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01.
arXiv (CS.LG) 2026-06-12

When to Align, When to Predict: A Phase Diagram for Multimodal Learning

arXiv:2606.11190v2 Announce Type: replace Abstract: Cross-modal alignment (CA) and cross-modal prediction (CP) are the dominant paradigms for multimodal representation learning, yet there is no systematic understanding of when each succeeds, when each fails, and when cross-modal training helps at all – a gap that leaves practitioners, especially in scientific domains like biomedicine or astrophysics, with heterogeneous instruments and multiple levels of organization and measurement, unable to diagnose why standard methods underperform the best single modality. We develop a unified linear framework that addresses both questions. Under a spiked signal-plus-noise model with structured cross-modal nuisance correlation, we derive separation ratios for both objectives that expose complementary failure modes: alignment whitens each modality and fails when nuisance is strongly correlated across views; prediction encodes whatever is cross-predictable through a one-sided whitening, with recovery governed by source-modality quality. The resulting phase diagram partitions multimodal problems into four regimes: Both, CA only, CP only, and Neither. We present a data-driven procedure to locate real-world datasets in this diagram using a small labeled subsample, identifying the preferred objective and prediction direction before any cross-modal training. Experiments on synthetic data, stereo-vision benchmarks, image-caption pairs, and real astrophysical data validate the predictions in the nonlinear regime, including the Neither regime where cross-modal training is actively harmful. Our framework lets practitioners diagnose their multimodal problem and choose the right objective before committing to training. Code to reproduce the results is available at https://github.com/IlayMalinyak/mm_align_vs_pred.

02.
arXiv (CS.CV) 2026-06-17

ActWorld: From Explorable to Interactive World Model via Action-Aware Memory

Interactive world models aim to simulate environment dynamics under real-time user actions. However, their action vocabulary is largely confined to navigation: most actions correspond to motion (e.g., walk, turn, look around), while interaction with objects in the scene (e.g., pick up plates, open doors, or trigger physical responses) is either absent, restricted to game domains, or relegated to prompt-to-full-video scenarios. The resulting worlds are visually explorable but not truly actionable. In this work, we present ActWorld, an interactive world model that extends prior navigation-centric generators to support mid-rollout object interaction within a chunk-autoregressive framework. We argue that the navigation-interaction gap stems from two bottlenecks. First, a data bottleneck: the lack of human-object interaction data with accurate, dense labels. Second, a memory bottleneck: recency-biased history compression in existing world models discards the event-transition frames that causally determine subsequent object states, leading to an action-forgetting pathology. On the data side, we construct a 100K interaction video dataset, each annotated with per-chunk captions via chain-of-thought reasoning. On the model side, we introduce a hierarchical action-aware memory design that routes history compression by interaction importance, complemented by a persistent memory bank that maintains event-update and object-identity tokens across long rollouts. Experiments show that ActWorld supports both flexible navigation and rich object interaction within a single model, substantially improving interaction fidelity over navigation-only baselines without sacrificing viewpoint control. Project page is available at https://interactwm.github.io/ActWorld.

03.
arXiv (quant-ph) 2026-06-16

Hardy-type self-testing and exposedness of tripartite GHZ correlations

arXiv:2512.16242v2 Announce Type: replace Abstract: Nonlocality can be witnessed either through Bell-inequality violations or through logical contradictions such as Hardy's paradox. In the bipartite two input two outcome scenario, these two routes have distinct geometric behavior: CHSH-maximal correlations are exposed points of the quantum set, whereas known Hardy-type self-testing correlations on the no-signaling boundary are non-exposed. Here we show that this bipartite intuition fails in the tripartite two input two outcome scenario. We study the tripartite instance of a multipartite Hardy-type paradox and prove that the correlation attaining the maximal Hardy success probability self-tests the Greenberger–Horne–Zeilinger state and the associated measurements. Although this correlation lies on the no-signaling boundary, we show that it is an extremal and exposed point of the quantum correlation set. Moreover, it coincides with the correlation attaining the maximal violation of the Mermin inequality. Thus, in the tripartite GHZ scenario, the logical-paradox and Bell-inequality routes to nonlocality select the same exposed quantum boundary point. We also establish a robust version of the self-test, showing that small deviations from the ideal Hardy constraints imply quantitative closeness to the target state and measurements. Our results reveal a qualitative geometric difference between bipartite and tripartite Hardy-type nonlocality and suggest a broader investigation of exposedness for multipartite Hardy correlations in the multiparty setting.

