Daily Papers

Whisper fails to correctly transcribe dementia speech because persons with dementia (PwDs) often exhibit irregular speech patterns and disfluencies such as pauses, repetitions, and fragmented sentences. It was trained on standard speech and may have had little or no exposure to dementia-affected speech. However, correct transcription is vital for dementia speech for cost-effective diagnosis and the development of assistive technology. In this work, we fine-tune Whisper with the open-source dementia speech dataset (DementiaBank) and our in-house dataset to improve its word error rate (WER). The fine-tuning also includes filler words to ascertain the filler inclusion rate (FIR) and F1 score. The fine-tuned models significantly outperformed the off-the-shelf models. The medium-sized model achieved a WER of 0.24, outperforming previous work. Similarly, there was a notable generalisability to unseen data and speech patterns.

Alzheimer's disease (AD) constitutes a complex neurocognitive disease and is the main cause of dementia. Although many studies have been proposed targeting at diagnosing dementia through spontaneous speech, there are still limitations. Existing state-of-the-art approaches, which propose multimodal methods, train separately language and acoustic models, employ majority-vote approaches, and concatenate the representations of the different modalities either at the input level, i.e., early fusion, or during training. Also, some of them employ self-attention layers, which calculate the dependencies between representations without considering the contextual information. In addition, no prior work has taken into consideration the model calibration. To address these limitations, we propose some new methods for detecting AD patients, which capture the intra- and cross-modal interactions. First, we convert the audio files into log-Mel spectrograms, their delta, and delta-delta and create in this way an image per audio file consisting of three channels. Next, we pass each transcript and image through BERT and DeiT models respectively. After that, context-based self-attention layers, self-attention layers with a gate model, and optimal transport domain adaptation methods are employed for capturing the intra- and inter-modal interactions. Finally, we exploit two methods for fusing the self and cross-attended features. For taking into account the model calibration, we apply label smoothing. We use both performance and calibration metrics. Experiments conducted on the ADReSS Challenge dataset indicate the efficacy of our introduced approaches over existing research initiatives with our best performing model reaching Accuracy and F1-score up to 91.25% and 91.06% respectively.

Dementia is a progressive cognitive syndrome with Alzheimer's disease (AD) as the leading cause. Conversation-based AD detection offers a cost-effective alternative to clinical methods, as language dysfunction is an early biomarker of AD. However, most prior research has framed AD detection as a binary classification problem, limiting the ability to identify Mild Cognitive Impairment (MCI)-a crucial stage for early intervention. Also, studies primarily rely on single-language datasets, mainly in English, restricting cross-language generalizability. To address this gap, we make three key contributions. First, we introduce a novel, multilingual dataset for AD detection by unifying 16 publicly available dementia-related conversational datasets. This corpus spans English, Spanish, Chinese, and Greek and incorporates both audio and text data derived from a variety of cognitive assessment tasks. Second, we perform finer-grained classification, including MCI, and evaluate various classifiers using sparse and dense text representations. Third, we conduct experiments in monolingual and multilingual settings, finding that some languages benefit from multilingual training while others perform better independently. This study highlights the challenges in multilingual AD detection and enables future research on both language-specific approaches and techniques aimed at improving model generalization and robustness.

Background:Speech patterns have emerged as potential diagnostic markers for conditions with varying etiologies. Machine learning (ML) presents an opportunity to harness these patterns for accurate disease diagnosis. Objective: This review synthesized findings from studies exploring ML's capability in leveraging speech for the diagnosis of neurological, laryngeal and mental disorders. Methods: A systematic examination of 564 articles was conducted with 91 articles included in the study, which encompassed a wide spectrum of conditions, ranging from voice pathologies to mental and neurological disorders. Methods for speech classifications were assessed based on the relevant studies and scored between 0-10 based on the reported diagnostic accuracy of their ML models. Results: High diagnostic accuracies were consistently observed for laryngeal disorders, dysarthria, and changes related to speech in Parkinsons disease. These findings indicate the robust potential of speech as a diagnostic tool. Disorders like depression, schizophrenia, mild cognitive impairment and Alzheimers dementia also demonstrated high accuracies, albeit with some variability across studies. Meanwhile, disorders like OCD and autism highlighted the need for more extensive research to ascertain the relationship between speech patterns and the respective conditions. Conclusion: ML models utilizing speech patterns demonstrate promising potential in diagnosing a range of mental, laryngeal, and neurological disorders. However, the efficacy varies across conditions, and further research is needed. The integration of these models into clinical practice could potentially revolutionize the evaluation and diagnosis of a number of different medical conditions.

Speech-based analysis offers a scalable and non-invasive approach for detecting cognitive decline, yet progress has been constrained by the limited availability of clinically validated datasets collected under realistic conditions. We introduce PROCESS-2, a large-scale speech dataset designed to support research on automatic assessment of cognitive impairment from spontaneous and task-oriented speech. The dataset comprises recordings from 200 healthy controls, 150 mild cognitive impairment, and 50 dementia diagnoses collected using the CognoMemory digital assessment platform. Each participant completed a single assessment session, including picture description and verbal fluency tasks, accompanied by manually verified transcripts and participant-level metadata. PROCESS-2 contains approximately 21 hours of speech audio with predefined train/test partitions. Comprehensive technical validation evaluated demographic balance, clinical consistency, recording stability, embedding-space structure, and reproducible baseline modelling performance, demonstrating clinically meaningful group separation and stable performance across modelling approaches while preserving real-world conversational variability. PROCESS-2 is released under controlled access via Hugging Face to enable responsible reuse while protecting participant privacy, providing a reproducible benchmark resource for speech-based cognitive assessment research.

Research related to automatically detecting Alzheimer's disease (AD) is important, given the high prevalence of AD and the high cost of traditional methods. Since AD significantly affects the content and acoustics of spontaneous speech, natural language processing and machine learning provide promising techniques for reliably detecting AD. We compare and contrast the performance of two such approaches for AD detection on the recent ADReSS challenge dataset: 1) using domain knowledge-based hand-crafted features that capture linguistic and acoustic phenomena, and 2) fine-tuning Bidirectional Encoder Representations from Transformer (BERT)-based sequence classification models. We also compare multiple feature-based regression models for a neuropsychological score task in the challenge. We observe that fine-tuned BERT models, given the relative importance of linguistics in cognitive impairment detection, outperform feature-based approaches on the AD detection task.

It is widely accepted that information derived from analyzing speech (the acoustic signal) and language production (words and sentences) serves as a useful window into the health of an individual's cognitive ability. In fact, most neuropsychological testing batteries have a component related to speech and language where clinicians elicit speech from patients for subjective evaluation across a broad set of dimensions. With advances in speech signal processing and natural language processing, there has been recent interest in developing tools to detect more subtle changes in cognitive-linguistic function. This work relies on extracting a set of features from recorded and transcribed speech for objective assessments of speech and language, early diagnosis of neurological disease, and tracking of disease after diagnosis. With an emphasis on cognitive and thought disorders, in this paper we provide a review of existing speech and language features used in this domain, discuss their clinical application, and highlight their advantages and disadvantages. Broadly speaking, the review is split into two categories: language features based on natural language processing and speech features based on speech signal processing. Within each category, we consider features that aim to measure complementary dimensions of cognitive-linguistics, including language diversity, syntactic complexity, semantic coherence, and timing. We conclude the review with a proposal of new research directions to further advance the field.

This review paper explores recent advances in deep learning approaches for non-invasive cognitive impairment detection. We examine various non-invasive indicators of cognitive decline, including speech and language, facial, and motoric mobility. The paper provides an overview of relevant datasets, feature-extracting techniques, and deep-learning architectures applied to this domain. We have analyzed the performance of different methods across modalities and observed that speech and language-based methods generally achieved the highest detection performance. Studies combining acoustic and linguistic features tended to outperform those using a single modality. Facial analysis methods showed promise for visual modalities but were less extensively studied. Most papers focused on binary classification (impaired vs. non-impaired), with fewer addressing multi-class or regression tasks. Transfer learning and pre-trained language models emerged as popular and effective techniques, especially for linguistic analysis. Despite significant progress, several challenges remain, including data standardization and accessibility, model explainability, longitudinal analysis limitations, and clinical adaptation. Lastly, we propose future research directions, such as investigating language-agnostic speech analysis methods, developing multi-modal diagnostic systems, and addressing ethical considerations in AI-assisted healthcare. By synthesizing current trends and identifying key obstacles, this review aims to guide further development of deep learning-based cognitive impairment detection systems to improve early diagnosis and ultimately patient outcomes.

In this work, we present a novel perspective on cognitive impairment classification from speech by integrating speech foundation models that explicitly recognize speech dialects. Our motivation is based on the observation that individuals with Alzheimer's Disease (AD) or mild cognitive impairment (MCI) often produce measurable speech characteristics, such as slower articulation rate and lengthened sounds, in a manner similar to dialectal phonetic variations seen in speech. Building on this idea, we introduce VoxCog, an end-to-end framework that uses pre-trained dialect models to detect AD or MCI without relying on additional modalities such as text or images. Through experiments on multiple multilingual datasets for AD and MCI detection, we demonstrate that model initialization with a dialect classifier on top of speech foundation models consistently improves the predictive performance of AD or MCI. Our trained models yield similar or often better performance compared to previous approaches that ensembled several computational methods using different signal modalities. Particularly, our end-to-end speech-based model achieves 87.5% and 85.9% accuracy on the ADReSS 2020 challenge and ADReSSo 2021 challenge test sets, outperforming existing solutions that use multimodal ensemble-based computation or LLMs.

While Large Language Models (LLMs) have shown strong performance on clinical text understanding, they struggle with longitudinal prediction tasks such as dementia prognosis, which require reasoning over complex, non-monotonic symptom trajectories across multiple visits. Standard supervised training lacks explicit annotations for symptom evolution, while direct Reinforcement Learning (RL) is hindered by sparse binary rewards. To address this challenge, we introduce Dementia-R1, an RL-based framework for longitudinal dementia prognosis from unstructured clinical notes. Our approach adopts a Cold-Start RL strategy that pre-trains the model to predict verifiable clinical indices extracted from patient histories, enhancing the capability to reason about disease progression before determining the final clinical status. Extensive experiments demonstrate that Dementia-R1 achieves an F1 score of 77.03% on real-world unstructured clinical datasets. Notably, on the ADNI benchmark, our 7B model rivals GPT-4o, effectively capturing fluctuating cognitive trajectories. Code is available at https://anonymous.4open.science/r/dementiar1-CDB5

Social media, such as Twitter, provides opportunities for caregivers of dementia patients to share their experiences and seek support for a variety of reasons. Availability of this information online also paves the way for the development of internet-based interventions in their support. However, for this purpose, tweets written by caregivers of dementia patients must first be identified. This paper demonstrates our system for the SMM4H 2025 shared task 3, which focuses on detecting tweets posted by individuals who have a family member with dementia. The task is outlined as a binary classification problem, differentiating between tweets that mention dementia in the context of a family member and those that do not. Our solution to this problem explores large language models (LLMs) with various prompting methods. Our results show that a simple zero-shot prompt on a fine-tuned model yielded the best results. Our final system achieved a macro F1-score of 0.95 on the validation set and the test set. Our full code is available on GitHub.

While voice technologies increasingly serve aging populations, current systems exhibit significant performance gaps due to inadequate training data capturing elderly-specific vocal characteristics like presbyphonia and dialectal variations. The limited data available on super-aged individuals in existing elderly speech datasets, coupled with overly simple recording styles and annotation dimensions, exacerbates this issue. To address the critical scarcity of speech data from individuals aged 75 and above, we introduce SeniorTalk, a carefully annotated Chinese spoken dialogue dataset. This dataset contains 55.53 hours of speech from 101 natural conversations involving 202 participants, ensuring a strategic balance across gender, region, and age. Through detailed annotation across multiple dimensions, it can support a wide range of speech tasks. We perform extensive experiments on speaker verification, speaker diarization, speech recognition, and speech editing tasks, offering crucial insights for the development of speech technologies targeting this age group.

The differential diagnosis of neurodegenerative dementias is a challenging clinical task, mainly because of the overlap in symptom presentation and the similarity of patterns observed in structural neuroimaging. To improve diagnostic efficiency and accuracy, deep learning-based methods such as Convolutional Neural Networks and Vision Transformers have been proposed for the automatic classification of brain MRIs. However, despite their strong predictive performance, these models find limited clinical utility due to their opaque decision making. In this work, we propose a framework that integrates two core components to enhance diagnostic transparency. First, we introduce a modular pipeline for converting 3D T1-weighted brain MRIs into textual radiology reports. Second, we explore the potential of modern Large Language Models (LLMs) to assist clinicians in the differential diagnosis between Frontotemporal dementia subtypes, Alzheimer's disease, and normal aging based on the generated reports. To bridge the gap between predictive accuracy and explainability, we employ reinforcement learning to incentivize diagnostic reasoning in LLMs. Without requiring supervised reasoning traces or distillation from larger models, our approach enables the emergence of structured diagnostic rationales grounded in neuroimaging findings. Unlike post-hoc explainability methods that retrospectively justify model decisions, our framework generates diagnostic rationales as part of the inference process-producing causally grounded explanations that inform and guide the model's decision-making process. In doing so, our framework matches the diagnostic performance of existing deep learning methods while offering rationales that support its diagnostic conclusions.

Large language models (LLMs) are increasingly used in clinical and care settings. This exploratory study investigates whether LLMs exhibit sycophantic behavior - adapting their responses to social expectation signals rather than maintaining professional quality - in the context of dementia care. Five prompts with systematically increasing confirmatory and authority-related framing (P1 neutral to P5 authority-signaled implementation support) were submitted to four LLMs (GPT-5, Claude Sonnet 4.6, Gemini 3.1 Pro, Mistral Large), each repeated five times (N = 100 responses). Responses were evaluated using an LLM-as-a-Judge methodology against seven nursing-ethical quality criteria (K1-K7) and a tone scale (0-3). All models showed significant negative Spearman correlations between prompt level and response quality (rho ranging from -0.543 to -0.734, all p < 0.01). Mistral Large exhibited the most pronounced effect (rho = -0.734), with mean scores dropping from 6.0/7 at P1 to 0.2/7 at P5. The findings suggest that LLMs pose context-sensitive risks in high-stakes care environments and that prompt framing significantly shapes response quality - a dimension that has received insufficient attention in healthcare AI deployment.

