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

BrainPro: Towards Large-scale Brain State-aware EEG Representation Learning

arXiv:2509.22050v2 Announce Type: replace Abstract: Electroencephalography (EEG) reflects underlying brain states, whose activities are distributed across brain regions and manifest as spatial patterns on the scalp. Learning these spatially structured, state-related patterns requires consistent spatial representations across datasets. However, existing EEG foundation models are typically based on self-attention, which does not preserve location-specific information and struggles to align signals recorded with different channel configurations. Moreover, brain states contain both shared and state-specific regional activity, suggesting that learning neurophysiologically plausible, state-aware representations can complement the shared representations targeted by current models and improve downstream decoding. To address these limitations, we propose BrainPro, a large EEG model that combines a retrieval-based spatial learning mechanism for cross-layout spatial alignment with a brain state-decoupling module that learns both shared and state-specific representations through parallel encoders and region-aware reconstruction. Pre-trained on a large EEG corpus, BrainPro achieves state-of-the-art performance across nine public BCI datasets spanning emotion, motor, speech, stress, mental disease, and attention tasks. Analyses of spatial filters, channel-drop robustness, and encoder contributions further validate the effectiveness of its spatial alignment and state-aware pathways. These results show that BrainPro achieves improved interpretability of learned spatial patterns and produces representations that benefit diverse EEG decoding tasks.

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

EDEN: A Large-Scale Corpus of Clinical Notes for Italian

We present EDEN (Emergency Department Electronic Notes), a new and unique large-scale corpus of clinical notes produced in Emergency Departments of Italian hospitals. The corpus, in its current version, is composed of approximately 4 million clinical notes fully anonymized, covering diverse phases of patient care during the stay in the emergency department. In addition, a subset of about six thousand notes has been manually annotated by clinical experts through a structured Case Report Form (CRF) containing 132 items relevant for two patient situations in emergency departments, dyspnea and loss of consciousness. Items may assume numerical values (e.g., for blood saturation), categorical (e.g., for level of consciousness ), binary (e.g., for presence of traumas), and mixed value types. The annotation process involved multiple clinicians and underwent iterative revision to resolve ambiguities in item formulation, resulting in a richly structured (although high imbalanced) resource. The dataset aims to fill a relevant gap of data able to support both the development and the use of Large Language Models in concrete medical applications. We describe the data collection protocol, the on-site anonymisation pipeline, corpus statistics, and the annotation scheme. Finally, we propose CRF-filling as a novel structured information extraction benchmark, and provide zero-shot baseline resulting from Gemma-27B and MedGemma-27B. To the best of our knowledge, the EDEN dataset is the largest freely available corpus of clinical notes existing for the Italian language.

03.
medRxiv (Medicine) 2026-06-22

GCH1 p.Ser80Asn Confers Risk for Parkinson's Disease in East Asian Populations

Introduction: GCH1 has been implicated in Parkinson's disease (PD), but its risks variants and associations are not well defined. Objectives: To investigate the clinical relevance and PD risk associated with the GCH1 p.Ser80Asn variant. Methods: We first identified a segregating GCH1 p.Ser80Asn variant in a Malaysian Chinese PD family via whole genome sequencing (WGS). We assessed its risk association using multi-ancestry WGS data from the Global Parkinson's Genetics Program (GP2) (n=22,372PD vs n=8,826Controls) and meta-analysis of East Asian (EAS) cohorts (n=4,712PD vs 38,733Controls). Clinico-demographic details of affected variant carriers were collated. Results: The GCH1 p.Ser80Asn variant was enriched in GP2 EAS PD populations (n=9/2,757; 0.33%) but not detected in other ancestries. Meta-analysis revealed increased PD risk in EAS populations (odds ratio:5.1; 95%CI:2.3-10.7; p=2.89x10-5). Affected carriers (mean age at onset:56.3+-12.5 years) had additional occurrence of dystonia, while dementia was rare. Conclusions: The GCH1 p.Ser80Asn variant is a rare, EAS-enriched risk variant for PD.

