Medical innovation in LMICs: can India lead the way?
With its biomedicine at an inflection point, India can seize the opportunity to scale up research and development at home and offer a distinct model of biomedical innovation for the global south.
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With its biomedicine at an inflection point, India can seize the opportunity to scale up research and development at home and offer a distinct model of biomedical innovation for the global south.
by Andrew S. C. Yuen, Kenneth K. C. Man Pain and fever in pregnancy require treatment, but fetal safety concerns complicate analgesic choice. A recent PLOS Medicine study presents new evidence on the safety of first-trimester NSAID use and congenital malformation risk, but interpreting findings across studies is challenging. In this Perspective, Kenneth Man and Andrew Yuen highlight a recent PLOS Medicine study that presents new evidence on the safety of first-trimester NSAID use and congenital malformation risk, but discuss why interpreting findings across studies is challenging.
Early-life exposures are important to several late-life health outcomes. We sought to study the effect of an in utero nutritional environment and its interaction with Alzheimer's disease (AD) genetic risk on late-life cognitive function. We used a natural experiment created by the pellagra epidemic, a nutritional disease caused by a vitamin B3 deficiency, to evaluate the association between in utero pellagra epidemic exposure and late-life cognitive function in the Health and Retirement Study (N = 18,285). We also evaluated whether the in utero exposure could modify the AD polygenic score's (PGS) effect on cognition. In utero pellagra epidemic exposure was significantly associated with cognition ({beta} = -0.025). However, these effects were not isolated to the prenatal period as exposure during childhood periods also had an effect. The interaction between the in utero exposure and the AD PGS was significant, where the genetic effect on cognition was amplified with increasing (progressively worse) in utero exposure levels. These associations imply that the early-life nutritional environment affects late-life cognitive function and that these effects can modify genetic risk.
arXiv:2606.13311v1 Announce Type: cross Abstract: Contextual anomaly detection aims to identify abnormal behavior conditional on context variables, but practical deployments often face highly imbalanced context distributions where rare regimes can be critical information. Under such frequency bias, context-conditioned models can produce unstable decisions and excessive false alarms in rare contexts. We propose Rarity-Gated Feature-wise Linear Modulation (RGFiLM), a rarity-aware conditioning module that combines feature-wise modulation (i.e., context-conditioned scaling and shifting of hidden features) with a gate controlled by a data-driven rarity score. The rarity score is estimated from the empirical distribution of context variables and regulates how strongly context modulates intermediate representations: the gate becomes more decisive under rare contexts while remaining conservative under frequent contexts. We evaluate RGFiLM on maritime trajectory anomaly detection using AIS motion sequences with ERA5 environmental context in an environment-sensitive detour scenario. When instantiated in a sequential anomaly scoring pipeline, RGFiLM achieves the best mean F1–False Positive Rate (FPR) trade-off among the compared context-agnostic and context-conditioned methods. These results suggest that explicitly accounting for context rarity is an effective approach for reducing false alarms in context-sensitive anomaly detection.
arXiv:2606.00807v2 Announce Type: replace Abstract: Traditional artificial intelligence has largely conceptualized intelligence as isolated computation occurring within bounded agents. Across classical AI, machine learning, and many generative systems, the dominant unit of analysis remains the individual model or autonomous system evaluated through outputs, benchmarks, prediction accuracy, or optimization performance. While these approaches have produced major advances, they often under-theorize the role of interaction in the emergence of intelligence, creativity, meaning, and adaptive behavior. This paper proposes interaction as the primary unit of analysis for co-creative AI and interaction-centered intelligence more broadly. Drawing from distributed cognition, embodied cognition, enaction, participatory sense-making, human-computer interaction, and computational creativity, the paper traces a historical progression toward increasingly relational accounts of intelligence. Building upon prior work in Creative Sense-Making, quantified co-creation, and co-creative systems such as the Drawing Apprentice and AI Drawing Partner, it argues that intelligence emerges through evolving interaction dynamics among agents, environments, and socio-technical systems rather than solely through internal computation. The paper introduces Interaction-Centered Intelligence as a framework for understanding human-AI co-creation, collaborative emergence, adaptive participation, and interactional dynamics. Rather than evaluating intelligence solely through generated outputs, the framework emphasizes interaction trajectories, coordination patterns, participatory engagement, adaptive regulation, and interactional drift unfolding through time. Implications for explainable co-creative AI, hybrid intelligence, enactive AI, and future human-AI systems are discussed.
