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

Decoding the Multimodal Maze: A Systematic Review on the Adoption of Explainability in Multimodal Attention-based Models

arXiv:2508.04427v2 Announce Type: replace-cross Abstract: Multimodal learning has witnessed remarkable advancements in recent years, particularly with the integration of attention-based models, leading to significant performance gains across a variety of tasks. Parallel to this progress, the demand for explainable artificial intelligence (XAI) has spurred a growing body of research aimed at interpreting the complex decision-making processes of these models. This systematic literature review analyzes research published between January 2020 and early 2024 that focuses on the explainability of multimodal models. Framed within the broader goals of XAI, we examine the literature across multiple dimensions, including model architecture, modalities involved, explanation algorithms and evaluation methodologies. Our analysis reveals that most studies are concentrated on vision-language and language-only models, with attention-based techniques being the most commonly employed for explanation. However, these methods often fall short in capturing the full spectrum of interactions between modalities, a challenge further compounded by the architectural heterogeneity across domains. Importantly, we find that evaluation methods for XAI in multimodal settings are largely non-systematic, lacking consistency, robustness, and consideration for modality-specific cognitive and contextual factors. To address these gaps, we not only synthesize findings from the surveyed works but also incorporate a complementary analysis that integrates recent and emerging advances driving multimodal explainability. Based on these insights, we provide a comprehensive set of recommendations aimed at promoting rigorous, transparent, and standardized evaluation and reporting practices in multimodal XAI research. Our goal is to support future research in more interpretable, accountable, and responsible multimodal AI systems, with explainability at their core.

02.
Nature (Science) 2026-06-17

Cortical development dynamics across autism spectrum disorder mouse models

Despite the functional diversity of over 100 causal genes1–3, phenotypic convergence across models may reveal common neurobiological processes in autism spectrum disorder (ASD). Here we profiled 251 samples from 11 monogenic mouse models of ASD using single-nucleus multi-omic sequencing across three developmental stages, both sexes and two brain regions. Despite genetic heterogeneity, ASD-linked mutations converged on perturbations of the radial glial cell lineage. These alterations reflect a transient developmental delay rather than lasting lineage misspecification and resolve by postnatal stages. Molecularly, the largest transcriptional differences emerged in neurons at early postnatal stages. These changes included downregulation of synaptic and ion channel-related genes, consistent with homeostatic adaptation or delayed maturation. Network analysis showed molecular convergence across models within each developmental stage, suggesting that diverse mutations linked to ASD impinge on common, stage-specific processes. Convergence becomes less pronounced by postnatal day 14, highlighting the dynamic nature of ASD-associated changes. Cross-genotype heterogeneity is superimposed on stage-specific effects. Electrophysiology corroborated this pattern: mutants generally showed altered neuronal excitability and synaptic properties with model-specific nuances. Our study also highlighted sex-specific gene expression alterations, with female mice often displaying larger effect sizes than male mice. Together, our findings provide a comprehensive view of developmental cellular and molecular dynamics across models of ASD. Using single-nucleus multi-omic sequencing, diverse autism spectrum disorder-linked gene mutations converge on transient, stage-specific disruptions in early brain development, and highlight sex-specific gene expression alterations.

03.
arXiv (CS.AI) 2026-06-16

Scaling Adaptive Depth with Norm-Agnostic Residual Networks

arXiv:2606.16112v1 Announce Type: cross Abstract: Residual architectures are ubiquitous in deep learning, but they suffer from a subtle structural limitation: the norm of the residual stream can grow rapidly with depth. As a result, updates from later layers become small relative to the accumulated residual state. This reduces their impact on the representation and limits the benefits of scaling models in depth. To address this, we introduce NAG, a norm-agnostic residual architecture that separates magnitude from directional information in the residual stream, preserving meaningful layer contributions throughout depth and preventing later updates from being systematically suppressed by residual-norm growth. Importantly, NAG introduces only a negligible number of additional parameters and relies on simple operations that are easily kernel-fusible, preserving training efficiency in practice. We show that this architecture outperforms baseline Transformers, with gains that increase substantially as depth grows, enabling effective training of much deeper models. The norm-agnostic formulation also leads to an interpretable Mixture-of-Depths (MoD) mechanism that adaptively skips both attention and MLP layers. Beyond serving as a post-training accuracy-compute tradeoff, this mechanism can be used as a pretraining-time scaling strategy: under iso-FLOP training, compute saved by reducing per-token forward-pass cost can be reinvested into training on more tokens while keeping the total parameter count and KV-cache budget fixed. In our experiments, moderate Mixture-of-Depths rates of approximately 20%-25% match full-depth baseline performance under equal training compute while substantially reducing the number of executed layer parameters and forward-pass FLOPs. These results identify sparsity in depth as a new scaling axis for fixed-compute training, enabling very deep yet FLOP-efficient models.