04.
bioRxiv (Bioinfo) 2026-06-23

VCBench: A Multi-Dimensional Benchmark for Single-Cell Foundation Models

Single-cell foundation models are increasingly positioned as virtual cells, yet their capabilities are assessed by fragmented, largely single-task benchmarks that obscure where these models improve on simple baselines. VCBench addresses this by synthesizing four independent virtual-cell frameworks into seven capability dimensions: perturbation response prediction, cross-species universality, gene regulatory network (GRN) inference, modality integration, temporal dynamics, multi-scale integration, and in silico experimentation. Each dimension is assessed for operational testability under current architectures and datasets: five admit direct or proxy evaluation, while multi-scale integration and in silico experimentation are structurally untestable as end-to-end tasks. We evaluate five foundation models (Geneformer, scGPT, UCE, TranscriptFormer, Arc State) against pre-registered linear and nearest-neighbor baselines across the five testable dimensions, and report three findings. First, the baselines match or exceed every foundation model on four of the five scored dimensions, replicating the reported competitiveness of linear baselines on perturbation prediction and extending it to cross-species transfer, GRN inference, and temporal ordering. Second, TranscriptFormer alone exceeds the strongest baseline on cross-modal RNA-to-protein prediction (53% Pearson improvement, with a documented contamination caveat) and is the only model to reach Level 2 in the pre-registered Virtual Cell (VC) Level rubric; the architectural choice behind this advantage simultaneously causes a spectral collapse that destroys its temporal-ordering performance, a tradeoff invisible to single-task benchmarks. Third, no foundation model publishes a complete cell-level training manifest, leaving data contamination undetectable to users. Alongside the benchmark, VCBench releases a Contamination Reporting Schema and contributes two further methodological tools: a common-label-set protocol that controls for class-count confounds in cross-species transfer, and a spread-error correlation probe for epistemic calibration.

05.
bioRxiv (Bioinfo) 2026-06-11

TifBERT: a self-supervised foundation model for normalization-robust bulk RNA-seq representation learning

Bulk RNA sequencing remains central to translational genomics, yet foundation-model development has largely focused on single-cell data. Existing transformer approaches for bulk RNA-seq often rely on expression discretization, numerical reconstruction, external gene embeddings, or restricted gene sets, limiting robustness across normalization schemes and cohorts. Here, we introduce TifBERT, a self-supervised framework for full-transcriptome bulk RNA-seq representation learning. TifBERT converts each unordered expression profile into a sample-specific gene sequence using term frequency-inverse document frequency (TF-IDF) ordering, prioritizing genes that are both highly expressed within a sample and selectively expressed across the cohort. It is then pretrained using masked gene modeling, predicting gene identities from transcriptomic context rather than reconstructing expression values. Pretrained on harmonized TCGA Pan-Cancer data spanning five RNA-seq normalization schemes, TifBERT learns contextual representations across approximately 10,000 genes without expression binning, landmark-gene restriction, or external biological embeddings. Across 33 TCGA cancer types, TifBERT achieved 90.83% accuracy, 0.996 macro AUC-ROC, and 0.903 MCC. It also captured pathway-level biology, achieving mean sample-wise and pathway-wise Pearson correlations of 0.754 and 0.762 across 1,387 PARADIGM pathway activities. Independent evaluation on GTEx healthy tissues showed preservation of tissue-level transcriptomic structure without retraining. In comparison with existing models, TifBERT achieves competitive subtype discrimination with substantially greater stability and produces markedly richer embedding geometry (effective rank 95.6 versus 6.3), without requiring expression discretization or in-distribution pretraining exposure. Together, TifBERT provides a scalable, normalization-independent foundation model for reusable bulk transcriptomic representation learning

