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01.
medRxiv (Medicine) 2026-06-10

Human genetic evidence links serine biosynthesis to diabetic peripheral neuropathy

Diabetic peripheral neuropathy (DPN) is a common and disabling condition for which no disease-modifying therapies are available. Glycemic and metabolic drivers do not fully explain why only a subset of individuals with diabetes develop DPN, and genetic contributors remain poorly defined. We aimed to perform a multi-population genome-wide association study (GWAS) of DPN to highlight potential new etiological pathways and therapeutic targets. Methods We performed a multi-population GWAS of neuropathy in people with and without diabetes using the VA Million Veteran Program and UK Biobank, followed by replication in the All of Us Research Program (AoU), and gene-based and gene-set analyses to identify implicated pathways. Causal relationships between circulating serine levels and DPN were further tested using two sample Mendelian randomization. To further evaluate pathogenic potential, we analyzed rare, high impact variants in GWAS implicated genes among individuals with unresolved inherited neuropathies using the GENESIS platform. Findings Among individuals with type 2 diabetes, we identified seven genome wide significant loci (p

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

Towards End-to-End Automation of AI Research

arXiv:2606.15497v1 Announce Type: new Abstract: The automation of science is a long-standing ambition in the field of AI. While the community has made significant progress in automating individual components of the scientific process, a system that autonomously navigates the entire research lifecycle – from conception to publication – has remained out of reach. Here, we present the strongest demonstration to date toward automating the entire process end-to-end. We present The AI Scientist, which creates research ideas, writes code, runs experiments, plots and analyzes data, writes the entire scientific manuscript and performs its own peer review. Its ideas, execution, and presentation are of sufficient quality to produce a manuscript generated by an AI system that passes the first round of peer review at a major machine learning conference workshop. The workshop has an acceptance rate of 70 percent. Our system leverages modern foundation models within a complex agentic system. We evaluate The AI Scientist in two settings: a focused mode using human-provided code templates as an initial scaffold to conduct research on a specific topic, and a template-free, open-ended mode that leverages agentic search for wider scientific exploration. Both settings produce diverse ideas and automatically test, report on, and evaluate them. This achievement demonstrates AI's growing capacity for scientific contribution and signifies a potential paradigm shift in how research is conducted. As with any impactful new technology, there could be significant risks, including taxing overwhelmed review systems and adding noise to scientific literature. However, if developed responsibly, such autonomous systems could greatly accelerate scientific discovery.

03.
arXiv (CS.AI) 2026-06-18

AI Sovereignty as National Learning Capacity: A Human-Centered Learning Mechanics Viewpoint on France, the United States, and China

arXiv:2606.00729v2 Announce Type: replace Abstract: Artificial intelligence in France is often discussed through separate dimensions such as investment, compute, regulation, employment, sovereignty, and education. This viewpoint paper proposes a unified interpretation: France can be analyzed as a national AI learning system. Building on Human-Centered Learning Mechanics (HCLM), we use HCLM not as a validated econometric model, but as a conceptual and diagnostic lens for interpreting national AI development as a balance between information injection, absorptive capacity, and institutional dissipation. Information injection includes compute, data, talent, research, capital, industrial deployment, and policy experimentation. Institutional dissipation refers to avoidable frictions such as administrative overload, coordination failures, energy constraints, regulatory uncertainty, talent mobility pressures, and weak industrial absorption. Regulation is not treated as mere friction: adaptive governance, trusted data spaces, and safety-oriented standards may increase long-term learning capacity by improving legitimacy, interoperability, and social trust. The central claim is not that a country follows neural-network equations, but that AI sovereignty depends on how effectively it converts distributed information into absorbed, coordinated, and socially legitimate capability. The paper connects HCLM with neural scaling laws, endogenous growth theory, creative destruction, absorptive capacity, and coordination mechanisms. It offers a formal heuristic, policy indicators, illustrative scenarios, and implications for France. The numerical results are diagnostic scenarios, not econometric estimates or official rankings. The proposed viewpoint reframes AI policy as the governance of an open, strategic, non-equilibrium learning system that should be tested with historical and cross-country data.

