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

Pitch Spelling Jazz Lead Sheets, Solo Transcriptions, Classical Piano and Monophonic Scores

We present an algorithm for pitch spelling and key estimation. Given an input in MIDI-like format, containing information on note pitches (expressed in semitones relative to the lowest reference note) and bar boundaries, it estimates the appropriate note names, a global Key Signature, and a local scale for each bar. This related information elements are evaluated jointly during two stages of optimisation. During an initial 'modal' stage, a probable scale is proposed for each bar, minimising the number of accidentals to be printed in the printed score with a shortest-path search. Then, during a second stage called 'tonal', these local scales are used to estimate the Key Signature and note names that would result in the best musical notation for the entire piece. We present evaluations conducted on datasets comprising a variety of digital musical scores: jazz lead sheets taken from the Real Book, transcriptions of recordings of jazz soli and bass lines, traditional tunes, as well as classical scores for piano and monophonic instruments. Our procedure was originally designed for use in music transcription, specifically for building digital collections of jazz solos transcribed from audio recordings, for the purposes of music analysis, teaching and the preservation of cultural heritage. This method should also prove useful for other tasks related to the processing of musical notation. Furthermore, to this end, we have defined new distances between various common jazz scales, which may be of some interest to musicological studies.

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

The Latent Color Subspace: Emergent Order in High-Dimensional Chaos

Text-to-image generation models have advanced rapidly, yet achieving fine-grained control over generated images remains difficult, largely due to limited understanding of how semantic information is encoded. We develop an interpretation of the color representation in the Variational Autoencoder latent space of FLUX.1 [Dev], revealing a structure reflecting Hue, Saturation, and Lightness. We verify our Latent Color Subspace (LCS) interpretation by demonstrating that it can both predict and explicitly control color, introducing a fully training-free method in FLUX based solely on closed-form latent-space manipulation. Code is available at https://github.com/ExplainableML/LCS.

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

MedSynth: Realistic, Synthetic Medical Dialogue-Note Pairs

Physicians spend significant time documenting clinical encounters, a burden that contributes to professional burnout. To address this, robust automation tools for medical documentation are crucial. We introduce MedSynth – a novel dataset of synthetic medical dialogues and notes designed to advance the Dialogue-to-Note (Dial-2-Note) and Note-to-Dialogue (Note-2-Dial) tasks. Informed by an extensive analysis of disease distributions, this dataset includes over 10,000 dialogue-note pairs covering over 2000 ICD-10 codes. We demonstrate that our dataset markedly enhances the performance of models in generating medical notes from dialogues, and dialogues from medical notes. The dataset provides a valuable resource in a field where open-access, privacy-compliant, and diverse training data are scarce. Code is available at https://github.com/ahmadrezarm/MedSynth/tree/main and the dataset is available at https://huggingface.co/datasets/Ahmad0067/MedSynth.

04.
arXiv (CS.AI) 2026-06-11

Federated continual learning: A comprehensive survey on lifelong and privacy-preserving learning over distributed and non-stationary data

arXiv:2606.11272v1 Announce Type: cross Abstract: Federated Learning (FL) enables collaborative and privacy-preserving model training across distributed clients, but most existing FL systems implicitly assume data stationarity. In real-world settings-such as healthcare, industrial IoT (IIOT), cybersecurity, and smart cities-data streams are inherently non-stationary, leading classical FL methods to suffer from performance degradation, instability, and catastrophic forgetting. Continual Learning (CL) addresses learning under evolving data distributions but has been largely studied in centralized settings, overlooking key constraints of federated systems, including privacy, limited communication, and client heterogeneity. Federated Continual Learning (FCL) emerges at the intersection of FL and CL, aiming to support lifelong, adaptive, and privacy-aware learning over distributed and non-stationary data. This survey provides a comprehensive and systematic overview of FCL. We first present a formal definition of the FCL problem and clarify its distinctive characteristics. We then analyze the limitations of classical FL under non-stationary conditions, highlighting how CL principles support long-term adaptation. To organize the rapidly growing literature, we propose a multi-dimensional taxonomy of FCL approaches. Furthermore, we review representative application domains and data modalities, summarize commonly used evaluation metrics, and discuss experimental perspectives for assessing long-term performance and forgetting. Finally, we highlight key open challenges, including handling extreme heterogeneity under temporal drift, designing scalable and privacy-preserving memory mechanisms, and establishing standardized benchmarks. This survey aims to serve as a reference and a roadmap for advancing FCL toward robust and deployable real-world systems.

