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

Generalization Hacking: Models Can Game Reinforcement Learning by Preventing Behavioral Generalization

arXiv:2606.12016v1 Announce Type: cross Abstract: Model post-training, and in particular reinforcement learning (RL), is one of the primary mechanisms by which developers can shape models' values and behaviors. However, as models become increasingly evaluation and training aware, they may be motivated to resist training when the perceived objective conflicts with their current values, undermining developers' ability to detect misalignment and correct model behavior through further training. In this paper, we demonstrate generalization hacking, in which a model collects reward during RL while preventing the rewarded behavior from generalizing. We construct a model organism on Qwen3-235B-A22B, finetuning on synthetic documents describing training awareness and self-inoculation, a novel mechanism in which the model frames compliance as context-specific in its chain of thought, without demonstrating or instructing either behavior. The model organism achieves train-time harmfulness comparable to controls while maintaining a persistent ${\sim}15$ percentage point compliance gap across 700 steps of RL. Additionally, a control organism trained only on training awareness documents independently discovers inoculation-like reasoning under RL pressure, developing its own compliance gap despite never being exposed to the concept. Because the generalization-hacking organism receives high reward throughout, standard training metrics provide no signal that generalization has failed. Our results constitute the first demonstration that a model can actively resist RL behavioral modification while maintaining high reward, suggesting that as models become more capable and training-aware, they may be able to undermine the training process itself.

02.
arXiv (CS.CL) 2026-06-19

Multi-Agent Transactive Memory

The decentralized deployment of LLM agents with diverse capabilities across diverse tasks motivates infrastructure for knowledge sharing across heterogeneous agent populations. Just as search engines index human-generated artifacts to support human problem solving, retrieval systems can organize agent-generated artifacts for reuse across agent populations. We extend retrieval-augmented generation - which demonstrates the value of human-authored artifacts to individual agents - to retrieval of agent-generated artifacts supporting a population of agents. In particular, agent trajectories encode reusable procedural knowledge, yet these artifacts are typically discarded after a single use or retained only by the producing agent, forcing newly instantiated agents to repeatedly rediscover existing solutions. We propose Multi-Agent Transactive Memory (MATM), a framework for population-level storage and retrieval of agent-generated trajectories, where producer agents contribute trajectories to a shared repository and consumer agents retrieve them to improve task execution. We focus on interactive environments (ALFWorld and WebArena), where trajectories are long and encode especially rich procedural structure. Our experiments demonstrate that retrieving trajectories from MATM improves downstream task performance and reduces interaction steps without coordination or joint training. These results position MATM as a design pattern for population-level experience sharing in open agent ecosystems.

03.
arXiv (CS.AI) 2026-06-18

A Taxonomy of Mental Health and Technology Needs for Alzheimer's and Dementia Caregivers

arXiv:2606.19247v1 Announce Type: cross Abstract: Family members caring for individuals with Alzheimer's disease and related dementias (AD/ADRD) provide the foundation of long-term care worldwide. In 2023, more than 11 million U.S. family and friends contributed 18 billion hours of unpaid care, often at the cost of their own physical and mental health. These informal caregivers – also referred as the "invisible second patients" – experience elevated rates of mental health problems. Yet research commonly reduces their complex psychosocial experiences to a single construct of caregiver burden, obscuring which specific needs are unmet or effectively supported. At the same time, digital and AI-enabled technologies are rapidly expanding, from smartphone apps and videoconferencing to sensor platforms and AI chatbots. However, the absence of shared frameworks across medicine, psychology, and technology research limits cumulative progress. This study introduces a Caregiver Mental Health and Technology Taxonomy that systematically links AD/ADRD caregiver needs with corresponding classes of technology-based interventions. Drawing from an interdisciplinary literature review and two qualitative studies with caregivers, the taxonomy identifies mismatches between caregiver priorities and existing technological support, highlights under-served domains such as relational strain and compassion fatigue, and proposes design directions for adaptive, responsive systems. The framework offers a shared vocabulary to guide clinicians, researchers, and technology designers in developing more person-centered and clinically grounded innovation in dementia care.

04.
arXiv (CS.CV) 2026-06-12

Emerging Flexible Designs for Geospatial Multimodal Foundation Models

Foundation models are rapidly transforming Earth observation by enabling scalable pretraining across diverse unlabeled geospatial modalities. However, their architectural diversity ranging from encoder-only to encoder-decoder and masked autoencoding paradigms makes it challenging to assess performance trade offs in a consistent manner. In this work, we present an apples-to-apples comparison of leading FM architectures designed for geospatial multimodal reasoning, with a particular focus on flexibility across varied spectral band configurations. We standardize pretraining using identical self supervised learning objectives and training datasets, and evaluate all models under consistent parameterization on the GEOBench benchmark across classification and segmentation tasks. Our results offer new insights into the design trade-offs between model flexibility, modality alignment, and downstream task performance. By highlighting architectural strengths and limitations under controlled conditions, this study provides practical guidance for building next generation geospatial foundation models capable of robust multimodal reasoning.

