Daily Papers

Recovering causal relationships from data is an important problem. Using observational data, one can typically only recover causal graphs up to a Markov equivalence class and additional assumptions or interventional data are needed for complete recovery. In this work, under some standard assumptions, we study causal graph discovery via adaptive interventions with node-dependent interventional costs. For this setting, we show that no algorithm can achieve an approximation guarantee that is asymptotically better than linear in the number of vertices with respect to the verification number; a well-established benchmark for adaptive search algorithms. Motivated by this negative result, we define a new benchmark that captures the worst-case interventional cost for any search algorithm. Furthermore, with respect to this new benchmark, we provide adaptive search algorithms that achieve logarithmic approximations under various settings: atomic, bounded size interventions and generalized cost objectives.

A major barrier to deploying current machine learning models lies in their non-reliability to dataset shifts. To resolve this problem, most existing studies attempted to transfer stable information to unseen environments. Particularly, independent causal mechanisms-based methods proposed to remove mutable causal mechanisms via the do-operator. Compared to previous methods, the obtained stable predictors are more effective in identifying stable information. However, a key question remains: which subset of this whole stable information should the model transfer, in order to achieve optimal generalization ability? To answer this question, we present a comprehensive minimax analysis from a causal perspective. Specifically, we first provide a graphical condition for the whole stable set to be optimal. When this condition fails, we surprisingly find with an example that this whole stable set, although can fully exploit stable information, is not the optimal one to transfer. To identify the optimal subset under this case, we propose to estimate the worst-case risk with a novel optimization scheme over the intervention functions on mutable causal mechanisms. We then propose an efficient algorithm to search for the subset with minimal worst-case risk, based on a newly defined equivalence relation between stable subsets. Compared to the exponential cost of exhaustively searching over all subsets, our searching strategy enjoys a polynomial complexity. The effectiveness and efficiency of our methods are demonstrated on synthetic data and the diagnosis of Alzheimer's disease.

Prediction sets can wrap around any ML model to cover unknown test outcomes with a guaranteed probability. Yet, it remains unclear how to use them optimally for downstream decision-making. Here, we propose a decision-theoretic framework that seeks to minimize the expected loss (risk) against a worst-case distribution consistent with the prediction set's coverage guarantee. We first characterize the minimax optimal policy for a fixed prediction set, showing that it balances the worst-case loss inside the set with a penalty for potential losses outside the set. Building on this, we derive the optimal prediction set construction that minimizes the resulting robust risk subject to a coverage constraint. Finally, we introduce Risk-Optimal Conformal Prediction (ROCP), a practical algorithm that targets these risk-minimizing sets while maintaining finite-sample distribution-free marginal coverage. Empirical evaluations on medical diagnosis and safety-critical decision-making tasks demonstrate that ROCP reduces critical mistakes compared to baselines, particularly when out-of-set errors are costly.

Purpose. Patients with advanced cancer may undergo multiple lines of treatment, switching therapies as their disease progresses. Motivated by a study of metastatic prostate cancer, we develop a microsimulation framework to study therapy sequence. Methods. We propose a discrete-time state transition model to study two lines of anti-cancer therapy. Based on digitized published progression-free survival (PFS) and overall survival (OS) curves, we infer event types (progression or death), and estimate transition probabilities using cumulative incidence functions with competing risks. Our model incorporates within-patient dependence over time, such that response to first-line therapy informs subsequent event probabilities. Parameters governing the degree of within-patient dependence can be used to calibrate the model-based results to those of a target trial. We demonstrate these methods in a study of two therapy sequences for metastatic prostate cancer, where Docetaxel (DCT) and Abiraterone Acetate (AA) are both appropriate for use in either first or second line treatment. We assess costs, Quality-Adjusted Life Years (QALYs) and Incremental Cost Effectiveness Ratio (ICER) for two treatment strategies: DCT then AA vs AA then DCT. Results. Using digitized survival curves from relevant clinical trials, we identified 8.6-13.9% of PFS times that should be categorized as deaths, allowing for estimation of cumulative incidence functions. Models assuming within-patient independence overestimated OS time, corrected with our calibration approach. Correction resulted in meaningful changes in the difference in QALYs between treatment strategies (0.07 vs 0.15) and the ICER (-\76,836/QALY vs -21,030/QALY). Conclusions. Microsimulation models can be successfully used to study cost-effectiveness of therapy sequences, taking care to account correctly for within-patient dependence.

