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Post-training quantization is widely employed to reduce the computational demands of neural networks. Typically, individual substructures, such as layers or blocks of layers, are quantized with the objective of minimizing quantization errors in their pre-activations by fine-tuning the corresponding weights. Deriving this local objective from the global objective of minimizing task loss involves two key simplifications: assuming substructures are mutually independent and ignoring the knowledge of subsequent substructures as well as the task loss. In this work, we assess the effects of these simplifications on weight-only quantization of large language models. We introduce two multi-block fine-tuning strategies and compare them against the baseline of fine-tuning single transformer blocks. The first captures correlations of weights across blocks by jointly optimizing multiple quantized blocks. The second incorporates knowledge of subsequent blocks by minimizing the error in downstream pre-activations rather than focusing solely on the quantized block. Our findings indicate that the effectiveness of these methods depends on the specific network model, with no impact on some models but demonstrating significant benefits for others.

Stroke remains a leading cause of global morbidity and mortality, placing a heavy socioeconomic burden. Over the past decade, advances in endovascular reperfusion therapy and the use of CT and MRI imaging for treatment guidance have significantly improved patient outcomes and are now standard in clinical practice. To develop machine learning algorithms that can extract meaningful and reproducible models of brain function for both clinical and research purposes from stroke images - particularly for lesion identification, brain health quantification, and prognosis - large, diverse, and well-annotated public datasets are essential. While only a few datasets with (sub-)acute stroke data were previously available, several large, high-quality datasets have recently been made publicly accessible. However, these existing datasets include only MRI data. In contrast, our dataset is the first to offer comprehensive longitudinal stroke data, including acute CT imaging with angiography and perfusion, follow-up MRI at 2-9 days, as well as acute and longitudinal clinical data up to a three-month outcome. The dataset includes a training dataset of n = 150 and a test dataset of n = 100 scans. Training data is publicly available, while test data will be used exclusively for model validation. We are making this dataset available as part of the 2024 edition of the Ischemic Stroke Lesion Segmentation (ISLES) challenge (https://www.isles-challenge.org/), which continuously aims to establish benchmark methods for acute and sub-acute ischemic stroke lesion segmentation, aiding in creating open stroke imaging datasets and evaluating cutting-edge image processing algorithms.

Accurate estimation of core (irreversibly damaged tissue) and penumbra (salvageable tissue) volumes is essential for ischemic stroke treatment decisions. Perfusion CT, the clinical standard, estimates these volumes but is affected by variations in deconvolution algorithms, implementations, and thresholds. Core tissue expands over time, with growth rates influenced by thrombus location, collateral circulation, and inherent patient-specific factors. Understanding this tissue growth is crucial for determining the need to transfer patients to comprehensive stroke centers, predicting the benefits of additional reperfusion attempts during mechanical thrombectomy, and forecasting final clinical outcomes. This work presents the ISLES'24 challenge, which addresses final post-treatment stroke infarct prediction from pre-interventional acute stroke imaging and clinical data. ISLES'24 establishes a unique 360-degree setting where all feasibly accessible clinical data are available for participants, including full CT acute stroke imaging, sub-acute follow-up MRI, and clinical tabular data. The contributions of this work are two-fold: first, we introduce a standardized benchmarking of final stroke infarct segmentation algorithms through the ISLES'24 challenge; second, we provide insights into infarct segmentation using multimodal imaging and clinical data strategies by identifying outperforming methods on a finely curated dataset. The outputs of this challenge are anticipated to enhance clinical decision-making and improve patient outcome predictions. All ISLES'24 materials, including data, performance evaluation scripts, and leading algorithmic strategies, are available to the research community following \url{https://isles-24.grand-challenge.org/}.