04.
arXiv (CS.LG) 2026-06-17

Clarify Before You Draw: Proactive Agents for Robust Text-to-CAD Generation

arXiv:2602.03045v2 Announce Type: replace Abstract: Large language models have recently enabled text-to-CAD systems that synthesize parametric CAD programs (e.g., CadQuery) from natural-language prompts. In practice, however, geometric descriptions can be under-specified or internally inconsistent: critical dimensions may be missing and constraints may conflict. However, existing fine-tuned models tend to reactively follow the user instructions and hallucinate dimensions when the text is ambiguous. To address this, we propose a proactive agentic framework for text-to-CadQuery generation, named as ProCAD, that resolves specification issues before code synthesis. Our framework pairs a proactive clarifying agent, which audits the prompt and asks targeted clarification questions only when necessary to produce a self-consistent specification, with a CAD coding agent that translates the specification into an executable CadQuery program. We fine-tune the coding agent based on a curated high-quality text-to-CadQuery dataset and train the clarifying agent via agentic SFT on clarification trajectories. Experiments show that proactive clarification significantly improves robustness to ambiguous prompts while keeping interaction overhead low. ProCAD outperforms frontier closed-source models, including Claude Sonnet 4.5, reducing the mean Chamfer distance by 79.9% and lowering the invalidity ratio from 4.8% to 0.9%. Our code and datasets are made publicly available on https://github.com/BoYuanVisionary/Pro-CAD.

05.
arXiv (CS.AI) 2026-06-18

AI Sandboxes: A Threat Model, Taxonomy, and Measurement Framework

arXiv:2606.18532v1 Announce Type: cross Abstract: AI systems are increasingly evaluated in bounded environments that combine isolation, simulation, instrumentation, supervision, and evidence capture. For physical AI, AIoT, and cyber-physical systems, this shift is not a matter of terminology: the system under test may sense, decide, actuate, communicate, and fail through physical processes, networked devices, and human operators. This article develops an assurance-oriented account of AI sandboxes as controlled environments for testing, evaluation, verification, and validation across digital AI, embodied autonomy, and cyber-physical deployments. We formalize the sandbox boundary and a weakest-link rule for composing per-dimension evidence into a bounded deployment claim; separate major sandbox archetypes; define a cyber-physical threat model that includes attacks on the assurance apparatus itself; and introduce a measurement framework spanning fidelity, controllability, observability, containment, reproducibility, and governance artifacts, instantiated on three worked case studies of real sandboxes. The resulting threat model, taxonomy, and measurement framework clarify what a sandbox can validly test, which risks it can contain, and what forms of evidence it can support for safety, security, and regulatory assurance.

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

Causal Clothes-Invariant Feature Learning for Cloth-Changing Person Re-ID

In cloth-changing person re-identification (CCReID), it is critical to learn clothes-invariant feature, which can provide discriminative ID features that remain robust against clothing changes. However, a spurious correlation currently limits existing ReID methods from effectively extracting these clothing-invariant features. This spurious correlation arises from clothing ownership: clothing is rarely shared across different identities, so models tend to memorize clothing cues for identity recognition, and this strategy generalizes poorly to unseen clothing. In this paper, we propose Causal Clothes-Invariant Learning (CCIL), which explicitly shifts CC-ReID from likelihood learning P (Y|X) to causal intervention learning P (Y|do(X)) to block the clothing shortcut. CCIL realizes this intervention through three modules: a Confounder Dictionary, an Intervention Module, and Disentangle Regularization. The causality-based modeling makes the entire model naturally clothes-invariant, effectively preventing the capture of spurious correlations in feature learning. Extensive experiments validate the effectiveness of CCIL. On PRCC and DeepChange datasets, CCIL achieves Rank-1 accuracies of 66.4% and 59.2%, outperforming state-of-the-art methods by 1.4 and 4.1 percentage points, respectively.

