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01.
bioRxiv (Bioinfo) 2026-06-16

Integrative Transfer Network: Deep Transfer Learning Across Populations and Prediction Targets

Authors:
Gao↗Cui↗

Large-scale clinical and biomedical datasets increasingly contain both diverse subgroup attributes (e.g., demographic or clinical subgroups) and multiple prediction targets. Although various machine learning approaches can address subgroup differences or multi-target prediction, they often consider these aspects independently rather than jointly. To more effectively capture the shared and subgroup-specific information in such complex datasets, we propose the Integrative Transfer Network (ITN), a deep neural network designed to leverage data across subgroups and multiple related outcomes simultaneously. In extensive experiments, including time-to-event and classification tasks where demographic subgroups and multiple disease endpoints are prevalent, ITN demonstrates consistent improvements in subgroup-specific prediction by borrowing strength from other subgroups and outcomes. We envision ITN as a unified framework for learning from heterogeneous datasets where subgroup-specific insights are critical.

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02.
arXiv (CS.AI) 2026-06-16

Why Low-Precision Transformer Training Fails: An Analysis on Flash Attention

Authors:
Haiquan Qiu↗Quanming Yao↗

arXiv:2510.04212v4 Announce Type: replace-cross Abstract: The pursuit of computational efficiency has driven the adoption of low-precision formats for training transformer models. However, this progress is often hindered by notorious training instabilities. This paper provides the first mechanistic explanation for a long-standing and unresolved failure case where training with flash attention in low-precision settings leads to catastrophic loss explosion. Our in-depth analysis reveals that the failure is not a random artifact but caused by two intertwined phenomena: the emergence of similar low-rank representations within the attention mechanism and the compounding effect of biased rounding errors inherent in low-precision arithmetic. We demonstrate how these factors create a vicious cycle of error accumulation that corrupts weight updates, ultimately derailing the training dynamics. To validate our findings, we introduce a minimal modification to the flash attention that mitigates the bias in rounding errors. This simple change stabilizes the training process, confirming our analysis and offering a practical solution to this persistent problem. Code is available at https://github.com/ucker/why-low-precision-training-fails.

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03.
medRxiv (Medicine) 2026-06-18

Entrainment of cortical gamma oscillations predicts improved bradykinesia and dyskinesia in Parkinson's disease

Authors:
Shcherbakova↗Cernera↗Hahn↗A. G↗Little↗Starr↗P. A↗

Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is hypothesized to improve motor symptoms in Parkinson's disease (PD) by suppressing pathologically elevated beta activity and promoting "prokinetic" gamma activity in the cortico-basal ganglia-thalamo-cortical loop. Advances in bidirectional DBS devices have revealed that stimulation can modify gamma oscillations via subharmonic entrainment, though entrainment's therapeutic role remains unclear. Objectives: To identify stimulation parameters that entrain motor cortical and STN gamma oscillations in PD at rest and during movement, and examine their association with motor function. Methods: Sensorimotor cortex and STN field potentials were collected using a bidirectional DBS system in four subjects with PD over a range of stimulation amplitudes and frequencies. Entrainment amplitude at half the stimulation frequency was quantified at rest and during a finger-tapping task in the ON-medication state. The presence or absence of entrainment was studied as a physiomarker of motor symptom severity. Results: The amplitude of stimulation-entrained gamma oscillations was non-linearly related to stimulation intensity and frequency and varied by stimulation contact choice. Entrainment amplitude was highest in precentral gyrus and increased with movement. In the ON-medication state, precentral gyrus gamma entrainment was associated with reduced bradykinesia, dyskinesia, and dystonia. Subthalamic gamma entrainment predicted improved dystonia but was a less significant marker for motor benefit than cortical entrainment. Conclusions: Stimulation-entrained gamma oscillations in the motor network are a physiomarker for optimal DBS response in PD, and could have a role in physiology-guided DBS programming, complementing existing strategies based on suppression of basal ganglia beta activity.

