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

When Roleplaying, Do Models Believe What They Say?

Language models can state that "the Earth orbits the Sun" and, when role-playing Aristotle, assert the opposite. Recent work argues that persona adoption is fundamental to how language models operate, with models constantly selecting the most appropriate persona for a given context. Does such role-playing merely change the model's outputs, or does it also affect what the model internally represents as truthful? We study this question with linear truth probes, applying them to LLMs role-playing historical personas whose likely beliefs differ from modern consensus. For each persona, we compare false claims the persona would likely have endorsed (*era-believed*) with topic-matched false claims they would not have endorsed (*era-false*). Across prompting, in-context learning, and supervised fine-tuning, persona induction suppresses era-believed statements less than equally false alternatives, yet they remain classified as false overall. Role-play therefore shifts what these models say more than what they internally represent as true. We contrast this with models trained on harmful advice that exhibit Emergent Misalignment (EM). Across three model families (Qwen 2.5 14B, Qwen 3 8B, and Llama 3.3 70B), their false claims move substantially toward the true region of probe space, are defended under challenge roughly half the time versus about a sixth for role-play, and are used in downstream reasoning. Role-play and Emergent Misalignment thus are points on a spectrum of belief internalization, where role-play changes what a model says with little representational change, while Emergent Misalignment shifts the internal representation of false claims without fully marking them as true.

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

Visual Retrieval-Augmented Generation for Silhouette-Guided Animal Art

Generative AI has advanced the ability to render photorealistic or artistic images, yet it remains limited in a key aspect of human creativity: interpreting ambiguous shapes. This phenomenon, rooted in pareidolia, allows humans to perceive meaningful forms in random patterns such as clouds, stones, or leaves. To computationally replicate this imaginative process, we introduce Visual Retrieval-Augmented Generation (Visual-RAG), a framework that generates animal art directly from natural silhouettes. Our method retrieves structurally similar animal shapes from a curated corpus of 28,586 high-quality silhouettes and uses them as reference exemplars to guide diffusion-based generation with ControlNet and IP-Adapter. Ablation studies confirm that shape Context with RANSAC provides the most accurate alignment, while removing shape standardization reduces the inlier ratio to just 13.4\%, underscoring the importance of structural fidelity in Visual-RAG. A user study with 12 participants evaluated the outputs in terms of aesthetics, silhouette fidelity, and overall impression. Results reveal that while Visual-RAG provides plausible interpretations, challenges remain in achieving high perceptual impact. This work lays the foundation for computational pareidolia, showing how machines can contribute to the early stages of imaginative discovery.

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

A Turbo-Inference Strategy for Object Detection and Instance Segmentation

Object detection and instance segmentation tasks are closely related. Existing top-down instance segmentation methods usually follow a detect-then-segment paradigm, where an initial detector is used to recognize and localize objects with bounding boxes, followed by the segmentation of an instance mask within each bounding box. In such methods, the detection accuracy directly influences the subsequent segmentation performance. However, previous research has seldom explored the impact of the instance segmentation task on object detection. In this paper, we present a turbo-inference strategy for the top-down methods that leverages the complementary information between detection and segmentation tasks iteratively. Specifically we design two modules: turbo-detection head and turbo-segmentation head, which facilitate communication between the tasks. The two modules form a closed loop that interlaces the detection and segmentation results without retraining the model. Comprehensive experiments on the COCO, iFLYTEK, and Cityscapes datasets demonstrate that our method substantially enhances both detection and segmentation accuracies with a certain increase in computational cost. The proposed method represents a tradeoff between prediction accuracy and inference speed. Codes are available at https://github.com/zhaozhen2333/Turbo-Learning.git.