07.
arXiv (CS.CV) 2026-06-16

Mutual Distillation of Dual-Foundation Models for Semi-Supervised PET/CT Segmentation

Organ segmentation from PET/CT is critical for quantitative analysis and radiotherapy planning in oncology. To ease the high annotation cost of PET/CT segmentation, semi-supervised learning (SSL) provides a practical and effective solution for developing deep models with limited labeled data. Recent developments in visual foundation models have demonstrated remarkable adaptability with improved efficiency. In this work, we propose a mutual distillation framework that seamlessly exploits both structural and functional foundation models, which act as modality-specific generalists for distilling knowledge from structural CT and metabolic PET imaging. By bridging the gap between the task-specific precision of student models and the segmentation priors of generalist foundation models, we propose MuDuo, a mutual distillation framework that synergistically leverages SAM-Med3D for CT and SegAnyPET for PET to distill their knowledge into a lightweight student network. Our approach eliminates the need for manual prompts while maximizing the utility of unlabeled data for automatic segmentation, achieving state-of-the-art performance on the AutoPET dataset with only 5 labeled cases. Our source code is available at https://github.com/Wu-beining/MuDuo.

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

CT-VDETR: Semi-supervised 3D Trauma Detection in Computed Tomography (CT) scans using Dense Vertex Relative Position Encoding

Accurate detection and localization of traumatic injuries in abdominal CT remain challenging because voxel-level annotations are limited and expensive to obtain. We present a label-efficient framework for 3D abdominal trauma detection that combines self-supervised pretraining with semi-supervised transformer-based detection. First, we use Masked Image Modeling (MIM) on 1098 CT volumes to pretrain a 3D U-Net encoder for anatomical representation learning. Next, we adapt V-DETR to dense volumetric CT through a feature adapter that converts the encoder feature grid into a compact token sequence for transformer decoding. The pretrained encoder is then integrated with V-DETR and 3D Vertex Relative Position Encoding (3D V-RPE) to improve the localization of irregularly shaped injuries. Finally, semi-supervised teacher-student consistency regularization leverages 2,000 additional unlabeled volumes during detector training. To the best of our knowledge, this is the first application of a 3D DETR-style detector to the RSNA abdominal trauma detection task. On this benchmark, the proposed method achieves 31.33% test mAP@0.50 using only 78 labeled training volumes, corresponding to a 1.53x improvement over supervised-only training. These results show that combining medical-domain pretraining with semi-supervised learning is an effective strategy for label-scarce 3D medical detection.

09.
arXiv (CS.AI) 2026-06-19

ZeSTA: Zero-Shot TTS Augmentation with Domain-Conditioned Training for Data-Efficient Personalized Speech Synthesis

arXiv:2603.04219v2 Announce Type: replace-cross Abstract: We investigate the use of zero-shot text-to-speech (ZS-TTS) as a data augmentation source for low-resource personalized speech synthesis. While synthetic augmentation can provide linguistically rich and phonetically diverse speech, naively mixing large amounts of synthetic speech with limited real recordings often leads to speaker similarity degradation during fine-tuning. To address this issue, we propose ZeSTA, a simple domain-conditioned training framework that distinguishes real and synthetic speech via a lightweight domain embedding, combined with real-data oversampling to stabilize adaptation under extremely limited target data, without modifying the base architecture. Experiments on LibriTTS and an in-house dataset with two ZS-TTS sources demonstrate that our approach improves speaker similarity over naive synthetic augmentation while preserving intelligibility and perceptual quality. Audio samples are available on our web page.

10.
arXiv (CS.LG) 2026-06-15

Deep Doubly Debiased Longitudinal Effect Estimation with ICE G-Computation

arXiv:2602.12379v2 Announce Type: replace Abstract: Estimating longitudinal treatment effects is essential for sequential decision-making but is challenging due to treatment-confounder feedback. While Iterative Conditional Expectation (ICE) G-computation offers a principled approach, its recursive structure suffers from error propagation, corrupting the learned outcome regression models. We propose D3-Net, a framework that mitigates error propagation in ICE training and then applies a robust final correction. First, to interrupt error propagation during learning, we train the ICE sequence using Sequential Doubly Robust (SDR) pseudo-outcomes, which provide bias-corrected targets for each regression. Second, we employ a multi-task transformer with a covariate simulator head for auxiliary supervision, regularizing representation learning, and a target network to stabilize training dynamics. For the final estimate, we discard the SDR correction and instead use the uncorrected nuisance models to perform Longitudinal Targeted Minimum Loss-Based Estimation (LTMLE) on the original outcomes. This second-stage, targeted debiasing ensures robustness and optimal finite-sample properties. Comprehensive experiments demonstrate that our model, D3-Net, robustly reduces bias and variance across different horizons, counterfactuals, and time-varying confoundings, compared to existing state-of-the-art ICE-based estimators.

