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01.
arXiv (CS.AI) 2026-06-11

The Impossibility of Eliciting Latent Knowledge

arXiv:2606.12268v1 Announce Type: new Abstract: Advanced AI systems have extensive knowledge of their environments; in fact, their knowledge may (far) exceed that of their developers or users. Consequently, a desirable property for an AI system is that it is honest – that it accurately reports its beliefs about the world. Designing an AI system to be honest may be difficult, especially if we want to ask it questions about latent variables in the environment – variables which are hidden from the human interacting with it. This gives rise to the problem of eliciting latent knowledge (ELK): the problem of training an AI agent to honestly report its beliefs. In this paper, we make ELK formally precise using Causal Influence Diagrams (CIDs). CIDs can be used to describe the relationship between an agent's training environment and its subjective representation of the world. We use CIDs to formalise the distinction between observable and latent variables, to specify what exactly it means for an agent to be honest, and to formally define goal misgeneralisation. We show that, under certain circumstances, developers can incentivise an agent to honestly answer questions by providing correct feedback during training. However, a natural, but undesirable, way for an agent to generalise is to provide answers which humans would evaluate as true, rather than honest answers. We prove an impossibility theorem stating: There is no feedback-based training strategy that depends only on agent behaviour and with certainty produces an honest agent, even if feedback is perfect during training.

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

Attention, not scale, drives human-AI alignment in multimodal language prediction

Humans routinely draw on visual context to predict upcoming words. To what extent current vision-language models produce comparable behaviour is unclear. Here we placed five state-of-the-art pretrained systems side-by-side with 600 human participants in a web-based Visual-World Paradigm. On each of 100 six-second movie clips, models and participants received either text only or synchronised video and text and judged how likely a specified target word was to appear next; human eye movements were tracked throughout. Adding visual context increased model-human alignment in predictability ratings across all architectures (average Delta r = 0.18) with no impact of parameter size. When visual context was informative, transformer attention significantly increased alignment. Attention maps from two transformer models corresponded with human gaze, explaining up to 70% of the inter-participant variance when the scene contained informative cues. Notably, cross-modal attention reliably tracked anticipatory human fixations on semantic cues. These results suggest that current transformer-based vision-language models can approximate human behaviour exploiting visual context during language prediction - and that selective attention to informative cues, not sheer model scale, is the principal driver of this alignment.

03.
arXiv (CS.AI) 2026-06-11

Signed Compression Progress on a Sealed Audit is Goodhart-Resistant

arXiv:2606.11417v1 Announce Type: cross Abstract: Compression progress is a long-standing proposal for intrinsic motivation: reward an agent when its world model becomes better at predicting or compressing experience. The folk claim is that this reward is "credible" because it is paid only for learning. We make this precise and prove it. If intrinsic reward is the signed decrease of a fixed sealed-audit loss, r_t = E(theta_{t-1}) - E(theta_t), then cumulative reward telescopes exactly to endpoint audit improvement, so no policy can push reward up indefinitely while true audit performance stagnates or degrades. For finite audit panels the same result holds with a sharp false-positive budget: cumulative empirical reward is at most true audit improvement plus 2 Delta_n(F, delta), the uniform audit deviation of the model class. This is horizon-free: adaptivity over time costs nothing once the sealed panel uniformly controls the class. The theorem also identifies the failure modes: the guarantee disappears if progress is clipped, scored on the agent's own stream, exposed to a high-capacity model on a reusable panel, or applied to a neural class that makes Delta_n vacuous. We give a Lean 4 mechanization of the structural core (telescoping, the finite-audit bound, finite Gibbs, and the entropy floor) and an experiment suite on ARC-TGI grid-transformation generators with adaptive holdout attacks. Experiments confirm the theory: finite-audit deviation scales as n^{-0.527}; signed progress resists clip-farming, stream leakage, and noisy-TV curiosity; naive reusable audits are exploitable by black-box scalar feedback, while standard release defenses keep the attack below the 2 Delta_n threshold. Signed compression progress on a sealed audit is an accounting signal of genuine improvement.

