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01.
arXiv (CS.AI) 2026-06-19

Confidence Calibration for Multimodal LLMs: An Empirical Study through Medical VQA

arXiv:2606.19950v1 Announce Type: cross Abstract: Multimodal Large Language Models (MLLMs) show great potential in medical tasks, but their elicited confidence often misaligns with actual accuracy, potentially leading to misdiagnosis or overlooking correct advice. This study presents the first comprehensive analysis of the relationship between accuracy and confidence in medical MLLMs. It proposes a novel method that combines Multi-Strategy Fusion-Based Interrogation (MS-FBI) with auxiliary expert LLM assessment, aiming to improve confidence calibration in Medical Visual Question Answering (VQA). Experiments demonstrate that our method reduces the Expected Calibration Error (ECE) by an average of 40\% across three Medical VQA datasets, significantly enhancing MLLMs' reliability. The findings highlight the importance of domain-specific calibration for MLLMs in healthcare, offering a more trustworthy solution for AI-assisted diagnosis.

02.
arXiv (CS.AI) 2026-06-12

Decentralized Autoregressive Generation

arXiv:2601.03184v3 Announce Type: replace-cross Abstract: The decentralization of autoregressive generation has attracted considerable attention in recent years as a solution to scaling bottlenecks. However, despite promising empirical results, this paradigm currently lacks rigorous theoretical justification. In this work, we formally establish the theoretical equivalence between decentralized and centralized training. To achieve this, we adapt the Discrete Flow Matching framework for autoregressive generation, leveraging its inherent properties to demonstrate that global models naturally decompose into independent experts. Finally, we conduct extensive experiments across diverse multimodal benchmarks, empirically validating that decentralized training maintains competitive parity with standard centralized architectures.

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

Enhancing Spectral Embedding through Robust and Flexible Knowledge Transfer in Electronic Health Records

arXiv:2606.11570v1 Announce Type: cross Abstract: We propose a spectral-based, unsupervised representation learning framework to derive low-dimensional embeddings for clinical concepts and patients in rare disease cohorts from electronic health records, where data are high-dimensional but sample sizes are limited. To overcome this challenge, we incorporate a knowledge matrix extracted from a broader population that shares a partially overlapping subspace with the rare-disease cohort. Our method departs from existing approaches by relaxing restrictive one-to-one signal-alignment assumptions between the latent data matrix and knowledge matrix, allowing more flexible and realistic forms of structured sharing. We introduce a novel two-step spectral embedding procedure: first, we identify and remove irrelevant components from the knowledge matrix; then, we apply a projection-based method to separately recover shared and heterogeneous components. Simulations and an analysis of a real-world multiple sclerosis cohort show that the proposed method outperforms competing approaches, particularly in challenging scenarios where shared signals are weak and only partially aligned, as is common in rare-disease data.

04.
PLOS Computational Biology 2026-06-15

Fung-AI: An AI/ML-driven pipeline for antifungal peptide discovery

by Daniel S. Berman, Libby M. Lewis, Tom D. Curtis, Olivia N. Tiburzi, Daniel F. Q. Smith, Arturo Casadevall, Laura J. Dunphy Emerging fungal pathogens represent a concerning threat to both global health and food security. In this study, we aimed to address our rising vulnerability to fungal pathogens through the development of the Fung-AI pipeline: an AI/ML-driven approach for antifungal discovery. A generative adversarial network (GAN) was trained to generate novel candidate antifungal peptide sequences. Next, in silico antifungal and hemolytic classifiers were built to further prioritize AI-generated peptides for experimental validation. From a pool of ~10,000 candidates, thirteen peptides were selected for testing over two-stages of experimentation. Five peptides were found to display mild antifungal activity against the wheat pathogen, Fusarium graminearum, with minimal inhibitory concentrations (MICs) ranging from 250 µg/mL to 500 µg/mL. Four of the five peptides also showed activity against the human pathogen, Candida albicans (MIC: 500 µg/mL). Two of our AI-generated antifungal peptides additionally demonstrated low cytotoxicity in HepG2 human liver carcinoma cells (LC50 > 704.2 µg/mL) indicating that they may be useful as scaffolds for future optimization for therapeutic applications. None of our peptides were found to considerably inhibit the emerging pathogen C. auris, suggesting the need for pathogen-specific down-selection of candidate peptides. Overall, we present a proof-of-principle, generative-AI-based approach for the rapid design of de novo antifungal peptides.