Vision-language artificial intelligence models (VLMs) possess medical knowledge and can be employed in healthcare in numerous ways, including as image interpreters, virtual scribes, and general decision support systems. However, here, we demonstrate that current VLMs applied to medical tasks exhibit a fundamental security flaw: they can be attacked by prompt injection attacks, which can be used to output harmful information just by interacting with the VLM, without any access to its parameters. We performed a quantitative study to evaluate the vulnerabilities to these attacks in four state of the art VLMs which have been proposed to be of utility in healthcare: Claude 3 Opus, Claude 3.5 Sonnet, Reka Core, and GPT-4o. Using a set of N=297 attacks, we show that all of these models are susceptible. Specifically, we show that embedding sub-visual prompts in medical imaging data can cause the model to provide harmful output, and that these prompts are non-obvious to human observers. Thus, our study demonstrates a key vulnerability in medical VLMs which should be mitigated before widespread clinical adoption., Comment: 57 Pages, 5 Figures

Matching cancer patients to clinical trials is essential for advancing treatment and patient care. However, the inconsistent format of medical free text documents and complex trial eligibility criteria make this process extremely challenging and time-consuming for physicians. We investigated whether the entire trial matching process - from identifying relevant trials among 105,600 oncology-related clinical trials on clinicaltrials.gov to generating criterion-level eligibility matches - could be automated using Large Language Models (LLMs). Using GPT-4o and a set of 51 synthetic Electronic Health Records (EHRs), we demonstrate that our approach identifies relevant candidate trials in 93.3% of cases and achieves a preliminary accuracy of 88.0% when matching patient-level information at the criterion level against a baseline defined by human experts. Utilizing LLM feedback reveals that 39.3% criteria that were initially considered incorrect are either ambiguous or inaccurately annotated, leading to a total model accuracy of 92.7% after refining our human baseline. In summary, we present an end-to-end pipeline for clinical trial matching using LLMs, demonstrating high precision in screening and matching trials to individual patients, even outperforming the performance of qualified medical doctors. Our fully end-to-end pipeline can operate autonomously or with human supervision and is not restricted to oncology, offering a scalable solution for enhancing patient-trial matching in real-world settings., Comment: 149 pages, including Supplements. 3 Main Figures

Recent advances in large language models (LLMs) have increased the demand for comprehensive benchmarks to evaluate their capabilities as human-like agents. Existing benchmarks, while useful, often focus on specific application scenarios, emphasizing task completion but failing to dissect the underlying skills that drive these outcomes. This lack of granularity makes it difficult to deeply discern where failures stem from. Additionally, setting up these environments requires considerable effort, and issues of unreliability and reproducibility sometimes arise, especially in interactive tasks. To address these limitations, we introduce the Massive Multitask Agent Understanding (MMAU) benchmark, featuring comprehensive offline tasks that eliminate the need for complex environment setups. It evaluates models across five domains, including Tool-use, Directed Acyclic Graph (DAG) QA, Data Science and Machine Learning coding, Contest-level programming and Mathematics, and covers five essential capabilities: Understanding, Reasoning, Planning, Problem-solving, and Self-correction. With a total of 20 meticulously designed tasks encompassing over 3K distinct prompts, MMAU provides a comprehensive framework for evaluating the strengths and limitations of LLM agents. By testing 18 representative models on MMAU, we provide deep and insightful analyses. Ultimately, MMAU not only sheds light on the capabilities and limitations of LLM agents but also enhances the interpretability of their performance. Datasets and evaluation scripts of MMAU are released at https://github.com/apple/axlearn/tree/main/docs/research/mmau.

Large Language Models (LLMs) with their strong task-handling capabilities have shown remarkable advancements across a spectrum of fields, moving beyond natural language understanding. However, their proficiency within the chemistry domain remains restricted, especially in solving professional molecule-related tasks. This challenge is attributed to their inherent limitations in comprehending molecules using only common textual representations, i.e., SMILES strings. In this study, we seek to enhance the ability of LLMs to comprehend molecules by equipping them with a multi-modal external module, namely MolX. In particular, instead of directly using a SMILES string to represent a molecule, we utilize specific encoders to extract fine-grained features from both SMILES string and 2D molecular graph representations for feeding into an LLM. Moreover, a handcrafted molecular fingerprint is incorporated to leverage its embedded domain knowledge. Then, to establish an alignment between MolX and the LLM's textual input space, the whole model in which the LLM is frozen, is pre-trained with a versatile strategy including a diverse set of tasks. Experimental evaluations show that our proposed method outperforms baselines across 4 downstream molecule-related tasks ranging from molecule-to-text translation to retrosynthesis, with and without fine-tuning the LLM, while only introducing a small number of trainable parameters 0.53% and 0.82%, respectively.

