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01.
arXiv (CS.AI) 2026-06-16

Evolutionary Dynamics of Cooperation in Next-Generation LLM Agent Systems: A Cross-Provider Empirical Extension

arXiv:2605.29874v2 Announce Type: replace-cross Abstract: Do next-generation LLM agents inherit the cooperative biases documented in their predecessors, or does scale and provider diversity reshape equilibrium behaviour in competitive multi-agent settings? Willis et al. established a benchmark for this question using evolutionary game theory and the Iterated Prisoner's Dilemma (IPD), finding consistent cooperative biases in ChatGPT-4o and Claude 3.5 Sonnet. We extend this benchmark to four frontier models released in 2025-2026 - Claude Sonnet 4.6, Gemini 2.5 Flash, Gemini 3.1 Pro, and GPT-5.4 Mini - applying the identical protocol across three prompting styles (Default, Prose, Self-Refine) and four population compositions (balanced and biased, with and without noise). Cooperative bias persists across providers (H1): ten of twelve model-prompt combinations favour cooperative equilibria in balanced noiseless conditions. Cross-provider divergence is substantial (H3): Gemini 2.5 Flash reaches up to 77% aggressive equilibria under biased conditions, while GPT-5.4 Mini reaches 70% cooperative equilibria under Self-Refine. Support for aggressive capability parity is partial (H2): Self-Refine raises ICD in all models and Gemini 3.1 Pro Refine achieves the highest ICD in the dataset (0.925), but Default and Prose prompts show no systematic narrowing. Evidence on noise robustness is directionally positive but not robustly confirmed (H4): with n=500 Moran iterations per condition, average noise sensitivity is about 6 percentage points for Claude Sonnet 4.6 versus 13 pp for Claude 3.5 Sonnet, but this cross-study gap is not statistically significant once the predecessor's unreported sampling error is propagated. Provider identity, rather than model generation, is the strongest correlate of equilibrium outcomes; noise remains a universal challenge regardless of model size or vintage.

02.
medRxiv (Medicine) 2026-06-18

Hospital-Level Variation in Antenatal Corticosteroids for Late Preterm Births

Objective: To determine whether and to what extent hospitals across the United States vary in their use of late-preterm steroids using a novel data set in which the timing of steroid administration relative to delivery can be observed. Methods: This was a retrospective cohort study of singleton births with known gestational ages identified in the Premier Healthcare Database from 2015 to 2022. The primary variable of interest was hospital-level adoption of antenatal corticosteroids for late-preterm singleton deliveries, calculated as the proportion of late-preterm singleton births (34-36 completed weeks of gestation) with any betamethasone exposure during the same late-preterm period. Hospital adoption was defined as the weighted average rate of ALPS administration among late-preterm infants across the entire post-period. Hospitals were ranked by their late-preterm steroid adoption rates and categorized by quartile based on the empirical distribution. Temporal trends were assessed using annual hospital-level adoption rates and visualized using time-series plots and distributional plots. A logistic regression model was constructed to determine hospital characteristics associated with being a highest-quartile adopting hospital. Results: The analysis cohort included 728 hospitals and 5,452,791 births, of which 361,006 (6.6%) were singleton late preterm births. Hospital steroid exposure rates ranged from 0 to 82% and were categorized into quartiles based on overall exposure rate, with cutoffs at 20.6%, 29.8%, and 40.1%. Median exposure rates increased progressively across quartiles from 14.1% (IQR 9.3-17.4%) in the lowest adopting hospitals (Q1) to 47.6% (IQR 43.7-53.2%) in the highest adopting hospitals (Q4), with substantial within-quartile variation. In the multivariable model, urban location was a strong predictor of high adoption after adjustment (aOR 2.05; 95% CI 1.11-3.83, p=0.02). Compared to Midwest hospitals, Southern hospitals had significantly lower odds of being high adopters (aOR 0.37; 95% CI 0.20-0.69, p

03.
medRxiv (Medicine) 2026-06-18

Comparative Evaluation of Pretrained Large Language Models for Suicide Risk Prediction from Clinical Notes in U.S. Veterans

