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01.
arXiv (CS.AI) 2026-06-18

Robust Regularized Policy Iteration under Transition Uncertainty

arXiv:2603.09344v3 Announce Type: replace Abstract: Offline reinforcement learning (RL) enables data-efficient and safe policy learning without online exploration, but its performance often degrades under distribution shift. The learned policy may visit out-of-distribution state-action pairs where value estimates and learned dynamics are unreliable. To address policy-induced extrapolation and transition uncertainty in a unified framework, we formulate offline RL as robust policy optimization, treating the transition kernel as a decision variable within an uncertainty set and optimizing the policy against the worst-case dynamics. We propose Robust Regularized Policy Iteration (RRPI), which replaces the intractable max-min bilevel objective with a tractable KL-regularized surrogate and derives an efficient policy iteration procedure based on a robust regularized Bellman operator. We provide theoretical guarantees by showing that the proposed operator is a $\gamma$-contraction and that iteratively updating the surrogate yields monotonic improvement of the original robust objective with convergence. Experiments on D4RL benchmarks demonstrate that RRPI achieves strong average performance, outperforming recent baselines including percentile-based methods on the majority of environments while remaining competitive on the rest. Moreover, RRPI exhibits robust performance by aligning lower $Q$-values with high epistemic uncertainty, which prevents the policy from executing unreliable out-of-distribution actions.

02.
arXiv (CS.LG) 2026-06-16

Bayesian Optimization for Learning Nonlinear MPC in Autonomous Agent Navigation

arXiv:2606.14763v1 Announce Type: cross Abstract: Real-time autonomous navigation in dynamic, unknown environments remains a fundamental challenge for mobile robotics. We propose a map-free framework that tightly integrates reactive rolling-horizon planning with nonlinear Model Predictive Control (MPC). At each control cycle, a LiDAR-based Gaussian occupancy representation is constructed and used to generate collision-free trajectories via A* search, which are then tracked by a CasADi/IPOPT MPC formulation incorporating a smooth sigmoid obstacle barrier. To improve robustness to parameter sensitivity, we adopt an offline Bayesian optimization scheme based on Tree-structured Parzen Estimators (TPE), which identifies near-optimal controller parameters with respect to a composite navigation objective. In addition, a Gaussian Process surrogate is used to analyze parameter sensitivity and provide insight into the optimization landscape. The proposed framework is robot-agnostic and is evaluated on the Unitree Go2 quadruped in simulation using Gazebo, followed by deployment on the physical robot. Experimental results show that parameters tuned in simulation transfer effectively to hardware, maintaining comparable performance without additional tuning. The full system achieves up to a 90.0\% navigation success rate when deployed, along with a 38.9\% average improvement in the evaluation metrics across simulated environments.

03.
arXiv (CS.CV) 2026-06-19

GenTrack2: An Improved Hybrid Approach for Multi-Object Tracking

This paper proposes a visual multi-object tracking method that jointly employs stochastic and deterministic mechanisms to ensure identifier consistency for unknown and time-varying target numbers under nonlinear dynamics. A stochastic particle filter addresses nonlinear dynamics and non-Gaussian noise, with support from particle swarm optimization (PSO) to guide particles toward state distribution modes and mitigate divergence through proposed fitness measures incorporating motion consistency, appearance similarity, and social-interaction cues with neighboring targets. Deterministic association further enforces identifier consistency via a proposed cost matrix incorporating spatial consistency between particles and current detections, detection confidences, and track penalties. Subsequently, a novel scheme is proposed for the smooth updating of target states while preserving their identities, particularly for weak tracks during interactions with other targets and prolonged occlusions. Moreover, velocity regression over past states provides trend-seed velocities, enhancing particle sampling and state updates. The proposed tracker is designed to operate flexibly for both pre-recorded videos and camera live streams, where future frames are unavailable. Experimental results confirm superior performance compared to state-of-the-art trackers. The source-code reference implementations of both the proposed method and compared-trackers are provided on GitHub: https://github.com/SDU-VelKoTek/GenTrack2

05.
Nature (Science) 2026-06-11

‘Footballers are not superheroes’: we must tackle the mental and physical pressures of elite sport

Authors:

As the men’s football World Cup gets under way, how the game weighs on the health of athletes still isn’t talked about enough, says player-turned-medic Vincent Gouttebarge. As the men’s football World Cup gets under way, how the game weighs on the health of athletes still isn’t talked about enough, says player-turned-medic Vincent Gouttebarge.