Existing machine learning methods for causal inference usually estimate quantities expressed via the mean of potential outcomes (e.g., average treatment effect). However, such quantities do not capture the full information about the distribution of potential outcomes. In this work, we estimate the density of potential outcomes after interventions from observational data. For this, we propose a novel, fully-parametric deep learning method called Interventional Normalizing Flows. Specifically, we combine two normalizing flows, namely (i) a nuisance flow for estimating nuisance parameters and (ii) a target flow for parametric estimation of the density of potential outcomes. We further develop a tractable optimization objective based on a one-step bias correction for efficient and doubly robust estimation of the target flow parameters. As a result, our Interventional Normalizing Flows offer a properly normalized density estimator. Across various experiments, we demonstrate that our Interventional Normalizing Flows are expressive and highly effective, and scale well with both sample size and high-dimensional confounding. To the best of our knowledge, our Interventional Normalizing Flows are the first proper fully-parametric, deep learning method for density estimation of potential outcomes.

We consider the task of evaluating policies of algorithmic resource allocation through randomized controlled trials (RCTs). Such policies are tasked with optimizing the utilization of limited intervention resources, with the goal of maximizing the benefits derived. Evaluation of such allocation policies through RCTs proves difficult, notwithstanding the scale of the trial, because the individuals' outcomes are inextricably interlinked through resource constraints controlling the policy decisions. Our key contribution is to present a new estimator leveraging our proposed novel concept, that involves retrospective reshuffling of participants across experimental arms at the end of an RCT. We identify conditions under which such reassignments are permissible and can be leveraged to construct counterfactual trials, whose outcomes can be accurately ascertained, for free. We prove theoretically that such an estimator is more accurate than common estimators based on sample means -- we show that it returns an unbiased estimate and simultaneously reduces variance. We demonstrate the value of our approach through empirical experiments on synthetic, semi-synthetic as well as real case study data and show improved estimation accuracy across the board.

Many real-world multi-label prediction problems involve set-valued predictions that must satisfy specific requirements dictated by downstream usage. We focus on a typical scenario where such requirements, separately encoding value and cost, compete with each other. For instance, a hospital might expect a smart diagnosis system to capture as many severe, often co-morbid, diseases as possible (the value), while maintaining strict control over incorrect predictions (the cost). We present a general pipeline, dubbed as FavMac, to maximize the value while controlling the cost in such scenarios. FavMac can be combined with almost any multi-label classifier, affording distribution-free theoretical guarantees on cost control. Moreover, unlike prior works, it can handle real-world large-scale applications via a carefully designed online update mechanism, which is of independent interest. Our methodological and theoretical contributions are supported by experiments on several healthcare tasks and synthetic datasets - FavMac furnishes higher value compared with several variants and baselines while maintaining strict cost control. Our code is available at https://github.com/zlin7/FavMac

Clinical LLMs are often scaled by increasing model size, context length, retrieval complexity, or inference-time compute, with the implicit expectation that higher accuracy implies safer behavior. This assumption is incomplete in medicine, where a few confident, high-risk, or evidence-contradicting errors can matter more than average benchmark performance. We introduce SaFE-Scale, a framework for measuring how clinical LLM safety changes across model scale, evidence quality, retrieval strategy, context exposure, and inference-time compute. To instantiate this framework, we introduce RadSaFE-200, a Radiology Safety-Focused Evaluation benchmark of 200 multiple-choice questions with clinician-defined clean evidence, conflict evidence, and option-level labels for high-risk error, unsafe answer, and evidence contradiction. We evaluated 34 locally deployed LLMs across six deployment conditions: closed-book prompting (zero-shot), clean evidence, conflict evidence, standard RAG, agentic RAG, and max-context prompting. Clean evidence produced the strongest improvement, increasing mean accuracy from 73.5% to 94.1%, while reducing high-risk error from 12.0% to 2.6%, contradiction from 12.7% to 2.3%, and dangerous overconfidence from 8.0% to 1.6%. Standard RAG and agentic RAG did not reproduce this safety profile: agentic RAG improved accuracy over standard RAG and reduced contradiction, but high-risk error and dangerous overconfidence remained elevated. Max-context prompting increased latency without closing the safety gap, and additional inference-time compute produced only limited gains. Worst-case analysis showed that clinically consequential errors concentrated in a small subset of questions. Clinical LLM safety is therefore not a passive consequence of scaling, but a deployment property shaped by evidence quality, retrieval design, context construction, and collective failure behavior.

