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01.
arXiv (CS.CL) 2026-06-12

PersonaDrive: Human-Style Retrieval-Augmented VLA Agents for Closed-Loop Driving Simulation

Closed-loop driving simulators typically populate their environments with non-ego traffic agents that behave largely the same way, produced either by rule-based traffic managers or by learned models trained toward a single behavioral mode. Recent work introduces style variation through post-hoc labels on observational data or LLM-inferred reward weights, but these signals act as proxies for what a style should reward rather than demonstrations of humans explicitly asked to drive in that style. We introduce PersonaDrive, a pipeline that conditions a vision-language-action (VLA) driving agent on retrieved demonstrations from a style-instructed human driving dataset, in which participants drive CARLA leaderboard routes under aggressive, neutral, and conservative instructions on a driver-in-the-loop rig. The pipeline has three stages: (i) offline triplet mining over per-style human driving data using a combined image-text similarity score; (ii) training a lightweight retrieval head that fuses frozen visual features with a small control encoder over per-style databases; and (iii) fine-tuning a single VLA backbone to treat retrieved context points as in-context behavioral demonstrations during waypoint prediction. At inference, the same backbone is conditioned on any style by swapping which per-style database the retrieval head queries, so selecting a style requires no per-style retraining while enabling human-style, style-diverse non-ego agents for closed-loop simulation. On Bench2Drive, PersonaDrive (no style) improves the driving score by 4.6% over SimLingo and 2.5% over HiP-AD, and under style conditioning attains the highest driving score in every style within a roughly 2% band (its weakest style surpassing the strongest baseline, DMW, by 5.4%), while average speed and acceleration rise by 18% and 25% from the conservative to the aggressive instruction.

02.
arXiv (CS.AI) 2026-06-17

Counterfactual Optimization of Baseball Pitch Sequences and Estimation of Its Impact on Season-Level Statistics

arXiv:2606.17345v1 Announce Type: cross Abstract: Although pitch sequencing is a central topic in baseball analytics, previous studies have primarily focused on optimizing the final pitch within a single plate appearance, leaving the role of preceding setup pitches and their impact on long-term season-level performance insufficiently examined. To address these issues, this study conducted counterfactual analyses using MLB Statcast data. A Transformer-based machine-learning model was trained to predict whether a target pitch would result in an in-play outcome or swing-out. Counterfactual pitch sequences were then generated by replacing either the final pitch or the preceding setup pitch with alternative pitch types and locations while keeping the surrounding contextual information fixed. Optimal counterfactual selections were defined as those that minimized the predicted in-play probability, and their expected effects on pitchers' seasonal statistics were estimated using regression models linking model outputs to season statistics. The results suggest that the optimization of both final and setup pitches may substantially influence season-level performance, including improvements of more than 1.0 in K/9. The analyses also provided several practical insights, including velocity-band-specific effective locations, the importance of pitch commands, and the expansion of pitch-selection options through middle-velocity pitches. These findings quantitatively support the strategic importance of pitch sequencing in baseball.

03.
arXiv (CS.CL) 2026-06-16

In-Domain Supervised Pathology Report Classification: A Reproducible Pipeline from Data Curation to Production-Matched Evaluation

We introduce an in-domain supervised pipeline designed to counter the out-of-distribution performance drop that hampers supervised biomedical NLP models, a problem observed when models trained on pathology reports are moved across cancer registries. Our contribution is a reproducible recipe for training a supervised classifier from routinely collected cancer registry data. It describes how to build the in-domain training set and a production-matched holdout, and to choose operating points that keep the false-negative rate (FNR) very low while keeping reviewer workload manageable. The pipeline standardizes data curation with facility-stratified sampling and separate handling of reports linked to registry cases, and includes a blinded manual audit to estimate positive-case prevalence and label noise. On a 418k-report holdout set, the Kentucky model achieved FNR 0.003 and false-positive rate (FPR) 0.097, improving over the Seattle-trained MOSSAIC OncoID baseline (FNR 0.010, FPR 0.183) and raising F1 from 0.860 to 0.922. In a blinded manual review of 600 reports, estimated positive prevalence declined from 0.500 to 0.398, indicating substantial label noise with errors concentrated in rare primary sites.

