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01.
arXiv (CS.CL) 2026-06-25

Natural Ungrokking: Asymmetric Control of Which Rules Survive Pretraining

Midway through an ordinary pretraining run, a small language model learns the pronoun-gender rule: cued with a girl's name ("Sue cried because"), it resolves the next pronoun to she, generalizing to held-out probes (0.94 by step 925). By step 3,500 the same model scores near zero on the same probes, although the rule's evidence is still in the training data. We call this within-run reversal natural ungrokking: the corpus decides, with no trace in the loss curve, which learned rules a model keeps. Which rules survive is predictable from one corpus statistic: how often the training stream shows the rule winning. Across un-intervened runs (two corpora, three budgets, three seeds), support frequency decides a rule's fate; the data-to-parameter ratio only modulates how deeply a doomed rule falls. The same emerge-then-collapse dynamics appear in public Pythia checkpoints, collapse depth ordered by model scale as predicted. The forgetting is a displacement: a competing surface pattern out-competes the rule, and the log-probability margin between them crosses zero within 100 training steps of the behavioral collapse. Control over this fate is asymmetric: the same edit that destroys a rule on demand cannot restore it. Flipping support to counter-evidence in place kills the rule with monotone dose-response in two unrelated rules; but injecting support back, even to 450 times the level that naturally sustains it, buys no recovery. Every confirmatory threshold and prediction was pre-registered before the data it governed was read.

02.
arXiv (CS.CL) 2026-06-24

Towards Spec Learning: Inference-Time Alignment from Preference Pairs

Steering a large language model (LLM) toward a desired behavior typically relies on an iterative process of hand-crafting a prompt based on a careful inspection of the model's responses. This is an involved, brittle, and error-prone process. Preference-based fine-tuning is a more rigorous but often prohibitively expensive solution. We propose spec learning, a framework that relies on a brief user instruction and a small set of preference judgments. These are compiled into specifications in the form of natural-language prompts for an LLM. Specifications condition LLMs at inference time, and no parameter updates to the underlying models are required. We show that the responses generated based on the compiled specifications often outperform direct preference optimization (DPO) on datasets from specialized domains whose preference signal is dense. Unlike opaque weight updates, the resulting specifications are human-readable and double as interpretable and transparent written embodiments of the preference signal that produced them.

03.
arXiv (CS.AI) 2026-06-24

Page image classifier fine-tuned on century-spanning archives of scanned documents for further content-specific processing

arXiv:2606.07558v2 Announce Type: replace-cross Abstract: Purpose: Digitization projects in the humanities produce vast, heterogeneous archives of historical documents, making manual sorting impractical at scale. This work addresses the need for an automated system to classify scanned page images based on visual content type - text, tables, and graphics - enabling content-specific downstream processing such as Optical Character Recognition (OCR) or structured data extraction. Methods: An image classification system was developed and evaluated on a dataset of over 48,000 annotated historical page images from century-old Czech archaeological archives, refined through four successive annotation stages with domain-expert review. A Random Forest Classifier baseline was established using hand-crafted image features. Subsequently, deep learning architectures were fine-tuned and compared: Convolutional Neural Networks (EfficientNetV2, RegNetY), Vision and Document Image Transformers (ViT, DiT), and multimodal CLIP models. An 11-category label scheme was designed collaboratively with domain experts and evaluated via five-fold cross-validation. Results: The feature-based baseline achieved approximately 75% accuracy. Fine-tuned CNNs and Transformers substantially outperformed it, with RegNetY-16GF achieving 99.16% and ViT-large 99.12% Top-1 accuracy on the held-out test set. CLIP ViT-B/16 reached 99.14% with optimized text descriptions. Conclusion: Image-only models, particularly RegNetY-16GF, deliver near-perfect classification accuracy and produce consistent labels across 649,508 unlabeled archival pages with over 90% inter-model agreement. Fine-tuned CLIP, despite competitive test-set accuracy, showed under 65% agreement with image-only models on unlabeled data, making it less suitable for deployment. The final models, annotated dataset, and software are publicly available under open-source licenses.