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

RogueAI: A Reverse Turing Test for Detecting Licensed AI Deception in Dialogue

The original Turing Test asks a human judge to distinguish a machine from a person through dialogue. Three quarters of a century later, conversational systems pass this test in casual settings; the interesting epistemological question has shifted. We argue that the relevant modern variant asks not whether a dialogue partner is artificial, but whether it can be trusted. We present RogueAI, an interactive webapp that operationalizes this revisited test as a one-on-two interrogation game: a human player questions two indistinguishable Large Language Model agents, knowing that exactly one of them has been licensed to deceive within a shared fictional scenario. The player's task is to identify the deceptive agent and "shut it off" before a turn budget is exhausted. We further introduce AutoRogueAI, a procedural extension in which players co-design a custom scenario with a narrator agent that secretly chooses its own deception strategy. We describe the framing, sketch the abstract architecture and gameplay loop, and situate the artifact within recent work on LLM deception, social-deduction benchmarks, and scalable oversight via debate. A three-day pilot deployment (467 initiated sessions, 415 completed, 1876 interaction turns in Italian) provides early feasibility evidence and surfaces a concrete tension: the deceptive agent carries a reliable, locally-present linguistic signature - differential helpfulness, brevity, hedging - that a simple heuristic exploits at 75.6% accuracy, yet human players achieved only 56.6%, consistent with ignoring the most diagnostic signal entirely. We discuss what this gap implies for the artifact's use as a data-collection vehicle, a teaching tool, and an evaluation harness for honesty-trained models.

06.
arXiv (math.PR) 2026-06-16

Layerwise Terminal Discrepancy in Chen's Reverse-Heat Coupling on the Boolean Cube

arXiv:2606.04573v2 Announce Type: replace-cross Abstract: Recently, Chen [Chen2026] proved that Talagrand's Boolean convolution conjecture holds up to the dimension-free factor \((\log\log\eta)^{3/2}\), namely for every fixed \(\tau>0\), \[ \mu\{P_\tau f>\eta\|f\|_1\} \le C_\tau \frac{(\log\log\eta)^{3/2}}{\eta\sqrt{\log\eta}}, \qquad \eta>e^3. \] We revisit the terminal testing-discrepancy step in Chen's perturbed reverse-heat coupling. Chen estimates this discrepancy globally in terms of the remaining gap to the terminal level. We keep the same coupling and the same reverse-heat formulations, but localize the terminal discrepancy on each remaining-gap layer before summing the layers. This changes the fixed-time anti-concentration cost from order \((\log L)^{3/2}/\sqrt L\) to order \((\log L)/\sqrt L\), where \(L=\log\eta\). Consequently, we obtain a \((\log\log\eta)^{1/2}\) improvement as \[ \mu\{P_\tau f>\eta\|f\|_1\} \le C_\tau \frac{\log\log\eta}{\eta\sqrt{\log\eta}}, \qquad \eta>e^3. \]

07.
arXiv (CS.LG) 2026-06-12

Scalable anomaly detection via a univariate Christoffel function

arXiv:2606.12483v1 Announce Type: new Abstract: Anomaly detection plays a critical role in identifying unusual patterns across domains such as fraud detection, network intrusion, and system fault diagnosis. Recently, Christoffel function-based methods, rooted in polynomial optimization, have emerged as promising alternatives to deep learning due to their strong mathematical foundations and computational frugality. However, their practical applicability is hindered by the need to invert a matrix whose size grows exponentially with the data dimension, rendering the method intractable even for moderate-dimensional datasets. This paper addresses the dimensionality limitations of Christoffel function-based anomaly detection while preserving its key theoretical properties, i.e., the on-off support dichotomy behavior and the accurate support shape capture. We introduce UCF, a univariate Christoffel function which is based on the squared distance between the query point and the support points. Extensive experiments on the ADBench benchmark demonstrate that UCF consistently outperforms 14 state-of-the-art baselines in terms of Average Precision. By resolving the scalability bottleneck of the Christoffel Function, this work expands the toolkit of anomaly detection methods with a robust, theoretically grounded, and universally applicable approach.

