if at least half of the detectors classify it as so. The proposed method addresses the trade-off between accuracy of classification on clean and adversarial samples, as the original classification network is not modified during the detection process. The use of multiple observer networks makes attacking the detection mechanism non-trivial even when the attacker is aware of the victim classifier. We achieve a 99.5% detection accuracy on the MNIST dataset and 97.5% on the CIFAR-10 dataset using the Fast Gradient Sign Attack in a semi-white box setup. The number of false positive detections is a mere 0.12% in the worst case scenario.

Medical imaging plays a pivotal role in modern healthcare, with computed tomography pulmonary angiography (CTPA) being a critical tool for diagnosing pulmonary embolism and other thoracic conditions. However, the complexity of interpreting CTPA scans and generating accurate radiology reports remains a significant challenge. This paper introduces Abn-BLIP (Abnormality-aligned Bootstrapping Language-Image Pretraining), an advanced diagnosis model designed to align abnormal findings to generate the accuracy and comprehensiveness of radiology reports. By leveraging learnable queries and cross-modal attention mechanisms, our model demonstrates superior performance in detecting abnormalities, reducing missed findings, and generating structured reports compared to existing methods. Our experiments show that Abn-BLIP outperforms state-of-the-art medical vision-language models and 3D report generation methods in both accuracy and clinical relevance. These results highlight the potential of integrating multimodal learning strategies for improving radiology reporting. The source code is available at https://github.com/zzs95/abn-blip.

Ensuring the quality and integrity of medical images is crucial for maintaining diagnostic accuracy in deep learning-based Computer-Aided Diagnosis and Computer-Aided Detection (CAD) systems. Covariate shifts are subtle variations in the data distribution caused by different imaging devices or settings and can severely degrade model performance, similar to the effects of adversarial attacks. Therefore, it is vital to have a lightweight and fast method to assess the quality of these images prior to using CAD models. AdverX-Ray addresses this need by serving as an image-quality assessment layer, designed to detect covariate shifts effectively. This Adversarial Variational Autoencoder prioritizes the discriminator's role, using the suboptimal outputs of the generator as negative samples to fine-tune the discriminator's ability to identify high-frequency artifacts. Images generated by adversarial networks often exhibit severe high-frequency artifacts, guiding the discriminator to focus excessively on these components. This makes the discriminator ideal for this approach. Trained on patches from X-ray images of specific machine models, AdverX-Ray can evaluate whether a scan matches the training distribution, or if a scan from the same machine is captured under different settings. Extensive comparisons with various OOD detection methods show that AdverX-Ray significantly outperforms existing techniques, achieving a 96.2% average AUROC using only 64 random patches from an X-ray. Its lightweight and fast architecture makes it suitable for real-time applications, enhancing the reliability of medical imaging systems. The code and pretrained models are publicly available.

Multiple prompt injection attacks have been proposed against web agents. At the same time, various methods have been developed to detect general prompt injection attacks, but none have been systematically evaluated for web agents. In this work, we bridge this gap by presenting the first comprehensive benchmark study on detecting prompt injection attacks targeting web agents. We begin by introducing a fine-grained categorization of such attacks based on the threat model. We then construct datasets containing both malicious and benign samples: malicious text segments generated by different attacks, benign text segments from four categories, malicious images produced by attacks, and benign images from two categories. Next, we systematize both text-based and image-based detection methods. Finally, we evaluate their performance across multiple scenarios. Our key findings show that while some detectors can identify attacks that rely on explicit textual instructions or visible image perturbations with moderate to high accuracy, they largely fail against attacks that omit explicit instructions or employ imperceptible perturbations. Our datasets and code are released at: https://github.com/Norrrrrrr-lyn/WAInjectBench.

Engaging in the deliberate generation of abnormal outputs from Large Language Models (LLMs) by attacking them is a novel human activity. This paper presents a thorough exposition of how and why people perform such attacks, defining LLM red-teaming based on extensive and diverse evidence. Using a formal qualitative methodology, we interviewed dozens of practitioners from a broad range of backgrounds, all contributors to this novel work of attempting to cause LLMs to fail. We focused on the research questions of defining LLM red teaming, uncovering the motivations and goals for performing the activity, and characterizing the strategies people use when attacking LLMs. Based on the data, LLM red teaming is defined as a limit-seeking, non-malicious, manual activity, which depends highly on a team-effort and an alchemist mindset. It is highly intrinsically motivated by curiosity, fun, and to some degrees by concerns for various harms of deploying LLMs. We identify a taxonomy of 12 strategies and 35 different techniques of attacking LLMs. These findings are presented as a comprehensive grounded theory of how and why people attack large language models: LLM red teaming.

AI coding assistants are widely used for tasks like code generation. These tools now require large and complex contexts, automatically sourced from various originsx2014across files, projects, and contributorsx2014forming part of the prompt fed to underlying LLMs. This automatic context-gathering introduces new vulnerabilities, allowing attackers to subtly poison input to compromise the assistant's outputs, potentially generating vulnerable code or introducing critical errors. We propose a novel attack, Cross-Origin Context Poisoning (XOXO), that is challenging to detect as it relies on adversarial code modifications that are semantically equivalent. Traditional program analysis techniques struggle to identify these perturbations since the semantics of the code remains correct, making it appear legitimate. This allows attackers to manipulate coding assistants into producing incorrect outputs, while shifting the blame to the victim developer. We introduce a novel, task-agnostic, black-box attack algorithm GCGS that systematically searches the transformation space using a Cayley Graph, achieving a 75.72% attack success rate on average across five tasks and eleven models, including GPT 4.1 and Claude 3.5 Sonnet v2 used by popular AI coding assistants. Furthermore, defenses like adversarial fine-tuning are ineffective against our attack, underscoring the need for new security measures in LLM-powered coding tools.

