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01.
arXiv (CS.LG) 2026-06-19

Streaming Interventions: Can Video Large Language Models Correct Mistakes as They Occur?

arXiv:2606.09547v2 Announce Type: replace-cross Abstract: Learning everyday skills, like cooking a dish, relies increasingly on instructional media such as online videos. This opens the door to the use of video (and multimodal) large language models (LLMs) as task guidance assistants. A crucial capability for the real-world success of a prospective task guidance assistant is it's ability to intervene proactively as soon as a mistake is apparent in order to guide the user. To evaluate this crucial capability, we introduce Ego-MC-Bench (Mistake Corrections), a benchmark for evaluating reactive, step-by-step task guidance in realistic cooking scenarios. Extensive experiments show that Ego-MC-Bench is highly challenging for state-of-the-art video LLMs. We argue that a key reason is the limited availability of training data for fine-tuning models on this task. Although there exists a wide range of cooking video datasets, existing datasets lack examples of mistakes along with appropriately timed interventions. To help address this data limitation, we also introduce Ego-CoMist, a counterfactual synthetic dataset created by transforming non -interactive cooking videos into supervised training examples showing proactive interventions. We show that fine-tuning on Ego-CoMist yields performance gains especially for smaller and more efficient video LLMs that are well suited for delivering assistance on edge devices.

02.
medRxiv (Medicine) 2026-06-22

Assessment of adaptive functioning in Angelman syndrome using the Vineland Adaptive Behavior Scales, Third Edition

Purpose: This study examined longitudinal trajectories of adaptive functioning in 331 individuals with Angelman syndrome (AS) using the Vineland Adaptive Behavior Scales, Third Edition (Vineland-3) and examined differences by molecular subtype. Methods: A total of 331 individuals (156 females, 47%) with genetically confirmed AS (ages 6 months to 52 years) were assessed between 2018 and 2025, including 207 with a deletion subtype, 63 with uniparental disomy or imprinting defect, and 61 with a UBE3A point mutation. Growth scale values were analyzed using linear mixed-effects models with log2-transformed age. Results: Individuals with deletion subtypes demonstrated significantly lower adaptive functioning across domains compared to those with non-deletion subtypes. Adaptive skills across all Vineland-3 subdomains increased nonlinearly with age, showing faster growth early in life that slowed over time, with largely parallel trajectories across subtypes. Conclusion: Individuals with AS demonstrate slow but steady growth in adaptive functioning that continues into adulthood, with progress varying by molecular subtype. These findings provide updated natural history benchmarks and demonstrate the utility of the Vineland-3 for clinical trials.

03.
arXiv (CS.CL) 2026-06-19

Think Again or Think Longer? Selective Verification for Budget-Aware Reasoning

Test-time reasoning is increasingly used as a serving-time control knob, but extra reasoning is not uniformly valuable: it can repair failed attempts, waste compute on already-correct answers, or introduce harmful answer changes. We study this as a deployment allocation problem rather than a new-verifier problem. We introduce \sevra, Selective Verification for Reasoning Allocation, a serving-layer controller that decides whether to preserve a frozen solver's initial answer or invoke active verification. Using a frozen Qwen3-4B solver, we log intervention outcomes and train recoverability-aware gates from serving-visible attempt state. On \mathfive, selective verification reaches 76.3\% accuracy, compared with 75.5\% for always verifying, while reducing post-generation tokens by 26.8\% and harmful flips from 2.2\% to 1.0\%. However, an 8,192-token initial solve reaches 76.0\% accuracy with 28\% fewer total model tokens, showing that selective recovery is useful but not the best tested cost frontier. In frozen transfer to \gsm, the selective policy verifies only 3.0\% of examples, improves accuracy from 93.4\% to 94.5\%, and reduces verification tokens by 91.2\% relative to always verifying; again, a longer initial solve matches its accuracy with fewer realized tokens. On CommonsenseQA, always-on verification hurts, while Self-Consistency@5 improves accuracy at about five times the realized token cost. The resulting deployment rule is: tune the initial budget first, then use selective recovery when explicit checks, bounded retries, auditability, or regression-risk control matter.