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

Input-Dependent Fisher Information for Local Sensitivity Analysis of Medical Image Classifiers

arXiv:2606.16362v1 Announce Type: cross Abstract: Deep neural networks have achieved strong performance in medical image classification, but often work like black-box. Commonly used post-hoc interpretation methods often provide heuristic visualizations whose relationship to the classifier's predictive distribution is indirect. This work introduces a local sensitivity analysis framework based on the input-dependent Fisher Information Matrix (iFIM) of a trained classifier. The iFIM characterizes how the classifier's predictive distribution changes under infinitesimal perturbations of the input image. By using a Gram-matrix formulation, the nonzero eigenspectrum of the iFIM can be recovered without explicitly forming the full image-dimensional Fisher matrix. The leading iFIM eigenspace is then used to project an input image into a high local-sensitivity component and its orthogonal component. These components provide a model-intrinsic description of local predictive sensitivity, rather than a conventional pixel-wise attribution heatmap or a causal segmentation of task-relevant anatomy. The framework is evaluated on controlled and clinical medical image classification tasks using multiple classifier architectures. Perturbation-based experiments show that high-sensitivity iFIM components are more strongly coupled to changes in predictive confidence and classification performance than lower-sensitivity complementary components. The results support the iFIM framework as a principled tool for analyzing local decision sensitivity and for complementing existing attribution-based interpretability methods in medical imaging.

05.
arXiv (quant-ph) 2026-06-16

Intrinsic preservation of plasticity in continual quantum learning

arXiv:2511.17228v2 Announce Type: replace Abstract: Artificial intelligence in dynamic, real-world environments requires the capacity for continual learning. However, standard deep learning suffers from a fundamental issue: loss of plasticity, in which networks gradually lose their ability to learn from new data. Here we show that quantum learning models naturally overcome this limitation, preserving plasticity over long timescales. We demonstrate this advantage systematically across a broad spectrum of tasks from multiple learning paradigms, including supervised learning and reinforcement learning, and diverse data modalities, from classical high-dimensional images to quantum-native datasets. Although classical models exhibit performance degradation correlated with unbounded weight and gradient growth, quantum neural networks maintain consistent learning capabilities regardless of the data or task. We identify the origin of the advantage as the intrinsic physical constraints of quantum models. Unlike classical networks where unbounded weight growth leads to landscape ruggedness or saturation, the unitary constraints confine the optimization to a compact manifold. Our results suggest that the utility of quantum computing in machine learning extends beyond potential speedups, offering a robust pathway for building adaptive artificial intelligence and lifelong learners.

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

Visual-Redundancy-Controlled Parallel Decoding for Diffusion-Based Multimodal Large Language Models

arXiv:2605.25820v2 Announce Type: replace Abstract: Diffusion-based multimodal large language models (dMLLMs) decode by iteratively predicting tokens at multiple masked positions in parallel. This turns each decoding step into a position-selection problem: the model must choose not only which predictions are reliable in isolation, but also which positions should be committed together as context for later decoding steps. Existing confidence-based decoding ranks masked positions independently and commits the top-K positions, largely ignoring whether the committed tokens provide complementary visual grounding. We identify a step-level limitation of this strategy in multimodal settings: high-confidence tokens selected in the same step can rely on overlapping visual grounding, introducing visual redundancy among the committed tokens and leaving less complementary visual grounding available for later decoding. To quantify this effect, we introduce the Visual Redundancy Index (VRI), which measures visual grounding overlap among tokens committed in parallel. To control this redundancy during decoding, we propose Visual-Redundancy-Controlled Decoding (VRCD), a training-free inference-time decoding method that uses token-to-image attention to prioritize visually complementary positions. Across diverse multimodal benchmarks, VRCD reduces visual redundancy and remaining-position entropy with modest runtime overhead. In longer decoding experiments, it also achieves relative accuracy gains of up to 18.8% on M^3CoT and 6.9% on MMBench over confidence-based decoding. Code is available at https://github.com/infiniteYuanyl/VRCD.