11.
arXiv (CS.AI) 2026-06-16

Metric Match: A Subset Selection Approach to Evaluating LLM Judge Reliability

arXiv:2606.15029v1 Announce Type: new Abstract: LLM judges are used to reduce the need for costly human labor in evaluating open-ended text generation. However, the reliability of these judges depends critically on their alignment with human raters – a property that itself depends on costly human annotations. In this work, we develop a method (Metric Match) for estimating correlation-based reliability metrics of LLM judges from limited annotations. Metric Match selects a subset of samples for human annotation such that the subset matches the population reliability metric with respect to acquired synthetic labels. We empirically show that Metric Match achieves a win-rate of 0.838 against random subset selection across four different correlation metrics and 15 datasets, with an 18.7% decrease in average estimation error and reduces annotation needs by 32.5%. We provide a cost model and highlight a medical case study where our method saves $1,041.67 compared to random selection for expert annotation. Further, we shift our task from reliability estimation to reliability classification of whether a given judge is above a deployment threshold, outperforming random selection with Metric Match. All project code is publicly available, and we additionally provide an installable package for ease of use.

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

Pushing the Boundaries of Natural Reasoning: Interleaved Bonus from Formal-Logic Verification

arXiv:2601.22642v2 Announce Type: replace Abstract: Large Language Models (LLMs) show remarkable capabilities, yet their stochastic next-token prediction creates logical inconsistencies and reward hacking that formal symbolic systems avoid. To bridge this gap, we introduce a formal logic verification-guided framework that dynamically interleaves formal symbolic verification with the natural language generation process, providing real-time feedback to detect and rectify errors as they occur. Distinguished from previous neuro-symbolic methods limited by passive post-hoc validation, our approach actively penalizes intermediate fallacies during the reasoning chain. We operationalize this framework via a novel two-stage training pipeline that synergizes formal logic verification-guided supervised fine-tuning and policy optimization. Extensive evaluation on six benchmarks spanning mathematical, logical, and general reasoning demonstrates that our 7B and 14B models outperform state-of-the-art baselines by average margins of 10.4% and 14.2%, respectively. These results validate that formal verification can serve as a scalable mechanism to significantly push the performance boundaries of advanced LLM reasoning.

13.
medRxiv (Medicine) 2026-06-11

Development of iADJUST: a theory-informed, patient co-designed digital psychological intervention for adjustment in chronic kidney disease

Background: Psychological distress is common in chronic kidney disease (CKD) and is associated with reduced quality of life, treatment non-adherence, and worse clinical outcomes. Distress in CKD is also linked to difficulties adjusting to the demands of illness management. Despite this, psychological support remains inconsistently integrated within kidney care pathways, and existing interventions often lack clear theoretical specification and explicit targeting of mechanisms underpinning adjustment to CKD. Objectives: To describe the systematic development of iADJUST, a theory-informed patient co-designed digital psychological intervention targeting key cognitive and behavioural mechanisms involved in adjustment to CKD. Methods: Intervention development was guided by the Medical Research Council framework for complex interventions. A structured, iterative process integrated empirical evidence, psychological theory, and patient and public involvement and engagement. The Common-Sense Model of Self-Regulation and cognitive behavioural theories informed the identification of modifiable maintaining mechanisms associated with adjustment to CKD. Intervention components were mapped onto these mechanisms and refined through co-design with people living with CKD. Results: iADJUST is a six-session self-guided digital psychological intervention delivered over 12 weeks and supplemented by therapist contact. The intervention targets illness-related uncertainty, fatigue-related activity dysregulation, catastrophic what-if thinking, self-critical evaluation, and behavioural withdrawal. It integrates psychoeducation, cognitive and behavioural strategies, maintenance planning, and elements from acceptance and commitment therapy and compassion-focused approaches. Content is delivered through video, audio, and guided tasks and activities. Conclusion: iADJUST provides a theory-informed, evidence-based psychological intervention for CKD explicitly mapping intervention components to maintaining cognitive and behavioural mechanisms implicated in adjustment. Feasibility evaluation is underway.