04.
arXiv (CS.CV) 2026-06-16

Lesion-DDPM: Lesion-Enhanced 3D Diffusion for MS MRI Synthesis

3D FLAIR MRI is widely recommended as one of the standard MRI sequences for brain imaging in multiple sclerosis (MS), but publicly available MS datasets remain relatively small and vary across scanners, acquisition protocols, and lesion patterns. This scarcity and variability hinder the development of robust neuroimaging machine learning models and are particularly challenging for generative models that aim to synthesize images while preserving small, sparse lesions. We propose Lesion-DDPM, a 3D conditional diffusion framework for lesion-aware FLAIR synthesis that incorporates multi-level anatomical mask injection together with a lesion-weighted reconstruction loss to emphasize lesion voxels while maintaining global brain structure. Using a curated subset of the MSLesSeg dataset, we compare Lesion-DDPM with representative state-of-the-art GAN- and diffusion-based models, assessing both image-generation metrics and downstream 3D U-Net segmentation. In our experiments, Lesion-DDPM achieved the lowest lesion-region reconstruction error among all methods. In a downstream 3D U-Net lesion segmentation task, a model trained only on Lesion-DDPM-generated scans and evaluated on real MRIs reached a Dice score of 0.616 compared with 0.569 for the best competing synthetic dataset. When Lesion-DDPM images were added to the real training set, the Dice score further increased to 0.685.

05.
arXiv (CS.AI) 2026-06-24

Alternate loss functions and regression models that achieve robustness to outliers by modulating the learning rate

arXiv:2606.22068v2 Announce Type: replace-cross Abstract: Most real-world datasets used for training supervised learning models are contaminated with noisy data and outliers leading to large prediction errors. This paper proposes a new approach for achieving robustness where the learning rate is modulated by a factor that is sensitive to outliers. In this approach a reduction of the learning rate is shown to be achieved by using alternate loss functions that are infinitely differentiable, strictly convex or quasiconvex and more closely approximate the absolute error than Huber and log-cosh losses. A comparison of the performance of regression models trained with different loss functions on a wide variety of benchmarks and datasets is presented to demonstrate the superior performance of the Square Root Loss (SRL) and Smooth Mean Absolute Error (SMAE) losses proposed in this paper. Two new robust linear regression models are presented. Highly vectorized robust parameter update formulae that take advantage of modern GPUs for both stochastic and batch gradient descent are presented.

06.
arXiv (CS.AI) 2026-06-18

Learning-Based Decision Making for Combustion Phasing Control in Multi-Fuel CI Engines with Latent Fuel Reactivity Estimation

arXiv:2606.18393v1 Announce Type: cross Abstract: Multi-fuel compression-ignition engines offer fuel flexibility but introduce uncertain, time-varying fuel reactivity, represented by cetane number (CN), which complicates cycle-to-cycle combustion-phasing control. This work formulates CA50 regulation under latent CN variation as a partially observable sequential decision problem and systematically evaluates controllers with increasing temporal and representational capacity, including LinUCB, history-augmented contextual bandits, observation-only DDPG, recurrent DDPG, and a proposed GRU-guided RL framework. A Gaussian-process surrogate trained on experimental multi-fuel engine data provides a controlled and reproducible evaluation environment. Results show that myopic and fixed-history bandit methods degrade under CN variation, observation-only RL suffers from latent-state aliasing, and generic recurrence is insufficient when CN evolves rapidly. The proposed framework learns a compact GRU-based representation of fuel reactivity from combustion history and conditions both actor and critic on this estimated signal rather than oracle CN. By training the policy on the same imperfect fuel-reactivity information available at deployment, the controller avoids train-deploy inconsistency in conventional online estimate-then-control pipelines. Across unseen CN trajectories, the policy achieves stable CA50 regulation with mean absolute tracking error below 0.25{\deg} CA at the training setpoint, while producing smooth, physically consistent SOI and glow-plug-power actuation. These results show that combustion control under latent, continuously evolving fuel dynamics requires more than standalone estimation or generic recurrence. By aligning fuel-reactivity inference with control policy learning, the proposed framework enables reactivity-aware decision-making using the same estimated state available during deployment.

07.
arXiv (CS.AI) 2026-06-16

Entropy-Gated Latent Recursion

arXiv:2606.16620v1 Announce Type: cross Abstract: Inference-time scaling has become the dominant lever for improving language-model reasoning, but existing methods derive rollout diversity from a single source: stochastic token-level sampling. We argue that this single-axis sampling space is fundamentally limiting, and identify a second, fully deterministic and complementary axis: the layer span $L$ at which a frozen model's top decoder layers are recursively re-applied at high-uncertainty tokens. Different choices of $L$ produce distinct rollouts that solve different subsets of problems, with no stochasticity. We instantiate this axis through Entropy-Gated Latent Recursion (EGLR), a training-free decoding procedure that re-applies the top-$L$ layers for at most $K_{\max}$ iterations until the next-token distribution converges. Combined with $T$ temperature samples, EGLR turns a single-axis stochastic rollout pool into an $L\times T$ Cartesian sampling space at almost the same per-rollout cost. We characterize this space across $8$ instruction-tuned models and $6$ math reasoning benchmarks, and show that the $L$-axis is genuinely complementary to temperature: on MATH-500 with Qwen2.5-3B-Instruct, the joint $L\times T$ oracle reaches $91.6\%$, $+8.2$ percentage points beyond the temperature-only oracle ($83.4\%$) and $+10.4$ points beyond the layer-only oracle ($81.2\%$), confirming that the two axes capture genuinely complementary problems. The expanded rollout pool provides richer per-prompt candidates for any downstream procedure that consumes rollouts, including self-consistency, best-of-$N$ with verifiers, and group-relative RL training (GRPO), opening a new direction for inference-time scaling that does not rely on stochastic noise.