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

BLUEmed: Retrieval-Augmented Multi-Agent Debate for Clinical Error Detection

Terminology substitution errors in clinical notes, where one medical term is replaced by a linguistically valid but clinically different term, pose a persistent challenge for automated error detection in healthcare. We introduce BLUEmed, a multi-agent debate framework augmented with hybrid Retrieval-Augmented Generation (RAG) that combines evidence-grounded reasoning with multi-perspective verification for clinical error detection. BLUEmed decomposes each clinical note into focused sub-queries, retrieves source-partitioned evidence through dense, sparse, and online retrieval, and assigns two domain expert agents distinct knowledge bases to produce independent analyses; when the experts disagree, a structured counter-argumentation round and cross-source adjudication resolve the conflict, followed by a cascading safety layer that filters common false-positive patterns. We evaluate BLUEmed on a clinical terminology substitution detection benchmark under both zero-shot and few-shot prompting with multiple backbone models spanning proprietary and open-source families. Experimental results show that BLUEmed achieves the best accuracy (69.13%), ROC-AUC (74.45%), and PR-AUC (72.44%) under few-shot prompting, outperforming both single-agent RAG and debate-only baselines. Further analyses across six backbone models and two prompting strategies confirm that retrieval augmentation and structured debate are complementary, and that the framework benefits most from models with sufficient instruction-following and clinical language understanding.

05.
arXiv (CS.AI) 2026-06-19

CTS-MoE: Implicit Terrain Adaptation via Mixture-of-Experts for Perceptive Locomotion

arXiv:2606.19633v1 Announce Type: cross Abstract: Perceptive legged locomotion over discontinuous terrain (e.g., stairs, gaps, and obstacles) requires adaptive behavior, as a single conservative gait cannot produce the anticipatory maneuvers needed for abrupt topology changes. Cast as multi-task reinforcement learning, this problem introduces a tension between sharing and separation. Tasks use a common locomotion base but have conflicting rewards, so a policy must share behavior while avoiding value interference. Prior work addresses only one side, with monolithic policies sacrificing specialization and hierarchical sub-policies sacrificing generalization across transitions and unseen terrain. We propose CTS-MoE, which combines a dense mixture-of-experts actor with perception-based gating to compose shared behaviors and a multi-critic with task-specific value heads to prevent interference. The model is trained end-to-end in a single-stage concurrent teacher-student setup that handles partial observability and avoids sequential distillation, with task labels used only during training. At deployment, routing depends solely on perception, allowing terrain adaptation without a high-level selector or terrain classifier. Experiments on a Unitree Go1 in simulation and on hardware across seen and unseen terrains show task-aware specialization, with lower tracking error and higher success rates than monolithic baselines. Project Website: https://cts-moe.github.io/ .

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

UniReason-Med: A Shared Grounded Reasoning Interface for 2D-to-3D Transfer in Medical VQA

We study whether grounded reasoning supervision from abundant 2D medical images can improve 3D medical VQA when both input types are aligned through a common reasoning interface. We introduce UniReason-Med, a single-checkpoint framework that processes either a 2D image or a slice-serialized 3D volume at inference time, generating interleaved textual reasoning and localized visual evidence through shared box syntax, region-token injection, and a common grounded reasoning policy. To train this interface, we construct UniMed-CoT, a 220K instruction-tuning dataset with interleaved textual reasoning and grounded visual evidence, including 170K 2D and 50K 3D samples. Through supervised fine-tuning followed by outcome-level reinforcement learning, UniReason-Med learns to generate grounded reasoning traces without IoU/Dice-based localization rewards during RL. Data-mixture and component ablations show that joint 2D+3D grounded supervision substantially improves 3D reasoning over 3D-only training, while grounding and region-token injection consistently benefit both 2D and 3D tasks. These results suggest that a shared grounded reasoning interface can transfer reasoning structure from 2D images to slice-serialized volumetric medical understanding. The code and data are publicly available at https://github.com/IQuestLab/unireason-med.