04.
Nature (Science) 2026-06-19

Daily briefing: Human detritus remakes geology

Authors:

What, exactly, is a rock? Plus, a stem-cell success for a severe autoimmune disease and evidence that ‘AI deskilling’ is real. Researchers have tracked the electrical activity of individual brain cells during conversation in real time. Plus, the history of GPS and a cross-species transplant that could reveal clues about the origin of animals.

05.
arXiv (CS.LG) 2026-06-17

Continuous-time Optimal Stopping through Deep Reinforcement Learning

arXiv:2606.17545v1 Announce Type: new Abstract: Simulation based solvers for optimal stopping problems must discretize the stopping decision. Under classical dynamic programming, a coarse exercise grid with only a few stopping opportunities can materially undervalue the optimal expected reward, whereas on a very fine grid, approximation errors accumulate through the backward recursion. To remove this limitation, we develop a new reinforcement-learning inspired algorithm that enables us to learn the exercise rule at arbitrarily fine time resolution. Our CARLOS (Continuous-time Adaptive Reinforcement Learning for Optimal Stopping) algorithm utilizes an aggregate deep neural network (ADNN) to learn a joint space-time decision boundary. Starting from a coarse time grid, we progressively increase the frequency of stopping opportunities, while in parallel training the ADNN to refine its timing-value estimates. We moreover design an adaptive sampling strategy that gradually concentrates training effort near the stopping boundary. Benchmarked results show that CARLOS delivers higher prices than existing Bermudan solvers, approaching the American upper bound, and achieves high computational efficiency relative to non-RL comparators.

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

IndicContextEval: A Benchmark for Evaluating Context Utilisation in Audio Large Language Models Across 8 Indic Languages

AudioLLMs enable speech recognition conditioned on textual prompts such as domain descriptions or entity lists. However, it remains unclear whether these models genuinely utilise such context or rely on parametric knowledge learned during pretraining. Existing benchmarks cannot answer this question because they evaluate transcription under fixed prompting conditions and rarely include explicit contextual inputs. We introduce IndicContextEval, a 56-hour multilingual benchmark of natural speech from 555 speakers across 8 Indian languages and 23 professional domains. We design a 7-level prompting framework that progressively introduces contextual signals, including metadata, natural-language descriptions, entity lists in English and native script, and adversarial prompts with incorrect entities. Evaluating five models reveals substantial differences in context utilisation behaviour, highlighting the need for explicit evaluation of contextual grounding in AudioLLMs.

07.
arXiv (CS.CV) 2026-06-11

4DP-QA: Scalable QA for 4D Perception in Vision Language Models

Despite recent advances, Vision Language Models (VLMs) still struggle to grasp the dynamics of the world. We note that the ability to reason about a 4D scene, challenging in itself, is further complicated by two factors. First, VLMs observe motion indirectly via its projection onto 2D images. Second, existing datasets fail to disentangle object and camera motion. To address these challenges, we present a QA generation pipeline that focuses on motion-related scene understanding. We take particular care of the entanglement of camera and object motion by casting tracking in both the traditional way and in a novel, fixed reference system, dubbed True-Motion Tracking, which provides an intuitive description of motion. From this pipeline, we generate a large-scale training dataset of 400K samples, 4DP-QA (4D Perception QA), and a 2.2K-sample benchmark, 4DP-QA-Bench. Training existing models on our dataset yields performance improvements on an external benchmark, validating the effectiveness of our method.

08.
arXiv (CS.CV) 2026-06-12

Goal2Pixel: Grounding Goals to Pixels for Vision-Language Navigation

Vision-language models (VLMs) have become a common foundation for vision-and-language navigation in continuous environments (VLN-CE). Yet most VLM-based methods cast navigation as low-level action prediction, an interface that is ambiguous, tied to short-horizon motion primitives, and inefficient due to repeated VLM querying. We propose Goal2Pixel, a pure pixel-based paradigm that reformulates VLN-CE as navigable pixel grounding. Rather than predicting actions, Goal2Pixel uses the image plane as a unified spatial interface between VLM reasoning and robot motion: the model predicts a visible navigable pixel to the agent, which is back-projected into a 3D waypoint for forward navigation. For non-forward actions, we append auxiliary directive regions to the image plane, where the left/right/bottom regions are interpreted as turning left, turning right, and stopping, respectively. To enable long-horizon navigation, we propose a visibility-aware keyframe memory for compact and informative history representation. To adapt pretrained VLMs to navigable pixel grounding, we introduce semantic embeddings and coordinate-aware auxiliary losses. Goal2Pixel achieves competitive state-of-the-art performance while requiring fewer VLM inference calls than prior methods. On R2R-CE Val-Unseen it achieves 54.1% SR and 52.5% SPL with just 7.75 VLM calls per episode, 6x fewer than the 46.62 required by direct action prediction at 32.9% SR. The same trend holds on RxR-CE.Project Page: https://baobao0926.github.io/Goal2Pixel/.