05.
arXiv (CS.AI) 2026-06-16

A Causal Model of Theory of Mind in Conflict for Artificial Intelligence

arXiv:2606.16944v1 Announce Type: new Abstract: Theory of mind (ToM), the capacity to ascribe mental states to others and use those ascriptions for prediction and inference, is widely assumed to be essential for effective human-machine integration. Existing AI-ToM models address how to mentalize, but leave the question of when largely unaddressed. The central question is: under what situational and agent-level conditions is ToM engagement causally warranted in conflict? This paper presents a structural causal model formalized as a directed acyclic graph (DAG), treating ToM as a mechanism activated by situational and agent-level conditions rather than as an always-on capacity. The model specifies four exogenous variables capturing situational and agent-level conditions, five endogenous mediators, and a mechanistic ToM node producing engagement states through three distinct causal pathways: a tractability pathway, a reasoning-depth pathway, and an enabling-cause pathway. The primary outcome is epistemic accuracy, which decouples social reasoning from behavioral policy and generalizes across social phenomena beyond conflict. The framework gives AI systems a principled, resource-rational decision procedure for mentalizing, with implications for efficiency, trust, and the development of robust artificial social intelligence. Simulation validation, empirical human-machine teaming studies, and ethical considerations arising from conflict-optimized mentalizing are discussed.

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

MEMPROBE: Probing Long-Term Agent Memory via Hidden User-State Recovery

Long-term memory promises LLM agents that grow more capable across sessions, maintaining an accurate, evolving understanding of the user that interaction forms. In practice, however, this memory is evaluated mostly through downstream behavior, such as later answers, personalization quality, or task success, which tests that understanding only indirectly and leaves the memory artifact itself largely unaudited. We argue that long-term memory should instead be evaluated as an auditable post-interaction artifact: after ordinary assistance, what structured user state can be reconstructed from the memory the agent leaves behind? We instantiate this view in MEMPROBE, a benchmark in which a memory-equipped agent assists simulated users, each carrying a hidden, taxonomy-anchored user-state bank, across a trajectory of leak-controlled tasks, after which that bank is reconstructed from the agent's resulting memory under both full-store and top-k access. Built on synthetic ground truth for efficient, scalable measurement, MEMPROBE spans 50 simulated users with 31 hidden dimensions each (1,550 recovery targets) and tests 5 representative memory systems. Testing state-of-the-art memory agents, we find that successful assistance and recoverable memory behave as distinct capabilities. Task completion nearly saturates, even for a memoryless baseline, while category-balanced recovery stays moderate (about 0.6) and drops further under top-k retrieval. MEMPROBE is the first benchmark to study memory recovery directly, reconstructing the user state a system retains and scoring it against ground truth. We see recovery as a concrete objective for future memory agents to optimize, and MEMPROBE as a step toward an environment where agents are trained to remember their users, growing more faithful the longer they know them.

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

Appearance-Invariant Detection of Suggestive Motion via Laban Movement Descriptors

Content moderation in online multiplayer 3D virtual environments is increasingly automated, yet detection has focused on images, video, and audio, leaving suggestive motion a blind spot. We present a motion-only classification pipeline that detects suggestive and explicit movement from SMPL skeleton trajectories using Laban Movement Analysis (LMA) descriptors. On a dataset spanning everyday, artistic, suggestive, and explicit movement (17+ hours of video), a logistic regression trained on 61-feature LMA descriptors reaches 68% binary SFW/NSFW accuracy (70% random forest) under a leak-free evaluation protocol. At this level, our descriptor performs comparably to a learned video model trained on the same motion re-rendered as appearance-free video, a gray figure with no clothing, skin, or scene. The indirectness (tortuosity) of each joint's trajectory, measured as the ratio of the joint's path length to its net displacement, peaks at the suggestive tier, showing that the Direct-to-Indirect polarity of Laban's Space factor provides an interpretable marker of the shift from functional to suggestive motion. Ultimately, Laban-based kinematic descriptors offer a lightweight, interpretable approach to suggestive-motion detection: every decision decomposes into named, theory-grounded features. Because the classifier operates on pose trajectories alone, moderation can run directly on avatar poses in virtual environments, with no appearance data.