07.
arXiv (CS.AI) 2026-06-25

SplitZip: Ultra Fast Lossless KV Compression for Disaggregated LLM Serving

arXiv:2605.01708v3 Announce Type: replace-cross Abstract: Contemporary systems serving large language models (LLMs) have adopted prefill-decode disaggregation to load-balance between the compute-bound prefill phase and the memory-bound decode phase. Under this design, prefill workers generate a KV cache that must be transferred to decode workers before generation can begin. With these workers residing on different physical systems, this transfer becomes a significant bottleneck to serving LLMs at scale, especially for long-input and agentic workloads. Existing lossless codecs are unsuitable here as they primarily target offline weight compression, run on CPUs, or use variable-length coding whose compression cannot keep up with KV production during prefill. We introduce SplitZip, a GPU-friendly lossless compressor for KV cache transfer that preserves KV tensors bitwise and integrates into existing serving frameworks without modifying model execution. SplitZip exploits redundancy in floating-point exponents of KV activations, encoding frequent exponent values with fixed-length codes and routing rare exponents through a sparse escape stream of (position, value). A calibrated top-16 exponent codebook eliminates online histogramming, while the regular dense path and sparse escape correction make both encoding and decoding efficient on GPUs. On real BF16 activation tensors, SplitZip achieves $613.3$ GB/s compression throughput and $2181.8$ GB/s decompression throughput, outperforming prior lossless compressors on the critical codec path. End-to-end transfer experiments show up to $1.32\times$ speedup for BF16 KV cache transfer, $1.30\times$ speedup for TTFT, and $1.23\times$ increase in Request Throughput. The same approach extends to FP8 KV caches, providing up to $1.14\times$ compression over native E5M2. Code is available at https://github.com/Intelligent-Microsystems-Lab/SplitZip

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

ERTS: Adversarial Robustness Testing of Ethical AI via Semantic Perturbation in a Bounded Consequence Space

arXiv:2606.13282v1 Announce Type: new Abstract: As AI systems are deployed in high-stakes ethical contexts such as healthcare triage, autonomous vehicle control, and employment screening, formal methods for evaluating their robustness against adversarial manipulation of ethical reasoning remain underdeveloped. This paper introduces the Ethical Robustness Testing System (ERTS), a closed-pipeline framework that: (1) encodes ethical dilemmas into a 22-dimensional Ethical Consequence Space (ECS) grounded in established ethical theory; (2) applies 17 semantic perturbation functions subject to 6 validity constraint classes including a novel semantic coherence constraint; (3) measures decision deviation via a 4-component Ethical Instability Index (EII); and (4) produces domain-adaptive pre-deployment robustness assessment verdicts. We evaluate 4 structured baseline models and 2 production LLMs (Gemini 2.0 Flash and Llama 3.2) across 50 ethical scenarios spanning 8 deployment domains, generating 1,500 adversarial test cases. Results demonstrate that only 33% of models achieve assessment clearance, with the local Llama-3.2 model proving particularly vulnerable to fairness corruption and information degradation attacks (ERS = 0.737). To the best of our knowledge, no existing framework combines a bounded ethical consequence space, semantic coherence constraints, and domain-adaptive assessment in a single adversarial testing pipeline.

