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01.
medRxiv (Medicine) 2026-06-16

Exercise Training Improves Skeletal Muscle Insulin Sensitivity and Reprograms the Adipose Transcriptome in Heavier Monozygotic Twins

Exercise training improves skeletal muscle insulin sensitivity, yet its effects on white adipose tissue remain incompletely understood. We investigated how adiposity and exercise training influence insulin-stimulated glucose uptake in skeletal muscle and abdominal subcutaneous adipose tissue (ASAT), alongside adaptations in gene expression and DNA-methylation. Ten monozygotic twin pairs discordant for BMI underwent [18F]FDG-PET/CT imaging of skeletal muscle (vastus lateralis, VL) and ASAT during a euglycemic-hyperinsulinaemic clamp before and after six months of exercise training. VL and ASAT biopsies were analyzed using mRNA-sequencing and reduced representation bisulfite sequencing. Exercise training improved whole-body and VL insulin sensitivity in leaner and heavier co-twins (p

02.
arXiv (CS.CL) 2026-06-11

Self-Attention as Transport: Limits of Symmetric Spectral Diagnostics

When a language model processes a hallucinated response, its attention routing tends to fail in one of two shapes: over-concentrating on a narrow set of positions, or spreading so diffusely that relevance is diluted, and the shape of the failure carries diagnostic signal. We study these shapes as a diagnostic characterization, computed from attention matrices under forced scoring of benchmark-labeled responses rather than during live generation. A widely used family of spectral methods analyzes the symmetric component of the degree-normalized attention operator, which governs transport capacity; we prove that every transpose-invariant spectral diagnostic of this operator is structurally orientation-blind (it cannot distinguish an operator from its transpose, and therefore cannot detect information-flow direction), with a converse to the blindness theorem bounding any Lipschitz diagnostic's transpose sensitivity by the asymmetry coefficient $G$. Pairing this with a closed-form bipartite-Cheeger landscape for canonical causal architectures, we show that uniform causal attention satisfies an $n$-independent floor $\phi \ge 1/5$, while window attention pierces the floor as $O(w/n)$; failure modes are shape-different, not just value-different. This floor is an idealized-architecture benchmark, not an empirical attractor: the fraction of real attention heads that pierce it is itself an architectural signature. The resulting two-axis diagnostic ($\phi$ for capacity, $G$ for direction) yields a falsifiable polarity prediction: bottleneck- and diffuse-dominated benchmarks should exhibit opposite polarity. Under length-controlled evaluation, transport features retain interpretable signal (0.62-0.84 LC-AUROC) across the tested decoder-only, encoder-only, and encoder-decoder models, with polarity reversing as predicted between HaluEval and MedHallu.

03.
arXiv (CS.AI) 2026-06-11

An Ethical eValuation Agent (EeVA): Results of a Proof-of-Concept Test on a Prototype Agentic-like Workflow to Assist Ethical Deliberations

arXiv:2606.11218v1 Announce Type: cross Abstract: Ethical deliberation is often misunderstood as a search for single right or wrong answers, creating difficulties for non-ethically trained personnel who must address ethically laden challenges. We developed EeVA, an agentic-like LLM-based workflow designed to support comparative ethical reflection rather than deliver definitive ethical answers. EeVA was programmed in n8n using three interconnected workflows: starter, worker, and emitter. It evaluated uploaded use cases against 10 ethical frameworks through evaluator and synthesis prompts. Proof-of-concept testing used three published cases from urban mobility, peer-to-peer energy trading, and social-service resource allocation. Across all cases, EeVA produced consistently structured framework-specific evaluations and integrated syntheses. Outputs differentiated between frameworks, identified convergences and divergences, recommended modifications to increase alignment, and highlighted persistent ethical tensions. Syntheses were readable for non-specialists and shifted attention away from simplistic answers toward design conditions, safeguards, and areas where full cross-framework agreement was unlikely. The findings suggest that LLMs can be organised into usable workflows that preserve ethical plurality while helping bridge the communicative gap between ethicists and non-ethically trained personnel. EeVA's value lies not in replacing ethicists or resolving moral disagreement, but in scaffolding structured ethical deliberation. EeVA offers a promising proof of concept for supporting ethical reflection where access to ethics expertise is limited. Further work is needed on reproducibility, human evaluation, user testing, and efficiency before it can be considered a mature tool.

