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

Mitigating Content Shift and Hallucination in GenAI Image Editing via Structural Refinement

Generative AI (GenAI) image editors, such as Nano Banana, produce visually compelling results for retouching tasks, enabling non-experts to edit images through text prompts alone. However, the generative nature of these models often introduces spatial misalignment, texture distortion, and content hallucination, all of which are detrimental to downstream workflows that require pixel-level fidelity. We identify a problem setting we call "structure-preserving GenAI fusion" for black-box GenAI image retouching: retain the perceptual enhancements of a GenAI output while enforcing structural faithfulness to the original input image. To address this problem, we propose a post-processing framework that fuses an input image with its GenAI-enhanced counterpart by first establishing coarse spatial and photometric correspondences, then performing a fusion stage that transfers desired enhancements while suppressing hallucinated content. In the absence of direct prior work in this setting, we evaluate our framework against representative methods from photorealistic style transfer and image fusion. Our experiments demonstrate that our method better preserves aesthetic quality while maintaining pixel-level structural consistency and the input resolution.

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

TreeGRNG: Binary Tree Gaussian Random Number Generator for Efficient Probabilistic AI Hardware

arXiv:2606.16599v1 Announce Type: cross Abstract: Bayesian Neural Networks (BNNs) offer opportunities for greatly enhancing the trustworthiness of conventional neural networks by monitoring the uncertainties in decision-making. A significant drawback for BNN inference at the extreme edge, however, is the imperative need to incorporate Gaussian Random Number Generators (GRNG) within each neuron. State-of-the-art GRNG algorithms heavily depend on multiple arithmetic operations and the use of extensive look-up tables, posing significant implementation challenges for ultra-low power hardware implementations. To overcome this, this paper presents an innovative binary tree random number generator (TreeGRNG) allowing the use of ultra-low-cost constant comparators instead of arithmetic units. We further enhance the TreeGRNG proposal with a set of hardware-aware optimizations exploiting the Gaussian properties. The optimized TreeGRNG surpasses the State-of-the-Art (SoTA) in terms of distribution accuracy while achieving a 3.7$\times$ reduction in energy per sample and boosting the throughput per unit area by 5.8$\times$. Moreover, our TreeGRNG proposal possesses a distinct advantage over the current SoTA in terms of flexibility, as it easily enables designers to adjust the shape of the sampled probability distribution, extending beyond the capabilities of traditional GRNGs, opening the horizon towards future probabilistic AI designs. The TreeGRNG design is available open-source in the link

03.
medRxiv (Medicine) 2026-06-12

Order-Based Bayesian Network Modeling of Early Detection and Post-Diagnosis Control for Cardiovascular Disease Risk in Type 2 Diabetes

Patients diagnosed with type 2 diabetes (T2D) are at increased risk of developing cardiovascular disease (CVD), the leading cause of morbidity and mortality in this population. Early detection and glycemic control within the first year after diagnosis reduce CVD risk. However, gaps remain in how to operationalize early detection of T2D using Electronic Health Record (EHR) data and quantify its relationship with subsequent CVD risk using longitudinal observations. We developed a probabilistic graph model to analyze the interdependencies between early detection of T2D, post-diagnosis glycemic control, and CVD occurrence. Using a temporally structured Bayesian Network (BN) learned from EHR data of 9,450 primary care patients between 2017 and 2023, we quantified probabilistic dependencies between demographics, diagnostic delay surrogates, glycemic control, and post-diagnosis CVD occurrence. Percentile based thresholds defined risk groups, where individuals with predicted probabilities in the bottom decile ([≤] 10th percentile) were classified as low risk, and those in the top decile ([≥] 90th percentile) as high risk. Results demonstrated heterogeneity in predicted risks across glycemic and cardiovascular outcomes. Predicted probability of developing CVD within the first year after T2D diagnosis ranged from a mean of 5.2% in the low-risk group to 28.9% in the high-risk group, while predicted probabilities of mean Hemoglobin A1c (HbA1c) [≥] 8% during the first year post-diagnosis ranged from 1.6% in low-risk to 55.1% in high-risk group. Patients with HbA1c at diagnosis [≥] 8% had higher predicted probabilities of first-year post-diagnosis mean HbA1c [≥] 8% (53.3% vs. 1.9%) and high HbA1c coefficient of variation (18.7% vs. 3.1%) compared with those with HbA1c [≤] 6.5%. Incorporating early clinical outcomes refined later risk predictions, with long-term CVD risk reaching 33.5% among high-risk individuals. The proposed model achieved predictive performance comparable to conventional machine learning approaches while providing interpretable relationships for risk stratification in primary care populations.

