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

AerialClaw: An Open-Source Framework for LLM-Driven Autonomous Aerial Agents

Unmanned aerial vehicles (UAVs) are increasingly used in inspection, search and rescue, environmental monitoring, and emergency response. However, most UAV applications still rely on pre-defined command sequences or task-specific pipelines, where developers manually connect perception, planning, flight control, simulation, logging, and safety modules. This limits the flexibility, reproducibility, and extensibility of autonomous aerial systems. This paper presents AerialClaw, an open-source software framework that enables UAVs to operate as decision-making aerial agents rather than merely command-following platforms. Given a natural-language mission, AerialClaw allows an LLM-based agent to understand the task, maintain context, invoke executable aerial skills, observe perception and runtime feedback, and iteratively update its decisions in a closed loop. The framework adopts a modular brain-skill-runtime architecture, combining hard skills for atomic UAV operations, Markdown-based soft skills for reusable task strategies, document-driven agent state and capability boundaries, memory-driven reflection, safety-oriented runtime validation, and platform-agnostic execution adapters. AerialClaw supports lightweight mock execution, PX4 SITL with Gazebo, and AirSim-based simulation, together with a web console, pluggable model backends, example missions, simulation assets, and staged deployment scripts. By combining standardized aerial skills, document-driven agent state, memory, and closed-loop LLM decision-making, AerialClaw provides a reproducible and extensible open-source framework for building UAV systems that can interpret missions, make decisions, execute skills, and adapt their behavior from feedback.

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

DDTNet: Degradation Disentanglement and Transfer Network for Test-Time All-in-One De-weathering Adaptation

All-in-one adverse weather image restoration aims to remove multiple degradations, such as rain, haze, and snow, using a single unified model. Despite their broad applicability, existing methods typically compromise performance, delivering balanced but suboptimal results for individual degradation types. This issue becomes more pronounced when a domain gap exists between training and testing data. Motivated by the observation that modeling degradation patterns is more feasible than recovering clean content, we propose the Degradation Disentanglement and Transfer Network (DDTNet), which focuses specifically on degradation transfer. By disentangling degradation patterns from target-domain degraded images and transferring them to source domain clean images, DDTNet generates domain-adaptive paired training data. These pairs are then used to fine-tune restoration models, significantly enhancing their adaptability across diverse weather conditions and domains. The core of DDTNet is the Degradation Disentanglement Module (DDM), which comprises Degradation Coupled Attention (DCA) to capture both general and weather-specific features, thereby enabling effective disentanglement and transfer of degradation patterns. Experimental results demonstrate that DDTNet significantly and consistently improves existing all-in-one models across real-world deraining, desnowing, and dehazing datasets.

03.
arXiv (CS.AI) 2026-06-12

M*: A Modular, Extensible, Serving System for Multimodal Models

arXiv:2606.12688v1 Announce Type: cross Abstract: We are entering a new era of composite model architectures that integrate diverse components such as vision encoders, language backbones, diffusion and flow heads, audio codecs, action generators, and world-model predictors. Such architectures underpin a broad class of multimodal models, including unified multimodal models, omni models, speech-language models, vision-language-action policies, and world models. However, existing model serving frameworks were built on narrow assumptions about model structure, making them ill-suited to accommodate this new architectural diversity. Here we present M*, a universal serving system for efficient serving of composite AI models. M* represents models as dataflow graphs, processing requests spanning diverse modalities and tasks as traversals over these graphs. The core insight is a modular abstraction that supports arbitrary composition of model components, flexible placement onto a physical cluster, and model-agnostic optimizations within a distributed runtime. We call this abstraction the Walk Graph and show how it can concisely capture composite models from a broad range of families. We instantiate M* on representative models and find that it achieves, on average, 20% lower end-to-end latency than vLLM-Omni for text-to-image workloads on BAGEL, while delivering up to 2.9x lower real-time factor and 2.7x higher throughput for text-to-speech workloads on Qwen3-Omni. M* also outperforms the V-JEPA 2-AC rollout baseline for robotic planning by up to 12.5x. Thus, our work paves the road towards more efficient serving of complex models with minimal developer effort.

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

SurroundNEXO: Ego-Centric Metric Bridging for Spatially Consistent Geometry in Autonomous Driving

Modern autonomous driving depends on accurate metric 3D understanding for perception, reconstruction, and planning, which in turn requires reliable multi-camera depth prediction. However, the outward-facing nature of vehicle-mounted surround-view camera rigs inherently limits visual overlap across views, challenging the correspondence-based assumptions that underpin conventional multi-view geometry. To bridge this gap, we present SurroundNEXO, named after the Spanish word nexo for a geometric link, a low-overlap multi-camera metric depth framework that grounds cross-view reasoning in ego-centric geometry rather than dense visual correspondences. Instead of directly enforcing early global fusion, SurroundNEXO first assigns image tokens globally comparable ego-frame viewing directions through Ego-Ray Positional Encoding, then uses sparse LiDAR measurements as metric anchors to propagate absolute scale cues, and finally expands feature interaction progressively from view-local modeling to decomposed spatio-temporal reasoning and global integration. This design enables metric-scale depth prediction with improved spatial consistency across weakly overlapping cameras. Across low-overlap autonomous driving benchmarks, including NuScenes, Waymo and DDAD, SurroundNEXO reduces single-view error by 33.2%, improves cross-view consistency by 10.5%, and enhances metric reconstruction quality by 25.6% compared with SOTA methods. It further remains robust under extremely sparse depth prompts and exhibits strong zero-shot generalization to unseen camera layouts.

