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01.
arXiv (CS.AI) 2026-06-17

Agentic Discovery of Non-Canonical Antimicrobial Peptides with AMPGAN v3

arXiv:2606.17127v1 Announce Type: cross Abstract: Antimicrobial resistance causes to over a million deaths annually. Antimicrobial peptides (AMPs) are a promising solution, but generative AMP models are not yet ready to design peptides with non-natural amino acids and/or chemical modifications, which are essential for real-world peptide drugs. We present AMPGAN v3, a multi-objective conditional GAN that expands the generative vocabulary to D-amino acids and N/C-terminus modifications such as amidation. By separating adversarial and activity-aware supervision across two specialized discriminators, AMPGAN v3 substantially improves training stability and outperforms prior generative AMP models on external classifiers. We validated five candidates spanning three structural classes in vitro; two showed activity against Gram-positive strains, with the best candidate reaching MIC 8 {\mu}g/mL against B. subtilis. To support downstream curation, we further present PepCraft, a multi-agent framework for end-to-end AMP discovery in which a Planning Agent orchestrates specialized executors for generation, filtering, and verification. Its prioritization recommendations align with our in vitro outcomes. Together, these contributions let us examine, on a small but real scale, how generative and agentic AI compose in therapeutic peptide discovery. Code: https://github.com/marszzibros/AMPGANv3

03.
arXiv (CS.CL) 2026-06-16

XAI-Grounded Explanation Generation for Speech Deepfake Detection with Training-Free Multimodal Large Language Models

Speech deepfake detection (SDD) systems require trustworthy explanations for reliable decision-making. Existing explanation ways mainly fall into two categories. Traditional explainable AI (XAI), such as gradient-based attribution, produces low-level attribution signals tightly coupled with model decisions, and harder to be understood by human than natural language explanations. Meanwhile, large language model (LLM)-based explanation generation often produces generic and ungrounded descriptions due to the lack of heuristic evidence and task-specific supervision, stemming from limited grounded explanation datasets for SDD. We therefore propose a training-free explanation framework that integrates XAI evidence with multimodal LLMs to generate grounded and specific explanations. Using the PartialSpoof dataset, we construct a grounded explanation dataset and show that methods with XAI increase inside accuracy by over 45\%, verified through human evaluation and faithfulness checks.

04.
arXiv (CS.CL) 2026-06-19

Beyond the GUI Paradigm: Do Mobile Agents Need the Phone Screen?

Recent advances in mobile agents are dominated by the GUI paradigm, in which agents perceive UI information and emit screen interactions. However, mobile platforms also expose a command-line interface (CLI) that provides direct access to device services and data. We argue CLI deserves first-class consideration alongside GUI. We evaluate three coding agents (Claude Code, Terminus-2, mini-swe-agent) across four model APIs on AndroidWorld and MobileWorld without any mobile-specific post-training, comparing against three reproducible GUI baselines (GUI-Owl-1.5-32B, MAI-UI, Qwen3-VL-32B). Claude Code (Opus 4.7) reaches 71.8\% and 51.9\%, outperforming every reproducible GUI baseline (69.3/68.1/57.8\% on AndroidWorld; 43.2/26.3/13.3\% on MobileWorld), while every other CLI configuration remains competitive. To establish the paradigm's ceiling, we provide oracle CLI solutions that reach 88.8\% on AndroidWorld (103/116 tasks CLI-solvable) and 86.3\% on MobileWorld (101/117 tasks CLI-solvable), indicating substantial room for future improvement. To cover everyday user intents beyond the GUI scope, we introduce the CLI-Advantage Task Suite, comprising 45 templates across five categories: bulk operations, multi-condition filtering, aggregation, cross-app workflows, and hidden device state. Every CLI agent outperforms every GUI baseline in all five categories, with substantially fewer steps per task (10.7 vs.\ 18.6). To support future research on mobile CLI agents, we will open-source agent implementations, oracle solutions, the CLI-Advantage suite, and evaluation infrastructure.

