OBJECTIVES: This study explores the use of advanced natural language processing (NLP) techniques to enhance food classification and dietary analysis using raw text input from a diet tracking app. MATERIALS AND METHODS: The study was conducted in 3 stages: data collection, framework development, and application. Data were collected from a 12-week randomized controlled trial (RCT: NCT04259632), in which participants recorded their meals in free-text format using the myCircadianClock app. Only de-identified data were used. We developed nutrition-focused retrieval-augmented generation (NutriRAG), an NLP framework that uses a retrieval-augmented generation approach to enhance food classification from free-text inputs. The framework retrieves relevant examples from a curated database and then leverages large language models, such as GPT-4, to classify user-recorded food items into predefined categories without fine-tuning. NutriRAG was then applied to data from the RCT, which included 77 adults with obesity recruited from the Twin Cities metro area and randomized into 3 intervention groups: time-restricted eating (TRE, 8-hs eating window), caloric restriction (CR, 15% reduction), and unrestricted eating. RESULTS: NutriRAG significantly enhanced classification accuracy and helped to analyze dietary habits, as noted by the retrieval-augmented GPT-4 model achieving a micro-F1 score of 82.24. Both interventions showed dietary alterations: CR participants ate fewer snacks and sugary foods, while TRE participants reduced nighttime eating. CONCLUSION: By using artificial intelligence, NutriRAG marks a substantial advancement in food classification and dietary analysis of nutritional assessments. The findings highlight NLP's potential to personalize nutrition and manage diet-related health issues, suggesting further research to expand these models for wider use.

Huixue Zhou, Hengrui Gu, Zaifu Zhan, Xi Liu, Kaixiong Zhou, Yongkang Xiao, Mingfu Liang, Srinivas Prasad Govindan, Piyush Chawla, Jiyan Yang, Xiangfei Meng, Huayu Li, Buyun Zhang, Liang Luo, Wen-Yen Chen, Yiping Han, Bo Long, Rui Zhang, Tianlong Chen. Proceedings of the 63rd Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers). 2025.

Automatic question generation (QG) is essential for AI and NLP, particularly in intelligent tutoring, dialogue systems, and fact verification. Generating multiple-choice questions (MCQG) for professional exams, like the United States Medical Licensing Examination (USMLE), is particularly challenging, requiring domain expertise and complex multi-hop reasoning for high-quality questions. However, current large language models (LLMs) like GPT-4 struggle with professional MCQG due to outdated knowledge, hallucination issues, and prompt sensitivity, resulting in unsatisfactory quality and difficulty. To address these challenges, we propose MCQG-SRefine, an LLM self-refine-based (Critique and Correction) framework for converting medical cases into high-quality USMLE-style questions. By integrating expert-driven prompt engineering with iterative self-critique and self-correction feedback, MCQG-SRefine significantly enhances human expert satisfaction regarding both the quality and difficulty of the questions. Furthermore, we introduce an LLM-as-Judge-based automatic metric to replace the complex and costly expert evaluation process, ensuring reliable and expert-aligned assessments.

The privacy concerns associated with the use of Large Language Models (LLMs) have grown dramatically with the development of pioneer LLMs such as ChatGPT. Differential Privacy (DP) techniques that utilize DP-SGD are explored in existing work to mitigate their privacy risks at the cost of generalization degradation. Our paper reveals that the flatness of DP-SGD trained models’ loss landscape plays an essential role in the trade-off between their privacy and generalization. We further propose a holistic framework Privacy-Flat to enforce appropriate weight flatness, which substantially improves model generalization with promising privacy protection. It innovates from three coarse-to-grained levels: Perturbation-aware min-max optimization within a layer, flatness-guided sparse prefix-tuning across layers, and weight knowledge distillation between private & non-private weights copies. We empirically demonstrate that our framework Privacy-Flat outperforms vanilla private training baseline while protecting privacy from membership inference attacks (MIA). Comprehensive experiments of both black-box and white-box scenarios are conducted to demonstrate the effectiveness of our proposal in enhancing generalization. The code link is provided at https://github.com/tiejin98/Privacy_ Flatness.

OBJECTIVES: This article aims to enhance the performance of larger language models (LLMs) on the few-shot biomedical named entity recognition (NER) task by developing a simple and effective method called Retrieving and Chain-of-Thought (RT) framework and to evaluate the improvement after applying RT framework. MATERIALS AND METHODS: Given the remarkable advancements in retrieval-based language model and Chain-of-Thought across various natural language processing tasks, we propose a pioneering RT framework designed to amalgamate both approaches. The RT approach encompasses dedicated modules for information retrieval and Chain-of-Thought processes. In the retrieval module, RT discerns pertinent examples from demonstrations during instructional tuning for each input sentence. Subsequently, the Chain-of-Thought module employs a systematic reasoning process to identify entities. We conducted a comprehensive comparative analysis of our RT framework against 16 other models for few-shot NER tasks on BC5CDR and NCBI corpora. Additionally, we explored the impacts of negative samples, output formats, and missing data on performance. RESULTS: Our proposed RT framework outperforms other LMs for few-shot NER tasks with micro-F1 scores of 93.50 and 91.76 on BC5CDR and NCBI corpora, respectively. We found that using both positive and negative samples, Chain-of-Thought (vs Tree-of-Thought) performed better. Additionally, utilization of a partially annotated dataset has a marginal effect of the model performance. DISCUSSION: This is the first investigation to combine a retrieval-based LLM and Chain-of-Thought methodology to enhance the performance in biomedical few-shot NER. The retrieval-based LLM aids in retrieving the most relevant examples of the input sentence, offering crucial knowledge to predict the entity in the sentence. We also conducted a meticulous examination of our methodology, incorporating an ablation study. CONCLUSION: The RT framework with LLM has demonstrated state-of-the-art performance on few-shot NER tasks.