08.
PLOS Computational Biology 2026-06-09

Multi-stable oscillations in cortical networks with two classes of inhibition

by Arnab Dey Sarkar, Bard Ermentrout In the classical view of cortical rhythms, interactions between excitatory pyramidal neurons (E) and inhibitory parvalbumin-expressing interneurons (I) are sufficient to generate gamma- and beta-band oscillations. However, it is now well established that multiple inhibitory interneuron subtypes exist and that they play important roles in the generation and modulation of these rhythms. In this paper, we develop a spiking network model consisting of populations of E, I, and an additional interneuron type, somatostatin-expressing neurons (S), which receive excitation from the E cells and inhibit both the E and I populations. The S cells are further modulated by a third inhibitory subtype, vasoactive intestinal peptide (VIP) neurons, which receive inputs from other cortical areas. We reduce the spiking network to a system of nine differential equations that describe the mean membrane potential, firing rate, and synaptic conductance for each population. Using this reduced model, we identify a wide range of parameters that exhibit multiple coexisting rhythms. Employing tools from nonlinear dynamics, we then explore the roles of the two classes of inhibition, as well as VIP modulation, in shaping the properties of these rhythms.

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

Moebius: 0.2B Lightweight Image Inpainting Framework with 10B-Level Performance

While 10B-level industrial foundation models have pushed the boundaries of image inpainting, their prohibitive computational costs severely hinder practical deployment. Constructing a highly optimized task-specific specialist offers a promising solution; however, extreme structural compression inevitably triggers a severe representation bottleneck. To conquer this, we propose Moebius, a highly efficient lightweight inpainting framework. We systematically reconstruct the diffusion backbone by introducing the Local-$\lambda$ Mix Interaction ($L\lambda MI$) block. Comprising Local-$\lambda$ and Interactive-$\lambda$ modules, it elegantly summarizes spatial contexts and global semantic priors into fixed-size linear matrices, preserving complex latent interactions while drastically shedding parameters. Furthermore, to unlock the full representational capacity of this highly compact architecture, we synergistically pair it with an adaptive multi-granularity distillation strategy. Operating strictly within the latent space to avoid expensive pixel-space decoding, this strategy dynamically balances multiple gradient-based losses to achieve high-fidelity alignment. Extensive experiments across natural and portrait benchmarks demonstrate that this optimal synergy enables Moebius to rival or even surpass the generation quality of the 10B-level industrial generalist FLUX.1-Fill-Dev. Remarkably, Moebius achieves this using less than 2\% of the parameters (0.22B vs. 11.9B) while delivering a $>15\times$ acceleration in total inference time, setting a new efficiency standard for high-fidelity inpainting. Project page at https://hustvl.github.io/Moebius.

10.
arXiv (CS.CV) 2026-06-17

Learning QoE from Packet-Level Measurements in Encrypted Video Conferencing Traffic

The quality of the user experience has become one of the most important aspects in todays world, as it directly influences individuals willingness to continue using or abandon a product or service. In this context, video conferencing applications (VCAs), which experienced widespread adoption following the COVID-19 pandemic, must deliver excellent performance to remain competitive in an increasingly crowded market. Although content providers (CPs) such as Zoom, WhatsApp, Telegram, and Google Meet can assess conversation quality by comparing transmitted and received data. The widespread use of end-to-end encryption in VCAs makes quality-of-experience (QoE) evaluation by internet service providers (ISPs) far more challenging. Since ISPs do not have access to the encrypted content, they must rely on passive measurements of unencrypted traffic characteristics on the data path. In this work, we present a simple yet effective QoE prediction framework based on an almost stock convolutional neural network (CNN) architecture that uses only the packet sizes extracted from the communication between two participants in a video conferencing (VC) call to predict two QoE metrics: BRISQUE and MOS. The proposed framework is simple, easy to implement, and does not require high-end computational resources, yet it provides superior prediction performance, as shown in our experiments on two custom datasets collected from WhatsApp and Zoom, which achieve substantial improvements over previous models for the QoE prediction task.