Background: Suicide remains a significant and potentially preventable cause of death among United States veterans. Predictive models based on structured electronic health record (EHR) data, including the U.S. Department of Veterans Affairs' Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment (REACH-VET) program, aim to identify individuals at elevated risk for enhanced monitoring and follow-up. Increasing evidence suggests that unstructured clinical narratives contain additional psychosocial information that may enhance risk prediction when analyzed using natural language processing (NLP). However, optimal approaches for representing clinical text remain uncertain. Recent advances in large language models (LLMs) enable contextual text representations that capture complex semantic relationships beyond traditional lexical methods. Methods: We compared the predictive performance of pretrained LLMs with classical bag-of-words (BoW) representations for suicide risk prediction using clinical notes from 27,241 veterans receiving care in the Veterans Health Administration. Patients were stratified by REACH-VET risk tier (low, moderate, high), and models were evaluated across prediction windows defined by note look-back periods (

04.
arXiv (CS.CV) 2026-06-18

Posterior Continuation with Noise-Conditioned Frequency Exposure for Diffusion Inverse Problems

Diffusion posterior sampling solves inverse problems by combining a pretrained diffusion prior with measurement-consistency guidance. However, full-band guidance can be unreliable at high noise levels, where clean estimates contain score-induced errors and high-frequency measurement directions are weakly identifiable. We argue that posterior guidance should expose measurement frequencies according to the instantaneous diffusion noise level. Based on this principle, we propose a posterior continuation framework that constructs a family of intermediate posteriors whose likelihood emphasizes currently reliable frequency bands and gradually returns to full-band consistency. We instantiate this framework with a stabilized sampler that combines a diffusion predictor, frequency-limited likelihood refinement, and a Haar-domain commitment rule that commits reliable coarse corrections while deferring weakly identifiable details. Across super-resolution, inpainting, and deblurring, our method achieves competitive-to-state-of-the-art restoration performance, including up to 5 dB PSNR improvement on motion deblurring over strong baselines in evaluations on FFHQ and ImageNet.

05.
arXiv (CS.AI) 2026-06-25

ExTra: Exploratory Trajectory Optimization for Language Model Reinforcement Learning

arXiv:2606.24994v1 Announce Type: cross Abstract: Reinforcement Learning with Verifiable Rewards (RLVR) for language-model reasoning can fail at both extremes of task difficulty: easy prompts often produce all-correct, low-diversity rollout groups with little gradient signal, while hard prompts can produce all-incorrect groups with no positive reward. We introduce ExTra (Exploratory Trajectory Optimization), a GRPO-compatible framework that extracts exploration signals from the model's own rollouts. ExTra combines two mechanisms: (i) a novelty reward that adds embedding-based diversity bonuses after GRPO normalization, rewarding diverse correct solutions; and (ii) entropy-guided prefix regeneration, which scores partial trajectories using entropy signals and continues exploration from promising intermediate steps. Across six mathematical reasoning benchmarks, ExTra improves Qwen3-1.7B over GRPO by about +5 points on pass@1 and +7 points on pass@16, showing that trajectory-level exploration signals can improve both single-sample accuracy and inference-time coverage.

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

Mirror Descent Beyond Euclidean Stability: An Exponential Separation in Initialization Sensitivity

arXiv:2606.11431v1 Announce Type: new Abstract: Mirror Descent (MD) extends Gradient Descent (GD) beyond Euclidean geometry and has recently reappeared as a lens for KL-regularized policy optimization in reinforcement learning and LLM post-training. This raises a basic robustness question, crucial to reproducibility and reliability: how sensitive are MD dynamics to their inputs? We focus on initialization, often itself a pretrained or previously aligned model. Quadratic-regularized MD, including GD and Mahalanobis geometries, is well-known to be stable for convex smooth objectives. We show a sharp contrast: once the regularizer is non-quadratic, MD can be exponentially more sensitive to initialization than GD, even with a well-conditioned regularizer in Euclidean norm. We give a three-dimensional construction with a convex, smooth objective and a strongly convex, smooth, well-conditioned regularizer where an initial $\varepsilon$ perturbation is quickly amplified to $\min\{polylog^{-1}(1/\varepsilon), \varepsilon e^{\Omega(\eta T)}\}$ after $T$ iterations of MD with step size $\eta$. For canonical KL-regularized MD on the simplex, we show that even linear objectives can amplify an initial $\varepsilon$ perturbation exponentially fast in high-dimensional or near-boundary regimes. Finally, we show that adding a Bregman regularization term toward an anchor point can stabilize the dynamics while largely preserving the optimization guarantees, and that the choice of anchor is crucial: anchoring at the initialization only partially mitigates the instability, whereas anchoring at a fixed point yields a more stable mechanism.

