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01.
arXiv (CS.LG) 2026-06-24

Aligning Audio Captions with Human Preferences

Authors:
Kartik Hegde↗Rehana Mahfuz↗Yinyi Guo↗Erik Visser↗

arXiv:2509.14659v3 Announce Type: replace-cross Abstract: Current audio captioning relies on supervised learning with paired audio-caption data, which is costly to curate and may not reflect human preferences in real-world scenarios. To address this, we propose a preference-aligned audio captioning framework based on Reinforcement Learning from Human Feedback (RLHF). To capture nuanced preferences, we train a Contrastive Language-Audio Pretraining (CLAP) based reward model using human-labeled pairwise preference data. This reward model is integrated into an RL framework to fine-tune any baseline captioning system without ground-truth annotations. Extensive human evaluations across multiple datasets show that our method produces captions preferred over baseline models, particularly when baselines fail to provide correct and natural captions. Furthermore, our framework achieves performance comparable to supervised approaches with ground-truth data, demonstrating effective alignment with human preferences and scalability in real-world use.

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02.
medRxiv (Medicine) 2026-06-24

Generative AI avatar videos for tobacco prevention on social media: a randomized controlled trial

Authors:
Merl↗N. B↗Wies↗Schramm↗Winterstein↗J. T↗Chanda↗Brinker↗T. J↗

Short-form video platforms increasingly shape how young audiences encounter health information. Generative artificial intelligence can produce standardized avatar-based messages at scale, but randomized evidence for tobacco prevention is scarce. In this three-arm randomized online intervention study with pre-post assessment, participants aged 16 years or older were assigned to an AI avatar video emphasizing short-term smoking consequences, an AI avatar video presenting long-term cancer-related information matched to an American Cancer Society fact sheet, or the same fact sheet in written form. The primary outcome was post-intervention intention to avoid smoking and secondhand smoke exposure, adjusted for baseline intention. Among 400 randomized participants, 272 had complete data for the primary baseline-adjusted analysis. Intention increased from baseline to post-intervention in all conditions, with no statistically significant between-group differences. These findings support AI avatar videos as a scalable, social-media-compatible format for digital tobacco prevention, while not establishing superiority or equivalence.

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03.
PLOS Computational Biology 2026-06-22

Heterogeneous suppressive effect of <i>Wolbachia</i> incompatible insect technique coupled with sterile insect technique across time and historical <i>Ae. aegypti</i> abundance - using distributional synthetic controls

Authors:
Yichen Zhai↗

by Yichen Zhai, Chia-Chen Chang, Zhiyong Xi, Cheong Huat Tan, Lee Ching Ng, Jue Tao Lim Background Biological control tools such as Wolbachia incompatible-insect technique, are a promising class of interventions to modify and suppress Aedes aegypti mosquitoes to reduce risk of Aedes-borne diseases. Due to the spatial nature of the intervention, intervention effects can be spatio-temporally heterogeneous. Yet, most evaluations of field-based technologies rely on average treatment effects, which preclude characterization and understanding of treatment effect heterogeneities and the factors influencing it. Methods Here, we developed a causal inference framework using distributional synthetic controls to explicitly account for spatio-temporal trap-level mosquito abundance data to ascertain the entomological efficacy of Wolbachia in suppressing Ae. aegypti abundance. This method is able to construct counterfactual distributions of intervened areas, provide detailed comparisons to actual distributions and quantify treatment effects of the intervention on mosquito abundance over different quantiles. By employing our framework to trap-level mosquito abundance data from 57,990 unique mosquito traps routinely maintained and measured twice a week, and a large-scale field trial of Wolbachia incompatible-insect technique coupled with sterile insect technique (IIT-SIT) in Singapore, we (1) quantified heterogeneous treatment effects for IIT-SIT across the time-since-intervention, over the traps’ historical mosquito abundance, over calendar time, (2) quantified whether elimination of wild-type Aedes aegypti was possible in intervention locations and (3) addressed if suppressive effects in spillover locations adjacent to directly intervened locations were heterogeneous. Results IIT-SIT interventions led to a strong suppressive effect on adult Aedes aegypti abundance. From the onset of intervention in directly treated locations, sector-specific intervention effectiveness (IE) ranged from 24.04% in the earliest treatment period, and reached 86.08% in the latest treatment period. Raw reductions in aegypti abundance were also found to increase over time as sectors were intervened over longer time periods. In spillover sectors, IE was lower in magnitude and more variable, but average IE reached a maximum of 78.08% in 2-years post-treatment. Wolbachia interventions also led to an increase in the percentage of traps recording no mosquitoes from 6.8% at the start of intervention to 33.01% 124-weeks post-intervention. We found that IE was higher in sectors with lower historical mosquito abundance. However, IE converged across sectors with different historical mosquito abundance as intervention time increased. Conclusion This study revealed spatial heterogeneities in suppressing wild-type female Ae. aegypti by IIT-SIT and provided strong evidence that IIT-SIT can drastically suppress wild-type Ae. aegypti populations despite heterogeneous treatment effects over time.