14.
arXiv (CS.CV) 2026-06-12

Stereo Vision-Based Fall Prediction and Detection using Human Pose Estimation on the AMD Kria K26 SOM

Background and Objective: Falls among elderly people can cause serious injury and reduce quality of life. Timely prediction and detection are essential to prevent harm and support well-being. We propose a portable, low-power, battery-operated, vision-based fall prediction and detection system using HPE on an AMD Kria K26 System-on-Module (SOM). The objective is a non-intrusive, privacy-preserving system for real-time fall detection. Methods: The system uses an Intel RealSense D455 range-sensing camera connected to the K26 SOM by USB. It captures synchronized RGB and depth frames, 640 x 480 x 3 and 640 x 480 pixels, at 60 FPS. The SOM runs a three-stage pipeline with quantized YOLOX, Anchor-to-Joint (A2J), and fall-detection models. YOLOX identifies human bounding boxes from RGB frames, then discards the RGB frames to preserve privacy. A2J uses depth frames to estimate 15 joint keypoints per person. A CNN uses selected joint coordinates (x, y, z) to classify fall activity. YOLOX was trained on CrowdHuman; A2J on ITOP, MP-3DHP, UR Fall Detection, and a custom SDSU PSG dataset; and the CNN on UR Fall Detection and SDSU PSG. The design used a single-core DPU with a serial pipeline and a dual-core DPU running YOLOX and A2J with multiple threads. Results: Quantized accuracy was evaluated using IoU >= 50% for YOLOX, mAP with a 10-cm rule for A2J, and classification accuracy, (TP + TN)/(TP + TN + FP + FN), for the CNN. Accuracies were 74%, 84.13%, and 75.85%. Throughput improved from 2.5 FPS for the single-threaded pipeline to 4.5 FPS for the multi-threaded version. Conclusion: Results demonstrate the feasibility of privacy-preserving fall detection on an AMD Kria K26 edge device. On-device HPE and fall classification runs without cloud dependency, supporting elderly monitoring and assistive healthcare. Future work will improve model accuracy and speed.

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

Measuring Curriculum Alignment across Topical Coverage, Competency, and Cognitive Depth: A Longitudinal Framework Applied to CS2013 and CS2023

arXiv:2606.19469v1 Announce Type: new Abstract: Undergraduate computer science is governed by international curricular guidelines revised about once a decade, yet programs lack a reliable, reproducible way to measure how completely they cover the current guidelines and how that coverage shifts when the guidelines are restructured. We address this with a human-in-the-loop pipeline that measures a program's coverage of an external body of knowledge, applied longitudinally to one accredited BSc in Computer Science against Computer Science Curricula 2013 (CS2013) and 2023 (CS2023). The pipeline represents the program and each guideline as structured corpora, generates candidate course-to-knowledge-unit matches by semantic retrieval, and confirms them through human judgment under an explicit coverage definition. Of seven benchmarked retrievers, a reciprocal-rank-fusion ensemble was strongest, and a reputed long-context model underperformed a small sentence model, so retriever choice must be measured. Both maps were validated by an independent second rater (Cohen's kappa 0.64 for CS2023, 0.69 for CS2013). The program covers 49.7% of CS2023 and 50.9% of CS2013 knowledge units, near-constant across a decade. Extending the same retrieve-then-confirm design to competency articulation and cognitive depth shows that the program articulates the competency for ~88% of covered units under each guideline, yet delivers it at the recommended depth for 76% of present units under CS2023 against 95% under CS2013, a gap reflecting the newer guideline's raised expectations, not the program. The longitudinal comparison separates persistent structural gaps (parallel and distributed computing, foundations of programming languages, systems fundamentals), uncovered against both guidelines and ABET, from differences that reflect the standard's evolution. The instrument is reusable and available from the authors on request.

16.
Science (Express) 2026-05-21

Observation of quantum vortex core fractionalization and skyrmion formation in a superconductor | Science

Authors: Unknown Author

Magnetic fields can penetrate a superconductor in the form of quantum vortices, which consist of a core singularity with circulating currents. London’s quantization implies that there is one core singularity per quantum of magnetic flux in single-component superconductors. Here, we report signatures of quantum vortex core fractionalization on the potassium-terminated surface of a multiband superconductor KFe 2 As 2 . The observed splitting of single integer-flux vortices into several fractional vortices results in a disparity between the numbers of flux quanta and vortex cores. These fractional vortices often arrange in chains, which calculations show are characterized by a ℂP 2 skyrmionic topological invariant; this constitutes a different type of topological defect: the chiral skyrmion. The disparate natures of integer and fractional vortices comprising skyrmions lead to distinct spectroscopic signatures.