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

A Comprehensive Ecosystem for Open-Domain Customized Video Generation

Recent progress in video generation has shown impressive visual synthesis capabilities. However, open-domain customized video generation remains limited by the lack of large-scale, annotated datasets capturing diverse identity-specific attributes. To address this, we introduce PexelsCustom-1M, the first publicly available million-scale dataset for identity-preserving video generation, containing one million curated triplets across 8,000+ categories. Leveraging this, we propose CustoMDiT, a parameter-efficient framework that adapts a pretrained multimodal Diffusion Transformer into a customized video generator with only 8% additional learnable parameters. Our method surpasses prior state-of-the-art. However, benchmarks such as DreamBooth cover only 100 classes, which is insufficient for real-world applications. To overcome this, we construct OpenCustom, a new benchmark with 1,000+ categories, created via cross-dataset knowledge fusion from ImageNet and MS-COCO. Extensive experiments confirm the advantages of both our dataset and model. We will open-source the entire ecosystem–including dataset, pipeline, benchmark, and implementations–to support further research.

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

Localizing Credit at the Divergence: Path-Conditioned Self-Distillation for LLM Reasoning

arXiv:2606.15576v1 Announce Type: cross Abstract: Reinforcement learning from verifiable rewards assigns a single scalar to each rollout, leaving token-level credit assignment underspecified in long reasoning traces. On-policy self-distillation addresses this by letting the same model act as a teacher conditioned on privileged information, producing a dense per-token signal. But the common choice of a ground-truth answer is only an endpoint cue: on terse-answer tasks, the teacher falls silent at the intermediate positions where path-level guidance matters most. We propose Hindsight Self-Distillation (HSD), which conditions the teacher on a successful peer rollout drawn from the current training group. Such a peer is an exact sample from the success-conditioned policy, requiring no additional sampled rollouts. By providing a full successful continuation rather than only the final answer, the resulting credit signal concentrates at the divergence position between a failed rollout and a successful peer. Across Qwen3-8B and Qwen3-32B on math and code benchmarks, HSD obtains the best result against GRPO variants and on-policy distillation baselines, with the largest gains on terse-answer tasks such as AIME.

06.
arXiv (math.PR) 2026-06-15

Upper tails for irregular graphs beyond the mean-field regime

arXiv:2606.14564v1 Announce Type: new Abstract: Let $G_{n,p}$ be the binomial random graph of density $p$ and let $X_H$ be the number of copies of a fixed graph $H$ in $G_{n,p}$. We prove asymptotically tight bounds on the logarithmic upper-tail probability of $X_H$ whenever $H$ is a connected, irregular graph with maximum degree $\Delta \ge 2$ and $p \ge n^{-1/\Delta - \varepsilon_H} (\log n)^{\omega(1)}$ for an explicit $\varepsilon_H >0$. These bounds are expressed in terms of a new variational problem that generalises the combinatorial optimisation problem arising from the naïve mean-field approximation. This new variational problem includes an entropy term that corresponds to the large number of embeddings of certain highly structured graphs in $K_n$. For a certain class of irregular graphs $H$ that we call stable, we show that this description of the upper-tail probability is valid in a range of densities that is optimal up to a poly($\log\log n$) factor. For a further subclass of stable graphs, which includes all irregular complete bipartite graphs, we show that this range of densities is optimal up to a multiplicative constant.

07.
arXiv (CS.AI) 2026-06-11

Noise-Guided Transport for Imitation Learning

arXiv:2509.26294v2 Announce Type: replace-cross Abstract: We consider imitation learning in the low-data regime, where only a limited number of expert demonstrations are available. In this setting, methods that rely on large-scale pretraining or high-capacity architectures can be difficult to apply, and efficiency with respect to demonstration data becomes critical. We introduce Noise-Guided Transport (NGT), a lightweight off-policy method that casts imitation as an optimal transport problem solved via adversarial training. NGT requires no pretraining or specialized architectures, incorporates uncertainty estimation by design, and is easy to implement and tune. Despite its simplicity, NGT achieves strong performance on challenging continuous control tasks, including high-dimensional Humanoid tasks, under ultra-low data regimes with as few as 20 transitions.