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

Why Depth Matters in Parallelizable Sequence Models: A Lie Algebraic View

Authors:
Gyuryang Heo↗Timothy Ngotiaoco↗Kazuki Irie↗Samuel J. Gershman↗Bernardo L. Sabatini↗

arXiv:2603.05573v2 Announce Type: replace Abstract: Scalable sequence models, such as Transformer variants and structured state-space models, often trade expressivity power for sequence-level parallelism, which enables efficient training. Here we examine the bounds on error and how error scales when models operate outside of their expressivity regimes using a Lie-algebraic control perspective. Our theory formulates a correspondence between the depth of a sequence model and the tower of Lie algebra extensions. Echoing recent theoretical studies, we characterize the Lie-algebraic class of constant-depth sequence models and their corresponding expressivity bounds. Furthermore, we analytically derive an approximation error bound and show that error diminishes exponentially as the depth increases, consistent with the strong empirical performance of these models. We validate our theoretical predictions using experiments on symbolic word and continuous-valued state-tracking problems.

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

Beyond Algorithms: Conceptual Innovation in Medical Imaging AI

Authors:
Mark A. Anastasio↗

arXiv:2606.19270v1 Announce Type: cross Abstract: Artificial intelligence has driven rapid progress in medical imaging research, producing increasingly sophisticated algorithms and steady improvements on benchmark tasks. However, this algorithm-centric trajectory has also revealed a growing imbalance: while computational methods advance rapidly, the conceptual foundations that define imaging tasks, evaluation metrics, and clinical meaning sometimes remain underexamined. In this Perspective, we distinguish algorithmic innovation, which focuses on improving computational implementations and performance within a fixed problem definition, from conceptual innovation, which reframes what problems are posed, how success is measured, and why an approach is clinically relevant. We argue that prevailing incentive structures, training pathways, and publication norms disproportionately reward algorithmic novelty, particularly for early-career researchers, while at times undervaluing conceptual contributions that are essential for scientific maturation and clinical translation. Through representative examples from medical imaging AI, we show how insufficient conceptual grounding can lead to misaligned objectives, fragile generalization, and limited real-world impact. We conclude with actionable recommendations for researchers, mentors, reviewers, and journals to better recognize, support, and integrate conceptual innovation alongside algorithmic advances.

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

ROSE: Benchmarking the Perception-to-Action Gap in Multimodal Models

Authors:
Yihao Wang↗Zijian He↗Jie Ren↗Keze Wang↗

arXiv:2606.19965v1 Announce Type: cross Abstract: Multimodal large language models (MLLMs) are increasingly expected to act on visual information, yet the same scene may require different actions under different task contexts. How reliably can a model turn the same visual evidence into the action required by the current context? To answer this question, we introduce \textsc{ROSE} (Reference-conditioned Oddity and Symbolic Execution), a controlled benchmark that holds the visual scene fixed while varying region constraints and required symbolic outputs. Through coupled counting and coordinate-action tasks, \textsc{ROSE} tests whether models can infer an implicit majority reference and act on the resulting fine-grained visual evidence under changing contexts. Across nine recent MLLMs, performance drops by as much as 44.5 percentage points from counting-oriented tasks to region-conditioned action, despite 98.8\% human performance. The gap persists on paired scenes and regions for which the same model returns the correct count, while global-click and matched local controls show that coordinate grounding explains only part of the loss, revealing a distinct, model-dependent bottleneck in turning shared visual evidence into context-specific actions.

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07.
medRxiv (Medicine) 2026-06-16

Development and reliability and validity test of the Questionnaire on Knowledge, Attitude and Practice of ICU Nurses on Blood Oxygen Saturation Management in Mechanically Ventilated Patients