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04.
arXiv (CS.LG) 2026-06-11

SpAArSIST: Sparsified AASIST for Efficient and Reliable Anti-Spoofing

Authors:
Anton Firc↗Vojt\v{e}ch Stan\v{e}k↗Zbyn\v{e}k Li\v{c}ka↗Kamil Malinka↗Martin Pere\v{s}\'ini↗

arXiv:2606.11674v1 Announce Type: cross Abstract: We present SpAArSIST, a deployment-oriented refinement of the widely used AASIST graph pooling backend for self-supervised learning (SSL) based anti-spoofing. Motivated by redundant operations in public implementations, we replace learned pooling and stack-node attention with explicit, lightweight choices: separate train and inference graph pooling ratios $(k_{\mathrm{tr}},k_{\mathrm{inf}})$, magnitude-based node scoring, and mean aggregation of graph nodes. The best overall configuration (rank 1) cuts backend compute by 20.7% (195.045M $\rightarrow$ 154.706M MACs) and model size by 4.1% (611.8k $\rightarrow$ 586.4k params), while improving out-of-domain robustness on In-the-Wild to 2.82% EER and 0.078 minDCF (from 4.64% and 0.133) and remaining competitive on ASVspoof5. We further provide a composite selection score that summarizes accuracy, calibration, and compute to support balanced deployment-oriented model choice.

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05.
arXiv (CS.AI) 2026-06-19

Neural Additive and Basis Models with Feature Selection and Interactions

Authors:
Yasutoshi Kishimoto↗Kota Yamanishi↗Takuya Matsuda↗Shinichi Shirakawa↗

arXiv:2606.19850v1 Announce Type: cross Abstract: Deep neural networks (DNNs) exhibit attractive performance in various fields but often suffer from low interpretability. The neural additive model (NAM) and its variant called the neural basis model (NBM) use neural networks (NNs) as nonlinear shape functions in generalized additive models (GAMs). Both models are highly interpretable and exhibit good performance and flexibility for NN training. NAM and NBM can provide and visualize the contribution of each feature to the prediction owing to GAM-based architectures. However, when using two-input NNs to consider feature interactions or when applying them to high-dimensional datasets, training NAM and NBM becomes intractable due to the increase in the computational resources required. This paper proposes incorporating the feature selection mechanism into NAM and NBM to resolve computational bottlenecks. We introduce the feature selection layer in both models and update the selection weights during training. Our method is simple and can reduce computational costs and model sizes compared to vanilla NAM and NBM. In addition, it enables us to use two-input NNs even in high-dimensional datasets and capture feature interactions. We demonstrate that the proposed models are computationally efficient compared to vanilla NAM and NBM, and they exhibit better or comparable performance with state-of-the-art GAMs.

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

Generalised Eigenvalue Geometry of Semantic Adversarial Attacks

Authors:
Martin Anthony↗Kaveh Salehzadeh Nobari↗

arXiv:2606.19212v1 Announce Type: cross Abstract: Recent empirical work shows that semantically equivalent paraphrases can fool financial sentiment classifiers: although a paraphrase remains close to the original under a strong reference embedding, it may shift the target model's representation enough to change the predicted class. Existing robustness theory either assumes a single-model threat model or focuses mainly on empirical attack algorithms. We develop a continuous local model of semantic paraphrase perturbations that captures this two-model structure. We show that the worst-case local displacement of the target representation, subject to a proxy-model budget, is governed by the largest generalised eigenvalue of a matrix pencil $(A,B)$ constructed from the Jacobians of the two embedding maps. The resulting attackability index $\lambda^*(x)$ is intrinsic to the local paraphrase geometry and the chosen embedders, yields a closed-form prediction-flip condition for affine readouts, and supports conservative population and finite-sample attackability certificates. For uniform control over classes of affine readouts, we derive a distribution-free VC bound for binary attackability indicators and a scale-sensitive margin bound based on an attackability-adjusted margin that subtracts a local geometric penalty from the standard classifier margin. We also connect the continuous theory to discrete paraphrase search, identify an asymmetry between successful and unsuccessful finite searches, and give a covering condition under which the discrete and continuous settings agree. Finally, we propose an empirical verification framework using soft-token relaxations and generated paraphrase sets to assess the local eigenvalue geometry, prediction-flip condition, and finite-search approximation on a deployed financial-text classifier.