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

Poster: Exploring the Limits of Audio-Based Detection of Turkish Phone Call Scams

Scam phone calls exploit vulnerable communities worldwide, yet research on detection has focused almost exclusively on English and other high-resource languages. In low-resource settings such as Turkish, detection is especially difficult, as annotated data is scarce and technological defenses remain limited. This research investigates how large language models (LLMs) can support scam detection in Turkish by introducing the first public multi-modal dataset of 100 aligned audio-transcript pairs of scam and benign conversations. We evaluate seven LLMs spanning three model families: Gemini 2.5 (Flash, Flash-Lite, Pro), GPT-4o, and Qwen (Max, Plus, Turbo), under three input conditions: raw audio, automatic speech-to-text transcripts, and transcripts refined by a native speaker. Our results suggest that transcript-based inputs consistently outperform direct audio processing, while human-corrected and uncorrected transcripts perform comparably. By centering a low-resource language and real world threat, this work highlights the urgent need for culturally and linguistically inclusive AI safety research and more robust multi-modal systems for fraud prevention.

09.
arXiv (CS.AI) 2026-06-15

Design Methodology and Performance Trade-offs Management for Distributed and Compound AI Systems

arXiv:2606.14350v1 Announce Type: cross Abstract: Artificial Intelligence (AI) systems must typically satisfy service-level objectives including accuracy, latency, and cost. The prevailing model-centric approaches select a monolithic model at design time and apply identical computation regardless of input difficulty, cannot decompose tasks across specialized components, and have knowledge that is fixed at training time. During runtime, this can lead to performance degradation and increasing costs. Because the model is the main design variable, it determines the majority of system behavior, coupling operational objectives to a single design-time choice. Addressing these limitations requires shifting from model-centric to system-centric design. Compound AI systems realize this shift by orchestrating multiple models, algorithms, and tools as distributed AI systems through explicit control logic. The performance of such systems depends on their workflow topology, the models assigned to each task, and the parameters governing runtime behavior. We present a design methodology that organizes this space along two dimensions, workflow topology and configuration selection, and identifies eight design patterns, each consolidating techniques to address a specific limitation of monolithic deployment. We validate our methodology through three case studies. Across our case studies, Compound AI configurations approach accuracy of monolithic models within 2.5 to 4 percentage points while reducing latency by up to 60% and cost by up to 71%. We show that model selection and parameter configuration jointly determine system performance, but the resulting design space grows combinatorially, as workflows compose more patterns and components. Thus, we identify five open challenges that define a roadmap from manually configured prototypes towards systems that automatically discover and maintain SLO-compliance in Compound and Distributed AI systems.

10.
medRxiv (Medicine) 2026-06-23

Clinical Characteristics and Predictors of Delayed Cerebral Ischemia in High-Altitude Aneurysmal Subarachnoid Hemorrhage

Background and Purpose-Aneurysmal subarachnoid hemorrhage (aSAH) remains a devastating cerebrovascular event, with delayed cerebral ischemia (DCI) representing its most feared complication. High-altitude environments induce profound cerebrovascular adaptations, yet no study has systematically examined aSAH outcomes in chronically hypoxic populations. We characterized clinical features and identified DCI predictors among aSAH patients on the Tibetan Plateau. Methods-This single-center retrospective cohort included 256 consecutive aSAH patients admitted at a tertiary neurosurgical center in Tibet (altitude 2,330-4,920 m) between 2013 and 2015. The primary outcome was DCI per consensus criteria. Multivariable logistic regression identified independent predictors; receiver operating characteristic analysis evaluated model performance. Altitude and hemoglobin were specifically evaluated as altitude-related risk factors. Results-DCI occurred in 26 patients (10.2%). In-hospital mortality was 1.6%. Most patients presented with good-grade aSAH (Hunt-Hess I-II, 73.0%; Fisher I-II, 73.1%). On multivariable analysis, only Fisher grade independently predicted DCI (odds ratio, 3.63 [95% CI, 1.14-11.52]; P=0.029). Neither altitude (P=0.697) nor hemoglobin concentration (P=0.858) was associated with DCI risk. The predictive model achieved an area under the curve of 0.812. At 1-year follow-up, 77.8% achieved favorable functional outcomes (modified Rankin Scale 0-2). Conclusions-Fisher grade is the sole independent predictor of DCI in high-altitude aSAH patients, while chronic hypoxia and compensatory hemoglobin elevation do not significantly modify DCI risk. Established sea-level prognostic frameworks remain valid in high-altitude settings, supporting their continued use for clinical risk stratification. Keywords: aneurysmal subarachnoid hemorrhage; high altitude; delayed cerebral ischemia; Fisher grade; Tibetan Plateau; prognosis