IMPORTANCE: Reinforcement learning (RL) represents a pivotal avenue within natural language processing (NLP), offering a potent mechanism for acquiring optimal strategies in task completion. This literature review studies various NLP applications where RL has demonstrated efficacy, with notable applications in healthcare settings. OBJECTIVES: To systematically explore the applications of RL in NLP, focusing on its effectiveness in acquiring optimal strategies, particularly in healthcare settings, and provide a comprehensive understanding of RL's potential in NLP tasks. MATERIALS AND METHODS: Adhering to the PRISMA guidelines, an exhaustive literature review was conducted to identify instances where RL has exhibited success in NLP applications, encompassing dialogue systems, machine translation, question-answering, text summarization, and information extraction. Our methodological approach involves closely examining the technical aspects of RL methodologies employed in these applications, analyzing algorithms, states, rewards, actions, datasets, and encoder-decoder architectures. RESULTS: The review of 93 papers yields insights into RL algorithms, prevalent techniques, emergent trends, and the fusion of RL methods in NLP healthcare applications. It clarifies the strategic approaches employed, datasets utilized, and the dynamic terrain of RL-NLP systems, thereby offering a roadmap for research and development in RL and machine learning techniques in healthcare. The review also addresses ethical concerns to ensure equity, transparency, and accountability in the evolution and application of RL-based NLP technologies, particularly within sensitive domains such as healthcare. DISCUSSION: The findings underscore the promising role of RL in advancing NLP applications, particularly in healthcare, where its potential to optimize decision-making and enhance patient outcomes is significant. However, the ethical challenges and technical complexities associated with RL demand careful consideration and ongoing research to ensure responsible and effective implementation. CONCLUSIONS: By systematically exploring RL's applications in NLP and providing insights into technical analysis, ethical implications, and potential advancements, this review contributes to a deeper understanding of RL's role for language processing.

OBJECTIVE: To construct an exhaustive Complementary and Integrative Health (CIH) Lexicon (CIHLex) to help better represent the often underrepresented physical and psychological CIH approaches in standard terminologies, and to also apply state-of-the-art natural language processing (NLP) techniques to help recognize them in the biomedical literature. MATERIALS AND METHODS: We constructed the CIHLex by integrating various resources, compiling and integrating data from biomedical literature and relevant sources of knowledge. The Lexicon encompasses 724 unique concepts with 885 corresponding unique terms. We matched these concepts to the Unified Medical Language System (UMLS), and we developed and utilized BERT models comparing their efficiency in CIH named entity recognition to well-established models including MetaMap and CLAMP, as well as the large language model GPT3.5-turbo. RESULTS: Of the 724 unique concepts in CIHLex, 27.2% could be matched to at least one term in the UMLS. About 74.9% of the mapped UMLS Concept Unique Identifiers were categorized as "Therapeutic or Preventive Procedure." Among the models applied to CIH named entity recognition, BLUEBERT delivered the highest macro-average F1-score of 0.91, surpassing other models. CONCLUSION: Our CIHLex significantly augments representation of CIH approaches in biomedical literature. Demonstrating the utility of advanced NLP models, BERT notably excelled in CIH entity recognition. These results highlight promising strategies for enhancing standardization and recognition of CIH terminology in biomedical contexts.

OBJECTIVE: To investigate the demonstration in large language models (LLMs) for biomedical relation extraction. This study introduces a framework comprising three types of adaptive tuning methods to assess their impacts and effectiveness. MATERIALS AND METHODS: Our study was conducted in two phases. Initially, we analyzed a range of demonstration components vital for LLMs' biomedical data capabilities, including task descriptions and examples, experimenting with various combinations. Subsequently, we introduced the LLM instruction-example adaptive prompting (LEAP) framework, including instruction adaptive tuning, example adaptive tuning, and instruction-example adaptive tuning methods. This framework aims to systematically investigate both adaptive task descriptions and adaptive examples within the demonstration. We assessed the performance of the LEAP framework on the DDI, ChemProt, and BioRED datasets, employing LLMs such as Llama2-7b, Llama2-13b, and MedLLaMA_13B. RESULTS: Our findings indicated that Instruction + Options + Example and its expanded form substantially improved F1 scores over the standard Instruction + Options mode for zero-shot LLMs. The LEAP framework, particularly through its example adaptive prompting, demonstrated superior performance over conventional instruction tuning across all models. Notably, the MedLLAMA_13B model achieved an exceptional F1 score of 95.13 on the ChemProt dataset using this method. Significant improvements were also observed in the DDI 2013 and BioRED datasets, confirming the method's robustness in sophisticated data extraction scenarios. CONCLUSION: The LEAP framework offers a compelling strategy for enhancing LLM training strategies, steering away from extensive fine-tuning towards more dynamic and contextually enriched prompting methodologies, showcasing in biomedical relation extraction.

Abstract A patient portal allows discharged patients to access their personalized discharge instructions in electronic health records (EHRs). However, many patients have difficulty understanding or memorizing their discharge instructions (Zhao et al., 2017). In this paper, we present PaniniQA, a patient-centric interactive question answering system designed to help patients understand their discharge instructions. PaniniQA first identifies important clinical content from patients’ discharge instructions and then formulates patient-specific educational questions. In addition, PaniniQA is also equipped with answer verification functionality to provide timely feedback to correct patients’ misunderstandings. Our comprehensive automatic & human evaluation results demonstrate our PaniniQA is capable of improving patients’ mastery of their medical instructions through effective interactions.1