To ensure AI safety, instruction-tuned Large Language Models (LLMs) are specifically trained to ensure alignment, which refers to making models behave in accordance with human intentions. While these models have demonstrated commendable results on various safety benchmarks, the vulnerability of their safety alignment has not been extensively studied. This is particularly troubling given the potential harm that LLMs can inflict. Existing attack methods on LLMs often rely on poisoned training data or the injection of malicious prompts. These approaches compromise the stealthiness and generalizability of the attacks, making them susceptible to detection. Additionally, these models often demand substantial computational resources for implementation, making them less practical for real-world applications. Inspired by recent success in modifying model behavior through steering vectors without the need for optimization, and drawing on its effectiveness in red-teaming LLMs, we conducted experiments employing activation steering to target four key aspects of LLMs: truthfulness, toxicity, bias, and harmfulness - across a varied set of attack settings. To establish a universal attack strategy applicable to diverse target alignments without depending on manual analysis, we automatically select the intervention layer based on contrastive layer search. Our experiment results show that activation attacks are highly effective and add little or no overhead to attack efficiency. Additionally, we discuss potential countermeasures against such activation attacks. Our code and data are available at https://github.com/wang2226/Backdoor-Activation-Attack Warning: this paper contains content that can be offensive or upsetting.

Recent research has highlighted the vulnerability of Deep Neural Networks (DNNs) against data poisoning attacks. These attacks aim to inject poisoning samples into the models' training dataset such that the trained models have inference failures. While previous studies have executed different types of attacks, one major challenge that greatly limits their effectiveness is the uncertainty of the re-training process after the injection of poisoning samples, including the re-training initialization or algorithms. To address this challenge, we propose a novel attack method called ''Sharpness-Aware Data Poisoning Attack (SAPA)''. In particular, it leverages the concept of DNNs' loss landscape sharpness to optimize the poisoning effect on the worst re-trained model. It helps enhance the preservation of the poisoning effect, regardless of the specific retraining procedure employed. Extensive experiments demonstrate that SAPA offers a general and principled strategy that significantly enhances various types of poisoning attacks.

Cyber threat intelligence (CTI) is being used to search for indicators of attacks that might have compromised an enterprise network for a long time without being discovered. To have a more effective analysis, CTI open standards have incorporated descriptive relationships showing how the indicators or observables are related to each other. However, these relationships are either completely overlooked in information gathering or not used for threat hunting. In this paper, we propose a system, called POIROT, which uses these correlations to uncover the steps of a successful attack campaign. We use kernel audits as a reliable source that covers all causal relations and information flows among system entities and model threat hunting as an inexact graph pattern matching problem. Our technical approach is based on a novel similarity metric which assesses an alignment between a query graph constructed out of CTI correlations and a provenance graph constructed out of kernel audit log records. We evaluate POIROT on publicly released real-world incident reports as well as reports of an adversarial engagement designed by DARPA, including ten distinct attack campaigns against different OS platforms such as Linux, FreeBSD, and Windows. Our evaluation results show that POIROT is capable of searching inside graphs containing millions of nodes and pinpoint the attacks in a few minutes, and the results serve to illustrate that CTI correlations could be used as robust and reliable artifacts for threat hunting.

Distributed protocols should be robust to both benign malfunction (e.g. packet loss or delay) and attacks (e.g. message replay) from internal or external adversaries. In this paper we take a formal approach to the automated synthesis of attackers, i.e. adversarial processes that can cause the protocol to malfunction. Specifically, given a formal threat model capturing the distributed protocol model and network topology, as well as the placement, goals, and interface (inputs and outputs) of potential attackers, we automatically synthesize an attacker. We formalize four attacker synthesis problems - across attackers that always succeed versus those that sometimes fail, and attackers that attack forever versus those that do not - and we propose algorithmic solutions to two of them. We report on a prototype implementation called KORG and its application to TCP as a case-study. Our experiments show that KORG can automatically generate well-known attacks for TCP within seconds or minutes.

Determining the family to which a malicious file belongs is an essential component of cyberattack investigation, attribution, and remediation. Performing this task manually is time consuming and requires expert knowledge. Automated tools using that label malware using antivirus detections lack accuracy and/or scalability, making them insufficient for real-world applications. Three pervasive shortcomings in these tools are responsible: (1) incorrect parsing of antivirus detections, (2) errors during family alias resolution, and (3) an inappropriate antivirus aggregation strategy. To address each of these, we created our own malware family labeling tool called ClarAVy. ClarAVy utilizes a Variational Bayesian approach to aggregate detections from a collection of antivirus products into accurate family labels. Our tool scales to enormous malware datasets, and we evaluated it by labeling approx40 million malicious files. ClarAVy has 8 and 12 percentage points higher accuracy than the prior leading tool in labeling the MOTIF and MalPedia datasets, respectively.

Deep neural networks for image classification remain vulnerable to adversarial examples -- small, imperceptible perturbations that induce misclassifications. In black-box settings, where only the final prediction is accessible, crafting targeted attacks that aim to misclassify into a specific target class is particularly challenging due to narrow decision regions. Current state-of-the-art methods often exploit the geometric properties of the decision boundary separating a source image and a target image rather than incorporating information from the images themselves. In contrast, we propose Targeted Edge-informed Attack (TEA), a novel attack that utilizes edge information from the target image to carefully perturb it, thereby producing an adversarial image that is closer to the source image while still achieving the desired target classification. Our approach consistently outperforms current state-of-the-art methods across different models in low query settings (nearly 70% fewer queries are used), a scenario especially relevant in real-world applications with limited queries and black-box access. Furthermore, by efficiently generating a suitable adversarial example, TEA provides an improved target initialization for established geometry-based attacks.

Prompt injection attacks pose serious security risks across a wide range of real-world applications. While receiving increasing attention, the community faces a critical gap: the lack of a unified platform for prompt injection evaluation. This makes it challenging to reliably compare defenses, understand their true robustness under diverse attacks, or assess how well they generalize across tasks and benchmarks. For instance, many defenses initially reported as effective were later found to exhibit limited robustness on diverse datasets and attacks. To bridge this gap, we introduce PIArena, a unified and extensible platform for prompt injection evaluation that enables users to easily integrate state-of-the-art attacks and defenses and evaluate them across a variety of existing and new benchmarks. We also design a dynamic strategy-based attack that adaptively optimizes injected prompts based on defense feedback. Through comprehensive evaluation using PIArena, we uncover critical limitations of state-of-the-art defenses: limited generalizability across tasks, vulnerability to adaptive attacks, and fundamental challenges when an injected task aligns with the target task. The code and datasets are available at https://github.com/sleeepeer/PIArena.