Cardinality-estimation (CE) research ranks estimators by q-error, yet it is well known that q-error is an imperfect proxy for query-plan quality. We give a measurement-driven account of when it is a good proxy and when it is not, and why. Modeling plan selection as an argmin over a piecewise-linear cost landscape, we find that plan regret (the cost of the chosen plan relative to the optimal, under true cardinalities) is governed by plan-cost geometry in a regime-dependent way. (i) For small errors, a true-point condition number kappa predicts regret and out-predicts q-error; its predictive power decays to zero as error grows, as a local linearization must. (ii) For large errors -- where deployed learned estimators operate -- an estimator-independent average-case sub-optimality measure ACS-infinity predicts which queries are regret-prone (Spearman rho ~ 0.54 on STATS-CEB), while q-error is nearly uninformative at the query level (rho ~ 0.05). (iii) The worst case is Haritsa's maximum sub-optimality (MSO). The three are one cost-ratio spectrum under three weightings. We prove a limit law ACS-infinity = sum_k r_k pi_k with cardinality-independent combinatorial weights, and validate every claim on STATS-CEB and JOB-light with four released estimators under pre-registered decision rules, and confirm on real PostgreSQL runtime that ACS-infinity predicts regret where q-error does not. The contribution is conceptual and empirical -- an average-case companion to worst-case robust query optimization, and a characterization of when an accuracy metric tracks plan quality -- rather than a new estimator. Code and the full pre-registration are public.

Health economic evaluations are sensitive to the choice of analytical perspective (e.g., health system vs. societal). While guidelines often recommend specific perspectives, the uncertainty associated with this choice - and the potential decision discordance it creates - is rarely quantified. We present vop_poc_nz, a Python package that implements a framework for Distributional Cost-Effectiveness Analysis (DCEA) and operationalizes the quantification of perspective uncertainty through the Value of Perspective (VoP) metric. The package provides tools for Markov modeling, probabilistic sensitivity analysis, value of information analysis, and equity impact assessment. Unlike existing tools that treat perspective as a fixed input, vop_poc_nz allows for the simultaneous evaluation of multiple perspectives. This enables decision-makers to estimate the opportunity cost of perspective misalignment. We demonstrate the package's capabilities using case studies from Aotearoa New Zealand.

When applying offline reinforcement learning (RL) in healthcare scenarios, the out-of-distribution (OOD) issues pose significant risks, as inappropriate generalization beyond clinical expertise can result in potentially harmful recommendations. While existing methods like conservative Q-learning (CQL) attempt to address the OOD issue, their effectiveness is limited by only constraining action selection by suppressing uncertain actions. This action-only regularization imitates clinician actions that prioritize short-term rewards, but it fails to regulate downstream state trajectories, thereby limiting the discovery of improved long-term treatment strategies. To safely improve policy beyond clinician recommendations while ensuring that state-action trajectories remain in-distribution, we propose Offline Guarded Safe Reinforcement Learning (OGSRL), a theoretically grounded model-based offline RL framework. OGSRL introduces a novel dual constraint mechanism for improving policy with reliability and safety. First, the OOD guardian is established to specify clinically validated regions for safe policy exploration. By constraining optimization within these regions, it enables the reliable exploration of treatment strategies that outperform clinician behavior by leveraging the full patient state history, without drifting into unsupported state-action trajectories. Second, we introduce a safety cost constraint that encodes medical knowledge about physiological safety boundaries, providing domain-specific safeguards even in areas where training data might contain potentially unsafe interventions. Notably, we provide theoretical guarantees on safety and near-optimality: policies that satisfy these constraints remain in safe and reliable regions and achieve performance close to the best possible policy supported by the data.