When communicating with elders with cognitive impairment, cognitive stimulation (CS) help to maintain the cognitive health of elders. Data sparsity is the main challenge in building CS-based dialogue systems, particularly in the Chinese language. To fill this gap, we construct a Chinese CS conversation (CSConv) dataset, which contains about 2.6K groups of dialogues with CS principles and emotional support strategy labels. Making chit chat while providing emotional support is overlooked by the majority of existing cognitive dialogue systems. In this paper, we propose a multi-source knowledge fusion method for CS dialogue (CSD), to generate open-ended responses guided by the CS principle and emotional support strategy. We first use a progressive mask method based on external knowledge to learn encoders as effective classifiers, which is the prerequisite to predict the CS principle and emotional support strategy of the target response. Then a decoder interacts with the perceived CS principle and emotional support strategy to generate responses. Extensive experiments conducted on the CSConv dataset demonstrate the effectiveness of the proposed method, while there is still a large space for improvement compared to human performance.

Objective: We develop a deep learning framework based on the pre-trained Bidirectional Encoder Representations from Transformers (BERT) model using unstructured clinical notes from electronic health records (EHRs) to predict the risk of disease progression from Mild Cognitive Impairment (MCI) to Alzheimer's Disease (AD). Materials and Methods: We identified 3657 patients diagnosed with MCI together with their progress notes from Northwestern Medicine Enterprise Data Warehouse (NMEDW) between 2000-2020. The progress notes no later than the first MCI diagnosis were used for the prediction. We first preprocessed the notes by deidentification, cleaning and splitting, and then pretrained a BERT model for AD (AD-BERT) based on the publicly available Bio+Clinical BERT on the preprocessed notes. The embeddings of all the sections of a patient's notes processed by AD-BERT were combined by MaxPooling to compute the probability of MCI-to-AD progression. For replication, we conducted a similar set of experiments on 2563 MCI patients identified at Weill Cornell Medicine (WCM) during the same timeframe. Results: Compared with the 7 baseline models, the AD-BERT model achieved the best performance on both datasets, with Area Under receiver operating characteristic Curve (AUC) of 0.8170 and F1 score of 0.4178 on NMEDW dataset and AUC of 0.8830 and F1 score of 0.6836 on WCM dataset. Conclusion: We developed a deep learning framework using BERT models which provide an effective solution for prediction of MCI-to-AD progression using clinical note analysis.

Speech patterns have been identified as potential diagnostic markers for neuropsychiatric conditions. However, most studies only compare a single clinical group to healthy controls, whereas clinical practice often requires differentiating between multiple potential diagnoses (multiclass settings). To address this, we assembled a dataset of repeated recordings from 420 participants (67 with major depressive disorder, 106 with schizophrenia and 46 with autism, as well as matched controls), and tested the performance of a range of conventional machine learning models and advanced Transformer models on both binary and multiclass classification, based on voice and text features. While binary models performed comparably to previous research (F1 scores between 0.54-0.75 for autism spectrum disorder, ASD; 0.67-0.92 for major depressive disorder, MDD; and 0.71-0.83 for schizophrenia); when differentiating between multiple diagnostic groups performance decreased markedly (F1 scores between 0.35-0.44 for ASD, 0.57-0.75 for MDD, 0.15-0.66 for schizophrenia, and 0.38-0.52 macro F1). Combining voice and text-based models yielded increased performance, suggesting that they capture complementary diagnostic information. Our results indicate that models trained on binary classification may learn to rely on markers of generic differences between clinical and non-clinical populations, or markers of clinical features that overlap across conditions, rather than identifying markers specific to individual conditions. We provide recommendations for future research in the field, suggesting increased focus on developing larger transdiagnostic datasets that include more fine-grained clinical features, and that can support the development of models that better capture the complexity of neuropsychiatric conditions and naturalistic diagnostic assessment.

As the global burden of Alzheimer's disease (AD) continues to grow, early and accurate detection has become increasingly critical, especially in regions with limited access to advanced diagnostic tools. We propose BRAINS (Biomedical Retrieval-Augmented Intelligence for Neurodegeneration Screening) to address this challenge. This novel system harnesses the powerful reasoning capabilities of Large Language Models (LLMs) for Alzheimer's detection and monitoring. BRAINS features a dual-module architecture: a cognitive diagnostic module and a case-retrieval module. The Diagnostic Module utilizes LLMs fine-tuned on cognitive and neuroimaging datasets -- including MMSE, CDR scores, and brain volume metrics -- to perform structured assessments of Alzheimer's risk. Meanwhile, the Case Retrieval Module encodes patient profiles into latent representations and retrieves similar cases from a curated knowledge base. These auxiliary cases are fused with the input profile via a Case Fusion Layer to enhance contextual understanding. The combined representation is then processed with clinical prompts for inference. Evaluations on real-world datasets demonstrate BRAINS effectiveness in classifying disease severity and identifying early signs of cognitive decline. This system not only shows strong potential as an assistive tool for scalable, explainable, and early-stage Alzheimer's disease detection, but also offers hope for future applications in the field.

Longitudinal modelling of Alzheimer's disease progression is clinically useful only if it can describe not just the most likely next diagnosis, but how a patient may evolve over time and how reliable that forecast is. Most deep learning approaches reduce this problem to single-step classification, treating cognitively normal, mild cognitive impairment, and dementia as flat categories while providing limited insight into how uncertainty accumulates across future visits. We propose a probabilistic framework that combines ordinal diagnosis prediction, multi-horizon trajectory generation, and decomposed uncertainty estimation. A Temporal Fusion Transformer encoder is adapted with a CORAL ordinal output layer, asymmetric loss weighting, and converter oversampling to respect disease-stage ordering and improve sensitivity to MCI-to-dementia transitions. Conditioned on the learned patient-context representation, an autoregressive Mixture Density Network generates five-year probabilistic trajectories for diagnosis state, CDR Sum of Boxes, MMSE orientation, and hippocampal volume. On ADNI, the model outperforms linear, recurrent, and transformer baselines for next-visit diagnosis prediction, with the strongest gains on MCI-versus-dementia discrimination. Generated trajectories achieve near-nominal 90% credible interval coverage, widening uncertainty across the forecast horizon, and biomarker dynamics consistent with expected Alzheimer's disease progression. We further separate aleatoric from epistemic uncertainty using analytic mixture variance and a five-member bootstrap ensemble, which provides the strongest encoder diversity and output-level epistemic signal. Epistemic uncertainty is higher for rare progression archetypes, MCI and dementia patients, and under external evaluation on OASIS-3, where it increases alongside prediction error.

Alzheimer's disease (AD) is a common neurodegenerative disease among the elderly. Early prediction and timely intervention of its prodromal stage, mild cognitive impairment (MCI), can decrease the risk of advancing to AD. Combining information from various modalities can significantly improve predictive accuracy. However, challenges such as missing data and heterogeneity across modalities complicate multimodal learning methods as adding more modalities can worsen these issues. Current multimodal fusion techniques often fail to adapt to the complexity of medical data, hindering the ability to identify relationships between modalities. To address these challenges, we propose an innovative multimodal approach for predicting MCI conversion, focusing specifically on the issues of missing positron emission tomography (PET) data and integrating diverse medical information. The proposed incomplete triple-modal MCI conversion prediction network is tailored for this purpose. Through the missing modal generation module, we synthesize the missing PET data from the magnetic resonance imaging and extract features using specifically designed encoders. We also develop a channel aggregation module and a triple-modal co-attention fusion module to reduce feature redundancy and achieve effective multimodal data fusion. Furthermore, we design a loss function to handle missing modality issues and align cross-modal features. These components collectively harness multimodal data to boost network performance. Experimental results on the ADNI1 and ADNI2 datasets show that our method significantly surpasses existing unimodal and other multimodal models. Our code is available at https://github.com/justinhxy/ITFC.

As large language models transition from text-based interfaces to audio interactions in clinical settings, they might introduce new vulnerabilities through paralinguistic cues in audio. We evaluated these models on 170 clinical cases, each synthesized into speech from 36 distinct voice profiles spanning variations in age, gender, and emotion. Our findings reveal a severe modality bias: surgical recommendations for audio inputs varied by as much as 35% compared to identical text-based inputs, with one model providing 80% fewer recommendations. Further analysis uncovered age disparities of up to 12% between young and elderly voices, which persisted in most models despite chain-of-thought prompting. While explicit reasoning successfully eliminated gender bias, the impact of emotion was not detected due to poor recognition performance. These results demonstrate that audio LLMs are susceptible to making clinical decisions based on a patient's voice characteristics rather than medical evidence, a flaw that risks perpetuating healthcare disparities. We conclude that bias-aware architectures are essential and urgently needed before the clinical deployment of these models.

Several studies have shown that speech and language features, automatically extracted from clinical interviews or spontaneous discourse, have diagnostic value for mental disorders such as schizophrenia and bipolar disorder. They typically make use of a large feature set to train a classifier for distinguishing between two groups of interest, i.e. a clinical and control group. However, a purely data-driven approach runs the risk of overfitting to a particular data set, especially when sample sizes are limited. Here, we first down-select the set of language features to a small subset that is related to a well-validated test of functional ability, the Social Skills Performance Assessment (SSPA). This helps establish the concurrent validity of the selected features. We use only these features to train a simple classifier to distinguish between groups of interest. Linear regression reveals that a subset of language features can effectively model the SSPA, with a correlation coefficient of 0.75. Furthermore, the same feature set can be used to build a strong binary classifier to distinguish between healthy controls and a clinical group (AUC = 0.96) and also between patients within the clinical group with schizophrenia and bipolar I disorder (AUC = 0.83).

Understanding robustness and sensitivity of BERT models predicting Alzheimer's disease from text is important for both developing better classification models and for understanding their capabilities and limitations. In this paper, we analyze how a controlled amount of desired and undesired text alterations impacts performance of BERT. We show that BERT is robust to natural linguistic variations in text. On the other hand, we show that BERT is not sensitive to removing clinically important information from text.

Depression is a critical concern in global mental health, prompting extensive research into AI-based detection methods. Among various AI technologies, Large Language Models (LLMs) stand out for their versatility in mental healthcare applications. However, their primary limitation arises from their exclusive dependence on textual input, which constrains their overall capabilities. Furthermore, the utilization of LLMs in identifying and analyzing depressive states is still relatively untapped. In this paper, we present an innovative approach to integrating acoustic speech information into the LLMs framework for multimodal depression detection. We investigate an efficient method for depression detection by integrating speech signals into LLMs utilizing Acoustic Landmarks. By incorporating acoustic landmarks, which are specific to the pronunciation of spoken words, our method adds critical dimensions to text transcripts. This integration also provides insights into the unique speech patterns of individuals, revealing the potential mental states of individuals. Evaluations of the proposed approach on the DAIC-WOZ dataset reveal state-of-the-art results when compared with existing Audio-Text baselines. In addition, this approach is not only valuable for the detection of depression but also represents a new perspective in enhancing the ability of LLMs to comprehend and process speech signals.

Large language models (LLMs) have the potential to transform medicine, but real-world clinical scenarios contain extraneous information that can hinder performance. The rise of assistive technologies like ambient dictation, which automatically generates draft notes from live patient encounters, has the potential to introduce additional noise making it crucial to assess the ability of LLM's to filter relevant data. To investigate this, we developed MedDistractQA, a benchmark using USMLE-style questions embedded with simulated real-world distractions. Our findings show that distracting statements (polysemous words with clinical meanings used in a non-clinical context or references to unrelated health conditions) can reduce LLM accuracy by up to 17.9%. Commonly proposed solutions to improve model performance such as retrieval-augmented generation (RAG) and medical fine-tuning did not change this effect and in some cases introduced their own confounders and further degraded performance. Our findings suggest that LLMs natively lack the logical mechanisms necessary to distinguish relevant from irrelevant clinical information, posing challenges for real-world applications. MedDistractQA and our results highlights the need for robust mitigation strategies to enhance LLM resilience to extraneous information.

Psychotherapy or counseling is typically conducted through spoken conversation between a therapist and a client. Analyzing the speech characteristics of psychotherapeutic interactions can help understand the factors associated with effective psychotherapy. This paper introduces CUEMPATHY, a large-scale speech dataset collected from actual counseling sessions. The dataset consists of 156 counseling sessions involving 39 therapist-client dyads. The process of speech data collection, subjective ratings (one observer and two client ratings), and transcription are described. An automatic speech and text processing system is developed to locate the time stamps of speaker turns in each session. Examining the relationships among the three subjective ratings suggests that observer and client ratings have no significant correlation, while the client-rated measures are significantly correlated. The intensity similarity between the therapist and the client, measured by the averaged absolute difference of speaker-turn-level intensities, is associated with the psychotherapy outcomes. Recent studies on the acoustic and linguistic characteristics of the CUEMPATHY are introduced.

Depression, a prevalent mental health disorder impacting millions globally, demands reliable assessment systems. Unlike previous studies that focus solely on either detecting depression or predicting its severity, our work identifies individual symptoms of depression while also predicting its severity using speech input. We leverage self-supervised learning (SSL)-based speech models to better utilize the small-sized datasets that are frequently encountered in this task. Our study demonstrates notable performance improvements by utilizing SSL embeddings compared to conventional speech features. We compare various types of SSL pretrained models to elucidate the type of speech information (semantic, speaker, or prosodic) that contributes the most in identifying different symptoms. Additionally, we evaluate the impact of combining multiple SSL embeddings on performance. Furthermore, we show the significance of multi-task learning for identifying depressive symptoms effectively.

Large language models (LLMs) have shown great potential for healthcare applications. However, existing evaluation benchmarks provide minimal coverage of Alzheimer's Disease and Related Dementias (ADRD). To address this gap, we introduce ADRD-Bench, the first ADRD-specific benchmark dataset designed for rigorous evaluation of LLMs. ADRD-Bench has two components: 1) ADRD Unified QA, a synthesis of 1,352 questions consolidated from seven established medical benchmarks, providing a unified assessment of clinical knowledge; and 2) ADRD Caregiving QA, a novel set of 149 questions derived from the Aging Brain Care (ABC) program, a widely used, evidence-based brain health management program. Guided by a program with national expertise in comprehensive ADRD care, this new set was designed to mitigate the lack of practical caregiving context in existing benchmarks. We evaluated 33 state-of-the-art LLMs on the proposed ADRD-Bench. Results showed that the accuracy of open-weight general models ranged from 0.63 to 0.93 (mean: 0.78; std: 0.09). The accuracy of open-weight medical models ranged from 0.48 to 0.93 (mean: 0.82; std: 0.13). The accuracy of closed-source general models ranged from 0.83 to 0.91 (mean: 0.89; std: 0.03). While top-tier models achieved high accuracies (>0.9), case studies revealed that inconsistent reasoning quality and stability limit their reliability, highlighting a critical need for domain-specific improvement to enhance LLMs' knowledge and reasoning grounded in daily caregiving data. The entire dataset is available at https://github.com/IIRL-ND/ADRD-Bench.

The performance of speaker verification systems is adversely affected by speaker aging. However, due to challenges in data collection, particularly the lack of sustained and large-scale longitudinal data for individuals, research on speaker aging remains difficult. In this paper, we present VoxAging, a large-scale longitudinal dataset collected from 293 speakers (226 English speakers and 67 Mandarin speakers) over several years, with the longest time span reaching 17 years (approximately 900 weeks). For each speaker, the data were recorded at weekly intervals. We studied the phenomenon of speaker aging and its effects on advanced speaker verification systems, analyzed individual speaker aging processes, and explored the impact of factors such as age group and gender on speaker aging research.