arXiv:2601.02893v3 Announce Type: replace Abstract: In quantum information, asymmetry, i.e., the lack of symmetry, is a resource allowing one to accomplish certain tasks that are otherwise impossible. Similarly, in a Bell test using any given Bell inequality, the maximum violation achievable using quantum strategies respecting or disregarding a certain symmetry can be different. In this work, we focus on the symmetry involved in the exchange of parties and explore when we have to trade this symmetry for a lower-dimensional quantum strategy in achieving the maximal violation of given Bell inequalities. For the family of symmetric Collins-Gisin-Linden-Massar-Popescu inequalities, we provide evidence showing that there is no such trade-off. However, for several other Bell inequalities with a small number of dichotomic measurement settings, we show that symmetric quantum strategies in the minimal Hilbert space dimension can only lead to a suboptimal Bell violation. In other words, there exist symmetric Bell inequalities that can only be maximally violated by asymmetric quantum strategies of minimal dimension. In contrast, one can also find examples of asymmetric Bell inequalities that are maximally violated by symmetric correlations. The implications of these findings on the geometry of the set of quantum correlations and the possibility of performing self-testing therefrom are briefly discussed.
arXiv:2606.17104v1 Announce Type: cross Abstract: As large language models (LLMs) are increasingly deployed in latency- and cost-sensitive settings, inference efficiency has become a central systems challenge. While GPUs dominate current deployments, a growing number of AI accelerators claim advantages for LLM inference, yet it remains unclear under which conditions such accelerators outperform GPUs in practice. Recent inference systems decompose execution into Prefill and Decode phases, which exhibit distinct computational characteristics and latency metrics, commonly captured by time to first token (TTFT) and time per output token (TPOT). This paper presents a phase-aware evaluation of LLM inference performance across GPUs and emerging AI accelerators using a common model, Llama2-7B. By separately measuring Prefill and Decode performance, we reveal that accelerator advantages differ by phase and metric. Our results show that GPUs consistently excel in the compute-intensive Prefill phase, while GroqRack achieves significantly lower TPOT during Decode (batching not currently supported). However, GPUs regain an advantage in Decode throughput as batch size increases. These findings demonstrate that each platform exhibits distinct phase-dependent strengths. We further analyze heterogeneous Prefill/Decode disaggregation across different accelerator platforms, identifying performance gains and the workload and network conditions under which such gains are realized.
arXiv:2606.15549v1 Announce Type: cross Abstract: The adoption of AI agents is increasing rapidly. Terminal AI agents, i.e., AI agents that run in terminal environments, are a widely used type of AI agents. Terminal AI agents rely heavily on shell command execution to interact with the host systems. They adopt a three-list command-gating mechanism to mitigate security risks introduced by command execution, with denylists serving as the load-bearing component. However, modern operating systems often ship a large, ever-expanding set of shell commands with complex functionalities. Our observation is that even a built-in denylist of Claude Code, well-maintained by its developers, can overlook bypass commands that invalidate its effectiveness. Such negligence leads to fragile command denylists that cannot even block operations that practitioners expect them to block. This paper presents the first systematic characterization of command denylist fragility in terminal AI agents. The paper formalizes the command denylist fragility problem and proposes an LLM-driven pipeline, CmdNeedle, to detect such fragility. It prompts the LLM to propose possible bypasses and iteratively repairs them using feedback from a validator that executes them in a sandbox. In the evaluation, we applied CmdNeedle to 1,709 real-world command denylists (containing 13,332 denylist rules) collected from GitHub. The evaluation shows several key findings, including that 69.0–98.6% of the denylists are fragile, that this fragility occurs consistently across projects and agents, and the validity of several possible root causes for this fragility. Our pipeline and findings will hopefully facilitate future research and practice regarding the command denylists used by AI agents.
