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01.
arXiv (CS.AI) 2026-06-17

How Inference Compute Shapes Frontier LLM Evaluation

arXiv:2606.17930v1 Announce Type: new Abstract: AI evaluations are shifting toward harder tasks that benefit from longer trajectories involving tool use and iterative problem solving. As a result, performance is increasingly sensitive to the amount and allocation of compute available at test time ("inference compute"). Yet many evaluations still report performance at a single restrictive budget, meaning that low scores may reflect the evaluation setup rather than the model's underlying capability. To test this, we evaluate up to 12 frontier language models on seven challenging benchmarks spanning software engineering, mathematics, medicine, and cybersecurity. We use a controlled setup combining three simple inference-scaling interventions: larger token budgets, context compaction, and repeated submission attempts, guided either by the model itself or by minimal correctness feedback. We find three main results. First, larger token budgets substantially improve performance on benchmarks across multiple domains, including cybersecurity, FrontierMath, Humanity's Last Exam, and TerminalBench. Second, fixed-budget evaluations can increasingly understate frontier capability as models advance. Newer models reach higher performance at large budgets, where they unlock harder tasks and solve them more reliably. Third, benchmarks differ in which inference-scaling methods help most: repeated submission broadly improves performance, but the value of larger token budgets, external feedback, and parallel attempts varies by benchmark. Overall, our results show that benchmark scores are protocol-dependent. We therefore argue that evaluations should report capability as a function of inference-time compute, specify protocol choices explicitly, and compare model generations over a large shared compute range at matched budgets, especially in safety- or policy-relevant settings.

02.
arXiv (CS.CV) 2026-06-11

FOCUS on Contamination: Hydrology-Informed Noise-Aware Learning for Geospatial PFAS Mapping

Per- and polyfluoroalkyl substances (PFAS) are persistent environmental contaminants with significant public health impacts, yet large-scale monitoring remains severely limited due to the high cost and logistical challenges of field sampling. The lack of samples leads to difficulty simulating their spread with physical models and limited scientific understanding of PFAS transport in surface waters. Yet, rich geospatial and satellite-derived data describing land cover, hydrology, and industrial activity are widely available. We introduce FOCUS, a geospatial deep learning framework for PFAS contamination mapping that integrates sparse PFAS observations with large-scale environmental context, including priors derived from hydrological connectivity, land cover, source proximity, and sampling distance. These priors are integrated into a principled, noise-aware loss, yielding a robust training objective under sparse labels. Across extensive ablations, robustness analyses, and real-world validation, FOCUS consistently outperforms baselines including sparse segmentation, Kriging, and pollutant transport simulations, while preserving spatial coherence and scalability over large regions. Our results demonstrate how AI can support environmental science by providing screening-level risk maps that prioritize follow-up sampling and help connect potential sources to surface-water contamination patterns in the absence of complete physical models.

03.
arXiv (CS.AI) 2026-06-18

A Taxonomy of Mental Health and Technology Needs for Alzheimer's and Dementia Caregivers

arXiv:2606.19247v1 Announce Type: cross Abstract: Family members caring for individuals with Alzheimer's disease and related dementias (AD/ADRD) provide the foundation of long-term care worldwide. In 2023, more than 11 million U.S. family and friends contributed 18 billion hours of unpaid care, often at the cost of their own physical and mental health. These informal caregivers – also referred as the "invisible second patients" – experience elevated rates of mental health problems. Yet research commonly reduces their complex psychosocial experiences to a single construct of caregiver burden, obscuring which specific needs are unmet or effectively supported. At the same time, digital and AI-enabled technologies are rapidly expanding, from smartphone apps and videoconferencing to sensor platforms and AI chatbots. However, the absence of shared frameworks across medicine, psychology, and technology research limits cumulative progress. This study introduces a Caregiver Mental Health and Technology Taxonomy that systematically links AD/ADRD caregiver needs with corresponding classes of technology-based interventions. Drawing from an interdisciplinary literature review and two qualitative studies with caregivers, the taxonomy identifies mismatches between caregiver priorities and existing technological support, highlights under-served domains such as relational strain and compassion fatigue, and proposes design directions for adaptive, responsive systems. The framework offers a shared vocabulary to guide clinicians, researchers, and technology designers in developing more person-centered and clinically grounded innovation in dementia care.