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

MedVeriSeg: Teaching LISA-Like Medical Segmentation Models to Verify Query Validity Without Extra Training

Despite recent progress in text-prompt-based medical image segmentation, existing LISA-like MLLM-based methods typically generate masks regardless of whether the target specified in the query is present, leading to hallucinated segmentation. In this work, we propose MedVeriSeg, a training-free query verification framework that enables LISA-like medical segmentation models to reject false segmentation queries. MedVeriSeg first quantifies the response quality between the [SEG] token and image features through a Similarity Response Quality Scoring Module. To further improve robustness, it employs a Lightweight Routed Multi-Agent Verification Module, which fuses quantitative score evidence with qualitative agent evidence to comprehensively verify the validity of the query. To support systematic evaluation, we construct MedVeriSeg-Bench, a benchmark designed for query verification in medical image segmentation. Experimental results demonstrate that MedVeriSeg effectively identifies false segmentation queries and reduces hallucinated segmentation, while maintaining a high acceptance rate for valid queries, thereby largely preserving the segmentation utility of LISA-like medical segmentation models.

05.
arXiv (CS.CL) 2026-06-12

Constrained Semantic Decompression in LLMs through Persian Proverb-Conditioned Story Generation

Transforming a dense, abstract proverb into an engaging and morally faithful narrative requires deep cultural understanding and robust semantic grounding. We frame this problem as a constrained semantic decompression task and study proverb-conditioned story generation as a testbed for abstraction-to-realization in large language models (LLMs). Focusing on Persian, we introduce the Proverb Aligned Narrative Dataset (PAND), pairing proverbs with human-written stories and explicit meanings. By a hybrid evaluation framework that combines human-calibrated LLM-as-a-Judge with structural metrics, we analyze model behavior across multiple prompting regimes. Our findings reveal a persistent decompression gap: current LLMs often achieve strong surface-level fluency while failing to faithfully instantiate the underlying moral and causal structure encoded in proverbs. We further show that explicit reasoning and iterative refinement can partially mitigate these failures, suggesting that many decompression errors arise from difficulties in translating abstract meaning into narrative form rather than a complete lack of relevant knowledge. Our proposed task naturally extends to other forms of compressed cultural knowledge.

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

C-QUERI: Congressional Questions, Exchanges, and Responses in Institutions Dataset

Questions in political interviews and hearings serve strategic purposes beyond information gathering including advancing partisan narratives and shaping public perceptions. However, these strategic aspects remain understudied due to the lack of large-scale datasets for studying such discourse. Congressional hearings provide an especially rich and tractable site for studying political questioning: Interactions are structured by formal rules, witnesses are obliged to respond, and members with different political affiliations are guaranteed opportunities to ask questions, enabling comparisons of behaviors across the political spectrum. We develop a pipeline to extract question-answer pairs from unstructured hearing transcripts and construct a novel dataset of committee hearings from the 108th–117th Congress. Our analysis reveals systematic differences in questioning strategies across parties, by showing the party affiliation of questioners can be predicted from their questions alone. Our dataset and methods not only advance the study of congressional politics, but also provide a general framework for analyzing question-answering across interview-like settings.

07.
arXiv (CS.LG) 2026-06-18

ToolChain-CRC: Conformal Risk Control for Agentic AI Under Retrieval and Tool-Use Drift

arXiv:2606.18467v1 Announce Type: cross Abstract: Modern AI agents retrieve documents, call tools, check intermediate information, and then produce a final answer or action. This creates a risk-control problem that is not visible from the final answer alone. A final response may look acceptable even when the retrieval was weak, a tool output was wrong, or an earlier step was unsupported. We propose ToolChain-CRC, a conformal risk-control method for retrieval-augmented and tool-using agents under drift. The method treats each agent run as a full trajectory of actions, observations, and final output. It builds step-level risk scores, combines them into a trajectory risk score, calibrates an accept-or-intervene rule, and adds an anytime alarm that can stop risky runs before the final answer. We prove trajectory-level risk control under exchangeable calibration runs, give a drift-aware extension with auditable constants, and prove an anytime escalation rule through a supermartingale construction. Experiments cover synthetic tool-chain drift, RAG/tool-use stress tests, public SQuAD-derived retrieval tasks, an API-free agentic QA case study, ablations, target-risk sensitivity checks, 20-seed robustness checks, a drift-margin audit, and a live RAG/tool-use agent benchmark. Across these settings, final-answer-only calibration can miss retrieval and tool failures, while trajectory-level calibration keeps accepted-trajectory risk below the target.