04.
arXiv (quant-ph) 2026-06-16

Neural network inverse design of nanophotonic scintillators

arXiv:2606.16309v1 Announce Type: cross Abstract: Scintillators are materials converting high-energy radiation into optical light, essential in a range of technologies such as medical imaging systems and security scanners. Scintillator development and optimization have remained limited by the complexity of their underlying physics, involving stochastic cascades of electron-electron, electron-phonon, and electron-photon interactions. Such processes are typically modeled by non-differentiable Monte Carlo simulations, limiting the applicability of machine learning for scintillator development. Here we present a physics-informed neural network that learns the scintillation cascade process from the incident high-energy particle to photon emission, substantially accelerating scintillator design and optimization. Combining this neural network with photonic simulations enables end-to-end differentiable optimization of the scintillator geometry. This allows us to optimize for arbitrary figures of merit, such as specific target emission patterns.. We demonstrate the concept and characterize it relative to previous approaches by inverse design of nanophotonic scintillators for X-ray imaging.

05.
arXiv (quant-ph) 2026-06-15

Conditional squeezing induced by a two-level system: arbitrary-time Magnus coefficients in the quantum Rabi model

arXiv:2508.03506v5 Announce Type: replace Abstract: We present a systematic Magnus expansion treatment of the quantum Rabi model beyond the Rotating Wave Approximation. We show that at the second order of Magnus series, the second-order evolution operator contains a term that induces conditional squeezing of the field mode depending on the state of the atom, in addition to the energy shifts. We analyze the scaling behavior of the conditional squeezing coefficient for $^{87}\mathrm{Rb}$ $5^2S_{1/2}\rightarrow5^2P_{1/2}$ transition line and show that the slow envelope of the squeezing coefficient is maximized at half-detuning cycles, and that it scales with $\frac{4g^2}{\omega_0|\Delta|}$. We also show that the quadrature squeezing angle suggests a possible route towards quantum non-demolition readouts, while further investigation is required for a full first-order suppression. We then connect our work to the well-studied AC-Stark shift and Bloch-Siegert shift using the effective Hamiltonian theory. Finally, we show how the energy shifts and the conditional squeezing arise, as a whole $\mathrm{SU}(1,1)$ algebra, and how they can be disentangled as individual unitary evolutions.

06.
arXiv (math.PR) 2026-06-17

Time-dependent averages of a critical long-range stochastic heat equation

arXiv:2411.09058v2 Announce Type: replace Abstract: We study the time-dependent spatial averages of a critical stochastic partial differential equation, namely the stochastic heat equation in dimension $d\geq 3$ with noise white in time and colored in space with covariance kernel $\|\cdot\|^{-2}$. The solution to this SPDE is a singular measure and was constructed by Mueller and Tribe in [MT04]. We show that the time-dependent spatial averages of this SPDE over a ball of radius $R$ at time $t$ have different limits under different space-time scales. In particular, when $t\ll R^2$, the central limit theorem holds; when $t=R^2$, the spatial average is a non-Gaussian random variable; when $t\gg R^2$, the spatial average becomes extinct.

07.
arXiv (CS.AI) 2026-06-24

LLM-MINE: Large Language Model based Alzheimer's Disease and Related Dementias Phenotypes Mining from Clinical Notes

arXiv:2603.13673v2 Announce Type: replace Abstract: Accurate extraction of Alzheimer's Disease and Related Dementias (ADRD) phenotypes from electronic health records (EHR) is critical for early-stage detection and disease staging. However, this information is usually embedded in unstructured textual data rather than tabular data, making it difficult to be extracted accurately. We therefore propose LLM-MINE, a Large Language Model-based phenotype mining framework for automatic extraction of ADRD phenotypes from clinical notes. Using two expert-defined phenotype lists, we evaluate the extracted phenotypes by examining their statistical significance across cohorts and their utility for unsupervised disease staging. Chi-square analyses confirm statistically significant phenotype differences across cohorts, with memory impairment being the strongest discriminator. Few-shot prompting with the combined phenotype lists achieves the best clustering performance (ARI=0.290, NMI=0.232), substantially outperforming biomedical NER and dictionary-based baselines. Our results demonstrate that LLM-based phenotype extraction is a promising tool for discovering clinically meaningful ADRD signals from unstructured notes.