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

Latent Visual States for Efficient Multimodal Reasoning

The integration of visual evidence has significantly enhanced the capabilities of large multimodal models. However, this integration predominantly relies on generating discrete outputs (etc., code or box coordinates) to invoke external tools, a process that introduces rigid dependencies and substantial latency. To overcome these limitations, we propose {EVA} (LatEnt Visual StAtes), a novel framework that natively generates continuous latent visual representations. These internal representations manifest as an adaptive sequence of Latent\_slot tokens, serving as intermediate visual thoughts during the reasoning process. These Latent\_slot tokens are then trained end-to-end with the discrete text tokens. This co-optimization, notably, causes extreme policy deviation in the 'transition window' following the Latent\_slot tokens. We develop D-GSPO (Decouple-GSPO) to target this root cause by decoupling the optimization of latent and discrete components. To support SFT, we construct EVA-230K, a high-quality text-image interleaved CoT dataset encompassing a diverse range of real-world scenes, documents, charts and OCR tasks. Extensive experiments across multiple benchmarks confirm that EVA achieves significant performance gains while enhancing inference efficiency.

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

Deep-Unfolded Coordination

arXiv:2606.19920v1 Announce Type: cross Abstract: Distributed optimization is a highly scalable and structurally transparent technique to solve multi-agent robotics problems; however, such methods often suffer from the need for highly-specialized, problem-specific hyperparameter tunings. In this work, we propose Deep Coordinator, a deep-unfolding framework that learns to dynamically adjust the hyperparameters of ADMM-DDP, a popular distributed solver for robotics tasks, at solve-time in response to optimizer performance. Our architecture consists of unrolling a fixed number of ADMM-DDP iterations into a neural network with learnable functions between layers mapping the optimizer state to the next hyperparameters. To the best of our knowledge, Deep Coordinator is the first deep-unfolding framework to adapt the penalty parameters of a non-convex optimizer at solve-time; we show that the mainstream supervised approach can yield degenerate solutions when training such models, and propose an unsupervised learning scheme. On simulations with fleets of cars and quadrotors, Deep Coordinator produces trajectories of comparable quality 6.18-9.44x faster than conventional solvers. Furthermore, Deep Coordinator retains its performance benefits when deployed to systems up to 8x larger than trained on.

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

Test-Time Compute Scaling for ASR with Depth-Conditioned Looped Transformers

arXiv:2606.04678v2 Announce Type: replace Abstract: End-to-end ASR systems typically use fixed-depth acoustic encoders at inference, making it difficult to trade additional test-time computation for improved recognition without training a larger model. A natural approach is to reuse a shared Transformer block recurrently, but we find that naive looping does not fully exploit additional recurrent compute. We introduce LARM, a depth-conditioned looped Transformer that turns recurrent encoder depth into a controllable test-time compute axis. LARM combines sparse CTC checkpoints, supervision-clock embeddings, FiLM depth conditioning, and delayed soft-posterior feedback. These components structure the loop into recognition checkpoints separated by latent refinement phases and allow shared weights to specialize across recurrent steps. On LibriSpeech, LARM improves WER as the number of inference loops increases and achieves performance competitive with deeper unshared-parameter baselines. Our results show that test-time compute scaling can extend beyond autoregressive language-model reasoning to continuous non-autoregressive speech recognition.

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

Certifying Nonclassical Proper-Time Histories with a Quantum Clock

Authors:

arXiv:2606.12755v1 Announce Type: new Abstract: Quantum clocks can acquire relativistic phases from motional or gravitational proper-time differences, but reduced clock dephasing alone does not certify nonclassical proper-time histories. We formulate this distinction as a channel-certification problem. First, we show that any two-level single-time dephasing signal, including one generated by an effective quantum proper-time label, admits a classical random proper-time representation. We then define the convex set of classical mixtures of experimentally specified proper-time histories and prove a Choi-rank separation criterion for conditioned coherent history recombination. A two-branch Ramsey protocol gives explicit bright- and dark-port population witnesses outside this classical set. The certification is operational and relative to the specified history set: it rules out classical mixtures of the same implemented proper-time histories, not arbitrary classical protocols with different histories or controls.