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

Reward Modeling for Multi-Agent Orchestration

Multi-Agent Systems (MAS) built on Large Language Models (LLMs) require effective orchestration to coordinate specialized agents, yet training such orchestrators is hindered by limited supervision and high computational cost. We propose Orchestration Reward Modeling (OrchRM), a self-supervised framework for evaluating orchestration quality without human annotations. OrchRM leverages intermediate artifacts from multi-agent executions to construct win-lose pairs for Bradley-Terry reward model training. Unlike existing MAS test-time scaling and orchestrator training frameworks that rely on costly sub-agent rollouts, OrchRM operates directly at the orchestration level, enabling efficient and high-performing reward-guided orchestrator training and MAS test-time scaling. OrchRM improves training efficiency by up to 10x in token usage while improving MAS test-time scaling performance by up to 8% in accuracy. These gains consistently transfer across multiple domains, including mathematical reasoning, web-based question answering, and multi-hop reasoning, demonstrating orchestration-level reward modeling as a scalable direction for robust multi-agent orchestration. Code will be available at https://github.com/Wang-ML-Lab/OrchRM.

18.
bioRxiv (Bioinfo) 2026-06-16

Orion: Towards Lab Automation with Computer-Using Agents

Laboratory discovery increasingly depends on computational workflows that connect experimental data to analysis, interpretation and follow-up hypotheses. Yet these workflows remain constrained by labor-intensive use of specialized software, visual inspection through graphical user interfaces, and integration of knowledge across multiple sources. Here, we present Orion, a computer-using AI agent for biomedical image analysis and interpretation that moves towards lab automation by automating this computational layer of laboratory work. Orion combines large language models with terminal execution, GUI control and adaptive multi-step reasoning in a shared computing environment. It can inspect visual data, operate standard scientific software, mine web resources and conduct end-to-end analysis and interpretation workflows without requiring bespoke software integrations. Across benchmarks, Orion achieved over 90% accuracy on biomedical database and literature retrieval tasks, learned to use the popular tools CellProfiler and QuPath for quantitative analysis of cellular and tissue images, respectively, and facilitated autonomous discovery in experimental imaging data. In 100 hours of autonomous exploration of a large-scale perturbation imaging dataset, Orion generated 52 research reports, of which human scientist review prioritized 22 plausible mechanistic hypotheses. These results show that computer-using AI agents can substantially expand the reach of laboratory automation, providing a scalable and auditable route from experimental imaging data to quantitative analysis, reports and biologically grounded hypotheses.

19.
PLOS Medicine 2026-05-20

Associations between hematologic dynamics during pregnancy and obstetric complications: A retrospective observational study

by Veronica Tozzo, Rachel Petherbridge, Kaitlyn James, Sarah Hsu, Deepti Pant, Chloe Michalopoulos, Brody H. Foy, Tanayott Thaweethai, Christopher Mow, Jacqueline Maya, Carolina Batlle Camero, Lydia Shook, Kathryn J. Gray, Logan Mauney, John M. Higgins, Camille E. Powe Background Pregnancy alters hematologic state as measured by complete blood count (CBC), but the longitudinal changes in CBC indices that define healthy pregnancies are not well established. In a large cohort based at an academic health system in the United States, we aimed to define reference intervals and typical longitudinal changes in CBC indices during pregnancy. We then tested for associations between extreme CBC values for gestational age or extreme longitudinal changes in CBC indices and obstetric complications. Methods and findings We studied nine CBC indices in individuals with singleton pregnancies who delivered after 30 weeks’ gestation and presented for prenatal care prior to 20 weeks. The electronic health record (EHR)-based Maternal Health Cohort (Massachusetts General Hospital; 1998–2016) formed our discovery cohort of 45,992 pregnancies, 18% of which had relevant complications. We developed a validation cohort of 48,868, 27% with complications from EHR data in the Mass General Brigham healthcare system from 2016 to 2024. In pregnancies without complications in the discovery cohort, we derived gestational-age-specific reference intervals (2.5th–97.5th percentile) and established typical intra-pregnancy longitudinal changes. In the validation cohort, we then tested CBC values outside of the 26–29 weeks’ gestation reference interval and CBC rare changes (uncommon changes in magnitude and direction) between 7–14 and 26–29 weeks’ gestation for association with a composite outcome (hypertensive disorders of pregnancy, small for gestational age birthweight, preterm birth) and its individual components using generalized estimating equations. Derived reference intervals differed from those in the literature for mean red cell volume, mean red cell hemoglobin, red cell count, and mean red cell hemoglobin concentration; reference intervals for other indices were similar to those previously published. In validation, hematocrit, hemoglobin, and red cell count values above their gestational-age specific reference intervals were associated with increased risk of the composite obstetric outcome: odds ratios (ORs) of 1.4 (95% CI [1.2, 1.5] p 

20.
bioRxiv (Bioinfo) 2026-06-18

Accounting for allelic diversity and multicopy gene detection improves the accuracy of antibiotic resistance genotypic determination