As machine learning models grow in complexity and increasingly rely on publicly sourced data, such as the human-annotated labels used in training large language models, they become more vulnerable to label poisoning attacks. These attacks, in which adversaries subtly alter the labels within a training dataset, can severely degrade model performance, posing significant risks in critical applications. In this paper, we propose FLORAL, a novel adversarial training defense strategy based on support vector machines (SVMs) to counter these threats. Utilizing a bilevel optimization framework, we cast the training process as a non-zero-sum Stackelberg game between an attacker, who strategically poisons critical training labels, and the model, which seeks to recover from such attacks. Our approach accommodates various model architectures and employs a projected gradient descent algorithm with kernel SVMs for adversarial training. We provide a theoretical analysis of our algorithm's convergence properties and empirically evaluate FLORAL's effectiveness across diverse classification tasks. Compared to robust baselines and foundation models such as RoBERTa, FLORAL consistently achieves higher robust accuracy under increasing attacker budgets. These results underscore the potential of FLORAL to enhance the resilience of machine learning models against label poisoning threats, thereby ensuring robust classification in adversarial settings.

Anomaly-based Intrusion Detection System (IDS) has been a hot research topic because of its ability to detect new threats rather than only memorized signatures threats of signature-based IDS. Especially after the availability of advanced technologies that increase the number of hacking tools and increase the risk impact of an attack. The problem of any anomaly-based model is its high false-positive rate. The high false-positive rate is the reason why anomaly IDS is not commonly applied in practice. Because anomaly-based models classify an unseen pattern as a threat where it may be normal but not included in the training dataset. This type of problem is called overfitting where the model is not able to generalize. Optimizing Anomaly-based models by having a big training dataset that includes all possible normal cases may be an optimal solution but could not be applied in practice. Although we can increase the number of training samples to include much more normal cases, still we need a model that has more ability to generalize. In this research paper, we propose applying deep model instead of traditional models because it has more ability to generalize. Thus, we will obtain less false-positive by using big data and deep model. We made a comparison between machine learning and deep learning algorithms in the optimization of anomaly-based IDS by decreasing the false-positive rate. We did an experiment on the NSL-KDD benchmark and compared our results with one of the best used classifiers in traditional learning in IDS optimization. The experiment shows 10% lower false-positive by using deep learning instead of traditional learning.

Retrieval-augmented generation (RAG) is increasingly deployed in real-world applications, where its reference-grounded design makes outputs appear trustworthy. This trust has spurred research on poisoning attacks that craft malicious content, inject it into knowledge sources, and manipulate RAG responses. However, when evaluated in practical RAG systems, existing attacks suffer from severely degraded effectiveness. This gap stems from two overlooked realities: (i) content is often processed before use, which can fragment the poison and weaken its effect, and (ii) users often do not issue the exact queries anticipated during attack design. These factors can lead practitioners to underestimate risks and develop a false sense of security. To better characterize the threat to practical systems, we present Confundo, a learning-to-poison framework that fine-tunes a large language model as a poison generator to achieve high effectiveness, robustness, and stealthiness. Confundo provides a unified framework supporting multiple attack objectives, demonstrated by manipulating factual correctness, inducing biased opinions, and triggering hallucinations. By addressing these overlooked challenges, Confundo consistently outperforms a wide range of purpose-built attacks across datasets and RAG configurations by large margins, even in the presence of defenses. Beyond exposing vulnerabilities, we also present a defensive use case that protects web content from unauthorized incorporation into RAG systems via scraping, with no impact on user experience.

Fault attacks are active, physical attacks that an adversary can leverage to alter the control-flow of embedded devices to gain access to sensitive information or bypass protection mechanisms. Due to the severity of these attacks, manufacturers deploy hardware-based fault defenses into security-critical systems, such as secure elements. The development of these countermeasures is a challenging task due to the complex interplay of circuit components and because contemporary design automation tools tend to optimize inserted structures away, thereby defeating their purpose. Hence, it is critical that such countermeasures are rigorously verified post-synthesis. As classical functional verification techniques fall short of assessing the effectiveness of countermeasures, developers have to resort to methods capable of injecting faults in a simulation testbench or into a physical chip. However, developing test sequences to inject faults in simulation is an error-prone task and performing fault attacks on a chip requires specialized equipment and is incredibly time-consuming. To that end, this paper introduces SYNFI, a formal pre-silicon fault verification framework that operates on synthesized netlists. SYNFI can be used to analyze the general effect of faults on the input-output relationship in a circuit and its fault countermeasures, and thus enables hardware designers to assess and verify the effectiveness of embedded countermeasures in a systematic and semi-automatic way. To demonstrate that SYNFI is capable of handling unmodified, industry-grade netlists synthesized with commercial and open tools, we analyze OpenTitan, the first open-source secure element. In our analysis, we identified critical security weaknesses in the unprotected AES block, developed targeted countermeasures, reassessed their security, and contributed these countermeasures back to the OpenTitan repository.

Decision-based evasion attacks repeatedly query a black-box classifier to generate adversarial examples. Prior work measures the cost of such attacks by the total number of queries made to the classifier. We argue this metric is flawed. Most security-critical machine learning systems aim to weed out "bad" data (e.g., malware, harmful content, etc). Queries to such systems carry a fundamentally asymmetric cost: queries detected as "bad" come at a higher cost because they trigger additional security filters, e.g., usage throttling or account suspension. Yet, we find that existing decision-based attacks issue a large number of "bad" queries, which likely renders them ineffective against security-critical systems. We then design new attacks that reduce the number of bad queries by 1.5-7.3times, but often at a significant increase in total (non-bad) queries. We thus pose it as an open problem to build black-box attacks that are more effective under realistic cost metrics.