08.
arXiv (CS.AI) 2026-06-11

Robust Privacy: Inference-Stage Privacy through Certified Robustness

arXiv:2601.17360v2 Announce Type: replace-cross Abstract: An adversary observing a model's released prediction can infer sensitive attributes of the queried input, or even reconstruct representatives of the model's training data. The inference interface thus acts as a side channel for privacy leakage. We introduce Robust Privacy (RP), an inference-stage privacy notion inspired by certified robustness: if a model's prediction is provably invariant within a radius-R neighborhood around an input x with confidence at least $1-\alpha$, then x enjoys $(R,\alpha)$-Robust Privacy, under which we prove that any adversary observing the released prediction has at most $\alpha/2$ advantage in distinguishing x from any input within distance R of x. Building on RP, we formalize Robust Attribute Privacy (RAP), an attribute-level privacy notion that characterizes the set of sensitive-attribute values that remain compatible with a released prediction. On a classification task, RP increases the median length of the RAP-compatible inference interval from 23.50 to 29.96, reducing attribute-inference precision. Model inversion attacks, often treated as a training-stage threat, in fact rely on fine-grained signals leaked through the inference interface; RP masks these signals at the inference stage, reducing attack success rate (ASR) from 73% to 4% on a black-box inversion attack. This direct targeting of the leakage channel enables RP to dominate DP-SGD and randomized response in the privacy-utility tradeoff space: RP retains 98.4% accuracy at 21% ASR, whereas DP-SGD must drop accuracy to 61.7% to reach a comparable ASR. Across both experiments, increasing the smoothing sample size N strengthens privacy and improves utility together. Finally, we examine model distillation as a scope boundary and show that RP mitigates attribute-level and instance-level inference-stage privacy leakage, but not function-level extraction through model distillation.

09.
arXiv (CS.CV) 2026-06-16

MeshFlow: Efficient Artistic Mesh Generation via MeshVAE and Flow-based Diffusion Transformer

We present MeshFlow, a new method for generating artist-like 3D meshes. Current mesh generators often adopt Auto-Regressive (AR) next-token prediction, a natural choice given the discrete nature of mesh topology. However, AR methods scale poorly because the inference cost is quadratic in mesh size. They also require discretizing the vertex coordinates, which introduces quantization errors. To address these challenges, we introduce a Variational Autoencoder (VAE) that, supervised with a contrastive loss, represents both continuous vertex positions and discrete connectivity in a continuous latent space. This latent space is significantly more compact than prior token-based mesh representations. We then build a 3D generator based on a Rectified Flow transformer, generating all mesh vertices and edges in parallel. Our model generates meshes 18x faster than the fastest AR generator while also achieving excellent accuracy across standard mesh-generation metrics. Homepage: https://mesh-flow.github.io/, Code: https://github.com/facebookresearch/meshflow

10.
arXiv (quant-ph) 2026-06-16

Non-Markovianity-based ultrasensitive parameter estimation

Authors:

arXiv:2211.05142v2 Announce Type: replace Abstract: Accurate parameter estimation is a central task in quantum metrology and sensing, where quantum resources can provide precision beyond classical limits. In realistic settings, however, system-environment interactions lead to decoherence, reducing these strategies to their classical counterparts. Noise is typically classified as Markovian or non-Markovian, with the latter often preserving quantum coherence longer and thus supporting better metrological performance. Still, the absence of noise is generally considered ideal. In this work, we uncover a striking reversal: certain non-Markovian environments not only outperform Markovian ones - including their quantum Cramér-Rao bounds - but can also surpass the entirely noiseless case. We demonstrate these findings numerically for an all-optical setup, which is experimentally feasible and can be extended to other physical platforms. In general, our results open new avenues for noise-assisted quantum metrology beyond conventional limits.