07.
arXiv (CS.AI) 2026-06-25

EvoAgent: An Evolvable Agent Framework with Skill Learning and Multi-Agent Delegation

arXiv:2604.20133v3 Announce Type: replace Abstract: This paper proposes EvoAgent–an evolvable large language model (LLM) agent framework that integrates structured skill learning with a hierarchical sub-agent delegation mechanism. EvoAgent models skills as multi-file structured capability units equipped with triggering mechanisms and evolutionary metadata, and enables continuous skill generation and optimization through a user-feedback-driven closed-loop process. In addition, by incorporating a three-stage skill matching strategy and a three-layer memory architecture, the framework supports dynamic task decomposition for complex problems and long-term capability accumulation. Experimental results based on real-world foreign trade scenarios demonstrate that, after integrating EvoAgent, GPT5.2 achieves significant improvements in professionalism, accuracy, and practical utility. Under a five-dimensional LLM-as-Judge evaluation protocol, the overall average score increases by approximately 28\%. Further model transfer experiments indicate that the performance of an agent system depends not only on the intrinsic capabilities of the underlying model, but also on the degree of synergy between the model and the agent architecture. Code, data, and documents will be released at https://github.com/Focus-AI-Center/Mentarc-EvoAgent.git.

08.
arXiv (CS.AI) 2026-06-17

Memory as a Wasting Asset: Pricing Flash Endurance for Embodied Agents, and the Limits of Doing So

arXiv:2606.18144v1 Announce Type: new Abstract: A robot's flash endurance is a non-renewable stock: every persisted write spends one of a few thousand program/erase cycles and never refills, yet no fielded robot memory system prices which memories are worth an erase cycle. We treat embodied memory as depreciating capital and price that stock with a single endurance shadow price $\eta$, which makes cost-minimizing placement across a RAM / on-board NVM / cloud hierarchy a threshold in a wear-augmented per-byte index. The index is cost-optimal whatever the sign of the value-write association $\chi$; only when $\chi > 0$ does the optimum turn non-monotone, sending a robot's most valuable memories off its flash. The pivot is thus empirical, and we measure $\chi$ on real robot logs at a pre-specified gate: its sign is a property of the deployment regime – positive on recurrent long-horizon manipulation ($\hat{\chi} \approx +1.0 \times 10^{-3}$, replicated at full power), null on a shorter-horizon suite, and negative on non-recurrent teleoperation. Two boundaries scope the result. The endurance budget is dormant on premium 3,000-P/E TLC at datasheet prices and binding on the commodity QLC/eMMC ($\sim$1,000 P/E) that cheaper edge robots run. And where it binds, a learned wear-aware controller only ties price-based routing on task value, because realized value is tier-invariant across RAM, NVM, and cloud: the rent governs device lifetime and cost, not task performance. Whether wear-aware placement improves task value remains open – $\chi$ is measured against a value proxy, and the non-monotone optimum, while proven, is not yet observed in data.

09.
arXiv (CS.AI) 2026-06-18

WebSP-Eval: Evaluating Web Agents on Website Security and Privacy Tasks

arXiv:2604.06367v2 Announce Type: replace-cross Abstract: Web agents automate browser tasks, ranging from simple form completion to complex workflows like ordering groceries. While current benchmarks evaluate general-purpose performance~(e.g., WebArena) or safety against malicious actions~(e.g., SafeArena), no existing framework assesses an agent's ability to successfully execute user-facing website security and privacy tasks, such as managing cookie preferences, configuring privacy-sensitive account settings, or revoking inactive sessions. To address this gap, we introduce WebSP-Eval, an evaluation framework for measuring web agent performance on website security and privacy tasks. WebSP-Eval comprises 1) a manually crafted task dataset of 200 task instances across 28 websites; 2) a robust agentic system supporting account and initial state management across runs using a custom Google Chrome extension; and 3) an automated evaluator. We evaluate a total of 8 web agent instantiations using state-of-the-art multimodal large language models, conducting a fine-grained analysis across websites, task categories, and UI elements. Our evaluation reveals that current models suffer from limited autonomous exploration capabilities to reliably solve website security and privacy tasks, and struggle with specific task categories and websites. Crucially, we identify stateful UI elements are a primary reason for agent failure, with toggles causing more than 45% task failure across many models.