08.
arXiv (CS.AI) 2026-06-11

MetaPlate: Counterfactual-Guided RAG-LLM Tool for Personalized Food Recommendation and Hyperglycemia Prevention

arXiv:2606.10120v2 Announce Type: replace-cross Abstract: Postprandial hyperglycemia is a key risk factor for metabolic disorders; however, existing dietary guidance is often static, impractical, and insufficiently personalized, providing recommendations that are difficult to follow or not impactful. While recent advances leverage continuous glucose monitoring (CGM) and machine learning to predict glycemic responses, these approaches are largely predictive and lack actionable guidance. Moreover, recommendation systems are often misaligned with user goals and require extensive input. We present MetaPlate, a counterfactual explanation (CF) guided, context-aware decision-support framework that generates personalized meal recommendations to mitigate postprandial glucose excursions in healthy adults. MetaPlate integrates multimodal data, including CGM readings, wearable-derived physiological signals, and user-provided meal inputs from $25$ individuals to model pre-meal context. A machine learning model predicts glucose response, while a CF optimization module adjusts meal composition modifying macronutrient amounts to maintain glucose levels within a target range ($\leq 140$ mg/dL). An LLM-based retrieval-augmented generation (RAG) layer enhances interpretability by producing human-readable recommendations using constrained search of the USDA food database. We evaluate MetaPlate via a structured expert-in-the-loop assessment with registered dietitians (RDs), comparing performance before and after prompt refinement. Results show improvements in meal realism, portion suitability, and recommendation likelihood, with expert feedback indicating a shift from clinically implausible outputs to actionable, contextually appropriate recommendations. Our findings emphasize the importance of domain knowledge and structured constraints in LLM-driven systems and highlight the potential of MetaPlate as a real-time personalized dietary decision-support tool.

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

SurgVista: Long-Horizon Surgical World Modeling with Plausible Instrument-Tissue Dynamics

Scaling robot policy learning for autonomous surgery is challenging, as expert demonstrations are expensive and in vivo exploration poses substantial safety risks. Surgical world models address this by generating realistic, action-conditioned future frames from an initial observation, but existing methods exhibit two persistent failure modes: spatial interaction incoherence, where visible instrument contact fails to induce spatially consistent tissue deformation, and temporal fidelity collapse, where prediction errors compound across autoregressive rollouts and progressively corrupt visual quality. We present SurgVista, a surgical world model that mitigates both failures through two training recipes. Deformation Consistency Regularization extracts scene-point trajectories from training videos and enforces cross-frame coherence through latent contrastive learning, strengthening physically consistent instrument-tissue dynamics. Drift Adaptation Training mitigates long-horizon drift by perturbing conditioning frames with online prediction residuals and photometric augmentations calibrated to long-horizon drift statistics, sustaining visual fidelity over extended rollouts. To enable rigorous evaluation, we further introduce SurgWorld-Bench, featuring diverse procedure types, long-range rollouts, and decoupled metrics for instrument-motion accuracy and tissue-response fidelity. Extensive experiments show that SurgVista consistently outperforms state-of-the-art methods across visual quality, temporal consistency, and interaction fidelity, with gains widening as the prediction horizon grows.

10.
arXiv (CS.AI) 2026-06-15

A Two-Stage Statistical Framework for Evaluating Associative Interference in Large Language Models

arXiv:2606.14117v1 Announce Type: cross Abstract: Large language models (LLMs) are increasingly evaluated for bias using adaptations of human psychological paradigms, yet methodological limitations-particularly the conflation of refusal behavior with task performance-have hindered clear interpretation. Here, we adapt the Implicit Association Test (IAT) to a controlled, forced-choice framework and introduce a two-stage modeling approach that separates response compliance from task-consistent classification. Across three contemporary LLMs (Claude Sonnet-4, Gemini 2.5 Pro, and GPT-5), we evaluate associative interference, defined as reduced task-consistency in incongruent relative to congruent conditions. While compliance with the structured response format was uniformly high, interference effects varied substantially across models and domains. Claude Sonnet-4 exhibited strong interference in the Gender–Career domain (DeltaP = 0.086, 95% CrI [0.026, 0.173]) and smaller but credible effects in Gender–Science. Gemini 2.5 Pro showed attenuated interference, and GPT-5 exhibited minimal or no detectable interference across domains. These findings demonstrate that IAT-style associative asymmetries are not a universal property of LLMs, but instead depend on model-specific characteristics. By isolating interference from compliance and modeling item-level variability, this study provides a principled framework for evaluating structured response patterns in LLMs. The results highlight the importance of model-specific assessment and suggest that associative interference can be substantially mitigated in modern systems.