04.
arXiv (CS.CV) 2026-06-16

MNet++: Extended 2D/3D Networks for Anisotropic Medical Image Segmentation

This work demonstrates a full reproduction and extension of MNet, a hybrid 2D/3D convolutional network designed for anisotropic medical image segmentation. The original architecture was re-implemented within the nnU-Net framework to verify its reported performance and robustness to variable voxel spacing, known as anisotropy. Experiments were conducted on PROMISE prostate MRI and a controlled subset of LiTS liver CT under matched preprocessing and compute constraints. The reproduced MNet achieved a Dice similarity coefficient (DSC) of 89.0 +/- 0.9% on PROMISE, within 0.8% of the published result, and 94.3 +/- 1.9% / 54.6 +/- 3.1% for liver and tumor segmentation on LiTS, respectively. Two lightweight extensions were further introduced: (1) a learned Fusion Gating mechanism enabling adaptive 2D-3D feature blending, and (2) a VMamba state-space module for efficient long-range depth modelling. The Spatial Gating variant improved DSC by +0.8% with less than 3% inference overhead, while VMamba improved performance consistency, reducing PROMISE Dice variation to +/- 0.7% and achieving the strongest LiTS liver performance at 95.8% Dice. Both extensions preserved MNet robustness to anisotropy, with delta Dice = 1.5% across 1-4 mm voxel spacing. Overall, the study confirms MNet reproducibility and demonstrates that adaptive fusion and state-space modelling have the potential to further strengthen segmentation reliability under anisotropic conditions. However, further tests are required to provide definitive conclusions.

05.
medRxiv (Medicine) 2026-06-17

Sao Tome and Principe on the verge of eliminating lymphatic filariasis as a public health problem: evidence from IDA impact assessment surveys

Background Accelerated efforts to eliminate lymphatic filariasis (LF) as a public health problem have been supported by the introduction of the triple-drug regimen of ivermectin, diethylcarbamazine and albendazole (IDA) in endemic settings. In Sao Tome and Principe, nationwide mass drug administration (MDA) with diethylcarbamazine and albendazole was implemented in 2018, followed by IDA in 2019 and 2020. This study assesses progress towards elimination using post-MDA impact assessment surveys conducted after cessation of treatment. Methods Cross-sectional surveys were conducted among adults aged 20 years and older in 2022 and again between December 2024 and January 2025. Circulating filarial antigen (CFA) was detected using the filarial test strip (FTS). Individuals who tested positive were examined for microfilaremia using nocturnal calibrated thick blood smear microscopy. Additionally, programme data on MDA coverage and morbidity were obtained from national surveillance records. Results Three rounds of nationwide MDA achieved high epidemiological coverage (86.4% in 2018, 74.2% in 2019 and 80.0% in 2020). The impact assessment surveys conducted in 2022 evaluated 14 132 adults, with 21 individuals (0.15%) testing positive for CFA, while the follow-up survey conducted between December 2024 and January 2025 assessed 14 653 adults and detected seven positive cases (0.05%). No microfilariae were detected among the 28 antigen-positive individuals examined using nocturnal calibrated thick blood smears. National morbidity records documented 190 cases of lymphoedema and nine cases of hydrocoele. Conclusions Infection indicators remain well below WHO decision thresholds, suggesting that LF transmission is unlikely to be sustained. Sao Tome and Principe appears to be close to eliminating LF as a public health problem. However, strengthening morbidity management services will be essential to support the preparation of the national elimination dossier.

