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01.
PLOS Medicine 2026-05-29

Characterization of the VHH-Fc construct rimteravimab in healthy adults and patients hospitalized for mild-to-moderate COVID-19: Two Phase 1 randomized clinical trials

Authors:
Ellen Jansen↗

by Ellen Jansen, Viki Bockstal, Florence Herschke, Per Olsson Gisleskog, Manuela Rinaldi, Angélique Boerboom, Salah Hadi, Natalia Gaibu, Michel Moutschen, Dominique Tersago Background Variable Heavy domain of Heavy chains (VHH) are innovative tools to target unique epitopes, yet few have been developed as heavy chain-only antibodies for clinical use. Rimteravimab (referred to here as XVR011) is a humanized antibody developed for the treatment of mild-to-moderate coronavirus disease 2019 (COVID-19), consisting of two identical VHHs targeting the receptor binding domain (RBD) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike, with a human immunoglobulin (Ig) G1 fragment constant of antibody (Fc), silenced for Fc effector functions. We conducted two Phase 1 studies in healthy volunteers or hospitalized COVID-19 patients to evaluate its safety, tolerability, pharmacokinetics and immunogenicity. Methods and findings A randomized, double-blinded, single-center, placebo-controlled, single ascending dose study was performed in healthy volunteers (Phase 1a, EXEVIR0102, EudraCT 2021-003707-17), in parallel to an open-label, multi-center, single ascending dose study in patients hospitalized for mild to moderate COVID-19 (Phase 1b, EXEVIR0101, EudraCT 2020-005299-36, NCT04884295). Participants received a single intravenous infusion of 250, 500 or 1,000 mg of XVR011. The primary objective for both trials was the safety and tolerability of XVR011. Pharmacokinetics were evaluated as a secondary objective in Phase 1a and as an exploratory objective in Phase 1b. Efficacy (evaluated as respiratory parameters and COVID-19 clinical status) and antiviral activity in patients were evaluated as a secondary objective in Phase 1b. Immunogenicity was evaluated as an exploratory objective. Part 2 of the EXEVIR0101 study (initially a phase 1b/2 study) was not conducted due to the loss of XVR011 potency against SARS-CoV-2 Omicron BA.2. Demographics, safety, efficacy, and immunogenicity were analyzed using descriptive statistics, while pharmacokinetics were analyzed with noncompartmental pharmacokinetics (PK) modeling.In the Phase 1a study, there were no infusion-related reactions, serious treatment-emergent adverse events (TEAEs) or TEAEs grade ≥3. 22/30 volunteers (73.3%) reported 53 TEAEs (49 Grade 1, 4 Grade 2) with none being related to XVR011. The most common TEAE was headache (n = 8, 26.7%) in various treatment groups. In the Phase 1b study, 27 hospitalized patients were enrolled, and followed up to 30 days. Seven patients (25.9%) reported a total of 15 TEAEs, the majority (80%) being mild to moderate (Grade 1–2). There were no treatment-related serious TEAEs. All TEAEs resolved by the end of the study. Peak exposure (maximal concentration, Cmax) and systemic exposure (area under the curve, AUC0-t, and AUC0-inf) for XVR011 increased dose-proportionally. Geomean half-life ranged from 15.4 to 17.0 days in Phase 1a, while individual half-life ranged from 11.4 to 15.6 days in Phase 1b. SARS-CoV-2 viral load, as detected in nasopharyngeal samples by reverse transcription and quantitative polymerase chain reaction (RT-qPCR), decreased similarly in all cohorts compared to baseline. No treatment-induced anti-drug antibodies (ADA) were detected in Phase 1a. In Phase 1b, higher XVR011 concentrations increased the likelihood of ADA formation, without impacting pharmacokinetics and pharmacodynamics. No obvious dose-response in COVID-19 clinical status or respiratory parameters was observed.Technological limitations included study size, absence of placebo for the Phase 1b, absence of repeated dosing, evolving SARS-CoV-2 variants and standard-of-care. Conclusions XVR011 displayed a favourable safety, tolerability, pharmacokinetics, and immunogenicity profile, both in healthy volunteers and in patients hospitalized for mild to moderate COVID-19. These data pave the way for the design and clinical development of VHH-Fc constructs.