Authors:
Xie↗Bian↗Yu↗He↗

Objective: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in patients with mechanical ventilation was compiled, and its reliability and validity were tested. Method: Drawing upon the knowledge-attitude-practice theory, the initial questionnaire draft was developed through literature review and consultation with Delphi experts. Employing convenience sampling, 32 nurses from the General ICU of Wuxi Second People's Hospital were surveyed between 1 August 2025 and 27 September 2025, enabling item screening and assessment of reliability and validity.The full version of the developed questionnaire is provided as Supporting Information (S1 File). All items are published under a CC BY 4.0 license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Result: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in mechanically ventilated patients was finalised, comprising 26 items: 11 in the knowledge dimension, 6 in the attitude dimension and 9 in the behaviour dimension. The overall Cronbach's coefficient for the questionnaire was 0.88, with dimension-specific coefficients of 0.787, 0.722, and 0.781 respectively. The Spearman-Brown coefficient for the entire questionnaire was 0.967, while dimension-specific coefficients were 0.796, 0.666, and 0.728 respectively. The content validity index at the questionnaire level (S-CVI) was 0.886, and the item-level content validity index (I-CVI) ranged from 0.913 to 0.967. 0.728. The questionnaire's level content validity index (S-CVI) was 0.886, and the item level content validity index (I-CVI) ranged from 0.913 to 1.00. Conclusion: The questionnaire on knowledge, attitude and practice of blood oxygen saturation management in mechanically ventilated patients demonstrates good reliability and validity. It may serve as an assessment tool for intensive care unit nurses regarding their knowledge, attitude, and practices concerning blood oxygen saturation management in mechanically ventilated patients, thereby establishing a foundation for developing targeted intervention strategies in future practice.

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

Does Traversal Order Matter? A Systematic Study of Tree Traversal Methods in Transformer Grammars

Authors:
Zongru Liu↗Pengyu Ji↗Pengcheng Wang↗Kewei Tu↗

Transformer Grammars (TGs) enhance language modeling by incorporating syntactic tree structures. Despite the potentially significant impact on model performance of how syntactic trees are linearized in TGs, existing studies rely solely on Depth-First Traversal (DFT) for linearization. In this paper, we expand the traversal design space by exploring Breadth-First Traversal (BFT) and a novel hybrid traversal strategy, Production-Rule Traversal (PRT), which combines the structural lookahead of BFT with the early lexical generation of DFT. We integrate these traversal methods with varying tree configurations and masking strategies, and empirically evaluate their performance on language modeling, syntactic generalization and summarization. We reveal the inherent trade-offs between nested composition and global lookahead, providing actionable recommendations for designing task-aware Transformer Grammars.

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09.
arXiv (CS.AI) 2026-06-25

Privacy-preserving federated tensor decomposition of single-cell immune data: recovering multicellular programs across institutions

Authors:
Axel Faes↗Stephanie M. van den Berg↗Maryam Amir Haeri↗

arXiv:2606.24938v1 Announce Type: cross Abstract: Tensor decomposition of donor $\times$ cell-type $\times$ gene single-cell data recovers multicellular programs: coordinated axes of inter-individual transcriptional variation that span cell types and stratify disease. Yet immune single-cell atlases are increasingly multi-institution, multi-ancestry, and governed, so patient cells often cannot be pooled. We present a federated estimator: each site computes a local program subspace, and a coordinator merges these by stacked SVD under federated global-mean centering, provably equivalent (up to truncation) to the centralised decomposition. This centering makes the merge robust to site-label confounding (program AUC $0.957$ vs.\ $0.861$ for naive per-site centering). Only program subspaces leave a site, and aggregation is compatible with secure aggregation. On a 261-donor systemic lupus erythematosus atlas it recovers the canonical interferon program (ISG enrichment AUC $0.998$; case–control separation $0.958$; bootstrap $\DeltaAUC=-0.000$, 95\% CI $[-0.004,+0.012]$ vs.\ centralised), across institution-scale and multi-ancestry partitions, and across three real COVID-19 sites (subspace correlation $0.989$). It recovers the program when no site observes all cell types (correlation $1.000$, exact by construction), which fixed-feature federated PCA cannot. On an interstitial-lung-disease atlas the recovered program predicts disease better than the best single cell type (AUC $0.96$ vs.\ $0.91$; gap 95\% CI excludes zero) and the advantage survives federation; a liver cohort is consistent ($p=0.005$). Membership-inference shows secure aggregation cuts attack AUC from $0.91$ to $0.61$. The method enables cross-institution, cross-ancestry recovery of multicellular immune programs without sharing cells.

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10.
arXiv (quant-ph) 2026-06-12

Improving Variational Counterdiabatic Driving with Weighted Actions and Computer Algebra

Authors:
Naruo Ohga↗Takuya Hatomura↗

arXiv:2505.18367v4 Announce Type: replace Abstract: Variational counterdiabatic (CD) driving is a disciplined and widely used method to robustly control quantum many-body systems by mimicking adiabatic processes with high fidelity and reduced duration. Central to this technique is a universal structure of the adiabatic gauge potential (AGP) over a parameterized Hamiltonian. Here, we reveal that introducing a new degree of freedom into the theory of the AGP can significantly improve variational CD driving. Specifically, we find that the algebraic characterization of the AGP is not unique, and we exploit this nonuniqueness to develop the weighted variational method for deriving a refined driving protocol. This approach extends the conventional method in two aspects: it assigns customized weights to matrix elements relevant to specific problems, and it effectively incorporates nonlocal information into local driving coefficients. We also develop an efficient numerical algorithm to compute the refined driving protocol using computer algebra. Our framework is broadly applicable and, in principle, it can replace any previous use of variational CD driving. We demonstrate its practicality by applying it to adiabatic evolution along the ground state of a parameterized Hamiltonian. This proposal outperforms the conventional method in terms of fidelity, as confirmed by extensive numerical simulations on quantum Ising models.