08.
medRxiv (Medicine) 2026-06-12

Immunologically Optimized Zmp1 Peptides Reveal a Translational Serological Biomarker Platform for Tuberculosis Diagnosis Across Disease Manifestations

Tuberculosis (TB) diagnosis remains challenging, particularly for extrapulmonary TB (EPTB), where invasive sampling, low bacillary burden, and suboptimal sensitivity of nucleic acid-based tests in peripheral specimens hinder timely detection. Here, we report an immunology-driven strategy for biomarker discovery and development of a peptide-based serological assay targeting Mycobacterium tuberculosis zinc metalloprotease-1 (Zmp1). Leveraging fundamental principles of adaptive immunity that antigenic regions containing overlapping B-cell and CD4 T-helper cell epitopes would preferentially generate high antibody titers through linked recognition and cognate T-cell help, we used an immunoinformatics pipeline to identify two nested immunodominant peptide regions within Zmp1 (Mtb-Zp-NT and Mtb-Zp-CT) enriched for overlapping B- and T-cell epitopes. The diagnostic potential of these peptides was evaluated through ELISA-based serological assays. A blinded pilot study (N=137) demonstrated a clear discrimination between active TB and TB-recovered individuals. The assay was subsequently validated in an expanded cohort (N=875) by screening 6,086 individuals, which identified 457 TB-positive cases. The cohort included pulmonary TB (PTB), EPTB, TB-recovered individuals, household contacts, non-specific infections, and healthy controls. Receiver operating characteristic analyses, supported by DeLong and bootstrap comparisons, revealed superior diagnostic performance of the peptide-based assays relative to full-length Zmp1. Mtb-Zp-CT exhibited the highest accuracy (AUC=0.93; specificity >90%), while Mtb-Zp-NT also demonstrated strong discriminatory power (AUC{approx}0.89). These findings establish that the immunologically optimized Zmp1 peptides are highly promising serological biomarkers for TB and EPTB. More broadly, they demonstrate how mechanistically informed epitope selection can accelerate translation of pathogen-specific immune signatures into sensitive, minimally invasive, and potentially point-of-care diagnostic platforms for resource-limited settings.

09.
arXiv (CS.LG) 2026-06-19

Closing the Social-Semantic Gap: SPSD for Edge-Based Prompt Compression in Cloud LLM Inference

arXiv:2606.19364v1 Announce Type: new Abstract: The prefill stage of Large Language Model (LLM) inference is a growing contributor to cloud-scale energy cost. Many consumer-support and conversational prompts contain social scaffolding: politeness markers, apologetic preamble, repetition, and rapport-building language that is important for human communication but carries low marginal information for machine reasoning. We call this discrepancy the Social-Semantic Gap. We present SPSD (Sentiment Preserving Semantic Distillation), an edge-based pipeline that compresses user prompts using a 4-bit quantised Small Language Model before transmission to a cloud-deployed LLM. Evaluation on a 248-prompt corpus using Gemma-2-2B-Instruct (Q4_K_M) as the SLM and Llama-3.1-8B-Instruct as the cloud evaluation model yields a mean input token saving of 99.9 tokens per distilled call, with all 146 distilled calls yielding positive savings. Response quality, assessed by blind LLM-as-judge scoring across 121 pairs, is non-inferior to the raw path within a pre-specified 1-point margin on a 15-point rubric; the judge awarded 43 percent ties, 28 percent distilled wins, and 29 percent raw wins. Cosine similarity is mixed: mean 0.682, median 0.712, with 54.1 percent of pairs above the 0.70 reference threshold. Safety-critical domains are conservatively routed to passthrough via rule-based gates. Per-call net energy saving is estimated at 70-270 uWh under stated assumptions. SPSD shows that on-device prompt distillation can reduce cloud LLM input-token cost while preserving response quality within a practical non-inferiority margin.