08.
arXiv (CS.AI) 2026-06-16

RollArt: Disaggregated Multi-Task Agentic RL Training at Scale

arXiv:2512.22560v2 Announce Type: replace-cross Abstract: Agentic Reinforcement Learning (RL) trains LLMs through multi-turn interactions with environments, producing workloads that mix compute-bound prefill, bandwidth-bound decoding, CPU-heavy environment execution, and bursty reward evaluation. Existing systems either colocate all stages on a single GPU cluster or decouple them only at a coarse granularity, overlooking hardware heterogeneity and incurring substantial synchronization overhead across stages. We present ROLLART, a system for multi-task agentic RL on disaggregated infrastructure. ROLLART maps each pipeline stage to best-fit hardware, routing prefill-heavy tasks to compute-optimized GPUs, decode-heavy tasks to bandwidth-optimized GPUs, and environments to CPU clusters. It decouples rollout at the trajectory level, allowing generation, environment interaction, and reward scoring to proceed independently, so that slow or failed environments never block the others. ROLLART offloads stateless reward computation to serverless infrastructure and overlaps rollout with training via staleness-bounded asynchronous weight synchronization. Our results demonstrate that ROLLART effectively improves training throughput and achieves 1.31–2.05 \(\times\) training time reduction compared to various RL systems. We also evaluated ROLLART by training a hundreds-of-billions-parameter MoE model for Qoder product on an Alibaba cluster with above 3,000 GPUs, demonstrating its stability and scalability.

09.
arXiv (CS.CL) 2026-06-16

ArFake: A Robust Framework for Multi-Dialect Arabic Speech Spoofing Detection Benchmark

With the rise of generative text-to-speech models, distinguishing between real and synthetic speech has become challenging, especially for Arabic that have received limited research attention. Most spoof detection efforts have focused on English, leaving a significant gap for Arabic and its many dialects. In this work, we introduce the first multi-dialect Arabic spoofed speech dataset. To evaluate the difficulty of the synthesized audio from each model and determine which produces the most challenging samples, we aimed to guide the construction of our final dataset either by merging audios from multiple models or by selecting the best-performing model, we conducted an evaluation pipeline that included training classifiers using two approaches: modern embedding-based methods combined with classifier heads; classical machine learning algorithms applied to MFCC features; and the RawNet2 architecture. The pipeline further incorporated the calculation of Mean Opinion Score based on human ratings, as well as processing both original and synthesized datasets through an Automatic Speech Recognition model to measure the Word Error Rate. Our results demonstrate that FishSpeech outperforms other TTS models in Arabic voice cloning on the Casablanca corpus, producing more realistic and challenging synthetic speech samples. However, relying on a single TTS for dataset creation may limit generalizability.

10.
arXiv (CS.AI) 2026-06-19

SARLO-80: Worldwide Slant SAR Language Optic Dataset 80cm

arXiv:2606.20523v1 Announce Type: cross Abstract: Multimodal foundation models have advanced rapidly thanks to large optical benchmarks, but comparable resources for synthetic aperture radar (SAR) remain limited. Existing SAR–optical datasets largely rely on low-resolution, intensity-only Ground Range Detected~(GRD) products and do not preserve complex-valued SAR measurements or native acquisition geometry, which restricts physically grounded multimodal learning. In particular, large-scale public datasets combining very-high-resolution (VHR) SAR SLC, aligned optical imagery, and natural-language descriptions are still lacking. We present a VHR SAR–optical–text dataset built from open-access Umbra spotlight acquisitions distributed as Sensor Independent Complex Data (SICD). From around 2,500 worldwide scenes (VV/HH, 20cm–2m native resolution), we standardize all SAR data to an 80cm slant-range grid via band-limited FFT resampling and tile the imagery into 1024 by 1024 patches. For each SAR patch, we retrieve a high-resolution optical tile and warp it into the SAR grid using local coordinate correspondences for local pixel-level alignment. We further generate three caption variants (SHORT/MID/LONG) per sample to support vision–language training and evaluation. Our dataset contains 119,566 triplets (complex and amplitude slant-range SAR patch, aligned optical patch, natural-language description) covering 257 locations across 72 countries and a broad range of land types and infrastructures. We release fixed train/validation/test splits and the full preprocessing and baseline code to enable reproducible benchmarks for multimodal alignment on cross-modal retrieval and conditional generation in native SAR geometry. The dataset is publicly available on the Hugging Face Hub at https://huggingface.co/datasets/ONERA/SARLO-80.

