Daily Papers

While large language models (LLMs) show transformative potential in healthcare, their development remains focused on high-resource languages, creating a critical barrier for others as simple translation fails to capture unique clinical and cultural nuances, such as endemic diseases. To address this, we introduce MedPT, the first large-scale, real-world corpus for Brazilian Portuguese, comprising 384,095 authentic question-answer pairs from patient-doctor interactions. The dataset underwent a meticulous multi-stage curation protocol, using a hybrid quantitative-qualitative analysis to filter noise and contextually enrich thousands of ambiguous queries. We further augmented the corpus via LLM-driven annotation, classifying questions into seven semantic types to capture user intent. Our analysis reveals its thematic breadth (3,200 topics) and unique linguistic properties, like the natural asymmetry in patient-doctor communication. To validate its utility, we benchmark a medical specialty routing task: fine-tuning a 1.7B parameter model achieves an outstanding 94\% F1-score on a 20-class setup. Furthermore, our qualitative error analysis shows misclassifications are not random but reflect genuine clinical ambiguities (e.g., between comorbid conditions), proving the dataset's deep semantic richness. We publicly release MedPT to foster the development of more equitable, accurate, and culturally-aware medical technologies for the Portuguese-speaking world.

We formulate and solve the H-SARA Problem, a Vehicle Routing and Appointment Scheduling Problem motivated by home services management. We assume that travel times, service durations, and customer cancellations are stochastic. We use a two-stage process that first generates teams and routes using a VRP Solver with optional extensions and then uses an MC Scheduler that determines expected arrival times by teams at customers. We further introduce two different models of cancellation and their associated impacts on routing and scheduling. Finally, we introduce the Route Fracture Metaheuristic that iteratively improves an H-SARA solution by replacing the worst-performing teams. We present insights into the problem and a series of numerical experiments that illustrate properties of the optimal routing, scheduling, and the impact of the Route Fracture Metaheuristic for both models of cancellation.

Mixture of Experts models are widely assumed to achieve domain specialization through sparse routing. In this work, we question this assumption by introducing COMMITTEEAUDIT, a post hoc framework that analyzes routing behavior at the level of expert groups rather than individual experts. Across three representative models and the MMLU benchmark, we uncover a domain-invariant Standing Committee. This is a compact coalition of routed experts that consistently captures the majority of routing mass across domains, layers, and routing budgets, even when architectures already include shared experts. Qualitative analysis further shows that Standing Committees anchor reasoning structure and syntax, while peripheral experts handle domain-specific knowledge. These findings reveal a strong structural bias toward centralized computation, suggesting that specialization in Mixture of Experts models is far less pervasive than commonly believed. This inherent bias also indicates that current training objectives, such as load-balancing losses that enforce uniform expert utilization, may be working against the model's natural optimization path, thereby limiting training efficiency and performance.

The rapid growth of large language models (LLMs) with diverse capabilities, costs, and domains has created a critical need for intelligent model selection at inference time. While smaller models suffice for routine queries, complex tasks demand more capable models. However, static model deployment does not account for the complexity and domain of incoming queries, leading to suboptimal performance and increased costs. Dynamic routing systems that adaptively select models based on query characteristics have emerged as a solution to this challenge. We provide a systematic analysis of state-of-the-art multi-LLM routing and cascading approaches. In contrast to mixture-of-experts architectures, which route within a single model, we study routing across multiple independently trained LLMs. We cover diverse routing paradigms, including query difficulty, human preferences, clustering, uncertainty quantification, reinforcement learning, multimodality, and cascading. For each paradigm, we analyze representative methods and examine key trade-offs. Beyond taxonomy, we introduce a conceptual framework that characterizes routing systems along three dimensions: when decisions are made, what information is used, and how they are computed. This perspective highlights that practical systems are often compositional, integrating multiple paradigms under operational constraints. Our analysis demonstrates that effective multi-LLM routing requires balancing competing objectives. Choosing the optimal routing strategy depends on deployment and computational constraints. Well-designed routing systems can outperform even the most powerful individual models by strategically leveraging specialized capabilities across models while maximizing efficiency gains. Meanwhile, open challenges remain in developing routing mechanisms that generalize across diverse architectures, modalities, and applications.

Recent developments in Large Language Model (LLM)-based agents have shown impressive capabilities spanning multiple domains, exemplified by deep research systems that demonstrate superior performance on complex information-seeking and synthesis tasks. While general-purpose deep research agents have shown impressive capabilities, they struggle significantly with medical domain challenges, as evidenced by leading proprietary systems achieving limited accuracy on complex medical benchmarks. The key limitations are: (1) the model lacks sufficient dense medical knowledge for clinical reasoning, and (2) the framework is constrained by the absence of specialized retrieval tools tailored for medical contexts.We present a medical deep research agent that addresses these challenges through two core innovations. First, we develop a novel data synthesis framework using medical knowledge graphs, extracting the longest chains from subgraphs around rare medical entities to generate complex multi-hop question-answer pairs. Second, we integrate a custom-built private medical retrieval engine alongside general-purpose tools, enabling accurate medical information synthesis. Our approach generates 2100+ diverse trajectories across 12 medical specialties, each averaging 4.2 tool interactions.Through a two-stage training paradigm combining supervised fine-tuning and online reinforcement learning with composite rewards, our MedResearcher-R1-32B model demonstrates exceptional performance, establishing new state-of-the-art results on medical benchmarks while maintaining competitive performance on general deep research tasks. Our work demonstrates that strategic domain-specific innovations in architecture, tool design, and training data construction can enable smaller open-source models to outperform much larger proprietary systems in specialized domains.

Inventory Routing Problem (IRP) is a crucial challenge in supply chain management as it involves optimizing efficient route selection while considering the uncertainty of inventory demand planning. To solve IRPs, usually a two-stage approach is employed, where demand is predicted using machine learning techniques first, and then an optimization algorithm is used to minimize routing costs. Our experiment shows machine learning models fall short of achieving perfect accuracy because inventory levels are influenced by the dynamic business environment, which, in turn, affects the optimization problem in the next stage, resulting in sub-optimal decisions. In this paper, we formulate and propose a decision-focused learning-based approach to solving real-world IRPs. This approach directly integrates inventory prediction and routing optimization within an end-to-end system potentially ensuring a robust supply chain strategy.

Information retrieval methods often rely on a single embedding model trained on large, general-domain datasets like MSMARCO. While this approach can produce a retriever with reasonable overall performance, models trained on domain-specific data often yield better results within their respective domains. While prior work in information retrieval has tackled this through multi-task training, the topic of combining multiple domain-specific expert retrievers remains unexplored, despite its popularity in language model generation. In this work, we introduce RouterRetriever, a retrieval model that leverages multiple domain-specific experts along with a routing mechanism to select the most appropriate expert for each query. It is lightweight and allows easy addition or removal of experts without additional training. Evaluation on the BEIR benchmark demonstrates that RouterRetriever outperforms both MSMARCO-trained (+2.1 absolute nDCG@10) and multi-task trained (+3.2) models. This is achieved by employing our routing mechanism, which surpasses other routing techniques (+1.8 on average) commonly used in language modeling. Furthermore, the benefit generalizes well to other datasets, even in the absence of a specific expert on the dataset. To our knowledge, RouterRetriever is the first work to demonstrate the advantages of using multiple domain-specific expert embedding models with effective routing over a single, general-purpose embedding model in retrieval tasks.

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.