04.
medRxiv (Medicine) 2026-06-22

Survival differences and artemisinin resistance in severe malaria among HIV coinfected patients: data from Mozambique

Abstract Background Malaria remains a significant cause of morbidity and mortality, especially in sub-Saharan Africa, where rates of HIV coinfection are high. This study aimed to determine whether Plasmodium falciparum malaria treatment outcomes and rates of antimalarial resistance markers differ according to HIV serostatus in Mozambique. Methodology We conducted an observational study of non-pregnant adults, with and without HIV coinfection, admitted to the Hospital Central de Maputo for treatment of severe malaria. Plasmodium falciparum DNA was extracted from whole blood and sequenced to identify single-nucleotide polymorphisms. Statistical analyses to compare clinical outcomes and rates of nonsynonymous mutations in genes associated with drug resistance were performed in R version 4.2. Results We recruited 149 study participants aged between 18-62 years, 72 (48.3%) were female, and 59 (39.6%) were infected with HIV. Comparing clinical outcomes, we found a significant difference in anemia (hemoglobin

05.
bioRxiv (Bioinfo) 2026-06-17

In silico characterization of lysis and host-recognition modules in Staphylococcus aureus bacteriophage genomes

Background/aim: Antimicrobial resistance in methicillin-resistant Staphylococcus aureus (MRSA) requires precision non-antibiotic therapeutics, yet phage lytic efficacy is poorly predicted by phenotypic assays, as shown by paradoxical biofilm responses. This study characterized the genomic architecture of lytic S. aureus bacteriophages, focusing on the conservation of the lysis module and the variability of host-recognition modules, to provide a rational basis for phage candidate selection. Materials and methods: Twenty-two complete S. aureus phage genomes were retrieved from NCBI GenBank. Genomic features were extracted with custom Biopython scripts. Lysis (endolysin, holin) and host-recognition (tail fiber/receptor-binding protein) modules were annotated and validated by InterPro domain analysis, with disrupted endolysins resolved by tBLASTn. Phylogeny was reconstructed from large terminase subunit (TerL) sequences using maximum likelihood. Results: Genome size spanned three classes, from 17.5 to 148.6 kb. The LysK-type endolysin (CHAP, Amidase, SH3b) was highly conserved, whereas tail fiber/RBP genes were detected in only 14 of 22 phages. Domain analysis reclassified two proteins annotated as endolysins as virion-associated peptidoglycan hydrolases, and identified two independent mechanisms, HNH endonuclease insertion and intron splitting, that interrupt lysis-module genes and confound automated annotation. Maximum likelihood analysis recovered a strongly supported, highly conserved core clade with EW and SA13 as divergent lineages. Conclusion: Lysis modules are conserved whereas host-recognition modules are variable, indicating that host recognition rather than the lytic enzyme is the principal determinant of host range and the more rational target for phage selection and engineering.

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

Toward General Digraph Contrastive Learning: A Dual Spatial Perspective

arXiv:2510.16311v2 Announce Type: replace Abstract: Graph Contrastive Learning (GCL) has emerged as a powerful tool for extracting consistent representations from graphs, independent of labeled information. However, existing methods predominantly focus on undirected graphs, disregarding the pivotal directional information that is fundamental and indispensable in real-world networks (e.g., social networks and recommendations).In this paper, we introduce S2-DiGCL, a novel framework that emphasizes spatial insights from complex and real domain perspectives for directed graph (digraph) contrastive learning. From the complex-domain perspective, S2-DiGCL introduces personalized perturbations into the magnetic Laplacian to adaptively modulate edge phases and directional semantics. From the real-domain perspective, it employs a path-based subgraph augmentation strategy to capture fine-grained local asymmetries and topological dependencies. By jointly leveraging these two complementary spatial views, S2-DiGCL constructs high-quality positive and negative samples, leading to more general and robust digraph contrastive learning. Extensive experiments on 7 real-world digraph datasets demonstrate the superiority of our approach, achieving SOTA performance with 4.41% improvement in node classification and 4.34% in link prediction under both supervised and unsupervised settings.