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

Upper Bounds on the Generalization Error of Deep Learning Models via Local Robustness and Stability

Authors:
Abdul-Rauf Nuhu↗Parham M. Kebria↗Vahid Hemmati↗Mahmoud N. Mahmoud↗Edward Tunstel↗Abdollah Homaifar↗

arXiv:2606.16883v1 Announce Type: cross Abstract: Generalization is a critical property of data-driven models, particularly deep learning models deployed in safety-critical applications. Robustness-based generalization bounds have gained attention as a principled way to link robustness properties to generalization performance, often in a data-dependent manner. However, most existing bounds suffer from vacuousness in practical settings, yielding loose upper bounds that greatly exceed the actual error rates and limiting their usefulness for real-world evaluation. While this issue is often attributed to the uncertainty term, a substantial part of the problem originates from the robustness term itself, particularly for the 0-1 loss. Existing approaches typically treat the robustness term as a global measure, ignoring its variation across different sub-regions of the input space. In this work, we propose a generalization bound that addresses this limitation by scaling the robustness term according to the number of stable and unstable samples within each sub-region. Our bounds incorporate both data- and model-dependent factors while maintaining practical relevance (yielding tighter upper bounds on true error). Experiments on models trained on the ImageNet dataset show that our bounds remain consistently non-vacuous and achieve the tightest estimates among existing methods, closely aligning with empirical performance across a range of robust deep neural networks.

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03.
arXiv (CS.AI) 2026-06-12

"Did you lie?" Evaluating Lie Detectors across Model Scale and Belief-Verified Model Organisms

Authors:
Alan Cooney↗David Africa↗Geoffrey Irving↗

arXiv:2606.12618v1 Announce Type: new Abstract: Robust lie detectors for language models could enable powerful techniques for auditing, monitoring, and post-hoc investigation of model behaviour, but evaluating them requires testbeds where models verifiably believe the opposite of what they say. We show that existing trained model organisms often fail this requirement, leaving prior positive and negative detection results difficult to interpret. We address this with 13 reasoning model organisms whose hidden beliefs are verified in chain-of-thought and shown to generalise to held-out tasks, alongside Varied Deception, a prompted-lying testbed covering a broad range of lie-inducing motivations. On these testbeds we evaluate four detectors: a chain-of-thought judge, a logprob classifier, and two activation probes, including Did-You-Lie (DYL), a new method for training follow-up probes. On prompted lying, across 31 open-weight models spanning 2B to 1T parameters, all four detectors show positive scaling with model capability. However, every activation- and logprob-based detector drops sharply on our trained model organisms, with DYL retaining the most signal; only the chain-of-thought judge remains strong, with 0.82 balanced accuracy, partly as an artefact of our verification process favouring CoT-readable beliefs. Current lie detectors therefore cannot support high-confidence claims about model beliefs, and we suggest research directions that may address some of their current limitations. We release our datasets, model organisms, and trained detectors.

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

Understanding Truncated Positional Encodings for Graph Neural Networks

Authors:
James Flora↗Mitchell Black↗Weng-Keen Wong↗Amir Nayyeri↗

arXiv:2606.13671v1 Announce Type: new Abstract: Positional encodings (PEs) enhance the power of graph neural networks (GNNs), both theoretically and empirically. Two of the most popular families of PEs - spectral (e.g., Laplacian eigenspaces, effective resistance) and walk-based (polynomials of the adjacency matrix) - are theoretically equivalent in expressive power, with expressivity between the 1-WL and 3-WL tests. However, this equivalence assumes the GNN uses the "complete" version of these PEs, which requires $O(n^3)$ time and space complexity. Instead, practitioners commonly use truncated variants of these encodings, such as the first $k$ eigenspaces or powers of the adjacency matrix. However, the theoretical properties of these truncated PEs are unknown. In this work, we initiate the study of these truncated PEs. Theoretically, we show that, under truncation, several families of PEs are fundamentally different in expressive power. As a corollary, we show that truncated spectral PEs are no longer stronger than the 1-WL test. We also study a family of spectral PEs, the $k$-harmonic distances, to highlight the differences in expressive power of even closely related truncated PEs. Finally, we experimentally show that a mix of truncated PEs is preferable to any single family on real-world datasets.

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

A Survey on 3D Skeleton Based Person Re-Identification: Taxonomy, Advances, Challenges, and Interdisciplinary Prospects

Authors:
Haocong Rao↗Chunyan Miao↗

Person re-identification via 3D skeletons is an important emerging research area that attracts increasing attention within the pattern recognition community. With distinctive advantages across various application scenarios, numerous 3D skeleton based person re-identification (SRID) methods with diverse skeleton modeling and learning paradigms have been proposed in recent years. In this paper, we provide a comprehensive review and analysis of recent SRID advances. First of all, we define the SRID task and provide an overview of its origin and major advancements. Secondly, we formulate a systematic taxonomy that organizes existing methods into three categories centered on hand-crafted, sequence-based, and graph-based modeling. Then, we elaborate on the representative models along these three types with an illustration of foundational mechanisms. Meanwhile, we provide an overview of mainstream supervised, self-supervised, and unsupervised SRID learning paradigms and corresponding common methods. A thorough evaluation of state-of-the-art SRID methods is further conducted over various types of benchmarks and protocols to compare their effectiveness, efficiency, and key properties. Finally, we present the key challenges and prospects to advance future research, and highlight interdisciplinary applications of SRID with a case study.