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

Toward Vibe Medicine: A Self-Evolving Multi-Agent Framework for Clinical Decision Support

Authors:
Qianxue Zhang↗Yiming Ren↗Shihuan Qin↗Xiao Zhang↗Liao Zhang↗Jinyang Huang↗Zhengliang Liu↗Chenbin Liu↗Hongying Feng↗Jingyuan Chen↗Yuzhen Ding↗Weihang You↗…

arXiv:2606.15504v1 Announce Type: new Abstract: In recent years, the advances of large language models and autonomous agents have revolutionized the healthcare field, facilitating diagnosis and improving treatment results. However, most existing AI systems rely on pre-trained knowledge and predefined pipelines, which struggle to learn dynamically from the interactive chat session history that contains patient outcomes and past failures. To address this limitation, we propose VIBEMed, a multi-agent framework with a built-in self-evolution mechanism and architecture-level safety sandbox for robust clinical decision support. The system integrates three specialized agents, including a Clinical Diagnostic Agent (CDA) for hypothesis generation, a Therapeutic Execution Agent (TEA) for treatment planning, and a Clinical Evolution Manager Agent (CEMA) that distills longitudinal clinical feedback into reusable knowledge, transforming multimodal patient information into personalized medical decisions. Through self-evolution mechanism, the framework enables iterative updates across memory, model behavior, and decision strategies, allowing the system to improve over time. Experimental results show that VIBEMed demonstrates superior performance through its evolving mechanism in complex clinical cases, particularly in tasks that require integrated decision-making and longitudinal planning. The framework also supports reliable end-to-end decisions in challenging scenarios such as oncology treatment planning, highlighting its feasibility in real-world clinical contexts. Overall, VIBEMed provides a practical path beyond static AI systems toward adaptive, experience-driven clinical decision support, demonstrating the value of combining multi-agent collaboration with continuous evolution for advancing precision medicine.

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12.
arXiv (CS.AI) 2026-06-15

Learning Coordinated Preference for Multi-Objective Multi-Agent Reinforcement Learning

Authors:
Pengxin Wang↗Lihao Guo↗Yi Xie↗Bo Liu↗Siyang Cao↗Jingdi Chen↗

arXiv:2606.14693v1 Announce Type: cross Abstract: Cooperative multi-objective multi-agent reinforcement learning (MOMARL) models team decision making under multiple, potentially conflicting objectives. In this setting, conflicts arise not only across objectives but also across agents with different observations, roles, and contributions. We propose Preference Coordinated Multi-agent Policy Optimization (PCMA), which learns coordinated agent-specific preferences to enable complementary trade-offs among agents. Theoretically, we formulate cooperative MOMARL as a team-optimal game and show that, under suitable conditions, preference diversity can induce team improvement through a first-order improvement decomposition. Experiments on multiple cooperative MOMA environments and a practical traffic-control scenario show that PCMA improves both performance and trade-off coordination.

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

EG-VQA: Benchmarking Verifiable Video Question Answering with Grounded Temporal Evidence

Authors:
Linpeng Huang↗Weixing Chen↗Zexin Chen↗Yang Liu↗Liang Lin↗

arXiv:2606.24797v1 Announce Type: cross Abstract: Recent advances in Video Large Language Models (Video-LLMs) have yielded promising performance on video question answering (VideoQA). Nevertheless, existing benchmarks are predominantly evaluated through answer correctness, while the grounding of predictions in relevant video evidence remains largely unexamined. This disconnect between answer generation and evidence understanding motivates the construction of the Evidence-Grounded Video Question Answering Benchmark (EG-VQA), an open-ended evaluation protocol in which each QA pair is explicitly annotated with supporting temporal evidence, thereby requiring joint reasoning and precise evidence localization. EG-VQA is comprised of 2,067 videos and 11,838 QA pairs with fine-grained evidence annotations. To evaluate predicted evidence, Evidence-Grounded F1 (EG-F1) is introduced as a unified metric in which temporal alignment and semantic consistency against ground-truth evidence are jointly measured. Experimental evaluation reveals that even strong proprietary models struggle to accurately ground their predictions, exposing a fundamental discrepancy between answer correctness and faithful evidence localization. To bridge this gap, EG-Reasoner, an evidence-grounded reasoning model trained with explicit supervision, is proposed. State-of-the-art performance is achieved among open-source models, with results competitive against proprietary systems, particularly pronounced gains are observed on reasoning-intensive tasks such as counterfactual questions. These findings demonstrate that scaling alone is insufficient for robust video understanding and that structured evidence supervision is essential for the development of more reliable and interpretable VideoQA systems.