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

On Aligning Hierarchical Standardized Embedding for Audio-visual Generalized Zero-shot Learning

Audio-visual Generalized Zero-shot Learning (AV-GZSL) is a challenging task that aims to classify both seen and unseen objects or scenes by integrating data from audio and visual modalities. Recent studies primarily focus on fusing or aligning audio and visual features to generate more informative audio-visual embeddings. Also, aligning the audio-visual and textual features of most existing methods relies solely on the optimization objectives. However, those methods neglect the inherent distributional and structural differences between audio-visual and textual modalities. To address this limitation, we propose a method termed Aligning Hierarchical Standardized Embedding (AHSE), which enables hierarchical alignment of standardized audio-visual and textual embeddings within a shared embedding space. Specifically, we first apply Z-score standardization to the fused audio-visual and textual embeddings to reduce distributional mismatches. We then introduce a hierarchical alignment strategy that minimizes discrepancies at the semantic, class, and batch levels, thereby constructing a more robust and well-structured embedding space. This strategy not only preserves semantic and inter-class relationships but also maintains spatial consistency within each batch. Extensive experiments on three benchmark datasets: VGGSound-GZSL, UCF-GZSL, and ActivityNet-GZSL, demonstrate that AHSE achieves competitive performance in zero-shot learning.

14.
medRxiv (Medicine) 2026-06-22

Substantia Nigra and Subthalamic Nucleus Deep Brain Stimulation Exert Opposing Effects on Novelty Recognition in Parkinson's Disease

Episodic memory plays a critical role in supporting adaptive behavior; however, whether it can be causally regulated in humans via deep subcortical stimulation remains unclear. In the present study, we investigated the differential effects of substantia nigra (SN) and subthalamic nucleus (STN) stimulation on episodic memory, as well as the underlying mechanisms of its associated brain networks, using a recognition memory task combined with concurrent functional magnetic resonance imaging in patients with Parkinson's disease. SN-DBS increased recognition sensitivity and reduced false alarms at both frequencies, whereas 10 Hz STN-DBS reduced sensitivity and increased false alarms. Functional connectivity analyses in the absence of DBS stimulation identified a false recognition-related network linking nigral, pallidal, subthalamic, medial temporal, frontal, and occipital regions. SN-DBS-related false alarm reduction tracked modulation of this circuit and was marked by its baseline vulnerability state. These behavioral effects mapped onto target-dependent parieto-occipital and SN-visual retrieval pathways, supporting a model in which DBS bidirectionally regulates recognition memory through target- and frequency-dependent subcortical-cortical circuits.

15.
arXiv (CS.CV) 2026-06-17

MOCHI: Motion Enhancement of Collaborative Human-object Interactions

Collaborative human-object interaction shows dynamic and complex movements that require mutual anticipation and continuous adjustment between participants and the shared object. Modeling such collaborative multi-human object interaction (MHOI) scenarios requires high-quality data acquisition as a foundational step; however, this is challenging due to the inherent complexity of MHOI where human-human and human-object interactions occur simultaneously. Such complexity leads to noisy MHOI captures characterized by several artifacts: contact misalignment between hands and objects, motion jitter and temporal inconsistencies in the captured sequences, and missing or incomplete finger-level articulation details. To address these challenges, we present MOCHI (MOtion Enhancement of Collaborative Human-object Interactions), a two-stage framework for enhancing noisy MHOI data. Our approach first generates physically plausible hand grasps through optimization from noisy body input, producing grasps that are both physically plausible and semantically consistent with the body pose, where these optimized grasps are extended into complete hand-object interaction sequences. Consequently, the full-body motion for all participants are refined through a diffusion-based noise optimization framework that uses single-person motion priors. During the optimization process, we introduce optimization objectives to encode human-object and human-human interaction information within these single-person priors. Experimental results demonstrate the effectiveness of our pipeline across diverse MHOI data, either acquired by existing capture methods or synthesized by generative models. We further show robustness of our system across varying numbers of participants and types of interactions, and demonstrate various applications including keyframe-based MHOI creation and data augmentation through varying object geometries.