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

Sentinel: Decoding Context Utilization via Attention Probing for Efficient LLM Context Compression

Retrieval-augmented generation (RAG) often suffers from long and noisy retrieved contexts. Existing context compression methods typically rely on heuristic relevance estimation or supervised compression models rather than on how LLMs utilize retrieved context during inference. We propose Sentinel, a lightweight sentence-level compression framework that decodes inference-time contextual utilization behaviors from head-wise attention patterns of frozen LLMs. To ground supervision in retrieval-dependent answering behavior, Sentinel trains a lightweight probe using QA examples where the model succeeds only when retrieved context is available. Sentinel performs compression using only a single non-autoregressive forward pass without dedicated compression training or autoregressive scoring. Empirically, we find that effective contextual utilization signals remain accessible even in compact proxy models. On LongBench, Sentinel with a 0.5B proxy model achieves up to 5$\times$ compression while attaining question-answering performance competitive with compression methods built on 7B-scale models. Despite being trained only on English QA data, Sentinel also generalizes effectively to Chinese and out-of-domain settings.

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

Towards Understanding What State Space Models Learn About Code

arXiv:2602.06774v2 Announce Type: replace Abstract: State Space Models (SSMs) have emerged as an efficient alternative to the Transformer architecture. Prior work shows that, when trained under comparable conditions, SSMs can match or surpass Transformers on code understanding tasks. However, their internal mechanisms remain a black box. We present the first systematic analysis of what SSM-based code models learn along with the direct comparison between SSM and Transformer models in this domain. Our analysis shows that SSMs capture syntactic and semantic structure more effectively than Transformers during pretraining but forgets certain relations during fine-tuning on some tasks. To investigate this behavior, we introduce SSM-Interpret, a frequency-domain framework that exposes a spectral shift toward short-range dependencies during fine-tuning. Guided by these findings, we propose architectural modifications that significantly improve the performance of SSM-based code model by upto +6 MRR on NLCodeSearch. This demonstrates that our analysis not only explains model behavior but also leads directly to better designs.

08.
arXiv (CS.LG) 2026-06-17

Tensor-based second-order causal discovery

arXiv:2606.18074v1 Announce Type: cross Abstract: Causal discovery seeks to uncover the causal dependencies among variables. For this purpose, we propose an algorithm called Tensor-based Second-order Causal Discovery (TSCD). Its input is a tensor obtained from the covariance matrices of observational and interventional data. Assuming the causal dependencies follow a linear structural equation model on a directed acyclic graph (DAG), TSCD outputs the DAG and the functions on its edges, requiring only that the noise variables are uncorrelated. We also implement a version of the approach for nonlinear models. Our focus on second-order statistics (via the covariance matrices) is motivated by their statistical and computational efficiency relative to higher-order moments, their identifiability relative to first-order statistics, and that they work regardless of whether the variables are Gaussian. We show that TSCD has identifiable causal order and parameters from a number of interventions that is logarithmic in the number of variables. Experiments show that TSCD is robust to noise, competitive with existing methods, and scales to hundreds of variables.

09.
arXiv (CS.CL) 2026-06-18

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

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

11.
arXiv (CS.CV) 2026-06-17

Universal Image Restoration via Internalized Chain-of-Thought Reasoning

Image restoration seeks to recover high-quality images from degraded inputs but becomes highly ill-posed under complex, mixed degradations. While unified all-in-one models are common, their performance declines as degradation complexity increases. Recent works adopt Chain-of-Thought (CoT) reasoning for multi-round restoration using specialized modules. However, this approach faces two key limitations: (i) increased computational cost due to multi-step processing, and (ii) weak modeling of interactions between degradations during stepwise inference. We introduce CoTIR, a universal image restoration framework that internalizes CoT reasoning within a single model. Concretely, we view image restoration as a specialized subtask of image editing, which implies that a large-scale pre-trained editing model provides a more favorable optimization starting point. Building on this, we fine-tune the model for restoration and further encode structured CoT-style reasoning into the learning objective via a differentiable formulation inspired by Lagrangian optimization, enabling holistic restoration without chaining specialized restorers. To facilitate training and evaluation, we further present CoTIR-Bench, a large-scale benchmark comprising 5.2 million samples with CoT-style reasoning traces. Extensive experiments on CoTIR-Bench and broad real composite degradation scenes show that CoTIR achieves stronger perceptual quality and more competitive fidelity than both all-in-one models and multi-round restoration methods. The source code is available at https://github.com/gy65896/CoTIR.

