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Clinical rationales play a pivotal role in accurate disease diagnosis; however, many models predominantly use discriminative methods and overlook the importance of generating supportive rationales. Rationale distillation is a process that transfers knowledge from large language models (LLMs) to smaller language models (SLMs), thereby enhancing the latter's ability to break down complex tasks. Despite its benefits, rationale distillation alone is inadequate for addressing domain knowledge limitations in tasks requiring specialized expertise, such as disease diagnosis. Effectively embedding domain knowledge in SLMs poses a significant challenge. While current LLMs are primarily geared toward processing textual data, multimodal LLMs that incorporate time series data, especially electronic health records (EHRs), are still evolving. To tackle these limitations, we introduce ClinRaGen, an SLM optimized for multimodal rationale generation in disease diagnosis. ClinRaGen incorporates a unique knowledge-augmented attention mechanism to merge domain knowledge with time series EHR data, utilizing a stepwise rationale distillation strategy to produce both textual and time series-based clinical rationales. Our evaluations show that ClinRaGen markedly improves the SLM's capability to interpret multimodal EHR data and generate accurate clinical rationales, supporting more reliable disease diagnosis, advancing LLM applications in healthcare, and narrowing the performance divide between LLMs and SLMs., Comment: 11 pages. 4 figures

In this work, an innovative data-driven moving horizon state estimation is proposed for model dynamic-unknown systems based on Bayesian optimization. As long as the measurement data is received, a locally linear dynamics model can be obtained from one Bayesian optimization-based offline learning framework. Herein, the learned model is continuously updated iteratively based on the actual observed data to approximate the actual system dynamic with the intent of minimizing the cost function of the moving horizon estimator until the desired performance is achieved. Meanwhile, the characteristics of Bayesian optimization can guarantee the closest approximation of the learned model to the actual system dynamic. Thus, one effective data-driven moving horizon estimator can be designed further on the basis of this learned model. Finally, the efficiency of the proposed state estimation algorithm is demonstrated by several numerical simulations., Comment: 12 pages,3 figures

Deriving precise system dynamic models through traditional numerical methods is often a challenging endeavor. The performance of Model Predictive Control is heavily contingent on the accuracy of the system dynamic model. Consequently, this study employs Echo State Networks to acquire knowledge of the unmodeled dynamic characteristics inherent in the system. This information is then integrated with the nominal model, functioning as a form of model compensation. The present paper introduces a control framework that combines ESN with MPC. By perpetually assimilating the disparities between the nominal and real models, control performance experiences augmentation. In a demonstrative example, a second order dynamic system is subjected to simulation. The outcomes conclusively evince that ESNbased MPC adeptly assimilates unmodeled dynamic attributes, thereby elevating the system control proficiency., Comment: 5 pages,3 figures,conference

Electronic health records (EHRs) contain patients' heterogeneous data that are collected from medical providers involved in the patient's care, including medical notes, clinical events, laboratory test results, symptoms, and diagnoses. In the field of modern healthcare, predicting whether patients would experience any risks based on their EHRs has emerged as a promising research area, in which artificial intelligence (AI) plays a key role. To make AI models practically applicable, it is required that the prediction results should be both accurate and interpretable. To achieve this goal, this paper proposed a label-dependent and event-guided risk prediction model (LERP) to predict the presence of multiple disease risks by mainly extracting information from unstructured medical notes. Our model is featured in the following aspects. First, we adopt a label-dependent mechanism that gives greater attention to words from medical notes that are semantically similar to the names of risk labels. Secondly, as the clinical events (e.g., treatments and drugs) can also indicate the health status of patients, our model utilizes the information from events and uses them to generate an event-guided representation of medical notes. Thirdly, both label-dependent and event-guided representations are integrated to make a robust prediction, in which the interpretability is enabled by the attention weights over words from medical notes. To demonstrate the applicability of the proposed method, we apply it to the MIMIC-III dataset, which contains real-world EHRs collected from hospitals. Our method is evaluated in both quantitative and qualitative ways.

Disease risk prediction has attracted increasing attention in the field of modern healthcare, especially with the latest advances in artificial intelligence (AI). Electronic health records (EHRs), which contain heterogeneous patient information, are widely used in disease risk prediction tasks. One challenge of applying AI models for risk prediction lies in generating interpretable evidence to support the prediction results while retaining the prediction ability. In order to address this problem, we propose the method of jointly embedding words and labels whereby attention modules learn the weights of words from medical notes according to their relevance to the names of risk prediction labels. This approach boosts interpretability by employing an attention mechanism and including the names of prediction tasks in the model. However, its application is only limited to the handling of textual inputs such as medical notes. In this paper, we propose a label dependent attention model LDAM to 1) improve the interpretability by exploiting Clinical-BERT (a biomedical language model pre-trained on a large clinical corpus) to encode biomedically meaningful features and labels jointly; 2) extend the idea of joint embedding to the processing of time-series data, and develop a multi-modal learning framework for integrating heterogeneous information from medical notes and time-series health status indicators. To demonstrate our method, we apply LDAM to the MIMIC-III dataset to predict different disease risks. We evaluate our method both quantitatively and qualitatively. Specifically, the predictive power of LDAM will be shown, and case studies will be carried out to illustrate its interpretability.