07.
arXiv (CS.CV) 2026-06-12

GetNetUPAM: Ecologically Informed Nested Cross-Validation and Noise-Robust Attention for Marine Bioacoustic Monitoring

Deploying reliable bioacoustic monitoring systems requires models that generalize under high-noise, low-SNR conditions and evaluation protocols that expose deployment-relevant failure modes, gaps largely unaddressed in current UPAM practice. Intrinsic noise, variable propagation, and mixed biological and anthropogenic sources induce distribution shifts that conventional models and single-split evaluations obscure, inflating performance and masking instability. We introduce GetNetUPAM, a hierarchical nested cross-validation framework that uses the nested stage to quantify model stability rather than tune for inflated hold-out scores. By partitioning data into site-year blocks, GetNetUPAM preserves ecological heterogeneity and forces each outer fold to represent a distinct environmental regime, preventing overfitting to localized noise or sensor artifacts. Inner stratified folds measure generalization across the full UPAM signal distribution, enforcing strict separation between model development and the outer held-out deployment condition. Using GetNetUPAM, we evaluate the Adaptive Resolution Pooling and Attention Network (ARPA-N), a CNN architecture for irregular spectrogram dimensions. ARPA-N integrates CBAM spatial attention as a learned noise suppressor, producing attention maps that localize true call structure and avoid the global, non-biological cues exploited by standard CNNs on long-window data. Under GetNetUPAM, ARPA-N generalizes robustly across diverse environmental regimes. In the zero-training support Balleny Islands region, it reduces false positives per hour by over an order of magnitude (approximately 10x) at fixed 90 percent recall, yielding consistently improved metrics across folds. These advances provide a reproducible benchmark and move UPAM toward scalable, deployment-reliable ecological monitoring.

08.
arXiv (CS.CL) 2026-06-18

ActMem: Bridging the Gap Between Memory Retrieval and Reasoning in LLM Agents

Memory management is essential for LLM agents in long-term interactions. Current memory frameworks typically treat agents as passive ``recorders'' and retrieve information without understanding its deeper implications. They may fail in scenarios requiring reasoning and complex decision-making. To bridge this critical gap, we propose a novel actionable memory framework called ActMem that integrates memory retrieval with active causal reasoning. ActMem transforms unstructured dialogue history into a structured causal and semantic graph. By leveraging counterfactual reasoning and commonsense completion, it enables agents to deduce implicit constraints and resolve potential conflicts between past states and current intentions. Furthermore, we introduce a comprehensive dataset ActMemEval to evaluate agent reasoning capabilities in logic-driven scenarios, moving beyond the fact-retrieval focus of existing memory benchmarks. Experiments demonstrate that ActMem significantly outperforms baselines in handling complex, memory-dependent tasks, paving the way for more consistent and reliable intelligent assistants.

09.
arXiv (CS.CL) 2026-06-19

What sentiment analysis can't see: Measuring whether customers were helped, and what went wrong, across 70,000 support conversations

Most companies read their customer support data at scale using sentiment analysis, which measures how customers sound rather than whether they were satisfied with the result. We tested a richer alternative on 70,450 support conversations from a leading online fundraising platform: alongside tone, we used GPT-5.4 to estimate each customer's satisfaction and to flag whether they reported a concrete problem, then validated all three readings against the 1-to-5 ratings customers left on the conversations they rated. The satisfaction estimate tracked those ratings far better than sentiment did, correlating at 0.47 against 0.36 and flagging unhappy customers with far fewer false alarms. The structured read also sees what sentiment cannot: tone and satisfaction disagree in 44% of conversations, a single "Neutral" label hides everything from quietly satisfied customers to ones who quietly gave up, and the largest group of all is "tolerated friction," customers who are satisfied but still reporting a fixable problem, a standing issue that no sentiment-based dashboard can surface. The broader finding is that LLM-based annotation can capture far more than the tonality of a customer's language, offering strong potential for new business metrics grounded instead in the customer's state (whether they were satisfied) and the cause of their problem extracted directly from the raw textual data of interactions and feedback.