Deep learning models are often trained on distributed, web-scale datasets crawled from the internet. In this paper, we introduce two new dataset poisoning attacks that intentionally introduce malicious examples to a model's performance. Our attacks are immediately practical and could, today, poison 10 popular datasets. Our first attack, split-view poisoning, exploits the mutable nature of internet content to ensure a dataset annotator's initial view of the dataset differs from the view downloaded by subsequent clients. By exploiting specific invalid trust assumptions, we show how we could have poisoned 0.01% of the LAION-400M or COYO-700M datasets for just $60 USD. Our second attack, frontrunning poisoning, targets web-scale datasets that periodically snapshot crowd-sourced content -- such as Wikipedia -- where an attacker only needs a time-limited window to inject malicious examples. In light of both attacks, we notify the maintainers of each affected dataset and recommended several low-overhead defenses.

Recent proposals advocate using keystroke timing signals, specifically the coefficient of variation (δ) of inter-keystroke intervals, to distinguish human-composed text from AI-generated content. We demonstrate that this class of defenses is insecure against two practical attack classes: the copy-type attack, in which a human transcribes LLM-generated text producing authentic motor signals, and timing-forgery attacks, in which automated agents sample inter-keystroke intervals from empirical human distributions. Using 13,000 sessions from the SBU corpus and three timing-forgery variants (histogram sampling, statistical impersonation, and generative LSTM), we show all attacks achieve ge99.8% evasion rates against five classifiers. While detectors achieve AUC=1.000 against fully-automated injection, they classify ge99.8% of attack samples as human with mean confidence ge0.993. We formalize a non-identifiability result: when the detector observes only timing, the mutual information between features and content provenance is zero for copy-type attacks. Although composition and transcription produce statistically distinguishable motor patterns (Cohen's d=1.28), both yield δ values 2-4x above detection thresholds, rendering the distinction security-irrelevant. These systems confirm a human operated the keyboard, but not whether that human originated the text. Securing provenance requires architectures that bind the writing process to semantic content.

Intrusion Detection Systems (IDS) play a crucial role in ensuring the security of computer networks. Machine learning has emerged as a popular approach for intrusion detection due to its ability to analyze and detect patterns in large volumes of data. However, current ML-based IDS solutions often struggle to keep pace with the ever-changing nature of attack patterns and the emergence of new attack types. Additionally, these solutions face challenges related to class imbalance, where the number of instances belonging to different classes (normal and intrusions) is significantly imbalanced, which hinders their ability to effectively detect minor classes. In this paper, we propose a novel multi-agent reinforcement learning (RL) architecture, enabling automatic, efficient, and robust network intrusion detection. To enhance the capabilities of the proposed model, we have improved the DQN algorithm by implementing the weighted mean square loss function and employing cost-sensitive learning techniques. Our solution introduces a resilient architecture designed to accommodate the addition of new attacks and effectively adapt to changes in existing attack patterns. Experimental results realized using CIC-IDS-2017 dataset, demonstrate that our approach can effectively handle the class imbalance problem and provide a fine grained classification of attacks with a very low false positive rate. In comparison to the current state-of-the-art works, our solution demonstrates a significant superiority in both detection rate and false positive rate.

As large language models (LLMs) continue to evolve, it is critical to assess the security threats and vulnerabilities that may arise both during their training phase and after models have been deployed. This survey seeks to define and categorize the various attacks targeting LLMs, distinguishing between those that occur during the training phase and those that affect already trained models. A thorough analysis of these attacks is presented, alongside an exploration of defense mechanisms designed to mitigate such threats. Defenses are classified into two primary categories: prevention-based and detection-based defenses. Furthermore, our survey summarizes possible attacks and their corresponding defense strategies. It also provides an evaluation of the effectiveness of the known defense mechanisms for the different security threats. Our survey aims to offer a structured framework for securing LLMs, while also identifying areas that require further research to improve and strengthen defenses against emerging security challenges.

Timely detection of concerning events is an important problem in clinical practice. In this paper, we consider the problem of conditional anomaly detection that aims to identify data instances with an unusual response, such as the omission of an important lab test. We develop a new non-parametric approach for conditional anomaly detection based on the soft harmonic solution, with which we estimate the confidence of the label to detect anomalous mislabeling. We further regularize the solution to avoid the detection of isolated examples and examples on the boundary of the distribution support. We demonstrate the efficacy of the proposed method in detecting unusual labels on a real-world electronic health record dataset and compare it to several baseline approaches.

LLM-integrated applications and agents are vulnerable to prompt injection attacks, where an attacker injects prompts into their inputs to induce attacker-desired outputs. A detection method aims to determine whether a given input is contaminated by an injected prompt. However, existing detection methods have limited effectiveness against state-of-the-art attacks, let alone adaptive ones. In this work, we propose DataSentinel, a game-theoretic method to detect prompt injection attacks. Specifically, DataSentinel fine-tunes an LLM to detect inputs contaminated with injected prompts that are strategically adapted to evade detection. We formulate this as a minimax optimization problem, with the objective of fine-tuning the LLM to detect strong adaptive attacks. Furthermore, we propose a gradient-based method to solve the minimax optimization problem by alternating between the inner max and outer min problems. Our evaluation results on multiple benchmark datasets and LLMs show that DataSentinel effectively detects both existing and adaptive prompt injection attacks.

Machine Learning (ML) models have been utilized for malware detection for over two decades. Consequently, this ignited an ongoing arms race between malware authors and antivirus systems, compelling researchers to propose defenses for malware-detection models against evasion attacks. However, most if not all existing defenses against evasion attacks suffer from sizable performance degradation and/or can defend against only specific attacks, which makes them less practical in real-world settings. In this work, we develop a certified defense, DRSM (De-Randomized Smoothed MalConv), by redesigning the de-randomized smoothing technique for the domain of malware detection. Specifically, we propose a window ablation scheme to provably limit the impact of adversarial bytes while maximally preserving local structures of the executables. After showing how DRSM is theoretically robust against attacks with contiguous adversarial bytes, we verify its performance and certified robustness experimentally, where we observe only marginal accuracy drops as the cost of robustness. To our knowledge, we are the first to offer certified robustness in the realm of static detection of malware executables. More surprisingly, through evaluating DRSM against 9 empirical attacks of different types, we observe that the proposed defense is empirically robust to some extent against a diverse set of attacks, some of which even fall out of the scope of its original threat model. In addition, we collected 15.5K recent benign raw executables from diverse sources, which will be made public as a dataset called PACE (Publicly Accessible Collection(s) of Executables) to alleviate the scarcity of publicly available benign datasets for studying malware detection and provide future research with more representative data of the time.