11.
arXiv (CS.LG) 2026-06-24

Bridging Mechanistic Interpretability and Prompt Engineering with Gradient Ascent for Interpretable Persona Control

arXiv:2601.02896v3 Announce Type: replace Abstract: Controlling emergent behavioral personas (e.g., sycophancy, hallucination) in Large Language Models (LLMs) is critical for AI safety, yet remains a persistent challenge. Existing solutions face a dilemma: manual prompt engineering is intuitive but unscalable and imprecise, while automatic optimization methods are effective but operate as "black boxes" with no interpretable connection to model internals. We propose a novel framework that adapts gradient ascent to LLMs, enabling targeted prompt discovery. In specific, we propose two methods, RESGA and SAEGA, that both optimize randomly initialized prompts to achieve better aligned representation with an identified persona direction. We introduce fluent gradient ascent to control the fluency of discovered persona steering prompts. We demonstrate RESGA and SAEGA's effectiveness across Llama 3.1, Qwen 2.5, and Gemma 3 for steering three different personas, sycophancy, hallucination, and myopic reward. Crucially, on sycophancy, our automatically discovered prompts achieve significant improvement (49.90% compared with 79.24%). By grounding prompt discovery in mechanistically meaningful features, our method offers a new paradigm for controllable and interpretable behavior modification. We release our scripts for RESGA and SAEGA in this github repo: https://github.com/HarshSaini10/RESGA_SAEGA.

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

Brick-DICL: Dynamic In-Context Learning for Automated Brick Schema Classification

arXiv:2606.17637v1 Announce Type: new Abstract: Building Management Systems (BMS) are essential for optimizing energy efficiency and operational performance in modern buildings. However, the lack of standardization across BMS points from different manufacturers creates significant barriers to integration and data utilization. While the Brick schema offers a standardized ontology for building systems, mapping BMS points to appropriate Brick classes presents three critical challenges: (i) the extensive number of Brick classes (936 in the latest version), (ii) limited domain-specific knowledge in large language models (LLMs), and (iii) substantial manual effort required for verification. To address these challenges, we propose Brick-DICL, a two-stage dynamic in-context learning framework for automated Brick schema classification. Brick-DICL consists of two primary components: metadata-RAG, which retrieves relevant examples to enhance LLMs' domain knowledge, and class-RAG, which narrows down potential Brick classes to address the large classification space. Additionally, we implement a multi-LLM filtering mechanism that compares predictions across multiple models, flagging low-confidence classifications for human review. As a result: (i) General: Brick-DICL is applicable to any building management system regardless of manufacturer or metadata format; (ii) Novel and Powerful: as the first dynamic in-context learning approach for Brick schema classification, Brick-DICL achieves significant classification accuracy improvements on building datasets, outperforming existing methods; (iii) Efficient: our multi-LLM filtering strategy reduces manual verification effort, enabling rapid digital building onboarding. Extensive experiments demonstrate Brick-DICL's effectiveness across diverse building datasets, accelerating the path toward standardized, interoperable building management systems.