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

Conditioning Matters: Stabilizing Inversion and Attention in Diffusion Image Editing

Inversion-based image editing offers flexible and training-free control but still struggles with inversion accuracy and the trade-off between editing fidelity and background preservation. While recent methods improve inversion formulations or attention interactions, the role of textual conditioning in shaping diffusion dynamics and editing behavior remains underexplored. We show both empirically and theoretically that the precision of textual conditioning influences inversion stability by modulating the geometry of the diffusion velocity field, while also affecting the consistency of cross-branch attention during editing. These effects directly impact background preservation and semantic fidelity. Building on this analysis, we propose SimEdit, a conditioning-aware framework with two complementary components: (a) conditioning refinement, which constructs conditioning signals with improved semantic precision and structural alignment to facilitate stable inversion and consistent attention manipulation, and (b) token-wise cross-branch attention control, which separates edit-relevant and structure-preserving components and modulates them asymmetrically during attention manipulation. Extensive experiments on PIE-Bench demonstrate that SimEdit consistently improves both inversion reconstruction quality and editing performance over previous attention-manipulation approaches. Our code is available at https://github.com/zju-pi/SimEdit.

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

What Type of Inference is Active Inference?

arXiv:2606.04935v2 Announce Type: replace Abstract: Active inference casts decision-making as inference, with the Expected Free Energy (EFE) unifying goal-directed and information-seeking behavior. Recent work showed that EFE minimization can be written as Variational Free Energy (VFE) minimization on a generative model augmented with epistemic priors. We prove that the VFE of the augmented model can be rewritten as the VFE of the predictive model plus explicit entropy-correction terms, making the EFE contribution transparent. We then show that proper EFE-based planning requires combining these epistemic corrections with a planning correction that turns marginal inference into policy optimization, yielding a full variational characterization of EFE-based planning. This clarifies which corrections are needed for cross-entropy planning and for full EFE-based planning. The same entropy-corrected formulation leads to a detailed message-passing scheme for EFE-based planning together with simpler ablations. Experiments on three grid-world environments show that full EFE-based planning outperforms ablations that omit either the planning correction or the epistemic corrections.

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

FrameOracle: Learning What to See and How Much to See in Videos

Vision-language models (VLMs) advance video understanding but operate under tight computational budgets, making performance dependent on selecting a small, high-quality subset of frames. Existing frame sampling strategies, such as uniform or fixed-budget selection, fail to adapt to variations in content density or task complexity. To address this, we present FrameOracle, a lightweight, plug-and-play module that predicts both (1) which frames are most relevant to a given query and (2) how many frames are needed. FrameOracle is trained via a curriculum that progresses from weak proxy signals, such as cross-modal similarity, to stronger supervision with FrameOracle-41K, the first large-scale VideoQA dataset with validated keyframe annotations specifying minimal sufficient frames per question. Extensive experiments across five VLMs and six benchmarks show that FrameOracle reduces 16-frame inputs to an average of 10.4 frames without accuracy loss. When starting from 64-frame candidates, it reduces inputs to 13.9 frames on average while improving accuracy by 1.5%, achieving state-of-the-art efficiency-accuracy trade-offs for scalable video understanding.

10.
arXiv (CS.LG) 2026-06-19

Self-Adaptive Scale Handling for Forecasting Time Series with Scale Heterogeneity

arXiv:2606.20010v1 Announce Type: new Abstract: Current time series forecasting (TSF) research predominantly focuses on scale-homogeneous data, where different time series share similar numerical magnitude ranges. However, in real-world industrial scenarios such as financial product sales, different time series often differ by orders of magnitude (scale heterogeneity). Since these series share similar temporal patterns, joint modeling is desirable for better data utilization, yet existing scaling methods either compress low-scale signals (global normalization) or destroy semantic discriminability and amplify inverse-scaling errors (window-based scaling). This paper proposes a self-Adaptive Scale-handling (AS) module that learns adaptive scale factors tailored to each input, preserving semantic discriminability while reducing inverse-scaling errors. AS consists of Scale Calibrating (SC), which calibrates prior mean scaling factors through neural networks, and Scaling Selection (SS), which decides whether to apply calibration or retain the original factor, avoiding over-calibration. Experiments on real-world fund sales datasets from Ant Fortune and Alipay show that AS seamlessly integrates into popular TSF models and consistently improves their performance. The code and dataset are available at the link https://github.com/Meteor-Stars/ASTSF.