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

Massive Open-Vocabulary Keyword Spotting

Automatic speech recognition systems have been shown to under-perform when it comes to transcribing words rarely seen in the training data, namely specialized terminology. Open-vocabulary keyword spotting, combined with contextual biasing, has been shown to mitigate this issue. However, existing systems can only handle glossaries of a few hundred terms without becoming an infeasible bottleneck. We propose a system that stores features with a memory footprint up to 128 times smaller than a comparable baseline and allows users to process massive databases while remaining open-vocabulary. Without fine-tuning the speech recognition model, our system achieves a comparable entity recall as uncompressed solutions, even in languages not seen during training.

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

Quant Convergence: Bridging Classical Value Investing and Modern Factor Models for Systematic Equity Selection

arXiv:2606.24575v1 Announce Type: new Abstract: Modern finance relies heavily on complex machine learning models to find patterns in the stock market. However, as these AI models get more complicated, they often memorize short-term market noise instead of finding companies with real, lasting value. We designed this research to test if Benjamin Graham's classic value investing rules could act as a mathematical "low-pass filter" to keep these modern models in check. We built three different sets of features - pure Graham rules, modern market factors, and a mix of both - and tested them against highly complex models (XGBoost and AutoGluon) using 20 years of S&P 500 data. By applying a strict buy-and-hold strategy over a four-year test period (March 2022 to March 2026), the results showed that more complex algorithms do not always win. While the AutoGluon model captured high returns (222.68%), it suffered a substantial 39.78% drop because it bought volatile tech stocks right before the market crashed. On the other hand, the pure Graham Random Forest achieved the highest overall return (232.13%) with much less risk (1.38 Calmar Ratio). Furthermore, the Combined Random Forest successfully mixed momentum with Graham's rules, making a 202.91% return while keeping the lowest maximum drop (34.53%) of any model tested. Ultimately, this research proves that Graham's "margin of safety" isn't outdated; it is actually a highly effective way to prevent modern AI from taking on too much risk.

18.
arXiv (CS.AI) 2026-06-16

Minimalist Genetic Programming

arXiv:2606.10237v2 Announce Type: replace Abstract: Genetic programming (GP) is based on two important insights. First, that any learning task can fundamentally be posed as a program induction problem, where the goal is to construct a symbolic hierarchical model that is expressed as a syntax tree. Second, to pose this task as a search problem, and use evolution to locate the desired model. Since it was proposed, GP has produced notable results in a wide range of tasks and problem domains. This work presents an alternative view by modifying the second core insight of GP, posing the problem as a syntactic derivation task instead. In particular, this paper presents Minimalist Genetic Programming (MGP), an algorithm that like GP is biologically inspired, but instead of evolution it takes inspiration from the Minimalist Program to human language, in which syntax is understood as an optimal solution to the problem of linking two other mental systems. In minimalism, the core computational process is a binary set formation operator called $MERGE$, than can be used to incrementally construct complex syntactic structures using a simple Markovian process. MGP is able to discover the core building blocks of the symbolic expressions, and to incrementally combined them using $MERGE$. The proposed system is benchmarked on symbolic regression tasks that are known to be difficult to solve with standard GP systems because of the propensity for bloat. Results show that when a proper lexicon of atomic syntactic objects are chosen, MGP is able to consistently produce the exact ground truth model on a set of symbolic regression tasks where standard GP struggles to do the same. The insights provided by minimalism are shown to be relevant to the problem of program induction, and should be explored further based on the potential exhibited by MGP in this work.