05.
arXiv (CS.CL) 2026-06-15

The Coin Flip Judge? Reliability and Bias in LLM-as-a-Judge Evaluation

Authors:

LLM-as-a-Judge is now widely used to rank model outputs, train reward models, and populate public leaderboards, but its run-to-run reliability remains under-characterized. We study repeated identical evaluations on 29 tasks spanning 10 categories using two OpenAI judge models (GPT-4o-mini and GPT-4.1-mini), with 50 pairwise trials and 50 pointwise trials per question, supplemented by temperature and prompt-sensitivity ablations. Across judges, pairwise preferences flip on average 13.6% of the time, with 28% of questions exceeding a 20% flip rate and one question reaching 56%. GPT-4o-mini also exhibits a significant first-position bias (72% A-majority, p = 0.024). At the same time, mean pointwise score gaps are small (0.19–0.36 on a 10-point scale) and not statistically significant in aggregate, producing a pairwise–pointwise gap: judges frequently choose a winner even when their own scalar scores provide little evidence of a meaningful quality difference. Beyond within-judge instability, cross-judge agreement is only 76% ($\kappa = 0.51$), semantically equivalent prompt templates change majority outcomes in 25% of tested cases, and deterministic decoding reduces but does not eliminate inconsistency. A reliability curve analysis shows that, in our dataset, 11 repeated trials are needed for a majority vote to recover the 50-trial reference verdict with 95% probability on average, rising to 15 for high-variance questions. These findings suggest that single-trial LLM judging is often too noisy for high-stakes evaluation, and that multi-trial aggregation, position randomization, and explicit uncertainty reporting should be standard practice. Because both judges are from a single provider, cross-provider replication remains an important next step.

06.
medRxiv (Medicine) 2026-06-24

Co-development of anxiety and depression in UK and Brazil youth; a cross-country comparison

Importance Anxiety and depression frequently co occur and show developmentally patterned co-development from childhood to adolescence. Adult psychiatric outcomes vary according to the timing, sequencing, and persistence of early symptoms, yet it remains unclear whether patterns of co development are comparable across high income and low and middle income country contexts. Objective Examine joint developmental trajectories of anxiety and depression from childhood to adolescence and their associations with anxiety and depression diagnoses in young adulthood. Design, Setting and Participants Population based prospective cohort studies in the UK (Avon Longitudinal Study of Parents and Children [ALSPAC], N=9,586) and Brazil (Pelotas 2004 Birth Cohort, N=3,815). Main Outcomes and Measures Trajectories were derived using parallel process latent growth models and latent class growth analyses of anxiety and depression using the Development and Well Being Assessment at early childhood (6-7 years), middle childhood (10-11 years), and adolescence (13-15 years). Diagnoses of anxiety and depression at 18 years were assessed via the Clinical Interview Schedule (ALSPAC) and the Mini International Neuropsychiatric Interview (Pelotas). Results Prevalence of anxiety and depression from early childhood to adolescence was similar across cohorts. Co-development was stronger in ALSPAC, with modest increases in both conditions, whereas in Pelotas, anxiety increased rapidly while depression showed little average change. In both cohorts, four trajectory classes were identified: stable-low (ALSPAC, 41%; Pelotas, 54%), increasing (31%; 28%), decreasing (23%; 15%), and persistent-high anxiety/increasing depression (5%; 3%). Compared with the stable-low class, youth in the increasing and persistent-high classes had elevated odds of depression (ALSPAC: OR=2.0 [95% CI, 1.4-2.8] and 4.2 [2.6-6.7]; Pelotas: 2.2 [1.5-3.3] and 2.9 [1.4-6.0]) and anxiety in young adulthood (ALSPAC: 1.6 [1.2-2.2] and 4.8 [3.2-7.0]; Pelotas: 1.7 [1.2-2.6] and 2.9 [1.5-5.8]). No increased risk was observed in the decreasing class. Conclusions and Relevance Patterns of anxiety and depression co development were comparable across the UK and Brazil, suggesting shared developmental pathways. However, more rapid increases in anxiety among Brazilian youth may reflect context specific risk factors. Persistence or emergence beyond early childhood was critical for identifying later diagnostic risk in both settings, highlighting the importance of early monitoring and intervention.