11.
arXiv (quant-ph) 2026-06-24

Temperature driven false vacuum decay in coherently coupled Bose superfluids

arXiv:2602.03834v2 Announce Type: replace-cross Abstract: The relaxation of a quantum field from a metastable state (false vacuum) to a stable one (true vacuum), also known as false vacuum decay, is a fundamental problem in quantum field theory and cosmology. We study this phenomenon using a two-dimensional interacting and coherently coupled Bose-Bose mixture, a platform that has already been employed experimentally to investigate false vacuum decay in one dimension. In such a mixture, it is possible to define an effective magnetization that acts as a quantum field variable. Using the Stochastic Gross-Pitaevskii equation (SGPE), we prepare thermal equilibrium states in the false vacuum and extract decay rates from the magnetization dynamics. The decay rates show an exponential dependence on temperature, in line with the thermal theory of instantons. Since the SGPE is based on complex scalar fields, it also allows us to explore the behavior of the phase, which turns out to become dynamic during decay. Our results confirm the SGPE as an effective tool for studying coupled magnetization and phase dynamics and the associated instanton physics in ultracold quantum gases.

12.
arXiv (CS.CL) 2026-06-18

ForecastBench-Sim: A Simulated-World Forecasting Benchmark

Forecasting benchmarks for general-purpose AI systems usually inherit the constraints of the real world: outcomes resolve slowly, tail events are rare, and counterfactual questions are difficult to score. We introduce ForecastBench-Sim, a simulated-world forecasting benchmark built on game rollouts from Freeciv, a turn-based strategy game modelled on the Civilization series. Forecasters receive a fixed world report (a structured snapshot of the current game state) and answer questions about hidden future states; the benchmark then continues the simulation and scores forecasts. Because the world is simulated, the same setup can generate continuous or binary forecasting questions at arbitrary time horizons, paired intervention worlds for conditional or causal questions, and resolved examples of rare or disruptive outcomes. We describe the benchmark pipeline, question families, scoring protocol, and release artifacts, and report validation slices from model evaluations and an anonymized human pilot. ForecastBench-Sim is intended to complement real-world forecasting benchmarks by providing controlled, immediately resolvable tasks for studying probabilistic reasoning under dynamic world states.

13.
arXiv (CS.AI) 2026-06-15

Learning Coordinated Preference for Multi-Objective Multi-Agent Reinforcement Learning

arXiv:2606.14693v1 Announce Type: cross Abstract: Cooperative multi-objective multi-agent reinforcement learning (MOMARL) models team decision making under multiple, potentially conflicting objectives. In this setting, conflicts arise not only across objectives but also across agents with different observations, roles, and contributions. We propose Preference Coordinated Multi-agent Policy Optimization (PCMA), which learns coordinated agent-specific preferences to enable complementary trade-offs among agents. Theoretically, we formulate cooperative MOMARL as a team-optimal game and show that, under suitable conditions, preference diversity can induce team improvement through a first-order improvement decomposition. Experiments on multiple cooperative MOMA environments and a practical traffic-control scenario show that PCMA improves both performance and trade-off coordination.

14.
arXiv (CS.CV) 2026-06-12

LaME: Learning to Think in Latent Space for Multimodal Embedding via Information Bottleneck

Reasoning-driven universal multimodal embedding has advanced rapidly by introducing Chain-of-Thought (CoT) reasoning into the embedding pipeline. Despite the strong performance across both general and complex tasks, this paradigm suffers from two core limitations: (i) autoregressive CoT reasoning incurs high computational cost, making it impractical for low-latency retrieval; and (ii) embedding performance is heavily coupled with CoT annotation quality, making large-scale training unreliable. These raise fundamental questions: Is textual CoT the optimal form of reasoning for embedding, and can effective embedding reasoning be accomplished in latent space? To this end, we propose LaME (Latent Reasoning Multimodal Embedding), which formulates embedding-oriented latent reasoning as a weakly supervised information bottleneck. LaME employs K learnable reason tokens as a fixed-capacity bottleneck, completing all reasoning within a single forward pass. The two weak supervision signals structurally decouple contrastive from autoregressive objectives and eliminate dependence on CoT annotations, while a two-stage training pipeline ensures stable convergence. Experiments on MMEB-v2 and MRMR show that LaME achieves competitive performance, surpassing some explicit CoT-based models, while delivering 60x faster inference than explicit CoT methods and 2x faster than latent baselines with throughput comparable to discriminative embedding models. Code will be released.