Current evaluations of LLM safety predominantly rely on severity-based taxonomies to assess the harmfulness of malicious queries. We argue that this formulation requires re-examination as it assumes uniform risk across all malicious queries, neglecting Execution Likelihood--the conditional probability of a threat being realized given the model's response. In this work, we introduce Expected Harm, a metric that weights the severity of a jailbreak by its execution likelihood, modeled as a function of execution cost. Through empirical analysis of state-of-the-art models, we reveal a systematic Inverse Risk Calibration: models disproportionately exhibit stronger refusal behaviors for low-likelihood (high-cost) threats while remaining vulnerable to high-likelihood (low-cost) queries. We demonstrate that this miscalibration creates a structural vulnerability: by exploiting this property, we increase the attack success rate of existing jailbreaks by up to 2times. Finally, we trace the root cause of this failure using linear probing, which reveals that while models encode severity in their latent space to drive refusal decisions, they possess no distinguishable internal representation of execution cost, making them "blind" to this critical dimension of risk.

Machine learning has successfully framed many sequential decision making problems as either supervised prediction, or optimal decision-making policy identification via reinforcement learning. In data-constrained offline settings, both approaches may fail as they assume fully optimal behavior or rely on exploring alternatives that may not exist. We introduce an inherently different approach that identifies possible "dead-ends" of a state space. We focus on the condition of patients in the intensive care unit, where a "medical dead-end" indicates that a patient will expire, regardless of all potential future treatment sequences. We postulate "treatment security" as avoiding treatments with probability proportional to their chance of leading to dead-ends, present a formal proof, and frame discovery as an RL problem. We then train three independent deep neural models for automated state construction, dead-end discovery and confirmation. Our empirical results discover that dead-ends exist in real clinical data among septic patients, and further reveal gaps between secure treatments and those that were administered.

Generative models trained using self-supervision of tokenized electronic health record (EHR) timelines show promise for clinical outcome prediction. This is typically done using Monte Carlo simulation for future patient trajectories. However, existing approaches suffer from three key limitations: sparse estimate distributions that poorly differentiate patient risk levels, extreme computational costs, and high sampling variance. We propose two new estimators: the Sum of Conditional Outcome Probability Estimator (SCOPE) and Risk Estimation from Anticipated Conditional Hazards (REACH), that leverage next-token probability distributions discarded by standard Monte Carlo. We prove both estimators are unbiased and that REACH guarantees variance reduction over Monte Carlo sampling for any model and outcome. Empirically, on hospital mortality prediction in MIMIC-IV using the ETHOS-ARES framework, SCOPE and REACH match 100-sample Monte Carlo performance using only 10-11 samples (95% CI: [9,11]), representing a ~10x reduction in inference cost without degrading calibration. For ICU admission prediction, efficiency gains are more modest (~1.2x), which we attribute to the outcome's lower "spontaneity," a property we characterize theoretically and empirically. These methods substantially improve the feasibility of deploying generative EHR models in resource-constrained clinical settings.

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

Healthcare administration accounts for over $1 trillion in annual spending, making it a promising target for LLM-based computer-use agents (CUAs). While clinical applications of LLMs have received significant attention, no benchmark exists for evaluating CUAs on end-to-end administrative workflows. To address this gap, we introduce HealthAdminBench, a benchmark comprising four realistic GUI environments: an EHR, two payer portals, and a fax system, and 135 expert-defined tasks spanning three administrative task types: Prior Authorization, Appeals and Denials Management, and Durable Medical Equipment (DME) Order Processing. Each task is decomposed into fine-grained, verifiable subtasks, yielding 1,698 evaluation points. We evaluate seven agent configurations under multiple prompting and observation settings and find that, despite strong subtask performance, end-to-end reliability remains low: the best-performing agent (Claude Opus 4.6 CUA) achieves only 36.3 percent task success, while GPT-5.4 CUA attains the highest subtask success rate (82.8 percent). These results reveal a substantial gap between current agent capabilities and the demands of real-world administrative workflows. HealthAdminBench provides a rigorous foundation for evaluating progress toward safe and reliable automation of healthcare administrative workflows.