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07.
arXiv (CS.CV) 2026-06-19

FrozenDrive: Zero-Shot Text-Guided Driving Scene Generation and Data Augmentation with Parameter-Free Frozen Diffusion Model

Authors:
Yuhwan Jeong↗Hyeonseong Kim↗Daehyun We↗Seonkyu Song↗Jinnyeong Yang↗Hyun-Kurl Jang↗Youngho Yoon↗Kuk-Jin Yoon↗

Synthetic data for autonomous driving is surging, powered by diffusion models that promise scalable scene generation. Yet key obstacles remain, as enforcing multi-view and temporal consistency often relies on backbone fine-tuning or added layers, which erodes pre-trained knowledge and weakens text alignment. Models also stay close to the training distribution, struggling under adverse weather and unseen configurations, and fidelity favors frequent over rare classes. We address these gaps with FrozenDrive, a controllable generative framework that preserves a pretrained diffusion models knowledge while achieving strong consistency. FrozenDrive conditions on rich driving-stack signals and text prompts, and introduces knowledge-preserving spatio-temporal attention to impose cross-view alignment and temporal coherence in a single pass within a parameter-free frozen diffusion backbone. An additional object-focused constraint improves per-object fidelity for rare categories. Without any weather- or scene-specific fine-tuning, our model synthesizes globally coherent multi-view driving scenes from text, particularly under adverse and rare conditions, and surpasses prior baselines. On nuScenes, FrozenDrive augmented data significantly improves AD models performance, especially at night and in rain, demonstrating stronger robustness when trained with our scenario-targeted data.

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08.
medRxiv (Medicine) 2026-06-22

Population-Scale, Genotype-First Characterization of Monogenic Diabetes in 374,973 Multi-Ancestry Individuals from the All of Us Research Program

Authors:
Hasebe↗Yoshiji↗

OBJECTIVE To characterize the prevalence and penetrance of maturity-onset diabetes of the young (MODY) in a multi-ancestry population using a genotype-first design. RESEARCH DESIGN AND METHODS We analyzed whole-genome sequencing and clinical data from 374,973 unrelated All of Us participants (42.0% non-European ancestry). We identified pathogenic or likely pathogenic (P/LP) variants in 10 established MODY genes and assessed carrier prevalence, diabetes penetrance, and glycemic profiles. We evaluated age-dependent diabetes risk by comparing carriers with non-carriers stratified by type 2 diabetes polygenic risk score (T2D PRS). RESULTS We identified 370 carriers of P/LP MODY gene variants (0.099%; 1 in 1,013), with similar carrier prevalence among European- and African-ancestry participants (0.105% in both groups). Diabetes penetrance was incomplete (13.4% by age 40; 43.5% by age 60) and varied by etiology: highest for GCK (56.0% by age 60), intermediate for HNF genes (HNF1A/HNF1B/HNF4A; 45.4%), and lowest for non-GCK/HNF genes (ABCC8/INS/KCNJ11/NEUROD1/PDX1/RFX6; 29.0%). In multivariable Cox models using non-carriers in the middle 80% of the T2D PRS as the reference, non-GCK/HNF gene variant carriers had modestly increased diabetes risk (HR, 1.57), similar to non-carriers in the top 10% of T2D PRS (HR, 1.64). These associations were observed in both European- and non-European-ancestry individuals. HbA1c profiles differed by etiology, with stable mild hyperglycemia in GCK variant carriers and greater variability among HNF and non-GCK/HNF gene variant carriers. CONCLUSIONS MODY gene variants showed incomplete, etiology-dependent penetrance across ancestries. Carriers of P/LP variants in lower-penetrance genes had diabetes risk comparable to that of non-carriers with high polygenic susceptibility.

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09.
Nature (Science) 2026-06-17

Reimagining machine vision with optical computing

Authors: Unknown Author

A general-purpose artificial-intelligence vision system for use in image-sensing devices has been developed by embedding fundamentals of core computer-vision operations into a light-manipulating planar material called an optical metasurface. A prototype enables accurate, real-time perception and processing across diverse tasks, suggesting that this could be a solution for rapid, low-energy, on-device vision intelligence. A specialized ‘metasurface’ can preprocess incoming scene information on image-generating devices.

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10.
PLOS Computational Biology 2026-06-05

StPedf: Cell trajectory inference of spatial transcriptomics via spatial proximity embedding and spatial density-adaptive fusion