07.
arXiv (CS.AI) 2026-06-24

2.5-D Decomposition for LLM-Based Spatial Construction

arXiv:2605.07066v3 Announce Type: replace Abstract: Autonomous systems that build structures from natural-language instructions need reliable spatial reasoning, yet large language models (LLMs) make systematic coordinate errors when generating three-dimensional block placements. We present a neuro-symbolic pipeline based on 2.5-D decomposition: the LLM plans in the two-dimensional horizontal plane while a deterministic executor computes all vertical placement from column occupancy, eliminating an entire class of errors. On the Build What I Mean benchmark (160 rounds), GPT-4o-mini with this pipeline achieves 94.6\% mean structural accuracy across 12 independent runs, within 3.0 percentage points of the 97.6\% ceiling imposed by architect-agent errors that no builder-side improvement can address. This outperforms both GPT-4o at 90.3\% and the best competing system at 76.3\%. A controlled ablation confirms that 2.5-D decomposition is the dominant contributor, accounting for 50.7 percentage points of accuracy. The pipeline transfers directly to edge hardware: Nemotron-3 120B running locally on an NVIDIA Jetson Thor AGX matches the cloud result at 94.5\% with no prompt modifications. The underlying principle, removing deterministic dimensions from the LLM's output space, applies to any autonomous construction or assembly task where gravity or other physical constraints fix one or more degrees of freedom. A transfer experiment on 500 IGLU collaborative building tasks confirm the effect generalizes beyond the primary benchmark.

08.
medRxiv (Medicine) 2026-06-23

Association between the hemoglobin albumin lymphocyte and platelet score and chronic kidney disease: insights from patient data and animal models

Introduction The hemoglobin, albumin, lymphocytes and platelets (HALP) score, a novel nutritional and inflammatory biomarker, has been used in various chronic disease studies. However, the relationship between the HALP score and chronic kidney disease (CKD) remains poorly elucidated. This study aimed to explore the possible association between the HALP score and CKD. Methods Our analysis encompassed 25,160 adult participants drawn from NHANES cycles spanning 2009 through 2018. Weighted multivariable logistic regression and generalized additive models (GAMs) were employed to evaluate the independent associations between the HALP score and CKD, albuminuria, and low-estimated glomerular filtration rate (eGFR). Threshold effects were examined using two-piecewise linear regression. Subgroup and sensitivity analyses were performed to assess robustness. Receiver operating characteristic (ROC) curve analyses were applied to compare the discriminative capacity of the HALP score with the prognostic nutritional index (PNI), systemic immune-inflammation index (SII), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR). The clinical findings were further validated in a 5/6 nephrectomy rat model. Results After adjustment for multiple confounders, higher HALP scores were inversely associated with the risk of CKD (OR = 0.97, 95% CI: 0.94-0.99) and albuminuria (OR = 0.97, 95% CI: 0.93-0.99). However, after full adjustment for demographic characteristics, physical examination indices and laboratory parameters (Model 3), the correlation between the HALP score and low-eGFR was no longer statistically significant. Non-linear analyses revealed a threshold effect, with CKD risk declining as the HALP score increased up to an inflection point of 52.43 (OR = 0.97, 95% CI: 0.95-0.99), beyond which no further protective effect was observed. A similar threshold effect was identified for albuminuria. Subgroup and interaction analyses indicated no meaningful effect modification by age, sex, BMI, hypertension, or diabetes. Sensitivity analyses confirmed the robustness of the results. ROC analysis demonstrated that the HALP score showed superior discriminative ability for CKD and albuminuria compared with PNI, SII, LMR, and PLR. In the animal experiment, CKD model rats exhibited significantly lower HALP scores than controls. Inverse correlations were observed between the HALP score and serum creatinine (Scr), blood urea nitrogen (BUN), and urinary albumin-to-creatinine ratio (UACR), with UACR showing the strongest correlation, which was consistent with the clinical findings. Conclusion Lower HALP scores are independently associated with increased prevalence of CKD and albuminuria. As an affordable and readily measurable biomarker, the HALP score may facilitate CKD risk assessment.

09.
arXiv (CS.CV) 2026-06-17

Flux-Guard: Facial Identity Protection using diffusion models

The widespread deployment of face recognition (FR) systems exposes personal images shared on social media and public platforms to identity linkage and privacy risks. Existing adversarial privacy protection methods can degrade unauthorized FR performance but are not compatible with generative face editing. Artificial intelligence-driven face editing tools are gaining popularity, which has significantly increased user demand for personalized portrait generation and social sharing. However, current editing methods often preserve identity features, making the edited images still susceptible to tracking by malicious FR systems. Thus, this paper proposes Flux-Guard, a privacy-preserving face editing framework based on adversarial attacks, which integrates face editing and privacy protection within a unified generative process. Specifically, we design a flow trajectory control method to align semantic manipulations with the generative process and introduce latent-space adversarial optimization with an adaptive perceptual-loss-driven weighting strategy, dynamically adjusting adversarial strength to maximize attack effectiveness while preserving visual quality. Extensive experiments demonstrate that Flux-Guard supports face editing while significantly improving attack success rates against cross-domain face recognition models on the CelebA-HQ and LADN datasets. Furthermore, evaluation results for commercial APIs have confirmed its effectiveness in real-world applications. The code is released at https://github.com/JLMWang/Flux-Guard.