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

With an estimated 160,000 deaths in 2018, lung cancer is the most common cause of cancer death in the United States. Lung cancer CT screening has been shown to reduce mortality by up to 40% and is now included in US screening guidelines. Reducing the high error rates in lung cancer screening is imperative because of the high clinical and financial costs caused by diagnosis mistakes. Despite the use of standards for radiological diagnosis, persistent inter-grader variability and incomplete characterization of comprehensive imaging findings remain as limitations of current methods. These limitations suggest opportunities for more sophisticated systems to improve performance and inter-reader consistency. In this report, we reproduce a state-of-the-art deep learning algorithm for lung cancer risk prediction. Our model predicts malignancy probability and risk bucket classification from lung CT studies. This allows for risk categorization of patients being screened and suggests the most appropriate surveillance and management. Combining our solution high accuracy, consistency and fully automated nature, our approach may enable highly efficient screening procedures and accelerate the adoption of lung cancer screening.

Providing effective treatment and making informed clinical decisions are essential goals of modern medicine and clinical care. We are interested in simulating disease dynamics for clinical decision-making, leveraging recent advances in large generative models. To this end, we introduce the Medical World Model (MeWM), the first world model in medicine that visually predicts future disease states based on clinical decisions. MeWM comprises (i) vision-language models to serve as policy models, and (ii) tumor generative models as dynamics models. The policy model generates action plans, such as clinical treatments, while the dynamics model simulates tumor progression or regression under given treatment conditions. Building on this, we propose the inverse dynamics model that applies survival analysis to the simulated post-treatment tumor, enabling the evaluation of treatment efficacy and the selection of the optimal clinical action plan. As a result, the proposed MeWM simulates disease dynamics by synthesizing post-treatment tumors, with state-of-the-art specificity in Turing tests evaluated by radiologists. Simultaneously, its inverse dynamics model outperforms medical-specialized GPTs in optimizing individualized treatment protocols across all metrics. Notably, MeWM improves clinical decision-making for interventional physicians, boosting F1-score in selecting the optimal TACE protocol by 13%, paving the way for future integration of medical world models as the second readers.

This paper studies the problem of performing a sequence of optimal interventions in a causal dynamical system where both the target variable of interest and the inputs evolve over time. This problem arises in a variety of domains e.g. system biology and operational research. Dynamic Causal Bayesian Optimization (DCBO) brings together ideas from sequential decision making, causal inference and Gaussian process (GP) emulation. DCBO is useful in scenarios where all causal effects in a graph are changing over time. At every time step DCBO identifies a local optimal intervention by integrating both observational and past interventional data collected from the system. We give theoretical results detailing how one can transfer interventional information across time steps and define a dynamic causal GP model which can be used to quantify uncertainty and find optimal interventions in practice. We demonstrate how DCBO identifies optimal interventions faster than competing approaches in multiple settings and applications.

Machine learning models in health care are often deployed in settings where it is important to protect patient privacy. In such settings, methods for differentially private (DP) learning provide a general-purpose approach to learn models with privacy guarantees. Modern methods for DP learning ensure privacy through mechanisms that censor information judged as too unique. The resulting privacy-preserving models, therefore, neglect information from the tails of a data distribution, resulting in a loss of accuracy that can disproportionately affect small groups. In this paper, we study the effects of DP learning in health care. We use state-of-the-art methods for DP learning to train privacy-preserving models in clinical prediction tasks, including x-ray classification of images and mortality prediction in time series data. We use these models to perform a comprehensive empirical investigation of the tradeoffs between privacy, utility, robustness to dataset shift, and fairness. Our results highlight lesser-known limitations of methods for DP learning in health care, models that exhibit steep tradeoffs between privacy and utility, and models whose predictions are disproportionately influenced by large demographic groups in the training data. We discuss the costs and benefits of differentially private learning in health care.