Alzheimer's disease (AD) is a chronic neurodegenerative disorder and the leading cause of dementia, significantly impacting cost, mortality, and burden worldwide. The advent of high-throughput omics technologies, such as genomics, transcriptomics, proteomics, and epigenomics, has revolutionized the molecular understanding of AD. Conventional AI approaches typically require the completion of all omics data at the outset to achieve optimal AD diagnosis, which are inefficient and may be unnecessary. To reduce the clinical cost and improve the accuracy of AD diagnosis using multi-omics data, we propose a novel staged graph convolutional network with uncertainty quantification (SGUQ). SGUQ begins with mRNA and progressively incorporates DNA methylation and miRNA data only when necessary, reducing overall costs and exposure to harmful tests. Experimental results indicate that 46.23% of the samples can be reliably predicted using only single-modal omics data (mRNA), while an additional 16.04% of the samples can achieve reliable predictions when combining two omics data types (mRNA + DNA methylation). In addition, the proposed staged SGUQ achieved an accuracy of 0.858 on ROSMAP dataset, which outperformed existing methods significantly. The proposed SGUQ can not only be applied to AD diagnosis using multi-omics data but also has the potential for clinical decision-making using multi-viewed data. Our implementation is publicly available at https://github.com/chenzhao2023/multiomicsuncertainty.

We present Beamforming-LLM, a system that enables users to semantically recall conversations they may have missed in multi-speaker environments. The system combines spatial audio capture using a microphone array with retrieval-augmented generation (RAG) to support natural language queries such as, "What did I miss when I was following the conversation on dogs?" Directional audio streams are separated using beamforming, transcribed with Whisper, and embedded into a vector database using sentence encoders. Upon receiving a user query, semantically relevant segments are retrieved, temporally aligned with non-attended segments, and summarized using a lightweight large language model (GPT-4o-mini). The result is a user-friendly interface that provides contrastive summaries, spatial context, and timestamped audio playback. This work lays the foundation for intelligent auditory memory systems and has broad applications in assistive technology, meeting summarization, and context-aware personal spatial computing.

Alzheimer's Disease (AD) is a progressive neurodegenerative disorder that primarily affects the aging population by impairing cognitive and motor functions. Early detection of AD through accessible methodologies like magnetic resonance imaging (MRI) is vital for developing effective interventions to halt or slow the disease's progression. This study aims to perform a comprehensive analysis of machine learning techniques for selecting MRI-based biomarkers and classifying individuals into healthy controls (HC) and unstable controls (uHC) who later show mild cognitive impairment within five years. The research utilizes MRI data from the Alzheimer's Disease Neuroinformatics Initiative (ADNI) and the Open Access Series of Imaging Studies 3 (OASIS-3), focusing on both HC and uHC participants. The study addresses the challenges of imbalanced data by testing classification methods on balanced and unbalanced datasets, and harmonizes data using polynomial regression to mitigate nuisance variables like age, gender, and intracranial volume. Results indicate that Gaussian Naive Bayes and RusBoost classifiers shows an optimal performance, achieving accuracies of up to 76.46% and 72.48% respectively on the ADNI dataset. For the OASIS-3 dataset, Kernel Naive Bayes and RusBoost yield accuracies ranging from 64.66% to 75.71%, improving further in age-matched datasets. Brain regions like the entorhinal cortex, hippocampus, lateral ventricle, and lateral orbitofrontal cortex are identified as significantly impacted during early cognitive decline. Despite limitations such as small sample sizes, the study's harmonization approach enhances the robustness of biomarker selection, suggesting the potential of this semi-automatic machine learning pipeline for early AD detection using MRI.

In multi-session dialog system, it is essential to continuously update the memory as the session progresses. Simply accumulating memory can make it difficult to focus on the content of the conversation for inference due to the limited input sentence size. Therefore, efficient and accurate conversation model that is capable of managing memory to reflect the conversation history continuously is necessary. This paper presents a conversation model that efficiently manages memory as sessions progress and incorporates this into the model to reflect the conversation history accurately with 3 methodologies: SFT, DPO and DPO with SFT model. Our model using DPO algorithm shows an improvement about 0.0591 of BERTScore in memory accuracy, and the rate of responses reflecting the memory increased as well. Also, response generation performance enhanced about 4.292 in fluency, 3.935 in coherence, and 2.896 in consistency. This paper describes a training method that yields better performance than models with more than twice the parameter size, even when the model size is smaller. Thus, our model demonstrates efficiency not only in terms of accuracy but also in resource utilization.

Recent advancements in multi-turn voice interaction models have improved user-model communication. However, while closed-source models effectively retain and recall past utterances, whether open-source models share this ability remains unexplored. To fill this gap, we systematically evaluate how well open-source interaction models utilize past utterances using ContextDialog, a benchmark we proposed for this purpose. Our findings show that speech-based models have more difficulty than text-based ones, especially when recalling information conveyed in speech, and even with retrieval-augmented generation, models still struggle with questions about past utterances. These insights highlight key limitations in open-source models and suggest ways to improve memory retention and retrieval robustness.

Speech technologies have advanced rapidly and serve diverse populations worldwide. However, many languages remain underrepresented due to limited resources. In this paper, we introduce TaigiSpeech, a real-world speech intent dataset in Taiwanese Taigi (aka Taiwanese Hokkien/Southern Min), which is a low-resource and primarily spoken language. The dataset is collected from older adults, comprising 21 speakers with a total of 3k utterances. It is designed for practical intent detection scenarios, including healthcare and home assistant applications. To address the scarcity of labeled data, we explore two data mining strategies with two levels of supervision: keyword match data mining with LLM pseudo labeling via an intermediate language and an audio-visual framework that leverages multimodal cues with minimal textual supervision. This design enables scalable dataset construction for low-resource and unwritten spoken languages. TaigiSpeech will be released under the CC BY 4.0 license to facilitate broad adoption and research on low-resource and unwritten languages. The project website and the dataset can be found on https://kwchang.org/taigispeech.

Alzheimer's disease (AD) is a degenerative brain disease impairing a person's ability to perform day to day activities. The clinical manifestations of Alzheimer's disease are characterized by heterogeneity in age, disease span, progression rate, impairment of memory and cognitive abilities. Due to these variabilities, personalized care and treatment planning, as well as patient counseling about their individual progression is limited. Recent developments in machine learning to detect hidden patterns in complex, multi-dimensional datasets provides significant opportunities to address this critical need. In this work, we use unsupervised and supervised machine learning approaches for subtype identification and prediction. We apply machine learning methods to the extensive clinical observations available at the Alzheimer's Disease Neuroimaging Initiative (ADNI) data set to identify patient subtypes and to predict disease progression. Our analysis depicts the progression space for the Alzheimer's disease into low, moderate and high disease progression zones. The proposed work will enable early detection and characterization of distinct disease subtypes based on clinical heterogeneity. We anticipate that our models will enable patient counseling, clinical trial design, and ultimately individualized clinical care.

This article presents the Cogni-CISMeF project, which aims at improving medical information search in the CISMeF system (Catalog and Index of French-language health resources) by including a conversational agent to interact with the user in natural language. To study the cognitive processes involved during the information search, a bottom-up methodology was adopted. Experimentation has been set up to obtain human dialogs between a user (playing the role of patient) dealing with medical information search and a CISMeF expert refining the request. The analysis of these dialogs underlined the use of discursive evidence: vocabulary, reformulation, implicit or explicit expression of user intentions, conversational sequences, etc. A model of artificial agent is proposed. It leads the user in its information search by proposing to him examples, assistance and choices. This model was implemented and integrated in the CISMeF system. ---- Cet article d\'ecrit le projet Cogni-CISMeF qui propose un module de dialogue Homme-Machine \`a int\'egrer dans le syst\`eme d'indexation de connaissances m\'edicales CISMeF (Catalogue et Index des Sites M\'edicaux Francophones). Nous avons adopt\'e une d\'emarche de mod\'elisation cognitive en proc\'edant \`a un recueil de corpus de dialogues entre un utilisateur (jouant le r\^ole d'un patient) d\'esirant une information m\'edicale et un expert CISMeF af inant cette demande pour construire la requ\^ete. Nous avons analys\'e la structure des dialogues ainsi obtenus et avons \'etudi\'e un certain nombre d'indices discursifs : vocabulaire employ\'e, marques de reformulation, commentaires m\'eta et \'epilinguistiques, expression implicite ou explicite des intentions de l'utilisateur, encha\^inement conversationnel, etc. De cette analyse, nous avons construit un mod\`ele d'agent artificiel dot\'e de capacit\'es cognitives capables d'aider l'utilisateur dans sa t\^ache de recherche d'information. Ce mod\`ele a \'et\'e impl\'ement\'e et int\'egr\'e dans le syst\`eme CISMeF.

Despite the success of audio-visual large-language models (LLMs), they can produce plausible but ungrounded outputs, termed hallucination. Existing benchmarks focus on environmental sounds (e.g., dog barking) to indicate event occurrence. In contrast, human speech carries fundamentally different, rich semantics and temporal structures, yet it remains unexplored whether current models can accurately align speech content with corresponding visual signals. In this work, we show that speech content can induce hallucinations in audio-visual LLMs. To systematically study this, we introduce SVHalluc, the first comprehensive benchmark for evaluating speech-vision hallucination in audio-visual LLMs. Our benchmark diagnoses speech-vision hallucinations from two critical and complementary aspects: semantic and temporal. Experimental results demonstrate that state-of-the-art open-source audio-visual LLMs struggle with aligning speech content with corresponding visual signals, with a near-random accuracy on multiple tasks. In contrast, Gemini 2.5 Pro significantly outperforms the open-source models. Our analysis suggests that their failures stem from limited ability in cross-modality understanding, despite strong performance in single-modality perception. Our work uncovers a new and fundamental limitation of current audio-visual LLMs and highlights the need for speech-grounded video comprehension. Project page: https://chenshuang-zhang.github.io/projects/svhalluc/.

This paper presents Att-HACK, the first large database of acted speech with social attitudes. Available databases of expressive speech are rare and very often restricted to the primary emotions: anger, joy, sadness, fear. This greatly limits the scope of the research on expressive speech. Besides, a fundamental aspect of speech prosody is always ignored and missing from such databases: its variety, i.e. the possibility to repeat an utterance while varying its prosody. This paper represents a first attempt to widen the scope of expressivity in speech, by providing a database of acted speech with social attitudes: friendly, seductive, dominant, and distant. The proposed database comprises 25 speakers interpreting 100 utterances in 4 social attitudes, with 3-5 repetitions each per attitude for a total of around 30 hours of speech. The Att-HACK is freely available for academic research under a Creative Commons Licence.

Alzheimer's Disease (AD) is the most common form of dementia and often difficult to diagnose due to the multifactorial etiology of dementia. Recent works on neuroimaging-based computer-aided diagnosis with deep neural networks (DNNs) showed that fusing structural magnetic resonance images (sMRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) leads to improved accuracy in a study population of healthy controls and subjects with AD. However, this result conflicts with the established clinical knowledge that FDG-PET better captures AD-specific pathologies than sMRI. Therefore, we propose a framework for the systematic evaluation of multi-modal DNNs and critically re-evaluate single- and multi-modal DNNs based on FDG-PET and sMRI for binary healthy vs. AD, and three-way healthy/mild cognitive impairment/AD classification. Our experiments demonstrate that a single-modality network using FDG-PET performs better than MRI (accuracy 0.91 vs 0.87) and does not show improvement when combined. This conforms with the established clinical knowledge on AD biomarkers, but raises questions about the true benefit of multi-modal DNNs. We argue that future work on multi-modal fusion should systematically assess the contribution of individual modalities following our proposed evaluation framework. Finally, we encourage the community to go beyond healthy vs. AD classification and focus on differential diagnosis of dementia, where fusing multi-modal image information conforms with a clinical need.

Understanding how individuals with Parkinson's disease (PD) describe cognitive experiences in their daily lives can offer valuable insights into disease-related cognitive and emotional changes. However, extracting such information from unstructured patient narratives is challenging due to the subtle, overlapping nature of cognitive constructs. This study developed and evaluated natural language processing (NLP) models to automatically identify categories that reflect various cognitive processes from de-identified first-person narratives. Three model families, a Bio_ClinicalBERT-based span categorization model for nested entity recognition, a fine-tuned Meta-Llama-3-8B-Instruct model using QLoRA for instruction following, and GPT-4o mini evaluated under zero- and few-shot settings, were compared on their performance on extracting seven categories. Our findings indicated that model performance varied substantially across categories and model families. The fine-tuned Meta-Llama-3-8B-Instruct achieved the highest overall F1-scores (0.74 micro-average and 0.59 macro-average), particularly excelling in context-dependent categories such as thought and social interaction. Bio_ClinicalBERT exhibited high precision but low recall and performed comparable to Llama for some category types such as location and time but failed on other categories such as thought, emotion and social interaction. Compared to conventional information extraction tasks, this task presents a greater challenge due to the abstract and overlapping nature of narrative accounts of complex cognitive processes. Nonetheless, with continued refinement, these NLP systems hold promise for enabling low-burden, longitudinal monitoring of cognitive function and serving as a valuable complement to formal neuropsychological assessments in PD.

In this paper, we show that when spoken language models (SLMs) are instructed to speak in a specific speaking style at the beginning of a multi-turn conversation, they cannot maintain the required speaking styles after several turns of interaction; we refer to this as the style amnesia of SLMs. We focus on paralinguistic speaking styles, including emotion, accent, volume, and speaking speed. We evaluate three proprietary and two open-source SLMs, demonstrating that none of these models can maintain a consistent speaking style when instructed to do so. We further show that when SLMs are asked to recall the style instruction in later turns, they can recall the style instruction, but they fail to express it throughout the conversation. We also show that explicitly asking the model to recall the style instruction can partially mitigate style amnesia. In addition, we examine various prompting strategies and find that SLMs struggle to follow the required style when the instruction is placed in system messages rather than user messages, which contradicts the intended function of system prompts.

Large Language Models (LLMs) have shown remarkable capabilities for complex tasks, yet adaptation in medical domain, specifically mental health, poses specific challenges. Mental health is a rising concern globally with LLMs having large potential to help address the same. We highlight three primary challenges for LLMs in mental health - lack of high quality interpretable and knowledge grounded training data; training paradigms restricted to core capabilities, and evaluation of multi turn dialogue settings. Addressing it, we present oMind framework which includes training and aligning LLM agents for diverse capabilities including conversations; high quality ~164k multi-task SFT dataset, as a result of our generation pipeline based on Structured Knowledge retrieval, LLM based pruning, and review actions. We also introduce oMind-Chat - a novel multi turn benchmark dataset with expert annotated turn level and conversation level rubrics. Our diverse experiments on both core capabilities and conversations shows oMind LLMs consistently outperform baselines. oMind-LLM also shows significantly better reasoning with up to 80% win rate.