04.
arXiv (CS.AI) 2026-06-16

LLM4RTL: Tool-Assisted LLM for RTL Generation

arXiv:2606.15500v1 Announce Type: cross Abstract: Large language models (LLMs) have facilitated impressive progress in software engineering, code generation, tooling, and systems. Concurrently, a significant body of research has developed which explores a growing variety of methods and systems for applying LLMs to hardware and chip design (e.g., systems for RTL code generation based on functional description). However, when it comes to open Verilog/RTL code-generation, we need high-quality training samples to build specialized and more effective LLM systems through fine-tuning or low-rank adaptation. Here, we propose a ``judge-renew-check-renew-check'' (JRCRC) pipeline which updates a current public dataset using a hierarchy of state-of-the-art commercial LLM models differing in their costs and capabilities in RTL code generation. This approach achieves a cost-effective mechanism for filtering and refining code-generation samples into a higher-quality training dataset. Our experiments also identify some common weaknesses of LLMs in rule-based reasoning and logic, and consequently, in RTL code-generation. Having identified these weaknesses, we develop an architecture for incorporating pre-processing tools to dynamically assist the LLMs in inferring logical relationships from tabular data formats. With our tools-assisted architecture for RTL code generation, we achieve significant overall performance gains in the VerilogEval benchmark and outperform many state-of-the-art methods. Our LLM4RTL system achieves performance comparable to that of GPT-4O using a significantly much smaller LLM.

05.
arXiv (quant-ph) 2026-06-12

Quantum Network Routing based on Surface Code Error Correction

arXiv:2606.12781v1 Announce Type: new Abstract: Quantum networks encounter unavoidable channel noises and erasure errors, presenting a huge obstacle in designing protocols that attain both high reliability and efficiency. Typically, quantum networks fall into two categories: those utilize quantum entanglements for quantum teleportation, and those directly transfer the actual quantum messages. In this paper, we present SurfNet, a quantum network that inherits the main advantages from both categories. It employs surface codes as logical qubits for encoding messages, and utilizes two parallel communication channels to fault-tolerantly transfer each surface code in a modular manner. Our approach of using surface codes can timely correct both operational and photon loss errors within the network, and the integration of the two channels within the network can greatly improve network throughput. For the implementation of SurfNet, we propose a novel network architecture, designed to better integrate surface codes into quantum networks. We also propose a novel error correction decoder, designed to fully utilize the modular characteristic of surface codes within our network. Simulation results demonstrate that SurfNet with its decoder significantly enhances the communication fidelity within quantum networks.

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

Last-Iterate Convergence of Optimistic Multiplicative Weight Update

arXiv:2606.11773v1 Announce Type: cross Abstract: Optimistic Gradient Descent Ascent (OGDA) and Optimistic Multiplicative-Weights Update (OMWU) are two very popular algorithms to solve convex/concave saddle-point problems, where OMWU is the non-Euclidean, entropic version of OGDA. It is known since the '80s that the last iterate of OGDA asymptotically converges to a saddle point in smooth problems. On the other hand, it is unknown if OMWU has the same property. In this paper, I show that OMWU converges asymptotically for smooth convex-concave saddle-point problems, with a small enough constant learning rate. The result does not require uniqueness, strict complementarity, an error bound, or initialization near a solution. The main new ingredient is a boundary argument showing that every cluster point satisfies the inactive-coordinate KKT inequalities. The boundary argument was discovered with assistance from ChatGPT and is documented in the appendix.

07.
arXiv (CS.AI) 2026-06-16

Embedded Arena: Iterative Optimization via Hardware Feedback

arXiv:2606.16190v1 Announce Type: cross Abstract: Embedded devices from wildlife monitoring stations to clinical wearables require local AI inference due to latency, communication, or privacy constraints. Optimizing models for heterogeneous microcontrollers (MCUs) requires simultaneously satisfying hard physical constraints on memory, power, and temperature while preserving accuracy, a multidimensional optimization that is today performed manually by experts. We ask whether an LLM agent can autonomously navigate this complex, multi-turn pipeline guided by real hardware feedback, and introduce a hardware-in-the-loop agent arena in which the agent iteratively refines both model and firmware – compiling, flashing, and measuring on real hardware – to enable closed-loop optimization. Frontier models, including Claude Opus 4.7 and Gemini 3.1 Pro, fail entirely without hardware feedback (0% deployment success), whereas our hardware-in-the-loop formulation achieves the first successful deployment within three iterations and can surpass human expert results within seven. This agentic co-optimization achieves 250x compression for vision models with