12.
PLOS Computational Biology 2026-06-15

Environmental “knees” and “wiggles” as strong stabilizers of species’ range limits set by interspecific competition

by Farshad Shirani, Benjamin G. Freeman Whether interspecific competition is a major contributing factor to setting species’ range limits has been debated for a long time. Theoretical studies have proposed that the interactions between interspecific competition and disruptive gene flow along an environmental gradient can halt range expansion of ecologically similar species where they meet. However, the stability of such range limits has not been well addressed. We use a deterministic mathematical model of adaptive range evolution over a continuous habitat to show that the range limits set by interspecific competition are unlikely to be evolutionarily stable if the environmental optima for fitness-related traits vary (almost) linearly in space. That is, in a linear environment without a dispersal barrier or a third (or more) species, the range borders formed between two competing species constantly move towards the weaker species. We demonstrate that environmental nonlinearities such as “knees” and “wiggles”—wherein an isolated sharp change or a step-like change occurs in the steepness of a trait optimum—can strongly stabilize competitively formed range limits. The stabilization mechanism relies on the contrast that such nonlinearities create in the level of disruptive gene flow to the peripheral population of each species, and succeeds when an additional process, such as Allee effects, prevents the establishment of an infinitesimal population in the presence of an abundant competitor. We show that the stability of the range limits at these nonlinearities is robust against moderate environmental disturbances. Whether strong disturbances such as rapid high-amplitude climate changes can destabilize such range limits depends on how the competitive dominance of the species changes across the nonlinearity. Therefore, our findings underscore the importance of assessing species’ competitive ability when predicting responses to climate change, and identify geographic regions where established range limits are likely to persist as well as regions where shifting limits may eventually stabilize.

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

Mood-Aware Music Recommendation: Integrating User Affective Signals into Ranking Systems

arXiv:2606.13858v1 Announce Type: cross Abstract: Recommendation systems are essential in modern music streaming platforms due to the vast amount of available content. While collaborative filtering is widely used to suggest items based on the preferences of others with similar patterns, it performs poorly in domains where user-item interactions are sparse, such as music. Content-based filtering is an alternative approach that examines the qualities of the items themselves. Genre, instrumentation, and lyrics have been explored; however, relatively little attention has been given to emotion recognition. Since a user's emotional state strongly influences their music choice, incorporating mood signals offers a promising direction for personalization. In this work, we propose a mood-conditioned ranking framework that integrates user affective signals into the recommendation process via softmax-based sampling in the energy-valence space. We evaluate the approach via single-blind experiments in which participants compare recommendations from the proposed system against a baseline. The results indicate improved perceived recommendation quality, providing preliminary evidence for the effectiveness of incorporating mood-based inputs into music recommendations.

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

DataEvolver: Automatic Data Preparation for Large Language Models through Multi-Level Self-Evolving

arXiv:2606.07001v2 Announce Type: replace-cross Abstract: High-quality training data is essential to large language models (LLMs) and typically requires extensive and costly manual curation. Existing automatic data preparation methods rely on predefined pipelines or customized human instructions, which limits their adaptability to diverse data distributions and lacks principled guidance from high-quality examples. In this paper, we introduce DataEvolver, the first self-evolving data preparation system that automatically constructs pipelines to transform raw data into high-quality data. DataEvolver employs a multi-level mechanism to ensure both pipeline executability and effectiveness. At the operator level, it incrementally expands the operator set to construct a logical plan while resolving dependency conflicts. At the pipeline level, it instantiates logical plans into executable code and iteratively refines pipeline orchestration through a feedback loop that reduces the distribution gap between prepared data and high-quality examples. Experiments on seven benchmarks show that DataEvolver substantially improves data quality and achieves an average 10\% gain in downstream LLM performance compared with training on original data, highlighting new opportunities for the iterative co-evolution of LLMs and data.