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14.
arXiv (CS.AI) 2026-06-17

C2FL: Clustered Continual Federated Learning under Spatial and Temporal Drift

Authors:
Davide Domini↗Gianluca Aguzzi↗Lorenzo Pellegrini↗Mirko Viroli↗Lukas Esterle↗

arXiv:2606.18003v1 Announce Type: cross Abstract: Collective Adaptive Systems (CAS) increasingly rely on machine learning to let each node learn from locally sensed data, aligning its behavior with the surrounding environment. Scaling this intelligence, however, raises fundamental challenges: sensed data is often privacy-sensitive, preventing centralized collection; nodes are mobile, traversing regions where nearby nodes perceive similar phenomena while distant ones observe radically different conditions, creating natural spatial clusters; and these distributions evolve over time due to mobility, introducing temporal drift that makes local models progressively stale. These dynamics arise across domains - vehicular sensing, drone-based monitoring, smartphone crowdsensing - yet the interplay of privacy, spatial heterogeneity, and temporal drift severely undermines conventional learning strategies. Therefore, we propose C2FL, a fully distributed Federated Learning (FL) approach where nodes self-organize into learning groups through spatial clustering, reflecting the geographic structure of the environment. To counteract temporal drift, each node combines experience replay with a dwell-time-aware adaptive averaging step, progressively incorporating the regional consensus as it remains longer within the same area, while preserving previously acquired knowledge under evolving distributions. We evaluate our approach on synthetic experiments that systematically reproduce spatial and temporal shifts, showing that standard federated strategies degrade significantly under these conditions and that our method restores robust collective adaptation.

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15.
arXiv (CS.CL) 2026-06-11

Organize then Retrieve: Hierarchical Memory Navigation for Efficient Agents

Authors:
Hao-Lun Hsu↗Nikki Lijing Kuang↗Boyi Liu↗Zhewei Yao↗Yuxiong He↗

Large language model (LLM) agents struggle with long-horizon tasks due to their inherent statelessness, requiring all task-relevant information to be encoded in growing input contexts. The resulting degraded reasoning quality, increased inference cost, and higher latency necessitate efficient working memory mechanisms. However, existing approaches either rely on lossy compression or similarity-based retrieval, which often fail to capture temporal structure and causal dependencies required for multi-step agentic tasks. In this work, we present HORMA, a Hierarchical Organize-and-Retrieve Memory Agent that organizes experience into a file-system-like hierarchical structure, where summarized entities are linked to the corresponding raw trajectories, enabling efficient access without losing detailed information. HORMA decomposes working memory into two stages: structured memory construction and navigation-based retrieval. The construction module iteratively refines how experiences are structured by distinguishing between failures caused by missing information and those caused by misleading or overloaded context. The navigation module retrieves task-relevant context by traversing the hierarchy using a lightweight agent trained with reinforcement learning to select minimal yet sufficient context, thereby reducing latency along the critical execution path. Across ALFWorld, LoCoMo, and LongMemEval, HORMA improves task performance under constrained context budgets while requiring at most 22.17% of the baseline token usage in long conversation tasks. Compared to existing methods, it consistently achieves better efficiency-performance trade-offs and generalizes effectively to unseen tasks.

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16.
medRxiv (Medicine) 2026-06-12

Heterogeneity of Treatment Effect of Aspirin and Clinically Significant Bleeding in Older Adults

Authors:
Tzimas↗Tchoua↗R. B↗Vanghelof↗J. C↗Wolfe↗R. C↗Cloud↗Mahady↗Du↗Ernst↗M. E↗…