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The integration of Large Language Models (LLMs) and Multimodal LLMs (MLLMs) into scientific peer-review workflows introduces novel and significant risks for adversarial manipulation, especially given the multimodal nature of scientific papers where figures, not just text, convey core evidence. This creates a significant gap: current robustness studies on AI peer-review are overwhelmingly text-only. Moreover, the problem is distinct from standard jailbreaking, as a peer-review attack seeks to induce a domain-specific, targeted failure (e.g., "inflate this score") rather than a general safety policy violation, for which no practical defenses exist. To address this, we introduce PaperGuard, the first comprehensive benchmark designed to systematically evaluate and defend AI-generated peer-review against these domain-specific, cross-modal attacks. Our framework is built on three pillars: (1) a new multimodal peer-review dataset spanning multiple scientific domains; (2) a unified suite of attacks, including black-box prompt injections and white-box perturbations, specifically designed to target both text (GCG) and figures (PGD); and (3) a practical defense, motivated by the long-context challenge of academic papers, that uses chunk-based embedding search to efficiently localize and mitigate harmful instructions. Our extensive experiments, conducted across state-of-the-art models, confirm that AI reviewers are pervasively vulnerable. PaperGuard establishes the foundational benchmark, protocols, and actionable defense necessary to pioneer trustworthy, attack-resilient AI-assisted scholarly reviewing.
arXiv:2606.16165v1 Announce Type: new Abstract: In order to make the right empirical predictions Bohmian mechanics requires a special statistical boundary condition – the distribution postulate – but it is unclear how best to understand this condition. We show how one might use the theory of algorithmic randomness to formulate the distribution postulate as an objective constraining law. The framework requires us to say something about admissible quantum-mechanical states and measurements. In return, algorithmic Bohmian mechanics (aBM) guarantees the standard Born statistics for a collection of canonical quantum experiments in the limit, not just with high probability. The algorithmic distribution postulate provides a sharp typicality condition, clarifies the status of quantum probabilities in the deterministic theory, and provides a concrete example of how notions provided by the theory of algorithmic randomness can aid in specifying the content of a physical law.
arXiv:2601.06572v4 Announce Type: replace-cross Abstract: Multimodal variational autoencoders (VAEs) are widely used for weakly supervised generative learning with multiple modalities. Predominant methods aggregate unimodal inference distributions using either a product of experts (PoE), a mixture of experts (MoE), or their combinations to approximate the joint posterior. In this work, we revisit multimodal inference through the lens of probabilistic opinion pooling, an optimization-based approach. We start from Hölder pooling with $\alpha=0.5$, which corresponds to the unique symmetric member of the $\alpha-divergence$ family, and derive a moment-matching approximation, termed Hellinger. We then leverage such an approximation to propose HELVAE, a multimodal VAE that avoids sub-sampling, yielding an efficient yet effective model that: (i) learns more expressive latent representations as additional modalities are observed; and (ii) empirically achieves better trade-offs between generative coherence and quality, outperforming state-of-the-art multimodal VAE models.
arXiv:2606.14636v1 Announce Type: new Abstract: Control-function instrumental variable estimators need a first-stage residual, not merely a first-stage prediction. High-capacity first stages can interpolate treatment and leave too little residual information for the outcome equation. We study Adaptive Anisotropic Instrumental Heat Flow (A-IHF), a deterministic graph-diffusion residual extractor for flexible control functions. A-IHF treats treatment as a signal on a graph of first-stage features, uses pilot diffusion to detect large treatment jumps, attenuates conductance across those jumps, and computes the generated control with a sparse graph resolvent. Its observational selection rule uses only $(Z,X)$, combining graph generalized cross-validation, roughness, residualized-treatment relevance, and graph-admissibility filtering. The analysis decomposes error into structural leakage, residual attenuation, and residualized treatment variation, yielding finite-sample bounds, graph-admissibility rates under latent piecewise-smooth geometry, and finite-path selection calibration. Across 54 synthetic benchmark cells with tuned graph, kernel, tree, boosting, series, and neural control-function baselines, guarded observational A-IHF has the lowest average structural-response MSE; the A-IHF family beats the best non-A-IHF baseline in 32 cells. Performance is strongest when the graph captures piecewise-smooth first-stage structure.