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

VGGHeads: 3D Multi Head Alignment with a Large-Scale Synthetic Dataset

Authors:
Orest Kupyn↗Eugene Khvedchenia↗Christian Rupprecht↗

Human head detection, keypoint estimation, and 3D head model fitting are essential tasks with many applications. However, traditional real-world datasets often suffer from bias, privacy, and ethical concerns, and they have been recorded in laboratory environments, which makes it difficult for trained models to generalize. Here, we introduce \method – a large-scale synthetic dataset generated with diffusion models for human head detection and 3D mesh estimation. Our dataset comprises over 1 million high-resolution images, each annotated with detailed 3D head meshes, facial landmarks, and bounding boxes. Using this dataset, we introduce a new model architecture capable of simultaneous head detection and head mesh reconstruction from a single image in a single step. Through extensive experimental evaluations, we demonstrate that models trained on our synthetic data achieve strong performance on real images. Furthermore, the versatility of our dataset makes it applicable across a broad spectrum of tasks, offering a general and comprehensive representation of human heads.

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07.
arXiv (CS.LG) 2026-06-19

A Model-Driven Approach for Developing Families of Reinforcement Learning Environments

Authors:
Xiaoran Liu↗Istvan David↗

arXiv:2606.20324v1 Announce Type: cross Abstract: Virtual training environments are software-intensive systems in which reinforcement learning (RL) agents learn, adapt, and demonstrate meaningful behavior. Virtual training environments offer a safe and cost-efficient alternative to training agents in real-world settings. However, to converge, most realistic RL problems require training in multiple, mostly similar but slightly different environments - i.e., families of environment variants. The typical development process of environment families is a labor-intensive and error-prone manual endeavor that does not scale well. To alleviate these issues, in this paper, we propose a model-driven approach for developing families of RL training environments. To obtain the family of environments, we develop an approach and prototype tool. In our approach, a hybrid genetic algorithm - a combination of population-based global search and heuristic local search - generates environment families. Mutations and constraints are expressed as model transformations and are operationalized into a search process by a state-of-the-art model transformation engine. We demonstrate the soundness of our approach in a wildfire mitigation scenario and curriculum learning - a particular learning paradigm that relies on environment families.

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08.
arXiv (CS.LG) 2026-06-12

Deep Learning-based Algebraic Reynolds Stress Closures for RANS Simulations of Turbulent Flows

Authors:
Daniel Dehtyriov↗Jonathan F. MacArt↗Justin Sirignano↗

arXiv:2605.26358v2 Announce Type: replace-cross Abstract: Turbulence is ubiquitous in engineering and science, yet direct simulation is prohibitively expensive. The Reynolds-averaged Navier-Stokes (RANS) equations provide savings exceeding ten orders of magnitude but introduce unclosed terms (the closure problem). Offline-trained machine-learning (ML) closures suffer distribution shift in predictive simulations, while ML methods that bypass the governing equations struggle to generalise from scarce high-fidelity data. We develop a physics-derived deep learning closure model for RANS, the Deep Algebraic Reynolds Stress Model (DARSM), which can be trained on small datasets and accurately generalise across Reynolds numbers, to unseen geometries, and to different flow regimes. A neural network maps flow invariants to empirical parameters in an implicit algebraic Reynolds stress equation, derived from the Reynolds stress transport equations under the weak-equilibrium assumption, imposing physics-based structure on the ML closure. End-to-end optimisation through the governing PDEs and the coupled implicit closure eliminates distribution shift, but both unrolled and implicit automatic differentiation fail on the stiff coupled solver. We derive adjoint equations that exploit the solver's implicit-explicit structure for efficient optimisation. On canonical square-duct and periodic-hill benchmarks, DARSM reduces average test velocity error over baseline RANS by $2$-$4\times$ across Reynolds number, geometries, and flow regimes, with peak case-level reductions of $12\times$. The model trained on attached, anisotropy-dominated flows (square duct) accurately generalises without retraining to separated flows (periodic hills), a regime change in the underlying physics. DARSM also outperforms five established ML methods: offline training, tensor-basis neural networks, field-inversion machine learning, DeepONets, and physics-informed neural networks.