09.
arXiv (CS.CL) 2026-06-11

Energy-Efficient On-Device RAG on a Mobile NPU: System Design and Benchmark on Snapdragon X Elite

Retrieval-Augmented Generation (RAG) pipelines are compute-intensive, combining embedding, retrieval, reranking, and large language model (LLM) generation. Running them entirely on-device benefits privacy, latency, and offline use, but the energy cost of CPU inference is a major barrier. We present what is, to our knowledge, the first end-to-end RAG pipeline that runs all neural stages – embedding, reranking, and LLM generation – on the Qualcomm Hexagon NPU of the Snapdragon X Elite. Profiling on a Dell XPS 13 laptop, we compare NPU-accelerated RAG against CPU and OpenCL/Adreno GPU baselines on indexing and query workloads. On indexing, the NPU achieves 9.1x higher embedding throughput and 12.3x less system energy. On a 120-query Wikipedia-passage benchmark, it delivers 18.1x faster LLM prefilling, 4.0x lower end-to-end query latency, and 4.0x less system energy than the CPU baseline; the same workload on the integrated GPU is 1.7x slower than CPU and uses 6.5x more energy than the NPU. A GPT-4.1 LLM-as-judge evaluation finds NPU answer quality on par with CPU and GPU within evaluator noise (mean 9.32 vs. 8.95 vs. 9.03 on a 1-10 rubric), with 86.7% of queries scoring identically across all three backends. On the Snapdragon X Elite / Hexagon class of laptop SoC, the NPU thus enables practical, energy-efficient on-device RAG without quality regression – a sustainable path toward green edge intelligence that we expect to generalize to comparable mobile NPUs (Apple Neural Engine, Intel NPU, MediaTek APU) as their software stacks mature.

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

BrainDINO: A Brain MRI Foundation Model for Generalizable Clinical Representation Learning

Brain MRI underpins a wide range of neuroscientific and clinical applications, yet most learning-based methods remain task-specific and require substantial labeled data. Here we show that a single self-supervised representation can generalize across heterogeneous brain MRI endpoints. We trained BrainDINO, a self-distilled foundation model, on approximately 6.6 million unlabeled axial slices from 20 datasets encompassing broad variation in population, disease, and acquisition setting. Using a frozen encoder with lightweight task heads, BrainDINO supported transfer across tumor segmentation, neurodegenerative and neurodevelopmental conditions classification, brain age estimation, post-stroke temporal prediction, molecular status prediction, MRI sequence classification, and survival modeling. Across tasks and supervision regimes, BrainDINO consistently equaled or exceeded natural-image and MRI-specific self-supervised baselines, with particularly strong advantages under label scarcity. Representation analyses further showed anatomically organized and pathology-sensitive feature structure in the absence of task-specific supervision. Our findings indicate that large-scale slice-wise self-supervised learning can yield a unified brain MRI representation that supports diverse neuroimaging tasks without volumetric pretraining or full-network fine-tuning, establishing a scalable foundation for robust and data-efficient brain imaging analysis. Code is available at https://github.com/mclwu22/BrainDINO

11.
medRxiv (Medicine) 2026-06-15

SPIRIT-CONSORT-ELM: Element-Level Assessment of Randomized Controlled Trial Reporting Using Large Language Models