Two recent studies (Jones et al. (2026); Zeng et al. (2026)) reach apparently contradictory conclusions about whether LVLMs can coordinate on efficient referring expressions. We control for task differences between the studies while directly comparing their prompting styles. We replicate the finding that models can coordinate efficient referring expressions when explicitly prompted to do so, suggesting that other task differences are not responsible for divergent results. However, we also find that the same models fail to infer the need for communicative efficiency from a more implicit prompt, highlighting critical differences between how humans and AI systems communicate.
Reasoning with a Code Interpreter (CI) has emerged as an effective paradigm for enhancing the reasoning capabilities of large language models (LLMs) through executable computation and iterative verification. Despite its growing adoption, the behavioral properties underlying effective code reasoning remain largely underexplored. In this work, we investigate code reasoning from two distinct perspectives inspired by prior studies of natural language reasoning: extrinsic properties, represented by crucial tokens, and intrinsic properties, represented by code-specific cognitive behaviors. Across multiple LLMs, we find that stronger CI reasoning models consistently exhibit a higher prevalence of crucial tokens and cognitive behaviors, particularly verification, backtracking, and backward chaining. Building on these observations, we examine how these properties can be leveraged during both inference and training. At inference time, appending code-specific crucial tokens improves performance on several reasoning capabilities, including mathematical, ordering, and optimization, while yielding limited benefits elsewhere. At training time, augmenting a state-of-the-art framework with code-specific cognitive behaviors improves supervised fine-tuning and reinforcement learning performance in two of three evaluated models. Further analysis shows that these behaviors reduce overthinking in incorrect responses and improve token efficiency, while also revealing factors that limit gains in a certain model. Our findings provide the first systematic characterization of effective reasoning with CI and demonstrate both the potential and limitations of leveraging key properties to improve CI-based reasoning.
arXiv:2603.15988v3 Announce Type: replace-cross Abstract: Dysarthric speech quality assessment (DSQA) is critical for clinical diagnostics and inclusive speech technologies. However, subjective evaluation is costly and difficult to scale, and the scarcity of labeled data limits robust objective modeling. To address this, we propose a three-stage framework that leverages unlabeled dysarthric speech and large-scale typical speech datasets to scale training. A teacher model first generates pseudo-labels for unlabeled samples, followed by weakly supervised pretraining using a label-aware contrastive learning strategy that exposes the model to diverse speakers and acoustic conditions. The pretrained model is then fine-tuned for the downstream DSQA task. Experiments on five unseen datasets spanning multiple etiologies and languages demonstrate the robustness of our approach. Our Whisper-based baseline significantly outperforms SOTA DSQA predictors such as SpICE, and the full framework achieves an average SRCC of 0.761 across unseen test datasets.
arXiv:2606.19562v1 Announce Type: new Abstract: This chapter reviews recent advances in Scientific Machine Learning (SciML) for modeling coupled fluid flow and transport phenomena governed by the incompressible Navier-Stokes and scalar transport equations. Such systems, found in applications like turbidity currents and thermal convection, feature strong nonlinear coupling and multiscale behavior that make high-fidelity simulations computationally expensive. To address this, the chapter surveys state-of-the-art SciML methods for building efficient surrogate models, including linear reduced-order techniques based on Singular Value Decomposition (such as Dynamic Mode Decomposition) and nonlinear neural network approaches like Physics-Informed Neural Networks (PINNs) and $\beta$-Variational Autoencoders ($\beta$-VAEs). It first covers the authors' work combining these models with High Performance Computing strategies, including Adaptive Mesh Refinement/Coarsening (AMR/C) and scientific floating-point data compression. It then presents two new contributions: surrogate modeling of turbidity currents via PINNs, and the extraction of disentangled nonlinear modes from thermal flows using $\beta$-VAEs. Governing equations and representative benchmarks, including lock-exchange flows and Rayleigh-Bénard convection, illustrate these methodologies. The chapter is intentionally long, covering both the mathematical and physical foundations of coupled fluid flow and the computational aspects of state-of-the-art modeling. Overall, it demonstrates how SciML enables fast, accurate approximations of complex coupled systems within the specific data regimes and modeling assumptions considered, while substantially reducing computational cost relative to full-order simulations. Broader capabilities such as real-time prediction and uncertainty quantification remain active research directions whose feasibility depends strongly on the problem at hand.