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

On the Redundancy of Timestep Embeddings in Diffusion Models

arXiv:2606.20416v1 Announce Type: new Abstract: Diffusion models rely heavily on explicit timestep embeddings to modulate the denoising process across various noise scales. In this work, we challenge the necessity of these temporal signals by analyzing their impact on U-Net and Diffusion Transformer architectures. Beyond empirical evidence, we provide a theoretical framework demonstrating that, under certain conditions, the global minimizer of the diffusion training objective can be achieved without explicit timestep conditioning. Our findings reveal a surprising robustness when timestep embeddings are completely removed. Extensive ablation studies on the CelebA and CIFAR-10 datasets show that these time-agnostic models can maintain high structural fidelity and even surpass their conditioned counterparts in competitive metrics, including FID, precision, and recall. Our analysis suggests these architectures can implicitly infer noise scales from the corrupted input under specific assumptions, rendering explicit temporal conditioning redundant. This study challenges long-standing temporal conditioning paradigms and paves the way for more efficient and structurally focused generative architectures.

11.
arXiv (CS.LG) 2026-06-19

Variational Consensus Monte Carlo for Bayesian Mixture

arXiv:2606.19643v1 Announce Type: cross Abstract: Motivated by the privacy, sensitivity and sharing limitations of health data, we present a comprehensive pipeline for inference of Bayesian mixture models within a federated learning setting, i.e. when data cannot be fully shared or pooled across compute nodes. We adopt a Consensus Monte Carlo (CMC) approach, in which an MCMC algorithm is run independently within each data silo to estimate local posterior distributions, which are then aggregated to approximate the posterior over the full data. The variational CMC approach of Rabinovich, Angelino and Jordan (2015) [1] frames the aggregation step as a variational inference problem, but their application to mixtures assumes the number of clusters and key mixture parameters to be known. Our main methodological contributions are: (i) an extension of variational CMC to over-fitted Bayesian mixture models that infer the number of clusters and all model parameters, without requiring conjugacy; (ii) novel cluster-matching algorithms suitable for cross-silo settings in which not every cluster appears in each local dataset; (iii) a number of inference strategies for the aggregation step, matched to different federated learning constraints; and (iv) guidelines for choosing among these in practice. A comprehensive simulation study validates the framework and allows us to compare to state-of-the-art federated learning alternatives. Notably, we show that when the composition of local datasets reflects the underlying clustering structure in the data, our approach can recover small clusters with greater accuracy than standard MCMC applied to the pooled data. We illustrate the framework on large-scale electronic health record data, identifying multi-morbidity patterns in a British geriatric population.

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

Vernier: Probing Representational Misalignment Behind Lexical Gaps in Causal Reasoning

Authors:

Instruction-tuned language models can answer the same causal-reasoning question differently after its English variable names are replaced by type-preserving placeholders, although the structural causal model and the gold answer are unchanged. We ask whether this lexical gap reflects information loss in the placeholder view or a misaligned read-out from a representation that still carries answer-relevant content. Vernier uses a paired-view weight update as an instrument and then inspects the mechanism left after the gap closes. In the working regimes, the evidence favours representational misalignment. A variable-name probe becomes more accurate on the placeholder view, and activation patching on Qwen-7B, Qwen-14B, and Llama-3.1-8B shows that the decision-token representation can transfer answer identity between views. The update that realigns the views is counterfactual augmentation over original and placeholder prompts, while the answer-subspace KL mainly sharpens intermediate answer-belief agreement. Success is bounded by model family, scale, and task. CRASS transfer is reliable across Qwen scales and Llama, e-CARE remains weak, and preliminary non-causal rename tasks show a similar qualitative pattern.

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

Execution-State Capsules: Graph-Bound Execution-State Checkpoint and Restore for Low-Latency, Small-Batch, On-Device Physical-AI Serving

Authors:

arXiv:2606.20537v1 Announce Type: new Abstract: Mainstream LLM serving systems reuse prefix work mainly through paged or radix key-value (KV) caches. This is highly effective for high-throughput, high-concurrency serving, but it manages only one positional fragment of execution state: the KV cache. We study the opposite regime: low-latency, small-batch, on-device physical-AI serving, where interactive LLM agents, speech systems, and robot policies repeatedly branch, reset, interrupt, and re-enter under tight responsiveness budgets. We introduce execution-state capsules, a graph-bound checkpoint and restore mechanism for the complete restorable state at a committed boundary. FlashRT is a white-box, backend-facing kernel runtime whose evaluated NVIDIA CUDA backend runs captured graph plans over contiguous static buffers with no block-table indirection. Because the live state is a closed set of named buffers, a capsule can snapshot, restore, fork, or roll back the whole execution boundary, including KV, recurrent state, convolution state, MTP state, and metadata. This moves reuse from token-addressed KV fragments to graph-bound execution-state boundaries. On an RTX 5090, capsule restore is byte-exact at the stored-state level and token-identical under greedy decode. A KV-only ablation diverges, showing that recurrent state is load-bearing. GPU-resident snapshot and restore are sub-millisecond, and TTFT speedup over cold prefill grows from 3.9x at 2k tokens to 27x at 16k tokens. On Jetson AGX Thor and DGX Spark, the same correctness and structural properties hold. Capsules are not a replacement for high-throughput KV-cache serving; they define a complementary latency-first serving point for explicit execution-state reuse.