Randomized controlled trials (RCTs) play a central role in assessing the benefits and harms of interventions. Incomplete reporting in RCT publications can compromise the verifiability and usefulness of RCTs. SPIRIT and CONSORT reporting guidelines aim to improve the completeness of RCT protocols and results publications, respectively. However, many RCTs are not reported completely. Checking manuscripts automatically could help authors improve the completeness of reports prior to publication. We previously annotated SPIRIT-CONSORT-TM, a corpus of 200 articles (comprising 100 protocol-results publication pairs) using 83 checklist items drawn from SPIRIT 2013 and CONSORT 2010. We also trained machine learning models to automatically assess reporting at the item level. Each checklist item can include multiple constituent elements (i.e., specific details required for that item), and an item might be considered fully reported when all of its elements are present. However, prior work does not explicitly capture or evaluate reporting at the element level. To address this gap, we extended SPIRIT-CONSORT-TM by incorporating element-level annotations and using them to assess reporting completeness (SPIRIT-CONSORT-ELM). We formulated element-level assessment as a machine reading comprehension task, operationalized through 119 questions, where each question targets a specific reporting element within a checklist item. Using the 200 articles included in SPIRIT-CONSORT-TM, two annotators independently answered 119 questions for 50 articles (25 protocol-results pairs) and resolved any discrepancies through discussion; the remaining 150 articles (75 protocol-results pairs) were assessed by a single annotator. We then developed an automated pipeline for element-level assessment using SPIRIT-CONSORT-ELM. The pipeline first applies a PubMedBERT-based model to identify sentences containing item-level reporting information, then it uses a generative large language model (LLM; GPT-5) with chain-of-thought reasoning to answer element-level questions based on the retrieved evidence. Agreement between the two annotators was high (Gwet's AC1: 0.782) and our pipeline achieved high accuracy in identifying element-level reporting evidence (F1: 0.822, Gwet's AC1: 0.796). Ablation studies indicate that chain-of-thought reasoning and the inclusion of illustrative in-context examples modestly improve LLM performance on the machine reading comprehension task. SPIRIT-CONSORT-ELM provides a benchmark for evaluating reporting guideline completeness at the element level, enabling assessment of RCT transparency beyond the simple presence or absence of checklist items and is publicly available at https://osf.io/kznx4/. The automated pipeline establishes a robust baseline for assessing RCT reporting and demonstrates potential as a practical aid for authors, reviewers, and editors to identify and address gaps in completeness and transparency of RCT reports.

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

SICI: A Semantic-Pragmatic Complexity Index Reveals Regime Shifts in LLM Stance Detection

Prompt-based LLMs are increasingly used for stance detection, but harder examples are not always repaired by clearer instructions, reasoning prompts, retrieval, or debate. We introduce SICI (Stance Inference Complexity Index), a seven-dimensional diagnostic measure of the semantic-pragmatic burden imposed by a target–text pair. Across SemEval-2016 and VAST, SICI predicts LLM accuracy better than surface proxies and shows substantial cross-scorer reliability ($\alpha=0.771$). More importantly, LLM errors change regime as SICI increases: low-complexity examples invite over-attribution, especially Against predictions; intermediate examples form an unstable boundary; and high-complexity examples rapidly concentrate on None. This phase-transition-like structure persists across GPT-3.5, GPT-4o-mini, DeepSeek-V3, and GPT-4o, although stronger models move the boundaries. A 15-method intervention study further shows that prompting, retrieval, and debate often shift models along the attribution–abstention axis rather than removing the high-complexity bottleneck.

13.
arXiv (CS.CL) 2026-06-11

Short Chains, Deep Thoughts: Balancing Reasoning Efficiency and Intra-Segment Capability via Split-Merge Optimization

While Large Reasoning Models (LRMs) have demonstrated impressive capabilities in solving complex tasks through the generation of long reasoning chains, this reliance on verbose generation results in significant latency and computational overhead. To address these challenges, we propose CoSMo (Consistency-Guided Split-Merge Optimization), a framework designed to eliminate structural redundancy rather than indiscriminately restricting token volume. Specifically, CoSMo utilizes a split-merge algorithm that dynamically refines reasoning chains by merging redundant segments and splitting logical gaps to ensure coherence. We then employ structure-aligned reinforcement learning with a novel segment-level budget to supervise the model in maintaining efficient reasoning structures throughout training. Extensive experiments across multiple benchmarks and backbones demonstrate that CoSMo achieves superior performance, improving accuracy by 3.3 points while reducing segment usage by 28.7\% on average compared to reasoning efficiency baselines.