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

MAWARITH: A Dataset and Benchmark for Legal Inheritance Reasoning with LLMs

Islamic inheritance law is challenging for large language models because solving inheritance cases requires complex, structured, multi-step reasoning and the correct application of juristic rules to compute heirs' shares. We introduce MAWARITH, a large-scale annotated dataset of 12,500 Arabic inheritance cases for training and evaluating models on the full reasoning chain: (i) identifying eligible heirs, (ii) applying blocking (\d{hajb}) and allocation rules, and (iii) computing exact inheritance shares. To the best of our knowledge, MAWARITH is the first Arabic corpus and benchmark designed for end-to-end Islamic inheritance reasoning. Unlike prior datasets that restrict inheritance case solving to multiple-choice questions, MAWARITH supports the full reasoning chain and provides step-by-step solutions with justifications grounded in classical juristic sources and established inheritance rules, as well as exact share calculations. This enables models to learn how to generate detailed, step-by-step responses to user queries that reflect real-world Islamic inheritance cases. To evaluate models beyond final-answer accuracy, we propose MIR-E (Mawarith Inheritance Reasoning Evaluation), a weighted multi-stage metric that scores key reasoning stages and captures error propagation across the pipeline. We evaluate six large language models in a zero-shot setting. A commercial model achieves about 90\%, whereas all evaluated open-source models remain below 50\%. Our error analysis identifies recurring failure patterns, including scenario misinterpretation, errors in heir identification, errors in share allocation, and missing or incorrect application of key inheritance rules such as \textquotesingle awl and radd. The MAWARITH dataset is publicly available at https://gitlab.com/nlpresearcher/mawarith.

17.
arXiv (CS.AI) 2026-06-11

Towards Responsibly Non-Compliant Machines

arXiv:2606.12147v1 Announce Type: new Abstract: We consider the problem of engineering autonomous intelligent agents that are capable to responsibly not comply with user requests. We argue that machine non-compliance comes in many different forms, and sketch the issues we should pursue on the road of accomplishing responsibly non-compliant intelligent machines. We anchor responsible non-compliance in justifications for task refusal, pathways to override the non-compliance, as well as careful tracking of security risks and liability transfers.

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

Can Machine Learning Forecast Rice Yields in Data-Constrained Settings? Satellite Climate Data, National Crop Statistics, and Lessons from Sierra Leone

arXiv:2606.13959v1 Announce Type: new Abstract: Sierra Leone's agriculture operates with almost no data-driven decision support, and no published machine learning study has examined the country's crop yields. We ask whether rice yield can be forecast from data Sierra Leone currently has. Using 25 years of FAOSTAT production data (2000-2024) for nine major crops, we train XGBoost, Gradient Boosting, and Random Forest under a strict anti-leakage protocol with expanding-window walk-forward evaluation across seven held-out years, benchmarked against naive persistence. No model trained on crop statistics alone outperforms persistence. Augmenting with free satellite climate data (CHIRPS rainfall, NASA POWER temperature) reverses this result: a climate-only XGBoost reduces forecast error by one third (RMSE 284 vs 428 kg/ha), a gain that holds for a linear model and is robust to excluding the anomalous 2018 season. Early-season (May-June) rainfall is the dominant predictor, implying seasonal yield risk is observable months before harvest. No model anticipated the 2018 collapse, whose origins were institutional rather than climatic. We translate the findings into policy recommendations for Sierra Leone's Feed Salone Strategy, with a fully open-source pipeline.

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

Adaptive inference and function vectors in deep transformers

arXiv:2606.16694v1 Announce Type: cross Abstract: Transformers are widely used as a general-purpose substrate for learning complex correlations between a large collection of coupled variables, but their internal mechanisms have remained mysterious. We introduce a theory of a deep transformer as a mean-field interacting system that implements distributed inference, subject to constraints on communication, locality and depth. We show that such a system can exploit internal state representations ('function vectors') to infer a latent context variable at increasingly finer scales over its layers. In an in-context regression task, the theory predicts a non-trivial relationship between non-Gaussian, hierarchical structure in the latent context variable, and transformer depth. Predictions are tested using constrained linear attention transformers and demonstrate adaptive inference in deep architectures. Feedforward blocks and depth enable transformers to implement a much richer class of in-context learning algorithms than previously described.