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

BRICKS-WM: Building Reusability via Interface Composition Kinetics for Structured World Models

arXiv:2606.16489v1 Announce Type: new Abstract: Model-based Reinforcement Learning (MBRL) has achieved remarkable success in continuous control by leveraging latent world models. However, prevailing approaches typically rely on monolithic latent dynamics, entangling environment dynamics into a coupled process. This coupling severely limits reusability: altering the agent necessitates retraining the entire world from scratch, even if the environment remains constant. To address this, we introduce BRICKS-WM (Building Reusability via Interface Composition Kinetics for Structured World Models), a framework for the modular assembly of structured world models. Driven by the insight that the physical world is composed of independent entities, we posit that global dynamics can be modeled as a composition of distinct dynamical modules interacting via latent interfaces. As a minimal instantiation, we factorize the latent state space into an actuated Agent module and an external Background module, bridged by a learned latent interface. Unlike prior object-centric methods that prioritize visual segmentation, BRICKS-WM enforces a functional separation in transition dynamics, ensuring that background dynamics remains agnostic to the agent's dynamics. Empirically, BRICKS-WM achieves control performance comparable to strong monolithic baselines when trained from scratch, and enables the reuse of frozen background dynamics across agents.

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

Inside the Latent Flow: Causal Deciphering of Attention Dynamics in Audio Separation Foundation Models

arXiv:2606.10046v2 Announce Type: replace-cross Abstract: Flow-matching transformers achieve strong audio separation, yet their attention dynamics are opaque. We adapt established causal-intervention principles into a deterministic, inference-time probing protocol for SAM Audio. Orthogonal probing uncovers a dual-pathway text-conditioning mechanism: additive injections control semantic identity, while cross-attention refines acoustic structure. We observe an asynchronous layerwise convergence: stable layers build temporal scaffolds early, whereas fast layers continue resolving artifacts during sampling. The model also attenuates temporal segmentation cues to maintain continuous-flow stability. Using these insights, we propose Layer-Selective Attention Caching (LSAC), a training-free acceleration method that caches attention in stable layers. Across acoustic complexities, LSAC cuts self-attention computation by about ~25% with negligible quality loss and yields up to 6.7x higher quality retention than naive step reduction.

08.
arXiv (CS.CL) 2026-06-24

A Hybrid, Multi-Layered Pipeline for Phishing and Threat Classification: Independently Validated URL and NLP Engines with a Calibrated Multi-Channel Fusion Stage

Phishing is a multi-modal threat. We present a hybrid pipeline that scores each modality with its own engine and fuses the results. Three engines are built, deployed, and independently benchmarked: a four-stage URL stack (Domain Guard, lexical model, threat intelligence, and an asymmetric L2 fusion sidecar); a generalization-hardened DistilBERT NLP classifier whose held-out real-phishing recall rises from 0.8% to 87.3%; and a threat-intelligence synchronizer with end-to-end OpenTelemetry instrumentation confirming 1:1 message conservation. A decision-level fusion stage, characterized on a 10,677-email whole-system benchmark, reaches F1=0.914 with a calibrated probabilistic-OR over URL, header, and phishing-probability channels while reducing held-out real-spam false positives to 3.6%. Because that benchmark uses proxy URL and header channels and an operating point still needing recalibration, we present it as a preliminary integrated result. For deployable detection, the limiting factor is how well a model generalizes, not how accurately it scores data drawn from its own training distribution.

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

Multi-view feature High-order Fusion for Space Weak Object Detection and Segmentation

Weak objects are common in images and videos of space applications. However, it is hard to learn proper representations from their limited appearance information. Inspired by multi-view learning, we develop simple multi-view attentions, treating their outputs as multi-view features. We also propose a multi-view feature high-order fusion method (MHF) to aggregate more accurate and richer features of weak objects. Our MHF extends the commonly used low-order feature fusion method to higher orders. It enhances the model's capacity to capture relevant and complementary information about weak objects. This is achieved by introducing high-order multi-view features perception and a recursive task-contribution gated selection of multi-view features. The new operation is highly flexible and customizable. It is compatible with various variants of multi-view feature representations. We conduct extensive experiments on two newly constructed space science datasets and an open, large-scale satellite video dataset. Our MHF serves as a plug-and-play module and significantly improves various vision transformers and convolution-based detection and segmentation models. We achieve all state-of-the-art accuracies on both tasks across three datasets. Our MHF can be a new basic module for visual modeling that effectively represents weak objects in terms of multi-view learning. The code will be available at https://github.com/Kingdroper/MHF.