05.
arXiv (CS.LG) 2026-06-24

Which Spaces can be Embedded in $L_p$-type Reproducing Kernel Banach Space? A Characterization via Metric Entropy

arXiv:2410.11116v4 Announce Type: replace-cross Abstract: In this paper, we establish a novel connection between the metric entropy growth and the embeddability of function spaces into reproducing kernel Hilbert/Banach spaces. Metric entropy characterizes the information complexity of function spaces and has implications for their approximability and learnability. Classical results show that embedding a function space into a reproducing kernel Hilbert space (RKHS) implies a bound on its metric entropy growth. Surprisingly, we prove a converse: a bound on the metric entropy growth of a function space allows its embedding to a $L_p-$type Reproducing Kernel Banach Space (RKBS). This shows that the ${L}_p-$type RKBS provides a broad modeling framework for learnable function classes with controlled metric entropies. Our results shed new light on the power and limitations of kernel methods for learning complex function spaces.

06.
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.

07.
arXiv (CS.AI) 2026-06-17

Belief-Space Control for Personalized Cancer Treatment via Active Inference

arXiv:2606.10376v2 Announce Type: replace Abstract: Cancer treatment is at the core a sequential decision-making problem with partial observability, latent patient heterogeneity, and explicit constraints on the budget for medical measurements. Unlike standard Reinforcement Learning (RL) approaches that control state trajectories, cancer treatments permanently modify patients' transition dynamics, changing how states evolve over time. We model cancer treatment as a belief-space planning problem using active inference, deriving an expected free-energy objective that unifies goal-directed control and information acquisition under measurement budgets without. We implement this framework using real clinical cancer data from the AACR Project GENIE Biopharma Collaborative dataset. Results on clinical data demonstrate a simultaneous patient categorization and high treatment efficacy, under real measurement and treatment constraints.

08.
Nature (Science) 2026-06-10

Building user-driven climate adaptation products

Climate adaptation products have traditionally been developed using a supply-driven model reliant on available climate information, leading to usability gaps1–4. To better meet user needs, the climate services field has recognized a need to shift towards a demand-driven model emphasizing co-production, that is, user-driven, scientifically informed products created through shared knowledge practices1–5. However, co-production can be challenging, especially for researchers unfamiliar with the approach or for digital and software-based products with complex user needs2,5–8. User-centred design, from the human–computer interaction field, offers a process that could complement co-production approaches to product development, yet its potential remains underexplored2. Here we show how user-centred design can be integrated into, and strengthen, co-production approaches for building user-driven climate adaptation products. Through a systematic review of the co-production and user-centred design literature, we identify key processes, mechanisms and best practices for both approaches. Our findings offer practical guidance for researchers and propose an integrated approach for developing climate adaptation products that are useful, usable and used. A systematic review and analysis shows how user-centred design can be integrated into, and strengthen, co-production approaches for building user-driven climate adaptation products.

09.
arXiv (CS.AI) 2026-06-12

Geometric and Quantum Kernel Methods for Predicting Skeletal Muscle Outcomes in chronic obstructive pulmonary disease

arXiv:2601.00921v3 Announce Type: replace-cross Abstract: Chronic obstructive pulmonary disease (COPD) affects hundreds of millions of people worldwide, and skeletal-muscle dysfunction is clinically important. Quantum machine learning is increasingly explored for biomedical prediction, but its value in small biomarker cohorts requires benchmarking against strong classical baselines. We analysed a cigarette-smoke COPD cohort of 213 animals with blood and bronchoalveolar-lavage biomarkers to predict tibialis anterior muscle weight, muscle quality, and force. We developed a kernel-geometric quantum hybrid method in which synthetic symmetric positive definite (SPD) references are mapped through a reproducing kernel Hilbert space, compressed using train-only random projection, normalised, and supplied to low-dimensional quantum regression circuits. We benchmarked this approach against classical ridge/kernel models, SPD relational representations, and quantum-kernel regression (QKR). All methods were evaluated using condition-stratified repeated cross-validation. The largest numerical improvement was observed for muscle weight, where the proposed method had the numerically lowest mean root mean squared error (RMSE), approximately 1.8% below the best classical comparator; paired fold-level testing did not establish statistically significant superiority after Holm adjustment, but the endpoint is biologically meaningful. The method also had the numerically lowest mean RMSE for muscle quality. For force, biomarker-only Ridge performed best, suggesting a more linear endpoint structure.