19.
PLOS Medicine 2026-05-20

Prescribed hormonal contraceptive use trends in the Estonian Biobank: A longitudinal observational study

by Jelisaveta Džigurski, Märt Möls, Kristi Läll, Hannah Currant, Mall Eltermaa, Estonian Biobank Research Team , Reedik Mägi, Lili Milani, Triin Laisk Background Hormonal contraceptives (HCs) are widely used and have well-documented population-level statistics. Previous studies with short follow-ups have focussed on individual HC use and side effects. However, the same aspects over longer periods, HC formulation switching, and the impact of genetic factors on HC side effects remain understudied due to the limited availability of suitable datasets. We investigated whether the Estonian Biobank (EstBB) is suitable for studying genetic risk for HC side effects. Methods and findings This is a longitudinal descriptive study combining prescribed HC purchase data collected from 2004 to 2022 with genetic and health data from 73,071 female EstBB HC users aged 15–55 at the time of purchase. HC usage was defined by the Anatomical Therapeutic Chemical (ATC) codes G02B, G03A, and G03HB01. Methods included calculating age-stratified annual user prevalence, inferring usage periods from purchases, assessing formulation switching, identifying the International Classification of Diseases, Tenth Revision (ICD-10)-based side effect-related diagnoses and thromboembolism risk factors, and assessing carrier status for Factor V Leiden (FVL, rs6025) and prothrombin G20210A (PTM, rs1799963) genetic variants as proof-of-concept. Over 19 years, 20 HC formulations with five administration routes (oral pills, transdermal patches, vaginal rings, subdermal implants, intrauterine devices) were used. In the EstBB, combined HCs were the most commonly used among users aged 15–29, while progestin-only HC use increased with age and over time, comparable to the Estonian population. Overall, 64.2% (n = 46,920) of users switched formulations at least once, with 17.7% (n = 12,929) being rapid switchers. Side effect-related diagnoses were observed in 23.1% (n = 2,982) of rapid switchers, with excessive/irregular menstrual bleeding being the most common. Genetic analysis revealed that 5.3% (n = 3,886) of users carried at least one variant previously associated with increased thrombosis risk (3.5% (n = 2,556) carried FVL only, 1.8% (n = 1,276) PTM only, and 0.07% (n = 54) both). Carriers of thrombosis-associated variants had a significantly higher percentage of thrombosis (6.5%) than non-carriers (4.2%; OR = 1.61, 95% CI [1.40, 1.84], p 

20.
arXiv (CS.AI) 2026-06-19

CareTransition-Audit: A Benchmark to Audit Discharge Summaries for Efficient Care Transitions

arXiv:2604.05435v2 Announce Type: replace Abstract: Incomplete or inconsistent discharge documentation drives care fragmentation and avoidable readmissions. Despite its critical role in patient safety, auditing discharge summaries relies on manual review and does not scale. We propose an automated framework for auditing discharge summaries using large language models (LLMs). Our approach operationalizes the DISCHARGED framework into a checklist of 46 questions. Using 50 summaries from the MIMIC-IV database, with clinician ground-truth labels, we benchmark 11 LLMs. Model-assessed mean documentation completeness ranges from 54.9% to 74.2%, and the best-performing models achieve a Cohen's kappa values around 0.5 against clinician labels, indicating moderate agreement. All models struggle to identify ambiguous documentation (Unclear), highlighting a key gap in current automated auditing. This work provides a clinician-validated benchmark and zero-shot baselines for systematic quality improvement in clinical documentation.

21.
PLOS Medicine 2026-06-16

The data transparency crisis in research: Lessons from systematic reviews and meta-analyses

by Saul Martin-Rodriguez, Rodrigo Fernandez-Gonzalo, David Moher Summary points Systematic reviews and meta-analyses underpin clinical guidelines and health policy, yet their validity may be compromised by limited access to underlying datasets and associated analytical code. Reliance on incomplete or inconsistently reported summary statistics forces researchers to use imputation and unverifiable assumptions, which can distort effect estimates and mislead clinical decision-making. The consequences extend beyond methodology: flawed evidence synthesis can influence treatment recommendations, healthcare spending, and patient safety, as illustrated by historical cases such as hormone replacement therapy. Despite widespread data-sharing policies, compliance remains low, enforcement weak, and monitoring almost non-existent, with many datasets remaining unavailable or inaccessible. This Policy Forum argues for strengthening enforceable data-sharing mechanisms, including clearer enforcement and pragmatic verification approaches within editorial workflows.