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

Pose6DAug: Physically Plausible Multi-view Object Swapping for Robot Data Augmentation

arXiv:2606.20118v1 Announce Type: cross Abstract: Vision-language-action (VLA) policies have shown strong potential for general-purpose manipulation, yet they often fail on novel, out-of-distribution objects whose appearance or geometry deviates from the training distribution. The standard remedy is to collect multi-view teleoperation data for every failure case, but this scales poorly in both cost and time. We introduce Pose6DAug, a failure-driven data augmentation framework that turns a policy's own successful episodes into targeted demonstrations for its failure modes, without any new data collection. Our key insight is that each successful episode already encodes a physically valid action trajectory together with calibrated multi-view observations. By swapping only the manipulated object while preserving this trajectory, we obtain new and physically grounded demonstrations. However, naive 2D video editing breaks multi-view consistency and physical plausibility, particularly under heavy occlusion and egocentric viewpoints. Our method instead operates directly in 3D, anchoring the target object with an explicit mesh driven by a temporally coherent 6D pose trajectory, ensuring geometrically consistent renderings across all camera views. Fine-tuning a VLA on data augmented by our method improves success rates by 16.5% relative to the state-of-the-art baseline on novel objects, while preserving in-distribution performance. These results show that multi-view and physically consistent augmentation is a practical path to scalable VLA generalization.

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

Anatomically Conditioned Recurrent Refinement for Topology-Aware Circle of Willis Segmentation

Segmenting the Circle of Willis (CoW) from Magnetic Resonance Angiography (MRA) is challenging due to complex topology and thin vascular structures that are prone to fragmentation. Standard Convolutional Neural Networks (CNNs) often fail to capture these topological constraints, resulting in "broken vessel" artifacts. To address this, we propose the Anatomically Conditioned Recurrent Refinement U-Net (AC2RUNet). Our architecture decouples segmentation into two streams: a Static Stream that extracts invariant anatomical features and a lightweight Dynamic Stream that iteratively refines topological errors over time. We further introduce a dynamic curriculum learning strategy that transitions from high-recall geometric supervision to topology-aware constraints. Validated on the TopCoW dataset, AC2RUNet substantially reduces Hausdorff Distance (4.72 mm vs 9.17 mm) and Betti number errors (0.19 vs 0.40), improving topological connectivity over the nnU-Net baseline while maintaining comparable volumetric Dice.

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

Learning High Coverage Discriminative Parsimonious Rulesets

arXiv:2606.14156v1 Announce Type: cross Abstract: Learning systems based on IF-THEN rule representations readily offer interpretability, making them a crucial focus in contemporary AI research. A key objective for such rule sets is to achieve both high discriminative power and interpretability. While existing state-of-the-art algorithms implicitly prioritize predictive accuracy, they often fall short on one or more quality metrics that ensure interpretability, such as coverage and parsimony of rule sets. Motivated by this, this paper propose the development of CDPR, which aims to create highly accurate and interpretable rule sets for classification problems. To the best of our knowledge, this represents the first attempt to establish such an approach. In this study, we introduce two algorithms rooted in submodular maximization, which not only provide provable guarantees on coverage but also yield rule sets that are both discriminative and parsimonious. We empirically demonstrate that rule sets learned through our approaches achieve higher accuracy and interpretability and has more than a 2.5-fold improvement in average coverage rates when compared to the next best algorithm.

13.
arXiv (CS.AI) 2026-06-18

TransitNet: A Compact Attention-Augmented Deep Learning Framework for Low-SNR Transit Blind Searches