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

Recursive Binding on a Budget: Subspace Carving in Order-p Tensor Memories

arXiv:2606.11391v1 Announce Type: new Abstract: Tensor Product Representations provide the structural fidelity required for symbolic reasoning in models but suffer from exponential dimensionality growth when encoding deep recursive structures. Conversely, Vector Symbolic Architectures maintain constant dimensionality but sacrifice capacity and fidelity due to noisy compression via superposition. In this work, we propose Orthogonal Subspace Carving (OSC), a memory architecture that binds fillers to roles by projecting onto the null space of the role basis before aggregating into a fixed order-p tensor. OSC uses projections to enforce geometric orthogonality between bound structures within a static memory trace. We show that this mechanism decouples the tensor order from the structural depth, enabling deep recursive binding within a constant memory footprint. By performing retrieval via recognition, this construction allows for component vectors that are orders of magnitude smaller than the memory tensor, giving superior memory efficiency in settings involving high superposition. We also show that TPR is a special case of binding in Clifford algebra, and give a Clifford formulation of OSC.

12.
arXiv (CS.AI) 2026-06-16

STRIDE: Strategic Trajectory Reasoning via Discriminative Estimation for Verifiable Reinforcement Learning

arXiv:2606.15866v1 Announce Type: new Abstract: Reinforcement Learning with Verifiable Rewards (RLVR) has become an effective post-training paradigm for improving the reasoning abilities of large language models. However, existing RLVR methods typically rely on final-answer correctness to assign trajectory-level rewards, providing sparse supervision and treating all tokens uniformly regardless of their actual contribution to reasoning. Although recent studies introduce intermediate signals such as process rewards, high-entropy tokens, and semantic uncertainty, these signals are often not inherently verifiable and may fail to distinguish beneficial strategic patterns from harmful ones. To address this limitation, we propose STRIDE (Strategic Trajectory Reasoning with Discriminative Estimation), a fine-grained RLVR framework that derives strategic reasoning supervision from verifiable outcomes. STRIDE contrasts successful and failed trajectories within each response group to estimate the outcome-discriminative preference of each $n$-gram strategic pattern, and further combines this signal with reasoning saliency entropy to identify decision-relevant strategic patterns. These patterns are assigned differentiated advantage values during RL optimization, enabling more precise credit assignment while preserving the verifiability of RLVR. Extensive experiments demonstrate that STRIDE consistently improves reasoning performance across diverse models, tasks, and extended settings, including VLMs and agent-based systems.

13.
arXiv (CS.CV) 2026-06-18

Performance Gap Analysis between Latin and Arabic Scripts HTR

Recent studies have shown that handwritten text recognition (HTR) systems perform worse on Arabic-script datasets than on Latin-script data. However, the reasons for this gap are still not well understood due to the lack of controlled comparisons. In this work, we present a comprehensive study of Arabic and Latin scripts HTR using a unified CRNN model for line-level HTR across nine datasets (including KHATT (Arabic), Muharaf (Arabic), NUST-UHWR (Urdu), PHTD (Persian), IAM (English), READ-2016 (German), and others) and di ferent training sizes (K in {100, 500, 1000, 2000, ..., Kfull}). Our results show the performance gap remains: it is large in low-resource settings, decreases with more data, but remains even at full scale, with a consistent difference of 5-7 CER points. We show that annotation quality matters, as many datasets contain labeling errors. Cleaning reduces error rates and narrows the gap, but does not eliminate it. In addition, we find that a fixed number of training samples provides less effective coverage in Arabic due to higher visual variability, requiring more data to learn similar representations. We compare recognition across datasets in terms of the number of text lines and the number of characters, showing an equivalence trade-off. We compare character frequency distributions across scripts and show that Arabic is significantly more heavy-tailed than Latin. Our error analysis reveals that around 30 percent of substitution errors in Arabic datasets (e.g., KHATT) are caused by confusion between visually similar characters, compared to about 15 percent in Latin-script datasets such as IAM.