10.
arXiv (CS.CL) 2026-06-24

Policies Permitting LLM Use for Polishing Peer Reviews Are Currently Not Enforceable

A number of scientific conferences and journals have recently enacted policies that prohibit LLM usage by peer reviewers, except for polishing, paraphrasing, and grammar correction of otherwise human-written reviews. But, are these policies enforceable? To answer this question, we assemble a dataset of peer reviews simulating multiple levels of human-AI collaboration, and evaluate five state-of-the-art detectors, including two commercial systems. Our analysis shows that all detectors misclassify a non-trivial fraction of LLM-polished reviews as AI-generated, thereby risking false accusations of academic misconduct. We further investigate whether peer-review-specific signals, including access to the paper manuscript and the constrained domain of scientific writing, can be leveraged to improve detection. While incorporating such signals yields measurable gains in some settings, we identify limitations in each approach and find that none meets the accuracy standards required for identifying AI use in peer reviews. Importantly, our results suggest that recent public estimates of AI use in peer reviews through the use of AI-text detectors should be interpreted with caution, as current detectors misclassify mixed reviews (collaborative human-AI outputs) as fully AI generated, potentially overstating the extent of policy violations.

11.
arXiv (CS.LG) 2026-06-16

MolE-RAG: Molecular Structure-Enhanced Retrieval-Augmented Generation for Chemistry

arXiv:2606.05693v2 Announce Type: replace Abstract: Large language models (LLMs) have shown promise for molecular property prediction, but their ability to reason over chemical structures remains limited, as molecular representations such as SMILES differ substantially from the natural language on which LLMs are primarily trained. To bridge this semantic and chemical knowledge gap, we propose MolE-RAG, a training-free, molecule-centric retrieval-augmented generation framework for LLM-based molecular property prediction. MolE-RAG augments each prediction with three complementary sources of inference-time context: retrieved chemistry literature, molecule-specific information including compound synonyms, identifiers, functional group annotations, and physicochemical descriptors, and structurally similar molecules retrieved from the training set. We evaluate MolE-RAG across nine molecular property prediction tasks using proprietary, chemistry-specialized, and open-source LLMs. Across general-purpose LLMs, MolE-RAG improves ROC-AUC by up to 28 percentage points on classification tasks and reduces regression RMSE by up to 67% relative to a SMILES-only baseline. We further find that the utility of each context source varies across models and tasks, with different models benefiting most from textual retrieval, molecular context, or structural retrieval. These results suggest that molecule-centric retrieval can improve LLM-based molecular property prediction without model fine-tuning while providing a flexible framework for integrating heterogeneous chemical knowledge at inference time.

12.
arXiv (CS.CV) 2026-06-16

Improved Knowledge Distillation for Land-Use Image Classification

In the present article, an improved Knowledge Distillation (KD) framework has been proposed for efficient compression of deep convolutional neural networks for land-use image classification task. Motivated by the need to achieve competitive classification accuracy while reducing computational complexity, a teacher-student learning paradigm is adopted in which a VGG16 network transfers knowledge to a lightweight MobileNetV2 model. The proposed framework integrates hard supervision from ground truth labels with a soft supervision strategy that combines Kullback-Leibler divergence and Cosine Similarity losses. Experiments conducted on three land-use datasets show that the proposed KD-based method yields improved performance, and achieves an accuracy of 99.04%, outperforming both baseline student training and single-loss distillation approaches, while retaining substantial model compression.

13.
arXiv (quant-ph) 2026-06-16

Phase controlled spectral topology, dynamic stability and sensitivity in Non-Hermitian Cavity Magnonics

arXiv:2606.16522v1 Announce Type: new Abstract: We theoretically investigate a non-Hermitian cavity-magnon platform in which coherent photonmagnon interactions and reservoir-mediated dissipative coupling interfere through a single externally tunable phase. We show that this interference phase provides a universal control parameter that continuously rotates the effective coupling between Hermitian and anti-Hermitian regimes, enabling dynamic transitions between level repulsion and level attraction without modifying intrinsic system parameters. The resulting phase-controlled non-Hermitian topology gives rise to exceptional points, linewidth engineering, and zero-damping conditions. Owing to the propagation-direction dependence of the dissipative interaction, the system further exhibits strong nonreciprocal transport and phase-tunable isolation arising from asymmetric hybridization of the cavity and magnon modes. Beyond its spectral and transport properties, we establish a direct connection between nonHermitian spectral topology and nonequilibrium population dynamics. The interference phase governs the stability of the hybrid modes, driving transitions between stable relaxation, critical slowing down near exceptional points, oscillatory energy exchange, and exponentially amplified dynamics. We further demonstrate that the same phase-controlled exceptional topology can be exploited for enhanced sensing, where the eigenvalue response exhibits the characteristic square-root scaling associated with exceptional-point physics. Our results provide a unified framework linking spectral topology, directional transport, dynamical stability, and sensing functionality through reservoirengineered interference in cavity magnonic systems.