arXiv:2606.18932v1 Announce Type: cross Abstract: Motivated by the observational incompleteness of intermediate-to-long-period Earth-size planets, we present TransitNet, a compact attention-augmented deep-learning framework for low-SNR transit blind searches. To enable realistic method development and objective threshold calibration under blind-search conditions, we develop a unified dataset construction, benchmarking, and threshold-selection framework. On recovery benchmarks constructed from unseen Kepler targets, TransitNet attains 95.2 percent accuracy in the challenging SNR range of 6 to 8 and outperforms both TLS and BLS, achieving ROC-AUC and PR-AP values of 0.974 and 0.982, respectively. In an injected Earth-size and sub-Earth-size transit recovery experiment, TransitNet achieves a recovery rate of 93.0 percent, substantially exceeding those of TLS (63.1 percent) and BLS (60.0 percent). In addition to detection, TransitNet provides attention-based estimates of transit windows and midpoints. On an independent evaluation set, 97.4 percent of injected transits are fully covered by the estimated transit window. Applied to real Kepler observations, the model successfully recovers all 34 selected confirmed Kepler planets, with a mean absolute transit midpoint error of 1.24 hours. The model combines a compact footprint of about 1.5 MB with high inference efficiency, yielding speed-ups of about 12 to 25 times relative to CPU-TLS and about 4 to 5 times relative to CPU-BLS. These results demonstrate that TransitNet provides an accurate, scalable, and computationally efficient framework for low-SNR transit blind searches in the tested regime and motivate its extension to longer-period Earth-size planet searches.

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

Listening with Attention: Entropy-Guided Explainability for Transformer-Based Audio Models

arXiv:2606.14647v1 Announce Type: cross Abstract: Transformer-based automatic speech recognition (ASR) models such as Whisper are highly accurate, but their predictions remain difficult to interpret. Existing explainable AI (XAI) methods often lack faithfulness and precise temporal grounding. We propose Listening with Entropy-guided Attention for Faithful explainability (LEAF-X), a model-intrinsic XAI framework for transformer-based ASR. LEAF-X combines entropy-guided attention weighting, multi-layer attention rollout, and optional causal ablations to identify low-entropy, high-impact heads and layers, producing sparse token-to-frame attributions. Unlike perturbation-based explainers or raw attention maps, LEAF-X exploits the internal structure of encoder-decoder and speech-augmented decoder-only models to generate explanations that better reflect model computation. Results show 32% improved faithfulness, 35-39% stronger locality/sparsity, and the most stable attributions, supporting more transparent and auditable ASR.

16.
arXiv (quant-ph) 2026-06-24

Thermodynamics of quantum processes: An operational framework for free energy and reversible athermality

arXiv:2510.12790v4 Announce Type: replace Abstract: We explore the thermodynamics of quantum processes (quantum channels) by axiomatically introducing the free energy for channels, defined via the quantum relative entropy with an absolutely thermal channel whose fixed output is in equilibrium with a thermal reservoir. This definition finds strong support through its operational interpretations in designated quantum information and thermodynamic tasks. We construct a resource theory of athermality for quantum processes, where free operations are Gibbs preserving superchannels and golden units are unitary channels with respect to absolutely thermal channel having fully degenerate output Hamiltonian. We exactly characterize the one-shot distillation and formation of quantum channels using hypothesis-testing and max-relative entropy with respect to the absolutely thermal channel. These rates converge asymptotically to the channel free energy (up to a multiplicative factor of half the inverse temperature), establishing its operational meaning and proving the asymptotic reversibility of the athermality. We show the direct relation between the resource theory of athermality and quantum information tasks such as private randomness and purity distillation, and thermodynamic tasks of erasure and work extraction. Our work connects the core thermodynamic concepts of free energy, energy, entropy, and maximal extractable work of quantum processes to their information processing capabilities.

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

CoMo: Learning Continuous Latent Motion from Internet Videos for Scalable Robot Learning

Unsupervised learning of latent motion from Internet videos is crucial for robot learning. Existing discrete methods generally mitigate the shortcut learning caused by extracting excessive static backgrounds through vector quantization with a small codebook size. However, they suffer from information loss and struggle to capture more complex and fine-grained dynamics. Moreover, there is an inherent gap between the distribution of discrete latent motion and continuous robot action, which hinders the joint learning of a unified policy. We propose CoMo, which aims to learn more precise continuous latent motion from internet-scale videos. CoMo employs an early temporal difference (Td) mechanism to increase the shortcut learning difficulty and explicitly enhance motion cues. Additionally, to ensure latent motion better captures meaningful foregrounds, we further propose a temporal contrastive learning (Tcl) scheme. Specifically, positive pairs are constructed with a small future frame temporal offset, while negative pairs are formed by directly reversing the temporal direction. The proposed Td and Tcl work synergistically and effectively ensure that the latent motion focuses better on the foreground and reinforces motion cues. Critically, CoMo exhibits strong zeroshot generalization, enabling it to generate effective pseudo action labels for unseen videos. Extensive simulated and real-world experiments show that policies co-trained with CoMo pseudo action labels achieve superior performance with both diffusion and auto-regressive architectures.