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

Mathematical perspective on genetic algorithms with optimization guided operators

arXiv:2606.12279v1 Announce Type: cross Abstract: Recent work in ML applies genetic algorithms at inference time to iteratively improve solutions to optimization problems. The basic mutation and recombination operators involved are qualitatively different from those studied classically. Mutations are no longer random; an ML algorithm mutates a solution with the goal of improving an objective. Similarly, recombination is not based on random collages of parent solutions. Instead, it is an ML optimization-based operator whose goal is to synthesize improved solutions from its inputs. Thus, these mutation and recombination operators are more likely to improve the objective, but their computational cost is much higher. We introduce a general model of genetic algorithms and formulating optimization in this model as a query-complexity problem, using the language of reinforcement learning. We then study specialized models. We show that some optimization problems require generation, mutation, and recombination to be solved. We then obtain qualitatively tight algorithms for a family of problems within this framework that captures the nontrivial role of diversity in the solution pool, a key feature of practical ML genetic algorithms.

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

Test-Time Adaptation in Optical Coherence Tomography Using Trajectory-Aligned Time-Independent Flow

Optical coherence tomography (OCT) is essential in ophthalmology, but inconsistent image quality especially in low-cost devices hinders automated analysis. To address this, we introduce a flow-matching-based test-time adaptation method that generates high-quality surrogate images from noisy inputs. Typically, domain gaps between test and training data cause pixel distribution mismatches during the denoising process. We overcome this by matching the test image's histogram to synthetic reference trajectories, successfully aligning the input with expected distributions. Additionally, we remove the network's time conditioning to account for slight deviations in real-world noise distributions. Our approach achieves state-of-the-art performance in segmenting critical biomarkers for two stages of Age-related Macular Degeneration (AMD). Code is available: https://github.com/Veit21/tta-flow.

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

Optimizing Lithium Production Decisions under Geological, Demand, and Pricing Uncertainties: A POMDP Framework for Multi-Objective Decision Making

arXiv:2606.18598v1 Announce Type: new Abstract: Decision making in lithium production is challenging, whether from an investor's perspective or a strategic production standpoint. Determining which mines to open and when to open them involves not only geological and price uncertainties, but also complexities around the choice of extraction method, from direct lithium extraction to hard rock mining. Prior work explored models of this problem and different methods to optimize mining decisions; these models did not account for uncertainty in pricing, uncertainty in demand, or different mining technologies to extract lithium. Incorporating different pricing models and extraction technology into these models enables more robust strategies for determining not only when and where to open a mine, but also which method of production to pursue. We frame the problem as a partially observable Markov decision process (POMDP) and solve using belief state planning methods to get optimal decision making. In our study, we show that POMDP solvers outperform human inspired heuristics by dynamically adapting to shifting lithium price regimes (static, linear, exponential, and stochastic) through belief state planning and explicit uncertainty management. By optimally sequencing exploration, production, and technology choice, the framework achieves higher demand fulfillment and more balanced economic environmental outcomes over the projects lifetime in all different pricing and deposit scenarios.

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

How Should World Models Be Evaluated? A Decision-Making-Centric Position

arXiv:2606.15032v1 Announce Type: new Abstract: World models have rapidly become one of the central abstractions in modern AI. Yet the term now refers to several different objects: action-conditioned environment models, latent imagination models, future-video predictors, interactive neural simulators, latent predictive representations, and synthetic-data engines. Evaluation has broadened with the term. Recent papers measure video realism, perceptual similarity, instruction following, physical plausibility, policy ranking, executability, planning success, and downstream policy improvement. The result is not only metric diversity but also a recurring problem of claim/evidence mismatch: papers frequently make a stronger claim about what their model is useful for than their evaluation can actually establish. This paper surveys the recent literature and argues that the central question is use-dependent. When a model is presented as a world model for embodied decision-making, a more decisive issue is not whether it generates visually compelling videos, but whether it supports reliable counterfactual reasoning, policy evaluation, planning, and policy optimization under intervention, policy-induced distribution shift, and long-horizon rollout. We organize the literature using an L0–L7 ladder that ranges from visual plausibility to policy optimization utility. In our interpretation, L0–L3 are most naturally read as diagnostics of generated artifacts, L4 is often the first genuinely interventional test, and L5–L7 provide the most direct evidence of decision usefulness. Based on this diagnosis, we propose a decision-making-centric evaluation framework and a benchmark protocol that foreground counterfactual action fidelity, closed-loop rollout validity, reward/value prediction, policy-ranking agreement, optimization lift, model exploitability, and uncertainty calibration.