10.
arXiv (CS.CL) 2026-06-12

A Context-Aware Dataset for Stance Detection in Bioethical Controversies on Reddit

Bioethical debates increasingly unfold on social media, yet stance detection research lacks large-scale, domain-specific resources for modeling such context-dependent discourse. We present BioStance, a context-aware dataset of 39,600 annotated Post-Comment pairs from Reddit bioethical discussions. BioStance covers six controversial targets across three dimensions of bioethical controversy: fundamental value conflicts, individual liberty versus collective responsibility, and technological uncertainty. Each instance preserves hierarchical conversational context and is labeled by three independent annotators using a three-class stance scheme: Favor, Against, and None. The annotations achieve a mean Krippendorff's $\alpha$ of 0.82, indicating substantial reliability. By combining thematic diversity, conversational structure, and high-quality human annotation, BioStance supports research on context-aware stance detection, argument mining, and computational analysis of bioethical discourse.

11.
arXiv (CS.CL) 2026-06-19

Connect the Dots: Training LLMs for Long-Lifecycle Agents with Cross-Domain Generalization Via Reinforcement Learning

This work presents a general framework for training large language models (LLMs) to "Connect the Dots" (CoD), a meta-capability required by long-lifecycle agents: as an LLM-based AI agent gets deployed in an environment, it solves a long sequence of tasks while continuously exploring the environment, learning from its own experiences, and iteratively self-updating its context about the environment, thereby achieving progressively better performance on future tasks conditioned on the updated context. Major components of the CoD framework include: (1) algorithm design and infrastructure for end-to-end reinforcement learning (RL) with long rollout sequences interleaving solve-task and update-context episodes; (2) tasks and environments for incentivizing and eliciting the targeted meta-capability in LLMs during training, as well as for faithfully measuring progress during evaluation. We present proof-of-concept implementations of the CoD framework, including a GRPO-style RL algorithm with fine-grained credit assignment, as well as tasks and environments tailored to the targeted meta-capability (rather than domain-specific LLM capabilities or standard task-by-task RL). Empirical results validate the efficacy of end-to-end RL training in the CoD setting, and demonstrate the potential for out-of-distribution generalization – within the training domains, across different domains, and from CoD to Ralph-loop settings – of the elicited meta-capability. Our investigation of CoD connects several lines of prior works, and opens up new opportunities for advancing LLMs and AI agents. To facilitate further research and applications, we release our implementations at \url{https://github.com/agentscope-ai/Trinity-RFT/tree/research/cod/examples/research_cod}.

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

LLM-ODDR: A Large Language Model Framework for Joint Order Dispatching and Driver Repositioning

arXiv:2505.22695v2 Announce Type: replace Abstract: Ride-hailing platforms face significant challenges in optimizing order dispatching and driver repositioning operations in dynamic urban environments. Traditional approaches based on combinatorial optimization, rule-based heuristics, and reinforcement learning often overlook driver income fairness, interpretability, and adaptability to real-world dynamics. To address these gaps, we propose LLM-ODDR, a novel framework leveraging Large Language Models (LLMs) for joint Order Dispatching and Driver Repositioning (ODDR) in ride-hailing services. LLM-ODDR framework comprises three key components: (1) Multi-objective-guided Order Value Refinement, which evaluates orders by considering multiple objectives to determine their overall value; (2) Fairness-aware Order Dispatching, which balances platform revenue with driver income fairness; and (3) Spatiotemporal Demand-Aware Driver Repositioning, which optimizes idle vehicle placement based on historical patterns and projected supply. We also develop JointDR-GPT, a fine-tuned model optimized for ODDR tasks with domain knowledge. Extensive experiments on real-world datasets from Manhattan taxi operations demonstrate that our framework significantly outperforms traditional methods in terms of effectiveness, adaptability to anomalous conditions, and decision interpretability. To our knowledge, this is the first exploration of LLMs as decision-making agents in ride-hailing ODDR tasks, establishing foundational insights for integrating advanced language models within intelligent transportation systems. While the current framework incurs higher computational costs than traditional methods, we show that parallel decomposition and model distillation can reduce latency to production-viable levels for deployment.