Authors:
Yuan Zhang↗

by Yuan Zhang, Ziyan Sun, Zhixin Shi, Mengdi Nan, Yuhan Fu, Qing Ren, Jie Gao Spatial transcriptomics is transforming our multidimensional understanding of cellular spatial organization and its functional mechanisms in processes such as development and disease by systematically resolving the spatial heterogeneity of gene expression within tissues. To delve deeper into the dynamic processes underlying spatial expression patterns, spatial trajectory inference integrates genetic and spatial information to reconstruct the spatial developmental trajectories of cells within tissues. This approach reveals the patterns of differentiation and dynamic changes as cellular states evolve continuously along spatial axes. However, existing methods often struggle to uniformly model the complex, nonlinear interactions between high-dimensional gene expression and spatial coordinates. Here, we introduce StPedf, whose core lies in employing a neural network with a masking mechanism to capture complex nonlinear interactions between high-dimensional genes and spatial positions. It further leverages spatial proximity information as a guiding cue, dynamically and adaptively adjusting the embedding of gene and spatial information and the weighting of spatial proximity information based on spatial density. This enables trajectory inference guided by spatial information. This enables optimal transport to derive intercellular transition matrices, reconstruct cellular differentiation trajectories, and construct pseudo-spatiotemporal maps. StPedf demonstrates superior performance over existing methods on five structurally distinct simulated datasets. Using StPedf, we successfully mapped distinct lineages in the spatial trajectories of telencephalon regeneration in the Ambystoma mexicanum, multiple malignant lineages expanding within primary tumors, and developmental spatial trajectories and pseudo-spatiotemporal maps in human dorsolateral prefrontal cortex (DLPFC). StPedf significantly enhances the accuracy and interpretability of spatial trajectory inference, providing critical technical support for revealing the dynamic patterns of cellular fate transitions within tissue microenvironments.

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

DADP: Domain Adaptive Diffusion Policy

Authors:
Pengcheng Wang↗Qinghang Liu↗Haotian Lin↗Yiheng Li↗Guojian Zhan↗Masayoshi Tomizuka↗Yixiao Wang↗

arXiv:2602.04037v3 Announce Type: replace Abstract: Learning domain adaptive policies that can generalize to unseen transition dynamics, remains a fundamental challenge in learning-based control. Substantial progress has been made through domain representation learning to capture domain-specific information, thus enabling domain-aware decision making. We analyze the process of learning domain representations through dynamical prediction and find that selecting contexts adjacent to the current step causes the learned representations to entangle static domain information with varying dynamical properties. Such mixture can confuse the conditioned policy, thereby constraining zero-shot adaptation. To tackle the challenge, we propose DADP (Domain Adaptive Diffusion Policy), which achieves robust adaptation through unsupervised disentanglement and domain-aware diffusion injection. First, we introduce Lagged Context Dynamical Prediction, a strategy that conditions future state estimation on a historical offset context; by increasing this temporal gap, we unsupervisedly disentangle static domain representations by filtering out transient properties. Second, we integrate the learned domain representations directly into the generative process by biasing the prior distribution and reformulating the diffusion target. Extensive experiments on challenging benchmarks across locomotion and manipulation demonstrate the superior performance, and the generalizability of DADP over prior methods. More visualization results are available on the https://outsider86.github.io/DomainAdaptiveDiffusionPolicy/.

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

Adaptive Domain Models: Bayesian Evolution, Warm Rotation, and Principled Training for Geometric and Neuromorphic AI

Authors:
Houston Haynes↗

arXiv:2603.18104v5 Announce Type: replace Abstract: Prevailing AI training assumes reverse-mode automatic differentiation over IEEE-754 arithmetic. The memory overhead of training relative to inference, optimizer complexity, and structural degradation of geometric properties through training are consequences of this arithmetic substrate. This paper develops an alternative training architecture grounded in three prior results: the Dimensional Type System and Deterministic Memory Management framework (Haynes 2026), which establishes stack-eligible gradient allocation and exact quire accumulation as design-time verifiable properties; the Program Hypergraph (Haynes 2026), which establishes grade preservation through geometric algebra computations as a type-level invariant; and the b-posit bounded-regime design (Jonnalagadda et al. 2025), which makes posit arithmetic tractable across hardware targets conventionally considered inference-only. Their composition enables depth-independent training memory bounded to approximately twice the inference footprint, grade-preserving weight updates, and exact gradient accumulation, applicable uniformly to loss-function-optimized and spike-timing-dependent neuromorphic models. We introduce *Bayesian distillation*, a mechanism by which the latent prior structure of a general-purpose model is extracted through the ADM training regime, resolving the data-scarcity bootstrapping problem for domain-specific training. For deployment, we introduce *warm rotation*, an operational pattern in which an updated model transitions into an active inference pathway without service interruption, with correctness formalized through PHG certificates and signed version records. The result is a class of domain-specific AI systems that are smaller and more precise than general-purpose models, continuously adaptive, verifiably correct with respect to the physical structure of their domains, and initializable from existing models.