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

SEAL: Searching Expandable Architectures for Incremental Learning

arXiv:2505.10457v3 Announce Type: replace-cross Abstract: Incremental learning is a machine learning paradigm where a model learns from a sequential stream of tasks. This setting poses a key challenge: balancing plasticity (learning new tasks) and stability (preserving past knowledge). Neural Architecture Search (NAS), a branch of AutoML, automates the design of the architecture of Deep Neural Networks and has shown success in static settings. However, existing NAS-based approaches to incremental learning often rely on expanding the model at every task, making them impractical in resource-constrained environments. In this work, we introduce SEAL, a NAS-based framework tailored for data-incremental learning, a scenario where disjoint data samples arrive sequentially and are not stored for future access. SEAL adapts the model structure dynamically by expanding it only when necessary, based on a capacity estimation metric. Stability is preserved through cross-distillation training after each expansion step. The NAS component jointly searches for both the architecture and the optimal expansion policy. Experiments across multiple benchmarks demonstrate that SEAL effectively reduces forgetting and enhances accuracy while allocating additional capacity only when required. These results highlight the promise of combining NAS and selective expansion for efficient, adaptive learning in incremental scenarios.

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

A Learning Method with Gap-Aware Generation for Heterogeneous DAG Scheduling

arXiv:2603.23249v2 Announce Type: replace-cross Abstract: Efficient scheduling of directed acyclic graphs (DAGs) is a core problem in large-scale data-intensive computing systems, where query plans, data-processing workloads, and computation graphs consist of dependent tasks competing for limited heterogeneous resource pools. In practice, achieving high-performance execution requires schedulers to adapt across environments with varying resource pools and task types, while generating schedules under tight runtime budgets. We propose WeCAN, an end-to-end reinforcement learning framework for heterogeneous DAG scheduling that addresses task-pool compatibility coefficients and generation-induced optimality gaps. It adopts a two-stage single-pass design: a single forward pass produces task-pool scores and global parameters, followed by a generation map that constructs schedules without repeated network calls. Its weighted cross-attention encoder models task-pool interactions gated by compatibility coefficients, and is size-agnostic to environment fluctuations. Moreover, widely used list-scheduling maps can incur generation-induced optimality gaps from restricted reachability. We introduce an order-space analysis that characterizes the reachable set of generation maps via feasible schedule orders, explains the mechanism behind generation-induced gaps, and yields sufficient conditions for gap elimination. Guided by these conditions, we design a skip-extended realization with an analytically parameterized decreasing skip rule, which enlarges the reachable order set while preserving single-pass efficiency. Experiments on real-world TPC-H query DAGs, resource-intensive workload datasets, and ML-compiler computation graphs demonstrate improved makespan over strong baselines, with inference time comparable to classical heuristics and faster than multi-round neural schedulers.

13.
arXiv (CS.AI) 2026-06-24

VeryTrace: Verifying Reasoning Traces through Compilable Formalism and Structured Verification

arXiv:2606.24124v1 Announce Type: new Abstract: Multi-step reasoning with Chain-of-Thought (CoT) prompting remains fragile: logical errors or hallucinations in early steps silently propagate, producing confident but incorrect conclusions. This paper presents VeryTrace, a zero-shot verification-and-repair framework that formalizes natural-language reasoning traces into a structured, compilable representation. VeryTrace introduces a Domain-Specific Language (DSL) that (i) makes step dependencies explicit, (ii) mechanizes quantitative content as executable expressions, and (iii) structures semantic inferences via deduction schemas. Our hybrid verifier combines deterministic checks for computational correctness, dependency resolution, and constraint satisfaction with targeted LLM audits for non-mechanizable semantic judgments, enabling step-level error localization and repair. Across three diverse domains-competition mathematics (AIME 2025), robotics planning (LLM-BabyBench), and kinship reasoning (CLUTRR), VeryTrace improves accuracy over zero-shot baselines on state-of-the-art LLMs without requiring domain-specific training or in-context examples, demonstrating that formalized trace verification achieves both precision and generalization.