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09.
arXiv (CS.LG) 2026-06-24

Natural Identifiers for Privacy and Data Audits in Large Language Models

Authors:
Lorenzo Rossi↗Bart{\l}omiej Marek↗Franziska Boenisch↗Adam Dziedzic↗

arXiv:2606.24408v1 Announce Type: new Abstract: Assessing the privacy of large language models (LLMs) presents significant challenges. In particular, most existing methods for auditing differential privacy require the insertion of specially crafted canary data during training, making them impractical for auditing already-trained models without costly retraining. Additionally, dataset inference, which audits whether a suspect dataset was used to train a model, is infeasible without access to a private non-member held-out dataset. Yet, such held-out datasets are often unavailable or difficult to construct for real-world cases since they have to be from the same distribution (IID) as the suspect data. These limitations severely hinder the ability to conduct scalable, post-hoc audits. To enable such audits, this work introduces natural identifiers (NIDs) as a novel solution to the above-mentioned challenges. NIDs are structured random strings, such as cryptographic hashes and shortened URLs, naturally occurring in common LLM training datasets. Their format enables the generation of unlimited additional random strings from the same distribution, which can act as alternative canaries for audits and as same-distribution held-out data for dataset inference. Our evaluation highlights that indeed, using NIDs, we can facilitate post-hoc differential privacy auditing without any retraining and enable dataset inference for any suspect dataset containing NIDs without the need for a private non-member held-out dataset.

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10.
arXiv (CS.LG) 2026-06-24

Predictive variational inference: Learn the predictively optimal posterior distribution

Authors:
Jinlin Lai↗Antonio Linero↗Yuling Yao↗

arXiv:2410.14843v4 Announce Type: replace-cross Abstract: Vanilla variational inference finds an optimal approximation to the Bayesian posterior distribution, but even the exact Bayesian posterior is often not meaningful under model misspecification. We propose predictive variational inference (PVI): a general inference framework that seeks and samples from an optimal posterior density such that the resulting posterior predictive distribution is as close to the true data generating process as possible, while this closeness is measured by multiple scoring rules. By optimizing the objective, the predictive variational inference is generally not the same as, or even attempting to approximate, the Bayesian posterior, even asymptotically. Rather, we interpret it as implicit hierarchical expansion. Further, the learned posterior uncertainty detects heterogeneity of parameters among the population, enabling automatic model diagnosis. This framework applies to both likelihood-exact and likelihood-free models. We demonstrate its application in real data examples.

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11.
medRxiv (Medicine) 2026-06-15

VarEx: A Large Language Model Pipeline for Automated Extraction of Exposures, Outcomes, and Covariates from Epidemiologic Studies

Authors:
Malec↗S. A↗Pradhan↗Upadhayaya↗Metzger↗

Objective: Observational studies are essential for investigating risk factors for Alzheimer's disease and related dementias (ADRD), but inconsistent reporting and selection of covariates can contribute to residual confounding, omitted-variable bias, and reduced reproducibility. We developed and evaluated VAREX (Variable Extraction), a large language model (LLM)-based information extraction framework designed to automatically identify exposures, outcomes, and covariates from epidemiologic studies and populate structured evidence repositories. Materials and Methods: VAREX combines retrieval-augmented generation, biomedical language-model embeddings, semantic chunking, cross-encoder reranking, and prompt-engineered LLM workflows to extract epidemiologic variables from full-text biomedical articles. The framework was evaluated using a reference-standard corpus of observational studies examining blood pressure variability (BPV) and Alzheimer's disease-related dementias (ADRD), together with external validation datasets involving other exposure-outcome relationships. Extracted variables were compared with independently curated human reference standards using semantic matching and one-to-one assignment procedures. Covariates were additionally classified into ten epidemiologically relevant semantic categories. Results: In the primary BPV[->]ADRD corpus (10 studies), VAREX achieved a precision of 0.91, recall of 0.84, and F1-score of 0.87 for variable extraction. Covariate classification accuracy was 0.90, yielding a strict extraction-and-classification F1-score of 0.78. External validation datasets demonstrated comparable performance across diverse epidemiologic domains, with extraction F1-scores ranging from 0.73 to 0.85. Category-level performance was strongest for health behaviors (F1=0.96), sociodemographic variables (F1=0.90), and medication exposures (F1=0.89). Compared with published estimates of manual systematic-review effort, VAREX reduced processing time from approximately 61 minutes to 9 minutes per article, representing an 85.7% reduction in review time. Discussion: These findings demonstrate that LLM-based information extraction can accurately identify and classify epidemiologic variables across heterogeneous observational-study designs. Automated extraction enables scalable construction of structured repositories of exposures, outcomes, and covariates while substantially reducing the labor required for evidence synthesis and systematic reviews. Conclusion: VAREX provides an effective framework for automated extraction and classification of epidemiologic variables from the biomedical literature. By supporting large-scale evidence synthesis and structured knowledge resource development, VAREX may facilitate more rigorous observational research, improved confounder identification, and enhanced reproducibility in epidemiology.