14.
arXiv (CS.LG) 2026-06-19

Topological Data Analysis for High-Dimensional Dynamic Process Monitoring

arXiv:2606.20443v1 Announce Type: cross Abstract: Real-time process monitoring requires methods that extract actionable information from high-dimensional time-series data. In this work, we present a new approach for process monitoring that combines tools of topological data analysis (TDA) and machine learning. In the proposed approach, we represent multivariate time-series data as manifolds and use topological descriptors to summarize the structure of such data; we then use a neural ordinary differential equation to learn the dynamic evolution of the topological structure of the system. Using real data from an industrial process, we show that this trajectory-based event detection approach is effective at detecting diverse types of events. We contrast this approach against reconstruction-based approaches such as principal component analysis and autoencoders and against a trajectory-based approach that uses Koopman autoencoders.

15.
arXiv (CS.AI) 2026-06-11

Privacy-Preserving Federated Autoencoder for ECG Anomaly Detection on Edge Devices

arXiv:2606.11556v1 Announce Type: cross Abstract: Continuous electrocardiography (ECG) monitoring could surface rhythm abnormalities before they escalate into cardiovascular events. However, a deployable system must satisfy three requirements simultaneously: legal-grade privacy (GDPR, HIPAA), real-time inference on constrained edge hardware, and detection quality under non-IID cross-hospital data. We design and evaluate an end-to-end federated system addressing all three for unsupervised 12-lead ECG anomaly detection on PTB-XL dataset, combining three autoencoder families (VanillaAE, ConvAE, VAE), Flower-based federated averaging (FedAvg) across ten simulated hospitals, client-side differentially private SGD (DP-SGD) with a Rényi-DP accountant, and 8-bit integer (INT8) post-training quantization with Raspberry Pi 4 benchmarking. Our main contributions are: an empirical characterization of how these mechanisms compose, practical DP-specific recommendations, and technical and security insights for a clinically sensitive setting. Federated learning matches or exceeds the centralized baseline across all architectures (ConvAE federated area under the ROC curve, AUROC, $0.782$), and an $\varepsilon$ sweep identifies $\varepsilon=4$ as the recommended clinical operating point. INT8 quantization roughly halves model size and cuts Pi 4 latency by up to $44%$ with $

16.
arXiv (CS.AI) 2026-06-24

ReM-MoA: Reasoning Memory Sustains Mixture-of-Agents Scaling

arXiv:2606.24437v1 Announce Type: new Abstract: Mixture-of-Agents (MoA) architectures improve inference-time scaling by organizing multiple LLM agents into layered reasoning pipelines. However, existing MoA variants fail to sustain gains as depth increases, exhibiting degradation, early plateauing, or saturation. We propose ReM-MoA, a memory-augmented MoA framework that sustains scaling through two mechanisms: (1) a Ranked Reasoning Memory that persistently stores and ranks reasoning traces from all layers using a comparative Reviewer Agent, and (2) a Curated Diversified Memory Routing scheme that exposes different agents to distinct combinations of successful and failed traces, preserving exploration diversity while propagating high-quality reasoning. We further introduce an optional multi-domain Reviewer distillation pipeline that improves ranking quality through frontier-model supervision. Across five reasoning benchmarks spanning math, formal logic, code, knowledge, and commonsense, ReM-MoA consistently outperforms prior MoA variants across both depth and width scaling, and its advantage widens with depth, establishing structured cross-layer reasoning memory as a key missing mechanism for scalable multi-agent inference.

17.
arXiv (CS.LG) 2026-06-12

Data-driven Lake Water Quality Forecasting for Time Series with Missing Data using Machine Learning

arXiv:2601.15503v2 Announce Type: replace Abstract: Volunteer-led lake monitoring yields irregular, seasonal time series with many gaps arising from ice cover, weather-related access constraints, and occasional human errors, complicating forecasting and early warning of harmful algal blooms. We study Secchi Disk Depth (SDD) forecasting on a 30-lake, data-rich subset drawn from three decades of in-situ records collected across Maine lakes. Missingness is handled via Multiple Imputation by Chained Equations (MICE), and we evaluate performance with a normalized Mean Absolute Error (nMAE) metric for cross-lake comparability. Among six candidates, ridge regression provides the best mean test performance. Using ridge regression, we then quantify the minimal sample size, showing that under a backward, recent-history protocol, the model reaches within 5% of full-history accuracy with approximately 176 training samples per lake on average. We also identify a minimal feature set, where a compact four-feature subset matches the thirteen-feature baseline within the same 5% tolerance. Bringing these results together, we introduce a joint feasibility function that identifies the minimal training history and fewest predictors sufficient to achieve the target of staying within 5% of the complete-history, full-feature baseline. In our study, meeting the 5% accuracy target required about 64 recent samples and just one predictor per lake, highlighting the practicality of targeted monitoring. Hence, our joint feasibility strategy unifies recent-history length and feature choice under a fixed accuracy target, yielding a simple, efficient rule for setting sampling effort and measurement priorities for lake researchers.