08.
arXiv (CS.AI) 2026-06-24

Decentralized Coordination of Autonomous Traffic Through Advanced Air Mobility Corridors

arXiv:2606.23832v1 Announce Type: cross Abstract: The use of dedicated corridors for Advanced Air Mobility (AAM) traffic is one of the most commonly proposed pathways to integrating them into existing airspace operations. Most prior research has focused on the design of networks of AAM corridors and conflict resolution for aircraft within corridors. It is also generally believed that while attractive from an implementation perspective, corridor-based operations may be inefficient, especially in the absence of centralized traffic management. In this paper, we show that contrary to this belief, it is possible for autonomous aircraft to learn to self-organize into corridor flows in decentralized settings. We illustrate our approach using scenarios in which fixed-wing aircraft need to safely and efficiently traverse (1) a single corridor with metering after the exit, (2) a sequence of two consecutive corridors, and (3) a corridor that splits into two. We find that in decentralized settings with only local information, the aircraft are able to conform to the corridor boundaries more than 94% of the time and reach their goal in a relatively efficient manner. Furthermore, tactical interventions to handle violations of the separation minimum are needed only infrequently in low- and medium-density settings. However, such tactical interventions become more frequently necessary only when traffic density is high.

09.
medRxiv (Medicine) 2026-06-17

The Unreliable Judges: Assessing Reproducibility and Self-Preference Bias of LLMs as Free-Text Evaluators

Large Language Models (LLMs) are transforming clinical practice and research, but their adoption requires rigorous evaluation. While human assessment is ideal, its cost has driven the widespread use of LLMs as evaluators. We introduce an open-source reciprocal framework comparing 71 human experts against six LLMs. AI evaluators show a strong self-preference bias, yet neither group reliably identified whether a response was human- or AI-generated. AI scores correlated with surface features such as length and lexical diversity, whereas human scores did not. By probing the evaluator's hidden states and applying targeted steering, we show that verbosity is a major causal driver of the bias. Moreover, shuffling question-response pairings shows that long responses keep high scores even when they no longer answer the question, whereas short ones do not, demonstrating that AI judges reward verbosity largely independently of content alignment. Finally, API-based and batch inference inflate stochasticity, underscoring the need for controlled deployment.

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

NeuralMUSIC: A Hybrid Neural-Subspace Framework for Robot Sound Source Localization

arXiv:2606.18664v1 Announce Type: cross Abstract: Reliable sound source localization is fundamental to robot audition, enabling autonomous robots to perceive spatial cues and operate effectively in dynamic environments. Classical methods such as Multiple Signal Classification (MUSIC) offer strong theoretical foundations but degrade under low signal-to-noise ratios. While deep learning-based approaches achieve promising performance, they often struggle with limited generalization across conditions. To address these challenges, we propose NeuralMUSIC, a hybrid neural-subspace framework for robotic sound source localization. Specifically, a neural network first estimates the spatial covariance matrix from multichannel microphone observations. The predicted covariance is then integrated into a classical MUSIC pipeline with eigenvalue decomposition (EVD) and pseudo-spectrum computation, followed by a Frequency Attention Fusion (FAF) module to produce the final DOA estimates. To improve data efficiency, we further introduce a Self-supervised Spatial Correlation Learning (SSCL) strategy that leverages unlabeled acoustic data to capture spatial structure. Extensive experiments across different robotic tasks demonstrate that NeuralMUSIC achieves competitive localization accuracy while exhibiting improved robustness and cross-domain generalization.

11.
medRxiv (Medicine) 2026-06-17

The interaction between chronic hepatitis B (CHB) and Metabolic dysfunction-associated steatotic liver disease (MASLD) in a diverse central London population

Introduction: The overlap between chronic hepatitis B (CHB) and metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging global health challenge. We investigated the impact of MASLD and metabolic comorbidity in a diverse London viral hepatitis clinic. Methods: This retrospective cross-sectional study (May 2018-Feb 2024) included adults with CHB having controlled attenuation parameter (CAP) measurements. MASLD was defined as CAP >264 dB/m plus [≥]1 cardiometabolic factor (CMF). We used univariable and multivariable models to examine MASLD's relationship with liver stiffness and hepatitis B viral load (HBV VL). Results: Among 323 individuals (67% male, median age 36), most were from Black (35%) or non-white British/Irish (29%) backgrounds. Overall, 64% had [≥]1 CMF, and 20% had MASLD. The CHB/MASLD group was significantly older (median 43 vs 35 years, p