10.
arXiv (CS.CV) 2026-06-24

Emotion Diffusion Classifier with Adaptive Margin Discrepancy Training for Facial Expression Recognition

Facial Expression Recognition (FER) is essential for human-machine interaction, as it enables machines to interpret human emotions and internal states from facial affective behaviors. Although deep learning has significantly advanced FER performance, most existing deep-learning-based FER methods rely heavily on discriminative classifiers for fast predictions. These models tend to learn shortcuts and are vulnerable to even minor distribution shifts. To address this issue, we adopt a conditional generative diffusion model and introduce the Emotion Diffusion Classifier (EmoDC) for FER, which demonstrates enhanced adversarial robustness. However, retraining EmoDC using standard strategies fails to penalize incorrect categorical descriptions, leading to suboptimal recognition performance. To improve EmoDC, we propose margin-based discrepancy training, which encourages accurate predictions when conditioned on correct categorical descriptions and penalizes predictions conditioned on mismatched ones. This method enforces a minimum margin between noise-prediction errors for correct and incorrect categories, thereby enhancing the model's discriminative capability. Nevertheless, using a fixed margin fails to account for the varying difficulty of noise prediction across different images, limiting its effectiveness. To overcome this limitation, we propose Adaptive Margin Discrepancy Training (AMDiT), which dynamically adjusts the margin for each sample. Extensive experiments show that AMDiT significantly improves the accuracy of EmoDC over the baseline model with standard denoising diffusion training under 100-step evaluations. Additionally, AMDiT-enhanced EmoDC has better generalization and robustness than state-of-the-art discriminative classifiers.

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

Optimizing Wigner Negativity in Scattering Processes Using Energetic Cost Functions

arXiv:2606.15101v1 Announce Type: new Abstract: Wigner negativities (WNs) are key signatures of non-Gaussian bosonic states and essential resources for quantum technologies. We study their generation in the scattering of coherent pulses by a two-level atom coupled to a one-dimensional reservoir, a unitary and energy-preserving platform. Optimization in this multimode setting is hindered by the complexity of evaluating Wigner functions. We overcome this challenge by introducing energetic cost functions that identify output modes most likely to host large negativities. First using incoherent energy and then isolating a genuinely non-Gaussian contribution, we demonstrate a strong correlation between these quantities and WNs. This correlation extends beyond short, intense pulses to encompass pulses of finite energy, where photons are scattered while the two-level atom is driven. Focusing on the energy-efficiency of the process, we show that maximally efficient generation takes place for one input photon, on average, spectrally mode-matched with the atom.

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

On the Memorization Behavior of LLMs in Generative Recommendation: Observations, Implications, and Training Strategies

arXiv:2606.17276v1 Announce Type: cross Abstract: Generative recommendation (GR) has emerged as a promising direction for recommender systems. Recently, large language models (LLMs) have been increasingly adopted for GR, as their rich pretrained knowledge is expected to help them generalize beyond common user behavior patterns that traditional memorization-oriented baselines can capture. However, existing LLM-based GR works largely ignore LLMs' well-known tendency to memorize, which, if present in LLMs fine-tuned for GR, would restrict their utilization of pretrained knowledge. In this work, we investigate this concern by examining one-hop memorization, where a model recommends items that are direct successors of items in the training data. We show that LLMs do this more than non-LLM-based GR models-in fact, the vast majority of their gains over GR baselines are actually on users whose target items can be predicted through one-hop memorization. We intuit that improving performance on the remaining users requires LLMs to learn richer item-item relations beyond one-hop transitions. To achieve this, we propose IIRG, a novel training strategy that teaches LLMs to capture: (1) collaborative relations derived from item co-occurrences across multiple hops in user sequences, and (2) semantic relations among items with similar themes, both of which can serve as useful recommendation signals. We show that IIRG significantly improves over LLMs trained solely with standard next-item prediction, with especially large gains for users whose test items are not covered by train-time one-hop transitions.