Unified multimodal models (UMMs) have recently emerged as a promising paradigm for integrating multimodal understanding and generation within a single autoregressive transformer. However, during multimodal instruction tuning, these models often exhibit pronounced modality imbalance: language gradients dominate optimization, thus leading to lower image generation quality, especially under parameter-efficient fine-tuning such as LoRA. In this work, we systematically analyze modality imbalance in LoRA-based fine-tuning of UMMs for interleaved text-image generation. We show that vision modality performance degrades substantially more than text modality performance when compared to unimodal counterparts, and that modality-specific gradients can differ by orders of magnitude across various tasks and layers. Motivated by this observation, we reformulate the multimodal instruction tuning as a bi-objective optimization problem and propose Pareto LoRA, a Pareto-optimal gradient integration strategy that balances the text and image objectives by modulating the gradient direction and strength. Experiments on the CoMM benchmark with Emu2 demonstrate that Pareto LoRA consistently improves multimodal generation balance, achieving up to 44.9% gains in perceptual image quality over vanilla LoRA while maintaining comparable text performance.
arXiv:2606.12381v1 Announce Type: new Abstract: In this paper we prove the Markov property for the solution to stochastic partial differential equations driven by a cylindrical orthogonal martingale-valued measure. We assume our coefficients are time-dependent and satisfy some growth and Lipschitz conditions. We also prove that for time-independent coefficients and under mild assumptions on the cylindrical orthogonal martingale-valued measure, the solutions to our stochastic partial differential equations are Feller. Finally, in the case that the $C_{0}$-semigroup is quasi-contraction, we show that the solution to our stochastic partial differential equation possesses a càdlàg version.
arXiv:2606.18933v1 Announce Type: new Abstract: Active feature acquisition (AFA) sequentially selects which features to observe to reach a classification or ranking decision. Its central limitation is reliance on large amount of labeled data to fit probabilistic models guiding acquisition. Large language models (LLMs) supply unsupervised domain knowledge, but are poor sequential planners. Asking one to both know and decide conflates capabilities best kept separate. Here, we develop a framework for zero-shot AFA through disciplined elicitation: asking the LLM only for what it can be trusted to return, the unary deviations and pairwise co-variations that are the sufficient statistics of a Markov random field (MRF). We apply our framework to two settings: binary classification and top-$k$ identification. In practice, the LLM reliably returns only discriminative statistics, what distinguishes the classes rather than each class in isolation, which precludes classical AFA. We apply a maximum-entropy closure that resolves this gauge ambiguity. We evaluate on a cohort of Inflammatory Bowel Disease (IBD) patients, an active clinical setting where diagnostic ambiguity and patient heterogeneity obstruct stable treatment strategies. Our framework outperforms the LLM both on real labels and on its own extracted beliefs. Where it matters most, on the hardest patients, our top-$k$ acquisition policy markedly outperforms all existing methods.
Emergent communication enables agents to develop bespoke languages that improve communication efficiency. Despite the known importance of temporal structure in natural language, there is no existing evidence of temporal references in emergent communication. This paper addresses this gap, by exploring how agents communicate about temporal relationships. We analyse three potential factors for the emergence of temporal references: environmental, external, and architectural. Our experiments demonstrate that altering the loss function is insufficient for temporal references to emerge; rather, architectural changes are necessary. A minimal change in agent architecture, using a different batching method, allows the emergence of temporal references. This modified design is compared with the standard architecture in a temporal referential games environment, which emphasises temporal relationships. The analysis shows that over 95% of the agents with the modified batching method develop temporal references, without changes to their loss function. We consider temporal referencing necessary for future improvements to the agents' communication efficiency, enabling future agents to use a closer to optimal coding as compared to purely compositional languages. These insights provide the basis for incorporation of temporal references into other emergent communication settings, and investigation of other aspects of language.