14.
arXiv (CS.AI) 2026-06-24

Invariant Graph Representations for Continuous-Time Dynamic Graphs Under Distribution Shifts

arXiv:2405.19062v2 Announce Type: replace-cross Abstract: Continuous-Time Dynamic Graphs (CTDGs) enable fine-grained modeling of evolving relational systems. However, most existing CTDG representation learning methods are tailored to in-distribution settings and exhibit limited robustness under out-of-distribution (OOD) shifts. Although recent causal approaches learn invariant representations via interventions, they are primarily designed for static or discrete-time graphs and become computationally prohibitive for CTDGs due to the combinatorial explosion of structural and temporal variations. To address these challenges, we propose CIR, a framework grounded in a novel structural causal model termed the ICCM. To avoid exhaustive interventions, we leverage the Normalized Weighted Geometric Mean (NWGM) to efficiently approximate interventional predictions. We further instantiate ICCM within a practical deep learning architecture that jointly captures invariant structural and temporal patterns through dedicated subgraph extractors, and maintains an environment memory bank to model distributional shifts across evolving contexts. Extensive experiments demonstrate that CIR consistently outperforms existing methods under diverse OOD scenarios.

15.
medRxiv (Medicine) 2026-06-16

Fidelity-Derived Quantum Dissimilarity-Enhanced k-Nearest Neighbor Algorithm for Arterial Hypertension Prediction

We present a quantum-enhanced version of the classic k-Nearest Neighbors (kNN) classification algorithm, applied to the prediction of arterial hypertension. The traditional Euclidean distance metric of the kNN algorithm is replaced with a Fidelity-derived quantum dissimilarity measure to evaluate the similarity between data samples. We map classical real-world clinical and ECG-derived data features into quantum states via the Dense-Angle Encoding, which efficiently utilizes parameterized rotation gates to pack multiple features into minimal qubits while maintaining pure states. We evaluate the performance of the dissimilarity measure using both the noiseless state vector Simulator and the IBM Qiskit Estimator primitives. The quantum circuit demonstrates robust predictive capabilities comparable to the classical model. While it does not claim computational supremacy over the classical baseline, the framework proves that fidelity-based similarity is a physically meaningful and efficient approach for hybrid quantum classical classification.

16.
arXiv (CS.CL) 2026-06-24

What's Missing in Vision-Language Models? Probing Their Struggles with Causal Order Reasoning

Despite the impressive performance of vision-language models (VLMs) on downstream tasks, their ability to understand and reason about causal relationships in visual inputs remains unclear. Robust causal reasoning is fundamental to solving complex high-level reasoning tasks, yet existing benchmarks often include a mixture of reasoning questions, and VLMs can frequently exploit object recognition and activity identification as shortcuts to arrive at the correct answers, making it challenging to truly assess their causal reasoning abilities. To bridge this gap, we introduce VQA-Causal and VCR-Causal, two new benchmarks specifically designed to isolate and rigorously evaluate VLMs' causal reasoning abilities. Our findings reveal that while VLMs excel in object and activity recognition, they perform poorly on causal reasoning tasks, often only marginally surpassing random guessing. Further analysis suggests that this limitation stems from a severe lack of causal expressions in widely used training datasets, where causal relationships are rarely explicitly conveyed. We additionally explore fine-tuning strategies with hard negative cases, showing that targeted fine-tuning can improve model's causal reasoning while maintaining generalization and downstream performance. Our study highlights a key gap in current VLMs and lays the groundwork for future work on causal understanding.

17.
arXiv (CS.LG) 2026-06-16

Not all Jensen-Shannon Divergence Estimators are Equal

arXiv:2606.16411v1 Announce Type: new Abstract: The Jensen-Shannon divergence is widely reported as a scalar measure of fidelity for synthetic tabular data. Yet, in practice, it is estimated from finite samples using protocols that are often underspecified. This creates a measurement problem. Although the population divergence is well defined, the empirical value depends on the estimator family, sampling protocol, calibration, dimensionality, and class balance. We show that different protocols can yield non-comparable values: marginal-based estimators ignore dependencies in the joint distribution and can severely underestimate divergence, while classifier-based estimators capture joint structure but exhibit strong estimator dependence. We systematically study this behavior across controlled settings with reference divergences and real-world synthetic tabular benchmarks. Our analysis reveals dependence blindness in marginal estimators, prior-shift bias under class imbalance, and estimator sensitivity in high dimensions. To address prior shift, we derive a closed-form posterior correction for classifier-based Jensen-Shannon estimation. Our results show that empirical Jensen-Shannon divergence values are inherently protocol-dependent, making explicit specification of the estimation procedure necessary for meaningful comparison. We provide practical guidelines and an open-source tool for estimator-aware Jensen-Shannon evaluation.