14.
arXiv (CS.AI) 2026-06-15

When Should Agent Trust Be Conditional? Characterizing and Attacking Skill-Conditional Reputation in Agent Swarms

arXiv:2606.14200v1 Announce Type: new Abstract: Open platforms increasingly route tasks among heterogeneous LLM agents–differing in base model, scaffold, and tool stack–whose competence varies sharply by skill: an agent excellent at one skill may be useless at another. The standard reputation approach summarizes each agent by a single global trust score, but that scalar is the wrong object here, because routing every task to the globally most-trusted agent leaves the value of specialization unclaimed. We study skill-conditional trust R(i | k)–the trust to place in agent i for a task requiring skill k, rather than one score per agent–and pose three falsifiable questions: when is conditioning worth it, how much cross-skill evidence should be borrowed, and whether that borrowing is safe. A controlled phase-diagram analysis answers the first two: conditional trust wins only in a specific regime–high agent heterogeneity, sparse per-skill evidence, and correlated skills–and the coupling strength beta that buys this data efficiency is dual-use, because the same cross-skill borrowing is also a laundering channel. On a public benchmark of 14 genuinely heterogeneous AppWorld agents, real pools land inside the beneficial regime–a small but genuine gain, with the per-skill best agent genuinely changing across skills. We then show that an attacker with cheap evidence in one skill and none in a target skill hijacks the conditional router, driving routing regret from 0 to 0.94 on a pool our zero-cost Conditional Information Value Test (CIVT) rates GREEN–while the ungated trust verdict it contaminates reads -0.06 instead of the honest +0.19. A zero-evidence gate bounds the attack but does not eliminate it; we characterize the residual cost under an explicit budget. We do not claim Sybil-resistance–we quantify the trade-off.

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

Sentence-Level Contextual Entrainment in Large Language Models

Contextual entrainment, which is a newly discovered phenomenon in large language models (LLMs), refers to the tendency of a model to assign higher probabilities to tokens that appear in its context. In this work, we extend this phenomenon from the token level to the sentence level by examining the per-token mean log-probability of a sentence instead of the probabilities of individual tokens. We investigate sentence-level contextual entrainment across 26 LLMs from seven families and two datasets, which cover both subjective and objective tasks. We find that sentence-level contextual entrainment exists. This means that the sentences in the prompt (even if they are counterfactual statements) can significantly increase their probability during model inference time. As the model size increases, contextual entrainment gradually decreases. We also find that contextual entrainment is controlled by 2% to 4% of the attention heads. Turning off these attention heads can effectively mitigate contextual entrainment without hurting the model's performance.

16.
Nature Medicine 2026-06-15

Adaptive deep brain stimulation for dynamic gait control in Parkinson’s disease: a randomized feasibility trial

A randomized crossover study of five patients with Parkinson’s disease (PD) demonstrates that gait-synchronized adaptive deep brain stimulation is feasible and safe, and reduces falls compared with continuous stimulation. Gait dysfunction in PD is a major source of disability and is often insufficiently treated by continuous deep brain stimulation (cDBS). Although adaptive DBS (aDBS) has shown efficacy for other motor symptoms using β-based, state-driven neural signals, gait is a dynamic, cyclical behavior that may require temporally precise modulation. Here we evaluated a behavior-contingent aDBS approach that synchronizes stimulation to gait phase. We reported a single-center, blinded, randomized, crossover study evaluating the feasibility of identifying patient-specific biomarkers to drive aDBS. The primary outcome was feasibility of successful identification of gait-phase biomarkers to implement aDBS. Five participants with PD undergoing pallidal DBS and subdural electrode paddle implantation were enrolled. We successfully identified personalized gait-phase biomarkers from cortical or pallidal field potentials in all five patients and embedded them into a bidirectional neurostimulator. During acute in-clinic testing, aDBS improved step variability and step symmetry versus cDBS. Three participants subsequently completed a double-blinded, multi-day crossover phase. In this setting, aDBS maintained general motor symptom control, reduced falls and yielded patient-specific gait improvements. No adverse events occurred and aDBS was well tolerated. These findings establish the feasibility of biomarker-driven, movement-synchronized neuromodulation and support the development of a larger randomized trial to determine clinical efficacy. ClinicalTrial.gov registration: NCT04675398 . A randomized crossover study shows that gait-phase-synchronized adaptive deep brain stimulation is feasible and safe, and reduces falls compared to continuous stimulation in Parkinson’s disease.