11.
arXiv (CS.AI) 2026-06-24

Toward Autonomous O-RAN: A Multi-Scale Agentic AI Framework for Real-Time Network Control and Management

arXiv:2602.14117v3 Announce Type: replace-cross Abstract: Open Radio Access Networks (O-RAN) promise flexible 6G network access through disaggregated, software-driven components and open interfaces, but this programmability also increases operational complexity. Multiple control loops coexist across the service management layer and RAN Intelligent Controller (RIC), while independently developed control applications can interact in unintended ways. In parallel, recent advances in generative Artificial Intelligence (AI) are enabling a shift from isolated AI models toward agentic AI systems that can interpret goals, coordinate multiple models and control functions, and adapt their behavior over time. This article proposes a multi-scale agentic AI framework for O-RAN that organizes RAN intelligence as a coordinated hierarchy across the Non-Real-Time (Non-RT), Near-Real-Time (Near-RT), and Real-Time (RT) control loops: (i) A Large Language Model (LLM) agent in the Non-RT RIC translates operator intent into policies and governs model lifecycles. (ii) Small Language Model (SLM) agents in the Near-RT RIC execute low-latency optimization and can activate, tune, or disable existing control applications; and (iii) Wireless Physical-layer Foundation Model (WPFM) agents near the distributed unit provide fast inference close to the air interface. We describe how these agents cooperate through standardized O-RAN interfaces and telemetry. Using a proof-of-concept implementation built on open-source models, software, and datasets, we demonstrate the proposed agentic approach in two representative scenarios: robust operation under non-stationary conditions and intent-driven slice resource control.

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

PorTEXTO: A European Portuguese Benchmark for Visual Text Extraction

European Portuguese (pt-PT) is largely absent from OCR benchmarks, which skew toward high-resource languages. The few benchmarks that cover pt-PT focus on historical artifacts and literature. This work addresses modern OCR applications, introducing PorTEXTO, the first benchmark for contemporary and culturally relevant pt-PT visual text extraction. To ascertain quality, we employ an annotation pipeline combining transcriptions from a frontier LVLM with exhaustive review by native speakers. We observe a sharp performance drop from synthetic to real world samples in most models, and find that, currently, specialized multilingual data is a better driver for pt-PT performance than model size or resolution budget, motivating the release of open pt-PT OCR resources.

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

UniIntervene: Agentic Intervention for Efficient Real-World Reinforcement Learning

arXiv:2606.12372v1 Announce Type: cross Abstract: Human-in-the-loop reinforcement learning (HiL-RL) has emerged as an effective paradigm for real-world robotic manipulation, enabling online policy improvement with human guidance. However, current HiL-RL frameworks remain intervention-intensive, relying on frequent human corrections to redirect the policy out of unproductive exploration, which incurs high labor cost and limits real-world scalability. To address this, we propose UniIntervene, an agentic intervention model that detects unproductive exploration and autonomously recovers the policy toward high-value states, taking over the bulk of interventions from human operators. Specifically, UniIntervene first performs future-conditioned action-value estimation, predicting the latent consequence of the current action and evaluating its induced value, which provides a more stable progress signal. Building on this, a temporal value-risk critic aggregates recent value dynamics and triggers intervention when the estimated value exhibits sustained stagnation or degradation. When intervention is required, UniIntervene retrieves a high-value recovery target from a memory of past intervention episodes and produces executable corrective actions through a goal-conditioned recovery policy. In this way, UniIntervene turns intervention from passive human correction into a value-aware recovery process for efficient real-world RL. Extensive experiments on diverse real-world manipulation tasks demonstrate that UniIntervene improves the average success rate by 8.6% while reducing human interventions by 57% relative to state-of-the-art HiL-RL baselines.