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

Learning Object Manipulation from Scratch via Contrastive Interaction

arXiv:2606.11525v1 Announce Type: cross Abstract: Contrastive Reinforcement Learning (CRL) has seen recent success in a wide variety of goal-conditioned robotics tasks by learning structured representations of the dynamics. However, despite its success in locomotion and simpler control domains, CRL often struggles in interaction-rich manipulation. We argue that a key source of this difficulty is object-centric interaction, such as contact or grasping, that induces distinct changes in the underlying dynamic modes. In this work, we formulate manipulation dynamics as a piecewise-smooth Markov process and show that interaction-induced mode changes create piecewise nonlinear reachability structures that are difficult for standard CRL energy functions to represent and plan over. Based on this analysis, we introduce Interaction-weighted Resampling (IWR). IWR performs interaction-aware resampling around phases before, during, and after interactions, encouraging the learned representation to preserve the mode boundaries that determine future reachability to capture multi-modal and piecewise nonlinear reachability. Across interaction-centric environments, including 2D dynamic control, robotic manipulation, and robot air hockey, IWR improves both sample efficiency and overall performance over prior CRL methods, with 19.8% average improvement in simulation. Finally, using a sim-to-real pipeline with policies trained by IWR, we demonstrate the first real-world goal-conditioned robot air hockey agent capable of hitting goals, improving success from 25% to 60%. Project Page: IWR-arxiv.github.io.

13.
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.

14.
arXiv (CS.CV) 2026-06-18

Hierarchical Multi-Modal Retrieval for Knowledge-Grounded News Image Captioning

Traditional image captioning methods often struggle to generate comprehensive, context-rich descriptions, especially for details not directly observable from visual cues. To overcome this, we propose a novel retrieval-augmented image captioning framework that generates captions with deeper insights, such as object attributes, event context, and underlying significance, by leveraging external knowledge. Our approach features a hierarchical multi-modal article retrieval mechanism that moves beyond monolithic text entities. This retrieval considers article structure-aware features, including weighted textual components (e.g., headlines, body sections) and visual placement patterns, alongside multi-faceted similarity computations (content–visual, visual–visual, and discourse positioning). A subsequent contextual relevance refinement stage further enhances the retrieved information. The retrieved articles then serve as the knowledge base for caption generation: first, a VLM generates a concise image description; second, we segment relevant information from the retrieved articles based on this description; and finally, an LLM utilizes both the description and extracted knowledge to generate a comprehensive, contextually detailed caption. We participated in the ACM Multimedia EVENTA 2025 Challenge and achieved 5th place with an overall score of 0.2824 on the private test set of the OpenEvent-V1 dataset. Source code is publicly released at https://github.com/mf0212/EVENTA-Challange.

15.
arXiv (CS.AI) 2026-06-11

The Unreasonable Effectiveness of Discrete-Time Gaussian Process Mixtures for Robot Policy Learning

arXiv:2505.03296v2 Announce Type: replace-cross Abstract: We present Mixture of Discrete-time Gaussian Processes (MiDiGap), a novel approach for flexible policy representation and imitation learning in robot manipulation. MiDiGap enables learning from as few as five demonstrations using only camera observations and generalizes across a wide range of challenging tasks. It excels at long-horizon behaviors such as making coffee, highly constrained motions such as opening doors, dynamic actions such as scooping with a spatula, and multimodal tasks such as hanging a mug. MiDiGap learns these tasks on a CPU in less than a minute and scales linearly to large datasets. We also develop a rich suite of tools for inference-time steering using evidence such as collision signals and robot kinematic constraints. This steering enables novel generalization capabilities, including obstacle avoidance and cross-embodiment policy transfer. MiDiGap achieves state-of-the-art performance on diverse few-shot manipulation benchmarks. On constrained RLBench tasks, it improves policy success by 76 percentage points and reduces trajectory cost by 67%. On multimodal tasks, it improves policy success by 48 percentage points and increases sample efficiency by a factor of 20. In cross-embodiment transfer, it more than doubles policy success. We make the code publicly available at https://midigap.cs.uni-freiburg.de.