10.
arXiv (CS.LG) 2026-06-18

Towards Anomaly Detection on Relational Data

arXiv:2606.18621v1 Announce Type: new Abstract: Relational databases are widely used for managing structured data in real-world systems. Detecting anomalies from such relational data is crucial for identifying fraud, risks, and abnormal behaviors, yet remains under-explored. The key challenges lie in the intrinsic complexity of relational data: multi-table attributes are high-dimensional and heterogeneous, making sparse abnormal clues easy to overwhelm by normal or irrelevant information; and anomalies may further manifest as abnormal connection patterns across different foreign-key relations, which existing tabular and graph anomaly detection methods are ill-suited to capture. To address them, we propose RelAD, a reconstruction-based framework that captures anomalies from both attribute and relational edge reconstruction. RelAD contains two core modules: conditional sparse-gated attribute reconstruction, which suppresses redundant multi-table attributes and emphasizes abnormal semantic blocks, and dual-view multi-relational edge reconstruction, which detects relation-specific abnormal connections from both intrinsic and behavioral entity profiles. The resulting attribute and relational signals are integrated through a lightweight fusion module to produce the final anomaly score. We further construct 6 benchmark datasets with systematic anomalies, on which extensive experiments show that RelAD consistently outperforms other baselines while achieving competitive efficiency.

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

Qwen-RobotWorld Technical Report: Unifying Embodied World Modeling through Language-Conditioned Video Generation

We introduce Qwen-RobotWorld, a language-conditioned video world model for embodied intelligence. With natural language as a unified action interface, it predicts physically grounded future visual trajectories from current observations across robotic manipulation, autonomous driving, indoor navigation, and human-to-robot transfer. This unified formulation provides three promising application directions: synthetic data generation for policy training augmentation, scalable virtual environments for policy evaluation, and language-guided planning signals for downstream robot control. This is achieved through a three-part design: a) Double-Stream MMDiT with MLLM Action Encoding, where a 60-layer double-stream diffusion transformer couples frozen Qwen2.5-VL semantics with video-VAE latents through layer-wise joint attention; b) Embodied World Knowledge (EWK), an 8.6M video-text corpus (200M+ frames) with action-language mapping over 20+ embodiments and 500+ action categories; and c) General+Expert Progressive Curriculum, a two-stage training strategy that first learns general visual priors and then injects embodied specialization under a shared language interface. Extensive results show strong competitiveness: ranks 1st overall on EWMBench and DreamGen Bench, outperforms all open-source models on WorldModelBench and PBench. Additional zero-shot analyses on RoboTwin-IF benchmark further support robust generalization and multi-view consistency.

12.
arXiv (CS.CV) 2026-06-11

Weakly Supervised Segmentation as Semantic-Based Regularization

Weakly supervised semantic segmentation (WSSS) trains dense pixel-level segmentation models from partial or coarse annotations such as bounding boxes, scribbles, or image-level tags. While recent work leverages foundation models such as the Segment Anything Model (SAM) to generate pseudo-labels, these approaches typically depend on heuristic prompt choices and offer limited ways to incorporate prior knowledge or heterogeneous labels. We address this gap by taking a neurosymbolic perspective: integrating differentiable fuzzy logic with deep segmentation models. Weak annotations and domain-specific priors are unified as continuous logical constraints that fine-tune SAM under weak supervision. The refined foundation model then produces improved pseudo-labels, from which we train a second-stage prompt-free segmentation model. Experiments on Pascal VOC 2012 and the REFUGE2 optic disc/cup segmentation dataset show that our logic-guided fine-tuning yields higher-quality pseudo-labels, leading to state-of-the-art segmentation accuracy that often exceeds densely supervised baselines.