Multimodal artificial intelligence (AI) systems have the potential to enhance clinical decision-making by interpreting various types of medical data. However, the effectiveness of these models across all medical fields is uncertain. Each discipline presents unique challenges that need to be addressed for optimal performance. This complexity is further increased when attempting to integrate different fields into a single model. Here, we introduce an alternative approach to multimodal medical AI that utilizes the generalist capabilities of a large language model (LLM) as a central reasoning engine. This engine autonomously coordinates and deploys a set of specialized medical AI tools. These tools include text, radiology and histopathology image interpretation, genomic data processing, web searches, and document retrieval from medical guidelines. We validate our system across a series of clinical oncology scenarios that closely resemble typical patient care workflows. We show that the system has a high capability in employing appropriate tools (97%), drawing correct conclusions (93.6%), and providing complete (94%), and helpful (89.2%) recommendations for individual patient cases while consistently referencing relevant literature (82.5%) upon instruction. This work provides evidence that LLMs can effectively plan and execute domain-specific models to retrieve or synthesize new information when used as autonomous agents. This enables them to function as specialist, patient-tailored clinical assistants. It also simplifies regulatory compliance by allowing each component tool to be individually validated and approved. We believe, that our work can serve as a proof-of-concept for more advanced LLM-agents in the medical domain., Comment: 91 pages, 2 Figures

Diffusion-weighted MRI (DWI) is essential for stroke diagnosis, treatment decisions, and prognosis. However, image and disease variability hinder the development of generalizable AI algorithms with clinical value. We address this gap by presenting a novel ensemble algorithm derived from the 2022 Ischemic Stroke Lesion Segmentation (ISLES) challenge. ISLES'22 provided 400 patient scans with ischemic stroke from various medical centers, facilitating the development of a wide range of cutting-edge segmentation algorithms by the research community. Through collaboration with leading teams, we combined top-performing algorithms into an ensemble model that overcomes the limitations of individual solutions. Our ensemble model achieved superior ischemic lesion detection and segmentation accuracy on our internal test set compared to individual algorithms. This accuracy generalized well across diverse image and disease variables. Furthermore, the model excelled in extracting clinical biomarkers. Notably, in a Turing-like test, neuroradiologists consistently preferred the algorithm's segmentations over manual expert efforts, highlighting increased comprehensiveness and precision. Validation using a real-world external dataset (N=1686) confirmed the model's generalizability. The algorithm's outputs also demonstrated strong correlations with clinical scores (admission NIHSS and 90-day mRS) on par with or exceeding expert-derived results, underlining its clinical relevance. This study offers two key findings. First, we present an ensemble algorithm (https://github.com/Tabrisrei/ISLES22_Ensemble) that detects and segments ischemic stroke lesions on DWI across diverse scenarios on par with expert (neuro)radiologists. Second, we show the potential for biomedical challenge outputs to extend beyond the challenge's initial objectives, demonstrating their real-world clinical applicability.

Medical image classification requires labeled, task-specific datasets which are used to train deep learning networks de novo, or to fine-tune foundation models. However, this process is computationally and technically demanding. In language processing, in-context learning provides an alternative, where models learn from within prompts, bypassing the need for parameter updates. Yet, in-context learning remains underexplored in medical image analysis. Here, we systematically evaluate the model Generative Pretrained Transformer 4 with Vision capabilities (GPT-4V) on cancer image processing with in-context learning on three cancer histopathology tasks of high importance: Classification of tissue subtypes in colorectal cancer, colon polyp subtyping and breast tumor detection in lymph node sections. Our results show that in-context learning is sufficient to match or even outperform specialized neural networks trained for particular tasks, while only requiring a minimal number of samples. In summary, this study demonstrates that large vision language models trained on non-domain specific data can be applied out-of-the box to solve medical image-processing tasks in histopathology. This democratizes access of generalist AI models to medical experts without technical background especially for areas where annotated data is scarce., Comment: 40 pages, 5 figures

The yield of a chemical reaction quantifies the percentage of the target product formed in relation to the reactants consumed during the chemical reaction. Accurate yield prediction can guide chemists toward selecting high-yield reactions during synthesis planning, offering valuable insights before dedicating time and resources to wet lab experiments. While recent advancements in yield prediction have led to overall performance improvement across the entire yield range, an open challenge remains in enhancing predictions for high-yield reactions, which are of greater concern to chemists. In this paper, we argue that the performance gap in high-yield predictions results from the imbalanced distribution of real-world data skewed towards low-yield reactions, often due to unreacted starting materials and inherent ambiguities in the reaction processes. Despite this data imbalance, existing yield prediction methods continue to treat different yield ranges equally, assuming a balanced training distribution. Through extensive experiments on three real-world yield prediction datasets, we emphasize the urgent need to reframe reaction yield prediction as an imbalanced regression problem. Finally, we demonstrate that incorporating simple cost-sensitive re-weighting methods can significantly enhance the performance of yield prediction models on underrepresented high-yield regions.