14.
Nature (Science) 2026-06-17

Fast formation to reinforce lithium-rich cathodes

Authors:

Formation in lithium-ion battery manufacturing typically involves low-rate charge–discharge cycles to establish stable electrode–electrolyte interfaces—a time-consuming process1–4. Here, our findings on lithium-rich layered oxide cathodes challenge the necessity of conventional formation, which can even shorten battery lifespan. Fast formation, on the other hand, reduces production cost and enhances capacity and stability. Multiscale synchrotron-based techniques show that residual lithium ions after the initial charge are critical for subsequent structural evolution and cycling performance. Deep lithium de-intercalation causes severe structural degradation and capacity loss due to the inherently fragile lithium-deficient matrix. By contrast, the residual lithium ions from fast formation enhance reversibility through a self-pinning effect, preventing pernicious lattice deformation and reinforcing the ion-storage framework. Adjusting the initial charge current density from 0.2 C to 2 C improves reversible capacity by 20% and extends cycle life by more than 36%. This approach can also be extended to other electrode systems, providing insights for more-efficient battery production. Fast formation in lithium-ion batteries outperforms conventional slow formation, lowering costs and improving battery capacity, stability and cycle life, offering broader application to electrode systems.

15.
arXiv (CS.CV) 2026-06-12

VISTA: An End-to-End Benchmark for Visual Spec-to-Web-App Coding Agents

We present VISTA (VIsual Spec-To-App Benchmark), a benchmark for evaluating the end-to-end web-app generation capabilities of LLM-based agents. Unlike prior code generation benchmarks that focus on algorithmic tasks, VISTA targets realistic UI-centric development, where agents must produce functional, visually coherent applications from underspecified inputs. We define five prompt-information conditions that vary along two axes, visual/structural fidelity and stack constraint: (1) text only with free stack choice, (2) text with reference screenshots under three specified stacks, (3) text with reference screenshots under free stack choice, (4) text with screenshots and pruned Figma structure under a single specified stack, and (5) text with screenshots and pruned Figma structure under free stack choice. To enable robust evaluation, each page in the benchmark is manually annotated with interactive UI components and around three visual anchor points, addressing the well-known limitations of script-based testing tools such as Playwright in open-ended code generation settings. Evaluation combines DOM-grounded reference matching, behavior-specific browser tests, and CLIP-based visual similarity, jointly measuring structural alignment, behavioral completeness, and overall visual fidelity. We use VISTA to assess four agent systems drawn from two model families and two harnesses, finding that visual fidelity and functional correctness are partially decoupled across both input conditions and agents, and that agent editing style varies sharply but is largely orthogonal to task quality. VISTA establishes a rigorous and reproducible foundation for advancing agent-based software engineering research.

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

PhysDrift: Bridging the Embodiment Gap in Humanoid Co-Speech Motion Generation

arXiv:2606.19935v1 Announce Type: new Abstract: Humanoid robots require co-speech motions that are not only expressive and speech-aligned, but also physically executable under embodiment constraints. Existing co-speech generation pipelines are predominantly human-centric: motions are first generated in human-body representations such as SMPL-X and subsequently retargeted to humanoid robots. In this work, we identify a fundamental embodiment gap in this paradigm, where the mismatch between human motion manifolds and humanoid embodiment constraints disrupts embodiment consistency during motion transfer and physical execution. Through extensive analysis, we show that although retargeting can preserve coarse motion semantics, it significantly compresses motion diversity and weakens prosody-motion synchronization, limiting expressive humanoid behaviors. To address this problem, we first propose IK-EER, a prosody-preserving humanoid motion curation framework that jointly optimizes kinematic feasibility and speech-motion temporal alignment during retargeting. Building upon the curated robot-native motion dataset, we further introduce PhysDrift, an embodiment-aware co-speech motion generation framework that directly predicts executable humanoid joint trajectories from speech without relying on intermediate human-body representations. Unlike conventional human-centric pipelines, PhysDrift maintains embodiment consistency throughout both training and inference while incorporating physical regularization to stabilize robot motion dynamics. Extensive experiments and real-world humanoid deployment demonstrate that embodiment-aware robot-native generation substantially improves speech-motion alignment, physical plausibility, motion smoothness, inference efficiency, and real-time interaction capability.

17.
arXiv (CS.CV) 2026-06-18

Hand-4DGS: Feed-Forward 3D Gaussian Splatting for 4D Hand Reconstruction from Egocentric Videos

Dynamic 3D hand reconstruction from egocentric videos is essential for next-generation computing platforms such as AR/VR and AI glasses. Despite its importance, most prior works focus either on multi-view 3D hand reconstruction or on 4D human body reconstruction. Egocentric 4D hand reconstruction remains challenging due to fast head motion, rapid hand dynamics, severe occlusions, and inherent ambiguity from single-view observations. To address these challenges, we introduce Hand-4DGS, the first feed-forward framework for reconstructing dynamic 4D hands directly from egocentric videos, enabling both fast (~60 FPS) inference and strong generalization. Our approach incorporates a mesh-guided representation for structural priors and temporal convolutions to model dynamic motion. We evaluate our framework on two challenging egocentric datasets, H2O and ARCTIC, and demonstrate significant improvements over baselines. Our method benefits from the generalization capability of feed-forward networks and effective 2D image supervision through Gaussian splatting, without requiring expensive 3D hand pose ground-truth annotations.