18.
arXiv (quant-ph) 2026-06-16

Synthesizing Arbitrary Non-Hermitian Hamiltonian with Stochastic Floquet Engineering

arXiv:2606.15664v1 Announce Type: new Abstract: The conventional Floquet engineering scheme synthesizes a given target Hamiltonian with a deterministic temporal periodic driving field. In this work, we introduce the stochastic Floquet engineering scheme that can synthesize an arbitrary non-Hermitian target Hamiltonian using a time-periodic driving field with noisy amplitude. Our method is rooted in the Hermitian dynamics taking noise as a valuable quantum resource with no need for loss or gain in prior. We apply our method to engineer a cavity Hamiltonian with dissipative coupling between Fock states, and to prepare a given quantum state from a generally arbitrary quantum state. The stochastic Floqut engineering also provides a way to generate non-unitary quantum gates, which take advantage in certain tasks compared to unitary quantum computing, without the need for ancillae or state-dependent updating.

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

EchoFoley: Event-Centric Hierarchical Control for Video Grounded Creative Sound Generation

Sound effects build an essential layer of multimodal storytelling, shaping the emotional atmosphere and the narrative semantics of videos. Despite recent advancement in video-text-to-audio (VT2A), the current formulation faces three key limitations: First, an imbalance between visual and textual conditioning that leads to visual dominance; Second, the absence of a concrete definition for fine-grained controllable generation; Third, weak instruction understanding and following, as existing datasets rely on brief categorical tags. To address these limitations, we introduce EchoFoley, a new task designed for video-grounded sound generation with both event level local control and hierarchical semantic control. Our symbolic representation for sounding events specifies when, what, and how each sound is produced within a video or instruction, enabling fine-grained controls like sound generation, insertion, and editing. To support this task, we construct EchoFoley-6k, a large-scale, expert-curated benchmark containing over 6,000 video-instruction-annotation triplets. Building upon this foundation, we propose EchoVidia a sounding-event-centric agentic generation framework with slow-fast thinking strategy. Experiments show that EchoVidia surpasses recent VT2A models by 40.7% in controllability and 12.5% in perceptual quality.

20.
arXiv (CS.CV) 2026-06-12

GetNetUPAM: Ecologically Informed Nested Cross-Validation and Noise-Robust Attention for Marine Bioacoustic Monitoring

Deploying reliable bioacoustic monitoring systems requires models that generalize under high-noise, low-SNR conditions and evaluation protocols that expose deployment-relevant failure modes, gaps largely unaddressed in current UPAM practice. Intrinsic noise, variable propagation, and mixed biological and anthropogenic sources induce distribution shifts that conventional models and single-split evaluations obscure, inflating performance and masking instability. We introduce GetNetUPAM, a hierarchical nested cross-validation framework that uses the nested stage to quantify model stability rather than tune for inflated hold-out scores. By partitioning data into site-year blocks, GetNetUPAM preserves ecological heterogeneity and forces each outer fold to represent a distinct environmental regime, preventing overfitting to localized noise or sensor artifacts. Inner stratified folds measure generalization across the full UPAM signal distribution, enforcing strict separation between model development and the outer held-out deployment condition. Using GetNetUPAM, we evaluate the Adaptive Resolution Pooling and Attention Network (ARPA-N), a CNN architecture for irregular spectrogram dimensions. ARPA-N integrates CBAM spatial attention as a learned noise suppressor, producing attention maps that localize true call structure and avoid the global, non-biological cues exploited by standard CNNs on long-window data. Under GetNetUPAM, ARPA-N generalizes robustly across diverse environmental regimes. In the zero-training support Balleny Islands region, it reduces false positives per hour by over an order of magnitude (approximately 10x) at fixed 90 percent recall, yielding consistently improved metrics across folds. These advances provide a reproducible benchmark and move UPAM toward scalable, deployment-reliable ecological monitoring.