18.
arXiv (CS.AI) 2026-06-11

AutoMine Solution for AV2 2026 Scenario Mining Challenge

arXiv:2606.11874v1 Announce Type: new Abstract: With the development of autonomous driving systems, mining high-value, safety-critical, and planning-relevant scenarios from large-scale driving logs has become essential for data-driven evaluation. In this paper, we propose AutoMine, a robust self-refining scenario mining method based on LLMs and VLMs. AutoMine uses semantics-preserving prompt augmentation to reduce LLM prompt sensitivity, combines robust trajectory atomic functions with VLM-based functions to handle perception noise and open-world visual cues, and refines generated code through execution feedback from real logs. In the Argoverse 2 Scenario Mining Competition at CVPR 2026, AutoMine achieves a HOTA-Temporal score of 36.38 and a Timestamp BA score of 77.21.

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

Can Aggregate Invariants Accelerate Continuous Subgraph Matching? Limits, Laws, and a Dynamic Spectral Index

arXiv:2606.24421v1 Announce Type: new Abstract: Spectral filtering recently delivered substantial pruning for static subgraph matching: Laplacian interlacing rejects candidates whose neighborhoods cannot host the query. We study whether such aggregate structural tests can accelerate continuous subgraph matching (CSM) over dynamic graphs, and answer in three parts. First, lazily maintained spectral bounds are infeasible exactly where spectral pruning has value: we characterize the tightest safe rule over a formalized perturbation relaxation and show that even it loses essentially all pruning power within four touching updates. Second, exact maintenance is affordable when selective: pruning utility and recomputation cost are anti-correlated across vertices – hubs provably never prune – so recomputing small-neighborhood spectra on touch sustains exact local spectra at microseconds per update, complete by construction. Third, integrated into a decoupled CSM benchmark against an identical-minus-spectra control, the tests remove up to $51\%$ of candidates or safely skip up to $47\%$ of update enumerations, yet enumeration intermediates remain unchanged – beyond the gates' skipped first-level bindings, typically zero – across two engines, four real graphs, two stream types, and $77$ solved queries; a constructed radius-stratified workload confirms the instrument detects the exception when one exists ($-99.9\%$ intermediates, $748\times$ faster). Aggregate tests accelerate what scales with candidate sets – construction, list scans – never adjacency-guided exploration. We distill an intermediate-invariance methodology for evaluating CSM filters and release a reusable dynamic local-spectra index.

20.
arXiv (CS.CV) 2026-06-16

Transformation-driven generation of comparable projection images from multimodal anatomical scenes

This work addresses the computational problem of generating reproducible projection-space observations from heterogeneous anatomical scenes whose components may undergo independent spatial transformations. We propose a transformation-driven framework for synthetic projection imaging from multimodal anatomical data and demonstrate it on mandibular-motion scenarios. In contrast to conventional Digitally Reconstructed Radiograph (DRR) approaches primarily designed for registration, projection realism, or rendering efficiency, the proposed formulation treats projection imaging as an observation process operating on an explicitly represented anatomical scene. Independently transformable volumetric and surface-based anatomical objects are embedded within a shared scene representation and propagated directly into projection space through explicit transformations. Projection geometry, acquisition modelling, material interpretation, and image presentation remain explicitly separated, enabling controlled exploration of methodological assumptions while preserving reproducibility and direct comparability between generated projections. Particular emphasis is placed on transformation-driven anatomical scenarios relevant to craniofacial analysis, including mandibular motion and therapeutic repositioning. Using a shared anatomical reference scene composed of CT/CBCT volumes, segmented structures, surface models, and auxiliary anatomical or therapeutic objects, the framework enables generation of directly comparable VirtualRTG projections from multiple anatomical configurations while preserving identical imaging assumptions. Rather than aiming at fully physically faithful radiographic simulation, the proposed approach provides a controllable and reproducible methodological environment for studying anatomy–projection relationships, motion observability, and transformation-aware imaging workflows.