Aim: The global population of older adults is growing, and older age is linked to higher bleeding risk. Although guidelines discourage aspirin for primary prevention in healthy older adults due to bleeding harms outweighing benefits, many continue taking it without a clear indication. It remains unclear whether all older adults face uniform aspirin-related bleeding risk or if certain subgroups are more vulnerable. Methods: We analyzed data from 19,114 ASPREE trial participants to develop machine learning models using 116 baseline variables. Random forest (RF) and random survival forest (RSF) models predicted 5-year bleeding risk, and participants were stratified into low, intermediate, and high-risk groups based on the 20th and 80th percentiles of predicted risk. We assessed heterogeneity of treatment effect (HTE) by testing treatment-by-risk group interactions on the relative scale using Fine-Gray models, and on the absolute scale using observed 5-year cumulative incidence rates. Results: Over a median follow-up of 4.7 years, 626 major bleeding events occurred. The RF model had moderate discrimination (AUC = 0.65, 95% CI: 0.63-0.67) and good calibration (Brier = 0.032, 95% CI: 0.029-0.034). Statistically significant HTE was observed on the relative scale, with the greatest relative increase in bleeding risk seen in the low-risk group (subdistribution hazard ratio = 2.26, 95% CI: 1.27-4.01). On the absolute scale, low-risk participants experienced higher bleeding with aspirin (absolute risk difference (ARD) = 1.17%, 95% CI: 0.37-1.95), but heterogeneity in ARDs was not statistically significant (Cochran's Q p > 0.45). Similar findings were observed when using the RSF model. Conclusion: Participants at lowest baseline bleeding risk experienced the greatest relative increase in bleeding risk with aspirin therapy. We found statistically significant heterogeneity in treatment effects on the relative but not absolute scale. These findings support an individualized, risk-based approach to aspirin therapy decision-making in older adults.

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17.
medRxiv (Medicine) 2026-06-22

The Unsteady Return of Command-Following: Recovery and Instability of Bedside Motor Command-Following After Acute Brain Injury

Authors:
Gorenshtein↗Adiniaev↗Omar↗Barash↗Klang↗Daniel↗

Background/Objective: Following a verbal command marks the bedside transition from unresponsiveness to overt recovery of consciousness after acute brain injury. Its timing across phenotypes, stability once present, and dependence on sedation are uncharacterized at scale. Methods: Retrospective cohort of adults with acute brain injury, first intensive care unit stay, MIMIC-IV. Command-following was the Glasgow Coma Scale motor response "Obeys Commands." Among patients not following commands at admission, cumulative incidence was estimated with death or hospice and discharge without recovery as competing events. Instability was quantified as transient first recovery and threshold crossings; examinations were tagged for concurrent sedation. Principal findings were externally validated in the multicenter eICU Collaborative Research Database. Results: Of 13,900 brain-injured patients with three or more motor examinations, 5,498 (39.6%) were not following commands at admission. The cumulative incidence of first command-following was 43.5% by 24 hours and 65.0% by 14 days, ranging at 14 days from 36.9% in anoxic injury to 77.2% in ischemic stroke (anoxic versus ischemic stroke at 72 hours, difference 0.41; adjusted P = .002). Among 3,573 patients who recovered, the first recovery was transient in 22.2%, and 62.4% crossed the threshold repeatedly. Non-following was strongly associated with sedation, consistent with an arousal-dependent examination. In eICU, the 14-day incidence was 64.8%, and transient first recovery was 22.7%, closely matching the primary cohort. Conclusions: After acute brain injury, overt bedside command-following returns early but unsteadily, with phenotype-dependent timing, threshold fluctuation, and strong dependence on sedation. A single charted observation is an unreliable index of the underlying state.

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

CAGE: Curvature-Aware Gradient Estimation For Accurate Quantization-Aware Training

Authors:
Soroush Tabesh↗Mher Safaryan↗Andrei Panferov↗Alexandra Volkova↗Dan Alistarh↗

arXiv:2510.18784v3 Announce Type: replace Abstract: Despite significant work on low-bit quantization-aware training (QAT), there is still an accuracy gap between such techniques and native training. To address this, we introduce CAGE (Curvature-Aware Gradient Estimation), a new QAT method that augments the straight-through estimator (STE) gradient with a curvature-aware correction designed to counteract the loss increase induced by quantization. CAGE is derived from a multi-objective view of QAT that balances loss minimization with the quantization constraints, yielding a principled correction term that depends on local curvature information. On the theoretical side, we introduce the notion of Pareto-optimal solutions for quantized optimization, and establish that CAGE yields strong convergence guarantees in the smooth non-convex setting. In terms of implementation, our approach is optimizer-agnostic, but we provide a highly-efficient implementation that leverages Adam statistics. CAGE significantly improves upon the prior state-of-the-art methods in terms of accuracy, for similar computational cost: for QAT fine-tuning, it halves the compression accuracy loss relative to the prior best method, while for QAT pre-training of Llama models, its accuracy for 3-bit weights-and-activations (W3A3) matches the accuracy achieved at 4-bits (W4A4) with the prior best method. The official implementation can be found over https://github.com/IST-DASLab/CAGE .