08.
arXiv (CS.LG) 2026-06-19

Low-Energy Reduced RISC-V Instruction Subset Processor for Tsetlin Machine Inference at the Edge

arXiv:2606.19964v1 Announce Type: new Abstract: Tsetlin Machine (TM) is a logic-based machine learning approach that relies on simple bitwise operations and finite-state automata, which makes it attractive for edge AI deployments. Recent work has focused on co-processor and accelerator designs based on Tsetlin Machines (TMs). Although these designs achieve high performance, they typically depend on tightly coupled interfaces, microcode-style programming, and external host processors, limiting flexibility and ease of programming. In this work, we present a domain-specific RISC-V microprocessor architecture and design flow tailored for TM inference. Leveraging the modular structure of RISC-V, we design a reduced instruction subset processor that retains programmability while targeting improved performance and lower energy consumption for TM workloads. Instruction profiling is employed to guide instruction reduction, followed by datapath and control path simplifications tailored to TM inference. Both the baseline RV32IM core and the proposed reduced core are evaluated across multiple datasets and compared with Binarized Neural Networks (BNNs), which serve as a hardware-efficient baseline due to their reliance on bitwise operations during inference. Results show that TM achieves comparable or higher accuracy (e.g., up to 88.18% on CIFAR-2 compared to 60.0% for BNN) while reducing execution time by up to 98% across multiple datasets. Furthermore, the proposed design achieves an average $29.7\times$ reduction in energy consumption, demonstrating its effectiveness for programmable and efficient edge AI systems.

09.
medRxiv (Medicine) 2026-06-23

Associations Between Social Responsiveness and Sleep Disruption are Modulated by Chronotype in Early Adolescence: Cross-Sectional and Prospective Findings from 10,108 Participants of the Adolescent Brain and Cognitive Development (ABCD) Study

Background: Sleep disruption is prevalent in people with neurodevelopmental disorders such as autism but is not clear whether it occurs as an endophenotype or secondary to other behaviours. The ABCD Study is a population-based longitudinal study that monitors the health, demography and lifestyle of over 11,000 children in the US. In this study we leverage these data to investigate whether traits consistent with autism (social responsiveness) are associated with sleep disruption independent of lifestyle and other behavioural measures. Methods: Autistic traits were assessed using the Social Responsiveness Scale at age 11, and sleep disruption and behavioural outcomes were assessed at ages 11 and 13 years using the Sleep Disturbance Scale, and the Child Behaviour Check List, respectively. Demographic, health and lifestyle-related variables were assessed by caregiver questionnaires. Regression models were applied to investigate associations between autistic traits and sleep outcomes. Results: There was a significant cross-sectional association between sleep disturbance and SRS at age 11 years old that was independent of sex, ethnicity, socioeconomic position, physical activity, sedentary behaviour and anxiety/depression ({beta} = 0.12, 95% CI (0.07, 0.17); p < 0.001), that persisted at age 13, and that was modulated by chronotype, with evening types showing a stronger association. Discussion: Social responsiveness assessed in early adolescence (age 11) were associated with sleep disruption independent of multiple confounding factors and were prospectively associated with sleep disruption at age 13 years. These findings contribute to the evidence that disruption of sleep and circadian timing may have a primary role in the neurobiological mechanisms that mediate autistic traits.

10.
arXiv (CS.CV) 2026-06-16

Semantic Flip: Synthetic OOD Generation for Robust Refusal in Embodied Question Answering and Spatial Localization

Detecting unanswerable user queries remains essential for the reliable deployment of real-world embodied agents. However, modern vision-language models (VLMs) often generate overly confident answers even when the available visual memory cannot support the query. Such overconfidence poses various task-dependent risks. The agent may provide misleading information to the user in Embodied Question Answering and select an arbitrary coordinate and physically guide the user there in spatial reasoning for navigation. Despite these high stakes, only a few prior studies directly address when and how an embodied VLM should respond with "I do not know." This work proposes Semantic Flip, a simple yet effective framework that synthesizes auxiliary out-of-distribution (OOD) samples for embodied refusal without requiring external OOD annotations. The key idea is to independently transform the query and video memory to construct auxiliary OOD pairs that lack sufficient visual grounding. These synthesized pairs enable training a lightweight rejection module on top of a frozen pretrained VLM. The module attaches to any existing VLM-based pipeline without retraining the underlying model. Across two complementary benchmarks, Semantic Flip consistently outperforms strong prompting baselines. This work also introduces SpaceReject, a new refusal benchmark for spatial localization with deliberately unanswerable queries over long video memory, where Semantic Flip achieves an $F_1$ score of 0.9559. The source codes and datasets are publicly available at https://github.com/ndb796/SemanticFlip.