13.
medRxiv (Medicine) 2026-06-15

Multidimensional nutritional assessment in Crohns disease: cross-sectional comparison of active disease and remission

Malnutrition is common in Crohns disease (CD), and its assessment requires multiple tools. Comprehensive evaluation of nutritional status in a population with CD, predominantly characterized by metabolic phenotype, was inadequately reported. This study evaluated the nutritional status of CD patients using anthropometric, clinical, and biochemical measures and compared patients with active disease with those in remission. This cross-sectional study included 127 adults with CD: 63 with active disease and 64 in remission. Disease activity was classified using the Crohns Disease Activity Index, the Simple Endoscopic Score for Crohns Disease, and magnetic resonance enterography. Nutritional assessment included body mass index (BMI), mid-upper arm circumference, calf circumference, triceps skinfold thickness, mid-arm muscle circumference, Mini Nutritional Assessment-Short Form (MNA-SF), and biochemical markers including hemoglobin, serum iron, folate, vitamin B12, albumin, and zinc. Malnutrition was defined using the Global Leadership Initiative on Malnutrition criteria. Overall, 47.2% of participants were malnourished. Malnutrition was significantly more frequent in active disease than in remission (81.0% vs. 14.1%, P

14.
arXiv (CS.CV) 2026-06-11

Slots, Transitions, Loops: Learning Composable World Models for ARC

ARC tests in-context rule induction: given a few input-output demonstrations, a model must infer the hidden rule and apply it to a new query. While many approaches express ARC rules through language, code, or symbolic programs, ARC itself is visual-symbolic: rules appear as grid transitions over objects, colors, shapes, and spatial relations. We introduce Loop-OWM, an object-centric world-modeling architecture that learns these rules as composable transitions over structured states. It combines color-prototype slots, demonstration-conditioned task summaries, and a looped transition model with dense propagation and slot-conditioned correction. On both ARC-1 and ARC-2, Loop-OWM outperforms non-looped and looped baselines with comparable or fewer parameters. These results suggest that ARC rules can be learned not only as language descriptions or searched programs, but also as transitions over visual-symbolic world states.

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

From Isolation to Entanglement: When Do Interpretability Methods Identify and Disentangle Known Concepts?

A goal of interpretability is to recover disentangled representations of latent concepts (features) from the activations of neural networks. The quality of features is typically evaluated in isolation, and under implicit independence assumptions that may not hold in practice. Thus, it is unclear to what extent common featurization methods such as sparse autoencoders (SAEs) and probes disentangle one concept from another. We propose a multi-concept evaluation setting using concepts including sentiment, domain, voice, and tense. We evaluate how well featurizers produce disentangled representations of each concept, observing that features are typically sensitive to only one concept, but also that concepts are distributed across many features. Then, we steer these features, measuring whether each concept is independently manipulable, and whether features interact. Even in idealized settings, steering a feature often affects many concepts, despite a near absence of interaction effects. These results suggest that correlational metrics are insufficient to establish steering selectivity, and that demonstrating that two features operate in separate spaces is insufficient to claim that they will be selective for one concept. These results underscore the importance of multi-concept evaluations in interpretability research.