13.
arXiv (CS.AI) 2026-06-25

Conformal Recovery-Deadline Certificates for Runtime Assurance of Adapting Controllers

arXiv:2606.25371v1 Announce Type: cross Abstract: Runtime assurance (RTA) protects a safety-critical system by switching from an advanced controller to a verified safe controller when a monitored condition is violated. The standard latching rule, which trips on the first breach of the safe set and then coasts, is correct for a diverging controller but pathological for a capable online-adapting one. Such a controller is unsafe by design during a bounded recovery transient. It must excite the plant to identify the fault before it can correct it, so a latching shield trips on that transient and suppresses a controller that would have recovered. We introduce the conformal recovery-deadline certificate, a split-conformal, distribution-free, finite-sample upper bound on the adapting controller's recovery time that licenses delayed fallback with a coverage guarantee, backstopped by a verified monitor at a hard critical limit. The certified deadline discriminates capable from incapable controllers, keeping the recoverer autonomous while catching the diverger. The construction separates autonomy, governed by statistical coverage, from safety, governed by the verified backstop, as an instance of reliability-asymmetric design. We prove marginal coverage, a weighted extension that restores coverage under a known fault-distribution shift, and group-conditional Mondrian coverage. We demonstrate all three on two unrelated Simplex testbeds: a 6-DOF spacecraft attitude controller and a torque-controlled inverted pendulum. Both show the same suppression pathology and the same cure, making the certificate a domain-general mechanism rather than a single-system trick.

14.
arXiv (quant-ph) 2026-06-24

Offline Channel-Independent QAOA Angles for RIS Power Aggregation: Unit-Circle Phase Dictionaries and Infinite-Size Spin-Glass Limits

arXiv:2606.24540v1 Announce Type: new Abstract: Reconfigurable intelligent surfaces (RIS) maximize received power by setting per-element phases. Discrete-phase optimization is NP-hard in the worst case, while the quantum approximate optimization algorithm (QAOA) applied to RIS faces limited phase alphabets, either per-problem angle optimization or uncharacterized training cost exposed to barren plateaus, and no scalable performance benchmark. We introduce a $2^{M}$-phase $\theta$ dictionary for optimizing power $\|\mathbf{A} \, e^{j\theta}\|^{2}$ having $K \times N$ channel matrix $\mathbf{A}$ and QAOA angle offline optimization with instance and size-independent infinite-size limit of the mixed-$q$ Gaussian ensemble of Basso et al. Our design bounds the spin-Hamiltonian interaction order to at most quartic for any $M$, and the deployed order-2 reduction lies below the even-$q\!\ge\!4$ regime in which constant-level QAOA limitations are proved. We perform analytical, state-vector, matrix-product-state and Pauli-path-simulation numerical studies for $N=K \leq 100$ and QAOA depth $p=9$, verifying offline angle transfer to Rayleigh, Rician/line-of-sight, cascaded double-fading and spatially-correlated RIS channels at $N\!\in\!\{5,12\}$. We observe performance reaching a near-optimal multi-start single-flip local-search reference for $N\!\le\!16$ under order-2 modeling with $2^{5}{=}32$-phase dictionary while the order-4 model shows a performance ceiling below the classical reference. The approach suggests a route to near-optimal large-$N$ performance on future fault-tolerant (FTQ) quantum computers, which enable the higher-depth QAOA circuits.

15.
arXiv (CS.AI) 2026-06-19

Secure Coding Drift in LLM-Assisted Post-Quantum Cryptography Development: A Gamified Fix

arXiv:2606.19474v1 Announce Type: cross Abstract: The transition to Post Quantum Cryptography (PQC) introduces considerable implementation complexity, requiring strict adherence to constant-time execution, side channel resistance, and precise parametrisation. Simultaneously, large language models (LLMs) are heavily embedded in software development workflows, including cryptographic engineering. While LLMs improve productivity, evidence shows that they frequently generate insecure or suboptimal code, particularly in security critical domains. This paper introduces Secure Coding Drift in PQC, a novel socio technical vulnerability model capturing the gradual degradation of secure coding practices due to sustained reliance on LLM-generated code. Unlike prior work that focuses on static vulnerabilities, we conceptualise security risk as a longitudinal behavioural phenomenon rising from human AI interaction. To mitigate this, we propose a gamified, LLM augmented secure coding framework that embeds adversarial evaluation, behavioural feedback, and security scoring into development workflows. Our approach reframes LLMs from passive assistants into active security co-pilots, contributing toward safer PQC implementation in AI mediated environments.