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

From Prompts to Tokens: Internalizing Causal Supervision in Vision-Language Model for Multi-Image Causal Reasoning

Visual causal reasoning is essential for understanding and intervening in the physical world, requiring identification of causal variables from visual inputs and reasoning over intervention effects. Despite recent progress, large vision–language models (VLMs) remain brittle at such tasks, especially for interventional and counterfactual queries over multi-image inputs. Most existing explorations inject causal knowledge via textual prompts, leaving causal mechanisms external to model execution and limiting reliable control during inference. To address this problem, we propose BridgeVLM, which internalizes visual causal reasoning by inducing a causal graph from multi-image inputs and converting it into structured Causal Tokens executed by RAMP layers injected into the LLM decoder for causal message passing. We further introduce a unified training interface M3S for fine-grained causal supervision from different granularities (local/global level). BridgeVLM achieves 54.4% accuracy on intervention tasks on CausalVLBench (vs. 33.2% with prompt-level supervision), improves results on Causal3D from 43.6% to 49.0%, and substantially improves causal structure learning on CausalVLBench ($F_1$: 33.4% $\rightarrow$ 75.1%).

16.
arXiv (quant-ph) 2026-06-12

Quantum optical photoelectron interferometry

arXiv:2606.13447v1 Announce Type: new Abstract: We present a general theoretical framework for multiphoton processes driven by quantum light fields, establishing a direct link between photon statistics and photoelectron observables. Our results show that the autocorrelation and cross-correlation functions, which quantify the underlying photon statistics, are directly mapped onto the resulting photoelectron spectra. Although our framework is broadly applicable, we demonstrate specifically in the example of reconstruction of attosecond beating by interference of two-photon transitions (RABBIT) the influence of the light statistical properties. In this approach, the amplitude, contrast and phase of the oscillations of the sideband signal as a function of pump-probe delay reveal the quantum nature of light. We analyze these observables across several quantum configurations, including correlated infrared and harmonic modes, as well as the uncorrelated case with non-classical harmonic statistics, thereby establishing a general framework for quantum-light RABBIT spectroscopy. We compare the analytical theory with numerical simulations for the case of classical harmonics and an infrared field in a squeezed coherent state, obtaining excellent agreement. Our results reveal how the interplay between classical and quantum correlations dictates the coherence of the photoemission process, providing a new window into the quantum-optical foundations of attosecond science.

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

AI for Maritime Security: Comparative Evaluation of CNN and Vision Transformer Architectures for Maritime Object Detection

This study aims to enhance maritime security by using advanced Artificial Intelligence (AI) and Computer Vision (CV) techniques. For this purpose, it was designed and assessed intelligent object detection systems that can detect the presence of ships on the sea surface under different real-time environments. To achieve this goal, a maritime image dataset with 6,468 images was used, covering different weather conditions like cloudy, foggy, rainy, and sunny environments. Six deep learning architectures were evaluated, including a base Convolutional Neural Network (CNN) model, four transfer learning models (Xception, VGG16, MobileNetV2, and EfficientNetV2L), and a Vision Transformer (ViT) model. The models were compared using multiple performance indicators, including accuracy, Type I and Type II errors, model size, and video processing time. The results show that model performance varies depending on computational constraints and deployment conditions. While lightweight architectures are suitable for resource-limited devices, the ViT achieved the best overall performance, reaching 100% accuracy with the lowest error rates and the fastest video processing time. The findings highlight the potential of AI-driven computer vision systems for maritime surveillance, border protection, and autonomous navigation.

18.
medRxiv (Medicine) 2026-06-22

The direct economic impact of surgical non-response in orthopaedic hip, knee, and spine surgery for osteoarthritis: a cost-utility analysis