20.
arXiv (CS.CL) 2026-06-15

Towards Direct Latent-Space Synthesis for Parallel Branches in LLM-Agent Workflows

Large language models increasingly serve as execution engines for agentic systems, yet they still consume context through a sequential text interface. This creates a mismatch with modern structured agent workflows, in which independent branches explore subtasks, retrieve evidence, or generate candidate solutions before a final synthesis step. Existing systems typically merge these branches by concatenating their textual outputs, which discards the parallel structure and incurs redundant prefill computation. In this work, we introduce Parallel-Synthesis, a plug-and-play framework that enables a synthesizer to directly consume the KV caches produced by parallel worker agents. Parallel-Synthesis combines a cache mapper that calibrates independently generated branch caches with a fine-tuned synthesizer adapter that enables generation from this non-sequential cache interface. We train Parallel-Synthesis using data that exposes the synthesizer to parallel cache contexts, teaches aggregation across cached branches, and distills reasoning behavior from standard text-concatenation-based synthesis. Across nine downstream datasets spanning math, science QA, code generation, GAIA, and multi-agent database diagnosis, Parallel-Synthesis matches or outperforms text-based synthesis on seven datasets and remains close on the other two. It also reduces time-to-first-token by 2.5x-11x, suggesting that direct cache-based synthesis is a promising interface for more native and efficient synthesis over parallel agent branches.

21.
arXiv (CS.CL) 2026-06-16

Interactor: Agentic RL oriented Iterative Creation for Ad Description Generation in Sponsored Search

This paper focuses on automatically generating informative ad descriptions in sponsored search. Unlike ad titles which are usually optimized to attract user click feedbacks, ad descriptions have a longer text span and possess the potential of incorporating world knowledge to address user search intents while presenting the fine-grained selling points of the ads. We propose Interactor, a multi-turn iterative creation framework optimized with agentic RL for ad description generation. The generation model acts as a policy that interacts with a customized environment consisting of multiple generative reward models. Given initial generations by the policy, the customized GenRMs evaluate multi-dimensional qualities including knowledge capacity and landing page consistency, providing both binary signals and reasoning feedbacks. The policy then iteratively refines the descriptions based on such feedbacks to ensure continuous improvement. Experiments on industrial datasets show that the Interactor framework significantly outperforms state-of-the-art approaches in generating knowledge-rich and faithful ad descriptions. Since May 2026, it has been deployed online in a leading search ads system, contributing to both ad revenue and user experience.

22.
arXiv (CS.CL) 2026-06-15

Multimodal Speaker Identification in Classroom Environments

Automated analysis of K-12 classroom dynamics faces challenges due to background noise and variable child speech, often confounding acoustic-only models. This study evaluates a multimodal speaker identification framework anchoring acoustic embeddings with LLM-derived semantic context. Using a subset of the EDSI dataset (8 math classrooms, N = 2,801 utterances), we found an acoustic baseline (ECAPA-TDNN) achieved only 39.0% accuracy. By integrating transcript-based "contextual anchoring" into a gradient boosting classifier, our multimodal approach raised student identification to 50.3%. Performance also improved for utterances over 5 seconds, reaching 76.9% accuracy (vs. 64.9% baseline) with a 90.9% Top-3 accuracy. Additionally, the model distinguished teacher vs. student roles with 99.3% accuracy. This approach advances the feasibility of automated feedback systems capable of considering individual student participation, a crucial step for supporting equitable instruction at scale.