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

Unlocking LLM Code Correction with Iterative Feedback Loops

arXiv:2606.17514v1 Announce Type: cross Abstract: Large Language Models have shown remarkable capabilities in code generation. However, most existing evaluations focus only on single-attempt accuracy and overlook the iterative refinement process that is central to real-world programming. This study presents a systematic investigation of LLMs' ability to rectify their own code through execution feedback. Using real-world programming problems across four models and two major programming languages, this study evaluates performance using iterative refinement framework where LLMs receive compiler error messages and testcase feedback after each attempt. This study introduces metrics to evaluate code failures, analyze rectification patterns, and compare the effectiveness of reasoning and non-reasoning models, offering actionable insights into both the understanding and practical application of feedback loops in LLM-driven code generation systems. Results show that reasoning models consistently improve over iterations, substantially outperforming non-reasoning models in leveraging feedback, while syntactic and runtime errors are far more tractable than logical or algorithmic failures.

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

HAMON: Passive Optical Sequence Mixing for Long-Horizon Forecasting

arXiv:2606.17028v1 Announce Type: cross Abstract: Simple linear and frequency-domain models remain surprisingly competitive in long-horizon time-series forecasting, and recent mechanistic evidence suggests that standard forecasting benchmarks may not require the dense superposed representations that make transformers powerful in other domains. This raises a substrate-level question: if the core forecasting operator is often low-complexity and approximately linear, does it need to be implemented as learned digital temporal mixing? We introduce HAMON, a passive diffractive optical forecasting core in which historical values are encoded onto an optical aperture, future positions are left dark, and cascaded trainable phase masks with free-space diffraction shape the forecast directly in the output field. At inference, prediction is performed by a single passive optical propagation pass with no trainable digital sequence-mixing layer. Across standard benchmarks, HAMON outperforms the strongest digital baselines considered on ETTm2 at all horizons and on ETTh2 at all but the longest horizon, improving MSE by up to 14\% and doing so consistently across horizons rather than at isolated points. It is competitive on Weather and trails the strongest baselines on the remaining ETT settings and on the high-channel-count Traffic and Electricity datasets. Phase encoding, intensity-compatible readout, and phase-scrambling ablations, together with a TorchOptics cross-simulator check, indicate that the forecasts arise from the data-bearing optical field rather than from a digital forecasting head. Because the passive core uses standard Fourier optics, HAMON defines a concrete target for optical hardware and for passive physical sequence mixing.

18.
arXiv (CS.CV) 2026-06-15

Naive Visual Memory is Not Enough: A Failure-Mode Study of GUI Agents

Graphical User Interface (GUI) agents are increasingly used to automate complex computer tasks across applications, websites, and operating systems. To improve their reliability, recent work has introduced experiential memory, where agents retrieve prior trajectories to guide decision-making in similar states. More recent approaches further extend this idea to visual memory by storing and retrieving screenshots from past interactions, providing agents with richer contextual information than text-only memories. However, the effect of visual memory in GUI agents remains insufficiently understood: it is unclear which failures visual memory mitigates, or which failures it exacerbates. To systematically analyze the effect of visual memory, we introduce a taxonomy of four GUI agent failures (i.e., cognitive failure, visual state misunderstanding, hidden operation blindness, and grounding error) that map to distinct stages of the perception-reasoning-action pipeline. We find that prepending full-image memory has a divergent effect on the failure distribution: it reduces state-level failures but worsens action-level ones, and increases hidden operation blindness and grounding error. Motivated by this finding, we propose Action-Grounded Visual Memory (AGMem), an action-grounded memory framework for GUI agents. The core idea of AGMem is to store image crops that capture the local GUI region closely related to a successful action or a recovery, rather than storing full screenshots. Experiments on OSWorld show that AGMem improves task success rates by 33.3 % over full-image memory. These results demonstrate that AGMem is an effective representation for visual memory in GUI agents.

19.
arXiv (math.PR) 2026-06-17

Convergence Analysis of the Random Bisection Method

arXiv:2603.20483v2 Announce Type: replace-cross Abstract: We propose a generalized version of the bisection method where the cutting point between the two subintervals is chosen at random following an arbitrary distribution. We compute expected convergence rates with respect to any arbitrary a priori distribution for the position of the root in the initial interval and proved that it depends only on the the expectation $\mathbb{E}[c(1-c)]$ of the cut $c$. We also provide a generalization of the method for $K$ random cuts and study its convergence properties. Most probabilistic derivations are kept fairly simple for the ease of understanding of a larger audience. Our theoretical results are then validated numerically using statistical simulation.