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

PURe: A Plug-and-Play Product-Unit Residual Module for Vision Networks

Modern vision networks are dominated by additive local transformations, whereas explicit multiplicative local interactions remain underexplored. Product units offer a direct approach to modeling such interactions, but their use in deep architectures has been limited by optimization instability. In this work, we propose PURe, a Product-Unit Residual Module for deep vision networks. PURe is built around a 2D Product Unit with a real-valued log-domain formulation that makes multiplicative local aggregation practical within deep residual hierarchies. The resulting module serves as a drop-in replacement for native residual units. We instantiate PURe in residual CNNs for image classification and in 2D residual encoder-decoder networks for slice-based segmentation on volumetric CT data. Across Galaxy10 DECaLS, ImageNet, and CIFAR-10, PURe consistently improves residual CNNs and yields a more favorable accuracy-parameter trade-off, allowing moderately deep models to match or surpass substantially deeper ResNet baselines with much smaller parameter budgets. On the AMOS benchmark, PURe also improves slice-based CT segmentation under 3D case-level evaluation. These results show that explicit multiplicative local interaction is a practical and effective design primitive for deep residual vision networks.

12.
medRxiv (Medicine) 2026-06-15

Prevalence and Clinical Impact of Pathogenic Variants in Cardiomyopathy Genes Among Individuals with Cardiac Conduction Disorders

Importance: Cardiac conduction disorders have traditionally been regarded as a secondary manifestation of underlying structural heart diseases. However, isolated conduction disorders may precede the onset of heart failure (HF) suggesting shared mechanisms. Objective: To evaluate the prevalence and clinical significance of pathogenic/likely pathogenic (P/LP) rare variants in cardiomyopathy genes among individuals with conduction disorders. Design, Setting, and Participants: Biobank analysis of 192,834 participants with whole genome sequence data from Vanderbilt's BioVU and 353,092 participants from the All of Us Research Program (AoU). Participants with primary conduction disorder (left bundle branch block [LBBB], right bundle branch block [RBBB], high-grade atrioventricular block [AVB]) were identified after excluding secondary causes. Exposures: P/LP variants in cardiomyopathy genes. Main Outcomes and Measures: Primary outcome was P/LP carrier status by age and HF status. Secondary outcomes included incident HF and composite ventricular arrhythmias/sudden cardiac death/mortality (VA/SCD/mortality). Results: Among 16,959 participants with conduction disorders in BioVU and 13,442 in AoU, 432 (2.6%) and 206 (1.5%) were P/LP carriers, respectively. Conduction disorder was independently associated with carrier status (BioVU p

13.
arXiv (CS.LG) 2026-06-19

Prior-Informed Flow Matching for Graph Reconstruction

arXiv:2601.22107v2 Announce Type: replace Abstract: We introduce Prior-Informed Flow Matching (PIFM), a conditional flow model for graph reconstruction. Reconstructing graphs from partial observations remains a key challenge; classical embedding methods often lack global consistency, while modern generative models struggle to incorporate structural priors. PIFM bridges this gap by integrating embedding-based priors with continuous-time flow matching. Grounded in a permutation equivariant version of the distortion-perception theory, our method first uses a prior, such as GraphSAGE or node2vec, to form an informed initial estimate of the adjacency matrix based on local information. It then applies rectified flow matching to refine this estimate, transporting it toward the true distribution of clean graphs and learning a global coupling. Experiments on different datasets demonstrate that PIFM consistently enhances classical embeddings, outperforming them and state-of-the-art generative baselines in reconstruction accuracy.

14.
arXiv (quant-ph) 2026-06-11

Consistent Evaluation of Operators Involving the Position Operator in the Bloch Representation: Application to the Orbital Moment

arXiv:2606.11679v1 Announce Type: cross Abstract: The position operator plays a central role in condensed-matter observables such as velocity, orbital moment, and electric polarization. In solid-state physics, the evaluation of operators incorporating the position operator has not reached a consensus, as observed in the operator-level discrepancy between the local circulation of Wannier functions and the self-rotation of wave packets. Here, to achieve a consistent evaluation of such operators, we propose three rules for evaluating operators involving the position operator in the Bloch representation. The rules are devised to satisfy physical conditions: independence from the choice of unit cell, preservation of Hermitian conjugacy for the product of operators, and recovery of the correct intraband velocity. We further address the gauge dependence of the position operator and introduce a scheme termed gauge filtration, which systematically removes gauge-dependent contributions from the operators containing the position operator. This methodology ensures that the quantities obtained from the operator evaluation correspond to observable physical phenomena. By applying our framework, we reconcile the results concerning the self-rotation of the wave packet and the local circulation of the Wannier function. We expect our proposal to establish a consistent framework for evaluating operators involving the position operator.