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19.
arXiv (CS.AI) 2026-06-17

Temporal Motif-aware Graph Test-time Adaptation for OOD Blockchain Anomaly Detection

Authors:
Runang He↗Tongya Zheng↗Huiling Peng↗Yuanyu Wan↗Bingde Hu↗Jiawei Chen↗Canghong Jin↗Mingli Song↗Can Wang↗

arXiv:2605.29526v2 Announce Type: replace-cross Abstract: Ever-evolving transaction patterns have significantly hindered anomaly detection on emerging cryptocurrency blockchains due to the vast number of addresses and diverse anomalous behaviors. Recently, advanced Graph Anomaly Detection (GAD) approaches applied to blockchains have faced two critical challenges: adversarial pattern evolution by malicious actors and the out-of-distribution (OOD) problem caused by varied transaction semantics on blockchains. To address these challenges, we propose a novel framework termed TEmporal Motif-aware Graph Test-Time Adaptation (TEMG-TTA). First, we comprehensively capture the 3-node temporal motif distribution of each active address using an efficient computational mechanism, enabling downstream temporal motif-aware graph learning. Second, we design a simple yet effective test-time adaptation strategy to facilitate the sharing of common patterns between training and testing graphs. Extensive experiments on 5 real-world datasets demonstrate that our proposed TEMG-TTA outperforms state-of-the-art GAD approaches by an average of 54.88\%. A further case study on interpretable motif patterns reveals that TEMG-TTA explicitly characterizes the complex transaction patterns of anomalous addresses, thereby verifying the effectiveness of our technical designs. Our code is publicly available at https://github.com/LuoXishuang0712/TEMG-TTA/.

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20.
arXiv (quant-ph) 2026-06-16

Communication Complexity of Distributed Unitary Synthesis

Authors:
Longcheng Li↗Xiaoming Sun↗Jialin Zhang↗Jiadong Zhu↗

arXiv:2511.04250v2 Announce Type: replace Abstract: We study space-bounded communication complexity for unitary implementation in distributed quantum processors, where we restrict the number of qubits per processor to ensure practical relevance and technical non-triviality. We model distributed quantum processors using distributed quantum circuits with nonlocal two-qubit gates, defining the distributed communication complexity of a unitary as the minimum number of such nonlocal gates required for its realization, up to permutations of data qubit positions. Our contributions are twofold. First, for general $n$-qubit unitaries, we improve upon the trivial $O(4^n)$ communication bound. Considering $k$ pairwise-connected processors (each with $n/k$ data qubits and $m$ ancillas), we prove the communication complexity satisfies $O\left(\max\{4^{(1-1/k)n - m}, n\}\right)$ – for example, $O(2^n)$ when $m=0$ and $k=2$ – and establish the tightness of this upper bound. We further extend the analysis to approximation models and general network topologies. Second, for special unitaries, we show that both the Quantum Fourier Transform (QFT) and Clifford circuits admit linear upper bounds on communication complexity in the exact model, outperforming the trivial quadratic bounds applicable to these cases. In the approximation model, QFT's communication complexity reduces drastically from linear to logarithmic, while Clifford circuits retain a linear lower bound. These results offer fundamental insights for optimizing communication in distributed quantum unitary implementation, advancing the feasibility of large-scale DQC systems.

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21.
arXiv (CS.AI) 2026-06-25

CausalRAG2: Hierarchical Causal Knowledge Graph Design for RAG

Authors:
Nengbo Wang↗Tuo Liang↗Vikash Singh↗Chaoda Song↗Van Yang↗Yu Yin↗Jing Ma↗Jagdip Singh↗Vipin Chaudhary↗

arXiv:2602.05143v2 Announce Type: replace Abstract: Retrieval augmented generation (RAG) has enhanced large language models by enabling access to external knowledge, with graph-based RAG emerging as a powerful paradigm for structured retrieval and reasoning. However, existing graph-based methods often over-rely on entity-centric node matching and lack explicit causal modeling, leading to unfaithful or spurious answers. Prior attempts to incorporate causality are typically limited to local or single-document contexts and also suffer from information isolation that arises from modular graph structures, which hinders scalability and cross-module causal reasoning. To address these challenges, we propose CausalRAG2, a framework that rethinks knowledge organization for graph-based RAG through causal gating across hierarchical modules. CausalRAG2 explicitly models causal relationships to suppress spurious correlations while enabling scalable reasoning over large-scale knowledge graphs. We also introduce HolisQA, a benchmark for holistic comprehension beyond entity-centric matching. Extensive experiments demonstrate that CausalRAG2 consistently outperforms competitive graph-based RAG baselines across multiple datasets and evaluation metrics. Our work establishes a principled foundation for structured, scalable, and causally grounded RAG systems. Our code and HolisQA benchmark are available at https://github.com/Pwnb/CausalRAG2.