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13.
arXiv (CS.AI) 2026-06-17

The Stanford EDGAR Filings Dataset: Reconstructing U.S. Corporate and Financial Disclosures into Layout-Faithful and Token-Efficient Pretraining Data

Authors:
Nick Bettencourt↗Xiaowei Ding↗Kay Giesecke↗

arXiv:2606.18192v1 Announce Type: new Abstract: As high-quality public web corpora become increasingly exhausted, clean long-context documents have become a scarce and expensive source of training data for large language models (LLMs). Existing long-context corpora are often proprietary and costly to acquire, synthetically generated, or concentrated in narrow domains such as programming. We introduce the Stanford EDGAR Filings Dataset (SEFD), an open reconstruction of SEC filings into layout-faithful MultiMarkdown for financial language modeling and evaluation. SEFD makes audited financial statements, risk disclosures, ownership reports, accounting notes, and market-moving event filings usable as long-context pretraining data and as a basis for financial reasoning, forecasting, compliance, and document understanding. The resulting corpus is token-efficient, model-ready, and has less than 0.1% overlap with Common Crawl-derived corpora. We release SEFD-v1, a 152B-token initial public snapshot, and provide corpus-level analyses of a larger 18.5M-filing archive estimated at 550B tokens. We further introduce two SEFD-derived benchmarks: EDGAR-Forecast, which evaluates filing-grounded numerical forecasting after model knowledge cutoffs, and EDGAR-OCR, which evaluates transcription of complex financial tables.

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15.
arXiv (CS.CL) 2026-06-16

P3B3: A Multi-Turn Conversational Benchmark for Measuring European and Brazilian Portuguese Variety Bias in LLMs

Authors:
Rafael Ferreira↗In\^es Vieira↗In\^es Calvo↗James Furtado↗Iago Paulo↗Diogo Tavares↗Diogo Gl\'oria-Silva↗David Semedo↗Jo\~ao Magalh\~aes↗

As Large Language Models (LLMs) become embedded in everyday communication, capturing regional linguistic variation is essential for reliable and equitable language use. In Portuguese, European (pt-PT) and Brazilian (pt-BR) varieties remain unevenly represented, with pt-BR dominating in data quantity, while LLM preference for Portuguese variants remains underexplored. To address this gap, we introduce P3B3, an expert-curated language variety agnostic benchmark of conversational prompts, along with an evaluation framework for measuring variety bias and controllability. Experiments on several models show that most LLMs exhibit a strong bias toward pt-BR, with variation in controllability across models. These results highlight the need for more balanced multilingual representation across language varieties.

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16.
arXiv (quant-ph) 2026-06-11

Mathematical Basis for Analyzing Superconducting Phase Transitions Using Catastrophe Theory

Authors:
Jiu Hui Wu↗Hua Tian↗Kejiang Zhou↗

arXiv:2606.11810v1 Announce Type: cross Abstract: We establish a rigorous mathematical bridge from quantum many-body path integrals to the cusp catastrophe model by Lyapunov-Schmidt reduction, which provides a theoretical foundation for analyzing superconducting phase transition using the catastrophe theory. First, it is proved that, near the critical point the infinite-dimensional effective action is diffeomorphic to a finite-dimensional catastrophe. Secondly, starting from Ginzburg-Landau free energy functional, the Euler-Lagrange partial differential equation can be reduced to the cusp catastrophe model. Thirdly, the fermionic imaginary-time path integral to the cusp catastrophe is derived through the Hubbard-Stratonovich transformation, Matsubara frequency expansion, and Grassmann algebra. Furthermore, we connect this framework with the adsorption potential theory we proposed, elucidating the catastrophic topological nature of the electron pairing mechanism in high-temperature superconductivity. The precise microscopic derivation of the adsorption potential from first-principles electronic structure calculations would strengthen the predictive power of the theory.