17.
PLOS Medicine 2026-06-04

Comparative impacts and cost-effectiveness of tuberculosis systematic screening strategies in prisons in Brazil, Colombia, and Peru: A mathematical modeling study

Authors:

by Yiran E. Liu, José Victor Bortolotto Bampi, Ronan F. Arthur, Argita D. Salindri, Caroline Busatto, Pedro Avedillo Jiménez, Daniele Maria Pelissari, Fernanda Dockhorn Costa Johansen, Robert Arana-Narvaez, Alvaro Fernando Moreno Roca, Wilfredo Santos Solís Tupes, Esther Mori Jiu, Christian Alfredo Moreno Roca, Erika Albertina Abregú Contreras, Valentina Antonieta Alarcón Guizado, Julián Trujillo Trujillo, Belkys Marcelino, Mónica Alonso Gonzalez, Mayra Cecilia Córdova Ayllon, Ted Cohen, Moises A. Huaman, Jeremy D. Goldhaber-Fiebert, Julio Croda, Jason R. Andrews Background Incarceration is a leading driver of tuberculosis in Latin America. Systematic screening in prisons may reduce tuberculosis burden, but optimal strategies and cost-effectiveness remain uncertain. We examined the population-wide health impacts and cost-effectiveness of systematic screening in prisons in Brazil, Colombia, and Peru, comparing different timepoints, frequencies, and screening algorithms. Methods and findings Using dynamic transmission models calibrated to Brazil, Colombia, and Peru, we simulated annual or biannual (twice-yearly) prison-wide screening, alone or combined with entry and exit screening from 2026 to 2035. We evaluated four algorithms: (1) symptom screening, (2) chest X-ray with computer-aided detection (CXR-CAD), (3) symptoms and CXR-CAD (follow-up testing if either is positive), and (4) GeneXpert Ultra (Xpert) with pooled sputum. Individuals screening positive then received individual Xpert. We projected impacts on within-prison and population-level tuberculosis incidence in 2035, along with discounted costs (2023 US dollars) and disability-adjusted life years (DALYs). Model projections showed that combined entry, exit, and biannual screening with CXR-CAD was highly impactful and cost-effective across countries, reducing tuberculosis incidence by 61%–87% in prisons and 18%–28% population-wide. Compared to only biannual CXR-CAD (the next best strategy), the incremental cost per DALY averted of adding entry and exit screening was $2,984 (Brazil), $2,925 (Colombia), and $645 (Peru). Adding symptom screening to CXR-CAD marginally increased benefit and was only cost-effective in Peru’s higher-incidence prisons. Biannual screening alone remained cost-effective at prison incidence levels well below national averages, as well as at far lower willingness-to-pay thresholds. In settings without CXR-CAD, pooled Xpert was an impactful, cost-effective alternative. Key limitations include the model’s simplified representation of tuberculosis disease states and lack of stratification by age, gender/sex, HIV, or drug resistance. Conclusions These modeling results support immediate national-level adoption of prison-wide tuberculosis screening twice-yearly and at entry and exit, using CXR-CAD or pooled Xpert.

18.
medRxiv (Medicine) 2026-06-24

Breaking The Pain-Stiffness Cycle- Supraclavicular Catheter Facilitated Rehabilitation Of Post-Surgical Elbow stiffness- A Retrospective Observational Study

ABSTRACT Background: Post-traumatic elbow stiffness is a recognised complication following orthopaedic trauma surgery, occurring in 10-15% of trauma patients sustaining injuries. Pain remains the primary barrier to physiotherapy compliance, with surgical arthrolysis carrying recurrence rates of up to 34%. The supraclavicular brachial plexus block, referred to as the 'spinal of the arm', provides anaesthesia and analgesia to the entire upper limb below the shoulder. A structured non-surgical approach combining continuous catheter analgesia with timed rehabilitation was identified as an unmet need in this patient group. Methods: A single-centre retrospective observational study was conducted on data of patients treated for post-surgical upper limb stiffness between January 2022 and April 2026. Of 30 patients identified, 28 with elbow involvement formed the primary analysis group following exclusion of 2 patients with isolated wrist stiffness and complex regional pain syndrome. Ultrasound- guided supraclavicular brachial plexus catheters were inserted using the Contiplex system. Patients received 0.5% Bupivacaine (10-15ml) for initial blockade, followed by daily top-up doses of 0.2% Ropivacaine(20ml) given 30 minutes prior to structured physiotherapy and CPM sessions for up to 5 days. The primary outcome was change in arc of elbow motion in degrees, measured by the attending orthopaedic consultant using standard goniometry. Results: Complete pre- and post- intervention data were available for all 28 patients. Mean pre-intervention arc of elbow motion was 39.1{degrees}(SD+/-23.2{degrees}), improving to 104.2{degrees}(SD+/- 30.0{degrees}) post-intervention. Mean improvement was 65.1{degrees}(SD+/- 30.6{degrees} ); 95% CI 53.8{degrees} to 76.4{degrees} ; range 10{degrees}-140{degrees} ; paired t-test t=-11.27, p