11.
medRxiv (Medicine) 2026-06-17

LLM-Driven Extraction of NI-RADS and Imaging Tumor Characteristics to Enhance Oropharyngeal Cancer Survivorship Surveillance

Abstract Purpose Radiologic surveillance is essential for oropharyngeal cancer (OPC) survivors, guiding recurrence detection and follow-up strategies. The Neck Imaging Reporting and Data System provides a standardized framework for post-treatment risk reporting at both the primary tumor site (pNI-RADs) and cervical lymph nodes (nNI-RADS). Comprehensive surveillance additionally requires assessment of disease status, including the primary tumor, nodal involvement, and distant metastases. These clinical results are often embedded as unstructured data within free-text radiology reports. We hypothesized that a large language model (LLM) can reliably extract NI-RADS score criteria and summarize key imaging features from unstructured radiology text, achieving high concordance with expert review. Methods Previously untreated OPC patients who received definitive cancer therapy were identified. Eligible imaging reports included post-treatment head and neck CT, MRI, or FDG PET/CT scans containing narrative and impression text. Examinations lacking narrative or impression text, containing pre-existing NI-RADS annotations, or involving non-surveillance imaging modalities were excluded. A total of 200 reports were randomly selected from 7,076 eligible examinations for manual abstraction using a three-reviewer consensus framework to establish a reference dataset. Using the Palantir Foundry Pipeline Builder, a GPT-5-based LLM was deployed to extract pNI-RADS and nNI-RADS scores, and key imaging features of disease status from these reports. Performance was evaluated using exact agreement and F1-based metrics. Results Agreement for no evidence of disease (score of 1) was 93.3% (126/135; F1 = 0.94) and 90.3% (130/144; F1 = 0.93) for pNI-RADS and nNI-RADS, respectively. For NI-RADS [&ge;]2, exact category agreement was 73.1% (38/52; macro-F1 = 0.75) for pNI-RADS and 64.3% (27/42; macro-F1 = 0.56) for nNI-RADS. Quadratic weighted {kappa} was 0.81 and 0.59, respectively. For post-treatment disease surveillance variables, agreement was 94.9% (149/157; F1 = 0.87) for primary tumor presence, 89.1% (164/184; F1 = 0.87) for nodal disease presence, and 94.7% (126/133; F1 = 0.70) for distant metastasis detection. Specificity was high across disease-status variables (0.95-0.99), with negative predictive values of 0.95 for primary tumor, 0.87 for nodal disease, and 0.99 for distant metastasis. Conclusions Our LLM-based information retrieval and classification approach for radiographic treatment response from unstructured, multidimensional imaging reports achieved high performance for disease exclusion and moderate performance for detecting suspected residual and/or new disease. This pipeline supports scalable and standardized surveillance data capture for longitudinal monitoring, clinical analytics, and survivorship research in head and neck oncology.

12.
Nature (Science) 2026-06-10

Building user-driven climate adaptation products

Climate adaptation products have traditionally been developed using a supply-driven model reliant on available climate information, leading to usability gaps1–4. To better meet user needs, the climate services field has recognized a need to shift towards a demand-driven model emphasizing co-production, that is, user-driven, scientifically informed products created through shared knowledge practices1–5. However, co-production can be challenging, especially for researchers unfamiliar with the approach or for digital and software-based products with complex user needs2,5–8. User-centred design, from the human–computer interaction field, offers a process that could complement co-production approaches to product development, yet its potential remains underexplored2. Here we show how user-centred design can be integrated into, and strengthen, co-production approaches for building user-driven climate adaptation products. Through a systematic review of the co-production and user-centred design literature, we identify key processes, mechanisms and best practices for both approaches. Our findings offer practical guidance for researchers and propose an integrated approach for developing climate adaptation products that are useful, usable and used. A systematic review and analysis shows how user-centred design can be integrated into, and strengthen, co-production approaches for building user-driven climate adaptation products.

13.
bioRxiv (Bioinfo) 2026-06-11

Machine Learning-Guided Discovery of Bacterial-Selective Membrane-Active Compounds Reveals Mechanistic Bias in Antibiotic Training Datasets