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

Benchmarking Counterfactual Prediction in Epidemic Time Series with Time-Varying Interventions

Authors:
Wenhao Mu↗Facundo Yan↗Anik Mumssen↗Marisa Eisenberg↗Alexander Rodr\'iguez↗

arXiv:2606.05692v2 Announce Type: replace-cross Abstract: Deep learning has enabled significant advances in time-series causal inference, yet progress remains constrained by the lack of realistic benchmarks with observable counterfactual outcomes. Existing datasets either rely on real-world observations without ground-truth counterfactuals or on simplified simulations that fail to capture complex causal dynamics. To address this gap, we develop a large-scale benchmark for counterfactual prediction in epidemic time series under dynamic interventions. Unlike existing benchmarks, it supports static and time-varying treatments, as well as both single-policy and multi-policy intervention settings, enabling evaluation of causal inference methods across a broad range of causal inference scenarios. Leveraging a calibrated agent-based model grounded in real-world demographic, mobility, epidemiological, and policy data, we generate realistic counterfactual trajectories across more than 150 U.S. counties. Using this benchmark, we evaluate widely used and state-of-the-art causal inference methods, revealing substantial performance differences and highlighting the challenges of realistic time-series causal reasoning.

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13.
arXiv (CS.AI) 2026-06-11

The Impossibility of Eliciting Latent Knowledge

Authors:
Korbinian Friedl↗Francis Rhys Ward↗Paul Yushin Rapoport↗Tom Everitt↗Jonathan Richens↗

arXiv:2606.12268v1 Announce Type: new Abstract: Advanced AI systems have extensive knowledge of their environments; in fact, their knowledge may (far) exceed that of their developers or users. Consequently, a desirable property for an AI system is that it is honest – that it accurately reports its beliefs about the world. Designing an AI system to be honest may be difficult, especially if we want to ask it questions about latent variables in the environment – variables which are hidden from the human interacting with it. This gives rise to the problem of eliciting latent knowledge (ELK): the problem of training an AI agent to honestly report its beliefs. In this paper, we make ELK formally precise using Causal Influence Diagrams (CIDs). CIDs can be used to describe the relationship between an agent's training environment and its subjective representation of the world. We use CIDs to formalise the distinction between observable and latent variables, to specify what exactly it means for an agent to be honest, and to formally define goal misgeneralisation. We show that, under certain circumstances, developers can incentivise an agent to honestly answer questions by providing correct feedback during training. However, a natural, but undesirable, way for an agent to generalise is to provide answers which humans would evaluate as true, rather than honest answers. We prove an impossibility theorem stating: There is no feedback-based training strategy that depends only on agent behaviour and with certainty produces an honest agent, even if feedback is perfect during training.

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

Asynchronous Decentralized Federated Learning over Lossy Wireless Links via Reception- and Age-Aware Aggregation

Authors:
Chanuka A. S. Hewa Kaluannakkage↗Rajkumar Buyya↗

arXiv:2606.10774v2 Announce Type: replace Abstract: Decentralized Federated Learning(DFL) enables collaborative model training across wireless edge nodes, including IoT deployments, autonomous vehicles, UAV swarms, and satellite constellations. Operating over lossy wireless links under constraints, these systems cannot rely on retransmissions, so model parameters must be accepted as partial chunks, leading to two key failure modes, which are selection bias, where poor-quality links are systematically under-represented in gossip aggregation, and update staleness, where asynchronous nodes contribute outdated models. We prove that classical gossip aggregation introduces irreducible selection bias proportional to the link-loss rate. We propose DFL-AA (Decentralized Federated Learning with Adaptive AoI-weighted Aggregation), which corrects selection bias using Inverse Probability Weighting (IPW) with online channel estimation and mitigates staleness via Age-of-Information (AoI) decay without requiring a global clock. We prove that DFL-AA removes link-quality distortion in expectation and consistently outperforms state-of-the-art baselines across varying loss rates and heterogeneous channel conditions on fixed directed topologies.

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

Trusted Uncertainty in Large Language Models: A Unified Framework for Confidence Calibration and Risk-Controlled Refusal

Authors:
Markus Oehri↗Giulia Conti↗Kaviraj Pather↗Alexandre Rossi↗Laia Serra↗Adrian Parody↗Rogvi Johannesen↗Aviaja Petersen↗Arben Krasniqi↗