17.
arXiv (CS.CL) 2026-06-15

The Culture Funnel: You Can't Align What isn't in the Data

Current cultural alignment approaches focus on inference-time interventions, assuming models already contain sufficient cultural knowledge. We argue modern LLM pipelines suffer from a cultural data funnel. Using a multidimensional tagging framework across pretraining, fine-tuning, alignment, and reasoning datasets, we show explicit cultural signals decline sharply during post-training, while geographically concentrated, task-specialized data dominates. Multilinguality enhances geographic diversity of cultural knowledge but does not ensure balanced representation. Our tags improve downstream cultural benchmark performance, demonstrating that advances require shifting focus in training data pipelines. To facilitate future research, we release our culturally tagged dataset with 5.6M samples at https://huggingface.co/datasets/CohereLabs/CultureMarkers.

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

SVHighlights: Towards Extremely Long Sport Video Highlight Detection

While highlight detection for long-form videos is of great practical importance, most existing methods remain limited to short-form content, largely due to the absence of a suitable benchmark. To bridge this gap, we introduce SVHighlights, to the best of our knowledge, the first benchmark for highlight detection in extremely long sports videos, each exceeding one hour in duration, across multiple sports categories. SVHighlights is constructed from pairs of full-length sports videos and their corresponding official highlight videos using a dataset generation pipeline, enabling scalable label generation without conventional per-clip saliency annotation. The benchmark comprises 320 videos with an average duration of 2.00 hours and a total of 640.18 hours, substantially exceeding previous datasets. Existing methods also face fundamental challenges on long videos: models trained on short clips fail to generalize to hour-long content, and their clip-level scoring lacks the broader context needed to identify highlights. To address this and provide a strong baseline, we present TF-SELECTOR, a training-free segment-based approach that divides each video into context-aware segments by merging adjacent shots sharing the same semantic content, and predicts segment-level saliency scores using a large language model with multimodal inputs including visual captions, transcripts, and audio volume. Experiments demonstrate that TF-SELECTOR achieves superior performance across most metrics compared to Video Temporal Grounding (VTG)-tuned baselines, with improvements of +2.50 in HIT@1, +4.04 in HIT@K, and +2.95 in IoU. These results establish SVHighlights as a challenging testbed for long-form highlight detection and demonstrate that a simple segment-based strategy can effectively scale to hour-long videos.

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

Probing Dec-POMDP Reasoning in Cooperative MARL

arXiv:2602.20804v2 Announce Type: replace Abstract: Cooperative multi-agent reinforcement learning (MARL) is typically framed as a decentralised partially observable Markov decision process (Dec-POMDP), a setting whose hardness stems from two key challenges: partial observability and decentralised coordination. Genuinely solving such tasks requires Dec-POMDP reasoning, where agents use history to infer hidden states and coordinate based on local information. Yet it remains unclear whether popular benchmarks actually demand this reasoning or permit success via simpler strategies. We introduce a diagnostic suite combining statistically grounded performance comparisons and information-theoretic probes to audit the behavioural complexity of baseline policies (IPPO and MAPPO) across 37 scenarios spanning MPE, SMAX, Overcooked, Hanabi, and MaBrax. Our diagnostics reveal that success on these benchmarks rarely requires genuine Dec-POMDP reasoning. Reactive policies match the performance of memory-based agents in over half the scenarios, and emergent coordination frequently relies on brittle, synchronous action coupling rather than robust temporal influence. These findings suggest that some widely used benchmarks may not adequately test core Dec-POMDP assumptions under current training paradigms, potentially leading to over-optimistic assessments of progress. We release our diagnostic tooling to support more rigorous environment design and evaluation in cooperative MARL.