16.
arXiv (CS.CL) 2026-06-25

Shared Doubt: Zero-Shot Cross-Lingual Confidence Estimation for Language Models

Confidence estimation (CE), i.e., quantifying the reliability of a model's prediction, has attracted great interest in the context of large language models (LLMs). However, most studies focus on English, ignoring the multilingual reality of LLM usage, while many CE methods degrade or require retraining across languages. To address this gap, we investigate whether multilingual LLMs encode shared, language-transferable confidence features in open-ended question answering. We use a lightweight linear probe that predicts answer correctness directly from intermediate representations. Trained monolingually, the probe generalizes zero-shot to unseen, typologically diverse languages without target-language supervision. Learned layer weights and multiple ablations reveal that confidence features concentrate in middle layers across languages, suggesting a shared confidence subspace. While zero-shot cross-lingual performance depends on similarity to the source language, the probe provides a strong baseline without any retraining and compares favorably to other popular confidence estimation methods.

17.
arXiv (CS.AI) 2026-06-16

User as Code: Executable Memory for Personalized Agents

Authors:

arXiv:2606.16707v1 Announce Type: new Abstract: A personalized AI agent needs a user memory: a persistent model of who the user is, built across many conversations and consulted on each new one. Today this memory is almost always stored as unstructured text, a knowledge graph, or a flat store of facts, and consulted by retrieval – fetching the entries most similar to the current request. Such "bag-of-facts" memory recalls individual facts well, but because storing a fact and acting on it are separate steps, it struggles to resolve contradictions, aggregate over many records, or enforce rules. We argue that user memory should instead be executable. We introduce User as Code (UaC), a paradigm in which an agent's model of a user is a living software project: typed Python objects hold the user's state and ordinary Python functions encode the rules that govern it, so representing and reasoning about the user happen in one medium an interpreter can run. The enabling mechanism is a two-phase pipeline: an append-only log that never discards a fact, periodically checkpointed into typed code. This changes what memory can do. On standard long-term conversation benchmarks, UaC matches both a full-context upper bound and the strongest prior memory systems on recall (78.8% on LOCOMO). Its advantage emerges where representation matters most. On aggregate questions over a user's history – "how many international trips did I take last year?" – retrieval-based memory collapses (6-43%) while UaC stays near-perfect (99%), because the answer is a one-line computation over typed state rather than a search over text. And because its rules execute deterministically whenever the state changes, UaC can surface unsolicited, safety-critical alerts – such as a newly prescribed drug that conflicts with an allergy recorded months earlier – a capability query-driven memory cannot provide.

18.
medRxiv (Medicine) 2026-06-15

Evaluation of AI-Generated Synthetic Data for Clinical Research in Secondary Cardiovascular Prevention among Dyslipidemia Patients

Background: Access to high-quality clinical data is essential for advancing medical research and developing effective medical statistical and Artificial Intelligence models. However, privacy regulations and logistical barriers often hinder timely access to real-world data. Synthetic data offer a promising solution, preserving the statistical characteristics of original datasets while protecting patient privacy. Objectives: This study investigates the use of synthetic data for secondary cardiovascular prevention in patients with dyslipidemia, using two real-world datasets from Centro Cardiologico Monzino. Methods: Given the high dimensionality and limited sample size of the datasets, we employed a custom generative framework based on Large Language Models (LLMs). Pre-trained LLMs were fine-tuned on original clinical records to synthesize tabular data replicating source-data distributions. Fine-tuning was performed within the Centro Cardiologico Monzino's secure infrastructure to ensure data sovereignty. We evaluate clinical utility and privacy using fidelity and privacy metrics, identifying the optimal generative model and benchmarking against traditional anonymization methods. Results: Synthetic data achieved a superior trade-off than classically anonymized datasets. Real and synthetic datasets showed strong agreement, with significant distributional differences limited to few variables. Models trained on synthetic data replicated key associations from the original dataset, including therapy modification and creatine phosphokinase as predictors of SAMS, and pharmacological intensity as the main driver of LDL-C reduction. Conclusions: Results support the feasibility of using synthetic data as a proxy for real-world datasets in exploratory analyses and model development. Despite slight attenuation of some effect sizes, preserved clinical relationships reinforce the validity of synthetic data in medical research.