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

RODS: Reward-Driven Online Data Synthesis for Multi-Turn Tool-Use Agents

arXiv:2606.19047v1 Announce Type: new Abstract: Multi-turn tool-use RL is bottlenecked by the rapid depletion of informative samples in static datasets. We observe that the gradient signal in GRPO concentrates on tasks with the highest rollout reward variance, a consequence of the Popoviciu upper bound. Consequently, samples near the agent's capability boundary – where successes and failures are roughly balanced – contribute disproportionately large policy gradients. As training progresses, this boundary continuously shifts, which gradually depletes the pool of informative samples in a static dataset. We propose RODS (Reward-driven Online Data Synthesis) to resolve this depletion. RODS closes the loop between RL training and data generation by repurposing the progress reward variance as a practical, zero-cost boundary detector that requires no extra inference beyond the rollouts already computed for training. It continuously identifies such boundary samples, synthesizes new multi-turn variants matching their structural complexity (e.g., API topology and dependency depth) via a skill-aligned resampling pipeline, and manages a dynamic replay buffer that co-evolves with the policy. Starting from 400 human seeds and maintaining an active training pool of ~800 samples, RODS achieves comparable performance to a 17K-sample offline pipeline while requiring roughly 20x fewer trajectories, and improves over fixed-data RL and environment augmentation in our controlled setting.

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

On the Geometry of On-Policy Distillation

arXiv:2606.07082v2 Announce Type: replace-cross Abstract: On-policy distillation (OPD) is increasingly used to improve large language model reasoning, but its training dynamics remain poorly understood. We characterize the trajectory of OPD updates in parameter space and compare it with supervised fine-tuning (SFT) and reinforcement learning with verifiable rewards (RLVR). A suite of parameter-space diagnostics consistently places OPD in a relaxed off-principal regime: compared with SFT, its updates affect fewer weights and avoid principal directions more strongly, while compared with RLVR, they remain less tightly constrained. Beyond this static localization, OPD exhibits subspace locking: its cumulative updates rapidly enter a narrow low-dimensional channel. Constraining training to the update subspace formed early in training preserves OPD performance but substantially degrades SFT, indicating that the locked subspace is functionally sufficient for OPD. Control experiments further show that sparsifying the update tokens and shifting rollout generation off-policy preserve the rank dynamics, whereas mixing the OPD objective with RLVR changes them. Overall, these results suggest that OPD is not merely an intermediate point between SFT and RLVR, but induces its own update geometry in parameter space.

20.
medRxiv (Medicine) 2026-06-16

Comparative Effectiveness and Safety of Prophylactic Vasopressors for Preventing Post-induction Hypotension in the Elderly: A Systematic Review and Network Meta-analysis

Background: Post-induction hypotension is a predictable haemodynamic hazard in older adults undergoing general anaesthesia. Prevention remains divided among volume optimisation, anaesthetic dose reduction, rescue treatment after hypotension occurs and proactive vasoactive support. Methods: We searched PubMed, Embase, Web of Science, CENTRAL, CNKI, Wanfang and VIP from inception to 30 March 2026. Eligible studies were randomised trials of prophylactic vasoactive drugs given before, during or immediately after induction in older adults. The primary outcome was post-induction hypotension. Secondary outcomes were post-induction mean arterial pressure (MAP), systolic arterial pressure (SBP), heart rate (HR) and reported haemodynamic adverse events. Random-effects network meta-analysis was used, and confidence in network estimates was assessed using CINeMA principles. Results: Thirty-one trials including 2,821 participants were included in the revised network. Compared with placebo/control, all active agents favoured lower post-induction hypotension. The most favourable point estimates were observed for phenylephrine (odds ratio [OR] 0.17, 95% confidence interval [CI] 0.01 to 2.16) and metaraminol (OR 0.19, 95% CI 0.02 to 1.53), although both were imprecise. More precise reductions were observed for methoxamine (OR 0.23, 95% CI 0.13 to 0.43), norepinephrine (OR 0.25, 95% CI 0.13 to 0.47) and ephedrine (OR 0.34, 95% CI 0.19 to 0.63). Phenylephrine ranked highest for MAP support, norepinephrine ranked highest for SBP support, and ephedrine ranked highest for HR preservation. Global inconsistency was detected for SBP but not for hypotension incidence, MAP or HR, supporting cautious profile-based interpretation. Conclusions: Prophylactic vasopressor choice during induction should be guided by haemodynamic phenotype rather than ranking alone. In the revised network, active prophylaxis consistently favoured lower hypotension, but sparse nodes produced uncertainty. Norepinephrine retained a comparatively balanced profile when vasodilatory post-induction hypotension is anticipated, phenylephrine and related alpha-agonists provided stronger pressure support when HR and cardiac-output reserve are preserved, and ephedrine was most relevant when chronotropic support is desired. Keywords: general anaesthesia; induction; hypotension; norepinephrine; phenylephrine; ephedrine; network meta-analysis; older adults.