23.
medRxiv (Medicine) 2026-06-15

International Consensus Guideline on Management of Genitourinary Adverse Events Associated with Prostate Cancer Radiotherapy

Purpose/Objective: Genitourinary (GU) adverse events (AEs) are common during and after pelvic radiation therapy (RT) for prostate cancer and can substantially impact quality of life. We convened an international committee to establish consensus in the prevention, mitigation, and management of radiation-related acute and late GU AEs, as there are no relevant evidence-based consensus guidelines to inform treating providers. Materials/Methods: A systematic evidence review focused on mitigation and management of radiation-related acute and late GU AEs was performed in PubMed, Embase and Cochrane. The following topics were addressed: management of acute GU AEs in the intact and post-operative settings; RT techniques; bladder outlet obstruction procedures; and indications for urology referral or hyperbaric oxygen therapy (HBO). Evidence-based consensus recommendations were developed using a Delphi process. We highlight the current state of evidence and evidence gaps worthy of future study. Results: Consensus was reached for 31 key questions. For management of lower urinary tract symptoms (LUTS), most evidence comes from trials in patients without cancer and not undergoing RT. A consensus algorithm for medical management of acute GU AEs was developed with the following highlights: (a) alpha blockers as 1st-line for obstructive symptoms in the intact setting, (b) anti-spasmodics as 1st -line for irritative symptoms in the intact setting, and (c) anti-spasmodics as 1st -line in the post-operative setting. The consensus algorithm provides an ordered list of medications to offer if 1st -line options afford inadequate relief. For RT fractionation, randomized clinical trial (RCT) data are available. 40% of panelists rarely or never use standard fractionation over moderate hypofractionation for patients with baseline LUTS, but most consider moderate hypofractionation over SBRT for AUA IPSS > 15. For patients with severe obstructive LUTS (most commonly AUA IPSS >20), the panel recommends a prophylactic bladder outlet obstruction procedure and, if obstructive symptoms improve, consideration of moderate hypofractionation or SBRT, based on retrospective data. There is one RCT supporting use of HBO for late radiation cystitis. Conclusions: The consensus guideline synthesizes available evidence and expert opinion across key clinical decision points to provide practical guidance in the prevention, mitigation, and management of radiation-related acute and late GU AEs in prostate cancer RT. Envisioned as a living document with periodic updates, this guideline serves as a resource for practicing radiation oncologists by outlining expert-derived consensus recommendations of evidence-based care in areas where high-quality data is limited.

24.
medRxiv (Medicine) 2026-06-18

Comparative Evaluation of Pretrained Large Language Models for Suicide Risk Prediction from Clinical Notes in U.S. Veterans

Background: Suicide remains a significant and potentially preventable cause of death among United States veterans. Predictive models based on structured electronic health record (EHR) data, including the U.S. Department of Veterans Affairs' Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment (REACH-VET) program, aim to identify individuals at elevated risk for enhanced monitoring and follow-up. Increasing evidence suggests that unstructured clinical narratives contain additional psychosocial information that may enhance risk prediction when analyzed using natural language processing (NLP). However, optimal approaches for representing clinical text remain uncertain. Recent advances in large language models (LLMs) enable contextual text representations that capture complex semantic relationships beyond traditional lexical methods. Methods: We compared the predictive performance of pretrained LLMs with classical bag-of-words (BoW) representations for suicide risk prediction using clinical notes from 27,241 veterans receiving care in the Veterans Health Administration. Patients were stratified by REACH-VET risk tier (low, moderate, high), and models were evaluated across prediction windows defined by note look-back periods (

25.
arXiv (CS.CL) 2026-06-16

From Awareness to Adherence: Bridging the Context Gap in Spoken Dialogue Systems via Context-Aware Decoding

Despite the success of end-to-end (E2E) spoken dialogue systems, maintaining strict context adherence in multi-round conversations remains a challenge. While prior works attribute these failures to models forgetting dialogue history, we highlight an equally critical but overlooked bottleneck: a gap between latent context awareness and active adherence. Although models internally recognize relevant past utterances, strong parametric priors often overshadow these signals during decoding. To bridge this gap, we propose an audio-adapted Context-Aware Decoding (CAD) approach. By leveraging internal attention mechanisms to isolate key historical rounds, our approach contrasts output distributions with and without this key context during inference, directly amplifying multimodal contextual signals. Evaluations on the Audio MultiChallenge benchmark demonstrate significant improvements in Semantic Memory and Self Coherence subtasks, successfully enforcing strict, context-faithful adherence.