Deployed language models must decide not only what to answer but also when not to answer. We present UniCR, a unified framework that turns heterogeneous uncertainty evidence including sequence likelihoods, self-consistency dispersion, retrieval compatibility, and tool or verifier feedback into a calibrated probability of correctness and then enforces a user-specified error budget via principled refusal. UniCR learns a lightweight calibration head with temperature scaling and proper scoring, supports API-only models through black-box features, and offers distribution-free guarantees using conformal risk control. For long-form generation, we align confidence with semantic fidelity by supervising on atomic factuality scores derived from retrieved evidence, reducing confident hallucinations while preserving coverage. Experiments on short-form QA, code generation with execution tests, and retrieval-augmented long-form QA show consistent improvements in calibration metrics, lower area under the risk-coverage curve, and higher coverage at fixed risk compared to entropy or logit thresholds, post-hoc calibrators, and end-to-end selective baselines. Analyses reveal that evidence contradiction, semantic dispersion, and tool inconsistency are the dominant drivers of abstention, yielding informative user-facing refusal messages. The result is a portable recipe of evidence fusion to calibrated probability to risk-controlled decision that improves trustworthiness without fine-tuning the base model and remains valid under distribution shift.

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16.
medRxiv (Medicine) 2026-06-15

The clinical utility of functional testing in fibroblasts to diagnose primary mitochondrial disease

Authors:
Van Hove↗J. L. K↗Friederich↗M. W↗R. A↗Lee↗J. C↗Knight↗K. M↗Donovan↗T. E↗Silveira↗…

Genome sequencing of the heterogeneous primary mitochondrial disorders (PMD) frequently reveals variants of uncertain significance that require functional tests for diagnosis, and does not identify variants in all patients. We analyzed mitochondrial enzyme assays, blue native polyacrylamide gel electrophoresis (BN-PAGE) with in-gel activity staining, complex I assembly blot, and select protein abundances in fibroblasts of a case series of 204 PMD patients divided into functional classes, in comparison to 51 controls and 53 differential diagnostic conditions. Overall, sensitivity and specificity for respiratory chain enzyme assays were 46% and 93% respectively, for BN-PAGE 40% and 98%, for complex I assembly assay 49% and 99%. The overall sensitivity of all tests was 76%, specificity 93%, with positive predictive value 96% and negative predictive value 67%. Categories with high sensitivity were isolated complex deficiencies, nuclear DNA-encoded mitochondrial protein synthesis defects, co-factor defects, and mitochondrial amino-acyl-tRNA synthetase conditions when aided by protein abundance. Mitochondrial DNA mutations and maintenance disorders showed poor sensitivities. Secondary dysfunctions were rare. A complete battery of functional tests showed strong diagnostic clinical utility in fibroblasts.

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17.
medRxiv (Medicine) 2026-06-22

Generative Artificial Intelligence in Psychotherapy Practice: A Global Online Survey of Mental Health Professionals' Adoption

Authors:
Blease↗Hagström↗Gaab↗Carey↗Cipriani↗Gorman↗Nascimento↗A. F↗Fitzgerald↗Holtz↗Schwarz↗Strudwick↗…

Background: Generative artificial intelligence (GenAI) tools, including large language model (LLM)-based platforms such as ChatGPT, Google Gemini, and Microsoft Copilot, are being adopted across healthcare settings with increasing speed. Despite the increasing popularity of GenAI, empirical data on the extent and nature of adoption by mental health clinicians in routine psychotherapy practice globally remain scarce. Objective: This study aimed to characterize current use patterns of GenAI tools among a global sample of practicing mental health professionals, including prevalence of use, specific tools employed, clinical and administrative purposes served, perceived effect on workload, and the institutional context shaping adoption (e.g., encouragement, prohibition, and training). Methods: We administered a cross-sectional online survey to a global convenience sample of licensed mental health professionals who provide psychotherapy as part of the scope of their practice (i.e., psychotherapists, psychologists, counsellors, nurses, and psychiatrists). Participants were recruited via professional networks, purposely avoiding the use of social media platforms. Within the survey, we captured GenAI use behaviors in psychotherapy contexts, and demographic and professional background data. Descriptive statistics were analyzed for all variables. Multivariate logistic regression was used to examine demographic and professional predictors of GenAI use. Results: A total of 766 mental health professionals who provide psychotherapy from 30 countries completed the survey. Of these, 54.6% (n=418) reported having purposely used at least one GenAI tool in psychotherapy clinical practice. ChatGPT was the most frequently used tool (354/418, 84.7%). The most commonly reported clinical purpose was assisting with treatment planning (175/418, 41.9%), followed by managing administrative tasks (173/418, 41.4%) and generating psychoeducational materials for clients (166/418, 39.7%). 82.8% of AI users reported that these tools reduced their overall work burden. Only 18.1% (139/766) of respondents reported institutional encouragement to use AI tools, while 81.1% (621/766) reported not having received any professional training on AI use. Predictors of AI adoption included younger age and rural practice setting. Conclusions: In this global convenience sample survey, GenAI use among mental health professionals in psychotherapy settings is widespread, concentrated in a wide variety of clinical and administrative tasks. Formal training and institutional guidance substantially lag behind current adoption patterns. These findings highlight an urgent need for evidence-based competency frameworks, regulatory clarity, and professional education to support safe and ethically informed integration of AI into clinical mental health practice.