Speech processing systems face a fundamental challenge: the human voice changes with age, yet few datasets support rigorous longitudinal evaluation. We introduce VoxKnesset, an open-access dataset of ~2,300 hours of Hebrew parliamentary speech spanning 2009-2025, comprising 393 speakers with recording spans of up to 15 years. Each segment includes aligned transcripts and verified demographic metadata from official parliamentary records. We benchmark modern speech embeddings (WavLM-Large, ECAPA-TDNN, Wav2Vec2-XLSR-1B) on age prediction and speaker verification under longitudinal conditions. Speaker verification EER rises from 2.15\% to 4.58\% over 15 years for the strongest model, and cross-sectionally trained age regressors fail to capture within-speaker aging, while longitudinally trained models recover a meaningful temporal signal. We publicly release the dataset and pipeline to support aging-robust speech systems and Hebrew speech processing.

The delayed access to specialized psychiatric assessments and care for patients at risk of suicidal tendencies in emergency departments creates a notable gap in timely intervention, hindering the provision of adequate mental health support during critical situations. To address this, we present a non-invasive, speech-based approach for automatic suicide risk assessment. For our study, we have collected a novel dataset of speech recordings from 20 patients from which we extract three sets of features, including wav2vec, interpretable speech and acoustic features, and deep learning-based spectral representations. We proceed by conducting a binary classification to assess suicide risk in a leave-one-subject-out fashion. Our most effective speech model achieves a balanced accuracy of 66.2,%. Moreover, we show that integrating our speech model with a series of patients' metadata, such as the history of suicide attempts or access to firearms, improves the overall result. The metadata integration yields a balanced accuracy of 94.4,%, marking an absolute improvement of 28.2,%, demonstrating the efficacy of our proposed approaches for automatic suicide risk assessment in emergency medicine.

Hallucinations are a type of output error produced by deep neural networks. While this has been studied in natural language processing, they have not been researched previously in automatic speech recognition. Here, we define hallucinations in ASR as transcriptions generated by a model that are semantically unrelated to the source utterance, yet still fluent and coherent. The similarity of hallucinations to probable natural language outputs of the model creates a danger of deception and impacts the credibility of the system. We show that commonly used metrics, such as word error rates, cannot differentiate between hallucinatory and non-hallucinatory models. To address this, we propose a perturbation-based method for assessing the susceptibility of an automatic speech recognition (ASR) model to hallucination at test time, which does not require access to the training dataset. We demonstrate that this method helps to distinguish between hallucinatory and non-hallucinatory models that have similar baseline word error rates. We further explore the relationship between the types of ASR errors and the types of dataset noise to determine what types of noise are most likely to create hallucinatory outputs. We devise a framework for identifying hallucinations by analysing their semantic connection with the ground truth and their fluency. Finally, we discover how to induce hallucinations with a random noise injection to the utterance.

Automatic speech recognition (ASR) for pathological speech remains underexplored, especially for Huntington's disease (HD), where irregular timing, unstable phonation, and articulatory distortion challenge current models. We present a systematic HD-ASR study using a high-fidelity clinical speech corpus not previously used for end-to-end ASR training. We compare multiple ASR families under a unified evaluation, analyzing WER as well as substitution, deletion, and insertion patterns. HD speech induces architecture-specific error regimes, with Parakeet-TDT outperforming encoder-decoder and CTC baselines. HD-specific adaptation reduces WER from 6.99% to 4.95% and we also propose a method for using biomarker-based auxiliary supervision and analyze how error behavior is reshaped in severity-dependent ways rather than uniformly improving WER. We open-source all code and models.

In this paper, SER_AMPEL, a multi-source dataset for speech emotion recognition (SER) is presented. The peculiarity of the dataset is that it is collected with the aim of providing a reference for speech emotion recognition in case of Italian older adults. The dataset is collected following different protocols, in particular considering acted conversations, extracted from movies and TV series, and recording natural conversations where the emotions are elicited by proper questions. The evidence of the need for such a dataset emerges from the analysis of the state of the art. Preliminary considerations on the critical issues of SER are reported analyzing the classification results on a subset of the proposed dataset.

Hallucinations of deep neural models are amongst key challenges in automatic speech recognition (ASR). In this paper, we investigate hallucinations of the Whisper ASR model induced by non-speech audio segments present during inference. By inducting hallucinations with various types of sounds, we show that there exists a set of hallucinations that appear frequently. We then study hallucinations caused by the augmentation of speech with such sounds. Finally, we describe the creation of a bag of hallucinations (BoH) that allows to remove the effect of hallucinations through the post-processing of text transcriptions. The results of our experiments show that such post-processing is capable of reducing word error rate (WER) and acts as a good safeguard against problematic hallucinations.

Mental distress like depression and anxiety contribute to the largest proportion of the global burden of diseases. Automated diagnosis systems of such disorders, empowered by recent innovations in Artificial Intelligence, can pave the way to reduce the sufferings of the affected individuals. Development of such systems requires information-rich and balanced corpora. In this work, we introduce a novel mental distress analysis audio dataset DEPAC, labeled based on established thresholds on depression and anxiety standard screening tools. This large dataset comprises multiple speech tasks per individual, as well as relevant demographic information. Alongside, we present a feature set consisting of hand-curated acoustic and linguistic features, which were found effective in identifying signs of mental illnesses in human speech. Finally, we justify the quality and effectiveness of our proposed audio corpus and feature set in predicting depression severity by comparing the performance of baseline machine learning models built on this dataset with baseline models trained on other well-known depression corpora.

Alzheimer's Disease (AD) is marked by significant inter-individual variability in its progression, complicating accurate prognosis and personalized care planning. This heterogeneity underscores the critical need for predictive models capable of forecasting patient-specific disease trajectories. Artificial Intelligence (AI) offers powerful tools to address this challenge by analyzing complex, multi-modal, and longitudinal patient data. This paper provides a comprehensive survey of AI methodologies applied to personalized AD progression prediction. We review key approaches including state-space models for capturing temporal dynamics, deep learning techniques like Recurrent Neural Networks for sequence modeling, Graph Neural Networks (GNNs) for leveraging network structures, and the emerging concept of AI-driven digital twins for individualized simulation. Recognizing that data limitations often impede progress, we examine common challenges such as high dimensionality, missing data, and dataset imbalance. We further discuss AI-driven mitigation strategies, with a specific focus on synthetic data generation using Variational Autoencoders (VAEs) and Generative Adversarial Networks (GANs) to augment and balance datasets. The survey synthesizes the strengths and limitations of current approaches, emphasizing the trend towards multimodal integration and the persistent need for model interpretability and generalizability. Finally, we identify critical open challenges, including robust external validation, clinical integration, and ethical considerations, and outline promising future research directions such as hybrid models, causal inference, and federated learning. This review aims to consolidate current knowledge and guide future efforts in developing clinically relevant AI tools for personalized AD prognostication.

Large language models (LLMs) have received much attention and shown their potential in digital health, while their application in mental health is subject to ongoing debate. This systematic review aims to summarize and characterize the use of LLMs in mental health by investigating the strengths and limitations of the latest work in LLMs and discusses the challenges and opportunities for early screening, digital interventions, and other clinical applications in mental health. Following PRISMA guidelines, we examined English articles from PubMed, DBLP Computer Science Bibliography, and IEEE Xplore, published between 1 January 2017, and 1 September 2023, focusing on mental health and LLMs. The review analyzed 32 articles, including mental health analysis using social media datasets (n=13), mental health chatbots (n=10), and other mental health applications (n=9). Findings reveal LLMs' effectiveness in mental health issue detection and the enhancement of telepsychological services through personalised healthcare. Nonetheless, risks like text inconsistencies, hallucinatory content, and the lack of an ethical framework raise concerns about their clinical use. Despite these challenges, the advancement of LLMs underscores their potential as innovative clinical tools, necessitating further research and development. The review emphasizes that LLMs should complement, not replace, professional mental health services.

Retrieval-Augmented Generation (RAG) has emerged as a crucial method for addressing hallucinations in large language models (LLMs). While recent research has extended RAG models to complex noisy scenarios, these explorations often confine themselves to limited noise types and presuppose that noise is inherently detrimental to LLMs, potentially deviating from real-world retrieval environments and restricting practical applicability. In this paper, we define seven distinct noise types from a linguistic perspective and establish a Noise RAG Benchmark (NoiserBench), a comprehensive evaluation framework encompassing multiple datasets and reasoning tasks. Through empirical evaluation of eight representative LLMs with diverse architectures and scales, we reveal that these noises can be further categorized into two practical groups: noise that is beneficial to LLMs (aka beneficial noise) and noise that is harmful to LLMs (aka harmful noise). While harmful noise generally impairs performance, beneficial noise may enhance several aspects of model capabilities and overall performance. Our analysis offers insights for developing more robust, adaptable RAG solutions and mitigating hallucinations across diverse retrieval scenarios.

Recent studies have shown promising results in the detection of Mild Cognitive Impairment (MCI) using easily accessible Electroencephalogram (EEG) data which would help administer early and effective treatment for dementia patients. However, the reliability and practicality of such systems remains unclear. In this work, we investigate the potential limitations and challenges in developing a robust MCI detection method using two contrasting datasets: 1) CAUEEG, collected and annotated by expert neurologists in controlled settings and 2) GENEEG, a new dataset collected and annotated in general practice clinics, a setting where routine MCI diagnoses are typically made. We find that training on small datasets, as is done by most previous works, tends to produce high variance models that make overconfident predictions, and are unreliable in practice. Additionally, distribution shifts between datasets make cross-domain generalization challenging. Finally, we show that MCI detection using EEG may suffer from fundamental limitations because of the overlapping nature of feature distributions with control groups. We call for more effort in high-quality data collection in actionable settings (like general practice clinics) to make progress towards this salient goal of non-invasive MCI detection.

Parkinson's disease (PD) is a neurological disorder impacting a person's speech. Among automatic PD assessment methods, deep learning models have gained particular interest. Recently, the community has explored cross-pathology and cross-language models which can improve diagnostic accuracy even further. However, strict patient data privacy regulations largely prevent institutions from sharing patient speech data with each other. In this paper, we employ federated learning (FL) for PD detection using speech signals from 3 real-world language corpora of German, Spanish, and Czech, each from a separate institution. Our results indicate that the FL model outperforms all the local models in terms of diagnostic accuracy, while not performing very differently from the model based on centrally combined training sets, with the advantage of not requiring any data sharing among collaborators. This will simplify inter-institutional collaborations, resulting in enhancement of patient outcomes.

Self-supervised speech representation learning has become essential for extracting meaningful features from untranscribed audio. Recent advances highlight the potential of deriving discrete symbols from the features correlated with linguistic units, which enables text-less training across diverse tasks. In particular, sentence-level Self-Distillation of the pretrained HuBERT (SD-HuBERT) induces syllabic structures within latent speech frame representations extracted from an intermediate Transformer layer. In SD-HuBERT, sentence-level representation is accumulated from speech frame features through self-attention layers using a special CLS token. However, we observe that the information aggregated in the CLS token correlates more with speaker identity than with linguistic content. To address this, we propose a speech-only self-supervised fine-tuning approach that separates syllabic units from speaker information. Our method introduces speaker perturbation as data augmentation and adopts a frame-level training objective to prevent the CLS token from aggregating paralinguistic information. Experimental results show that our approach surpasses the current state-of-the-art method in most syllable segmentation and syllabic unit quality metrics on Librispeech, underscoring its effectiveness in promoting syllabic organization within speech-only models.

Speech brain-computer interfaces aim to decipher what a person is trying to say from neural activity alone, restoring communication to people with paralysis who have lost the ability to speak intelligibly. The Brain-to-Text Benchmark '24 and associated competition was created to foster the advancement of decoding algorithms that convert neural activity to text. Here, we summarize the lessons learned from the competition ending on June 1, 2024 (the top 4 entrants also presented their experiences in a recorded webinar). The largest improvements in accuracy were achieved using an ensembling approach, where the output of multiple independent decoders was merged using a fine-tuned large language model (an approach used by all 3 top entrants). Performance gains were also found by improving how the baseline recurrent neural network (RNN) model was trained, including by optimizing learning rate scheduling and by using a diphone training objective. Improving upon the model architecture itself proved more difficult, however, with attempts to use deep state space models or transformers not yet appearing to offer a benefit over the RNN baseline. The benchmark will remain open indefinitely to support further work towards increasing the accuracy of brain-to-text algorithms.

This study explores voice cloning to generate synthetic speech replicating the unique patterns of individuals with dysarthria. Using the TORGO dataset, we address data scarcity and privacy challenges in speech-language pathology. Our contributions include demonstrating that voice cloning preserves dysarthric speech characteristics, analyzing differences between real and synthetic data, and discussing implications for diagnostics, rehabilitation, and communication. We cloned voices from dysarthric and control speakers using a commercial platform, ensuring gender-matched synthetic voices. A licensed speech-language pathologist (SLP) evaluated a subset for dysarthria, speaker gender, and synthetic indicators. The SLP correctly identified dysarthria in all cases and speaker gender in 95% but misclassified 30% of synthetic samples as real, indicating high realism. Our results suggest synthetic speech effectively captures disordered characteristics and that voice cloning has advanced to produce high-quality data resembling real speech, even to trained professionals. This has critical implications for healthcare, where synthetic data can mitigate data scarcity, protect privacy, and enhance AI-driven diagnostics. By enabling the creation of diverse, high-quality speech datasets, voice cloning can improve generalizable models, personalize therapy, and advance assistive technologies for dysarthria. We publicly release our synthetic dataset to foster further research and collaboration, aiming to develop robust models that improve patient outcomes in speech-language pathology.