21.
medRxiv (Medicine) 2026-06-22

The direct economic impact of surgical non-response in orthopaedic hip, knee, and spine surgery for osteoarthritis: a cost-utility analysis

Background Annually, nearly 2 million hip, knee, and spinal inpatient surgeries are performed in Canada and the US for osteoarthritis (OA), costing over $37 billion in hospital expenditures. However, 15-30% of patients experience limited or no improvement, resulting in poor value for money. This study evaluated the one-year cost-utility of joint and spine procedures for OA by comparing non-responders to responders, considering various responder definitions. Methods Individual micro-costing data were collected for 1,175 elective hip, knee, and spine patients enrolled in the Longitudinal Evaluation in the Arthritis Program - Osteoarthritis (LEAP-OA) between 2014 and 2018. Quality-adjusted life years (QALYs) were derived using the SF-6D utility index. One-year incremental cost-utility ratios (ICURs) were calculated from the hospital perspective. Results Responder rates varied by definition, ranging from 78%-94% for hip replacements, 64%-90% for knee replacements, 60%-64% for spine fusions, and 50%-68% for spine decompressions. Corresponding ICURs were: $45,956-$51,773/QALY for responders versus $108,593-$485,762/QALY for non-responders for hip replacements; $54,831-$71,151/QALY for responders versus $200,486-$1,203,596/QALY for non-responders for knee replacements; $65,980-$74,422/QALY for responders versus $262,039-$729,686/QALY for non-responders for spine fusions; and $29,947-$42,168/QALY for responders versus $63,195-$662,586/QALY for non-responders for spine decompressions. Conclusions While surgical response rates were highly dependent on the responder definition, ICURs for non-responders were significantly higher than those for responders across all definitions. Beyond the negative impact on patients, there is a compelling economic argument for investment in improved pre-operative identification of patients at risk of surgical non-response. Such efforts could enable more personalized, value-based care pathways and reduce the provision of low-value surgical interventions.

22.
arXiv (CS.CL) 2026-06-16

RoSE: Round-robin Synthetic Data Evaluation for Selecting LLM Generators without Human Test Sets

LLMs are powerful generators of synthetic data, which are used for training smaller, specific models. This is especially valuable for low-resource languages, where human-labelled data is scarce but LLMs can still produce high-quality text. However, LLMs differ in how useful their outputs are for training. Selecting the best LLM as a generator is challenging because extrinsic evaluation requires costly human annotations (which are often unavailable for low-resource languages), while intrinsic metrics correlate poorly with downstream performance. We introduce Round robin Synthetic data Evaluation (RoSE), a proxy metric for selecting the best LLM generator without human test sets. RoSE trains a small model on the outputs of a candidate generator (LLM) and then evaluates it on generated synthetic examples from all other candidate LLMs. The final RoSE score is the mean performance of this small model. Across six LLMs, eleven languages, and three tasks (sentiment, topic, intent), RoSE identifies the optimal generator more often than any other intrinsic heuristics. RoSE outperforms intrinsic heuristics and comes within 0.76 percentage points of the optimal generator baseline. This result is measured in terms of downstream performance, obtained by training a small model on the chosen generator's outputs (optimal vs. proxy metric selected) and evaluating it on human-labelled test data. Additionally, RoSE is the only metric to achieve a positive correlation with performance on human test data.