16.
arXiv (CS.CL) 2026-06-24

MEMPROBE: Probing Long-Term Agent Memory via Hidden User-State Recovery

Long-term memory promises LLM agents that grow more capable across sessions, maintaining an accurate, evolving understanding of the user that interaction forms. In practice, however, this memory is evaluated mostly through downstream behavior, such as later answers, personalization quality, or task success, which tests that understanding only indirectly and leaves the memory artifact itself largely unaudited. We argue that long-term memory should instead be evaluated as an auditable post-interaction artifact: after ordinary assistance, what structured user state can be reconstructed from the memory the agent leaves behind? We instantiate this view in MEMPROBE, a benchmark in which a memory-equipped agent assists simulated users, each carrying a hidden, taxonomy-anchored user-state bank, across a trajectory of leak-controlled tasks, after which that bank is reconstructed from the agent's resulting memory under both full-store and top-k access. Built on synthetic ground truth for efficient, scalable measurement, MEMPROBE spans 50 simulated users with 31 hidden dimensions each (1,550 recovery targets) and tests 5 representative memory systems. Testing state-of-the-art memory agents, we find that successful assistance and recoverable memory behave as distinct capabilities. Task completion nearly saturates, even for a memoryless baseline, while category-balanced recovery stays moderate (about 0.6) and drops further under top-k retrieval. MEMPROBE is the first benchmark to study memory recovery directly, reconstructing the user state a system retains and scoring it against ground truth. We see recovery as a concrete objective for future memory agents to optimize, and MEMPROBE as a step toward an environment where agents are trained to remember their users, growing more faithful the longer they know them.

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

SimSiam Naming Game: A Unified Approach for Emergent Communication and Representation Learning

Emergent Communication (EmCom) investigates how agents develop symbolic communication through interaction without predefined language. Recent frameworks, such as the Metropolis–Hastings Naming Game (MHNG), formulate EmCom as the learning of shared external representations negotiated through interaction under joint attention, without explicit success or reward feedback. However, MHNG relies on sampling-based updates that suffer from high rejection rates in high-dimensional perceptual spaces, making the learning process sample-inefficient for complex visual datasets. In this work, we propose the SimSiam Naming Game (SSNG), a feedback-free EmCom framework that replaces sampling-based updates with a symmetric, self-supervised representation alignment objective between autonomous agents. Building on a variational inference–based probabilistic interpretation of self-supervised learning, SSNG formulates symbol emergence as an alignment process between agents' latent representations mediated by message exchange. To enable end-to-end gradient-based optimization, discrete symbolic messages are learned via a Gumbel–Softmax relaxation, preserving the discrete nature of communication while maintaining differentiability. Experiments on CIFAR-10 and ImageNet-100 show that the emergent messages learned by SSNG achieve substantially higher linear-probe classification accuracy than those produced by referential games, reconstruction games, and MHNG. These results indicate that self-supervised representation alignment provides an effective mechanism for feedback-free EmCom in multi-agent systems.

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

Token Complexity Theory for AI-Augmented Computing

Authors:

arXiv:2606.12647v1 Announce Type: cross Abstract: AI-augmented computing delegates natural language queries, code generation requests, and other open-ended tasks to a cluster of AI models that processes queries and generates responses. This paradigm introduces a resource dimension that neither classical time nor space complexity captures: the cost of sending queries to and receiving responses from such a cluster. We introduce token complexity, a formal resource measure defined as the minimum expected token cost to achieve a specified level of output quality on a task, and develop a taxonomy classifying AI systems by the strength of their probabilistic properties. We develop token complexity within the framework of AI-Oracle Turing machines, in which a probabilistic Turing machine interacts with a stochastic oracle via dedicated query and response tapes. We prove basic theorems establishing that token complexity behaves as expected: monotonicity (higher quality costs more tokens), convexity (quality improvements become progressively more expensive), price sensitivity (small price changes produce bounded cost changes), and price-relativity of task ordering (the token complexity ordering of tasks can reverse depending on the query-to-response cost ratio). We prove that the complexity frontier, defined as the set of all feasible resource bounds in tokens, time, and space, is non-empty, upward-closed, and convex.