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22.
arXiv (CS.CL) 2026-06-24

AI-PAVE-Br: Leveraging Large Language Models for Enhanced Product Attribute Value Extraction through a Golden Set Approach

Authors:
Murilo Gazzola↗Hugo Gobato Souto↗Samuel Silva↗J\'ulia Schubert Peixoto↗Felipe Siqueira↗Andr\'e Luis Pedroso de Morais↗Caio Gomes↗

The explosive growth and complexity of product data within the dynamic Brazilian e-commerce landscape demand robust and specialized methods for structured information extraction. Traditional approaches to Product Attribute Value Extraction (PAVE) often struggle with the linguistic nuances and sheer diversity of product descriptions in Portuguese. To address this critical gap, this paper introduces two major contributions. First, we present AI-PAVEBr, a specialized system engineered with Large Language Models (LLMs) to perform high-accuracy PAVE specifically for Brazilian e-commerce catalogs. Second, to facilitate reproducible research and provide a definitive benchmark, we introduce and share the Golden Set, a new, meticulously curated, and manually annotated dataset for PAVE in Portuguese. We detail the creation process and structure (Entity, Category, Subcategories) of this high-quality reference set. Our experiments conclusively show that AI-PAVE-Br, leveraging targeted prompt engineering, dramatically outperforms conventional Named Entity Recognition (NER) baselines. This work not only delivers a superior, scalable solution for a major non-English market but also enriches the NLP community with a valuable, publicly available resource for future PAVE research.

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23.
arXiv (CS.CV) 2026-06-17

Enhancing Pathological VLMs with Cross-scale Reasoning

Authors:
Chi Phan↗Tianyi Zhang↗Qiaochu Xue↗Yufeng Wu↗Dan Hu↗Zeyu Liu↗Sudong Wang↗Yueming Jin↗

Pathological images are inherently multi-scale, requiring pathologists to integrate evidence from global tissue architecture at low magnification to cellular morphology at higher magnification for accurate diagnosis. While existing pathological datasets for vision-language model (VLM) include various scales, they often lack an explicit cross-scale reasoning objective. This limitation prevents VLMs from capturing essential cross-scale representations and learning evidence-based reasoning. To bridge this gap, we introduce the first cross-scale training and evaluation paradigm that formulates pathology interpretation as multi-magnification reasoning. However, creating such a task reveals a critical challenge: multi-image visual question answering (VQA) is prone to text-only shortcuts, which allow models to guess answers using magnification-dependent artifacts rather than visual evidence. To address this, we propose a leakage-aware curation pipeline that combines adversarial text-only screening with constraint-guided question design. Using this pipeline, we construct Scale-VQA, a high-quality benchmark with 4,685 multiple-choice questions grounded in 2,537 pathology images across multiple magnification levels. Finally, we present ScaleReasoner-R1, a model trained via reinforcement learning to optimize performance on the cross-scale VQA task. ScaleReasoner-R1 achieves state-of-the-art performance on our cross-scale reasoning benchmark and generalizes to SOTA performance on established single-scale benchmarks. Findings suggest that even the limited cross-scale supervision can significantly improve pathological understanding. The code and demos will be open-sourced.

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24.
arXiv (CS.CL) 2026-06-12

Multi-Bitwidth Quantization for LLMs Using Additive Codebooks

Authors:
Liza Babaoglu↗Shuangyi Chen↗Ashish Khisti↗

As large language models (LLMs) are increasingly deployed across heterogeneous hardware with varying resource constraints, the ability to adaptively manage the trade-off between performance and efficiency without retraining is critical. We propose Drop-by-Drop, a novel multi-bitwidth post-training quantization framework that enables inference-time precision control over LLM weights from a single trained model. Our method is theoretically grounded in information theory and successive refinement. We establish that LLM weights, which commonly follow a Gaussian distribution, can be optimally reconstructed with increasing fidelity as additional bits are incorporated, under a weighted mean squared error distortion motivated by LLM loss functions. To realize this in practice, Drop-by-Drop incorporates Matryoshka-style supervision into the loss function, exploiting the structure of additive codebooks. Drop-by-Drop produces a single model where ordered subsets of codebooks yield accurate partial reconstructions at each precision level. This approach significantly reduces storage and memory overhead by allowing a single checkpoint to serve multiple bitwidths, while maintaining competitive perplexity and accuracy across major architectures, such as Qwen, LLaMA, Gemma, and Mistral.

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

Clifford Kolmogorov-Arnold Networks

Authors:
Matthias Wolff↗Francesco Alesiani↗Christof Duhme↗Xiaoyi Jiang↗

arXiv:2602.05977v2 Announce Type: replace-cross Abstract: We introduce Clifford Kolmogorov-Arnold Network (ClKAN), a flexible and efficient architecture for function approximation in arbitrary Clifford Algebra spaces. We propose the use of Randomized Quasi-Monte Carlo grid generation as a solution to the exponential scaling associated with higher-dimensional algebras. Our ClKAN also introduces new batch normalization strategies to deal with variable domain input. ClKAN finds application in scientific discovery and engineering, and is validated in synthetic and physics-inspired tasks.

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