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18.
arXiv (CS.CV) 2026-06-12

VDE Bench: Evaluating The Capability of Image Editing Models to Modify Visual Documents

Authors:
Hongzhu Yi↗Yujia Yang↗Yuanxiang Wang↗Tong Li↗Zhenyu Guan↗Tianyu Zong↗Jiahuan Chen↗Chenxi Bao↗Tiankun Yang↗Haopeng Jin↗Yixuan Yuan↗Xinming Wang↗…

In recent years, image editing models have made significant progress, enabling users to manipulate visual content in a flexible and interactive manner through natural language instructions. However, an important yet underexplored research direction remains dense visual document image editing, which involves modifying textual content within images while faithfully preserving the original text style and background context. Existing methods primarily focus on English scenarios and images with relatively sparse text, and thus cannot adequately address dense, structurally complex documents or non-Latin scripts such as Chinese. To bridge this gap, we propose VDE Bench (Visual Doc Edit Bench), a rigorously human annotated and evaluated benchmark specifically designed to assess the performance of image editing models on bilingual Chinese-English and complex visual document editing tasks. The benchmark comprises a high quality dataset of 942 instruction based image editing samples, whose seed images encompass dense Chinese and English text documents including academic papers, posters, presentation slides, examination materials, and newspapers. Furthermore, we introduce a novel evaluation framework that systematically quantifies editing performance at the OCR parsing level, thereby enabling fine grained assessment of text modification accuracy. Based on this benchmark, we conduct a comprehensive evaluation of representative image editing models. Human verification demonstrates a high degree of consistency between human judgments and automated evaluation metrics. VDE Bench constitutes the first systematic benchmark for evaluating the performance of image editing models on bilingual dense text visual documents.

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

Dual-Anchoring: Addressing State Drift in Vision-Language Navigation

Authors:
Kangyi Wu↗Pengna Li↗Kailin Lyu↗Xi Lin↗Lin Zhao↗Qingrong He↗Jinjun Wang↗Jianyi Liu↗

arXiv:2604.17473v4 Announce Type: replace-cross Abstract: Vision-Language Navigation(VLN) requires an agent to navigate through 3D environments by following natural language instructions. While recent Video Large Language Models(Video-LLMs) have largely advanced VLN, they remain highly susceptible to State Drift in long scenarios. In these cases, the agent's internal state drifts away from the true task execution state, leading to aimless wandering and failure to execute essential maneuvers in the instruction. We attribute this failure to two distinct cognitive deficits: Progress Drift, where the agent fails to distinguish completed sub-goals from remaining ones, and Memory Drift, where the agent's history representations degrade, making it lose track of visited landmarks. In this paper, we propose a Dual-Anchoring Framework that explicitly anchors the instruction progress and history representations. First, to address progress drift, we introduce Instruction Progress Anchoring, which supervises the agent to generate structured text tokens that delineate completed versus remaining sub-goals. Second, to mitigate memory drift, we propose Memory Landmark Anchoring, which utilizes a Landmark-Centric World Model to retrospectively predict object-centric embeddings extracted by the Segment Anything Model, compelling the agent to explicitly verify past observations and preserve distinct representations of visited landmarks. Facilitating this framework, we curate two extensive datasets: 3.6 million samples with explicit progress descriptions, and 937k grounded landmark data for retrospective verification. Extensive experiments in both simulation and real-world environments demonstrate the superiority of our method, achieving a 15.2% improvement in Success Rate and a remarkable 24.7% gain on long-horizon trajectories. To facilitate further research, we will release our code, data generation pipelines, and the collected datasets.

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

MLaGA: Multimodal Large Language and Graph Assistant

Authors:
Dongzhe Fan↗Yi Fang↗Jiajin Liu↗Djellel Difallah↗Qiaoyu Tan↗

arXiv:2506.02568v2 Announce Type: replace Abstract: Large Language Models (LLMs) have demonstrated substantial efficacy in advancing graph-structured data analysis. Prevailing LLM-based graph methods excel in adapting LLMs to text-rich graphs, wherein node attributes are text descriptions. However, their applications to multimodal graphs–where nodes are associated with diverse attribute types, such as texts and images–remain underexplored, despite their ubiquity in real-world scenarios. To bridge the gap, we introduce the Multimodal Large Language and Graph Assistant (MLaGA), an innovative model that adeptly extends LLM capabilities to facilitate reasoning over complex graph structures and multimodal attributes. We first design a structure-aware multimodal encoder to align textual and visual attributes within a unified space through a joint graph pre-training objective. Subsequently, we implement a multimodal instruction-tuning approach to seamlessly integrate multimodal features and graph structures into the LLM through lightweight projectors. Extensive experiments across multiple datasets demonstrate the effectiveness of MLaGA compared to leading baseline methods, achieving superior performance in diverse graph learning tasks under both supervised and transfer learning scenarios.