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17.
medRxiv (Medicine) 2026-06-18

Biomedical Capacity, Governance, and Health Security: A Dominican Republic Research Analysis of Stakeholder Perspectives

Authors:
Baez↗A. A↗Schad↗Malamud↗Montas↗M. C↗

The COVID-19 pandemic exposed critical vulnerabilities in globally concentrated biomedical supply chains and accelerated interest in nearshoring and hemispheric health-security strategies. The Dominican Republic, already the third-largest medical device exporter in Latin America, occupies a strategically significant but institutionally constrained position within this realignment. This study evaluates stakeholder perceptions of the principal opportunities and barriers affecting biomedical ecosystem development in the Dominican Republic, with particular attention to governance, workforce capacity, and value-chain upgrading pathways. Methods. A concurrent mixed-methods design was employed, integrating a cross-sectional electronic survey of 142 purposively sampled domain experts (administered September-December 2025) with a qualitative executive consultation with senior government and industry leaders. Survey analyses combined descriptive statistics, one-sample t-tests against the scale neutral midpoint, chi-square goodness-of-fit tests, Friedman non-parametric ranking, Spearman rank correlations, and exploratory linear and logistic multivariable regression. Qualitative responses were analyzed using a framework approach grounded in the Triple Helix model of innovation systems. Results. Perceived government support was significantly below neutral (mean = 2.67, SD = 1.12; p = 0.034). Workforce shortages (83.3%) and weak academia-industry collaboration (71.4%) were the most frequently endorsed barriers ({chi}2(5) = 18.7, p = 0.002). Regulatory modernization (88.1%) and workforce development (85.7%) ranked as the highest-priority policy levers (Friedman p = 0.005). Clinical trials and contract research organization services were the dominant sub-sector priority (76.2%, binomial p < 0.001). In multivariable analysis, perceived government support, talent availability, and confidence in IP protection jointly explained 46% of the variance in sector competitiveness (R2 = 0.46, p < 0.001). Strong majority support existed for a formal public-private biomedical coordination authority (73.8%, p < 0.001).Conclusion. Institutional credibility and advanced human capital–rather than geography or market access–are the perceived binding constraints on the Dominican Republics biomedical trajectory. Regulatory modernization, targeted workforce investment, and the establishment of a national biomedical coordination authority represent the highest-leverage interventions for positioning the country as a hemispheric hub for biomedical manufacturing, clinical research, and health security.

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18.
arXiv (CS.AI) 2026-06-19

Confidence-Aware Automated Assessment of Student-Drawn Scientific Models

Authors:
Luyang Fang↗Yingchuan Zhang↗Jongchan Park↗Zhaoji Wang↗Ping Ma↗Xiaoming Zhai↗

arXiv:2606.20264v1 Announce Type: new Abstract: Student-generated drawings are widely used in science education to assess learners' conceptual understanding in modeling-based tasks aligned with the Next Generation Science Standards (NGSS). However, scoring such drawings requires expert human judgment to interpret complex visual representations, making large-scale assessment costly to implement and sustain in classroom settings. In this work, we study automated scoring of student-generated scientific drawings using a vision-based model. We evaluate a Vision Transformer (ViT) with parameter-efficient adaptation and propose a confidence-aware scoring framework that derives response-level confidence from test-time predictive distributions. This confidence signal enables selective automation by scoring high-confidence responses automatically while deferring uncertain cases for human review. Experiments on six NGSS-aligned middle school assessment items show that the proposed approach improves scoring reliability while supporting a practical trade-off between automated coverage and scoring risk, highlighting the value of confidence-aware methods for trustworthy educational assessment.

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19.
medRxiv (Medicine) 2026-06-22

Agentic Artificial Intelligence for Hospital Readmission Review: A Single-Center Blinded Evaluation and Exploratory Qualitative Analysis

Authors:
Gensheimer↗M. F↗Adhikari↗Parmer-Chow↗Liu↗Ma↗Shieh↗

Background: Manual review of 30-day hospital readmissions can identify actionable quality and safety problems, but it is labor-intensive. We developed and evaluated an agentic AI workflow for evidence-grounded readmission review. Materials and methods: We studied adult patients with unplanned 30-day readmission after discharge from a medicine hospitalist service at a single academic health system. An AI agent using a large language model queried a database containing notes, encounters, procedures, laboratory results, and other clinical data, and completed the same structured readmission-review rubric used by physicians. In the primary comparative evaluation, 20 randomly selected readmissions from 2025 were each reviewed by two physicians and the AI system. Blinded physician evaluators rated review quality. After rubric refinement, the AI workflow was applied to 100 recent readmissions in an exploratory expanded-cohort analysis of recurring improvement opportunities. Results: In the primary comparative evaluation, the AI classified 9/20 readmissions (45%) as preventable, compared with 19/40 physician reviews (47.5%). Blinded overall quality ratings were similar for AI and physician reviews (4.35 vs. 4.20 on a 1-5 scale; mean difference 0.15, 95% CI -0.20 to 0.48; p=0.49), as were factuality/support and usefulness/actionability ratings. No AI hallucinations were identified during factuality review. Agreement on preventability and primary readmission category was low for both AI-human and human-human comparisons. The AI system cost $0.23 per chart; physician reviewers took a median of 15 minutes, corresponding to an estimated $42.43 per chart. In the exploratory expanded-cohort analysis, AI-assisted review identified recurring vulnerabilities in post-discharge follow-up plans, incomplete inpatient workups, medication-safety transitions, and indwelling-device transitions. Conclusions: Agentic AI produced readmission reviews with similar blinded quality ratings to physician reviews in this small single-center primary comparative evaluation and supported identification of recurring quality-improvement themes in the exploratory expanded-cohort analysis. Preventability judgments remained variable among both AI and physicians, underscoring the need for human oversight and prospective evaluation before operational use.