Background Genomic prediction of antimicrobial resistance (AMR) relies on the accurate detection of resistance genes or allelic variants of core genes from raw or assembled genomes sequences. For several bacterial species and antibiotics, AMR genotype-phenotype discrepancies are common, indicating that important sources of error remain unresolved. For Enterococcus faecium, we focused on identifying the sources of discrepancies for tetracycline resistance, for which genotypic detection had shown particularly low accuracy. We investigated the effect of structural variation in antibiotic resistance genes (ARGs), including gene duplications, truncations, interruptions, and mixed configurations of complete and partial gene copies, as a source of genotype-phenotype discrepancies from short-read data. We conduct further extended investigations to other antibiotic families and into another bacterial species: Escherichia coli. Methods We analyzed collections of E. faecium and E. coli genomes, integrating high-quality complete assemblies, simulated Illumina short reads, and matched AMR phenotypic data. The integrity, copy number, and allelic diversity of ARGs were examined for multiple antibiotic classes, and their impact on ARG detection and accuracy of AMR determination was assessed using several commonly used bioinformatic tools (SRST2, ARIBA and AMRFinderPlus). Results For E. faecium, after ruling out the effect of specific tet allelic variants on tetracycline susceptibility, we found that the integrity and copy number of tet(M) had a major effect on detection accuracy. Duplicated and incomplete ARGs are also common in E. faecium genomes, particularly for macrolides (erm(B)) and aminoglycosides (ant(6)-Ia and aph(3')-IIIa). In E. coli, similar patterns were observed for tet(A), erm(B) and aminoglycoside-associated genes (aph(3')-IIIa and ant(6)-Ia). Across ARGs in both species, short-read mapping methods wrongly reported interrupted genes as complete in some instances, while assembly-based methods often failed to resolve complete copies of duplicated genes. Detection accuracy improved when tools were adapted to account for gene integrity and when extended AMR databases incorporating species-specific alleles were included. Conclusions Our findings reveal that bioinformatic limitations in dealing with ARG copy number and completeness, and in accounting for allelic variation, underly a substantial source of genotype-phenotype errors, highlighting the need for improved AMR databases and bioinformatic tools that consider these factors to achieve reliable genomic prediction of AMR.

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

LESS Is More: Mutual-Stability Sampling for Diffusion Language Models

Diffusion large language models (dLLMs) offer a promising alternative to autoregressive decoding by iteratively refining masked sequences, enabling parallel token updates and bidirectional conditioning. Their practical efficiency, however, is limited by sampling procedures that execute a fixed number of reverse denoising steps selected before decoding, spending computation on already-stable positions and sometimes committing unstable ones too early. We present \textsc{LESS}, a training-free, model-agnostic adaptive sampler that treats token commitment as an online stopping problem. \textsc{LESS} implements mutual-stability sampling through a joint stability rule that makes a masked position eligible for unmasking only when its top-1 prediction has high confidence, its top-1 token persists across recent reverse steps, and its predictive distribution is stable under top-$K$ inter-step Jensen–Shannon divergence. We evaluate \textsc{LESS} on Dream-7B, LLaDA-8B, and LLaDA-1.5-8B, covering full-sequence diffusion and semi-autoregressive blockwise sampling regimes, across seven benchmarks spanning general knowledge, math, and code. \textsc{LESS} improves average accuracy over strong training-free adaptive samplers while using $72.1\%$ fewer reverse steps than fixed-budget decoding. Since each reverse step requires a Transformer forward pass, these step-count reductions translate into fewer forward evaluations, lower measured wall-clock latency, and lower estimated inference compute.

22.
arXiv (CS.CL) 2026-06-19

MedRLM: Recursive Multimodal Health Intelligence for Long-Context Clinical Reasoning, Sensor-Guided Screening, Evidence-Grounded Decision Support, and Community-to-Tertiary Referral Optimization

Real-world clinical decision support requires reasoning over heterogeneous and longitudinal patient information rather than answering isolated medical questions. However, current medical large language models and retrieval-augmented generation systems often rely on single-step prompting or retrieval, which can be fragile when clinical evidence is distributed across long electronic health records, medical images, sensor streams, guidelines, and referral constraints. This paper proposes MedRLM, a Recursive Multimodal Health Intelligence framework for long-context clinical reasoning, sensor-guided screening, and community-to-tertiary referral support. Instead of compressing all patient information into one prompt, MedRLM treats the patient case as an external clinical environment that can be recursively inspected, decomposed, retrieved, verified, and synthesized. The framework coordinates specialized agents for clinical text, longitudinal EHR, medical imaging, physiological sensor signals, guideline retrieval, uncertainty auditing, and referral planning. It further introduces a Clinical Evidence Graph Memory to connect patient-specific observations with retrieved evidence, standardized definitions, sensor-derived biomarkers, and referral criteria. A sensor-guided recursive triggering mechanism activates deeper reasoning when abnormal physiological or behavioral patterns are detected, while uncertainty-gated refinement supports clinician review for high-risk or low-confidence cases. We also outline a real-data evaluation design using public and credentialed clinical datasets spanning EHR, radiology, ECG, ICU time series, and referral-proxy outcomes. MedRLM aims to move medical AI from static question answering toward auditable, multimodal, and workflow-aware clinical decision support.