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

A Penalty Approach for Differentiation Through Black-Box Quadratic Programming Solvers

arXiv:2602.14154v3 Announce Type: replace Abstract: Differentiating through the solution of a quadratic program (QP) is a central problem in differentiable optimization. Most existing approaches differentiate through the Karush–Kuhn–Tucker (KKT) system, but their computational cost and numerical robustness can degrade at scale. To address these limitations, we propose dXPP, a penalty-based differentiation framework that decouples QP solving from differentiation. In the solving step (forward pass), dXPP is solver-agnostic and can leverage any black-box QP solver. In the differentiation step (backward pass), we map the solution to a smooth approximate penalty problem and implicitly differentiate through it, requiring only the solution of a much smaller linear system in the primal variables. This approach bypasses the difficulties inherent in explicit KKT differentiation and significantly improves computational efficiency and robustness. We evaluate dXPP on various tasks, including randomly generated QPs, large-scale sparse projection problems, and a real-world multi-period portfolio optimization task. Empirical results demonstrate that dXPP is competitive with KKT-based differentiation methods and achieves substantial speedups on large-scale problems. Our implementation is open source and available at https://github.com/mmmmmmlinghu/dXPP.

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

A First-Principles Derivation of LLM Policy Optimization: From Expected Reward to GRPO and Its Structural Extensions

arXiv:2606.16733v1 Announce Type: new Abstract: Policy gradient algorithms for language models optimize the same objective $J(\theta) = \mathbb{E}*{\tau \sim p*\theta(\tau)}[R(\tau)]$, which has exactly two factors: the trajectory probability $p_\theta(\tau)$ and the reward $R(\tau)$. Every method from REINFORCE to PPO to GRPO and their descendants modifies one or both factors to address a specific failure in the preceding formulation. Existing surveys organize these methods by domain or chronology, which obscures the rationale behind each design choice and the precise location of its intervention within the gradient estimator. This survey revisits the landscape of LLM policy optimization from $J(\theta)$ on first principles and uses the trajectory side, induced by $p_\theta(\tau)$, and the reward side, induced by $R(\tau)$, as the two axes along which methods are located. It covers the path from REINFORCE and PPO to GRPO, as well as post-GRPO variants, Agentic RL, and GRPO-OPD. The resulting framework is unified, diagnostic, and extensible: it analyzes methods from a shared objective, identifies which side each method modifies and why, and applies the same trajectory and reward axes across these settings. Across these settings, the framework also exposes compound failures that no single-side fix resolves and that therefore require joint design of the trajectory side and the reward side. The boundary cases and coupled failures identified by this map mark where existing solutions run out and provide a principled starting point for designing the next generation of LLM policy optimization algorithms.

22.
medRxiv (Medicine) 2026-06-17

Cross-Device Adaptation of Mirai for Mammography-Based Breast Cancer Risk Prediction

Fine-tuning can adapt pretrained medical imaging models to new clinical datasets, but device-specific domain shifts may limit generalizability. We evaluated Mirai, a mammography-based deep learning model for breast cancer risk prediction, in a large screening cohort containing Hologic and General Electric (GE) full-field digital mammography systems, including GE Premium View (GE PV) and Tissue Equalization (GE TE) post-processing software. Native Mirai showed lower performance on TE images than on Hologic or PV images. Fine-tuning on TE images improved TE performance, particularly for short-term risk prediction, but substantially reduced performance on Hologic images, consistent with catastrophic forgetting. To mitigate this effect, we developed a device-invariant model using interleaved multi-device sampling and conditional adversarial training. This approach largely restored Hologic performance while maintaining improved TE performance, providing better robustness across heterogeneous imaging platforms. Comparison of cumulative and annual risk AUCs over a five-year time horizon further showed that performance gains were driven mainly by short- and intermediate-term predictions. These findings highlight both the value and dangers of device-specific fine-tuning and support balanced domain-adaptation strategies for deploying mammography-based risk models across diverse clinical imaging environments.