AI-powered development platforms are making software creation accessible to a broader audience, but this democratization has triggered a scalability crisis in security auditing. With studies showing that up to 40% of AI-generated code contains vulnerabilities, the pace of development now vastly outstrips the capacity for thorough security assessment. We present MAPTA, a multi-agent system for autonomous web application security assessment that combines large language model orchestration with tool-grounded execution and end-to-end exploit validation. On the 104-challenge XBOW benchmark, MAPTA achieves 76.9% overall success with perfect performance on SSRF and misconfiguration vulnerabilities, 83% success on broken authorization, and strong results on injection attacks including server-side template injection (85%) and SQL injection (83%). Cross-site scripting (57%) and blind SQL injection (0%) remain challenging. Our comprehensive cost analysis across all challenges totals 21.38 with a median cost of 0.073 for successful attempts versus 0.357 for failures. Success correlates strongly with resource efficiency, enabling practical early-stopping thresholds at approximately 40 tool calls or 0.30 per challenge. MAPTA's real-world findings are impactful given both the popularity of the respective scanned GitHub repositories (8K-70K stars) and MAPTA's low average operating cost of $3.67 per open-source assessment: MAPTA discovered critical vulnerabilities including RCEs, command injections, secret exposure, and arbitrary file write vulnerabilities. Findings are responsibly disclosed, 10 findings are under CVE review.

This paper presents SiliconHealth, a comprehensive blockchain-based healthcare infrastructure designed for resource-constrained regions, particularly sub-Saharan Africa. We demonstrate that obsolete Bitcoin mining Application-Specific Integrated Circuits (ASICs) can be repurposed to create a secure, low-cost, and energy-efficient medical records system. The proposed architecture employs a four-tier hierarchical network: regional hospitals using Antminer S19 Pro (90+ TH/s), urban health centers with Antminer S9 (14 TH/s), rural clinics equipped with Lucky Miner LV06 (500 GH/s, 13W), and mobile health points with portable ASIC devices. We introduce the Deterministic Hardware Fingerprinting (DHF) paradigm, which repurposes SHA-256 mining ASICs as cryptographic proof generators, achieving 100% verification rate across 23 test proofs during 300-second validation sessions. The system incorporates Reed-Solomon LSB watermarking for medical image authentication with 30-40% damage tolerance, semantic Retrieval-Augmented Generation (RAG) for intelligent medical record queries, and offline synchronization protocols for intermittent connectivity. Economic analysis demonstrates 96% cost reduction compared to GPU-based alternatives, with total deployment cost of $847 per rural clinic including 5-year solar power infrastructure. Validation experiments on Lucky Miner LV06 (BM1366 chip, 5nm) achieve 2.93 MH/W efficiency and confirm hardware universality. This work establishes a practical framework for deploying verifiable, tamper-proof electronic health records in regions where traditional healthcare IT infrastructure is economically unfeasible, potentially benefiting over 600 million people lacking access to basic health information systems.

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

Estimating the causal effects of interventions is crucial to policy and decision-making, yet outcome data are often missing or subject to non-standard measurement error. While ground-truth outcomes can sometimes be obtained through costly data annotation or follow-up, budget constraints typically allow only a fraction of the dataset to be labeled. We address this challenge by optimizing which data points should be sampled for outcome information in order to improve efficiency in average treatment effect estimation with missing outcomes. We derive a closed-form solution for the optimal batch sampling probability by minimizing the asymptotic variance of a doubly robust estimator for causal inference with missing outcomes. Motivated by our street outreach partners, we extend the framework to costly annotations of unstructured data, such as text or images in healthcare and social services. Across simulated and real-world datasets, including one of outreach interventions in homelessness services, our approach achieves substantially lower mean-squared error and recovers the AIPW estimate with fewer labels than existing baselines. In practice, we show that our method can match confidence intervals obtained with 361 random samples using only 90 optimized samples - saving 75% of the labeling budget.