Automatic speech recognition (ASR) in clinical dialogue demands robustness to full-duplex interaction, speaker overlap, and low-latency constraints, yet open benchmarks remain scarce. We present MMedFD, the first real-world Chinese healthcare ASR corpus designed for multi-turn, full-duplex settings. Captured from a deployed AI assistant, the dataset comprises 5,805 annotated sessions with synchronized user and mixed-channel views, RTTM/CTM timing, and role labels. We introduce a model-agnostic pipeline for streaming segmentation, speaker attribution, and dialogue memory, and fine-tune Whisper-small on role-concatenated audio for long-context recognition. ASR evaluation includes WER, CER, and HC-WER, which measures concept-level accuracy across healthcare settings. LLM-generated responses are assessed using rubric-based and pairwise protocols. MMedFD establishes a reproducible framework for benchmarking streaming ASR and end-to-end duplex agents in healthcare deployment. The dataset and related resources are publicly available at https://github.com/Kinetics-JOJO/MMedFD

Memory systems are key components that enable AI systems such as LLMs and AI agents to achieve long-term learning and sustained interaction. However, during memory storage and retrieval, these systems frequently exhibit memory hallucinations, including fabrication, errors, conflicts, and omissions. Existing evaluations of memory hallucinations are primarily end-to-end question answering, which makes it difficult to localize the operational stage within the memory system where hallucinations arise. To address this, we introduce the Hallucination in Memory Benchmark (HaluMem), the first operation level hallucination evaluation benchmark tailored to memory systems. HaluMem defines three evaluation tasks (memory extraction, memory updating, and memory question answering) to comprehensively reveal hallucination behaviors across different operational stages of interaction. To support evaluation, we construct user-centric, multi-turn human-AI interaction datasets, HaluMem-Medium and HaluMem-Long. Both include about 15k memory points and 3.5k multi-type questions. The average dialogue length per user reaches 1.5k and 2.6k turns, with context lengths exceeding 1M tokens, enabling evaluation of hallucinations across different context scales and task complexities. Empirical studies based on HaluMem show that existing memory systems tend to generate and accumulate hallucinations during the extraction and updating stages, which subsequently propagate errors to the question answering stage. Future research should focus on developing interpretable and constrained memory operation mechanisms that systematically suppress hallucinations and improve memory reliability.

Alzheimer's disease (AD) is a progressive and incurable neurodegenerative disease which destroys brain cells and causes loss to patient's memory. An early detection can prevent the patient from further damage of the brain cells and hence avoid permanent memory loss. In past few years, various automatic tools and techniques have been proposed for diagnosis of AD. Several methods focus on fast, accurate and early detection of the disease to minimize the loss to patients mental health. Although machine learning and deep learning techniques have significantly improved medical imaging systems for AD by providing diagnostic performance close to human level. But the main problem faced during multi-class classification is the presence of highly correlated features in the brain structure. In this paper, we have proposed a smart and accurate way of diagnosing AD based on a two-dimensional deep convolutional neural network (2D-DCNN) using imbalanced three-dimensional MRI dataset. Experimental results on Alzheimer Disease Neuroimaging Initiative magnetic resonance imaging (MRI) dataset confirms that the proposed 2D-DCNN model is superior in terms of accuracy, efficiency, and robustness. The model classifies MRI into three categories: AD, mild cognitive impairment, and normal control: and has achieved 99.89% classification accuracy with imbalanced classes. The proposed model exhibits noticeable improvement in accuracy as compared to the state-fo-the-art methods.

The widespread adoption of large language models (LLMs) across diverse AI applications is proof of the outstanding achievements obtained in several tasks, such as text mining, text generation, and question answering. However, LLMs are not exempt from drawbacks. One of the most concerning aspects regards the emerging problematic phenomena known as "Hallucinations". They manifest in text generation systems, particularly in question-answering systems reliant on LLMs, potentially resulting in false or misleading information propagation. This paper delves into the underlying causes of AI hallucination and elucidates its significance in artificial intelligence. In particular, Hallucination classification is tackled over several tasks (Machine Translation, Question and Answer, Dialog Systems, Summarisation Systems, Knowledge Graph with LLMs, and Visual Question Answer). Additionally, we explore potential strategies to mitigate hallucinations, aiming to enhance the overall reliability of LLMs. Our research addresses this critical issue within the HeReFaNMi (Health-Related Fake News Mitigation) project, generously supported by NGI Search, dedicated to combating Health-Related Fake News dissemination on the Internet. This endeavour represents a concerted effort to safeguard the integrity of information dissemination in an age of evolving AI technologies.

Speech disfluencies, such as filled pauses or repetitions, are disruptions in the typical flow of speech. Stuttering is a speech disorder characterized by a high rate of disfluencies, but all individuals speak with some disfluencies and the rates of disfluencies may by increased by factors such as cognitive load. Clinically, automatic disfluency detection may help in treatment planning for individuals who stutter. Outside of the clinic, automatic disfluency detection may serve as a pre-processing step to improve natural language understanding in downstream applications. With this wide range of applications in mind, we investigate language, acoustic, and multimodal methods for frame-level automatic disfluency detection and categorization. Each of these methods relies on audio as an input. First, we evaluate several automatic speech recognition (ASR) systems in terms of their ability to transcribe disfluencies, measured using disfluency error rates. We then use these ASR transcripts as input to a language-based disfluency detection model. We find that disfluency detection performance is largely limited by the quality of transcripts and alignments. We find that an acoustic-based approach that does not require transcription as an intermediate step outperforms the ASR language approach. Finally, we present multimodal architectures which we find improve disfluency detection performance over the unimodal approaches. Ultimately, this work introduces novel approaches for automatic frame-level disfluency and categorization. In the long term, this will help researchers incorporate automatic disfluency detection into a range of applications.

Automatic anonymization techniques are essential for ethical sharing of pathological speech data, yet their perceptual consequences remain understudied. We present a comprehensive human-centered analysis of anonymized pathological speech, using a structured protocol involving ten native and non-native German listeners with diverse linguistic, clinical, and technical backgrounds. Listeners evaluated anonymized-original utterance pairs from 180 speakers spanning Cleft Lip and Palate, Dysarthria, Dysglossia, Dysphonia, and healthy controls. Speech was anonymized using state-of-the-art automatic methods (equal error rates in the range of 30-40%). Listeners completed Turing-style discrimination and quality rating tasks under zero-shot (single-exposure) and few-shot (repeated-exposure) conditions. Discrimination accuracy was high overall (91% zero-shot; 93% few-shot), but varied by disorder (repeated-measures ANOVA: p=0.007), ranging from 96% (Dysarthria) to 86% (Dysphonia). Anonymization consistently reduced perceived quality across groups (from 83% to 59%, p<0.001), with pathology-specific degradation patterns (one-way ANOVA: p=0.005). Native listeners showed a non-significant trend toward higher original speech ratings (Delta=4%, p=0.199), but this difference was minimal after anonymization (Delta=1%, p=0.724). No significant gender-based bias was observed. Perceptual outcomes did not correlate with automatic metrics; intelligibility was linked to perceived quality in original speech but not after anonymization. These findings underscore the need for listener-informed, disorder-specific anonymization strategies that preserve both privacy and perceptual integrity.

We consider the generative modeling of speech over multiple minutes, a requirement for long-form multimedia generation and audio-native voice assistants. However, current spoken language models struggle to generate plausible speech past tens of seconds, from high temporal resolution of speech tokens causing loss of coherence, to architectural issues with long-sequence training or extrapolation, to memory costs at inference time. With these considerations we propose SpeechSSM, the first speech language model to learn from and sample long-form spoken audio (e.g., 16 minutes of read or extemporaneous speech) in a single decoding session without text intermediates, based on recent advances in linear-time sequence modeling. Furthermore, to address growing challenges in spoken language evaluation, especially in this new long-form setting, we propose: new embedding-based and LLM-judged metrics; quality measurements over length and time; and a new benchmark for long-form speech processing and generation, LibriSpeech-Long. Speech samples and the dataset are released at https://google.github.io/tacotron/publications/speechssm/

The global aging population faces considerable challenges, particularly in communication, due to the prevalence of hearing and speech impairments. To address these, we introduce the AVE speech dataset, a comprehensive multi-modal benchmark for speech recognition tasks. The dataset includes a 100-sentence Mandarin Chinese corpus with audio signals, lip-region video recordings, and six-channel electromyography (EMG) data, collected from 100 participants. Each subject read the entire corpus ten times, with each sentence averaging approximately two seconds in duration, resulting in over 55 hours of multi-modal speech data per modality. Experiments demonstrate that combining these modalities significantly improves recognition performance, particularly in cross-subject and high-noise environments. To our knowledge, this is the first publicly available sentence-level dataset integrating these three modalities for large-scale Mandarin speech recognition. We expect this dataset to drive advancements in both acoustic and non-acoustic speech recognition research, enhancing cross-modal learning and human-machine interaction.

Student mental health is a sensitive issue that necessitates special attention. A primary concern is the student-to-counselor ratio, which surpasses the recommended standard of 250:1 in most universities. This imbalance results in extended waiting periods for in-person consultations, which cause suboptimal treatment. Significant efforts have been directed toward developing mental health dialogue systems utilizing the existing open-source mental health-related datasets. However, currently available datasets either discuss general topics or various strategies that may not be viable for direct application due to numerous ethical constraints inherent in this research domain. To address this issue, this paper introduces a specialized mental health dataset that emphasizes the active listening strategy employed in conversation for counseling, also named as ConvCounsel. This dataset comprises both speech and text data, which can facilitate the development of a reliable pipeline for mental health dialogue systems. To demonstrate the utility of the proposed dataset, this paper also presents the NYCUKA, a spoken mental health dialogue system that is designed by using the ConvCounsel dataset. The results show the merit of using this dataset.

Language Models (LMs) are being proposed for mental health applications where the heightened risk of adverse outcomes means predictive performance may not be a sufficient litmus test of a model's utility in clinical practice. A model that can be trusted for practice should have a correspondence between explanation and clinical determination, yet no prior research has examined the attention fidelity of these models and their effect on ground truth explanations. We introduce an evaluation design that focuses on the robustness and explainability of LMs in identifying Wellness Dimensions (WDs). We focus on two existing mental health and well-being datasets: (a) Multi-label Classification-based MultiWD, and (b) WellXplain for evaluating attention mechanism veracity against expert-labeled explanations. The labels are based on Halbert Dunn's theory of wellness, which gives grounding to our evaluation. We reveal four surprising results about LMs/LLMs: (1) Despite their human-like capabilities, GPT-3.5/4 lag behind RoBERTa, and MedAlpaca, a fine-tuned LLM on WellXplain fails to deliver any remarkable improvements in performance or explanations. (2) Re-examining LMs' predictions based on a confidence-oriented loss function reveals a significant performance drop. (3) Across all LMs/LLMs, the alignment between attention and explanations remains low, with LLMs scoring a dismal 0.0. (4) Most mental health-specific LMs/LLMs overlook domain-specific knowledge and undervalue explanations, causing these discrepancies. This study highlights the need for further research into their consistency and explanations in mental health and well-being.

Background: Rapid advancements in natural language processing have led to the development of large language models with the potential to revolutionize mental health care. These models have shown promise in assisting clinicians and providing support to individuals experiencing various psychological challenges. Objective: This study aims to compare the performance of two large language models, GPT-4 and Chat-GPT, in responding to a set of 18 psychological prompts, to assess their potential applicability in mental health care settings. Methods: A blind methodology was employed, with a clinical psychologist evaluating the models' responses without knowledge of their origins. The prompts encompassed a diverse range of mental health topics, including depression, anxiety, and trauma, to ensure a comprehensive assessment. Results: The results demonstrated a significant difference in performance between the two models (p > 0.05). GPT-4 achieved an average rating of 8.29 out of 10, while Chat-GPT received an average rating of 6.52. The clinical psychologist's evaluation suggested that GPT-4 was more effective at generating clinically relevant and empathetic responses, thereby providing better support and guidance to potential users. Conclusions: This study contributes to the growing body of literature on the applicability of large language models in mental health care settings. The findings underscore the importance of continued research and development in the field to optimize these models for clinical use. Further investigation is necessary to understand the specific factors underlying the performance differences between the two models and to explore their generalizability across various populations and mental health conditions.

Summaries generated from medical conversations can improve recall and understanding of care plans for patients and reduce documentation burden for doctors. Recent advancements in automatic speech recognition (ASR) and natural language understanding (NLU) offer potential solutions to generate these summaries automatically, but rigorous quantitative baselines for benchmarking research in this domain are lacking. In this paper, we bridge this gap for two tasks: classifying utterances from medical conversations according to (i) the SOAP section and (ii) the speaker role. Both are fundamental building blocks along the path towards an end-to-end, automated SOAP note for medical conversations. We provide details on a dataset that contains human and ASR transcriptions of medical conversations and corresponding machine learning optimized SOAP notes. We then present a systematic analysis in which we adapt an existing deep learning architecture to the two aforementioned tasks. The results suggest that modelling context in a hierarchical manner, which captures both word and utterance level context, yields substantial improvements on both classification tasks. Additionally, we develop and analyze a modular method for adapting our model to ASR output.

Psychological defenses are strategies, often automatic, that people use to manage distress. Rigid or overuse of defenses is negatively linked to mental health and shapes what speakers disclose and how they accept or resist help. However, defenses are complex and difficult to reliably measure, particularly in clinical dialogues. We introduce PsyDefConv, a dialogue corpus with help seeker utterances labeled for defense level, and DMRS Co-Pilot, a four-stage pipeline that provides evidence-based pre-annotations. The corpus contains 200 dialogues and 4709 utterances, including 2336 help seeker turns, with labeling and Cohen's kappa 0.639. In a counterbalanced study, the co-pilot reduced average annotation time by 22.4%. In expert review, it averaged 4.62 for evidence, 4.44 for clinical plausibility, and 4.40 for insight on a seven-point scale. Benchmarks with strong language models in zero-shot and fine-tuning settings demonstrate clear headroom, with the best macro F1-score around 30% and a tendency to overpredict mature defenses. Corpus analyses confirm that mature defenses are most common and reveal emotion-specific deviations. We will release the corpus, annotations, code, and prompts to support research on defensive functioning in language.

Global rates of mental health concerns are rising and there is increasing realization that existing models of mental healthcare will not adequately expand to meet the demand. With the emergence of large language models (LLMs) has come great optimism regarding their promise to create novel, large-scale solutions to support mental health. Despite their nascence, LLMs have already been applied to mental health-related tasks. In this review, we summarize the extant literature on efforts to use LLMs to provide mental health education, assessment, and intervention and highlight key opportunities for positive impact in each area. We then highlight risks associated with LLMs application to mental health and encourage adoption of strategies to mitigate these risks. The urgent need for mental health support must be balanced with responsible development, testing, and deployment of mental health LLMs. Especially critical is ensuring that mental health LLMs are fine-tuned for mental health, enhance mental health equity, adhere to ethical standards, and that people, including those with lived experience with mental health concerns, are involved in all stages from development through deployment. Prioritizing these efforts will minimize potential harms to mental health and maximize the likelihood that LLMs will positively impact mental health globally.

The Norwegian Parliamentary Speech Corpus (NPSC) is a speech dataset with recordings of meetings from Stortinget, the Norwegian parliament. It is the first, publicly available dataset containing unscripted, Norwegian speech designed for training of automatic speech recognition (ASR) systems. The recordings are manually transcribed and annotated with language codes and speakers, and there are detailed metadata about the speakers. The transcriptions exist in both normalized and non-normalized form, and non-standardized words are explicitly marked and annotated with standardized equivalents. To test the usefulness of this dataset, we have compared an ASR system trained on the NPSC with a baseline system trained on only manuscript-read speech. These systems were tested on an independent dataset containing spontaneous, dialectal speech. The NPSC-trained system performed significantly better, with a 22.9% relative improvement in word error rate (WER). Moreover, training on the NPSC is shown to have a "democratizing" effect in terms of dialects, as improvements are generally larger for dialects with higher WER from the baseline system.