The rise of antibiotic resistance necessitates the discovery of antibacterial compounds with novel mechanisms of action (MoAs). Recent machine learning approaches have shown promise in antibacterial compound discovery, but often identify derivatives of known antibiotic classes rather than mechanistically novel compounds. Previous approaches applied Tanimoto similarity filters at the end of screening pipelines, but this method has substantial drawbacks: Tanimoto similarity can be misleading in chemical space, and post-hoc filtering does not influence what activity models learn to prioritize. Here, we present a machine learning pipeline that addresses chemical novelty upfront by employing an XGBoost-based MoA classifier to explicitly prioritize compounds predicted to have mechanisms distinct from known antibiotic classes, combined with graph neural networks for antibacterial activity and toxicity prediction. Applied to the Zinc20 database, our approach successfully identified non-toxic antibacterial compounds structurally distinct from known antibiotics. Notably, the majority of these hits exhibited membrane-targeting activity with selectivity for bacterial cells over mammalian cells, suggesting potential for next-generation membrane-active antibiotics. However, we did not identify compounds with novel protein targets. Systematic analysis revealed that this limitation stems from mechanistic bias in training data rather than model architecture. Specifically, our activity model learned to preferentially score compounds similar to specific groups in the training data, thus overrepresenting certain MoA classes including membrane-active compounds. Even substantial model architecture and training data enhancements did not overcome this constraint. Our findings demonstrate that the primary bottleneck for discovering mechanistically novel antibiotics is the scarcity of diverse, mechanistically-annotated training data. This work provides both a methodological framework for mechanism-aware screening and critical insights into data requirements for genuinely novel antibiotic discovery.

14.
arXiv (CS.AI) 2026-06-18

Closing the Loop: PID Feedback Control for Interpretable Activation Steering in Symbolic Music Generation

arXiv:2606.18790v1 Announce Type: cross Abstract: Transformer-based architectures have significantly advanced the generation of complex symbolic sequences, yet a significant gap remains in achieving fine-grained, interpretable control over discrete signal attributes. This paper investigates the mechanistic interpretability of the Multitrack Music Transformer (MMT) and proposes a framework for deterministic attribute modulation without retraining to bridge this gap via inference-time activation steering. Utilizing the Difference-in-Means (DiffMean) methodology, we isolate latent directions for signal attributes, specifically Pitch and Duration, within the residual stream. We validate the Linear Representation Hypothesis in this domain, achieving high correlation between steering magnitude and attribute shift. To address the inherent feature entanglement in multi-attribute steering, we introduce a Dual Steering framework utilizing Gram-Schmidt Orthogonalization. Experimental results demonstrate that this geometric decoupling reduces conceptual interference and signal degradation compared to naive vector addition, enabling independent deterministic control even against strong autoregressive conditioning.

15.
medRxiv (Medicine) 2026-06-15

CDH13 is associated with cellular viability after exposure to ionizing radiation using genome-wide screening

Background: It is well known that genetic variants contribute to cellular sensitivity to chemotherapeutic agents and ionizing radiation (IR). The aim of this study was to identify single nucleotide polymorphisms (SNPs) and genes associated with the spectrum of normal cellular sensitivity of lymphoblastoid cell lines (LCLs) towards ionizing radiation and mitomycin C (MMC). Methods: In a first step, we determined the viability of LCLs established from male participants of the Berlin Aging Study II (BASE-II) aged >=62 years following treatments with increasing doses of IR (n=137 cell lines) or MMC (n=140 cell lines) using the alamarBlue assay. Results from intra-experimental triplicates and three independent experiments for each cell line and treatment were used to calculate the area under the curves (AUCs) representing the specific sensitivity to IR and MMC of each LCL. The data from these experiments were subsequently used as outcomes in genome-wide association studies (GWASs). In addition, we calculated polygenic risk scores (PGS) from UK Biobank GWAS results for four cancer-related phenotypes and assessed the extent to which the variance in the IR and MMC sensitivity is explained by these PGS. Results: The GWAS analyses revealed one variant, rs74728080, located in CDH13 on chromosome 16, to show genome-wide significant (p < 5 x 10-8, beta = 2.81) association with cellular viability after treatment with IR. In the GWAS on MMC sensitivity the most interesting signal was elicited by SNP rs113978558 in an intron of the PLD5 gene on chromosome 1 (p = 9.232 x 10-8; beta = 1.44). Several other SNPs with statistically suggestive (i.e., p < 1 x 10-5) evidence of association with IR or MMC sensitivity were identified. PGSs calculations from GWAS of four cancer-related traits in UKB explained ~5% and ~3% of phenotypic variance in IR- and MMC-induced cell viability, respectively. Conclusion: The genome-wide significant association of rs74728080 with IR sensitivity and the location of this variant in CDH13 is interesting and functionally highly plausible given its known involvement in oxidative-stress response and function as tumor suppressor. Taken together, our novel data suggest that CDH13 may be genuinely involved in regulating cellular IR sensitivity.