21.
medRxiv (Medicine) 2026-06-15

Recruitment, Retention Approaches and Community Engagement in the THRIVE pilot Trial: Lessons Learned from a Food is Medicine Trial

Background: Recruitment of underrepresented populations, including Black and Hispanic populations, for Food is Medicine (FIM) and cardiovascular trials, may pose significant challenges. Methods: We implemented a multi-component recruitment approach for the THRIVE (AdapTive personalized dietitian coacHing and messaging with pRoduce prescrIptions to improVE healthy dietary behaviors) pilot trial to engage primarily Black and Hispanic adults in a Food is Medicine for hypertension intervention. The recruitment approaches included community engagement at approximately 40 community events (cultural festivals and neighborhood gatherings); partnerships with 8 community and faith-based service hubs and food distribution sites; recruitment through safety net primary care clinics, digital outreach via the study website, and social media campaigns; and direct recruitment at places of worship. We report lessons learned from the community engagement process, recruitment efficiency, representativeness, and retention outcomes. Results: Within 6 months, the enrollment target was exceeded by 40%, with an accrual index of 1.04. Over 1,000 individuals were reached through the direct-to-community engagement process, while faith-based partnerships engaged about 900 adults. There were 2,673 visits to the study webpage, and social media achieved 12,259 impressions with 399 clicks. About 95% of participants resided within 10 miles of the faith-based recruitment sites. Face-to-face engagement at the food distribution sites within faith-based organizations or community service hubs outperformed digital methods. Faith leader endorsements and follow-up in-person meetings (following unsuccessful email outreach) dramatically increased recruitment. Regarding retention, pre-randomization attrition was 6%, and 82% of participants completed the study. Conclusion: Culturally tailored, community-engaged recruitment grounded in faith-based and local community partnerships, was highly effective in engaging Black and Hispanic populations in this FIM cardiovascular trial. This provides a replicable model for implementing equitable and sustainable cardiovascular health interventions.

22.
medRxiv (Medicine) 2026-06-16

MRMU: A New Paradigm for Mendelian Randomization by Accounting for Measured Covariates and Unmeasured Confounders

Mendelian randomization (MR) is a powerful approach for causal inference, however, its reliability is frequently compromised by unadjusted covariates and unmeasured confounders, such as unmeasured pleiotropy and sample structure. To address these challenges, we introduce MRMU, a novel paradigm for the MR framework. Unlike traditional single-variable or multivariable MR methods, MRMU selects instrumental variables only from the exposure of interest and estimates one exposure effect at a time, while jointly accounting for measured covariates and unmeasured confounders. This design improves the reliability of MR analyses. In simulations and real data, MRMU achieved better type I error control, higher statistical power, and more accurate effect estimation than existing MR methods. Applying to coronary artery disease (CAD), MRMU identified robust cardiometabolic risk factors, including LDL-C, APOB, systolic blood pressure, body mass index, and smoking initiation, with consistent evidence across multiple CAD datasets. In contrast, traits such as HDL-C, height, and educational attainment, which were found to be significant by existing MR methods, were no longer supported by MRMU. MRMU further supported blood pressure-related traits, rather than lipid traits, as the more relevant pathway linking urate to CAD. Finally, by integrating large-scale plasma proteomics data, MRMU identified candidate CAD drug targets beyond established HMGCR- and PCSK9-related pathways, highlighting its utility for therapeutic target prioritization.

23.
arXiv (CS.AI) 2026-06-11

Skill-Augmented AI Agents for Medical Research Analysis: An Exploratory Multi-Model Human Evaluation in an NSCLC Transcriptomic Biomarker Task