14.
arXiv (CS.AI) 2026-06-19

SleepMaMi: A Universal Sleep Foundation Model for Integrating Macro- and Micro-structures

arXiv:2602.07628v2 Announce Type: replace Abstract: While the shift toward unified foundation models has revolutionized many deep learning domains, sleep medicine remains largely restricted to task-specific models that focus on localized micro-structure features. These approaches often neglect the rich, multi-modal context of Polysomnography (PSG) and fail to capture the global macro-structure of a full night's sleep. To address this, we introduce SleepMaMi , a Sleep Foundation Model engineered to master both hour-long sleep architectures and fine-grained signal morphologies. Our framework utilizes a hierarchical dual-encoder design: a Macro-Encoder to model full-night temporal dependencies and a Micro-Encoder to capture short-term characteristics from biosignals. Macro-Encoder is trained via Demographic-Guided Contrastive Learning, which aligns overnight sleep patterns with objective subject metadata, such as age, sex and BMI to refine global representations. Micro-Encoder is optimized via a hybrid Masked Autoencoder (MAE) and multi-modal contrastive objective. Pre-trained on a massive corpus of $>$20,000 PSG recordings (158K hours),SleepMaMi outperforms or matches state-of-the-art existing foundation models across a diverse suite of downstream tasks, demonstrating superior generalizability and label-efficient adaptation for clinical sleep analysis.

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

Evaluation Sovereignty in Metadata-Driven Classification: A Multi-Track Framework for Weakly Supervised Information Systems

arXiv:2606.13436v1 Announce Type: new Abstract: Evaluation in machine learning is typically treated as a neutral measurement process. However, in operational information systems, evaluation outcomes are often conditioned by the processes used to generate labels. This paper does not seek to improve classification performance. Instead, it examines the validity of performance measurement under differing label-authority regimes. This issue is particularly relevant in large-scale metadata-driven systems, where labels are often incomplete, inconsistent, or weakly supervised. We introduce evaluation sovereignty, defined as the degree to which performance metrics are independent of label authority and supervision regime, and propose a multi-track evaluation framework that systematically varies training and evaluation label sources. Using hierarchical multi-label classification on large-scale scientific metadata, we demonstrate that models exhibiting strong performance under operational ("silver") evaluation degrade substantially under independent ("gold") evaluation, particularly for fine-grained classification. For example, Micro-F1 decreases from approximately 0.54 to 0.03. Notably, ranking-based metrics remain above baseline, revealing a divergence between latent model signal and classification validity. These findings suggest that commonly reported performance metrics may reflect alignment with labeling processes rather than true predictive capability. We therefore reconceptualize evaluation validity as a system-level property shaped by label governance and provide a practical methodology for auditing intelligent systems operating under weak supervision.

16.
arXiv (CS.AI) 2026-06-17

Models Take Notes at Prefill: KV Cache Can Be Editable and Composable

Authors:

arXiv:2606.17107v1 Announce Type: cross Abstract: Prefix caching reuses prefill only across an exactly shared prefix, so one changed field invalidates the entire downstream cache. Yet overwriting the field's own key/value vectors and reusing the rest leaves the model acting on the old value. The reason, established causally across four model families: at prefill the model has already written the field-conditioned conclusion onto downstream notes; the field's own key/value drives under 1% of the decision. Read as a notebook of memoized conclusions, two capabilities follow. (1) It is editable. A salient erratum amends the notes; and with chain-of-thought, editing the field alone recovers the decision (1.00 at 8B, ~1% compute), while without CoT it is ignored. (2) It is composable. The notes are position-portable, so a precompiled skill can be RoPE-repositioned and spliced into any context, indistinguishable from full recompute (logit cosine 0.90-0.999, twelve models) at O(L) rather than O(L^2) time-to-first-token. A unified edit+compose agent stays decision-identical to recompute at up to 14.9x lower latency. The approach applies to any per-token attention KV cache, validated across scale, quantization, Mixture-of-Experts, and multimodal caches, and extends to several attention variants through small adapters. Because the erratum is append-only, it composes with production prefix caching: in an online vLLM benchmark it keeps the prefix cache-aligned (98.5% hit-rate), cutting p90 time-to-first-token by 53-398x.