15.
arXiv (quant-ph) 2026-06-16

A short proof of the modified Kretschmann-Schlingemann-Werner conjecture

Authors:

arXiv:2606.16418v1 Announce Type: new Abstract: Let $\Phi_1, \Phi_2 : \mathbb{M}_d(\mathbb{C})\to \mathbb{M}_n(\mathbb{C})$ be two quantum channels with respective Stinespring isometries $V_1, V_2 : \mathbb{C}^{d}\to \mathbb{C}^{n} \otimes \mathbb{C}^{m}$ on any common dilation space $\mathbb{C}^{m}$. We prove that there exists a unitary $U$ on $\mathbb{C}^{m}$ such that $\|V_1-({\bf1}\otimes U)V_2\|_\infty\leq\sqrt{2\|\Phi_1-\Phi_2\|_\diamond},$ thus resolving vom Ende's modification of the Kretschmann-Schlingemann-Werner conjecture in the affirmative.

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

Temporal2Seq: A Unified Framework for Temporal Video Understanding Tasks

With the development of video understanding, there is a proliferation of tasks for clip-level temporal video analysis, including temporal action detection (TAD), temporal action segmentation (TAS), and generic event boundary detection (GEBD). While task-specific video understanding models have exhibited outstanding performance in each task, there remains a dearth of a unified framework capable of simultaneously addressing multiple tasks, which is a promising direction for the next generation of AI. To this end, in this paper, we propose a single unified framework, coined as Temporal2Seq, to formulate the output of these temporal video understanding tasks as a sequence of discrete tokens. With this unified token representation, Temporal2Seq can train a generalist model within a single architecture on different video understanding tasks. In the absence of multi-task learning (MTL) benchmarks, we compile a comprehensive co-training dataset by borrowing the datasets from TAD, TAS, and GEBD tasks. We evaluate our Temporal2Seq generalist model on the corresponding test sets of three tasks, demonstrating that Temporal2Seq can produce reasonable results on various tasks and achieve advantages compared with single-task training on this framework. We also investigate the generalization performance of our generalist model on new datasets from different tasks, which yields superior performance to the specific model.

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

Plan, Don't Pose: Long Composite Motion Generation with Text-Aligned BFM

arXiv:2605.29906v2 Announce Type: replace Abstract: Text-to-motion (T2M) generation has broad applications in character animation, virtual avatars, and human-robot interaction. Existing methods typically generate pose trajectories or motion tokens directly from language, forcing a single model to handle semantic interpretation, long-horizon structure, and low-level physical realization. This coupling makes them costly and often unreliable for long, compositional, or semantically dense prompts. We propose Text2BFM, the first framework that aligns natural language with pretrained Behavioral Foundation Models (BFMs) for T2M generation without relying on heavy end-to-end motion generators. Text2BFM operates in the latent policy space of a frozen BFM, using it as an executable motion prior. A text-aligned variational behavioral bottleneck compresses BFM policy-latent sequences into compact motion representations that are compatible with language and preserve long-horizon behavioral structure. Generation is performed in this compact behavioral manifold with a lightweight conditional generator, and the resulting latent encoded behaviors are decoded into policy latents that drive the pretrained frozen BFM. By decoupling semantic planning from motion execution, Text2BFM achieves efficient, robust T2M generation and strong performance on long, compositional textual descriptions.