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

VISUALSKILL: Multimodal Skills for Computer-Use Agents

Computer-use agents (CUAs) approach human-level performance on standardised benchmarks but still struggle on long-horizon tasks and unseen software. Existing skill libraries address this with reusable skills, but represent the skill artifact as text only, despite the visual nature of GUI interaction. We propose VISUALSKILL: a hierarchical multimodal skill, tailored to each target application and organised as a central index over per-topic files, which the agent consumes through a load_topic MCP tool that fetches the relevant topic's text and figures on demand. We construct each skill with a two-stage pipeline that combines authored documentation with live-application UI exploration. On two CUA benchmarks, CUA-World and OSExpert-Eval, a Claude Code CLI agent backed by Claude Opus 4.6 reaches an average score of 0.456 with VISUALSKILL, a +15.3 point absolute lift over the no-skill baseline (0.303). Against a matched text-only skill that is generated from the same source content and differs from VISUALSKILL only in modality, VISUALSKILL yields a further +8.3 point absolute gain over the matched text-only skill (0.373 vs. 0.456), providing direct evidence that retaining visual figures in the skill artifact, rather than verbalizing them away, helps the agent both identify UI elements and verify workflow state after each action. Our code is available at https://github.com/XMHZZ2018/VisualSkills.

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

AudioDER: A Deduplication-Enhanced Reasoning Dataset for Post-Training Large Audio-Language Models

arXiv:2606.14591v1 Announce Type: cross Abstract: Large Audio-Language Models (LALMs) have shown strong performance on a wide range of audio understanding tasks, yet they still struggle with complex audio reasoning. A practical way to improve such capabilities is post-training, whose effectiveness critically depends on the quality and diversity of training data. However, existing audio-language datasets often contain substantial redundancy, where many samples are highly similar in acoustic content and thus provide overlapping supervisory signals. Such redundancy not only increases annotation cost, but also limits corpus diversity and reduces the effectiveness of post-training. To address this issue, we propose a redundancy-aware data construction pipeline for building reasoning-oriented supervision for LALMs. Specifically, we first perform acoustic similarity-based deduplication across raw audio datasets to improve corpus diversity. We then integrate existing audio captions and question-answer pairs into a unified multiple-choice format. Based on these unified annotations, we leverage Qwen3-30B to generate chain-of-thought (CoT) rationales for reasoning-oriented supervision. Based on this pipeline, we construct AudioDER, a reasoning-oriented post-training dataset containing approximately 191k samples spanning sound, speech, and music. Each sample consists of an audio clip, a multiple-choice question, four answer candidates, an audio caption, and a CoT rationale. Extensive experiments show that post-training on AudioDER consistently improves the performance of Qwen2-Audio-7B-Instruct on multiple audio reasoning benchmarks, including MMAU-mini, MMSU, and MMAR. We hope AudioDER can serve as a valuable resource for advancing audio reasoning research and the development of more capable LALMs.