18.
arXiv (CS.CL) 2026-06-18

RECOM: A Validity Discrimination Tradeoff in Automatic Metrics for Open Ended Reddit Question Answering

Automatic metrics are the default for evaluating LLM-generated text, yet a metric is quietly asked to do two jobs: tell genuine content alignment from surface coincidence (validity), and tell a better system from a worse one (discriminative power). On open-ended, opinion-driven question answering, the two are in tension. We introduce RECOM (Reddit Evaluation for Correspondence of Models), a contamination-free evaluation dataset of 15,000 r/AskReddit questions (September 2025), each paired with its authentic community replies, which postdate every evaluated model's training cutoff. Scoring five open-source LLMs (7–10B) against every reply each metric paired with a random-derangement noise floor we find that no metric does both jobs well. Cosine similarity separates real from random answers (Cohen's $d \approx 2$) but cannot rank the five models ($|d| < 0.1$); BERTScore precision appears to rank the models (raw $|d|$ up to 0.63), but once response length is controlled this collapses to $|d| = 0.09$ and its validity is weak ($d \approx 0.8$, versus cosine's $\approx 2$). Because every metric scores the same outputs, this validity–discrimination tradeoff is a property of the metrics, not the models, and we argue it stems from representation design. Three independent LLM judges reproduce the validity gap and likewise separate the five models only weakly. We recommend reporting metrics on both axes, with an explicit random-baseline floor. RECOM is publicly available at https://anonymous.4open.science/r/recom-D4B0

19.
arXiv (CS.CL) 2026-06-16

EHRNote-ChatQA: A Benchmark for Evidence-Grounded Multi-Turn Clinical Question Answering over Longitudinal Discharge Summaries

Discharge summaries are crucial clinical documents containing the context of a patient's overall hospital stay, and are routinely reviewed by medical experts for patient readmission, ongoing care, and diagnostic decision-making. When reviewing them, medical experts often must iteratively synthesize information across multiple summaries while verifying the evidence supporting each answer. Although large language models (LLMs) are increasingly explored for clinical question answering, existing benchmarks do not sufficiently reflect this setting: they often evaluate exam-style medical knowledge or focus on single-turn question answering with limited evidence-grounding evaluation. We introduce EHRNote-ChatQA, the first benchmark for evidence-grounded multi-turn clinical question answering over patients' multiple discharge summaries. Built from de-identified MIMIC-IV discharge summaries, EHRNote-ChatQA contains 967 patient-level multi-turn samples spanning one to five notes and 16,072 medical-expert-verified QA pairs (8,036 content questions, each paired with an evidence-grounding question) across eight clinical categories. The benchmark is constructed through an expert-informed pipeline combining discharge-summary structuring schema, expert-curated multi-turn QA templates, and LLM-based generation, followed by review and revision of every single QA sample by 11 medical experts. Benchmarking 22 open- and closed-source LLMs reveals several challenges, including that LLMs struggle more with evidence grounding than content answering, multi-turn errors compound across turns, and single-turn clinical QA performance does not reliably transfer to this setting. These findings establish EHRNote-ChatQA as a rigorous and practical benchmark for evaluating clinical QA systems. The dataset will be made publicly available through PhysioNet credentialed access.

20.
arXiv (CS.AI) 2026-06-11

A Survey of Reasoning and Agentic Systems in Time Series with Large Language Models