16.
arXiv (CS.AI) 2026-06-18

A DeepLearning Framework for Dynamic Estimation of Origin-Destination Sequence

arXiv:2307.05623v2 Announce Type: replace-cross Abstract: OD matrix estimation is a critical problem in the transportation domain. The principle method uses the traffic sensor measured information such as traffic counts to estimate the traffic demand represented by the OD matrix. The problem is divided into two categories: static OD matrix estimation and dynamic OD matrices sequence(OD sequence for short) estimation. The above two face the underdetermination problem caused by abundant estimated parameters and insufficient constraint information. In addition, OD sequence estimation also faces the lag challenge: due to different traffic conditions such as congestion, identical vehicle will appear on different road sections during the same observation period, resulting in identical OD demands correspond to different trips. To this end, this paper proposes an integrated method, which uses deep learning methods to infer the structure of OD sequence and uses structural constraints to guide traditional numerical optimization. Our experiments show that the neural network(NN) can effectively infer the structure of the OD sequence and provide practical constraints for numerical optimization to obtain better results. Moreover, the experiments show that provided structural information contains not only constraints on the spatial structure of OD matrices but also provides constraints on the temporal structure of OD sequence, which solve the effect of the lagging problem well.

17.
arXiv (math.PR) 2026-06-18

A Unified Approach to Beta Moments, Combinatorial Identities, and Random Walks

arXiv:2605.05420v2 Announce Type: replace Abstract: The study of random walks has increasingly been popular across diverse disciplines such as statistics, mathematics, quantum physics, where they are used to model paths consisting of successive random steps in a mathematical space. A fundamental quantity of interest is the probability that a simple symmetric random walk returns to the origin after 2n steps. In this paper, we develop a unified probabilistic approach that connects the return probabilities in arbitrary dimensions with moment representations. Using this framework, we provide probabilistic proofs of several combinatorial identities involving beta and gamma functions, and derive new combinatorial identities in general dimensions.

18.
arXiv (CS.LG) 2026-06-15

Detecting Lookahead Bias in LLM Forecasts

arXiv:2512.23847v2 Announce Type: replace-cross Abstract: We develop a statistical procedure to detect lookahead bias in economic forecasts generated by large language models (LLMs). Using a date-only recall query for a firm-date pair, we estimate the probability that the LLM has internalized information about the realized outcome, a statistic we term Lookahead Propensity (LAP). LAP is materially positive throughout the in-sample period and collapses essentially to zero right after the training-data cutoff. We show that a positive interaction between LAP and the LLM forecast in an accuracy regression indicates lookahead-bias contamination, and apply the test to two forecasting tasks: news headlines predicting stock returns and earnings call transcripts predicting capital expenditures. In both applications, the LLM forecast's predictive power is amplified on high-LAP firm-date pairs, and the interaction loses significance on post-training-cutoff samples. Our test provides a cost-efficient, diagnostic tool for assessing the validity and reliability of LLM-generated forecasts.

19.
arXiv (CS.AI) 2026-06-24

Deciphering Fingerprints of 3D Molecular Surfaces for Accurate Epitope Prediction

arXiv:2606.23830v1 Announce Type: cross Abstract: Molecular surfaces encode the geometric and physicochemical patterns that determine antibody-antigen recognition, central to epitope prediction. However, existing methods rely on sequences or backbone structures and struggle to capture discontinuous, surface-driven epitopes. This study presents SurfBind, a surface-centric learning framework for epitope prediction that operates directly on molecular surface representations. SurfBind integrates geometric and physicochemical cues through a Transformer-based architecture with patch-level surface modeling, binder-aware cross-attention, and a hierarchical coarse-to-fine prediction paradigm. Experiments on challenging epitope identification benchmarks, including SAbDab and DB5.5, demonstrate that SurfBind achieves state-of-the-art performance and strong generalization across unseen antibodies and conformational states, highlighting the value of interaction-aware surface modeling for understanding the crucial mechanisms of protein-protein interactions.

20.
medRxiv (Medicine) 2026-06-16

Validation of a Smartphone-Image-Based Computer-Vision Model for Lean Mass and Body Fat Estimation Against Dual-Energy X-ray Absorptiometry