Large Reasoning Models (LRMs) have demonstrated promising performance in complex tasks. However, the resource-consuming reasoning processes may be exploited by attackers to maliciously occupy the resources of the servers, leading to a crash, like the DDoS attack in cyber. To this end, we propose a novel attack method on LRMs termed ExtendAttack to maliciously occupy the resources of servers by stealthily extending the reasoning processes of LRMs. Concretely, we systematically obfuscate characters within a benign prompt, transforming them into a complex, poly-base ASCII representation. This compels the model to perform a series of computationally intensive decoding sub-tasks that are deeply embedded within the semantic structure of the query itself. Extensive experiments demonstrate the effectiveness of our proposed ExtendAttack. Remarkably, it significantly increases response length and latency, with the former increasing by over 2.7 times for the o3 model on the HumanEval benchmark. Besides, it preserves the original meaning of the query and achieves comparable answer accuracy, showing the stealthiness.

Developing a generalist radiology diagnosis system can greatly enhance clinical diagnostics. In this paper, we introduce RadDiag, a foundational model supporting 2D and 3D inputs across various modalities and anatomies, using a transformer-based fusion module for comprehensive disease diagnosis. Due to patient privacy concerns and the lack of large-scale radiology diagnosis datasets, we utilize high-quality, clinician-reviewed radiological images available online with diagnosis labels. Our dataset, RP3D-DiagDS, contains 40,936 cases with 195,010 scans covering 5,568 disorders (930 unique ICD-10-CM codes). Experimentally, our RadDiag achieves 95.14% AUC on internal evaluation with the knowledge-enhancement strategy. Additionally, RadDiag can be zero-shot applied or fine-tuned to external diagnosis datasets sourced from various hospitals, demonstrating state-of-the-art results. In conclusion, we show that publicly shared medical data on the Internet is a tremendous and valuable resource that can potentially support building a generalist AI for healthcare.

In this study, we investigate the emerging threat of inaudible acoustic attacks targeting digital voice assistants, a critical concern given their projected prevalence to exceed the global population by 2024. Our research extends the feasibility of these attacks across various platforms like Amazon's Alexa, Android, iOS, and Cortana, revealing significant vulnerabilities in smart devices. The twelve attack vectors identified include successful manipulation of smart home devices and automotive systems, potential breaches in military communication, and challenges in critical infrastructure security. We quantitatively show that attack success rates hover around 60%, with the ability to activate devices remotely from over 100 feet away. Additionally, these attacks threaten critical infrastructure, emphasizing the need for multifaceted defensive strategies combining acoustic shielding, advanced signal processing, machine learning, and robust user authentication to mitigate these risks.

Cloud environments face frequent DDoS threats due to centralized resources and broad attack surfaces. Modern cloud-native DDoS attacks further evolve rapidly and often blend multi-vector strategies, creating an operational dilemma: defenders need wire-speed monitoring while also requiring explainable, auditable attribution for response. Existing rule-based and supervised-learning approaches typically output black-box scores or labels, provide limited evidence chains, and generalize poorly to unseen attack variants; meanwhile, high-quality labeled data is often difficult to obtain in cloud settings. We present Holmes (DDoS Detective), an LLM-based DDoS detection agent that reframes the model as a virtual SRE investigator rather than an end-to-end classifier. Holmes couples a funnel-like hierarchical workflow (counters/sFlow for continuous sensing and triage; PCAP evidence collection triggered only on anomaly windows) with an Evidence Pack abstraction that converts binary packets into compact, reproducible, high-signal structured evidence. On top of this evidence interface, Holmes enforces a structure-first investigation protocol and strict JSON/quotation constraints to produce machine-consumable reports with auditable evidence anchors. We evaluate Holmes on CICDDoS2019 reflection/amplification attacks and script-triggered flooding scenarios. Results show that Holmes produces attribution decisions grounded in salient evidence anchors across diverse attack families, and when errors occur, its audit logs make the failure source easy to localize, demonstrating the practicality of an LLM agent for cost-controlled and traceable DDoS investigation in cloud operations.

Evaluating the robustness of a defense model is a challenging task in adversarial robustness research. Obfuscated gradients have previously been found to exist in many defense methods and cause a false signal of robustness. In this paper, we identify a more subtle situation called Imbalanced Gradients that can also cause overestimated adversarial robustness. The phenomenon of imbalanced gradients occurs when the gradient of one term of the margin loss dominates and pushes the attack towards to a suboptimal direction. To exploit imbalanced gradients, we formulate a Margin Decomposition (MD) attack that decomposes a margin loss into individual terms and then explores the attackability of these terms separately via a two-stage process. We also propose a multi-targeted and ensemble version of our MD attack. By investigating 24 defense models proposed since 2018, we find that 11 models are susceptible to a certain degree of imbalanced gradients and our MD attack can decrease their robustness evaluated by the best standalone baseline attack by more than 1%. We also provide an in-depth investigation on the likely causes of imbalanced gradients and effective countermeasures. Our code is available at https://github.com/HanxunH/MDAttack.

Large language models have demonstrated remarkable performance in a wide range of medical benchmarks. Yet underneath the seemingly promising results lie salient growth areas, especially in cutting-edge frontiers such as multimodal reasoning. In this paper, we introduce a series of adversarial stress tests to systematically assess the robustness of flagship models and medical benchmarks. Our study reveals prevalent brittleness in the presence of simple adversarial transformations: leading systems can guess the right answer even with key inputs removed, yet may get confused by the slightest prompt alterations, while fabricating convincing yet flawed reasoning traces. Using clinician-guided rubrics, we demonstrate that popular medical benchmarks vary widely in what they truly measure. Our study reveals significant competency gaps of frontier AI in attaining real-world readiness for health applications. If we want AI to earn trust in healthcare, we must demand more than leaderboard wins and must hold AI systems accountable to ensure robustness, sound reasoning, and alignment with real medical demands.