14.
arXiv (CS.CL) 2026-06-15

Protean Compiler: An Agile Framework to Drive Fine-grain Phase Ordering

The phase ordering problem has been a long-standing challenge since the late 1970s, yet it remains an open problem due to having a vast optimization space and an unbounded nature, making it an open-ended problem without a finite solution, one can limit the scope by reducing the number and the length of optimizations. Traditionally, such locally optimized decisions are made by hand-coded algorithms tuned for a small number of benchmarks, often requiring significant effort to be retuned when the benchmark suite changes. In the past 20 years, Machine Learning has been employed to construct performance models to improve the selection and ordering of compiler optimizations, however, the approaches are not baked into the compiler seamlessly and never materialized to be leveraged at a fine-grained scope of code segments. This paper presents Protean Compiler: An agile framework to enable LLVM with built-in phase-ordering capabilities at a fine-grained scope. The framework also comprises a complete library of more than 140 handcrafted static feature collection methods at varying scopes, and the experimental results showcase speedup gains of up to 4.1% on average and up to 15.7% on select Cbench applications wrt LLVM's O3 by just incurring a few extra seconds of build time on Cbench. Additionally, Protean compiler allows for an easy integration with third-party ML frameworks and other Large Language Models, and two applications of this two-step optimization show a gain of 10.1\% and 8.5\% speedup w.r.t. -O3 on CBench's Susan and Jpeg applications. Protean compiler is seamlessly integrated into LLVM and can be used as a new, enhanced, full-fledged compiler. We plan to release the project to the open-source community in the near future.

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

JourneyFormer: Encoding Airbnb Guest Journey with Sequence Modeling

arXiv:2606.19108v1 Announce Type: new Abstract: Sequence modeling has become increasingly popular in recommendation and ranking algorithms, owing to its capacity to model users' historical behaviors and infer user intentions. Despite its theoretical simplicity, the practical deployment of a sequence model in production is non-trivial due to complexity of the sequence and sparse labels. For example, in Airbnb, guest sequences are often long, exploratory and complex, and we focus on booking labels, which are sparse. As such, we are often required to make various design decisions regarding data and modeling to strike a balance between effectiveness and scalability. This work delved into these production challenges and deployed JourneyFormer, a sequence modeling solution for search ranking at Airbnb. We detail crucial design considerations, covering aspects such as guest event selection, ID embeddings, model architecture, and label attribution. Additionally, we describe several tailored strategies to accelerate model training and inference. JourneyFormer has been successfully deployed within Airbnb's production, where its effectiveness and impact have been evidenced not only by improved offline ranking metrics but also by significant gains in key business metrics through online A/B testing across 2 production surfaces.

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

PANDA: An LLM-Enhanced Performance-Driven Analog Design Framework Bridging Design Intent and Layout Generation

arXiv:2606.15052v1 Announce Type: cross Abstract: Traditional design of analog circuits heavily relies on manual interventions across topology, sizing, and layout, with prior automation addressing stages in isolation. In this work, we propose PANDA, an LLM-enhanced framework that bridges high-level design intent to final layout by actively managing cross-stage dependencies through guided topology synthesis, substructure-aware sizing, and constraint-driven layout generation. This shifts automation from algorithm-centric execution to intent-centric co-design, reducing turnaround time from days or weeks to hours while improving design performance.

17.
medRxiv (Medicine) 2026-06-12

Heterogeneity of Treatment Effect of Aspirin and Clinically Significant Bleeding in Older Adults

Aim: The global population of older adults is growing, and older age is linked to higher bleeding risk. Although guidelines discourage aspirin for primary prevention in healthy older adults due to bleeding harms outweighing benefits, many continue taking it without a clear indication. It remains unclear whether all older adults face uniform aspirin-related bleeding risk or if certain subgroups are more vulnerable. Methods: We analyzed data from 19,114 ASPREE trial participants to develop machine learning models using 116 baseline variables. Random forest (RF) and random survival forest (RSF) models predicted 5-year bleeding risk, and participants were stratified into low, intermediate, and high-risk groups based on the 20th and 80th percentiles of predicted risk. We assessed heterogeneity of treatment effect (HTE) by testing treatment-by-risk group interactions on the relative scale using Fine-Gray models, and on the absolute scale using observed 5-year cumulative incidence rates. Results: Over a median follow-up of 4.7 years, 626 major bleeding events occurred. The RF model had moderate discrimination (AUC = 0.65, 95% CI: 0.63-0.67) and good calibration (Brier = 0.032, 95% CI: 0.029-0.034). Statistically significant HTE was observed on the relative scale, with the greatest relative increase in bleeding risk seen in the low-risk group (subdistribution hazard ratio = 2.26, 95% CI: 1.27-4.01). On the absolute scale, low-risk participants experienced higher bleeding with aspirin (absolute risk difference (ARD) = 1.17%, 95% CI: 0.37-1.95), but heterogeneity in ARDs was not statistically significant (Cochran's Q p > 0.45). Similar findings were observed when using the RSF model. Conclusion: Participants at lowest baseline bleeding risk experienced the greatest relative increase in bleeding risk with aspirin therapy. We found statistically significant heterogeneity in treatment effects on the relative but not absolute scale. These findings support an individualized, risk-based approach to aspirin therapy decision-making in older adults.