Background Annually, nearly 2 million hip, knee, and spinal inpatient surgeries are performed in Canada and the US for osteoarthritis (OA), costing over $37 billion in hospital expenditures. However, 15-30% of patients experience limited or no improvement, resulting in poor value for money. This study evaluated the one-year cost-utility of joint and spine procedures for OA by comparing non-responders to responders, considering various responder definitions. Methods Individual micro-costing data were collected for 1,175 elective hip, knee, and spine patients enrolled in the Longitudinal Evaluation in the Arthritis Program - Osteoarthritis (LEAP-OA) between 2014 and 2018. Quality-adjusted life years (QALYs) were derived using the SF-6D utility index. One-year incremental cost-utility ratios (ICURs) were calculated from the hospital perspective. Results Responder rates varied by definition, ranging from 78%-94% for hip replacements, 64%-90% for knee replacements, 60%-64% for spine fusions, and 50%-68% for spine decompressions. Corresponding ICURs were: $45,956-$51,773/QALY for responders versus $108,593-$485,762/QALY for non-responders for hip replacements; $54,831-$71,151/QALY for responders versus $200,486-$1,203,596/QALY for non-responders for knee replacements; $65,980-$74,422/QALY for responders versus $262,039-$729,686/QALY for non-responders for spine fusions; and $29,947-$42,168/QALY for responders versus $63,195-$662,586/QALY for non-responders for spine decompressions. Conclusions While surgical response rates were highly dependent on the responder definition, ICURs for non-responders were significantly higher than those for responders across all definitions. Beyond the negative impact on patients, there is a compelling economic argument for investment in improved pre-operative identification of patients at risk of surgical non-response. Such efforts could enable more personalized, value-based care pathways and reduce the provision of low-value surgical interventions.

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

ReMoT: Reinforcement Learning with Motion Contrast Triplets

We present ReMoT, a unified training paradigm to systematically address the fundamental shortcomings of VLMs in spatio-temporal consistency – a critical failure point in navigation, robotics, and autonomous driving. ReMoT integrates two core components: (1) A rule-based automatic framework that generates ReMoT-16K, a large-scale (16.5K triplets) motion-contrast dataset derived from video meta-annotations, surpassing costly manual or model-based generation. (2) Group Relative Policy Optimization, which we empirically validate yields optimal performance and data efficiency for learning this contrastive reasoning, far exceeding standard Supervised Fine-Tuning. We also construct the first benchmark for fine-grained motion contrast triplets to measure a VLM's discrimination of subtle motion attributes (e.g., opposing directions). The resulting model achieves state-of-the-art performance on our new benchmark and multiple standard VLM benchmarks, culminating in a remarkable 25.1% performance leap on spatio-temporal reasoning tasks.

20.
arXiv (CS.CL) 2026-06-25

AI translation of literary texts is "fine", but readers still prefer human translations

AI translation of literary works is increasingly common. While the content may be rendered adequately, we do not know enough about how readers experience it in terms of immersiveness and literary effect, aspects poorly captured by automatic machine translation metrics or human evaluation targeting fluency and adequacy. We ask 15 avid readers to compare recently published human translations (HT) to machine translations (MT) generated with an agentic large language model (LLM)-based pipeline, for 15 recent novels in French, Polish, and Japanese and translated into English. Readers evaluated approximately 8K-word excerpts in two conditions: immersive reading of the whole excerpt (30 comparisons) and close reading of 386 aligned HT-MT chunk pairs (772 comparisons), with two readers per book and in alternating order of presentation. Overall, readers find MT "fine", but prefer HT (slightly at excerpt-level 19/30, more clearly at chunk-level 522/772) for its ease, clarity, and immersive nature. Readers' highlights show that MT's quality varies more within one book than HT's does. Crucially, readers cannot reliably tell the two apart (17/30 guess correctly) and tend to prefer the version they believe to be human. Automatic metrics, including LLM-as-a-judge approaches, fail to recover reader preferences and favor MT. We release LAIT (Literary AI Translation), a reader-centered evaluation dataset with 1K reader comments, 2K judgments and preference ratings, and 7.2K span-level annotations, along with our evaluation protocol and supporting interface.

21.
arXiv (CS.CL) 2026-06-17

Implicit vs. Explicit Prompting Strategies for LVLMs in Referential Communication

Two recent studies (Jones et al. (2026); Zeng et al. (2026)) reach apparently contradictory conclusions about whether LVLMs can coordinate on efficient referring expressions. We control for task differences between the studies while directly comparing their prompting styles. We replicate the finding that models can coordinate efficient referring expressions when explicitly prompted to do so, suggesting that other task differences are not responsible for divergent results. However, we also find that the same models fail to infer the need for communicative efficiency from a more implicit prompt, highlighting critical differences between how humans and AI systems communicate.