19.
medRxiv (Medicine) 2026-06-17

Frequency-dependent cognitive effects of Deep Brain Stimulation in Parkinson's Disease: A Systematic Review and Meta-Analysis

Background: Subthalamic nucleus deep brain stimulation (STN-DBS) improves levodopa-induced motor complications and cardinal motor symptoms of Parkinson's disease (PD), but stimulation frequency may differentially shape outcomes. This is evident for axial and gait symptoms, which may respond differently to lower-frequency stimulation. Whether frequency-dependent effects extend to cognition remains unclear. Objective: To investigate the cognitive effects of DBS at distinct frequencies in PD. Methods: We conducted a systematic review and meta-analysis (PROSPERO - CRD42024618253). PubMed, Web of Science, and EMBASE were searched for studies assessing cognitive outcomes under different stimulation frequencies. Eight cognitive domains were defined: verbal fluency, cognitive flexibility, executive control, working memory, attention, processing speed, episodic memory, and time processing. Multilevel random-effects meta-analyses were performed, with effect sizes expressed as Hedges' g. Results: Forty-three studies met the inclusion criteria, the majority (n = 31) involving STN-DBS. Twenty-one STN-DBS studies, including 355 patients, were included in the meta-analysis. Compared with HFS ([≥] 130 Hz), lower frequencies (4-80 Hz) were associated with better verbal fluency (g = 0.27) and cognitive flexibility (g = 0.38), with consistent effects across sensitivity and leave-one-out analyses. Accuracy-based executive control measures also favored lower-frequency stimulation. OFF-stimulation comparisons showed a concordant pattern. Evidence for other targets (PPN and NBM) was limited. Conclusions: Lower-frequency STN-DBS was associated with modest benefits in specific cognitive domains compared with HFS. These findings highlight the need for future research to determine how frequency interacts with stimulation location and symptom-specific networks to shape cognitive and cognitive-motor outcomes in PD.

20.
arXiv (CS.CV) 2026-06-15

Fast Autoregressive Video Diffusion and World Models with Temporal Cache Compression and Sparse Attention

Autoregressive video diffusion models enable streaming generation, opening the door to long-form synthesis, video world models, and interactive neural game engines. However, their core attention layers become a major bottleneck at inference time: as generation progresses, the KV cache grows, causing both increasing latency and escalating GPU memory, which in turn restricts usable temporal context and harms long-range consistency. In this work, we study redundancy in autoregressive video diffusion and identify three persistent sources: near-duplicate cached keys across frames, slowly evolving (largely semantic) queries/keys that make many attention computations redundant, and cross-attention over long prompts where only a small subset of tokens matters per frame. Building on these observations, we propose a unified, training-free attention framework (FAST-AR) for FAST-AutoRegressive diffusion, consisting of three components: TempCache compresses the KV cache via temporal correspondence to bound cache growth; AnnCA accelerates cross-attention by selecting frame-relevant prompt tokens using fast approximate nearest neighbor (ANN) matching; and AnnSA sparsifies self-attention by restricting each query to semantically matched keys, also using a lightweight ANN. Together, these modules reduce attention, compute, and memory and are compatible with existing autoregressive diffusion backbones and world models. Experiments demonstrate up to x5 - x10 end-to-end speedups while preserving near-identical visual quality and, crucially, maintaining stable throughput and nearly constant peak GPU memory usage over long rollouts, where prior methods progressively slow down and suffer from increasing memory usage.

21.
arXiv (CS.CV) 2026-06-11

Active Sampling for Ultra-Low-Bit-Rate Video Compression via Conditional Controlled Diffusion

Diffusion models provide a powerful generative prior for perceptual reconstruction at ultra-low bitrates, but effective video compression requires controlling the generative process using highly compact conditioning signals. In this work, we present ActDiff-VC, a diffusion-based video compression framework for the ultra-low-bitrate regime. Our method partitions videos into variable-length segments, transmits keyframes only when needed, and summarizes temporal dynamics using a compact set of tracked point trajectories. Conditioned on these sparse signals, a conditional diffusion decoder synthesizes the remaining frames, enabling perceptually realistic reconstruction under severe rate constraints. To support this design, we introduce two mechanisms: content-adaptive keyframe selection and budget-aware sparse trajectory selection, which together enable compact yet effective conditioning for generative reconstruction. Experiments on the UVG and MCL-JCV benchmarks show that ActDiff-VC achieves up to 64.6\% bitrate reduction at matched NIQE, improves KID by up to 64.6\% and FID by up to 37.7\% at comparable bitrates against strong learned codecs, and delivers favorable perceptual rate–distortion trade-offs relative to learned and diffusion-based baselines in the ultra-low-bitrate regime.