arXiv:2509.11575v3 Announce Type: replace Abstract: Time series reasoning treats time as a first-class axis and incorporates intermediate evidence directly into the answer. This survey defines the problem and organizes the literature by reasoning topology with three families: direct reasoning in one step, linear chain reasoning with explicit intermediates, and branch-structured reasoning that explores, revises, and aggregates. The topology is crossed with the main objectives of the field, including traditional time series analysis, explanation and understanding, causal inference and decision making, and time series generation, while a compact tag set spans these axes and captures decomposition and verification, ensembling, tool use, knowledge access, multimodality, agent loops, and LLM alignment regimes. Methods and systems are reviewed across domains, showing what each topology enables and where it breaks down in faithfulness or robustness, along with curated datasets, benchmarks, and resources that support study and deployment (https://github.com/blacksnail789521/Time-Series-Reasoning-Survey). Evaluation practices that keep evidence visible and temporally aligned are highlighted, and guidance is distilled on matching topology to uncertainty, grounding with observable artifacts, planning for shift and streaming, and treating cost and latency as design budgets. We emphasize that reasoning structures must balance capacity for grounding and self-correction against computational cost and reproducibility, while future progress will likely depend on benchmarks that tie reasoning quality to utility and on closed-loop testbeds that trade off cost and risk under shift-aware, streaming, and long-horizon settings. Taken together, these directions mark a shift from narrow accuracy toward reliability at scale, enabling systems that not only analyze but also understand, explain, and act on dynamic worlds with traceable evidence and credible outcomes.

21.
arXiv (CS.LG) 2026-06-12

A2D2: Fine-Tuning Any-Length Discrete Diffusion for Adaptive Decoding

arXiv:2606.13565v1 Announce Type: new Abstract: Discrete diffusion models offer a simple and stable likelihood-based framework for sequence generation, recently extended to any-length settings via token insertion. Principled reward-guided fine-tuning for any-length discrete diffusion, however, remains largely unexplored. We introduce Fine-Tuning Any-Length Discrete Diffusion for Adaptive Decoding (A2D2), a unified framework for reward-guided fine-tuning of any-length discrete diffusion models via joint optimization of the insertion and unmasking policies together with a quality-based inference schedule. We derive the Radon-Nikodym derivative for the joint insertion-unmasking path measures, enabling theoretically guaranteed convergence to the intractable reward-tilted sequence distribution without requiring target samples. Building on this, we establish unmasking and insertion quality as tractable approaches for minimizing decoding error and introduce the Adaptive Joint Decoding (AJD) loss, which provably yields the optimal path measure that generates the reward-tilted distribution. Empirically, A2D2 improves reward optimization while enhancing generation flexibility and accuracy over prior fixed-length fine-tuning and inference-time guidance methods.

22.
medRxiv (Medicine) 2026-06-10

Prediction of immunotherapy response using live tumor fragments from routine clinical biopsies

Functional ex vivo assays using live tumor tissues have demonstrated strong predictive accuracy for response to immune checkpoint inhibitors (ICIs) but are not scalable, requiring manual processing of large resections collected at academic centers. Here, an ex vivo live tumor fragment (LTF) platform was developed using standard-of-care biopsies from 228 patients with suspected malignancy collected across prospective, multicenter observational trials and biobanks. Hierarchical clustering of ICI-mediated changes in cytokine production identified two groups: responders and nonresponders. A binary classifier (elive index) using 8 cytokines achieved an AUC of 0.99 for cluster prediction. elive index correctly predicted clinical benefit in 93% (26/28) of patients (P = 3.2x10-5) and accurately identified 83% (10/12) of objective responders. Critically, elive responders were identified among biomarker-negative patients, highlighting the platform as a scalable approach that complements existing companion diagnostics and expands the population of patients identified to benefit from ICI therapy.

23.
arXiv (CS.CL) 2026-06-11

Automated Creativity Evaluation of Language Models Across Open-Ended Tasks

Large language models (LLMs) have achieved remarkable progress in language understanding, reasoning, and generation, sparking growing interest in their creative potential. Realizing this potential requires systematic and scalable methods for evaluating creativity across diverse tasks. However, most existing creativity metrics are tightly coupled to specific tasks, embedding domain assumptions into the evaluation process, and limiting scalability and generality. To address this gap, we introduce an automated, domain-agnostic framework for quantifying LLM creativity across open-ended tasks. Our approach separates the measurement apparatus from the creative task itself, enabling scalable, task-agnostic assessment. Divergent creativity is measured using semantic entropy, a reference-free and robust metric for novelty and diversity, validated against human annotations, LLM-based novelty judgments and baseline diversity measures. Convergent creativity is assessed via a novel retrieval-based multi-agent judge framework that delivers context-sensitive evaluation of task fulfilment with over 60% improved efficiency. We validate our framework in three qualitatively distinct domains: problem-solving (MacGyver), research ideation (HypoGen), and creative writing (BookMIA), using a broad suite of LLMs. Empirical results show that our framework reliably captures key facets of creativity, including novelty, diversity, and task fulfilment, and reveal how model properties, such as size, temperature, recency, and reasoning, impact creative performance. Our work establishes a reproducible and generalizable standard for automated LLM creativity evaluation, paving the way for scalable benchmarking and accelerating progress in creative AI.