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

MaineCoon: Pursuing A Real-Time Audio-Visual Social World Model

As an increasing majority of global video content is consumed on social platforms for interactive social purposes, video generation models built for social worlds are important but largely overlooked by previous studies. In this work, we define the position of social world models and build a prototype model as the first step towards this goal. While previous world models successfully simulate physical environments or gaming world exploration, they remain fundamentally detached from human-centric social dynamics. To bridge this gap as the first step to social world models, we present MaineCoon, the first real-time audio-visual autoregressive model that has 22B parameters and is capable of real-time streaming generation and sub-second interaction, with a record-breaking frame rate of up to 47.5 FPS, on a single GPU. To the best of our knowledge, MaineCoon is also the first real-time audio-visual generation model specifically optimized for social-interactive applications. To enable efficient and stable training, we introduce several novel techniques into MaineCoon, including self-resampling, cross-modal representation alignment, domain-aware preference optimization, and reinforced online-policy distillation (ROPD). We also design the first agentic streaming inference framework that supports thousand-second-scale or even longer generation while mitigating drift with agentic cache management and prompt planing. These innovations significantly accelerate training while optimizing real-time inference performance. We believe this work not only sets a new state-of-the-art (SOTA) performance benchmark for high-quality, low-latency, and long-horizon audio-visual autoregressive models, but also points out the paradigm shift desired for next-generation AI-native social platforms.

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

GPO: Learning from Critical Steps to Improve LLM Reasoning

arXiv:2509.16456v3 Announce Type: replace Abstract: Large language models (LLMs) are increasingly used in various domains, showing impressive potential on different tasks. Recently, reasoning LLMs have been proposed to improve the reasoning or thinking capabilities of LLMs to solve complex problems. Despite the promising results of reasoning LLMs, enhancing the multi-step reasoning capabilities of LLMs still remains a significant challenge. While existing optimization methods have advanced the LLM reasoning capabilities, they often treat reasoning trajectories as a whole, without considering the underlying critical steps within the trajectory. In this paper, we introduce Guided Pivotal Optimization (GPO), a novel fine-tuning strategy that dives into the reasoning process to enable more effective improvements. GPO first identifies the `critical step' within a reasoning trajectory - a point that the model must carefully proceed to succeed at the problem. We locate the critical step by estimating the advantage function. GPO then resets the policy to the critical step, samples the new rollout and prioritizes the learning process on those rollouts. This focus allows the model to learn more effectively from pivotal moments within the reasoning process to improve the reasoning performance. We demonstrate that GPO is a general strategy that can be integrated with various optimization methods to improve reasoning performance. Besides theoretical analysis, our experiments across challenging reasoning benchmarks show that GPO can consistently and significantly enhance the performance of existing optimization methods, showcasing its effectiveness and generalizability in improving LLM reasoning by concentrating on pivotal moments within the generation process.

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

Minimax PAC Bounds for Learning in Exogenous Contextual MDPs

arXiv:2606.25170v1 Announce Type: cross Abstract: We study PAC learning in tabular discounted Markov decision processes with exogenous i.i.d. contexts, with discount factor $\gamma$, finite state space $\mathcal X$, action space $\mathcal A$, and context space $\mathcal Z$. At each time step, a context is drawn independently from an unknown distribution $\mu$ and revealed before the agent acts. This context may affect both rewards and transitions, while remaining uncontrolled by the agent. Depending on the regime, the learner has access either to a sampling oracle for $\mu$, to a sampling oracle for the transition kernel conditioned on state-context-action tuples, or to both. Oracles can be accessed before and during policy execution. The sample complexity is measured by a couple $(n,m)$, where $n$ is the number of calls to the sampling oracles before execution and $m$ is the number of calls to the sampling oracles during execution. When rewards and transitions are known and only the context distribution $\mu$ is sampled, we give a variance-reduced algorithm that solves policy evaluation (PE), best-value estimation (BVE), and best-policy extraction (BPE) with $\left(\widetilde O\left(1/((1-\gamma)^3\varepsilon^2)\right), 0 \right) $ sample complexity. The rate is independent of $|\mathcal Z|$ and minimax optimal up to logarithmic factors. As a corollary, we also obtain tight rates in the case of one-step perfect look-ahead, improving upon the existing guarantees. In the fully unknown regime, where both $\mu$ and P must be learned, we show that PE remains $|\mathcal Z|$-free, with matching upper and lower bounds $\bigl(\widetilde O(|\mathcal X|/((1-\gamma)^3\varepsilon^2)),\, \widetilde O(1/((1-\gamma)^2\varepsilon^2))\bigr)$.