17.
arXiv (CS.CV) 2026-06-24

EgoSAT: A Comprehensive Benchmark of Egocentric Streaming Interaction Understanding

We introduce EgoSAT, the first comprehensive benchmark for egocentric video reasoning in streaming settings, designed to evaluate the capabilities of modern vision-language models (VLMs). The benchmark targets streaming interaction understanding, where video frames arrive sequentially and models must continuously interpret evolving visual context. EgoSAT unifies several previously distinct tasks within a single streaming framework. In this formulation, queries about completed events correspond to retrospective reasoning, queries about ongoing activities require online understanding, and queries about future actions involve prospective anticipation. This unified setting requires models to reason about the past, present, and future while operating under the constraint that only previously observed frames are available. EgoSAT contains 1,997 unique videos spanning 165 hours of egocentric footage and around 4,800 high-quality question-answer pairs, carefully designed to probe reasoning across varying temporal contexts. Using this benchmark, we evaluate a diverse set of both open-weight and closed-weight VLMs, providing a systematic assessment of their ability for streaming interaction understanding. By distinguishing answerability and conducting diagnostics on confidence of models, we find existing models not only struggle with prospective and retrospective modeling, but also exhibit severe mis-calibration: confidence often fails to track inherent answerability, leading to dangerous "confidently wrong" behaviors. Project page: https://leiyj23.github.io/EgoSAT/

18.
medRxiv (Medicine) 2026-06-22

Integration of lung tissue proteomics and genome-wide association data to identify lung cancer susceptibility proteins and potential drug targets

Background: Proteins directly impact disease development and act as drug targets. Therefore, we integrated genomic and lung tissue proteomics data to identify lung cancer susceptibility proteins, elucidating genetic mechanisms and candidate drug targets. Method: We profiled the proteome and genome in non-neoplastic lung tissue from 200 lung cancer patients. Using this data, we constructed genetic models to predict abundance across the proteome in lung tissue. We applied these models to genome-wide association study (GWAS) data from 55,174 lung cancer cases and 1,294,174 controls to evaluate their associations with the risk of lung cancer, overall and by major histological subtypes. Bayesian colocalization and Mendelian randomization (MR) analyses were used to prioritize putative causal proteins, which were cross-referenced with three main drug-protein databases to identify potential therapeutic targets. Results: We identified 29 proteins associated with lung cancer risk at a false discovery rate < 5%, including 25 for overall lung cancer, two (AQP3 and IL18) specifically for adenocarcinoma, and another two (HMGN2 and HLA-DMB) for squamous cell carcinoma. Of them, genes encoding 17 proteins reside at least 2Mb away from any known GWAS risk loci, including 14 for overall lung cancer (HYI, GPX1, GMPPB, DSP, HDDC2, MTCH2, SUOX, JMJD7, PDIA3, IL16, IQGAP1, SULT1A2, ARHGAP27, and TYMP) and three for subtypes (AQP3, IL18, and HMGN2). Among the 12 proteins located within the known risk loci, EPHX2, CLDN18, PSMD5, and CYP2S1 proteins showed an association independent of the proximal GWAS-identified lead variant. Colocalization and/or MR analysis suggested 11 potential causal proteins. Five of these candidate causal proteins (DSP, CLDN18, IQGAP1, IL18 and TYMP) are targeted by nine drugs already approved by the FDA or in phase III trials. Conclusion: Our study identified novel lung cancer susceptibility proteins and potential drug targets, offering valuable insights into lung cancer biology and future translational utilities.

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

Visuals Lie, Consistency Speaks: Disentangling Spatial Attention from Reliability in Vision-Language Models

Multimodal Foundation Models are increasingly used as reasoning agents, making reliability, knowing when a model may hallucinate, critical. A common intuition, which we call the Attention-Confidence Assumption, holds that reliability follows from "structural" visual perception: tight attention on relevant regions should signal a trustworthy answer, while scattered attention signals confusion. We challenge this through the VLM Reliability Probe (VRP), a systematic cross-family study of reliability signals in contemporary Vision-Language Models (VLMs). We introduce structural-attention metrics, cluster counts (C_k) and spatial entropy (H_s), to quantify the visual encoder's gaze, and track its evolution (Delta H_s) across layers. This reveals a "Symbolic Detachment": models often "Early Lock" visual features only to diffuse attention later, severing early perception from final generation. Contrary to the grounding hypothesis, we find a "Cluster Failure": spatial attention has near-zero correlation (R approx 0.001) with accuracy. Instead, reliability is a phenomenon of generation dynamics and internal-state distributions. Self-Consistency, the agreement rate across sampled reasoning paths, is the dominant predictor of truth (R = 0.429). Scaling causal interventions exposes a sharp architectural divergence: LLaVA locks its prediction in a fragile late-stage bottleneck, whereas PaliGemma and Qwen2-VL distribute reliability globally, staying resilient even when ~50% or more of their most predictive layer is destroyed. For current VLMs, reliability signals are detached from visual grounding maps and are best inferred from generation-time dynamics and hidden-state probes.