18.
arXiv (CS.CV) 2026-06-16

Graph Regularized Non-negative Reduced Biquaternion Matrix Factorization for Color Image Recognition

Non-negative reduced biquaternion matrix factorization (NRBMF) uses the product of reduced biquaternion (RB) matrices to incorporate the non-negativity constraints of color image pixels into the factorization process. However, NRBMF mainly focuses on reconstruction accuracy and does not explicitly exploit the local geometric structure of image data, which may limit the discriminative ability of the obtained low-dimensional coefficient representations. To address this issue, we propose a graph regularized non-negative reduced biquaternion matrix factorization (GNRBMF) model for color image recognition. The proposed model incorporates a graph Laplacian regularizer into the reduced biquaternion coefficient matrix, encouraging nearby samples in the original space to have similar coefficient representations. Meanwhile, GNRBMF retains the non-negativity property of NRBMF in the reduced biquaternion algebra. To solve the optimization problem, a component-wise alternating projected gradient algorithm is derived, and its convergence properties are analyzed. Experimental results on three color image datasets show that the proposed GNRBMF model achieves competitive or superior recognition performance compared with several methods in most tested settings.

19.
arXiv (CS.AI) 2026-06-18

UBP2: Uncertainty-Balanced Preference Planning for Efficient Preference-based Reinforcement Learning

arXiv:2606.19328v1 Announce Type: cross Abstract: Preference-based RL provides an approach to learning reward models from pairwise comparisons of behaviors, bypassing the need for explicit reward design. However, existing methods typically rely on passive data collection and suffer from poor sample efficiency, especially during the early stages of learning. We introduce a model-based approach that actively directs exploration by jointly reasoning over uncertainties in the reward, dynamics, and value functions. Our method, Uncertainty-Balanced Preference Planning (UBP2), uses ensembles of reward, dynamics, and value function models to evaluate candidate trajectories according to a unified score that combines expected reward, terminal value, and epistemic uncertainty. Planning under this objective yields an explicit tradeoff between exploitation and information acquisition without requiring ad hoc exploration heuristics. Under standard regularity assumptions, we establish sublinear regret guarantees for both finite-horizon and infinite-horizon settings. Empirically, experiments on the Meta-World benchmark show UBP2 achieves substantially higher sample efficiency than model-free preference-based methods and non-optimistic model-based baselines.

20.
arXiv (CS.AI) 2026-06-18

Recursive Joint Simulation in Games

arXiv:2402.08128v3 Announce Type: replace Abstract: Game-theoretic dynamics between AI agents could differ from traditional human-human interactions in various ways. One such difference is that it may be possible to accurately simulate an AI agent, for example because its source code is known. Such an agent would then be fundamentally uncertain whether it is in the real world or in a simulation. Our aim is to explore ways of leveraging this possibility to achieve more cooperative outcomes in strategic settings. In this paper, we study an interaction between AI agents where the agents run a recursive joint simulation. That is, the agents first jointly observe a simulation of the situation they face. This simulation in turn recursively includes additional simulations (with a small chance of failure, to avoid infinite recursion), and the results of all these nested simulations are observed before an action is chosen. We show that the resulting interaction is strategically equivalent to an infinitely repeated version of the original game, allowing a direct transfer of existing results such as the various folk theorems. As evidence that the equivalence is robust, we show that it holds even when we relax some of the assumptions and that it also holds ``from the inside'' – meaning, for an agent that finds itself inside the game and has self-locating uncertainty.

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

RL-Index: Reinforcement Learning for Retrieval Index Reasoning

arXiv:2606.16316v1 Announce Type: cross Abstract: Retrieving external knowledge is essential for solving real-world tasks, yet it remains challenging when the relationship between a query and its relevant knowledge involves implicit and complex reasoning beyond surface-level semantic or lexical matching (e.g., mathematical problems relying on the same theorem or coding requiring deep reasoning). Existing approaches primarily rely on query-side reasoning (e.g., query rewriting), which introduces significant online latency and underutilizes the opportunity to perform reasoning over the knowledge corpus itself (i.e., index-side reasoning). In this paper, we propose RL-Index, an agentic indexing framework that formulates retrieval index reasoning as a reinforcement learning problem. Instead of performing reasoning at query time, RL-Index shifts reasoning to the indexing stage by augmenting documents with LLM-generated rationales that explicitly encode the latent query-knowledge relationship. To optimize the quality of these rationales, we employ Group Relative Policy Optimization (GRPO) and use retrieval similarity as a verifiable reward signal, enabling direct optimization of indexing decisions for retrieval effectiveness. Extensive experiments on the BRIGHT benchmark demonstrate that RL-Index consistently improves both retrieval and downstream question-answering performance, while significantly reducing online inference latency. Moreover, the learned rationale augmentation generalizes across diverse retrievers and generators, highlighting its robustness as a plug-and-play indexing strategy across different retrieval systems.