arXiv:2606.11830v1 Announce Type: new Abstract: Background. Large language models and AI agents are increasingly used to support biomedical research, but native model outputs may omit key analytical steps, misuse methods, or overstate conclusions. We evaluated whether autonomous access to a medical research skill package was associated with higher-quality AI-generated transcriptomic research-analysis outputs compared with native AI without skills. Methods. We conducted an exploratory multi-model human evaluation using a non-small cell lung cancer immunotherapy biomarker task. Six model backbones were tested. The evaluation included 21 anonymized outputs: 9 native-AI outputs and 12 skill-augmented outputs generated through an AI agent implementation represented by OpenClaw. Four non-expert biomedical reviewers and two blinded experts evaluated each output, with two ratings from each reviewer type. The primary outcome was expert-rated overall quality. Results. Skill-augmented outputs showed directionally higher expert overall quality than native-AI outputs (mean 5.50 vs 5.11; difference=0.39; bootstrap 95\% CI, -0.04 to 0.90; Welch p=0.156). Non-expert reviewer quality showed the same direction (mean 4.72 vs 4.47; difference=0.26; bootstrap 95\% CI, -0.25 to 0.80; Welch p=0.373). Expert agreement was limited (single-rating ICC=-0.15), and model-specific effects were descriptive and heterogeneous. Conclusions. Autonomous skill access showed a directional quality signal in this exploratory sample, but the signal was smaller than expert-rating noise and should not be interpreted as confirmatory evidence. The findings primarily motivate larger evaluations of skill-augmented AI agents with stronger reliability controls, platform replication, and biological-validity assessment.

24.
arXiv (CS.CL) 2026-06-16

PACT: Privileged Trace Co-Training for Multi-Turn Tool-Use Agents

Multi-turn tool-use agents must reason, call tools, and adapt to observations across several interaction turns. Post-training such agents is challenging, as reinforcement learning often suffers from sparse rewards and weak credit assignment despite matching the prompt-only inference setting, while supervised fine-tuning on expert traces provides dense process supervision but can over-constrain the model to fixed trajectories. To tackle this, we propose PACT, a Privileged trAce Co-Training framework for multi-turn tool-use agents. The key idea is to use expert traces only as training-time optimization signals rather than rollout-time hints. PACT keeps rollout generation prompt-only, then uses expert traces to guide optimization through two complementary signals: a trace-conditioned RL surrogate that evaluates prompt-only rollouts under expert-trace context, and a component-aware SFT loss that supervises reasoning prefixes and tool-calls with annealed strength. To reduce over-reliance on the training-only trace context, PACT further introduces a prompt-only anchoring. We also provide a latent-trace view that connects the two trace-based objectives and explains how expert traces can guide optimization without being used during rollout generation. Experiments on FTRL, BFCL, and ToolHop show that PACT consistently improves over strong SFT- and RL-based baselines, highlighting the value of privileged trace co-training for multi-turn tool-use learning.

25.
medRxiv (Medicine) 2026-06-18

Cost analysis of overseas versus domestic vaccination of US-bound refugees

Context: To ensure healthy resettlement and protect US health security, the Vaccination Program for US-bound Refugees (VPR) offers some recommended vaccines to refugees overseas before resettlement to the United States. The selected vaccines and number of doses vary by country of departure. VPR was found to be cost-saving in 2018 but had since expanded to more sites. Objective: Assess VPR's current costs and impact on post-arrival domestic vaccination needs and costs. Setting and Participants: A model-based analysis of the Federal government costs for VPR and post-arrival (US) vaccination of resettled refugees separated across five regions: Africa, Asia, the Middle East and North Africa/Republic of Turkiye and Middle East, Europe, and the Americas using fiscal year 2024 data. Design: We quantified and compared full vaccination costs for refugees under two scenarios: (1) 'No VPR' and (2) 'VPR'. Refugees would receive no vaccines overseas and be fully vaccinated after US arrival under 'No VPR'. Under 'VPR', refugees receive one or two doses of selected vaccines overseas before completing vaccination schedules after arrival. Main Outcomes: Costs were reported in 2023 US dollars for 'VPR' and 'No VPR' scenarios and further subdivided by grouping countries/sites depending on whether the International Organization for Migration (IOM) provides vaccination services for refugees (IOM sites) versus non-IOM providers (non-IOM sites). Results: 'VPR' resulted in average net cost savings of $147 per person or $14.7 million per 100,000-refugee cohort compared to providing all vaccines after US arrival ('No VPR'). 'VPR' was cost-saving across most regions, except for IOM sites in Europe, where a net cost of $44 per person was observed. Net cost savings per person were highest for IOM sites in Africa ($333). Conclusions: VPR remains a cost-saving strategy, while protecting US-bound refugees' health and US health security by preventing disease outbreaks during resettlement.