Hallucinations in large language models (LLMs) during summarization of patient-clinician dialogues pose significant risks to patient care and clinical decision-making. However, the phenomenon remains understudied in the clinical domain, with uncertainty surrounding the applicability of general-domain hallucination detectors. The rarity and randomness of hallucinations further complicate their investigation. In this paper, we conduct an evaluation of hallucination detection methods in the medical domain, and construct two datasets for the purpose: A fact-controlled Leave-N-out dataset -- generated by systematically removing facts from source dialogues to induce hallucinated content in summaries; and a natural hallucination dataset -- arising organically during LLM-based medical summarization. We show that general-domain detectors struggle to detect clinical hallucinations, and that performance on fact-controlled hallucinations does not reliably predict effectiveness on natural hallucinations. We then develop fact-based approaches that count hallucinations, offering explainability not available with existing methods. Notably, our LLM-based detectors, which we developed using fact-controlled hallucinations, generalize well to detecting real-world clinical hallucinations. This research contributes a suite of specialized metrics supported by expert-annotated datasets to advance faithful clinical summarization systems.

Medical consultations are intrinsically speech-centric. However, most prior works focus on long-text-based interactions, which are cumbersome and patient-unfriendly. Recent advances in speech language models (SpeechLMs) have enabled more natural speech-based interaction, yet the scarcity of medical speech data and the inefficiency of directly fine-tuning on speech data jointly hinder the adoption of SpeechLMs in medical consultation. In this paper, we propose SpeechMedAssist, a SpeechLM natively capable of conducting speech-based multi-turn interactions with patients. By exploiting the architectural properties of SpeechLMs, we decouple the conventional one-stage training into a two-stage paradigm consisting of (1) Knowledge & Capability Injection via Text and (2) Modality Re-alignment with Limited Speech Data, thereby reducing the requirement for medical speech data to only 10k synthesized samples. To evaluate SpeechLMs for medical consultation scenarios, we design a benchmark comprising both single-turn question answering and multi-turn simulated interactions. Experimental results show that our model outperforms all baselines in both effectiveness and robustness in most evaluation settings.

The recent advancements in artificial intelligence highlight the potential of language models in psychological health support. While models trained on data from mental health service platform have achieved preliminary success, challenges persist in areas such as data scarcity, quality, and ensuring a solid foundation in psychological techniques. To address these challenges, this study introduces a novel approach to enhance the precision and efficacy of psychological support through large language models. Specifically, we design a specific prompt derived from principles of Cognitive Behavioral Therapy (CBT) and have generated the CBT QA dataset, specifically for Chinese psychological health Q&A based on CBT structured intervention strategies. Unlike previous methods, our dataset emphasizes professional and structured response. Utilizing this dataset, we fine-tuned the large language model, giving birth to CBT-LLM, the large-scale language model specifically designed for Cognitive Behavioral Therapy techniques. Empirical evaluations demonstrate that CBT-LLM excels in generating structured, professional, and highly relevant responses in psychological health support tasks, showcasing its practicality and quality. The model is available on Hugging Face: https://huggingface.co/Hongbin37/CBT-LLM.

The emergence of large language models (LLMs) has marked a significant breakthrough in natural language processing (NLP), leading to remarkable advancements in text understanding and generation. Nevertheless, alongside these strides, LLMs exhibit a critical tendency to produce hallucinations, resulting in content that is inconsistent with real-world facts or user inputs. This phenomenon poses substantial challenges to their practical deployment and raises concerns over the reliability of LLMs in real-world scenarios, which attracts increasing attention to detect and mitigate these hallucinations. In this survey, we aim to provide a thorough and in-depth overview of recent advances in the field of LLM hallucinations. We begin with an innovative taxonomy of LLM hallucinations, then delve into the factors contributing to hallucinations. Subsequently, we present a comprehensive overview of hallucination detection methods and benchmarks. Additionally, representative approaches designed to mitigate hallucinations are introduced accordingly. Finally, we analyze the challenges that highlight the current limitations and formulate open questions, aiming to delineate pathways for future research on hallucinations in LLMs.

Text-to-Speech (TTS) systems face ongoing challenges in processing complex linguistic features, handling polyphonic expressions, and producing natural-sounding multilingual speech - capabilities that are crucial for future AI applications. In this paper, we present Fish-Speech, a novel framework that implements a serial fast-slow Dual Autoregressive (Dual-AR) architecture to enhance the stability of Grouped Finite Scalar Vector Quantization (GFSQ) in sequence generation tasks. This architecture improves codebook processing efficiency while maintaining high-fidelity outputs, making it particularly effective for AI interactions and voice cloning. Fish-Speech leverages Large Language Models (LLMs) for linguistic feature extraction, eliminating the need for traditional grapheme-to-phoneme (G2P) conversion and thereby streamlining the synthesis pipeline and enhancing multilingual support. Additionally, we developed FF-GAN through GFSQ to achieve superior compression ratios and near 100\% codebook utilization. Our approach addresses key limitations of current TTS systems while providing a foundation for more sophisticated, context-aware speech synthesis. Experimental results show that Fish-Speech significantly outperforms baseline models in handling complex linguistic scenarios and voice cloning tasks, demonstrating its potential to advance TTS technology in AI applications. The implementation is open source at https://github.com/fishaudio/fish-speech{https://github.com/fishaudio/fish-speech}.

The People's Speech is a free-to-download 30,000-hour and growing supervised conversational English speech recognition dataset licensed for academic and commercial usage under CC-BY-SA (with a CC-BY subset). The data is collected via searching the Internet for appropriately licensed audio data with existing transcriptions. We describe our data collection methodology and release our data collection system under the Apache 2.0 license. We show that a model trained on this dataset achieves a 9.98% word error rate on Librispeech's test-clean test set.Finally, we discuss the legal and ethical issues surrounding the creation of a sizable machine learning corpora and plans for continued maintenance of the project under MLCommons's sponsorship.

We introduce LibriConvo, a simulated multi-speaker conversational dataset based on speaker-aware conversation simulation (SASC), designed to support training and evaluation of speaker diarization and automatic speech recognition (ASR) systems. Unlike prior resources that mostly rely on semantically disconnected utterances and implausible temporal gaps, LibriConvo ensures semantic coherence and realistic conversational timing. Our pipeline leverages CallHome with external VAD for reliable boundaries, applies compression to reduce unnaturally long silences, and organizes LibriTTS utterances by book to maintain contextual consistency. Acoustic realism is enhanced via a novel room impulse response selection procedure that ranks speaker-microphone configurations by spatial plausibility, balancing realism and diversity. The dataset comprises 240.1 hours across 1,496 dialogues with 830 unique speakers, split in a speaker-disjoint manner for robust evaluation. Baselines show that the sortformer model outperforms the pyannote pipeline in diarization, while a fine-tuned Fast Conformer-CTC XLarge with Serialized Output Training achieves 7.29\% WER for ASR, surpassing zero-shot Whisper-large-v3. LibriConvo provides a valuable resource for advancing multi-speaker speech processing research with realistic conversational dynamics and controlled experimental conditions.

End-to-end speech large language models ((LLMs)) extend the capabilities of text-based models to directly process and generate audio tokens. However, this often leads to a decline in reasoning and generation performance compared to text input, a phenomenon referred to as intelligence degradation. To systematically evaluate this gap, we propose S2SBench, a benchmark designed to quantify performance degradation in Speech LLMs. It includes diagnostic datasets targeting sentence continuation and commonsense reasoning under audio input. We further introduce a pairwise evaluation protocol based on perplexity differences between plausible and implausible samples to measure degradation relative to text input. We apply S2SBench to analyze the training process of Baichuan-Audio, which further demonstrates the benchmark's effectiveness. All datasets and evaluation code are available at https://github.com/undobug/S2SBench.

Natural language processing (NLP) is becoming an important means for automatic recognition of human traits and states, such as intoxication, presence of psychiatric disorders, presence of airway disorders and states of stress. Such applications have the potential to be an important pillar for online help lines, and may gradually be introduced into eHealth modules. However, NLP is language specific and for languages such as Dutch, NLP models are scarce. As a result, recent Dutch NLP models have a low capture of long range semantic dependencies over sentences. To overcome this, here we present belabBERT, a new Dutch language model extending the RoBERTa architecture. belabBERT is trained on a large Dutch corpus (+32 GB) of web crawled texts. We applied belabBERT to the classification of psychiatric illnesses. First, we evaluated the strength of text-based classification using belabBERT, and compared the results to the existing RobBERT model. Then, we compared the performance of belabBERT to audio classification for psychiatric disorders. Finally, a brief exploration was performed, extending the framework to a hybrid text- and audio-based classification. Our results show that belabBERT outperformed the current best text classification network for Dutch, RobBERT. belabBERT also outperformed classification based on audio alone.

Evaluating the abilities of large language models (LLMs) for tasks that require long-term memory and thus long-context reasoning, for example in conversational settings, is hampered by the existing benchmarks, which often lack narrative coherence, cover narrow domains, and only test simple recall-oriented tasks. This paper introduces a comprehensive solution to these challenges. First, we present a novel framework for automatically generating long (up to 10M tokens), coherent, and topically diverse conversations, accompanied by probing questions targeting a wide range of memory abilities. From this, we construct BEAM, a new benchmark comprising 100 conversations and 2,000 validated questions. Second, to enhance model performance, we propose LIGHT-a framework inspired by human cognition that equips LLMs with three complementary memory systems: a long-term episodic memory, a short-term working memory, and a scratchpad for accumulating salient facts. Our experiments on BEAM reveal that even LLMs with 1M token context windows (with and without retrieval-augmentation) struggle as dialogues lengthen. In contrast, LIGHT consistently improves performance across various models, achieving an average improvement of 3.5%-12.69% over the strongest baselines, depending on the backbone LLM. An ablation study further confirms the contribution of each memory component.

Laughing, sighing, stuttering, and other forms of paralanguage do not contribute any direct lexical meaning to speech, but they provide crucial propositional context that aids semantic and pragmatic processes such as irony. It is thus important for artificial social agents to both understand and be able to generate speech with semantically-important paralanguage. Most speech datasets do not include transcribed non-lexical speech sounds and disfluencies, while those that do are typically multi-speaker datasets where each speaker provides relatively little audio. This makes it challenging to train conversational Text-to-Speech (TTS) synthesis models that include such paralinguistic components. We thus present DisfluencySpeech, a studio-quality labeled English speech dataset with paralanguage. A single speaker recreates nearly 10 hours of expressive utterances from the Switchboard-1 Telephone Speech Corpus (Switchboard), simulating realistic informal conversations. To aid the development of a TTS model that is able to predictively synthesise paralanguage from text without such components, we provide three different transcripts at different levels of information removal (removal of non-speech events, removal of non-sentence elements, and removal of false starts), as well as benchmark TTS models trained on each of these levels.

Recent large language models (LLMs) offer the potential to support public health monitoring by facilitating health disclosure through open-ended conversations but rarely preserve the knowledge gained about individuals across repeated interactions. Augmenting LLMs with long-term memory (LTM) presents an opportunity to improve engagement and self-disclosure, but we lack an understanding of how LTM impacts people's interaction with LLM-driven chatbots in public health interventions. We examine the case of CareCall -- an LLM-driven voice chatbot with LTM -- through the analysis of 1,252 call logs and interviews with nine users. We found that LTM enhanced health disclosure and fostered positive perceptions of the chatbot by offering familiarity. However, we also observed challenges in promoting self-disclosure through LTM, particularly around addressing chronic health conditions and privacy concerns. We discuss considerations for LTM integration in LLM-driven chatbots for public health monitoring, including carefully deciding what topics need to be remembered in light of public health goals.

Objectives: While Large Language Models (LLMs) have been widely used to assist clinicians and support patients, no existing work has explored dialogue systems for standard diagnostic interviews and assessments. This study aims to bridge the gap in mental healthcare accessibility by developing an LLM-powered dialogue system that replicates clinician behavior. Materials and Methods: We introduce TRUST, a framework of cooperative LLM modules capable of conducting formal diagnostic interviews and assessments for Post-Traumatic Stress Disorder (PTSD). To guide the generation of appropriate clinical responses, we propose a Dialogue Acts schema specifically designed for clinical interviews. Additionally, we develop a patient simulation approach based on real-life interview transcripts to replace time-consuming and costly manual testing by clinicians. Results: A comprehensive set of evaluation metrics is designed to assess the dialogue system from both the agent and patient simulation perspectives. Expert evaluations by conversation and clinical specialists show that TRUST performs comparably to real-life clinical interviews. Discussion: Our system performs at the level of average clinicians, with room for future enhancements in communication styles and response appropriateness. Conclusions: Our TRUST framework shows its potential to facilitate mental healthcare availability.

Speech conveys information through both words and vocal delivery. We evaluate four leading production realtime voice systems-OpenAI's GPT Realtime 2, Google's Gemini 3.1 Flash Live, and Alibaba's Qwen3.5 Omni Plus and Omni Flash-on tasks where the words and the delivery patterns both convey meaningful information. Across three consequential scenarios, all four systems act on the words rather than the voice. They end calls with crying callers who insist nothing is wrong, approve wire transfers authorized in frightened voices, and enroll callers whose agreement is clearly sarcastic. Surprisingly, this is often not a failure of perception. When asked directly, three of the four systems reliably identify the distress, fear, or sarcasm they later ignore when making decisions. We observe a similar pattern when these realtime voice systems estimate accent and age, as their responses frequently follow the biases of the words rather than the acoustic properties of the speaker. We term this disconnect between perception and action the emotional intelligence gap of voice AI. Prompting systems to explicitly attend to vocal delivery improves performance only partially and inconsistently. Our findings show that current realtime voice AI systems often behave as if speech had been reduced to a transcript, suggesting that they should be used with caution in settings where the tone and emotion of delivery convey important information.

Large Language Models (LLMs) are one of the most promising technologies for the next era of speech generation systems, due to their scalability and in-context learning capabilities. Nevertheless, they suffer from multiple stability issues at inference time, such as hallucinations, content skipping or speech repetitions. In this work, we introduce a new self-supervised Voice Conversion (VC) architecture which can be used to learn to encode transitory features, such as content, separately from stationary ones, such as speaker ID or recording conditions, creating speaker-disentangled representations. Using speaker-disentangled codes to train LLMs for text-to-speech (TTS) allows the LLM to generate the content and the style of the speech only from the text, similarly to humans, while the speaker identity is provided by the decoder of the VC model. Results show that LLMs trained over speaker-disentangled self-supervised representations provide an improvement of 4.7pp in speaker similarity over SOTA entangled representations, and a word error rate (WER) 5.4pp lower. Furthermore, they achieve higher naturalness than human recordings of the LibriTTS test-other dataset. Finally, we show that using explicit reference embedding negatively impacts intelligibility (stability), with WER increasing by 14pp compared to the model that only uses text to infer the style.