21.
medRxiv (Medicine) 2026-06-16

Infections and suicide and self-harm: a population-based matched cohort study

Background Infections have been associated with adverse mental health outcomes, including suicide, but evidence beyond severe or central nervous system infections is limited. We investigated associations between a range of acute infections and subsequent suicide/self-harm outcomes. Methods We conducted six infection-specific matched cohort studies using English primary care records from the Clinical Practice Research Datalink Aurum (2007-2024), linked to hospital admissions and mortality data. Adults ([≥]18 years) with a primary care record of infection (gastroenteritis, lower respiratory tract [LRTI], skin/soft-tissue [SSTI], urinary tract [UTI], sepsis, meningitis/encephalitis [positive control]) were matched (age, sex, practice, calendar period) to up to five comparators without infection. We estimated hazard ratios (HRs) for suicide/self-harm outcomes using Cox regression, stratified by matched set and implicitly adjusting for matching factors, with additional adjustment for deprivation, lifestyle factors, and comorbidities. We examined whether associations varied over time, by infection severity, antimicrobial treatment, sex, and prior mental health conditions. Findings Cohorts ranged from 18,192 individuals with meningitis/encephalitis (matched to 90,915 without) to 398,099 with SSTI (matched to 1,743,747). After adjustment, individuals with infection had a higher hazard of suicide/self-harm outcomes than comparators across all cohorts: sepsis (HR 1.79, 95% CI 1.65-1.93), gastroenteritis (1.62, 1.55-1.70), meningitis/encephalitis (1.56, 1.32-1.84), UTI (1.41, 1.33-1.50), SSTI (1.37, 1.31-1.43), and LRTI (1.37, 1.31-1.44). Risk was highest in the year post-infection, attenuating over time, and was higher among severe infections and those without prior mental health conditions. Interpretation Common acute infections recorded in primary care are associated with increased risk of suicide and self-harm, particularly following severe infections and in the year post-infection. Findings support suicide risk monitoring following acute infection, particularly among individuals without prior mental health conditions, and highlight infection prevention as a potentially modifiable strategy in vulnerable populations. Funding Wellcome and La Caixa. Copyright This work is licensed under a Creative Commons Attribution (CC BY) licence.

22.
arXiv (CS.CV) 2026-06-16

iTRIALSPACE: Programmable Virtual Lesion Trials for Controlled Evaluation of Lung CT Models

We introduce iTRIALSPACE, a programmable evaluation framework for controlled assessment of lung CT models. Standard benchmarks are static retrospective collections that entangle lesion size, lobe prevalence, anatomy, and acquisition context, making it difficult to determine what structurally drives model accuracy. iTRIALSPACE addresses this limitation by composing real clinical CTs and lesion profiles into controlled virtual lesion trials through a four-stage pipeline: multidataset nodule profiling, explicit trial specification, anatomy-aware mask insertion, and ControlNet-conditioned CT synthesis. The framework is built on a unified 54-attribute nodule-profile dataset spanning 13,140 annotated nodules from seven public CT sources and instantiated as 13 trial modes. We evaluate iTRIALSPACE in a 55,469-sample Virtual Lesion Study spanning three medical VLMs, four spatialguidance conditions, and three clinical tasks. Across all 13 modes, the synthetic substrate remains within the real-to-real FID baseline, and synthetic performance rankings transfer strongly to real clinical data ($\rho$ = 0.93, p < 10$^{-15}$). Controlled trial modes expose findings unavailable to fixed-distribution benchmarks, including shortcut-driven size prediction collapse under lobe-equalized sampling and hostto-donor variance ratios of 8.9x and 3.3x in twin-cross analysis. These results position iTRIALSPACE as an auditable evaluation infrastructure for controlled, falsifiable testing beyond static retrospective benchmarks.