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22.
arXiv (CS.LG) 2026-06-18

Kernel of Partition Paths: A Unified Representation for Tree Ensembles

Authors:
Nicolas Mahler↗

arXiv:2606.18853v1 Announce Type: cross Abstract: A recent line of work has reframed individual decision trees as linear models on engineered features associated with their splits, opening routes for oracle inequalities and feature-importance reinterpretation, but leaving open the question of what unified geometric object a forest induces when one indexes its feature map by nodes rather than by splits. The present paper studies that object. KPP indexes the feature map by the nodes of the forest, weighted by a path metric that turns each coordinate into a component of a squared-Euclidean path-isometric embedding. KPP unifies four pillars under a single non-diagonal Gram that carries a metric: prediction, exact additive attribution, deterministic Lipschitz robust radius in the KPP metric, and uniform Rademacher risk bounds for regression and classification under fixed, honest, or cross-fit conditioning. All probabilistic guarantees are conditional on the representation and are stated under three explicit conditioning regimes; the robust-radius guarantee is deterministic in the KPP metric rather than in a norm on the raw input. Conjectured fast-rate refinements for both regression and classification are stated as open problems and are not claimed as theorems.

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23.
arXiv (CS.LG) 2026-06-16

Empirical Study of Pop and Jazz Mix Ratios for Genre-Adaptive Chord Generation

Authors:
Jinju Lee↗

arXiv:2605.04998v2 Announce Type: replace-cross Abstract: This revision updates a pop-to-jazz chord-generation rehearsal study. Best-epoch metrics still show that modest pop rehearsal preserves pop accuracy while improving jazz prediction, but v2 corrects released-checkpoint selection: the released F1 equals Phase 0, F2 had a transcription error, and ft-pop80-v2 restores a hash-distinct jazz-adapted F1 across 3 seeds.

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24.
medRxiv (Medicine) 2026-06-24

Utility of genetic screening for the prediction of severe arrhythmic outcomes in mitral valve prolapse

Authors:
Jhawar↗Cristin↗Small↗Bibby↗Tastet↗Rich↗Delling↗F. N↗

Background: Cardiomyopathy and channelopathy (CC) gene variants have been linked to sudden cardiac arrest (SCA) or death (SCD) in small, selected pedigree or post-mortem studies of arrhythmic mitral valve prolapse (MVP). However, the utility of clinical whole exome sequencing (WES) panels as a risk stratification tool in unselected MVP samples is unknown. Objectives: The goal of the study was to test the utility of clinical WES panels with CC variant screening for arrhythmic risk stratification in MVP. Methods: We performed research based WES in 203 consecutive MVPs without other arrhythmic substrate. Variants were filtered for rare (

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25.
medRxiv (Medicine) 2026-06-18

Automated Airways Characterization and Assessment of Cystic Fibrosis from CT Imaging

Authors:
Chong Chie↗J. A. K. H↗Cooper↗M. L↗Persohn↗S. A↗Burton↗C. P↗Salama↗Territo↗P. R↗

Background Advancements in medical imaging have enabled non-invasive diagnosis and staging of cystic fibrosis (CF) using CT scans, revealing dilated airways, an increased number of visible airways, and airway generation splits in these patients. However, manual characterization of airways remains time-consuming and challenging due to the numerous structural changes, thereby limiting clinical feasibility. This study aims to develop an automated algorithm to characterize airways from segmented lung CT scans and apply this to a retrospective population. This approach reduces the time required to analyze images and obtain disease-staging results. Methods This framework consists of two stages. The first stage extracts and skeletonizes the airway tree from lung CTs, while the second stage measures lung features, including airway volumes, branch counts, generation splits, diameters, and cross-sectional areas. This permits comprehensive characterization for use in clinical assessment. Results The airways analysis was performed on 169 CT volumes ranging in age from 6 to 18 years of age, revealing substantial differences in detected airway branches, generation splits, and normalized airway volume between the control and CF groups. The framework also measures airway diameters and cross-sectional areas, revealing an increase in the number of small airways in cystic fibrosis patients, due to early bronchiectasis. These findings align with previous research and demonstrate the framework's ability to accurately quantify airway changes in patients with CF. Discussion The framework extracts entire airway trees, facilitating measurements of volume, branch count, diameters, and cross-sectional areas, which change with CF severity and/or treatment. However, partial lung atelectasis can limit the accuracy of airway detection in moderate-to-severe cases. Funding NIA U54 AG054345 and NIA R21 AG07857501

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