Introduction Body composition, rather than body weight alone, is an increasingly important health metric, and preservation of lean mass has become a central concern in obesity treatment, aging, and chronic disease management. Dual-energy X-ray absorptiometry (DXA) provides accurate assessment of fat and lean tissue, but its cost and logistical requirements limit repeated measurement. Computer-vision approaches show promise for estimating adiposity from smartphone images, but lean-mass estimation remains less established. Methods We evaluated a computer-vision body composition model, applied to consumer-grade smartphone photographs, against DXA in a held-out validation sample of 195 adults from an ongoing cross-sectional study. Body fat percentage and total lean mass percentage were co-primary outcomes; for total lean mass percentage, an image-only configuration (no added covariates) was pre-specified as primary. Agreement was quantified using Lin's concordance correlation coefficient (CCC) as the lead statistic, with Pearson correlation, mean absolute error, root mean square error, mean bias, and Bland-Altman limits of agreement. In secondary analyses, appendicular lean mass and total lean mass percentage were each estimated with and without routine anthropometric and demographic inputs (body weight, height, age, and sex). Results Total lean mass percentage agreed with DXA from image features alone (CCC 0.916). Body fat percentage, estimated with routine inputs added, agreed at least as closely (CCC 0.930). Adding routine inputs barely changed agreement for total lean mass percentage but markedly improved it for appendicular lean mass, an absolute quantity that scales with body size. Conclusions A smartphone-image-based model estimated both body fat and lean mass with strong agreement to DXA, with lean mass percentage from image features alone. The approach needs no fixed equipment or ionizing radiation. Whether it can track change over time, including in incretin-based weight loss where lean mass preservation is a concern, was not assessed in this cross-sectional study.

21.
arXiv (CS.CV) 2026-06-15

Temporal Backtracking Search for Test-time Generative Video Reasoning

While test-time scaling has revolutionized reasoning in large language models, generative video reasoning remains bottlenecked by a single-shot paradigm. We demonstrate that searching over denoising steps cannot rescue logically flawed rollouts because spatial trajectories commit early in the diffusion process. Root-level Best-of-N (BoN) sampling is similarly inefficient: reasoning errors cluster early in the temporal axis, and resampling blindly discards verified upstream progress. To unlock effective test-time scaling for video models, we introduce Temporal Backtracking Search (TBS), which shifts the search space to the temporal axis. TBS transforms video generation into an iterative generate-verify-restart loop via three core mechanisms: (1) variable-K conditioning to resume generation from arbitrary clean prefixes; (2) temporal process verification to localize failures and extract valid restart anchors; and (3) prefix-based search to reallocate compute toward extending correct trajectories rather than root resampling. Across algorithmic, navigation, and robotics domains, TBS Pareto-dominates matched-budget BoN. In a strict out-of-distribution setting where one-shot generation collapses (0.7% for BoN), TBS achieves 22.7%, with every solved episode stemming from a restarted branch. Ultimately, TBS reveals that the local reasoning competence of video models far exceeds what single-shot rollouts indicate, providing a scalable test-time framework to unlock it.

22.
medRxiv (Medicine) 2026-06-15

Beyond the Apnea-Hypopnea Index: Physiological and Demographic Predictors of Excessive Daytime Sleepiness in Obstructive Sleep Apnea

Excessive daytime sleepiness (EDS) is a common but inconsistently predicted symptom of obstructive sleep apnea (OSA). OSA is typically diagnosed with polysomnography (PSG), and the current standard for severity assessment is the apnea-hypopnea index (AHI). AHI has many limitations, including its inability to explain physiological mechanisms or reflect variability in patient symptoms, such as EDS. This retrospective study aims to find physiological and demographic parameters that better predict EDS in patients with OSA and to evaluate whether these parameters outperform AHI using PSG data from the Mount Sinai Integrative Sleep Center. Clinical variables used to predict EDS included arousal index (AI), average oxygen desaturation during sleep, average heart rate during sleep, and AHI, along with demographic variables including age, sex, and BMI. Hypothesis tests, logistic regression models, and decision tree classifier models were performed on the data to discriminate sleepy from nonsleepy patients as determined by an Epworth Sleepiness Scale (ESS) score [&ge;] 10. AI and oxygen desaturation were found to be the most predictive physiological variables, and sex and BMI were found to be the most predictive demographic variables. The final decision tree model with these four variables outperformed the AHI in predicting EDS. These findings suggest that daytime sleepiness in OSA can be better explained by measures of apnea burden, oxygenation impairment, and patient demographics than by AHI alone, although these remain only modestly predictive. Future studies should focus on investigating more comprehensive physiological markers, multi-night sleep data, and more objective assessments of sleepiness.