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

MyPCBench: A Benchmark for Personally Intelligent Computer-Use Agents

Current benchmarks for computer-use agents evaluate models in impersonal environments. This leaves a gap between evaluation and deployment where personal assistants are expected to work across a user's whole digital life, including their context, historical data, and logged-in accounts. This gap is widest on web tasks, where live web evaluations cannot exercise sites that require logging in or personal information, the kind of site a real personal assistant has to drive. We introduce MyPCBench, which tests computer-use agents as personal assistants on a Linux desktop populated with 17 simulated real-world web applications and a full desktop stack, all seeded for one canonical persona, Michael Scott from The Office. We define 184 tasks in this environment, each inspired by a real request drawn from the OpenClaw community, and benchmark six closed and open-weight models with a uniform computer+bash tool surface. We find that the best model, Claude Opus 4.6, fully solves 55.4\% of the tasks, the only model above 50\%. Model failures cluster on tasks that span many applications and on long trajectories, where personalization stresses an assistant the most. We release the environment, task set, and agent harness at https://mypcbench.com.

22.
arXiv (CS.AI) 2026-06-18

AI-Driven Assessment of Human Tutors: Linking Training Performance to Real-Life Practice

arXiv:2606.18617v1 Announce Type: cross Abstract: There exist numerous tutor training platforms. However, few provide AI-driven training and evaluation for human tutors based on real-life performance. We present an AI-driven system that assesses both open responses during training and authentic real-life tutoring. Unlike platforms that only assess learning through online training or simulations, our system utilizes Generative AI (Gemini-2.5-pro) to analyze transcriptions of authentic tutoring, measuring the transfer of tutor skills to real-life application. Human tutors instructing students remotely in math (N=86) completed six scenario-based lessons, averaging a significant 7.4% learning gain. Using mixed-effects models across 405 session-to-lesson pairs, we found that training performance significantly predicted real-life transcript scores with an effect size of 0.25 SD. Model comparison (AIC/BIC) indicated averaging open response and multiple choice performance during training predicted real-life tutor performance best, although open responses were comparatively more predictive. Exploratory analysis showed that after training, tutors were significantly more likely to encounter pedagogical opportunities to apply their skills (61.1% to 68.9%) and demonstrated higher execution quality within those opportunities (65.5% to 68.1%). Interrupted time series analysis suggested that these tutor improvements were part of a gradual trend over time rather than an immediate intervention effect of training. We illustrate an AI-driven method to link tutor training with real-life assessment. In doing so, we contribute open datasets, AI prompts, and scoring rubrics to support transparency and reproducibility.

23.
medRxiv (Medicine) 2026-06-12

Microbial etiology, antibiotic susceptibility profiles, and multidrug resistance of urinary tract infections at a secondary healthcare facility in Ghana

Background: Rising antibiotic resistance challenges empirical therapies for urinary tract infections (UTIs). This study evaluated the microbial etiology, susceptibility profiles, and multidrug resistance (MDR) patterns of uropathogens among outpatients at the Berekum Holy Family Hospital, Ghana. Methods: This cross-sectional study (February to August 2021) screened 263 symptomatic outpatients. Mid-stream urine samples underwent quantitative culture, biochemical identification, and antimicrobial susceptibility testing via the Kirby-Bauer disc diffusion method following the 2021 CLSI guidelines. Results: Significant bacteriuria prevalence was 22.8% (60/263). UTIs predominated in females (78.3%, 47/60; p = 0.1501) and individuals [≥]45 years (33.3%, 20/60). Gram-negative rods accounted for 90.0% of isolates, primarily Escherichia coli (26.7%), Citrobacter spp. (25.0%), and Enterobacter spp. (21.7%); Staphylococcus aureus (10.0%) was the only Gram-positive pathogen. Extreme phenotypic resistance was observed against piperacillin/tazobactam (98.3%), cefotaxime (93.3%), tetracycline (88.3%), and cefoperazone (85.0%). Conversely, highest therapeutic susceptibilities were retained by amikacin (78.3%), levofloxacin (61.7%), and gentamicin (58.3%). Conclusion: The high prevalence of MDR uropathogens against advanced beta-lactamase inhibitor combinations and cephalosporins necessitates an immediate re-evaluation of regional empirical protocols. Amikacin, levofloxacin, and gentamicin remain viable options prior to culture confirmation. These findings establish a crucial phenotypic baseline to guide localized prescribing policies and regional antimicrobial resistance tracking strategies.