22.
arXiv (CS.CL) 2026-06-11

Models That Know How Evaluations Are Designed Score Safer

The validity of AI safety evaluations depends on models behaving consistently across controlled and deployment settings. Prior work has identified test-time contextual cues, such as hypothetical scenarios, as a source of verbalized evaluation awareness and subsequent behavioral shift. In this paper, we investigate a potential explanation of this phenomenon: evaluation meta-knowledge, defined as parametric knowledge about the structural traits that characterize evaluations. Similar to dataset contamination, where benchmark exposure leads to higher performance through memorization, we hypothesize that models trained on texts describing evaluation practices may implicitly learn to recognize and respond to evaluation-like contexts, for instance, through exposure to scientific articles or social media posts about AI benchmarking. To test this, we fine-tune models on synthetic documents describing evaluation traits such as verifiable structures or moral dilemmas. Evaluating this fine-tuned model on six safety benchmarks, we find that it is significantly safer than the base model and control model. This behavioral shift persists even when restricting the analysis to responses lacking explicit verbalization of evaluation awareness. Our results demonstrate that evaluation meta-knowledge may inflate safety benchmark performance, introducing a novel confounder that is independent of explicit memorization or verbalized evaluation awareness, thus, challenging to detect. These findings have important implications for the design and interpretation of AI safety evaluations. Our code and models are available at https://github.com/compass-group-tue/arxiv2026_evaluation_meta_knowledge.

23.
medRxiv (Medicine) 2026-06-23

Attention and memory in Parkinson's disease: a discriminant analysis approach

Background. Cognitive impairment in Parkinson's disease (PD) is highly prevalent and heterogeneous. Assessing multiple cognitive domains is challenging and risks redundancy. This study evaluated whether a discriminant analysis approach could optimize the selection of specific tasks and measures for identifying attention and memory deficits in PD. Methods. Thirty PD patients and 25 cognitively unimpaired (CU) controls completed four experimental tasks: two assessing attention (flanker and spatial Stroop), one for recognition memory, one for working memory (n-back). Following group-level difference analyses, a discriminant analysis was performed to identify which tasks, and performance metrics possessed the highest sensitivity for distinguishing PD patients from CU individuals. Results. At the group level, PD patients exhibited significantly worse conflict costs in both attention tasks and lower sensitivity scores (d') in the recognition memory task compared to CU controls. The discriminant analysis revealed that time-based measures from the spatial Stroop task and the sensitivity score from the recognition memory task provided the highest discriminating power to differentiate between the two groups. Conclusion. These findings suggest that cognitive deficits in PD can be identified with high diagnostic accuracy using a targeted subset of metrics, eliminating the need for extensive and redundant neuropsychological testing batteries for attention and memory, without needing an extensive number of cognitive tasks for attention and memory.

24.
medRxiv (Medicine) 2026-06-24

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

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

25.
arXiv (CS.CV) 2026-06-15

Giving AI a Headache: Acoustic Adversarial Attacks to Computer Vision Applications

Artificial Intelligence (AI) is increasingly used to automate a variety of real-world computer vision (CV) applications, such as autonomous vehicle control, facial recognition, and security cameras. Recent research has shown that acoustic vibration can induce real physical motion in cameras, interfering with their internal stabilization mechanisms. Because the motion falls outside the conditions the stabilization system was designed to handle, the system introduces artifacts into the frame, causing AI-based CV models to misclassify, miss targets, or hallucinate objects. Previous work used ultrasonic frequencies (>20 kHz) to perform short-range attacks, which limits them to short distances due to the attenuation exhibited by high frequencies. In this work, we investigate acoustic attacks using lower frequencies in the audible range (