23.
medRxiv (Medicine) 2026-06-22

Three multimodal large language models fail at clinically actionable breast pathology in three different directions

Background. Breast cancer treatment depends on histopathological features, such as grade and receptor-defined subtype; however, specialist pathologist access is constrained when the workforce is limited. Commercial multimodal large language models (MLLMs) accept hematoxylin and eosin (H&E) image tiles through paid interfaces without local hardware or fine-tuning. However, prior pathology evaluations addressed only coarse tasks. Whether they reach treatment-determining accuracy and whether vendors agree remain unclear. Methods. We aimed to evaluate three vendor-designated flagship MLLMs (Claude Sonnet 4.6, Gemini 2.5 Pro, GPT-5.5) in 427 invasive breast cancer cases. Each case went to all three with identical H&E tiles and prompts, and the subtype was inferred in the second call. The reference was an institutional sign-out report of an immunohistochemistry-derived subtype. We calculated the concordance, sensitivity, specificity, Cohen's kappa, and pairwise McNemar and Bowker tests. Findings. Claude ranked highest by raw histologic-type concordance but lowest by kappa, classifying all 23 lobular and seven micropapillary carcinomas as invasive breast carcinoma of no special type. The models anchored the Nottingham grade to three modal grades. None of the models reliably identified human epidermal growth factor receptor 2-positive disease. The failure direction was vendor-specific: Claude and GPT-5.5 were under-detected, whereas Gemini was over-called. Twelve prompt variants (4,056 calls) did not recover sensitivity. Interpretation. No current commercial MLLM reaches deployment-ready accuracy for any treatment-determining feature of breast pathology. As each vendor fails in its own fixed direction, changing vendors alters the type of error rather than removing it; therefore, the value of these models is assistive rather than autonomous. At USD 0.20-0.50 per case, they may serve as supervised draft generators that leave the diagnosis with the pathologist.

24.
medRxiv (Medicine) 2026-06-18

Age as a moderator of a brief alcohol intervention among injury patients in Northern Tanzania

Background: Alcohol use is a leading modifiable risk factor for injury in sub-Saharan Africa. In Tanzania, young people ([&le;]24 years) experience greater alcohol-related harm despite drinking less frequently than adults. Punguza Pombe kwa Afya Yako (PPKAY) is a culturally adapted, brief intervention for injury patients in Tanzania. This study examined whether age moderates its effectiveness. Methods: We conducted an exploratory secondary analysis of baseline and 3-month data from the PPKAY randomized trial among injury patients aged [&ge;]18 years at Kilimanjaro Christian Medical Centre, Tanzania. Eligible participants reporting alcohol use before injury, AUDIT [&ge;]8, or positive breathalyzer were randomized to usual care or PPKAY with SMS boosters. The primary outcome was binge drinking days. Count outcomes were analyzed using negative binomial regression with robust SEs and continuous outcomes using mixed-effects models. Effect modification was assessed using a three-way interaction (Time x intervention x Age). Results: Among 543 participants (mean age 36.8 years; 16.2% aged 18–24), age moderated the intervention effect for drinking days (IRR = 0.27, 95% CI 0.07 – 0.98; p = 0.046) and drinks consumed (IRR = 0.17, 95% CI 0.04 – 0.77; p = 0.021). The intervention reduced 4 drinking days (95% CI -7.1 to -0.8) and 27.5 drinks (95% CI -42.8 to -12.2) among young people, while adults showed reductions in both arms, without intervention-specific effect. Conclusion: The effects of ED-based brief alcohol interventions are not uniform, varying across both age groups and alcohol-related outcomes. We found a greater responsiveness in drinking frequency and quantity reported among young people.

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arXiv (CS.CL) 2026-06-16

RoTRAG: Rule of Thumb Reasoning for Conversation Harm Detection with Retrieval-Augmented Generation

Detecting harmful content in multi turn dialogue requires reasoning over the full conversational context rather than isolated utterances. However, most existing methods rely mainly on models internal parametric knowledge, without explicit grounding in external normative principles. This often leads to inconsistent judgments in socially nuanced contexts, limited interpretability, and redundant reasoning across turns. To address this, we propose RoTRAG, a retrieval augmented framework that incorporates concise human written moral norms, called Rules of Thumb (RoTs), into LLM based harm assessment. For each turn, RoTRAG retrieves relevant RoTs from an external corpus and uses them as explicit normative evidence for turn level reasoning and final severity classification. To improve efficiency, we further introduce a lightweight binary routing classifier that decides whether a new turn requires retrieval grounded reasoning or can reuse existing context. Experiments on ProsocialDialog and Safety Reasoning Multi Turn Dialogue show that RoTRAG consistently improves both harm classification and severity estimation over competitive baselines, with an average relative gain of around 40% in F1 across benchmark datasets and an average relative reduction of 8.4% in distributional error, while reducing redundant computation without sacrificing performance.