24.
medRxiv (Medicine) 2026-06-15

Therapeutic efficacy study on shoulder impingement syndrome in swimmers: a network meta-analysis

Shoulder impingement syndrome (SIS), including subacromial impingement and rotator cuff tendinitis, is commonly caused by repetitive swimming movements and associated shoulder joint dysfunction. Despite numerous available treatment options, no consensus exists on the most effective treatment option. Therefore, this systematic review and network meta-analysis aimed to investigate treatment methods for SIS in swimmers. Using a frequentist framework and Cochrane PICOS principles, we compared SIS treatments, constructed network evidence diagrams, and assessed heterogeneity. A total of 45 studies were included in the qualitative synthesis, and 42 contributed to the network meta-analysis, comprising 1752 participants, 9 treatment categories, and outcome measures. For pain outcomes, some adjunctive interventions combined with exercise showed favorable ranking probabilities, although several estimates were accompanied by wide confidence intervals. For shoulder range-of-motion outcomes, taping, acupuncture, manual therapy, and sport-specific training showed favorable effects in selected comparisons, particularly for external and internal rotation. According to surface under the cumulative ranking curve (SUCRA) rankings, exercise combined with medium-frequency therapy ranked highly for pain reduction, whereas exercise combined with acupuncture or extracorporeal shock wave therapy ranked highly for shoulder flexion. Exercise combined with taping ranked highly for external rotation, and exercise combined with manual therapy ranked highly for internal rotation. However, the interpretation of ranking results should remain cautious because uncertainty and inconsistency were present in some comparisons. Exercise-based rehabilitation appears to remain central to the management of SIS in swimmers. Several adjunctive interventions showed favorable findings for selected outcomes, especially pain relief and shoulder rotational function. However, the available evidence was affected by heterogeneity, inconsistency, and imprecision across some treatment comparisons. More rigorously designed swimmer-specific randomized controlled trials are needed before firm treatment hierarchies can be established. Trial registration: The protocol for this systematic review is registered with PROSPERO (www.crd.york.ac.uk/PROSPERO; registration number: CRD42024498851). The first submission of PROSPERO was on January 15, 2024, and it was revised and updated on March 25, 2026.

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

PVminerLLM2: Improving Structured Extraction of Patient Voice via Preference Optimization

Motivation: Patient-generated text contains critical information on patients' lived experiences, social context, and care engagement, but remains largely unstructured, limiting its use in patient-centered outcomes research. Prior work introduced the PV-Miner benchmark and PVMinerLLM models for structured extraction. However, supervised fine-tuning (SFT) alone struggles with rare, fine-grained, and unevenly distributed errors, particularly in token-critical structured outputs. Results: We present PVminerLLM2, an improved set of LLMs for structured patient voice extraction that applies preference optimization to address token-critical errors beyond the reach of supervised fine-tuning. Our method introduces (i) a preference objective with token-level gated stabilization term that prevents degradation of absolute token likelihood under preference optimization, and (ii) confusion-aware preference pair construction to better capture low-separation distinctions. We further incorporate token-importance weighting and inverse-frequency reweighing to address token imbalance and class skew. Across multiple model sizes, PVMinerLLM2 consistently outperforms strong baselines, achieving gains of up to 4.43% (Code), 3.50% (Sub-code), and 1.55% (Span), and outperforms baseline LLM trained with existing preference optimization methods. Availability and Implementation: The supplementary material, code, evaluation scripts, and trained models for PVminerLLM2 are publicly available at: https://github.com/Data-Mining-Lab-Yale/PVminerLLM2