23.
arXiv (CS.CV) 2026-06-15

Pano3D: Unified 3D Reconstruction and Panoptic Segmentation

Recent advances in 3D feedforward reconstruction neural networks have achieved remarkable success in dense reconstruction from images without any camera parameters. Yet, equipping these models with robust semantic understanding remains an open problem. Here we introduce an approach that performs 3D reconstruction and 3D panoptic segmentation in a unified framework. We build on existing 3D reconstruction models and augment them with a set-based mask decoder. The approach is jointly trained with a geometric and semantic loss, which are shown to be mutually beneficial. More precisely, the features are initialized from the geometric information and then finetuned to capture jointly geometry and semantics. We demonstrate the generality of our approach by successfully applying our framework both to online and all-to-all attention reconstruction backbones. Our method achieves state-of-the-art performance in 3D panoptic segmentation across ScanNet, ScanNet200, and ScanNet++ datasets. Ablation studies show that such joint training of a unified model equips 3D feedforward reconstruction neural networks with panoptic segmentation and yields mutually beneficial improvements.

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

Bayesian Networks with Latent Time Embedding for Stage-Aware Causal Modeling of Alzheimer's Disease Progression

arXiv:2606.15784v1 Announce Type: new Abstract: Alzheimer's disease (AD) progression is often described through the amyloid-tau-neurodegeneration, or AT(N), cascade. However, most longitudinal models represent this cascade either as a fixed sequence of biomarkers or as a black-box forecasting task. This makes it difficult to determine when biologically guided biomarker relationships influence future regional pathology. In this study, we introduce Bayesian Networks with Latent Time Embedding (BN-LTE), a Bayesian structural framework for stage-aware modeling of AD progression. BN-LTE estimates disease pseudotime from baseline biomarker profiles and constrains directed dependencies according to biologically plausible AT(N) ordering. Posterior spline-varying structural equations are then used to link initial multimodal measurements with future annualized regional tau-PET change. Across repeated subject-disjoint evaluations using ADNI data, BN-LTE shows strong spatial reconstruction of tau progression compared with the included forecasting baselines. Beyond spatial reconstruction, BN-LTE recovers posterior stage-varying AT(N)-constrained effects and identifies a mid-pseudotime window of amyloid sensitivity. This window is supported by model-implied g-formula contrasts, root-adjusted AIPW, mechanism-sensitive ablations, and robustness analyses across spline and prior specifications. Overall, these findings position BN-LTE as a Bayesian structural framework for forecasting tau progression while examining stage-dependent AT(N)-cascade mechanisms in observational longitudinal neuroimaging data. Our code is available at https://github.com/danleneurocom/BN-LTE.

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arXiv (CS.AI) 2026-06-16

Upper Bounds on the Generalization Error of Deep Learning Models via Local Robustness and Stability

arXiv:2606.16883v1 Announce Type: cross Abstract: Generalization is a critical property of data-driven models, particularly deep learning models deployed in safety-critical applications. Robustness-based generalization bounds have gained attention as a principled way to link robustness properties to generalization performance, often in a data-dependent manner. However, most existing bounds suffer from vacuousness in practical settings, yielding loose upper bounds that greatly exceed the actual error rates and limiting their usefulness for real-world evaluation. While this issue is often attributed to the uncertainty term, a substantial part of the problem originates from the robustness term itself, particularly for the 0-1 loss. Existing approaches typically treat the robustness term as a global measure, ignoring its variation across different sub-regions of the input space. In this work, we propose a generalization bound that addresses this limitation by scaling the robustness term according to the number of stable and unstable samples within each sub-region. Our bounds incorporate both data- and model-dependent factors while maintaining practical relevance (yielding tighter upper bounds on true error). Experiments on models trained on the ImageNet dataset show that our bounds remain consistently non-vacuous and achieve the tightest estimates among existing methods, closely aligning with empirical performance across a range of robust deep neural networks.