23.
arXiv (CS.AI) 2026-06-19

Bistable by Construction: Wall-Clock-Calibrated State Monitors Have No Moment-Detection Regime at Agent Cadence

arXiv:2606.19386v1 Announce Type: cross Abstract: Runtime monitors for autonomous agents commonly threshold an accumulated internal state - a behavioural baseline, a drift statistic, or, in our prior work, a modelled affective state. We previously reported a State Saturation Trap: threshold-on-state triggers over a continuous affect engine become near-constant alarms on SWE-bench debugging agents (Modgil 2026). A post-release audit found the engine received dt=0 between actions, so its exponential decay never operated: the published trap is a pure-accumulator result. We correct the record (erratum, v2) and treat the flaw as an experiment. The key variable it exposes is whether a monitor's dynamics are calibrated in sample time (per observation, as in CUSUM) or wall-clock time (half-lives in seconds, as in affect models and EMA baselines). On fixed-rate streams these coincide; on agent streams, where inter-action time varies by orders of magnitude, they do not. A pre-registered sweep over uniform intervals (dt in {0..600}s) on 20 trajectories shows the wall-clock level trigger has two regimes: at dt=60s silent. Every critical dt lies in (1,30]s. Real agent runs measure latency at median 1.53s (p90 2.33s); real coding cadence sits inside the trap regime, vindicating the empirical finding under a corrected mechanism. The structure is a property of the calibration class, not the engine: a minimal wall-clock accumulator over the raw error stream reproduces the same cliff, while a sample-time CUSUM over the identical stream is exactly dt-invariant (20/20). A rising-edge trigger with hysteresis fires 0-3 times per trajectory in every condition. We conclude that wall-clock-calibrated leaky-integrator monitors admit no regime in which they act as moment detectors on agent streams; transition detection escapes the trap at every cadence, but does not recover human intervention timing.

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

Adversarial Concept Search: Predicting Compositional Errors From Feature Geometry

arXiv:2606.13934v1 Announce Type: new Abstract: Humans cannot always intuit what scenarios are most challenging to LLMs. Hoping to capture challenging edge cases, developers either design problems to be difficult for humans or curate extensive benchmarks. What if we could instead anticipate which scenarios a model will fail on? In this paper, we use an LLM's representational geometry to predict which concept combinations it will fail on. We attribute this compositional failure to interference between salient features. In tasks that require systematic composition - toy programmatic settings, multihop reasoning, multilingual factual recall - we find that when a pair of concepts is encoded near-orthogonally, the model reliably composes them. When their linear encodings are close, producing interference, the model fails to compose them. Our method reliably anticipates failure modes across different compositional tasks, without evaluating specific inputs. These results lay the groundwork to use representational geometry to identify high-risk examples, construct targeted stress tests, and provide a scalable foundation for active learning in real-world deployment.

25.
arXiv (CS.CL) 2026-06-15

Decoupled Mixture-of-Experts for Parametric Knowledge Injection

Knowledge injection aims to equip large language models (LLMs) with external, domain-specific, or time-sensitive knowledge. Existing approaches typically face a trade-off between flexibility and integration: retrieval-augmented generation keeps knowledge outside the model but only provides prompt-level augmentation, whereas post-training based methods encode new knowledge into shared parameters but may introduce catastrophic forgetting, knowledge conflict, and costly updates. In this paper, we propose Decoupled Mixture-of-Experts (DMoE), a modular architecture for parametric knowledge injection that decouples both experts and the router from the base model. DMoE converts external knowledge corpora into independently updatable expert modules and uses a lightweight uncertainty-aware router to activate relevant experts only when the base model lacks sufficient knowledge during generation. To support efficient auto-regressive inference, DMoE attaches experts only to the final-layer feed-forward network, preserving KV-cache reuse while enabling parameter-level knowledge augmentation. Experiments on knowledge-intensive benchmarks show that DMoE consistently improves answer quality over retrieval and adapter-based baselines.