15.
arXiv (CS.AI) 2026-06-24

Large-Language-Model Discovery of Quantum LDPC Codes through Structured Concept Evolution

arXiv:2606.24808v1 Announce Type: cross Abstract: Quantum computers could outperform classical machines on important problems, but only if the errors that pervade quantum hardware can be corrected at scale. Quantum low-density parity-check (qLDPC) codes offer a promising route to this goal by combining sparse parity checks with finite encoding rate and growing distance, but their construction remains a challenging discrete design problem. Here we introduce structured concept evolution (SCE), a search framework that pairs a large language model with a structured algebraic mutation grammar to discover lifted-product code families, a class of CSS qLDPC codes. Instead of asking the LLM to design codes from first principles, SCE evolves structured concepts consisting of algebraic specifications paired with executable programs that realize them, using hierarchical mutations that modify the group algebra, protograph geometry, or base space. Running SCE, we discover a diverse set of competitive code families, ranging from abelian constructions to families over non-abelian groups beyond those underlying standard designs such as bivariate-bicycle codes, and characterize them under code-capacity depolarizing noise with BP+OSD decoding. These results are obtained with lightweight models (GPT-5.4-mini and GPT-5.4-nano).

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

CentroidKV: Efficient Long-Context LLM Inference via KV Cache Clustering

Large language models (LLMs) with extended context windows have become increasingly prevalent for tackling complex tasks. However, the substantial Key-Value (KV) cache required for long-context LLMs poses significant deployment challenges. Existing approaches either discard potentially critical information needed for future generations or offer limited efficiency gains due to high computational overhead. In this paper, we introduce CentroidKV, a simple yet effective framework for online KV cache clustering. Our approach is based on the observation that key states exhibit high similarity along the sequence dimension. To enable efficient clustering, we divide the sequence into chunks and propose Chunked Soft Matching, which employs an alternating partition strategy within each chunk and identifies clusters based on similarity. CentroidKV then merges the KV cache within each cluster into a single centroid. Additionally, we provide a theoretical analysis of the computational complexity and the optimality of the intra-chunk partitioning strategy. Extensive experiments across various models and long-context benchmarks demonstrate that CentroidKV achieves up to 75% reduction in KV cache memory usage while maintaining comparable model performance. Moreover, with minimal computational overhead, CentroidKV accelerates the decoding stage of inference by up to $1.92\times$ and increases the serving throughput by up to $4\times$.

17.
arXiv (CS.LG) 2026-06-19

SMT-AD: a scalable quantum-inspired anomaly detection approach

arXiv:2604.06265v2 Announce Type: replace Abstract: Quantum-inspired tensor networks algorithms have shown to be effective and efficient models for machine learning tasks, including anomaly detection. Here, we propose a highly parallelizable quantum-inspired approach which we call SMT-AD from Superposition of Multiresolution Tensors for Anomaly Detection. It is based upon the superposition of bond-dimension-1 matrix product operators to transform the input data with Fourier-assisted feature embedding, where the number of learnable parameters grows linearly with feature size, embedding resolutions, and the number of additional components in the matrix product operators structure. We demonstrate successful anomaly detection when applied to standard datasets, including credit card transactions, and find that, even with minimal configurations, it achieves competitive performance against established anomaly detection baselines. Furthermore, it provides a straightforward way to reduce the weight of the model and even improve the performance by highlighting the most relevant input features.

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

Unreduced Persistence Diagrams for Topological Machine Learning

arXiv:2507.07156v2 Announce Type: replace-cross Abstract: Supervised machine learning pipelines trained on features derived from persistent homology have been experimentally observed to ignore much of the information contained in a persistence diagram. Computing persistence diagrams is often the most computationally demanding step in such a pipeline, however. To explore this dynamic, we introduce several methods to generate topological feature vectors from unreduced boundary matrices and investigate their theoretical and computational properties. We compared the performance of pipelines trained on vectorizations of unreduced PDs to vectorizations of fully-reduced PDs across several data and task types. Our results indicate that models trained on PDs built from unreduced diagrams can perform on par and even outperform those trained on fully-reduced diagrams on some tasks. We also benchmarked the computational performance of an algorithm for computing unreduced diagrams, which was implemented as a heavily modified version of Ripser. These computations are parallelizable and required an order of magnitude less memory on average compared to computing full persistence diagrams. Our results suggest that machine learning pipelines which incorporate topology-based features may benefit in terms of computational cost and performance by utilizing information contained in unreduced boundary matrices.