22.
arXiv (math.PR) 2026-06-16

Sharp freezing time estimates for the subcritical Facilitated Exclusion Process

arXiv:2606.15233v1 Announce Type: new Abstract: We investigate the exact transience time of the Facilitated Exclusion Process (FEP) on the one-dimensional torus with $N$ sites. The FEP exhibits an active/inactive phase transition at critical density $1/2$, such that in the subcritical density regime $(0,1/2)$, it becomes frozen after a finite time period – the transience time or freezing time. We first show that for the FEP starting from a Bernoulli product measure of marginal density $\rho \in (0,1/2)$, the transience time has exactly the scale of $\Theta(\log^3 N)$. Secondly, we prove that in the near-critical case $\rho \simeq 1/2 - N^{-\alpha}$ for $\alpha \in (0,1)$, the transience time is polynomial and has a scale of $N^{1 \wedge (2\alpha)}$. The key idea is to estimate the typical size of locally supercritical intervals of the initial distribution, which has order $\log N$ in the subcritical case and $N^{1 \wedge (2\alpha)}$ in the near-critical case. In the subcritical case this is enough, whereas in the near-critical case we need additional dynamical decorrelation inequalities to apply this static result to estimate the freezing time.

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

We Need to Rethink Benchmarking in Anomaly Detection

arXiv:2507.15584v2 Announce Type: replace Abstract: Despite the continuous proposal of new anomaly detection algorithms and extensive benchmarking efforts, progress seems to stagnate, with only minor performance differences between established baselines and new algorithms. In this position paper, we argue that this stagnation is due to limitations in how we evaluate anomaly detection algorithms. In current benchmarks, a trivial algorithm that only checks for extreme values in individual features performs competitively with state-of-the-art deep learning methods, despite failing on simple cases such as anomalies within an annulus of normal points. Moreover, existing benchmarks do not adequately reflect the diversity of anomaly detection applications, making it difficult for practitioners to reliably select algorithms for their applications. Consequently, we need to rethink benchmarking in anomaly detection. In our opinion, anomaly detection should be studied using scenarios that group applications sharing relevant characteristics, defined through a common taxonomy. Benchmarking within scenarios enables scenario-specific choices for preprocessing, metrics, and model selection, clarifying which advances transfer across similar applications and providing practitioners with reliable guidance for their specific contexts.

24.
arXiv (CS.CV) 2026-06-18

MUFASA: A Multi-Layer Framework for Slot Attention

Unsupervised object-centric learning (OCL) decomposes visual scenes into distinct entities. Slot attention is a popular approach that represents individual objects as latent vectors, called slots. Current methods obtain these slot representations solely from the last layer of a pre-trained vision transformer (ViT), ignoring valuable, semantically rich information encoded across the other layers. To better utilize this latent semantic information, we introduce MUFASA, a lightweight plug-and-play framework for slot-attention-based approaches to unsupervised object segmentation. Our model computes slot attention across multiple feature layers of the ViT encoder, fully leveraging their semantic richness. We propose a fusion strategy to aggregate slots obtained on multiple layers into a unified object-centric representation. Integrating MUFASA into existing OCL methods improves their segmentation results across multiple datasets, setting a new state of the art while simultaneously improving training convergence with only minor inference overhead.

25.
arXiv (CS.CL) 2026-06-18

Trade-offs in Medical LLM Adaptation: An Empirical Study in French QA

The development of large language models (LLMs) has led to an increased focus on their adaptation to specialized domains and languages, yet the effectiveness of domain adaptation strategies remains unclear. We present a study of medical domain adaptation using French medical question-answering (QA) as a case study. We compare continual pretraining (CPT), supervised fine-tuning (SFT), and their combination across three model families, multiple sizes, and three initialization types, explicitly disentangling adaptation effects from base model choice. We evaluate both multiple-choice (MCQA) and open-ended QA (OEQA) under greedy and constrained decoding using automatic metrics and LLM-as-a-Judge evaluation. For MCQA, CPT+SFT most often achieves the best scores, but gains over SFT are small and frequently not statistically significant, making SFT a strong and cost-effective default. For OEQA, CPT consistently improves overlap-based metrics, while SFT often degrades generation quality; instruction tuning and CPT+SFT are preferred by LLM-based evaluation. Cross-lingual experiments further show effective transfer from French adaptation to English benchmarks. Overall, we provide practical guidelines for selecting adaptation strategies under computational constraints.