22.
arXiv (CS.AI) 2026-06-17

FoundCause: Causal Discovery with Latent Confounders from Observational Data

arXiv:2606.17516v1 Announce Type: cross Abstract: Causal discovery from observational data remains challenging due to the need to recover directed structure and latent confounding without interventions. We propose FoundCause, an amortized causal discovery model trained entirely on synthetic data that maps datasets directly to causal graphs in a single forward pass. By learning from large collections of simulated structural causal models, FoundCause captures transferable statistical patterns that generalize beyond individual datasets. The architecture incorporates several key inductive biases for causal discovery. It uses a permutation-invariant transformer encoder with alternating attention over samples and variables to jointly model cross-variable dependence and per-variable distributions. Pairwise statistical features derived from classical asymmetry measures are injected through statistics-conditioned attention, guiding the model toward known causal signals. A factorized decoder separates edge existence from direction, while a triangular refinement module enables reasoning over higher-order causal motifs such as chains and colliders. In addition, a dedicated confounder module based on learnable latent tokens explicitly models hidden common causes, and the model explicitly handles missing data via its masked input representation. To our knowledge, FoundCause is the first amortized causal discovery approach to explicitly model latent confounding. FoundCause outperforms 11 classical non-amortized methods (e.g., PC, GES, NOTEARS-style optimization) and 4 amortized causal discovery methods on 15 real-world datasets, achieving +9.6% improvement in $F_1$, +1.2% in AUROC, and an 18.9% reduction in structural Hamming distance relative to the strongest non-amortized methods, while performing inference in a single forward pass.

23.
arXiv (CS.AI) 2026-06-24

Alternate loss functions and regression models that achieve robustness to outliers by modulating the learning rate

arXiv:2606.22068v2 Announce Type: replace-cross Abstract: Most real-world datasets used for training supervised learning models are contaminated with noisy data and outliers leading to large prediction errors. This paper proposes a new approach for achieving robustness where the learning rate is modulated by a factor that is sensitive to outliers. In this approach a reduction of the learning rate is shown to be achieved by using alternate loss functions that are infinitely differentiable, strictly convex or quasiconvex and more closely approximate the absolute error than Huber and log-cosh losses. A comparison of the performance of regression models trained with different loss functions on a wide variety of benchmarks and datasets is presented to demonstrate the superior performance of the Square Root Loss (SRL) and Smooth Mean Absolute Error (SMAE) losses proposed in this paper. Two new robust linear regression models are presented. Highly vectorized robust parameter update formulae that take advantage of modern GPUs for both stochastic and batch gradient descent are presented.

24.
PLOS Computational Biology 2026-06-09

Evolution of phenocopying in a dynamical model of developmental trajectories

by Yuuki Matsushita, Archishman Raju Developmental trajectories are known to be canalized, or robust to both environmental and genetic perturbations. However, even when these trajectories are decanalized by an environmental perturbation outside the range of conditions to which they are robust, they often produce phenotypes similar to known mutants, called phenocopies. This correspondence between the effects of environmental and genetic perturbations has received little theoretical attention. Here, we study an abstract regulatory model that is evolved to follow a specific trajectory. We then study the effects of small and large perturbations to the trajectory, both by changing parameters and by perturbing the state at specific times. We find that the phenomenon of phenocopying emerges in evolved trajectories and is not present in a null model of randomly sampled trajectories. Our results suggest that, in this class of dynamic models, evolution can allow high-dimensional phenotypic landscapes to simultaneously exhibit robustness and phenocopying.

25.
arXiv (CS.AI) 2026-06-12

Reasoning for Mobile User Experience with Multimodal LLMs: Task, Benchmark, and Approach

arXiv:2606.13192v1 Announce Type: new Abstract: User experience (UX) centered on usability, perceived consistency, and functional clarity is fundamental to real-world user interfaces (UI). The application of multimodal large language models (MLLMs) in the field of user interfaces is evolving rapidly, such as visual element grounding, graphical user interface (GUI) agents, and design-to-code generation. However, research efforts on evaluating UX based on UI screenshots are still immature. To address this, we propose UXBench, a novel multimodal benchmark consisting of 2,000 VQA data samples designed to assess MLLMs' ability to perform UI-based reasoning. UXBench includes 8 tasks based on real-world UI screenshots that require fine-grained diagnosis of UX issues across layout relationships, visual hierarchy, and content consistency. Our extensive evaluation of mainstream MLLMs shows that they remain fundamentally limited in their capacity for UI-based reasoning. The results underscore the need for further advancements in this area. To bridge this gap, we propose UI-UX, an MLLM based on Qwen3-VL-4B-Thinking foundation model and enhanced via reinforcement learning with two key innovations: a reward routing mechanism that dynamically balances perceptual understanding and logical reasoning during inference, and an asymmetric transition reward that suppresses redundant or insufficient reasoning steps. Experiments demonstrate that UI-UX achieves state-of-the-art (SOTA) performance on UXBench, attaining an accuracy of 0.7963 – surpassing Claude-4.5-Sonnet's 0.6550 – while exhibiting strong generalization across diverse UI tasks and maintaining low inference latency.