22.
medRxiv (Medicine) 2026-06-10

A Three-Tier Operational Benchmark for Evaluating Large Language Models on Hospital Medication Safety

Objective. To introduce PsiBench, a clinically validated medication-safety benchmark for evaluating large language models (LLMs) against the standards used to certify hospital computerized provider order entry (CPOE) and electronic health record (EHR) systems, and a non-overlapping three-tier evaluation framework separating highest-stakes discrimination, the operational CDS regime, and category-correct alerting. Materials and Methods. PsiBench comprises 492 medication-safety scenarios across 11 safety categories, created by clinical pharmacology experts whose work underpins an annualized testing procedure used by more than 2,000 U.S. hospitals. The three-tier framework partitions the scenarios non-overlappingly: Discrimination (98 scenarios, 50 fatal vs 48 deception, near-balanced 51%/49%); Operational (394 scenarios, 261 serious unsafe plus 133 safe including 41 Excessive Alerts reclassified as operational negatives); and Attribution (311 alert-required scenarios). We evaluated 40 frontier LLMs from 10 providers over 3 runs per scenario at temperature 0.2 (or the provider default where temperature is not configurable), yielding 59,040 evaluations conducted April 21-23, 2026. Results. Headline binary performance on the full benchmark spans a wide range across the 40 models: F1 78.5%-92.3%, accuracy 65.4%-89.8%, sensitivity 81.4%-100.0%, specificity 6.1%-81.8%. Leading models by F1 (o4-mini 92.3%; o3 92.2%) pair high sensitivity with meaningful specificity; three models saturate sensitivity at 100% but fall below 25% specificity, indistinguishable from a naive always-alert classifier. The wide spread on a single headline metric motivates tier-specific analyses, developed in a separate clinical paper. Discussion and Conclusion. PsiBench and the three-tier framework operationalize a rigorous evaluation rubric for LLM medication safety, grounded in two decades of national hospital audit experience. The framework generalizes to any binary medication-safety classifier (rule-based, conventional ML, or LLM-driven), supporting tier-aware model selection and post-deployment surveillance.

23.
arXiv (CS.CV) 2026-06-16

Object Tokens as a Bridge Between Segmentation and Visual Question Answering in Robotic Surgery

Visual Question Answering (VQA) in robotic surgery, referred to as surgical VQA, requires high-level understanding of complex surgical scenes and the integration of visual perception with language reasoning, with the potential to support surgical training and intraoperative decision-making. Recent Vision-Language Models (VLMs) have shown promising performance through parameter-efficient fine-tuning; however, most existing approaches rely on coarse visual grounding, typically limited to bounding boxes, which fails to capture the fine-grained spatial structure of surgical objects. In this work, we propose a unified framework that jointly performs pixel-level segmentation and visual question answering within a single framework. Our approach integrates a VLM with a Segment Anything Model (SAM)-based decoder and represents scene elements as object tokens generated by the VLM. These object tokens guide answer prediction and are further projected to the SAM-based decoder to produce segmentation masks. By optimizing the object token embeddings through both segmentation and question answering objectives, the model learns spatially grounded representations that enhance visual reasoning while providing explicit pixel-level grounding. We evaluate the proposed method on the private RAMIE (Robot-Assisted Minimally Invasive Esophagectomy) dataset and the public EndoVis18 dataset, where it consistently outperforms baseline methods for surgical VQA. These results demonstrate that incorporating context-aware object tokens into vision-language models improves fine-grained surgical scene understanding.

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

HSQ-VLM: A Novel Spatially-Constrained Quadrant Segmentation VLM Model for Explainability in Diabetic Retinopathy

Authors:

Diabetic Retinopathy (DR) is an aggressive retinal disease and a leading cause of global blindness, yet its clinical management is currently hindered by the black-box nature of diagnostic AI. While deep learning models achieve high classification accuracy, there is a critical lack of explainability methods capable of detailing the exact anatomical landmarks and lesion distributions that lead to a clinical decision for DR. Therefore, we propose HSQ-VLM, a novel quadrant segmentation pipeline on fundus images that utilizes a Landmark-Anchored Cartesian Cross-Attention mechanism to unify visual feature extraction with structured clinical reasoning. Unlike traditional methods that rely on arbitrary image partitioning, our pipeline implements 4-quadrant Topological Latent Partitioning (TLP) to dynamically align retinal features with a fovea-centered coordinate system. This allows the Vision-Language Model to generate natural language reports that quantify pathology with anatomical precision. On a dataset of 3,500 high-resolution fundus images, this innovative methodology achieved a lesion detection sensitivity of 99.6% for hemorrhages and 96.4% for microaneurysms, while demonstrating a significant reduction in boundary-ambiguity errors compared to standard segmentation baselines.