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20.
medRxiv (Medicine) 2026-06-15

Wellbeing After Stroke-2 (WAterS-2): a feasibility study with process evaluation exploring inclusive, accessible, online psychological support after stroke

Authors:
Longley↗Woodward-Nutt↗Cotterill↗Chouliaria↗Thomas↗Bamford↗Bowen↗Patchwood↗

Objectives: Explore feasibility and acceptability of upskilling a workforce to deliver a co-developed intervention, based on Acceptance and Commitment Therapy (ACT), to support psychological adjustment post-stroke targeting underserved groups. Design: Multi-site, single-arm feasibility study with embedded mixed-methods process evaluation (ISRCTN17628580). Setting: Four NHS community stroke services across England. Participants: 1. Stroke survivors [&ge;]18 years of age, [&ge;]4 months post-stroke, reporting psychological difficulties adjusting to stroke, able to consent and access remote group sessions in English; 2. Group facilitators from NHS stroke services, not ACT specialists. Intervention: WAterS-2: an eight-session, remotely-delivered ACT-informed group intervention. Outcome measures: Recruitment, fidelity, safety, acceptability and perceived value were assessed using fidelity checklists, post-intervention surveys and semi-structured interviews with stroke survivors and facilitators. Clinical outcomes including mood (HADS), wellbeing (ONS4), psychological flexibility (AAQ-ABI), measured post-group and three-months later. Results: Nineteen stroke survivors recruited (mean 9.6 months post-stroke; n=5 (26%) minoritised ethnicities; n=10 (52%) with aphasia). Thirteen facilitators - including two peer support workers - delivered the intervention with fidelity following structured training across four services. Drop-out was low (2/19; 11%); with 15 (79%) attending [&ge;]5/8 sessions. Remote data collection was feasible (79% follow-up completion), with no adverse events recorded. Acceptability was high: survivors valued peer connection, grounding and mindfulness practices. ACT metaphors were helpful for some but challenging for others, including some with aphasia. Online delivery was suitable but limited informal connection. Facilitators reported increased capability, incorporating ACT skills into routine care. NHS workforce pressures and geographically-constrained referral pathways limited recruitment reach. Conclusions: WAterS-2 is feasible, safe, acceptable and inclusive. A mixed workforce, including NHS peer support workers, can be upskilled to deliver with fidelity. Inclusion of underserved groups is achievable but requires active strategies beyond standard NHS referral routes. Findings inform a provisional logic model and a future pragmatic trial.

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21.
PLOS Computational Biology 2026-06-18

Ten simple rules for turning your qualifying exam into an NIH-style fellowship proposal: A guide for graduate students

Authors:
Courtney Peña-Lima↗

by Courtney Peña-Lima, Cameron S. Bader, Brendan K. Ball, Troy C. Dildine, Mekhala V. Dissanayake, Iris van ‘t Erve, Albina Ibrayeva, Amy Nippert, M.K. Quinn, Chelse Spinner, Samuel Thompson, Antonio Tomasso, Crystal M. Botham Qualifying exams, often referred to as “quals” or candidacy exams, are an important milestone in doctoral programs. Although the style of quals varies greatly by program and institution, it is usually a proposal that requires students to develop research ideas as well as their scientific writing skills. Many quals are modeled after funding mechanisms that graduate students can apply to and on a topic that the student will pursue in their dissertation. This paper offers graduate students a step-by-step guide on how to turn their quals into a fellowship-style research proposal, using National Institutes of Health (NIH) mechanisms as a benchmark, as this is the norm within US research institutions. This paper will be most useful for students who have completed or are in the process of completing proposal-based qualifying exams, usually in the second year of a doctoral program.