Large Language Models (LLMs) have achieved remarkable success across a wide array of tasks. Due to the impressive planning and reasoning abilities of LLMs, they have been used as autonomous agents to do many tasks automatically. Recently, based on the development of using one LLM as a single planning or decision-making agent, LLM-based multi-agent systems have achieved considerable progress in complex problem-solving and world simulation. To provide the community with an overview of this dynamic field, we present this survey to offer an in-depth discussion on the essential aspects of multi-agent systems based on LLMs, as well as the challenges. Our goal is for readers to gain substantial insights on the following questions: What domains and environments do LLM-based multi-agents simulate? How are these agents profiled and how do they communicate? What mechanisms contribute to the growth of agents' capacities? For those interested in delving into this field of study, we also summarize the commonly used datasets or benchmarks for them to have convenient access. To keep researchers updated on the latest studies, we maintain an open-source GitHub repository, dedicated to outlining the research on LLM-based multi-agent systems., Comment: This work is ongoing and we welcome your contribution!

The Circle of Willis (CoW) is an important network of arteries connecting major circulations of the brain. Its vascular architecture is believed to affect the risk, severity, and clinical outcome of serious neuro-vascular diseases. However, characterizing the highly variable CoW anatomy is still a manual and time-consuming expert task. The CoW is usually imaged by two angiographic imaging modalities, magnetic resonance angiography (MRA) and computed tomography angiography (CTA), but there exist limited public datasets with annotations on CoW anatomy, especially for CTA. Therefore we organized the TopCoW Challenge in 2023 with the release of an annotated CoW dataset. The TopCoW dataset was the first public dataset with voxel-level annotations for thirteen possible CoW vessel components, enabled by virtual-reality (VR) technology. It was also the first large dataset with paired MRA and CTA from the same patients. TopCoW challenge formalized the CoW characterization problem as a multiclass anatomical segmentation task with an emphasis on topological metrics. We invited submissions worldwide for the CoW segmentation task, which attracted over 140 registered participants from four continents. The top performing teams managed to segment many CoW components to Dice scores around 90%, but with lower scores for communicating arteries and rare variants. There were also topological mistakes for predictions with high Dice scores. Additional topological analysis revealed further areas for improvement in detecting certain CoW components and matching CoW variant topology accurately. TopCoW represented a first attempt at benchmarking the CoW anatomical segmentation task for MRA and CTA, both morphologically and topologically., Comment: 24 pages, 11 figures, 9 tables. Summary Paper for the MICCAI TopCoW 2023 Challenge

Reaction prediction, a critical task in synthetic chemistry, is to predict the outcome of a reaction based on given reactants. Generative models like Transformer and VAE have typically been employed to predict the reaction product. However, these likelihood-maximization models overlooked the inherent stochastic nature of chemical reactions, such as the multiple ways electrons can be redistributed among atoms during the reaction process. In scenarios where similar reactants could follow different electron redistribution patterns, these models typically predict the most common outcomes, neglecting less frequent but potentially crucial reaction patterns. These overlooked patterns, though rare, can lead to innovative methods for designing synthetic routes and significantly advance synthesis techniques. To break the limits of previous approaches, we propose organizing the mapping space between reactants and electron redistribution patterns in a divide-and-conquer manner. We address the reaction problem by training multiple expert models, each specializing in capturing a type of electron redistribution pattern in reaction. These experts enhance the prediction process by considering both typical and other less common electron redistribution manners. In the inference stage, a dropout strategy is applied to each expert to improve the electron redistribution diversity. The most plausible products are finally predicted through a ranking stage designed to integrate the predictions from multiple experts. Experimental results on the largest reaction prediction benchmark USPTO-MIT show the superior performance of our proposed method compared to baselines.