20.
medRxiv (Medicine) 2026-06-15

International Consensus Guideline on Management of Genitourinary Adverse Events Associated with Prostate Cancer Radiotherapy

Purpose/Objective: Genitourinary (GU) adverse events (AEs) are common during and after pelvic radiation therapy (RT) for prostate cancer and can substantially impact quality of life. We convened an international committee to establish consensus in the prevention, mitigation, and management of radiation-related acute and late GU AEs, as there are no relevant evidence-based consensus guidelines to inform treating providers. Materials/Methods: A systematic evidence review focused on mitigation and management of radiation-related acute and late GU AEs was performed in PubMed, Embase and Cochrane. The following topics were addressed: management of acute GU AEs in the intact and post-operative settings; RT techniques; bladder outlet obstruction procedures; and indications for urology referral or hyperbaric oxygen therapy (HBO). Evidence-based consensus recommendations were developed using a Delphi process. We highlight the current state of evidence and evidence gaps worthy of future study. Results: Consensus was reached for 31 key questions. For management of lower urinary tract symptoms (LUTS), most evidence comes from trials in patients without cancer and not undergoing RT. A consensus algorithm for medical management of acute GU AEs was developed with the following highlights: (a) alpha blockers as 1st-line for obstructive symptoms in the intact setting, (b) anti-spasmodics as 1st -line for irritative symptoms in the intact setting, and (c) anti-spasmodics as 1st -line in the post-operative setting. The consensus algorithm provides an ordered list of medications to offer if 1st -line options afford inadequate relief. For RT fractionation, randomized clinical trial (RCT) data are available. 40% of panelists rarely or never use standard fractionation over moderate hypofractionation for patients with baseline LUTS, but most consider moderate hypofractionation over SBRT for AUA IPSS > 15. For patients with severe obstructive LUTS (most commonly AUA IPSS >20), the panel recommends a prophylactic bladder outlet obstruction procedure and, if obstructive symptoms improve, consideration of moderate hypofractionation or SBRT, based on retrospective data. There is one RCT supporting use of HBO for late radiation cystitis. Conclusions: The consensus guideline synthesizes available evidence and expert opinion across key clinical decision points to provide practical guidance in the prevention, mitigation, and management of radiation-related acute and late GU AEs in prostate cancer RT. Envisioned as a living document with periodic updates, this guideline serves as a resource for practicing radiation oncologists by outlining expert-derived consensus recommendations of evidence-based care in areas where high-quality data is limited.

21.
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.

22.
PLOS Computational Biology 2026-06-22

Towards modeling phage therapy

by Rob J. de Boer, Robert Schooley, Alan S. Perelson Patients infected with life-threatening multi-drug resistant (MDR) bacteria have been treated with cocktails of bacteriophages. This is a complicated form of personalized medicine as the phages given to a patient have to be selected beforehand on the basis of their lytic capacity of the infecting bacteria. Because bacteria rapidly become resistant, the evolution of resistance to a diverse cocktail of phages is a complicated dynamical process, during which competing bacterial strains replace one another by accumulating several resistance mechanisms, each of which may involve a fitness cost. As a consequence, it is typically not known why a particular phage therapy succeeded or failed, and how one can optimize the composition of the cocktails to maximize the rate of success. To improve upon this, we extend an existing in vivo-calibrated mouse model into a novel mathematical model for the human situation, and include multiple phages infecting multiple bacterial strains, differing in their resistance to each of the phages. We adjust several parameter estimates of the bacterial model to the human situation, and use the model to describe a successful case of phage therapy involving several cocktails, each containing several phages. In the model, treatment success crucially depended on pretreatment resistance levels, and on the diversity and the timing of the cocktails. Once an appropriate cocktail is found, it is less important to further optimize the infection rates of the phages. Resistant bacterial strains expand rapidly when sensitive strains decline, and the higher the infectivity of the phages, the faster resistant strains expand. Because resistance evolves rapidly, it is best to provide a diverse set of phages right from the start of therapy, i.e., to hit hard and early, and create a high genetic barrier to bacterial resistance.