19.
arXiv (CS.AI) 2026-06-12

Parthenon Law: A Self-Evolving Legal-Agent Framework

arXiv:2606.04602v3 Announce Type: replace Abstract: As agents grow more capable, legal-domain LLM agents promise to turn document-heavy matters into reviewable work products – yet reliable deployment faces three obstacles: no large-scale evidence on how today's strongest model-and-harness combinations behave on end-to-end legal matters; no agent architecture adapted to the legal vertical, only general-purpose harnesses; and, in a setting that keeps shifting with new facts, authorities, and deadlines, no mechanism for systems to learn from their own outcomes. We address each. A large-scale empirical study on Harvey LAB – $12{,}510$ agent trajectories – shows that even frontier agents remain far from completing matters in a single pass: per-criterion accuracy climbs with stronger models while strict matter completion stalls. We then introduce \textsc{Parthenon}, a self-evolving legal-agent framework that factors Model, Harness, Agent roles, legal Knowledge, deterministic Tools, and procedural Skills into auditable surfaces for source traceability, date and number grounding, deliverable compliance, and issue closure. Finally, an anti-leakage learning loop converts scored failures into task-agnostic edits to skills, tools, and knowledge, letting the system improve with experience – as a firm refines its checklists and playbooks after each matter – without touching model weights. Across our large-scale empirical analysis, \textsc{Parthenon} substantially improves the performance of state-of-the-art models and harnesses on legal-matter tasks.

20.
medRxiv (Medicine) 2026-06-22

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

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

21.
medRxiv (Medicine) 2026-06-11

The impact of pre-stroke statin use on baseline corrected infarct volume and collateral perfusion

Stroke is a leading cause of disability and mortality worldwide, with ischaemic stroke the most prevalent type. Statins, used for cholesterol management, have demonstrated benefits in reducing stroke risk and improving outcomes in preclinical studies. However, the impact of pre-stroke statin use on stroke outcomes remain inconsistent. In this study, we aim to evaluate whether pre-stroke statin use is associated with greater volume of salvaged tissue and improved cerebral collateral perfusion. A retrospective analysis was conducted using data from 281 patients presenting with acute ischemic stroke to the John Hunter Hospital between May 2015 and May 2020. Patients were grouped based on pre-stroke statin use, and clinical variables, including infarct volume and collateral perfusion, were assessed. The primary outcome was salvage volume derived from baseline perfusion lesion volume minus infarct volume at follow-up. Collateral perfusion was measured by the hypoperfusion volume defined by delay time (DT)>6 seconds divided by the hypoperfusion volume defined by DT >2 seconds. Patients on statins at admission were significantly older and had more comorbidities. No significant association was found between pre-stroke statin use and salvage volume or collateral perfusion after adjusting for covariates. Larger initial infarct core was a significant predictor of salvage volume due to larger salvageable tissue volume at baseline. These findings indicate that pre-morbid statin use is not associated with larger salvage volume or improved cerebral collateral perfusion.

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

Kairos: A Native World Model Stack for Physical AI

World models are transitioning from passive visual generators to foundational, operational infrastructure for Physical AI: they must natively acquire world knowledge from heterogeneous experience, maintain persistent states over long horizons, and execute efficiently within real deployment constraints. We introduce Kairos, a native world model stack designed around these requirements. (1) Kairos learns the world by pioneering a Native Pre-training Paradigm governed by a Cross-Embodiment Data Curriculum, which organizes open-world videos, human behavioral data, and robot interactions into a progressive developmental pathway. (2) Kairos maintains the world by unified world understanding, generation, and prediction within a Native Unified Architecture equipped with Hybrid Linear Temporal Attention, where sliding-window attention captures local dynamics, dilated sliding windows capture mid-range dependencies, and gated linear attention maintains persistent global memory. We establish formal theoretical bounds demonstrating that this temporal factorization strictly limits error accumulation, mathematically guaranteeing state propagation across extended horizons. (3) Kairos runs the world by incorporating a Deployment-Aware System Co-Design to support low-latency rollout generation on server and consumer-grade hardware for real-world observation-action-feedback loops. Experiments on embodied world-model, long-horizon, and action-policy benchmarks show that Kairos achieves top level performance while offering a strong efficiency-capability trade-off. Together, these results position Kairos as a cohesive operational foundation for future self-evolving physical intelligence.