20.
arXiv (CS.CV) 2026-06-15

Context-aware Modality-Topology Co-Alignment for Multimodal Attributed Graphs

Multimodal Attributed Graphs (MAGs) model real-world entities by coupling graph topology with heterogeneous attributes such as text and images. They support graph-centric tasks requiring structural and class-discriminative representations, and modality-centric tasks requiring fine-grained cross-modal correspondence. However, existing MAG methods often rely on fixed graph contexts or uniformly fused representations, causing task-agnostic propagation and over-compressed fusion that hinder diverse task requirements and modality-specific evidence preservation. To address this, we propose CoMAG, a unified MAG backbone that learns task-adaptive reliable contexts and modality-preserving alignment within them. CoMAG first conducts Reliable Context Learning by estimating edge reliability from multimodal semantic consistency, complementing raw topology with semantic neighbors, and selecting context components through a task-aware gate. It then performs Modality-preserving Hop-token Alignment by maintaining modality-specific multi-hop trajectories, matching modality-hop tokens across modalities, and decoupling shared and private representations. Thus, CoMAG produces graph and modality representations from one forward pass while retaining modality-specific cues. We further analyze stable propagation, over-smoothing mitigation, and modality-collapse control. Experiments on nine OpenMAG datasets compare CoMAG with feature-only, graph-only, multimodal, and unified MAG baselines across graph-level prediction, modality matching, and graph-conditioned generation. Results show that CoMAG achieves the best reported performance, demonstrating that task-adaptive reliable contexts and modality-preserving alignment improve structural prediction, cross-modal matching, and graph-conditioned generation while retaining sparse edge-linear complexity.

21.
arXiv (CS.AI) 2026-06-16

Scaling Adaptive Depth with Norm-Agnostic Residual Networks

arXiv:2606.16112v1 Announce Type: cross Abstract: Residual architectures are ubiquitous in deep learning, but they suffer from a subtle structural limitation: the norm of the residual stream can grow rapidly with depth. As a result, updates from later layers become small relative to the accumulated residual state. This reduces their impact on the representation and limits the benefits of scaling models in depth. To address this, we introduce NAG, a norm-agnostic residual architecture that separates magnitude from directional information in the residual stream, preserving meaningful layer contributions throughout depth and preventing later updates from being systematically suppressed by residual-norm growth. Importantly, NAG introduces only a negligible number of additional parameters and relies on simple operations that are easily kernel-fusible, preserving training efficiency in practice. We show that this architecture outperforms baseline Transformers, with gains that increase substantially as depth grows, enabling effective training of much deeper models. The norm-agnostic formulation also leads to an interpretable Mixture-of-Depths (MoD) mechanism that adaptively skips both attention and MLP layers. Beyond serving as a post-training accuracy-compute tradeoff, this mechanism can be used as a pretraining-time scaling strategy: under iso-FLOP training, compute saved by reducing per-token forward-pass cost can be reinvested into training on more tokens while keeping the total parameter count and KV-cache budget fixed. In our experiments, moderate Mixture-of-Depths rates of approximately 20%-25% match full-depth baseline performance under equal training compute while substantially reducing the number of executed layer parameters and forward-pass FLOPs. These results identify sparsity in depth as a new scaling axis for fixed-compute training, enabling very deep yet FLOP-efficient models.

22.
arXiv (quant-ph) 2026-06-19

Operational Tube-Sector Theory of Quantum State Distinguishability Under Generalized Symmetries

Authors:

arXiv:2606.19678v1 Announce Type: cross Abstract: A variational principle for quantum-state distinguishability is established in many-body systems with generalized symmetries, including noninvertible cases described by fusion categories. Standard fidelity and symmetry-resolved diagnostics emerge as coarse-grained limits of a more refined operational structure. When symmetry actions terminate at entanglement cuts, distinguishability is governed by boundary tube algebras within a symmetry-constrained measurement resource theory. The physically admissible instruments are characterized by complete positivity, entanglement-cut locality, boundary-module covariance, and sequential stability. The resulting optimal measurement structure is uniquely fixed by the center of the boundary tube algebra, $\mathcal{A}_{\mathrm{phys}} = Z\!\left(\mathrm{Tube}_{\mathcal{C}}(\mathcal{M}_A)\right)$, whose primitive idempotents define tube-sector probabilities that refine fidelity-based and symmetry-resolved descriptions. The associated tube positive-operator-valued measures (POVM) are extremal and yield optimal one-shot hypothesis-testing distinguishability under symmetry constraints. The construction is universal across fusion categories and independent of microscopic realization.