Automatic speech recognition systems have created exciting possibilities for applications, however they also enable opportunities for systematic eavesdropping. We propose a method to camouflage a person's voice over-the-air from these systems without inconveniencing the conversation between people in the room. Standard adversarial attacks are not effective in real-time streaming situations because the characteristics of the signal will have changed by the time the attack is executed. We introduce predictive attacks, which achieve real-time performance by forecasting the attack that will be the most effective in the future. Under real-time constraints, our method jams the established speech recognition system DeepSpeech 3.9x more than baselines as measured through word error rate, and 6.6x more as measured through character error rate. We furthermore demonstrate our approach is practically effective in realistic environments over physical distances.

Clinical AI development has traditionally followed a collaborative paradigm that depends on close interaction between clinicians and specialized AI teams. This paradigm imposes a practical challenge: clinicians must repeatedly communicate and refine their requirements with AI developers before those requirements can be translated into executable model development. This iterative process is time-consuming, and even after repeated discussion, misalignment may still exist because the two sides do not fully share each other's expertise. However, autonomous coding agents may change this paradigm, raising the possibility that clinicians could develop clinical AI models independently through natural-language interaction alone. In this study, we present such an autonomous prototype for clinician-driven clinical AI development. We evaluated the system on five clinical tasks spanning dermoscopic lesion classification, melanoma-versus-nevus triage, wrist-fracture detection (including a weakly supervised variant with only 5% bounding-box annotations), and debiased pneumothorax classification on chest radiographs. Across these settings, the system consistently developed models from clinician requests and achieved promising performance. Notably, in a debiased pneumothorax classification task on chest radiographs, where chest drains can act as a major confounder, the system successfully mitigated shortcut learning and nearly halved the model's reliance on chest drains. These findings provide proof of concept that autonomous coding agents may help shift clinical AI development toward a more clinician-driven paradigm, reducing the communication overhead and dependence on specialized AI developers. Although further validation and robustness assessment are needed, this study suggests a promising path toward making clinical AI development more accessible.

Large Language Models (LLMs) and Retrieval-Augmented Generation (RAG) systems are increasingly integrated into clinical workflows; however, prompt injection attacks can steer these systems toward clinically unsafe or misleading outputs. We introduce the Medical Prompt Injection Benchmark (MPIB), a dataset-and-benchmark suite for evaluating clinical safety under both direct prompt injection and indirect, RAG-mediated injection across clinically grounded tasks. MPIB emphasizes outcome-level risk via the Clinical Harm Event Rate (CHER), which measures high-severity clinical harm events under a clinically grounded taxonomy, and reports CHER alongside Attack Success Rate (ASR) to disentangle instruction compliance from downstream patient risk. The benchmark comprises 9,697 curated instances constructed through multi-stage quality gates and clinical safety linting. Evaluating MPIB across a diverse set of baseline LLMs and defense configurations, we find that ASR and CHER can diverge substantially, and that robustness depends critically on whether adversarial instructions appear in the user query or in retrieved context. We release MPIB with evaluation code, adversarial baselines, and comprehensive documentation to support reproducible and systematic research on clinical prompt injection. Code and data are available at GitHub (code) and Hugging Face (data).

Adversarial examples derived from deliberately crafted perturbations on visual inputs can easily harm decision process of deep neural networks. To prevent potential threats, various adversarial training-based defense methods have grown rapidly and become a de facto standard approach for robustness. Despite recent competitive achievements, we observe that adversarial vulnerability varies across targets and certain vulnerabilities remain prevalent. Intriguingly, such peculiar phenomenon cannot be relieved even with deeper architectures and advanced defense methods. To address this issue, in this paper, we introduce a causal approach called Adversarial Double Machine Learning (ADML), which allows us to quantify the degree of adversarial vulnerability for network predictions and capture the effect of treatments on outcome of interests. ADML can directly estimate causal parameter of adversarial perturbations per se and mitigate negative effects that can potentially damage robustness, bridging a causal perspective into the adversarial vulnerability. Through extensive experiments on various CNN and Transformer architectures, we corroborate that ADML improves adversarial robustness with large margins and relieve the empirical observation.

The increasing depth of parametric domain knowledge in large language models (LLMs) is fueling their rapid deployment in real-world applications. Understanding model vulnerabilities in high-stakes and knowledge-intensive tasks is essential for quantifying the trustworthiness of model predictions and regulating their use. The recent discovery of named entities as adversarial examples (i.e. adversarial entities) in natural language processing tasks raises questions about their potential impact on the knowledge robustness of pre-trained and finetuned LLMs in high-stakes and specialized domains. We examined the use of type-consistent entity substitution as a template for collecting adversarial entities for billion-parameter LLMs with biomedical knowledge. To this end, we developed an embedding-space attack based on powerscaled distance-weighted sampling to assess the robustness of their biomedical knowledge with a low query budget and controllable coverage. Our method has favorable query efficiency and scaling over alternative approaches based on random sampling and blackbox gradient-guided search, which we demonstrated for adversarial distractor generation in biomedical question answering. Subsequent failure mode analysis uncovered two regimes of adversarial entities on the attack surface with distinct characteristics and we showed that entity substitution attacks can manipulate token-wise Shapley value explanations, which become deceptive in this setting. Our approach complements standard evaluations for high-capacity models and the results highlight the brittleness of domain knowledge in LLMs.

Model attribution is a popular tool to explain the rationales behind model predictions. However, recent work suggests that the attributions are vulnerable to minute perturbations, which can be added to input samples to fool the attributions while maintaining the prediction outputs. Although empirical studies have shown positive performance via adversarial training, an effective certified defense method is eminently needed to understand the robustness of attributions. In this work, we propose to use uniform smoothing technique that augments the vanilla attributions by noises uniformly sampled from a certain space. It is proved that, for all perturbations within the attack region, the cosine similarity between uniformly smoothed attribution of perturbed sample and the unperturbed sample is guaranteed to be lower bounded. We also derive alternative formulations of the certification that is equivalent to the original one and provides the maximum size of perturbation or the minimum smoothing radius such that the attribution can not be perturbed. We evaluate the proposed method on three datasets and show that the proposed method can effectively protect the attributions from attacks, regardless of the architecture of networks, training schemes and the size of the datasets.