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22.
arXiv (CS.AI) 2026-06-19

Enhancing Generative Auto-bidding with Offline Reward Evaluation and Policy Search

Authors:
Zhiyu Mou↗Yiqin Lv↗Miao Xu↗Qi Wang↗Yixiu Mao↗Jinghao Chen↗Qichen Ye↗Chao Li↗Rongquan Bai↗Chuan Yu↗Jian Xu↗Bo Zheng↗…

arXiv:2509.15927v5 Announce Type: replace-cross Abstract: Auto-bidding is a critical tool for advertisers to improve advertising performance. Recent progress has demonstrated that AI-Generated Bidding (AIGB), which learns a conditional generative planner from offline data, achieves superior performance compared to typical offline reinforcement learning (RL)-based auto-bidding methods. However, existing AIGB methods still face a performance bottleneck due to their inherent inability to explore beyond the static dataset with feedback. To address this, we propose AIGB-Pearl (Planning with \textbf{EvaluAtor via RL}), a novel method that integrates generative planning and policy optimization. The core of AIGB-Pearl lies in constructing a trajectory evaluator to assess the quality of generated scores and designing a provably sound KL-Lipschitz-constrained score-maximization scheme to ensure safe and efficient exploration beyond the offline dataset. A practical algorithm that incorporates the synchronous coupling technique is further developed to ensure the model regularity required by the proposed scheme. Extensive experiments on both simulated and real-world advertising systems demonstrate the state-of-the-art performance of our approach.

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23.
medRxiv (Medicine) 2026-06-15

Quality Improvement Based Implementation and Evaluation of a Decision Aid for Patients with Nephrolithiasis

Authors:
Lee↗Kazemi↗Wilson↗Thaker↗Kwan↗Cabri↗Li↗Dunn↗Yaghoubian↗Elkhoury↗Scotland↗Saigal↗…

Introduction Patients with nephrolithiasis face challenges in making a high-quality, preference sensitive decision. Our prior work established feasibility and patient acceptance of a software-based decision aid (DA). The objectives for this study were to identify implementation strategies for the DA in routine care and determine whether DA implementation enhances decisional quality for patients. Methods New nephrolithiasis patients were recruited from the institution Medical Center from June 2018 to April 2024 to receive a software-based pre-visit DA that measured care preferences and used decision analysis to rank treatments. The RE-AIM framework and Plan-Do-Study-Act (PDSA) cycles were used to improve implementation outcomes. Patients completed survey instruments evaluating decisional conflict, shared decision-making, care satisfaction, and treatment choice following their provider visit. These metrics were compared in the DA cohort (n=81) to those in a usual care cohort (n=78) with Wilcoxon rank-sum and Chi-square (or Fishers exact) tests. Results Implementation data revealed sustained reach and progressive improvement in fidelity. The DA cohort reported higher decisional quality relative to controls (p=0.003) and reported greater support/advice to make a choice (p=0.005). The DA cohort more often discussed options with their doctor (87.5% vs 69.2%, p=0.005) and were more likely to be promoters of their provider (p

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25.
arXiv (CS.AI) 2026-06-17

SEAGym: An Evaluation Environment for Self-Evolving LLM Agents

Authors:
Congjie Zheng↗Chuanyi Xue↗Bin Liang↗Jun Yang↗Changshui Zhang↗

arXiv:2606.17546v1 Announce Type: new Abstract: Self-evolving LLM-based agents improve mainly by changing their agent harness: the structured execution layer around a base model, including prompts, memory, tools, middleware, runtime state, and the model-tool interaction loop. Existing evaluations often reduce this process to isolated task scores or a single sequential curve, obscuring whether an update produces reusable improvement, overfits recent tasks, increases cost, or harms older behavior. We introduce SEAGym, an evaluation environment for measuring agent harness updates across training, validation, test, replay, and cost records. SEAGym turns Harbor-compatible benchmarks into dynamic self-evolution task sources with train batches, frozen update-validation, held-out ID and OOD transfer views, replay diagnostics, and saved snapshot and metric records. Instantiating SEAGym on Terminal-Bench 2.0 and HLE, we compare ACE, TF-GRPO, and AHE under a shared epoch/batch protocol. The results show that these evaluation views provide complementary signals about the evolution process: frequent updates may fail to improve held-out performance, useful intermediate snapshots may collapse later, and source diversity and model backend can affect harness reliability.

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