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

Hierarchical Modeling of ICD Codes in EHR Foundation Models

arXiv:2606.15447v1 Announce Type: new Abstract: Electronic health record foundation models typically treat ICD diagnosis codes as flat tokens, overlooking the clinically meaningful hierarchical structure that captures disease families, subcategories, and fine-grained diagnostic detail. As a result, existing EHR representation learning methods do not explicitly exploit the hierarchical structure already present in the coding system. In this work, we study ICD-10-CM hierarchy as a general inductive bias for clinical representation learning. We investigate two complementary mechanisms for incorporating hierarchy: first, by augmenting diagnosis sequences in a BERT-style transformer with tokens corresponding to different levels of the ICD hierarchy, and second, by injecting hierarchy into graph-based code representations through hierarchy-aware edges combined with diagnosis co-occurrence structure. Across these settings, we evaluate whether explicit hierarchy improves downstream prediction, which levels of the hierarchy are most useful, whether hierarchy encoding improves transfer across datasets, and how hierarchy reshapes embedding similarity structure. We conduct experiments on two large-scale real-world clinical datasets: MIMIC-IV, used for pretraining and in-domain evaluation, and eICU, used to assess cross-dataset transfer via frozen encoder probing. Our findings show that explicitly encoding ICD hierarchy improves over flat code representations in both in-domain and cross-dataset settings, while revealing that the most useful level of hierarchy depends on both the task and the modeling approach. More broadly, we focus on hierarchy-aware EHR representation learning and show that the benefits of encoding hierarchy are generalizable across modeling settings and hierarchy levels.

20.
arXiv (CS.CL) 2026-06-16

Do Safety Monitors Stay Reliable After an Update? Benchmarking and Predicting Activation-Monitor Staleness

Authors:

Activation monitors-lightweight probes trained on a language model's internal representations-are an increasingly common layer in deployment safety stacks. Deployed models however are rarely static: they are quantized, fine-tuned, adapted with LoRA, or served with merged adapters while the monitor remains frozen. We present the first systematic test of whether this implicit contract holds: whether activation monitors trained on a base model remain reliable after these routine model updates. Across multiple safety-relevant monitors, model depths, update families, and open-weight models, we find a sharp split: quantization-style updates largely preserve frozen probe performance, while fine-tuning-style updates frequently make probes stale. Fragility is highly monitor-dependent, with privacy/PII probes most affected and refusal-compliance probes comparatively stable, showing that retraining a behavior need not stale its corresponding monitor. QLoRA is especially damaging despite NF4 quantization alone being relatively benign, suggesting that quantization becomes riskier when combined with adaptation. We further show that degradation is predictable from pre-deployment features, enabling revalidation budgets to be triaged toward the monitors most likely to fail. These results suggest that fine-tuning should trigger activation-monitor revalidation by default, while prediction can help prioritize which monitors to check first.

21.
arXiv (CS.AI) 2026-06-18

Graph Grounded Cross Attention Transformer Neural Network for Structurally Constrained Full Event Sequence Generation in Predictive Process Monitoring

arXiv:2606.18726v1 Announce Type: cross Abstract: Structurally constrained event sequence generation remains challenging because generated paths must preserve transition feasibility, temporal order, termination, and attribute consistency. In predictive process monitoring (PPM), this challenge appears as full event sequence generation, whereas existing work mainly addresses component tasks such as next activity, remaining time, outcome, and attribute prediction. This paper proposes the Graph Grounded Cross Attention Transformer Neural Network (GGATN) for this unified PPM task. GGATN uses a global process graph as structured activity memory, contextualizes sequence positions through Transformer self attention, and injects process topology through graph grounded cross attention. Unlike autoregressive decoding, GGATN generates activities, timestamps, length, and event level and sequence level attributes in a single pass, followed by Viterbi style graph constrained decoding for feasible paths and explicit termination. Experiments on six benchmark event logs show more reliable generation quality than local instruction prompted LLM baselines. GGATN achieves strong performance on sequence similarity, Damerau Levenshtein similarity, bigram based control flow similarity, and duration distribution, while maintaining zero hallucinated activities and zero sequence level attribute inconsistency. Ablation analyses confirm the global graph encoder as a stable structural prior. Interpretability analyses show how graph structure, sequence context, feedback refinement, and constrained decoding shape generation.