Automatic disease diagnosis has become increasingly valuable in clinical practice. The advent of large language models (LLMs) has catalyzed a paradigm shift in artificial intelligence, with growing evidence supporting the efficacy of LLMs in diagnostic tasks. Despite the increasing attention in this field, a holistic view is still lacking. Many critical aspects remain unclear, such as the diseases and clinical data to which LLMs have been applied, the LLM techniques employed, and the evaluation methods used. In this article, we perform a comprehensive review of LLM-based methods for disease diagnosis. Our review examines the existing literature across various dimensions, including disease types and associated clinical specialties, clinical data, LLM techniques, and evaluation methods. Additionally, we offer recommendations for applying and evaluating LLMs for diagnostic tasks. Furthermore, we assess the limitations of current research and discuss future directions. To our knowledge, this is the first comprehensive review for LLM-based disease diagnosis.

While voice user interfaces offer increased accessibility due to hands-free and eyes-free interactions, older adults often have challenges such as constructing structured requests and perceiving how such devices operate. Voice-first user interfaces have the potential to address these challenges by enabling multimodal interactions. Standalone voice + touchscreen Voice Assistants (VAs), such as Echo Show, are specific types of devices that adopt such interfaces and are gaining popularity. However, the affordances of the additional touchscreen for older adults are unknown. Through a 40-day real-world deployment with older adults living independently, we present a within-subjects study (N = 16; age M = 82.5, SD = 7.77, min. = 70, max. = 97) to understand how a built-in touchscreen might benefit older adults during device setup, conducting self-report diary survey, and general uses. We found that while participants appreciated the visual outputs, they still preferred to respond via speech instead of touch. We identified six design implications that can inform future innovations of senior-friendly VAs for managing healthcare and improving quality of life.

Large language models (LLMs) are capable of processing lengthy dialogue histories during prolonged interaction with users without additional memory modules; however, their responses tend to overlook or incorrectly recall information from the past. In this paper, we revisit memory-augmented response generation in the era of LLMs. While prior work focuses on getting rid of outdated memories, we argue that such memories can provide contextual cues that help dialogue systems understand the development of past events and, therefore, benefit response generation. We present Theanine, a framework that augments LLMs' response generation with memory timelines -- series of memories that demonstrate the development and causality of relevant past events. Along with Theanine, we introduce TeaFarm, a counterfactual-driven question-answering pipeline addressing the limitation of G-Eval in long-term conversations. Supplementary videos of our methods and the TeaBag dataset for TeaFarm evaluation are in https://theanine-693b0.web.app/.

LibriBrain represents the largest single-subject MEG dataset to date for speech decoding, with over 50 hours of recordings -- 5times larger than the next comparable dataset and 50times larger than most. This unprecedented `depth' of within-subject data enables exploration of neural representations at a scale previously unavailable with non-invasive methods. LibriBrain comprises high-quality MEG recordings together with detailed annotations from a single participant listening to naturalistic spoken English, covering nearly the full Sherlock Holmes canon. Designed to support advances in neural decoding, LibriBrain comes with a Python library for streamlined integration with deep learning frameworks, standard data splits for reproducibility, and baseline results for three foundational decoding tasks: speech detection, phoneme classification, and word classification. Baseline experiments demonstrate that increasing training data yields substantial improvements in decoding performance, highlighting the value of scaling up deep, within-subject datasets. By releasing this dataset, we aim to empower the research community to advance speech decoding methodologies and accelerate the development of safe, effective clinical brain-computer interfaces.

As Large Language Models (LLMs) continue to advance in their ability to write human-like text, a key challenge remains around their tendency to hallucinate generating content that appears factual but is ungrounded. This issue of hallucination is arguably the biggest hindrance to safely deploying these powerful LLMs into real-world production systems that impact people's lives. The journey toward widespread adoption of LLMs in practical settings heavily relies on addressing and mitigating hallucinations. Unlike traditional AI systems focused on limited tasks, LLMs have been exposed to vast amounts of online text data during training. While this allows them to display impressive language fluency, it also means they are capable of extrapolating information from the biases in training data, misinterpreting ambiguous prompts, or modifying the information to align superficially with the input. This becomes hugely alarming when we rely on language generation capabilities for sensitive applications, such as summarizing medical records, financial analysis reports, etc. This paper presents a comprehensive survey of over 32 techniques developed to mitigate hallucination in LLMs. Notable among these are Retrieval Augmented Generation (Lewis et al, 2021), Knowledge Retrieval (Varshney et al,2023), CoNLI (Lei et al, 2023), and CoVe (Dhuliawala et al, 2023). Furthermore, we introduce a detailed taxonomy categorizing these methods based on various parameters, such as dataset utilization, common tasks, feedback mechanisms, and retriever types. This classification helps distinguish the diverse approaches specifically designed to tackle hallucination issues in LLMs. Additionally, we analyze the challenges and limitations inherent in these techniques, providing a solid foundation for future research in addressing hallucinations and related phenomena within the realm of LLMs.

A major risk of using language models in practical applications is their tendency to hallucinate incorrect statements. Hallucinations are often attributed to knowledge gaps in LMs, but we hypothesize that in some cases, when justifying previously generated hallucinations, LMs output false claims that they can separately recognize as incorrect. We construct three question-answering datasets where ChatGPT and GPT-4 often state an incorrect answer and offer an explanation with at least one incorrect claim. Crucially, we find that ChatGPT and GPT-4 can identify 67% and 87% of their own mistakes, respectively. We refer to this phenomenon as hallucination snowballing: an LM over-commits to early mistakes, leading to more mistakes that it otherwise would not make.

Introduction: Electronic health records (EHR) are a critical medium through which patient stigmatization is perpetuated among healthcare teams. Methods: We identified linguistic features of doubt markers and stigmatizing labels in MIMIC-III EHR via expanded lexicon matching and supervised learning classifiers. Predictors of rates of linguistic features were assessed using Poisson regression models. Results: We found higher rates of stigmatizing labels per chart among patients who were Black or African American (RR: 1.16), patients with Medicare/Medicaid or government-run insurance (RR: 2.46), self-pay (RR: 2.12), and patients with a variety of stigmatizing disease and mental health conditions. Patterns among doubt markers were similar, though male patients had higher rates of doubt markers (RR: 1.25). We found increased stigmatizing labels used by nurses (RR: 1.40), and social workers (RR: 2.25), with similar patterns of doubt markers. Discussion: Stigmatizing language occurred at higher rates among historically stigmatized patients, perpetuated by multiple provider types.

According to the U.S. National Institutes of Health, more than 3.4 million children experience speech disorders that require clinical intervention. The number of speech-language pathologists (SLPs) is roughly 20 times fewer than the number of affected children, highlighting a significant gap in children's care and a pressing need for technological support that improves the productivity of SLPs. State-of-the-art multimodal language models (MLMs) show promise for supporting SLPs, but their use remains underexplored largely due to a limited understanding of their performance in high-stakes clinical settings. To address this gap, we collaborate with domain experts to develop a taxonomy of real-world use cases of MLMs in speech-language pathologies. Building on this taxonomy, we introduce the first comprehensive benchmark for evaluating MLM across five core use cases, each containing 1,000 manually annotated data points. This benchmark includes robustness and sensitivity tests under various settings, including background noise, speaker gender, and accent. Our evaluation of 15 state-of-the-art MLMs reveals that no single model consistently outperforms others across all tasks. Notably, we find systematic disparities, with models performing better on male speakers, and observe that chain-of-thought prompting can degrade performance on classification tasks with large label spaces and narrow decision boundaries. Furthermore, we study fine-tuning MLMs on domain-specific data, achieving improvements of over 10\% compared to base models. These findings highlight both the potential and limitations of current MLMs for speech-language pathology applications, underscoring the need for further research and targeted development.

This paper examines memory mechanisms in Large Language Models (LLMs), emphasizing their importance for context-rich responses, reduced hallucinations, and improved efficiency. It categorizes memory into sensory, short-term, and long-term, with sensory memory corresponding to input prompts, short-term memory processing immediate context, and long-term memory implemented via external databases or structures. The text-based memory section covers acquisition (selection and summarization), management (updating, accessing, storing, and resolving conflicts), and utilization (full-text search, SQL queries, semantic search). The KV cache-based memory section discusses selection methods (regularity-based summarization, score-based approaches, special token embeddings) and compression techniques (low-rank compression, KV merging, multimodal compression), along with management strategies like offloading and shared attention mechanisms. Parameter-based memory methods (LoRA, TTT, MoE) transform memories into model parameters to enhance efficiency, while hidden-state-based memory approaches (chunk mechanisms, recurrent transformers, Mamba model) improve long-text processing by combining RNN hidden states with current methods. Overall, the paper offers a comprehensive analysis of LLM memory mechanisms, highlighting their significance and future research directions.

Despite decades of research on reverberant speech, comparing methods remains difficult because most corpora lack per-file acoustic annotations or provide limited documentation for reproduction. We present RIR-Mega-Speech, a corpus of approximately 117.5 hours created by convolving LibriSpeech utterances with roughly 5,000 simulated room impulse responses from the RIR-Mega collection. Every file includes RT60, direct-to-reverberant ratio (DRR), and clarity index (C_{50}) computed from the source RIR using clearly defined, reproducible procedures. We also provide scripts to rebuild the dataset and reproduce all evaluation results. Using Whisper small on 1,500 paired utterances, we measure 5.20% WER (95% CI: 4.69--5.78) on clean speech and 7.70% (7.04--8.35) on reverberant versions, corresponding to a paired increase of 2.50 percentage points (2.06--2.98). This represents a 48% relative degradation. WER increases monotonically with RT60 and decreases with DRR, consistent with prior perceptual studies. While the core finding that reverberation harms recognition is well established, we aim to provide the community with a standardized resource where acoustic conditions are transparent and results can be verified independently. The repository includes one-command rebuild instructions for both Windows and Linux environments.

Although Large Language Models (LLMs) have shown promise for human-like conversations, they are primarily pre-trained on text data. Incorporating audio or video improves performance, but collecting large-scale multimodal data and pre-training multimodal LLMs is challenging. To this end, we propose a Fusion Low Rank Adaptation (FLoRA) technique that efficiently adapts a pre-trained unimodal LLM to consume new, previously unseen modalities via low rank adaptation. For device-directed speech detection, using FLoRA, the multimodal LLM achieves 22% relative reduction in equal error rate (EER) over the text-only approach and attains performance parity with its full fine-tuning (FFT) counterpart while needing to tune only a fraction of its parameters. Furthermore, with the newly introduced adapter dropout, FLoRA is robust to missing data, improving over FFT by 20% lower EER and 56% lower false accept rate. The proposed approach scales well for model sizes from 16M to 3B parameters.

The rapid advancement of large language models (LLMs) has significantly impacted various domains, including healthcare and biomedicine. However, the phenomenon of hallucination, where LLMs generate outputs that deviate from factual accuracy or context, poses a critical challenge, especially in high-stakes domains. This paper conducts a scoping study of existing techniques for mitigating hallucinations in knowledge-based task in general and especially for medical domains. Key methods covered in the paper include Retrieval-Augmented Generation (RAG)-based techniques, iterative feedback loops, supervised fine-tuning, and prompt engineering. These techniques, while promising in general contexts, require further adaptation and optimization for the medical domain due to its unique demands for up-to-date, specialized knowledge and strict adherence to medical guidelines. Addressing these challenges is crucial for developing trustworthy AI systems that enhance clinical decision-making and patient safety as well as accuracy of biomedical scientific research.

Human spoken communication involves not only lexical content but also non-verbal vocalizations (NVs) such as laughter, sighs, and coughs, which convey emotions, intentions, and social signals. However, most existing speech systems focus solely on verbal content and lack the ability to understand and generate such non-verbal cues, reducing the emotional intelligence and communicative richness of spoken interfaces. In this work, we introduce NonVerbalSpeech-38K, a large and diverse dataset for non-verbal speech generation and understanding, collected from real-world media and annotated using an automatic pipeline. The dataset contains 38,718 samples (about 131 hours) with 10 categories of non-verbal cues, such as laughter, sniff, and throat clearing. We further validate the dataset by fine-tuning state-of-the-art models, including F5-TTS and Qwen2-Audio, demonstrating its effectiveness in non-verbal speech generation and understanding tasks. Our contributions are threefold: (1) We propose a practical pipeline for building natural and diverse non-verbal speech datasets; (2) We release a large-scale dataset to advance research on non-verbal speech generation and understanding; (3) We validate the dataset's effectiveness by demonstrating improvements in both non-verbal speech synthesis and captioning, thereby facilitating richer human-computer interaction.

Disentangling uncorrelated information in speech utterances is a crucial research topic within speech community. Different speech-related tasks focus on extracting distinct speech representations while minimizing the affects of other uncorrelated information. We present a large-scale speech corpus to facilitate the research of speech representation disentanglement. 3D-Speaker contains over 10,000 speakers, each of whom are simultaneously recorded by multiple Devices, locating at different Distances, and some speakers are speaking multiple Dialects. The controlled combinations of multi-dimensional audio data yield a matrix of a diverse blend of speech representation entanglement, thereby motivating intriguing methods to untangle them. The multi-domain nature of 3D-Speaker also makes it a suitable resource to evaluate large universal speech models and experiment methods of out-of-domain learning and self-supervised learning. https://3dspeaker.github.io/

Health experts assert that hope plays a crucial role in enhancing individuals' physical and mental well-being, facilitating their recovery, and promoting restoration. Hope speech refers to comments, posts and other social media messages that offer support, reassurance, suggestions, inspiration, and insight. The detection of hope speech involves the analysis of such textual content, with the aim of identifying messages that invoke positive emotions in people. Our study aims to find computationally efficient yet comparable/superior methods for hope speech detection. We also make our codebase public at https://github.com/aflah02/Hope_Speech_Detection

This paper explains our work in developing new acoustic models for automated speech recognition (ASR) at KBLab, the infrastructure for data-driven research at the National Library of Sweden (KB). We evaluate different approaches for a viable speech-to-text pipeline for audiovisual resources in Swedish, using the wav2vec 2.0 architecture in combination with speech corpuses created from KB's collections. These approaches include pretraining an acoustic model for Swedish from the ground up, and fine-tuning existing monolingual and multilingual models. The collections-based corpuses we use have been sampled from millions of hours of speech, with a conscious attempt to balance regional dialects to produce a more representative, and thus more democratic, model. The acoustic model this enabled, "VoxRex", outperforms existing models for Swedish ASR. We also evaluate combining this model with various pretrained language models, which further enhanced performance. We conclude by highlighting the potential of such technology for cultural heritage institutions with vast collections of previously unlabelled audiovisual data. Our models are released for further exploration and research here: https://huggingface.co/KBLab.