From financial filings to clinical records, legacy industries rely heavily on long, unstructured documents to store high-value information. Reliably extracting this information into structured, machine-readable representations is a key prerequisite to making the contents accessible to automated systems. JSON is a natural target for such structured extraction, yet constructing reliable and scalable text-to-JSON training data remains challenging. To address this gap, we propose STAGE (Spreadsheet-grounded Text-to-JSON Artifact GEneration), a source-grounded data generation pipeline that constructs reports and JSON schema by using LLMs for scalable synthesis while validating ground-truth values against the underlying spreadsheet. Evaluations on STAGE-Eval, our source-grounded benchmark with an 851-example test set, show that STAGE produces stronger training data than existing approaches. This improves Qwen3-4B exact match from 31.37% to 74.27% and value accuracy from 45.46% to 90.69%.
Four-dimensional computed tomography (4DCT) captures the full respiratory cycle of thoracic anatomy, yet current Internal Target Volume contouring workflows process each phase in isolation, discarding temporal coherence and leaving contours vulnerable to phase-specific artifacts. We present a lightweight framework that applies parameter-efficient fine-tuning to the Segment Anything Model 3 (SAM 3) via low-rank adaptation (LoRA) to align its text-prompted segmentation with the medical domain using only seven annotated 3D CT volumes. Furthermore, the framework incorporates a hard negative mining strategy to improve boundary discrimination in low-contrast thoracic regions. At inference, phase-wise predictions are refined through phase-coherent temporal filtering and spatial connectivity analysis. Since respiratory motion is continuous and periodic, genuine anatomy appears in contiguous blocks of phases, whereas transient artifacts appear sporadically and are thus effectively suppressed. Experiments on pulmonary and cardiac structures yield median Dice scores of 0.968 and 0.910 with 95th-percentile Hausdorff distances of 0.998 mm and 2.931 mm, respectively. The proposed framework effectively eliminates the severe false-positive predictions inherent in the zero-shot inference of the unadapted SAM 3. With only seven annotated volumes, the framework retains over 95% of full-data accuracy, and the entire pipeline is trainable on a single consumer-grade GPU, demonstrating a scalable, data-efficient solution for adaptive radiotherapy.
Autonomous web agents powered by large language models (LLMs) show strong potential for performing goal-oriented tasks such as information retrieval, report generation, and online transactions. These agents mark a key step toward practical embodied reasoning in open web environments. However, existing approaches remain limited in reasoning depth and efficiency: vanilla linear methods fail at multi-step reasoning and lack effective backtracking, while other search strategies are coarse-grained and computationally costly. We introduce Branch-and-Browse, a fine-grained web agent framework that unifies structured reasoning-acting, contextual memory, and efficient execution. It (i) employs explicit subtask management with tree-structured exploration for controllable multi-branch reasoning, (ii) bootstraps exploration through efficient web state replay with background reasoning, and (iii) leverages a page action memory to share explored actions within and across sessions. On the WebArena benchmark, Branch-and-Browse achieves a task success rate of 35.8\% and reduces execution time by up to 40.4\% relative to state-of-the-art methods. These results demonstrate that Branch-and-Browse is a reliable and efficient framework for LLM-based web agents.
arXiv:2606.15271v1 Announce Type: cross Abstract: This work presents a transparent and reproducible benchmark study of a direct dual-network Physics-Informed Neural Network (PINN) formulation for the optimal control of a mass-spring-damper system. The classical linear-quadratic optimal control problem is solved by two independent classical methods – Pontryagin's Minimum Principle with single shooting, and direct transcription through trapezoidal collocation – and recast as a constrained optimization problem solved by two feedforward neural networks: a state network whose boundary conditions are enforced exactly through a composite cubic-and-mask ansatz, and an unconstrained control network. The composite loss combines the physics residual at the collocation points with a trapezoidal approximation of the cost functional, weighted by a single scalar hyperparameter. On the benchmark considered, the PINN reproduces the classical optimal cost to four significant digits, satisfies the terminal state constraints exactly by construction, and produces pointwise state and control errors that fall within the spread of the two classical references. Training is approximately two orders of magnitude slower than classical shooting on this benchmark, which is honestly reported. The contribution is methodological clarity rather than methodological novelty: the formulation and the accompanying Google Colab implementation are intended to lower the barrier to entry for practitioners exploring PINN-based optimal control without prior exposure to adjoint methods or two-point boundary value problems.