Clinical Communication Processing with Models Trained on LLM-Generated Synthetic Data: A Structured Survey and Novel Application Case Studies

Much clinical value is conveyed not through structured records but through communication: exchanges in which patients describe symptoms, clinicians reason and give instructions, ambulances hand over to emergency departments, and nurses pass on a shift. Such language differs from tabular data because meaning depends on speaker role, intent, causality, uncertainty, omission, and channel noise. Healthcare natural language processing must therefore interpret information as conveyed rather than coded. This requires well-annotated corpora, which are scarce because authentic exchanges are private, fragmented, and costly to annotate. Large language models offer a way forward by transforming clinical sources, such as records, diagnostic labels, symptom lists, or care plans, into written and transcribed communication for downstream models. We present a structured narrative survey organized by source representation, communication form and participants, generation method, and downstream task, complemented by thirteen novel case studies. These build clinical NLP systems for communication channels and languages without labeled real-world data, including EMS pre-arrival reports, field-radio casualty documentation, nurse handoffs, patient-portal triage, and low-resource discharge communication. They show that synthetic communication can bootstrap such systems. Findings include the competitiveness of fine-tuned encoder models over evaluated zero-shot baselines and the value of deliberately degraded communication for robustness. The main limitation is that most studies evaluate on held-out synthetic communication, while train-on-synthetic, test-on-authentic evidence remains limited. We conclude that syn-thetic clinical communication is becoming a practical research resource; establishing it as reusable clinical infrastructure will require authentic-data transfer, safety and external validation.

Bridging Data Gaps in Structural Fragility Modeling through Transfer Learning: Methodology and Case Studies

This paper presents a methodology-centered transfer learning framework for fragility adaptation under domain shift, class imbalance, and scarce target labels while preserving engineering interpretability and supporting decision-making under uncertainty. Four transfer learning strategies (instance-based, parameter-based, hierarchical Bayesian, and multi-source) are demonstrated through three complementary case studies: (i) instance-based transfer learning via importance weighting, demonstrated on coastal bridge fragility using Hurricane Katrina observations; (ii) parameter-based transfer learning together with hierarchical Bayesian transfer learning, enabling partial pooling across strata and posterior uncertainty quantification, demonstrated on residential building fragility using Hurricane Ian observations; and (iii) multi-source transfer learning that fuses multiple analytical fragility models with learned source weights and regularized target-domain adaptation, demonstrated on seismic bridge fragility using observations from the 2001 Nisqually earthquake. Across these case studies, direct transfer of source models (i.e. using existing state-of-the-art models) fails under domain shift and severe class imbalance, while targeted adaptation substantially improves failure detection and predictive stability in low-data regimes. These findings highlight the need for systematic guidance on diagnostics, strategy selection, and uncertainty reporting when developing and adapting fragility models.

A Three-Layer Framework for AI in Scientific Discovery

Current discussions of AI in scientific discovery are often dominated by two visible capabilities: search over existing knowledge and execution through optimization, simulation, and automation. Both are important, but neither fully captures the central act of discovery: the formation and evolution of models. This paper proposes a three-layer view of AI in discovery. Layer 1 is search and retrieval by large language models. Layer 2, as the main innovation of this paper, is model formation through qualitative reasoning: the capacity to recognize when a current framework is structurally inadequate and to understand the problem within a broader representational space, not through trial and error, but through structural insight into what is missing and where it can be found. Layer 3 is execution, optimization, and refinement. The main claim is that Layer 2 is both the most important and the least developed. Search without model formation remains confined to inherited frameworks, while execution without conceptual revision only amplifies an existing formulation. We illustrate Layer 2 reasoning through three case studies: S. S. Chern's intrinsic proof of the Gauss-Bonnet theorem, the resolution of the Nesterov Accelerated Gradient convergence problem via Lyapunov functions, and the autonomous disproof of the Erdos unit distance conjecture by OpenAI in 2026. Each case exhibits the same structural signature: a framework that had become inadequate, a missing conceptual object, and a resolution found in an unexpected neighboring field.