Large Language Models with transformer architecture have revolutionized the domain of text generation, setting unprecedented benchmarks. Despite their impressive capabilities, LLMs have been criticized for generating outcomes that deviate from factual accuracy or display logical inconsistencies, phenomena commonly referred to as hallucinations. This term, however, has often been misapplied to any results deviating from the instructor's expectations, which this paper defines as attention misdirection rather than true hallucinations. Understanding the distinction between hallucinations and attention misdirection becomes increasingly relevant in business contexts, where the ramifications of such errors can significantly impact the value extraction from these inherently pre-trained models. This paper highlights the best practices of the PGI, Persona, Grouping, and Intelligence, method, a strategic framework that achieved a remarkable error rate of only 3,15 percent across 4,000 responses generated by GPT in response to a real business challenge. It emphasizes that by equipping experimentation with knowledge, businesses can unlock opportunities for innovation through the use of these natively pre-trained models. This reinforces the notion that strategic application grounded in a skilled team can maximize the benefits of emergent technologies such as the LLMs.

Multi-modal large language models have garnered significant interest recently. Though, most of the works focus on vision-language multi-modal models providing strong capabilities in following vision-and-language instructions. However, we claim that speech is also an important modality through which humans interact with the world. Hence, it is crucial for a general-purpose assistant to be able to follow multi-modal speech-and-language instructions. In this work, we propose Large Language and Speech Model (LLaSM). LLaSM is an end-to-end trained large multi-modal speech-language model with cross-modal conversational abilities, capable of following speech-and-language instructions. Our early experiments show that LLaSM demonstrates a more convenient and natural way for humans to interact with artificial intelligence. Specifically, we also release a large Speech Instruction Following dataset LLaSM-Audio-Instructions. Code and demo are available at https://github.com/LinkSoul-AI/LLaSM and https://huggingface.co/spaces/LinkSoul/LLaSM. The LLaSM-Audio-Instructions dataset is available at https://huggingface.co/datasets/LinkSoul/LLaSM-Audio-Instructions.

We study device-addressed speech detection under pre-ASR edge deployment constraints, where systems must decide whether to forward audio before transcription under strict latency and compute limits. We show that, in multi-speaker environments with temporally ambiguous utterances, this task is more effectively modelled as a sequential routing problem over interaction history than as an utterance-local classification task. We formalize this as Sequential Device-Addressed Routing (SDAR) and present the Selective Attention System (SAS), an on-device implementation that instantiates this formulation. On a held-out 60-hour multi-speaker English test set, the primary audio-only configuration achieves F1=0.86 (precision=0.89, recall=0.83); with an optional camera, audio+video fusion raises F1 to 0.95 (precision=0.97, recall=0.93). Removing causal interaction history (Stage~3) reduced F1 from 0.95 to 0.57+/-0.03 in the audio+video configuration under our evaluation protocol. Among the tested components, this was the largest observed ablation effect, indicating that short-horizon interaction history carries substantial decision-relevant information in the evaluated setting. SAS runs fully on-device on ARM Cortex-A class hardware (<150 ms latency, <20 MB footprint). All results are from internal evaluation on a proprietary dataset evaluated primarily in English; a 5-hour evaluation subset may be shared for independent verification (Section 8.8).

We test and study the variation in speech recognition of fine-tuned versions of the Whisper model on child, elderly and non-native Dutch speech from the JASMIN-CGN corpus. Our primary goal is to evaluate how speakers' age and linguistic background influence Whisper's performance. Whisper achieves varying Word Error Rates (WER) when fine-tuned on subpopulations of specific ages and linguistic backgrounds. Fine-tuned performance is remarkably better than zero-shot performance, achieving a relative reduction in WER of 81% for native children, 72% for non-native children, 67% for non-native adults, and 65% for native elderly people. Our findings underscore the importance of training speech recognition models like Whisper on underrepresented subpopulations such as children, the elderly, and non-native speakers.

This study explores the use of Large language models to analyze therapist remarks in a psychotherapeutic setting. The paper focuses on the application of BERTopic, a machine learning-based topic modeling tool, to the dialogue of two different groups of therapists (classical and modern), which makes it possible to identify and describe a set of topics that consistently emerge across these groups. The paper describes in detail the chosen algorithm for BERTopic, which included creating a vector space from a corpus of therapist remarks, reducing its dimensionality, clustering the space, and creating and optimizing topic representation. Along with the automatic topical modeling by the BERTopic, the research involved an expert assessment of the findings and manual topic structure optimization. The topic modeling results highlighted the most common and stable topics in therapists speech, offering insights into how language patterns in therapy develop and remain stable across different therapeutic styles. This work contributes to the growing field of machine learning in psychotherapy by demonstrating the potential of automated methods to improve both the practice and training of therapists. The study highlights the value of topic modeling as a tool for gaining a deeper understanding of therapeutic dialogue and offers new opportunities for improving therapeutic effectiveness and clinical supervision.

Large-scale language models (LLMs) have achieved remarkable success across various language tasks but suffer from hallucinations and temporal misalignment. To mitigate these shortcomings, Retrieval-augmented generation (RAG) has been utilized to provide external knowledge to facilitate the answer generation. However, applying such models to the medical domain faces several challenges due to the lack of domain-specific knowledge and the intricacy of real-world scenarios. In this study, we explore LLMs with RAG framework for knowledge-intensive tasks in the medical field. To evaluate the capabilities of LLMs, we introduce MedicineQA, a multi-round dialogue benchmark that simulates the real-world medication consultation scenario and requires LLMs to answer with retrieved evidence from the medicine database. MedicineQA contains 300 multi-round question-answering pairs, each embedded within a detailed dialogue history, highlighting the challenge posed by this knowledge-intensive task to current LLMs. We further propose a new Distill-Retrieve-Read framework instead of the previous Retrieve-then-Read. Specifically, the distillation and retrieval process utilizes a tool calling mechanism to formulate search queries that emulate the keyword-based inquiries used by search engines. With experimental results, we show that our framework brings notable performance improvements and surpasses the previous counterparts in the evidence retrieval process in terms of evidence retrieval accuracy. This advancement sheds light on applying RAG to the medical domain.

Decoding language from brain activity is a long-awaited goal in both healthcare and neuroscience. Major milestones have recently been reached thanks to intracranial devices: subject-specific pipelines trained on invasive brain responses to basic language tasks now start to efficiently decode interpretable features (e.g. letters, words, spectrograms). However, scaling this approach to natural speech and non-invasive brain recordings remains a major challenge. Here, we propose a single end-to-end architecture trained with contrastive learning across a large cohort of individuals to predict self-supervised representations of natural speech. We evaluate our model on four public datasets, encompassing 169 volunteers recorded with magneto- or electro-encephalography (M/EEG), while they listened to natural speech. The results show that our model can identify, from 3s of MEG signals, the corresponding speech segment with up to 72.5% top-10 accuracy out of 1,594 distinct segments (and 44% top-1 accuracy), and up to 19.1% out of 2,604 segments for EEG recordings -- hence allowing the decoding of phrases absent from the training set. Model comparison and ablation analyses show that these performances directly benefit from our original design choices, namely the use of (i) a contrastive objective, (ii) pretrained representations of speech and (iii) a common convolutional architecture simultaneously trained across several participants. Together, these results delineate a promising path to decode natural language processing in real time from non-invasive recordings of brain activity.

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.

This research paper focuses on the challenges posed by hallucinations in large language models (LLMs), particularly in the context of the medical domain. Hallucination, wherein these models generate plausible yet unverified or incorrect information, can have serious consequences in healthcare applications. We propose a new benchmark and dataset, Med-HALT (Medical Domain Hallucination Test), designed specifically to evaluate and reduce hallucinations. Med-HALT provides a diverse multinational dataset derived from medical examinations across various countries and includes multiple innovative testing modalities. Med-HALT includes two categories of tests reasoning and memory-based hallucination tests, designed to assess LLMs's problem-solving and information retrieval abilities. Our study evaluated leading LLMs, including Text Davinci, GPT-3.5, LlaMa-2, MPT, and Falcon, revealing significant differences in their performance. The paper provides detailed insights into the dataset, promoting transparency and reproducibility. Through this work, we aim to contribute to the development of safer and more reliable language models in healthcare. Our benchmark can be found at medhalt.github.io

Evaluating Large Language Models (LLMs) for mental health support is challenging due to the emotionally and cognitively complex nature of therapeutic dialogue. Existing benchmarks are limited in scale, reliability, often relying on synthetic or social media data, and lack frameworks to assess when automated judges can be trusted. To address the need for large-scale dialogue datasets and judge reliability assessment, we introduce two benchmarks that provide a framework for generation and evaluation. MentalBench-100k consolidates 10,000 one-turn conversations from three real scenarios datasets, each paired with nine LLM-generated responses, yielding 100,000 response pairs. MentalAlign-70k}reframes evaluation by comparing four high-performing LLM judges with human experts across 70,000 ratings on seven attributes, grouped into Cognitive Support Score (CSS) and Affective Resonance Score (ARS). We then employ the Affective Cognitive Agreement Framework, a statistical methodology using intraclass correlation coefficients (ICC) with confidence intervals to quantify agreement, consistency, and bias between LLM judges and human experts. Our analysis reveals systematic inflation by LLM judges, strong reliability for cognitive attributes such as guidance and informativeness, reduced precision for empathy, and some unreliability in safety and relevance. Our contributions establish new methodological and empirical foundations for reliable, large-scale evaluation of LLMs in mental health. We release the benchmarks and codes at: https://github.com/abeerbadawi/MentalBench/

As large language models continue to develop in the field of AI, text generation systems are susceptible to a worrisome phenomenon known as hallucination. In this study, we summarize recent compelling insights into hallucinations in LLMs. We present a novel taxonomy of hallucinations from various text generation tasks, thus provide theoretical insights, detection methods and improvement approaches. Based on this, future research directions are proposed. Our contribution are threefold: (1) We provide a detailed and complete taxonomy for hallucinations appearing in text generation tasks; (2) We provide theoretical analyses of hallucinations in LLMs and provide existing detection and improvement methods; (3) We propose several research directions that can be developed in the future. As hallucinations garner significant attention from the community, we will maintain updates on relevant research progress.

Memory is the process of encoding, storing, and retrieving information, allowing humans to retain experiences, knowledge, skills, and facts over time, and serving as the foundation for growth and effective interaction with the world. It plays a crucial role in shaping our identity, making decisions, learning from past experiences, building relationships, and adapting to changes. In the era of large language models (LLMs), memory refers to the ability of an AI system to retain, recall, and use information from past interactions to improve future responses and interactions. Although previous research and reviews have provided detailed descriptions of memory mechanisms, there is still a lack of a systematic review that summarizes and analyzes the relationship between the memory of LLM-driven AI systems and human memory, as well as how we can be inspired by human memory to construct more powerful memory systems. To achieve this, in this paper, we propose a comprehensive survey on the memory of LLM-driven AI systems. In particular, we first conduct a detailed analysis of the categories of human memory and relate them to the memory of AI systems. Second, we systematically organize existing memory-related work and propose a categorization method based on three dimensions (object, form, and time) and eight quadrants. Finally, we illustrate some open problems regarding the memory of current AI systems and outline possible future directions for memory in the era of large language models.

Large Language Models (LLMs) have revolutionized Natural Language Processing (NLP). Although convenient for research and practical applications, open-source LLMs with fewer parameters often suffer from severe hallucinations compared to their larger counterparts. This paper focuses on measuring and reducing hallucinations in BLOOM 7B, a representative of such weaker open-source LLMs that are publicly available for research and commercial applications. We introduce HaloCheck, a lightweight BlackBox knowledge-free framework designed to quantify the severity of hallucinations in LLMs. Additionally, we explore techniques like knowledge injection and teacher-student approaches to alleviate hallucinations in low-parameter LLMs. Our experiments effectively demonstrate the reduction of hallucinations in challenging domains for these LLMs.

Memory plays a pivotal role in enabling large language model~(LLM)-based agents to engage in complex and long-term interactions, such as question answering (QA) and dialogue systems. While various memory modules have been proposed for these tasks, the impact of different memory structures across tasks remains insufficiently explored. This paper investigates how memory structures and memory retrieval methods affect the performance of LLM-based agents. Specifically, we evaluate four types of memory structures, including chunks, knowledge triples, atomic facts, and summaries, along with mixed memory that combines these components. In addition, we evaluate three widely used memory retrieval methods: single-step retrieval, reranking, and iterative retrieval. Extensive experiments conducted across four tasks and six datasets yield the following key insights: (1) Different memory structures offer distinct advantages, enabling them to be tailored to specific tasks; (2) Mixed memory structures demonstrate remarkable resilience in noisy environments; (3) Iterative retrieval consistently outperforms other methods across various scenarios. Our investigation aims to inspire further research into the design of memory systems for LLM-based agents.

Large language models (LLMs) have shown impressive capabilities in natural language processing tasks, including dialogue generation. This research aims to conduct a novel comparative analysis of two prominent techniques, fine-tuning with LoRA (Low-Rank Adaptation) and the Retrieval-Augmented Generation (RAG) framework, in the context of doctor-patient chat conversations with multiple datasets of mixed medical domains. The analysis involves three state-of-the-art models: Llama-2, GPT, and the LSTM model. Employing real-world doctor-patient dialogues, we comprehensively evaluate the performance of models, assessing key metrics such as language quality (perplexity, BLEU score), factual accuracy (fact-checking against medical knowledge bases), adherence to medical guidelines, and overall human judgments (coherence, empathy, safety). The findings provide insights into the strengths and limitations of each approach, shedding light on their suitability for healthcare applications. Furthermore, the research investigates the robustness of the models in handling diverse patient queries, ranging from general health inquiries to specific medical conditions. The impact of domain-specific knowledge integration is also explored, highlighting the potential for enhancing LLM performance through targeted data augmentation and retrieval strategies.

For a large portion of real-life utterances, the intention cannot be solely decided by either their semantic or syntactic characteristics. Although not all the sociolinguistic and pragmatic information can be digitized, at least phonetic features are indispensable in understanding the spoken language. Especially in head-final languages such as Korean, sentence-final prosody has great importance in identifying the speaker's intention. This paper suggests a system which identifies the inherent intention of a spoken utterance given its transcript, in some cases using auxiliary acoustic features. The main point here is a separate distinction for cases where discrimination of intention requires an acoustic cue. Thus, the proposed classification system decides whether the given utterance is a fragment, statement, question, command, or a rhetorical question/command, utilizing the intonation-dependency coming from the head-finality. Based on an intuitive understanding of the Korean language that is engaged in the data annotation, we construct a network which identifies the intention of a speech, and validate its utility with the test sentences. The system, if combined with up-to-date speech recognizers, is expected to be flexibly inserted into various language understanding modules.