23.
medRxiv (Medicine) 2026-06-24

Mask-Based Breath Sampling for Detection of Pseudomonas aeruginosa in Adults with Cystic Fibrosis and Bronchiectasis

Background: Monitoring Pseudomonas aeruginosa (P. aeruginosa) infection in people with cystic fibrosis (pwCF) is essential for early detection, targeted treatment, and prevention of chronification. Sputum culture is the current standard, yet many patients, particularly those receiving CFTR modulator therapy, struggle to expectorate sputum. Microbial aerosols from the respiratory tract offer a non-invasive alternative. This proof-of-principle study assessed the accuracy and feasibility of the AveloMask, a novel breath aerosol collection kit paired with qPCR detection. Methods: Adult pwCF and bronchiectasis patients attending routine monitoring visits and healthy controls were enrolled in a cross-sectional study. Participants wore the mask for 30 minutes, followed by 20 instructed coughs. Mask filters were tested with a triplex qPCR assay targeting P. aeruginosa specific ecfX and gyrB, and human RPP30 as an endogenous control. Accuracy was evaluated using a composite reference standard (sputum culture and PCR). Results: Of 25 patients enrolled, 23 were included in the analyses. Sensitivity was 12/19 (63.2%) for breath qPCR versus 15/19 (78.9%) for sputum culture. Breath qPCR missed 5 cases detected by sputum culture but detected 2 sputum culture-negative/qPCR-positive cases. Specificity of breath qPCR was 100% in 4 patients and 15 healthy controls. RPP30 was detected in all mask samples. AveloMask was perceived as easy to use, with many patients preferring it over sputum collection. Discussion: Mask-based breath collection demonstrated promising diagnostic accuracy for detection of P. aeruginosa. Breath sampling may complement or partially substitute sputum-based diagnostics, especially in patients unable to expectorate. Further studies are needed to define its clinical role.

24.
medRxiv (Medicine) 2026-06-24

Multifactorial tuberculosis severity score for people living with HIV based on the Rand Appropriateness Method

Background In people living with Human Immunodeficiency Virus (PLWH), tuberculosis (TB) is the leading cause of death and is often associated with substantial morbidity. Better identifying PLWH with severe forms of TB could help target early interventions to reduce mortality and severe morbidity. Existing TB severity assessment tools may be sub-optimal for assessing disease severity in PLWH, since they incompletely integrate key determinants of disease severity. We aimed to develop a consensus-based TB severity score tailored to PLWH. Methods We developed a multifactorial TB severity score (TBSS) for PLWH using a modified Delphi process with a multidisciplinary group of international TB experts as the second part of a RAND/UCLA Appropriateness Method, following a previously published systematic review. Results Eight of 15 invited experts (53%) participated in both Delphi rounds. Of 62 candidate factors, 15 reflecting TB-related characteristics, host-related characteristics as well as characteristics related to both TB and host were rated as having high appropriateness for inclusion in the final TBSS. The total score ranges from 0 (no severity) to 61 (highest severity). Conclusion This study represents a first step towards the development of a multidimensional TB severity assessment tool for PLWH. However, its clinical usefulness, feasibility, and added value compared with existing severity scores remain to be demonstrated through validation studies before routine implementation can be considered. Key words: tuberculosis, HIV, severity.

25.
arXiv (CS.AI) 2026-06-12

Graph Reduction in Multirelational Networks: A Spreading-Oriented Reduction Benchmark

arXiv:2606.12581v1 Announce Type: cross Abstract: Real-world networks are inherently incomplete, noisy, and dynamically evolving, making it difficult to capture all actors and their relationships. Their scale often renders direct analysis computationally demanding. While influence maximisation (IM) has been widely studied, the role of graph reduction as a preprocessing step, and its impact on IM accuracy, remains underexplored. In this work, we introduce the Spreading-Oriented Reduction Benchmark (SORB), an open-source, standardised framework for systematically evaluating IM models across diverse task settings. SORB provides an extensible pipeline operating on a representative collection of real-world networks, including single- and multilayer structures, and accounts for graph reduction directly into the evaluation process. This design shifts the focus from analysing IM algorithms in isolation to quantifying how graph reduction alters predictive performance. Using SORB, we study the effects of sparsification and coarsening across multiple IM scenarios. Our results show that the impact of reduction is strongly dependent on both the network type (single-layer vs. multirelational) and the downstream task ($Gain@k$ vs. $\mathrm{AUC}_{\mathrm{cutoff}}$): sparsification preserves seed set quality on single-layer networks, whereas flattened multilayer networks exhibit systematic ranking degradation regardless of reduction strategy. These findings highlight the importance of reduction-aware, multi-task evaluation when studying spreading processes in complex networks.