23.
arXiv (CS.CL) 2026-06-12

Learning to Reason by Analogy via Retrieval-Augmented Reinforcement Fine-Tuning

Retrieval-augmented generation (RAG) has become a standard mechanism for grounding language models in external knowledge, yet conventional retrieval based on lexical or semantic similarity is poorly suited for complex reasoning tasks: a semantically similar problem may demand an entirely different solution strategy, while a superficially different problem may share the same underlying reasoning pattern. We propose Retrieval-Augmented Reinforcement Fine-Tuning (RA-RFT), a post-training framework that teaches language models to reason by analogy. RA-RFT uses gold-relevance distillation to train a retriever that ranks contexts by expected reasoning benefit rather than semantic overlap, and then fine-tunes the policy model via reinforcement fine-tuning methods with retrieved analogous demonstrations, so the model learns to leverage reasoning traces under verifiable outcome rewards. We further analyze the diversity of retrieved contexts and find that reasoning-aware retrieval surfaces complementary solution strategies that provide distinct reasoning scaffolds for individual problems. Across challenging mathematical reasoning benchmarks, RA-RFT consistently outperforms standard reinforcement fine-tuning methods. For example, it improves AIME 2025 average@32 accuracy by 7.1 and 2.8 points over GRPO for Qwen3-1.7B and Qwen3-4B respectively – suggesting that reasoning-aware retrieval is a complementary axis of improvement and orthogonal to advances in reward design or training curricula.

24.
arXiv (CS.CV) 2026-06-11

MedVeriSeg: Teaching LISA-Like Medical Segmentation Models to Verify Query Validity Without Extra Training

Despite recent progress in text-prompt-based medical image segmentation, existing LISA-like MLLM-based methods typically generate masks regardless of whether the target specified in the query is present, leading to hallucinated segmentation. In this work, we propose MedVeriSeg, a training-free query verification framework that enables LISA-like medical segmentation models to reject false segmentation queries. MedVeriSeg first quantifies the response quality between the [SEG] token and image features through a Similarity Response Quality Scoring Module. To further improve robustness, it employs a Lightweight Routed Multi-Agent Verification Module, which fuses quantitative score evidence with qualitative agent evidence to comprehensively verify the validity of the query. To support systematic evaluation, we construct MedVeriSeg-Bench, a benchmark designed for query verification in medical image segmentation. Experimental results demonstrate that MedVeriSeg effectively identifies false segmentation queries and reduces hallucinated segmentation, while maintaining a high acceptance rate for valid queries, thereby largely preserving the segmentation utility of LISA-like medical segmentation models.

25.
arXiv (CS.AI) 2026-06-16

Bridging the Gap: Enabling Natural Language Queries for NoSQL Databases through Text-to-NoSQL Translation

arXiv:2502.11201v3 Announce Type: replace-cross Abstract: NoSQL databases are core data infrastructure, yet natural-language access to them remains underdeveloped: correct query generation must recover how a non-relational data model represents entities, nested paths, arrays, missing fields, and dynamic keys. This paper studies Text-to-NoSQL, translating natural-language requests into executable NoSQL queries, instantiated with MongoDB aggregation pipelines over schema-less document stores. We present TEND, short for Text-to-NoSQL Dataset, an execution-verified benchmark with 1,210 MongoDB-native tasks across 11 databases. To our knowledge, TEND is the first Text-to-NoSQL benchmark whose database worlds are MongoDB-native by design: experts manually define collection boundaries, nested arrays, optional and sparse paths, polymorphic shapes, and dynamic-key conventions; these worlds are populated with real data and verified through frozen MongoDB execution, so TEND evaluates schema-less document reasoning rather than SQL-to-MQL transfer. We further introduce SAG, a Schema-as-Data Grounding solver that induces path and value grounding from stored-document evidence before bounded MQL generation, execution-grounded repair, and result-consistency selection. Evaluation uses bounded column-tolerant execution accuracy (EXC) as the headline metric, complemented by a graded result-set F1 and a mutually exclusive execution-outcome decomposition. Experiments show that LLMs with strong NL2SQL performance degrade substantially on TEND, validating Text-to-NoSQL as a distinct schema-less document reasoning problem.