24.
medRxiv (Medicine) 2026-06-15

Investigation of Intra-Fraction Stability and Inter-Fraction Reproducibility of Deep Inspiration Breath-Hold Across Two Hypofractionated Radiotherapy Regimens in the HYPORT Adjuvant Study.

Background: Deep Inspiration Breath Hold (DIBH) is a widely used respiratory motion management technique for minimizing cardiac dose in left-sided breast radiotherapy. In the Breast HYPORT Adjuvant study, DIBH was employed for cardiac sparing in patients without nodal irradiation using a standardized institutional protocol with the Varian Real-time Position Management (RPM) system. Both moderate-hypofractionation (control arm - 40Gy in 15 fractions) and one-week hypofractionation (experimental arm - 26 Gy in 5 fractions) regimens were delivered using this protocol. This study aimed to evaluate the robustness of DIBH by analyzing intra-fraction stability and inter-fraction reproducibility of breath-hold amplitude across the two treatment regimens. Methods: Respiratory waveforms acquired during each treatment session were analyzed to determine the median breath-hold amplitude and its standard deviation during beam delivery. Intra-fraction stability was assessed from vari- ations within individual treatment sessions, while inter-fraction reproducibility was evaluated relative to the simula- tion waveform amplitude across all treatment sessions. These parameters were compared between the two HYPORT regimens to examine breath-hold consistency during treatment delivery. Moreover, an additional comparison was made between the one-week hypofractionation regimen and the first five fractions of the moderate-hypofractionation regimen to evaluate the effect of treatment duration . Lung volumes from free-breathing and DIBH CT scans were analyzed to assess the effectiveness of patient breath-hold training. Results: Both arms demonstrated an average 1.7-fold increase of air volume in lung during the breath-hold position, confirming the effective implementation of DIBH during treatment planning and delivery. Structured training resulted in increased breath-hold amplitudes, with gains of 22.87% and 24.16% with respect to the first trial session in the experimental and control arms, respectively. Both regimens receive equivalent doses for approximately the same air volume in lung . Despite the different prescription doses in the two arms (26 Gy vs. 40 Gy), the experimental arm achieved an equivalent mean heart dose of 2.91% (75.6 cGy) compared with 2.95% (118.51 cGy) in the control arm, suggesting a similar cardiac preservation protocol adopted during treatment planning. Intra-fraction stability was similar between the control arm and the experimental arm, with median amplitude variations of 1.006 mm (95% CI: [0.998-1.015]) and 1.079 mm (95% CI: [1.067-1.097]), respectively. In contrast, inter-fraction reproducibility improved in the experimental arm, with lower deviation from simulation amplitude (0.44 {+/-} 0.24 mm vs. 0.66 {+/-} 0.25 mm) for the entire treatment schedule. The stability and reproducibility of experimental arm were further compared with the first five fractions of the control arm. The results were similar to those of the experimental arm. Conclusion: In this study, we compared two treatment regimens in terms of intra-fraction stability and inter-fraction reproducibility during DIBH radiotherapy. Both regimens demonstrated comparable intra-fraction stability, indicating effective motion management irrespective of treatment duration. However, the experimental arm showed better inter- fraction reproducibility, suggesting more consistent breath-hold performance throughout the treatment course. Based on stability and reproducibility, a reasonable narrowing of the DIBH gating window may be implemented with minor changes to the institutional protocol. The observed trend highlights the potential for improved consistency with the experimental approach and supports further investigation to better understand the underlying factors and strengthen these findings in future studies.

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arXiv (CS.CV) 2026-06-12

Improving Pre-trained Adult Glioma Segmentation Models Using only Post-processing Techniques

Gliomas are the most common malignant brain tumors in adults and are among the most lethal. Despite aggressive treatment, the median survival rate is less than 15 months. Accurate multiparametric MRI (mpMRI) tumor segmentation is critical for surgical planning, radiotherapy, and disease monitoring. While deep learning models have improved the accuracy of automated segmentation, large-scale pre-trained models generalize poorly and often underperform, producing systematic errors such as false positives, label swaps, and slice discontinuities in slices. These limitations are further compounded by unequal access to GPU resources and the growing environmental cost of large-scale model training. In this work, we propose adaptive post-processing techniques to refine the quality of glioma segmentations produced by large-scale pretrained models developed for various types of tumors. We demonstrated the techniques in multiple BraTS 2025 segmentation challenge tasks, with the ranking metric improving by 14.9 % for the sub-Saharan Africa challenge and 0.9% for the adult glioma challenge. This approach promotes a shift in brain tumor segmentation research from increasingly complex model architectures to efficient, clinically aligned post-processing strategies that are precise, computationally fair, and sustainable.