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

Hybrid ANN-SNN Pipeline with Local Plasticity

arXiv:2606.20151v1 Announce Type: cross Abstract: This work proposes a hybrid ANN-SNN pipeline that effectively leverages the rich embeddings of pretrained artificial neural networks (ANNs) to enable high-performance spiking neural networks (SNNs). The architecture couples a pretrained EfficientNet encoder with a CoLaNET spiking classifier. We convert the encoder's activations into spike trains via rate-coding and train the subsequent SNN classifier using local, biologically inspired learning rules, bypassing end-to-end gradient propagation. This approach achieves 99.09% accuracy on a 64-class ImageNet benchmark, demonstrating performance on par with conventional deep networks. The work presents a biologically plausible and efficient framework for adapting powerful pretrained encoders to downstream spiking neural network tasks.

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

DTVEM-RE: A Hierarchical Random-Effects Extension of the Differential Time-Varying Effect Model for Person-Specific Multi-Lag Estimation in Intensive Longitudinal Data

arXiv:2606.14116v1 Announce Type: new Abstract: The Differential Time-Varying Effect Model (DTVEM) of Jacobson et al. (2019) is a popular tool for finding the best time lag in intensive longitudinal data, but it assumes everyone shares the same lag structure. The original authors named fixing this as future work, and it clashes with the premise of modern clinical research, which is that people differ. We present DTVEM-RE, an extension that lets each person have their own lag coefficients, with two versions of the confirmatory step: a discrete-time hierarchical Bayesian VAR in Stan, which pools across people and gives calibrated uncertainty, and a continuous-time per-person Ornstein-Uhlenbeck model in ctsem, which handles unevenly spaced beeps directly. We report four results. A simulation shows the Bayesian version recovers the between-person spread tau_a with bias below 0.01 and coverage of 90 to 93 percent. On the Fisher et al. (2017) EMA dataset (N=40), person-specific lag-1 effects vary by an order of magnitude across three mood items, the Bayesian and GAMM estimates agree closely (r=0.87 to 0.92), and DTVEM-RE gives the best one-step-ahead prediction among four discrete-time methods. A multi-lag version shows all nine tau_k values have credible intervals excluding zero, and the lag where people differ most changes across items, something lag-1-only methods like mlVAR cannot detect. Finally, the two versions agree almost exactly on person-specific lag-1 estimates (r >= 0.995), differing only as shrinkage predicts. DTVEM-RE is, to our knowledge, the first person-specific implementation of DTVEM-style lag detection, and it contains standard DTVEM as a special case.

20.
medRxiv (Medicine) 2026-06-18

Cost-effectiveness of a virtual fracture clinic versus traditional in-person fracture clinic care for adults with acute simple fractures: a protocol for a health economic evaluation within the RECITAL trial