Molecular Representation Learning (MRL) has proven impactful in numerous biochemical applications such as drug discovery and enzyme design. While Graph Neural Networks (GNNs) are effective at learning molecular representations from a 2D molecular graph or a single 3D structure, existing works often overlook the flexible nature of molecules, which continuously interconvert across conformations via chemical bond rotations and minor vibrational perturbations. To better account for molecular flexibility, some recent works formulate MRL as an ensemble learning problem, focusing on explicitly learning from a set of conformer structures. However, most of these studies have limited datasets, tasks, and models. In this work, we introduce the first MoleculAR Conformer Ensemble Learning (MARCEL) benchmark to thoroughly evaluate the potential of learning on conformer ensembles and suggest promising research directions. MARCEL includes four datasets covering diverse molecule- and reaction-level properties of chemically diverse molecules including organocatalysts and transition-metal catalysts, extending beyond the scope of common GNN benchmarks that are confined to drug-like molecules. In addition, we conduct a comprehensive empirical study, which benchmarks representative 1D, 2D, and 3D molecular representation learning models, along with two strategies that explicitly incorporate conformer ensembles into 3D MRL models. Our findings reveal that direct learning from an accessible conformer space can improve performance on a variety of tasks and models., Comment: ICLR 2024

Large Language Models (LLMs) with strong abilities in natural language processing tasks have emerged and have been applied in various kinds of areas such as science, finance and software engineering. However, the capability of LLMs to advance the field of chemistry remains unclear. In this paper, rather than pursuing state-of-the-art performance, we aim to evaluate capabilities of LLMs in a wide range of tasks across the chemistry domain. We identify three key chemistry-related capabilities including understanding, reasoning and explaining to explore in LLMs and establish a benchmark containing eight chemistry tasks. Our analysis draws on widely recognized datasets facilitating a broad exploration of the capacities of LLMs within the context of practical chemistry. Five LLMs (GPT-4, GPT-3.5, Davinci-003, Llama and Galactica) are evaluated for each chemistry task in zero-shot and few-shot in-context learning settings with carefully selected demonstration examples and specially crafted prompts. Our investigation found that GPT-4 outperformed other models and LLMs exhibit different competitive levels in eight chemistry tasks. In addition to the key findings from the comprehensive benchmark analysis, our work provides insights into the limitation of current LLMs and the impact of in-context learning settings on LLMs' performance across various chemistry tasks. The code and datasets used in this study are available at https://github.com/ChemFoundationModels/ChemLLMBench., Comment: NeurIPS 2023 Datasets and Benchmarks Track camera-ready version

Automated brain tumor segmentation methods have become well-established and reached performance levels offering clear clinical utility. These methods typically rely on four input magnetic resonance imaging (MRI) modalities: T1-weighted images with and without contrast enhancement, T2-weighted images, and FLAIR images. However, some sequences are often missing in clinical practice due to time constraints or image artifacts, such as patient motion. Consequently, the ability to substitute missing modalities and gain segmentation performance is highly desirable and necessary for the broader adoption of these algorithms in the clinical routine. In this work, we present the establishment of the Brain MR Image Synthesis Benchmark (BraSyn) in conjunction with the Medical Image Computing and Computer-Assisted Intervention (MICCAI) 2023. The primary objective of this challenge is to evaluate image synthesis methods that can realistically generate missing MRI modalities when multiple available images are provided. The ultimate aim is to facilitate automated brain tumor segmentation pipelines. The image dataset used in the benchmark is diverse and multi-modal, created through collaboration with various hospitals and research institutions., Comment: Technical report of BraSyn

A myriad of algorithms for the automatic analysis of brain MR images is available to support clinicians in their decision-making. For brain tumor patients, the image acquisition time series typically starts with an already pathological scan. This poses problems, as many algorithms are designed to analyze healthy brains and provide no guarantee for images featuring lesions. Examples include, but are not limited to, algorithms for brain anatomy parcellation, tissue segmentation, and brain extraction. To solve this dilemma, we introduce the BraTS inpainting challenge. Here, the participants explore inpainting techniques to synthesize healthy brain scans from lesioned ones. The following manuscript contains the task formulation, dataset, and submission procedure. Later, it will be updated to summarize the findings of the challenge. The challenge is organized as part of the ASNR-BraTS MICCAI challenge., Comment: 14 pages, 6 figures