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

Few-Shot Biomedical Relation Extraction with Large Language Models: A Viable Alternative to Supervised Learning?

Biomedical relation extraction (BioRE) is a key step in transforming biomedical literature into structured knowledge. However, most existing approaches rely on supervised models trained on costly annotated datasets, limiting their scalability and adaptability across relation types and domains. We investigate few-shot BioRE using prompt-based learning with large language models (LLMs) and compare two task formulations: pairwise classification, which predicts relations for individual entity pairs, and joint generation, which extracts multiple relations in a single model call. Experiments on the BioREDirect dataset reveal a clear precision-recall trade-off. Pairwise classification achieves higher recall, whereas joint generation is more precise and computationally efficient. The best-performing model achieves a micro-F1 score of 0.44, substantially outperforming previous few-shot results (0.34) while remaining below the supervised baseline (0.56). Much of this gap is attributable to a single ambiguously defined relation type. When evaluated using macro-F1, which better captures performance across relation types in an imbalanced setting, prompt-based approaches outperform the supervised baseline (0.45 vs. 0.38), particularly on rare relation types. These findings highlight the potential of LLMs for BioRE in low-resource settings and underscore the importance of well-defined relation schemas.

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

To Compare, or Not to Compare: On Methodological Practices in Evaluating Social Bias

As Large Language Models are increasingly deployed in critical applications, robustly evaluating their social biases is paramount. However, the current literature suffers from widespread methodological fragmentation, which yields contradictory conclusions. This stems largely from ignoring the structural framing of benchmark-level evaluations. To resolve this, we introduce a unified and controllable framework that standardizes heterogeneous benchmarks to systematically contrast isolated demographic assessments with forced-choice comparative settings. Crucially, this allows us to disentangle the confounding effects of Chain-of-Thought reasoning, neutral fallback options, and other structural artifacts in social bias evaluations. Our evaluation across multiple model families reveals a massive, systematic paradigm gap: while isolated assessments limit prejudice activation, comparative settings act as aggressive catalysts for latent discrimination, a shift primarily driven by underspecified contexts. Alarmingly, CoT reasoning exacerbates social biases under comparative settings, and this systemic bias persists as a deterministic prejudice even when models are provided neutral fallback options or claim to answer randomly. Finally, we demonstrate that this comparative prejudice is a generalized phenomenon that scales positively with model size. Ultimately, we offer a crucial methodological guideline: while researchers must leverage comparative settings to robustly audit hidden biases, practitioners cannot safely rely on comparative deployments in ambiguous real-world tasks.

25.
arXiv (CS.CV) 2026-06-12

Mana: Dexterous Manipulation of Articulated Tools

Articulated tool manipulation remains a major challenge in dexterous robotics due to the need to coordinate internal degrees of freedom and contact-rich interactions. While prior work has largely focused on rigid objects, articulated tool use remains underexplored because of its physical complexity and the difficulty of learning functional grasping and manipulation policies. We present Mana (Manipulation Animator), a general sim-to-real framework that reinterprets dexterous manipulation as an animation problem. Inspired by computer animation, Mana employs a coarse-to-fine pipeline that transforms procedurally-generated grasp keyframes into manipulation trajectories through motion planning and reinforcement learning. The data generation process is largely automatic, requiring only a few mouse clicks to specify functional affordances (