ABSTRACT Introduction Traditional in-person fracture clinics are often overcrowded and inconvenient for patients. Virtual fracture clinics aim to address some of these concerns by improving the efficiency of the orthopaedic service and reducing unnecessary interventions while maintaining safety and quality of care. The RECITAL trial is a non-inferiority randomised controlled trial comparing follow-up care provided at a virtual fracture clinic for people with acute simple fractures to follow-up care provided at an in-person fracture clinic. This study describes the protocol for an economic evaluation of RECITAL where the primary aim is to investigate the cost-effectiveness of a virtual fracture clinic compared with traditional in-person fracture clinic care from a health system perspective. Methods and analysis The RECITAL trial recruited 312 participants with acute simple fractures and randomised them to receive follow-up care provided at a virtual fracture clinic or follow-up care provided at an in-person fracture clinic. We will conduct a within-trial analysis from a health system perspective (primary analysis), as well as a health service, patient and societal perspective. The economic evaluation will estimate the difference in the cost of resource inputs on an intention to treat basis used by participants in the two arms of the trial, allowing comparisons to be made between the in-person and virtual fracture clinics. Data for intervention costs and healthcare utilisation will be collected from trial records, hospital electronic medical records and district performance units. The results of the economic evaluation will be expressed in terms of incremental cost per utility weight gained at 12 weeks and will be plotted on a cost-effectiveness plane. Bootstrapping by resampling will be used to estimate 95% confidence intervals around costs and outcomes, and to calculate the confidence intervals around the incremental cost-effectiveness ratio. A cost-effectiveness acceptability curve (CEAC) will be plotted, which will provide information about the probability that an intervention is cost-effective, given the level of a decision makers willingness to pay for each additional outcome. Ethics and Dissemination The trail was approved by the SLHD Ethics Review Committee (RPAH Zone) (X23-0200 and 2023/ETH01038). The findings will be disseminated through a peer-reviewed journal and conference presentations. Trial registration number The trial was prospectively registered on the Australian New Zealand Clinical Trials Registry (ANZCTR; 12623000934640)

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

When Rules Learn: A Self-Evolving Agent for Legal Case Retrieval

arXiv:2606.17220v1 Announce Type: new Abstract: Legal case retrieval remains challenging due to the complexity of legal language and the need for precise lexical alignment between queries and relevant cases. Although dense retrieval models have achieved notable progress, empirical studies show that BM25 continues to serve as a strong baseline in this domain. It motivates us to propose a self-evolving framework for rule-driven query rewriting that enhances BM25 without any parameter training. The framework equips an LLM-based agent with an automatic evaluation environment, enabling it to iteratively create rewriting rules, plan validation experiments over rule combinations, and eliminate ineffective rules based on historical feedbacks. We evaluate our method on the Chinese legal case retrieval benchmark LeCaRD-v2. Experimental results demonstrate that the proposed framework outperforms non-evolutionary baselines, including human-designed rules and greedy rule selection, particularly when powered by a highcapacity core LLM. We also conduct detailed analyses to investigate the mechanisms underlying self-evolution. Our findings reveal that LLM's capabilities to leverage previous experimental results and its intrinsic knowledge of rule elimination play critical roles in refining the rule set via self-evolution.

22.
medRxiv (Medicine) 2026-06-17

Perceptions of aging well among older adults with heart failure: insights from a qualitative study

Background: Heart failure (HF) is a prevalent and often debilitating cardiovascular condition among older adults, frequently accompanied by multimorbidity, functional limitations, and the need to age in place. Traditional models of successful aging emphasize disease absence and preserved function, yet most individuals with HF live with ongoing symptoms and chronic health challenges. How older adults with HF define aging well, particularly across different socioeconomic contexts, remains underexplored. Objectives: To explore how older adults with HF conceptualize aging well and to identify perceived facilitators and barriers across more and less resourced New York City neighborhoods. Methods: We conducted semi-structured interviews with 20 adults diagnosed with HF residing in Manhattan and Brooklyn neighborhoods classified by 2019 United States Census data. Interviews were guided by Rowe and Kahn's model. Transcripts were analyzed using an inductive-deductive thematic approach and interpreted in alignment with the Healthy People 2030 framework. Results: Participants had a mean age of 69 years; 50% identified as Black and 50% were women. Despite functional limitations, 65% reported aging well. Five themes emerged: maintaining physical function, maintaining cognitive function, sustaining social relationships, avoiding pain, and promoting overall well-being. Avoiding pain and promoting well-being extended beyond traditional models. Neighborhood context shaped priorities, with financial stability emphasized in more affluent areas and social cohesion prioritized in less affluent communities. Conclusions: Older adults with HF frequently perceive themselves as aging well despite chronic illness, reframing successful aging beyond disease avoidance. These findings support a patient-centered, place-informed model of aging well with implications for healthcare delivery and policy.