22.
arXiv (CS.CV) 2026-06-17

Pareto LoRA: Mitigating Modality Imbalance in Unified Multimodal Models via Pareto-Optimal Gradient Integration

Unified multimodal models (UMMs) have recently emerged as a promising paradigm for integrating multimodal understanding and generation within a single autoregressive transformer. However, during multimodal instruction tuning, these models often exhibit pronounced modality imbalance: language gradients dominate optimization, thus leading to lower image generation quality, especially under parameter-efficient fine-tuning such as LoRA. In this work, we systematically analyze modality imbalance in LoRA-based fine-tuning of UMMs for interleaved text-image generation. We show that vision modality performance degrades substantially more than text modality performance when compared to unimodal counterparts, and that modality-specific gradients can differ by orders of magnitude across various tasks and layers. Motivated by this observation, we reformulate the multimodal instruction tuning as a bi-objective optimization problem and propose Pareto LoRA, a Pareto-optimal gradient integration strategy that balances the text and image objectives by modulating the gradient direction and strength. Experiments on the CoMM benchmark with Emu2 demonstrate that Pareto LoRA consistently improves multimodal generation balance, achieving up to 44.9% gains in perceptual image quality over vanilla LoRA while maintaining comparable text performance.

23.
arXiv (CS.CL) 2026-06-17

Toward Accessible Psychotherapy Training Using AI-Driven Interactive Patient Avatars

Training psychotherapists in evidence-based interventions such as Acceptance and Commitment Therapy (ACT) requires repeated practice with meaningful feedback, yet opportunities for safe, standardized training are limited by ethical, logistical, and resource constraints. We introduce a system designed to support ACT-oriented psychotherapy training through spoken dialogue with an embodied virtual patient. The system uses large language models to simulate patient behavior conditioned on profiles derived from real therapy sessions and configurable clinical scenarios, while a separate automated evaluator provides turn-by-turn feedback on therapist responses based on established ACT fidelity criteria. Rather than aiming to replace supervision, the system is intended to support deliberate practice by enabling experimentation, reflection, and immediate feedback in low-risk settings. Expert evaluation with practicing psychologists confirmed high realism in patient behavior and demonstrated that immediate turn-by-turn ACT feedback increased therapists' awareness of intervention choices and enabled effective experimentation with alternative responses. Quantitative evaluation across 49 therapy transcripts identified GPT-4o-mini as the optimal feedback model, achieving the lowest mean absolute error (MAE = 6.12) in replicating human supervisor ACT fidelity ratings with statistically significant agreement. This work demonstrates the potential of fidelity-aware simulated patients as a scalable complement to psychotherapy training.

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

Unifying Acoustic Features and Text with Multimodal LLMs for Neurodegenerative Screening

arXiv:2606.14788v1 Announce Type: cross Abstract: Voice-based screening offers a scalable and non-invasive way to assess neurodegenerative diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD), but their staging remains challenging due to the difficulty of integrating heterogeneous data. This paper presents NeurMLLM, an efficient multimodal generative framework for neurodegenerative disease staging. NeurMLLM first encodes the spectrograms and Mel-frequency cepstral coefficients of audio data with vision transformers and projects their representations into the embedding space of a large language model (LLM), where they are concatenated with transcript and demographic instruction tokens as a single unified sequence. The LLM is then instruction-tuned via Low-Rank Adaptation using task prompts to autoregressively predict a constrained label token, enabling a generative classification. By evaluating on the Bridge2AI-Voice dataset for fine-grained staging of AD and PD, we observe that NeurMLLM achieves strong performance, consistently outperforming classical machine learning methods and existing LLM-based approaches. The results show the high potential of multimodal LLMs in neurodegenerative disease staging, improving staging accuracy and supporting accessible deployment.

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arXiv (quant-ph) 2026-06-16

Optimizing Wigner Negativity in Scattering Processes Using Energetic Cost Functions

arXiv:2606.15101v1 Announce Type: new Abstract: Wigner negativities (WNs) are key signatures of non-Gaussian bosonic states and essential resources for quantum technologies. We study their generation in the scattering of coherent pulses by a two-level atom coupled to a one-dimensional reservoir, a unitary and energy-preserving platform. Optimization in this multimode setting is hindered by the complexity of evaluating Wigner functions. We overcome this challenge by introducing energetic cost functions that identify output modes most likely to host large negativities. First using incoherent energy and then isolating a genuinely non-Gaussian contribution, we demonstrate a strong correlation between these quantities and WNs. This correlation extends beyond short, intense pulses to encompass pulses of finite energy, where photons are scattered while the two-level atom is driven. Focusing on the energy-efficiency of the process, we show that maximally efficient generation takes place for one input photon, on average, spectrally mode-matched with the atom.