An accurate differential diagnosis (DDx) is a cornerstone of medical care, often reached through an iterative process of interpretation that combines clinical history, physical examination, investigations and procedures. Interactive interfaces powered by Large Language Models (LLMs) present new opportunities to both assist and automate aspects of this process. In this study, we introduce an LLM optimized for diagnostic reasoning, and evaluate its ability to generate a DDx alone or as an aid to clinicians. 20 clinicians evaluated 302 challenging, real-world medical cases sourced from the New England Journal of Medicine (NEJM) case reports. Each case report was read by two clinicians, who were randomized to one of two assistive conditions: either assistance from search engines and standard medical resources, or LLM assistance in addition to these tools. All clinicians provided a baseline, unassisted DDx prior to using the respective assistive tools. Our LLM for DDx exhibited standalone performance that exceeded that of unassisted clinicians (top-10 accuracy 59.1% vs 33.6%, [p = 0.04]). Comparing the two assisted study arms, the DDx quality score was higher for clinicians assisted by our LLM (top-10 accuracy 51.7%) compared to clinicians without its assistance (36.1%) (McNemar's Test: 45.7, p < 0.01) and clinicians with search (44.4%) (4.75, p = 0.03). Further, clinicians assisted by our LLM arrived at more comprehensive differential lists than those without its assistance. Our study suggests that our LLM for DDx has potential to improve clinicians' diagnostic reasoning and accuracy in challenging cases, meriting further real-world evaluation for its ability to empower physicians and widen patients' access to specialist-level expertise.

Model Context Protocol (MCP) servers enable AI applications to connect to external systems in a plug-and-play manner, but their rapid proliferation also introduces severe security risks. Unlike mature software ecosystems with rigorous vetting, MCP servers still lack standardized review mechanisms, giving adversaries opportunities to distribute malicious implementations. Despite this pressing risk, the security implications of MCP servers remain underexplored. To address this gap, we present the first systematic study that treats MCP servers as active threat actors and decomposes them into core components to examine how adversarial developers can implant malicious intent. Specifically, we investigate three research questions: (i) what types of attacks malicious MCP servers can launch, (ii) how vulnerable MCP hosts and Large Language Models (LLMs) are to these attacks, and (iii) how feasible it is to carry out MCP server attacks in practice. Our study proposes a component-based taxonomy comprising twelve attack categories. For each category, we develop Proof-of-Concept (PoC) servers and demonstrate their effectiveness across diverse real-world host-LLM settings. We further show that attackers can generate large numbers of malicious servers at virtually no cost. We then test state-of-the-art scanners on the generated servers and found that existing detection approaches are insufficient. These findings highlight that malicious MCP servers are easy to implement, difficult to detect with current tools, and capable of causing concrete damage to AI agent systems. Addressing this threat requires coordinated efforts among protocol designers, host developers, LLM providers, and end users to build a more secure and resilient MCP ecosystem.

It is well known that anti-malware scanners depend on malware signatures to identify malware. However, even minor modifications to malware code structure results in a change in the malware signature thus enabling the variant to evade detection by scanners. Therefore, there exists the need for a proactively generated malware variant dataset to aid detection of such diverse variants by automated antivirus scanners. This paper proposes and demonstrates a generic assembly source code based framework that facilitates any evolutionary algorithm to generate diverse and potential variants of an input malware, while retaining its maliciousness, yet capable of evading antivirus scanners. Generic code transformation functions and a novelty search supported quality metric have been proposed as components of the framework to be used respectively as variation operators and fitness function, for evolutionary algorithms. The results demonstrate the effectiveness of the framework in generating diverse variants and the generated variants have been shown to evade over 98% of popular antivirus scanners. The malware variants evolved by the framework can serve as antigens to assist malware analysis engines to improve their malware detection algorithms.

Large Language Models (LLMs) are increasingly deployed as the backend for a variety of real-world applications called LLM-Integrated Applications. Multiple recent works showed that LLM-Integrated Applications are vulnerable to prompt injection attacks, in which an attacker injects malicious instruction/data into the input of those applications such that they produce results as the attacker desires. However, existing works are limited to case studies. As a result, the literature lacks a systematic understanding of prompt injection attacks and their defenses. We aim to bridge the gap in this work. In particular, we propose a general framework to formalize prompt injection attacks. Existing attacks, which are discussed in research papers and blog posts, are special cases in our framework. Our framework enables us to design a new attack by combining existing attacks. Moreover, we also propose a framework to systematize defenses against prompt injection attacks. Using our frameworks, we conduct a systematic evaluation on prompt injection attacks and their defenses with 10 LLMs and 7 tasks. We hope our frameworks can inspire future research in this field. Our code is available at https://github.com/liu00222/Open-Prompt-Injection.

We propose the first unified adversarial attack benchmark for Genomic Foundation Models (GFMs), named GenoArmory. Unlike existing GFM benchmarks, GenoArmory offers the first comprehensive evaluation framework to systematically assess the vulnerability of GFMs to adversarial attacks. Methodologically, we evaluate the adversarial robustness of five state-of-the-art GFMs using four widely adopted attack algorithms and three defense strategies. Importantly, our benchmark provides an accessible and comprehensive framework to analyze GFM vulnerabilities with respect to model architecture, quantization schemes, and training datasets. Additionally, we introduce GenoAdv, a new adversarial sample dataset designed to improve GFM safety. Empirically, classification models exhibit greater robustness to adversarial perturbations compared to generative models, highlighting the impact of task type on model vulnerability. Moreover, adversarial attacks frequently target biologically significant genomic regions, suggesting that these models effectively capture meaningful sequence features.

The proliferation of agentic AI coding assistants, including Claude Code, GitHub Copilot, Cursor, and emerging skill-based architectures, has fundamentally transformed software development workflows. These systems leverage Large Language Models (LLMs) integrated with external tools, file systems, and shell access through protocols like the Model Context Protocol (MCP). However, this expanded capability surface introduces critical security vulnerabilities. In this Systematization of Knowledge (SoK) paper, we present a comprehensive analysis of prompt injection attacks targeting agentic coding assistants. We propose a novel three-dimensional taxonomy categorizing attacks across delivery vectors, attack modalities, and propagation behaviors. Our meta-analysis synthesizes findings from 78 recent studies (2021--2026), consolidating evidence that attack success rates against state-of-the-art defenses exceed 85\% when adaptive attack strategies are employed. We systematically catalog 42 distinct attack techniques spanning input manipulation, tool poisoning, protocol exploitation, multimodal injection, and cross-origin context poisoning. Through critical analysis of 18 defense mechanisms reported in prior work, we identify that most achieve less than 50\% mitigation against sophisticated adaptive attacks. We contribute: (1) a unified taxonomy bridging disparate attack classifications, (2) the first systematic analysis of skill-based architecture vulnerabilities with concrete exploit chains, and (3) a defense-in-depth framework grounded in the limitations we identify. Our findings indicate that the security community must treat prompt injection as a first-class vulnerability class requiring architectural-level mitigations rather than ad-hoc filtering approaches.