23.
medRxiv (Medicine) 2026-06-24

External Validation and Calibration Assessment of Explainable Machine Learning Models for GVHD Prediction After Allogeneic HSCT

Background Graft versus host disease (GVHD) remains a major determinant of morbidity and mortality following allogeneic hematopoietic stem cell transplantation (allo HSCT). Existing GVHD prediction models demonstrate modest discrimination and limited generalizability, and calibration drift across external populations is rarely characterized despite its essential role in the clinical interpretability of predicted probabilities. Objectives To develop and externally validate an explainable machine learning framework for predicting acute and chronic GVHD and associated overall survival in patients with acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and myelodysplastic syndromes (MDS) undergoing allo HSCT, and to systematically characterize calibration across heterogeneous external validation cohorts to inform deployment requirements. Study Design The model was developed on three publicly available registry-derived datasets (N = 2,509) and externally validated across six independent cohorts (N = 14,788) comprising adult and pediatric allo HSCT recipients, including a regional Middle Eastern cohort (UAE and Jordan). A standardized preprocessing pipeline harmonized heterogeneous datasets. Gradient boosting models (CatBoost) were used for binary GVHD prediction; exploratory overall survival analysis used a Cox proportional hazards model with predicted acute GVHD risk as a covariate. Discrimination (AUROC with bootstrap 95% CI), calibration (logistic recalibration intercept and slope with analytical 95% CI), and feature importance (SHapley Additive exPlanations, SHAP) were assessed in training out-of-fold and all external cohorts. Results In internal validation, AUROC was 0.63 (95% CI 0.61-0.65) for acute GVHD and 0.72 (95% CI 0.70-0.74) for chronic GVHD. External validation demonstrated AUROC ranges of 0.51-0.57 (acute) and 0.54-0.64 (chronic), with consistent performance across disease subgroups despite substantial heterogeneity in transplant practices and feature availability. In exploratory survival analysis, the acute-GVHD-informed Cox model achieved a training-cohort C-index of 0.679 (95% CI 0.658-0.697); external C-indices ranged from 0.47-0.53. Calibration analysis identified systematic external risk overestimation (negative calibration intercept in 10 of 11 evaluable external cohort-target combinations) with heterogeneous slope drift requiring cohort-specific recalibration. Key predictors included recipient age, graft source, conditioning intensity, GVHD prophylaxis, and HLA match ratio. Conclusions An explainable, externally validated GVHD prediction framework was developed using heterogeneous registry-derived datasets, with systematic characterization of calibration drift across multiple external cohorts, an analysis rarely reported in prior GVHD prediction literature. Predictive performance was modest for acute GVHD and moderate for chronic GVHD, constrained by missing immunobiological variables and incomplete HLA characterization. Per-cohort recalibration is required before clinical deployment, with prospective validation and benchmarking against established GVHD risk scores identified as priority next steps.

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

Few shot chain-of-thought driven reasoning to prompt LLMs for open ended medical question answering

In this paper, we propose a modified version of the MedQA-USMLE dataset, named MEDQA-OPEN, which contains open-ended medical questions without options to mimic clinical scenarios, along with clinician-approved reasoned answers. Additionally, we implement a prompt driven by Chain of Thought (CoT) reasoning, CLINICR, to mirror the prospective process of incremental reasoning, reaching a correct response to medical questions. We empirically demonstrate how CLINICR outperforms the state-of-the-art 5-shot CoT-based prompt (Liévin et al., 2022). We also present an approach that mirrors real-life clinical practice by first exploring multiple differential diagnoses through MCQ-CLINICR and subsequently narrowing down to a final diagnosis using MCQ-ELIMINATIVE. Finally, emphasizing the importance of response verification in medical settings, we utilize a reward model mechanism, replacing the elimination process performed by MCQ-ELIMINATIVE.

25.
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.