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

Frontier: Towards Comprehensive and Accurate LLM Inference Simulation

arXiv:2605.21312v2 Announce Type: replace-cross Abstract: Modern LLM serving is no longer homogeneous or monolithic. Production systems now combine disaggregated execution, complex parallelism, runtime optimizations, and stateful workloads such as reasoning, agents, and RL rollouts. Simulation is attractive for exploring this growing design space, yet existing simulators lack the architectural completeness and decision-grade fidelity it demands. Their monolithic-replica abstractions are ill-suited to disaggregated serving, while average-case analytical proxies can distort SLA predictions and even reverse optimization conclusions. We present Frontier, a discrete-event simulator for modern LLM inference serving. Frontier features a disaggregated abstraction. It captures the structure and dynamics of modern serving systems by modeling co-location, Prefill-Decode Disaggregation (PDD), and Attention-FFN Disaggregation (AFD) with role-specific cluster workers, incorporating key runtime optimizations (e.g., CUDA Graphs, speculative decoding) within the scheduler-batch-engine loop, and supporting stateful requests for emerging workloads. It further provides accurate and generalizable predictions of computation, communication, and memory costs across diverse serving scenarios with complex workload compositions. On 16-H800 GPU testbed, Frontier achieves an average throughput error below 4%. Compared with state-of-the-art simulators, it reduces end-to-end latency error from 44.9% to 6.4% under co-location and from 51.7% to 2.6% under disaggregation. It scales to over 1K GPUs on commodity CPUs and enables new use cases such as SLA-dependent Pareto frontier exploration, heterogeneous disaggregated allocation, agentic reasoning scheduling validation, and RL post-training reconfiguration. We release Frontier at https://github.com/NetX-lab/Frontier.

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

FundaPod: A Multi-Persona Agent Pod Platform with Knowledge Graph Memory for AI-Assisted Fundamental Investment Research

arXiv:2605.27864v4 Announce Type: replace Abstract: Large language models (LLMs) are increasingly applied in finance, yet most existing work emphasizes trading signals or financial NLP tasks centered on prediction. Institutional fundamental research, by contrast, requires human analysts or AI agents to gather evidence, identify business drivers, compare competing viewpoints, and generate investment memos. Its broader goal is not merely to predict outcomes, but to produce investment plans that are transparent, reusable, and verifiable, while contributing to the cumulative development of investment knowledge. We present FundaPod, a multi-persona agent platform for AI-assisted fundamental investment research. We argue that fundamental research is a human-centric decision-support task that is qualitatively distinct from trading-signal generation, and is therefore better served by an independence-preserving architecture. In FundaPod, AI agents with different personas, such as value investors or macro strategists, conduct research independently under a shared provenance contract. Their disagreements are then surfaced post hoc for adjudication by the human portfolio manager (PM) through a knowledge-graph memory system. This paper contributes five design principles for human-AI hybrid systems supporting fundamental research, grounded in design-science practice and theories of cognitive isolation and human-machine coordination. It also describes four architectural mechanisms: a persona distillation pipeline that turns public investor materials into deployable agents; a declarative skill registry that lets the planner derive typed task graphs; a grounded evidence model that links memo claims to verifiable sources; and a knowledge-graph "second brain" that connects tickers, memos, analysts, and themes. We demonstrate the architecture through a complete case study and a persona-based memo comparison.

25.
arXiv (CS.AI) 2026-06-18

Signals of Provenance: Practices & Challenges of Navigating Indicators in AI-Generated Media for Sighted and Blind Individuals

arXiv:2505.16057v2 Announce Type: replace-cross Abstract: AI-Generated (AIG) content has become increasingly widespread by recent advances in generative models and the easy-to-use tools that have significantly lowered the technical barriers for producing highly realistic audio, images, and videos through simple natural language prompts. In response, platforms are adopting provable provenance with platforms recommending AIG to be self-disclosed and signaled to users. However, these indicators may be often missed, especially when they rely solely on visual cues and make them ineffective to users with different sensory abilities. To address the gap, we conducted semi-structured interviews (N=28) with 15 sighted and 13 BLV participants to examine their interaction with AIG content through self-disclosed AI indicators. Our findings reveal diverse mental models and practices, highlighting different strengths and weaknesses of content-based (e.g., title, description) and menu-aided (e.g., AI labels) indicators. While sighted participants leveraged visual and audio cues, BLV participants primarily relied on audio and existing assistive tools, limiting their ability to identify AIG. Across both groups, they frequently overlooked menu-aided indicators deployed by platforms and rather interacted with content-based indicators such as title and comments. We uncovered usability challenges stemming from inconsistent indicator placement, unclear metadata, and cognitive overload. These issues were especially critical for BLV individuals due to the insufficient accessibility of interface elements. We provide practical recommendations and design implications for future AIG indicators across several dimensions.