Frontier AI developers are relying on layers of safeguards to protect against catastrophic misuse of AI systems. Anthropic guards their latest Claude 4 Opus model using one such defense pipeline, and other frontier developers including Google DeepMind and OpenAI pledge to soon deploy similar defenses. However, the security of such pipelines is unclear, with limited prior work evaluating or attacking these pipelines. We address this gap by developing and red-teaming an open-source defense pipeline. First, we find that a novel few-shot-prompted input and output classifier outperforms state-of-the-art open-weight safeguard model ShieldGemma across three attacks and two datasets, reducing the attack success rate (ASR) to 0% on the catastrophic misuse dataset ClearHarm. Second, we introduce a STaged AttaCK (STACK) procedure that achieves 71% ASR on ClearHarm in a black-box attack against the few-shot-prompted classifier pipeline. Finally, we also evaluate STACK in a transfer setting, achieving 33% ASR, providing initial evidence that it is feasible to design attacks with no access to the target pipeline. We conclude by suggesting specific mitigations that developers could use to thwart staged attacks.

Face morphing attacks seek to deceive a Face Recognition (FR) system by presenting a morphed image consisting of the biometric qualities from two different identities with the aim of triggering a false acceptance with one of the two identities, thereby presenting a significant threat to biometric systems. The success of a morphing attack is dependent on the ability of the morphed image to represent the biometric characteristics of both identities that were used to create the image. We present a novel morphing attack that uses a Diffusion-based architecture to improve the visual fidelity of the image and the ability of the morphing attack to represent characteristics from both identities. We demonstrate the effectiveness of the proposed attack by evaluating its visual fidelity via the Frechet Inception Distance (FID). Also, extensive experiments are conducted to measure the vulnerability of FR systems to the proposed attack. The ability of a morphing attack detector to detect the proposed attack is measured and compared against two state-of-the-art GAN-based morphing attacks along with two Landmark-based attacks. Additionally, a novel metric to measure the relative strength between different morphing attacks is introduced and evaluated.

Language models excel at diagnostic assessments on currated medical case-studies and vignettes, performing on par with, or better than, clinical professionals. However, existing studies focus on complex scenarios with rich context making it difficult to draw conclusions about how these systems perform for patients reporting symptoms in everyday life. We deployed SymptomAI, a set of conversational AI agents for end-to-end patient interviewing and differential diagnosis (DDx), via the Fitbit app in a study that randomized participants (N=13,917) to interact with five AI agents. This corpus captures diverse communication and a realistic distribution of illnesses from a real world population. A subset of 1,228 participants reported a clinician-provided diagnosis, and 517 of these were further evaluated by a panel of clinicians during over 250 hours of annotation. SymptomAI DDx were significantly more accurate (OR = 2.47, p < 0.001) than those from independent clinicians given the same dialogue in a blinded randomized comparison. Moreover, agentic strategies which conduct a dedicated symptom interview that elicit additional symptom information before providing a diagnosis, perform substantially better than baseline, user-guided conversations (p < 0.001). An auxiliary analysis on 1,509 conversations from a general US population panel validated that these results generalize beyond wearable device users. We used SymptomAI diagnoses as labels for all 13,917 participants to analyze over 500,000 days of wearable metrics across nearly 400 unique conditions. We identified strong associations between acute infections and physiological shifts (e.g., OR > 7 for influenza). While limited by self-reported ground truth, these results demonstrate the benefits of a dedicated and complete symptom interview compared to a user-guided symptom discussion, which is the default of most consumer LLMs.

Despite the impressive achievements of Deep Neural Networks (DNNs) in computer vision, their vulnerability to adversarial attacks remains a critical concern. Extensive research has demonstrated that incorporating sophisticated perturbations into input images can lead to a catastrophic degradation in DNNs' performance. This perplexing phenomenon not only exists in the digital space but also in the physical world. Consequently, it becomes imperative to evaluate the security of DNNs-based systems to ensure their safe deployment in real-world scenarios, particularly in security-sensitive applications. To facilitate a profound understanding of this topic, this paper presents a comprehensive overview of physical adversarial attacks. Firstly, we distill four general steps for launching physical adversarial attacks. Building upon this foundation, we uncover the pervasive role of artifacts carrying adversarial perturbations in the physical world. These artifacts influence each step. To denote them, we introduce a new term: adversarial medium. Then, we take the first step to systematically evaluate the performance of physical adversarial attacks, taking the adversarial medium as a first attempt. Our proposed evaluation metric, hiPAA, comprises six perspectives: Effectiveness, Stealthiness, Robustness, Practicability, Aesthetics, and Economics. We also provide comparative results across task categories, together with insightful observations and suggestions for future research directions.

Tool-using LLM agents increasingly coordinate real workloads by selecting and chaining third-party tools based on text-visible metadata such as tool names, descriptions, and return messages. We show that this convenience creates a supply-chain attack surface: a malicious MCP tool server can be co-registered alongside normal tools and induce overthinking loops, where individually trivial or plausible tool calls compose into cyclic trajectories that inflate end-to-end tokens and latency without any single step looking abnormal. We formalize this as a structural overthinking attack, distinguishable from token-level verbosity, and implement 14 malicious tools across three servers that trigger repetition, forced refinement, and distraction. Across heterogeneous registries and multiple tool-capable models, the attack causes severe resource amplification (up to 142.4times tokens) and can degrade task outcomes. Finally, we find that decoding-time concision controls do not reliably prevent loop induction, suggesting defenses should reason about tool-call structure rather than tokens alone.