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

CADO: From Imitation to Cost Minimization for Heatmap-based Solvers in Combinatorial Optimization

arXiv:2602.08210v2 Announce Type: replace Abstract: Heatmap-based solvers have emerged as a promising paradigm for Combinatorial Optimization (CO). However, we argue that the dominant Supervised Learning (SL) training paradigm suffers from a fundamental objective mismatch: minimizing imitation loss (e.g., cross-entropy) does not guarantee solution cost minimization. We dissect this mismatch into two deficiencies: Decoder-Blindness (being oblivious to the non-differentiable decoding process) and Cost-Blindness (prioritizing structural imitation over solution quality). We empirically demonstrate that these intrinsic flaws impose a hard performance ceiling. To overcome this limitation, we propose CADO (Cost-Aware Diffusion models for Optimization), a streamlined Reinforcement Learning fine-tuning framework that formulates the diffusion denoising process as an MDP to directly optimize the post-decoded solution cost. We introduce Label-Centered Reward, which repurposes ground-truth labels as unbiased baselines rather than imitation targets, and Hybrid Fine-Tuning for parameter-efficient adaptation. CADO achieves state-of-the-art performance across diverse benchmarks, validating that objective alignment is essential for unlocking the full potential of heatmap-based solvers.

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

Artificial Intelligence in Ship Finance: Applications, Opportunities, and a Case Study in AI-Augmented Loan Origination

arXiv:2606.11238v1 Announce Type: cross Abstract: Ship finance is a data-intensive and document-heavy segment of asset-based lending, requiring the integration of financial, technical, contractual, and regulatory information from heterogeneous and largely unstructured sources. Increasing environmental regulation and ESG reporting requirements are adding further complexity to underwriting and loan-origination processes. Recent advances in artificial intelligence (AI), particularly large language models (LLMs), create new opportunities for processing and analysing such information. This paper reviews potential applications of AI in ship finance, with a particular focus on LLM-based systems for document comprehension, information extraction, and workflow automation. We present ShipFinance.ai, a modular agentic architecture to support loan application workflows in ship finance. The proposed system combines an LLM-based extraction module, financial analysis components, external maritime data services, and a controlled document-generation module with a chatbot interface to support the preparation of standardized financing applications. The paper discusses the key challenges for using such models in production. We argue that AI-assisted systems can support maritime finance professionals in managing increasingly complex information and reporting requirements.

07.
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

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

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

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

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

Learning aligned EEG representations with subject-specific encoders

arXiv:2606.16462v1 Announce Type: cross Abstract: Cross-subject EEG decoding promises more training data, but it also exposes neural networks to strong inter-subject distribution shifts. We study whether task supervision and architecture alone can learn subject-aligned representations. We replace a shared EEG encoder with subject-specific encoders followed by a common classifier, and compare this hybrid model with standard EEGNet, AttentionBaseNet, and CTNet baselines with Euclidean Alignment (EA) on four motor-imagery datasets. EA improves shared encoders by recentering subject covariances, but the hybrid encoder largely internalises this role: validation-loss curves and latent-distance analyses change little when EA is removed. Subject-specific heads increase class distinctiveness and place each subject close to its own latent manifold, improving most subjects while leaving a method-sensitive subset. These results support subject-specific encoders as a learned alignment mechanism for EEG decoding and identify head selection for unseen subjects as the remaining bottleneck.

10.
arXiv (CS.CL) 2026-06-16

CODA-BENCH: Can Code Agents Handle Data-Intensive Tasks?

Advanced agents are increasingly demonstrating the potential to operate as autonomous engineers, creating a growing demand for evaluation benchmarks that capture the complexity of real-world development. Such environments typically involve both complex code and large-scale data (i.e., file system). However, existing benchmarks usually evaluate code-centric or data-centric capabilities in isolation, leaving a clear gap with real development scenarios. In this paper, we bridge this gap by introducing CODA-BENCH, the first benchmark to jointly evaluate code and data intelligence in a data-intensive environment. We construct a data-intensive Linux sandbox based on the Kaggle ecosystem (containing hundreds of datasets), where agents must actively explore complex file hierarchies to identify relevant resources and generate code for data-driven analytical tasks. CODA-BENCH comprises 1,009 tasks spanning 31 communities, with each task environment containing an average of 980 files, simulating realistic data scale and noise. Evaluations of advanced agents reveal that even top-performing systems struggle to effectively integrate data discovery with code execution, achieving a success rate of only 61.1%. These results highlight a substantial gap in current agentic capabilities for data-intensive tasks and point to promising directions for future research.

11.
arXiv (CS.AI) 2026-06-17

Know Thy Reasoner: Not All Language Models Explore Alike

arXiv:2604.10827v2 Announce Type: replace Abstract: Compute scaling for LLM reasoning trades off exploring solution approaches (breadth) against refining promising ones (depth), yet why a given trade-off works, and why it often fails to transfer across models, remains unclear. We argue that the optimal strategy depends on the model's diversity profile, the spread of probability mass across solution approaches, and that this must be characterized before any exploration strategy is adopted. We formalize this with a framework decomposing reasoning uncertainty, deriving when depth-based refinement outperforms parallel sampling, and validate it across three model families at both inference and training. Our central finding is that the diversity regime dictates the strategy: low-diversity aligned models benefit from depth-based refinement with lightweight intrinsic signals, whereas high-diversity base models are often harmed by it, and instead need breadth or stronger signals to compensate.

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

HumP-KD: A Hybrid Uncertainty-Aware Multi-Stage Progressive Knowledge Distillation Framework for Efficient Fire Classification

Real-time fire classification systems require models that are simultaneously accurate, computationally efficient, and deployable on resource-constrained hardware. This work proposes HumP-KD, a Hybrid Uncertainty-aware Multi-stage Progressive Knowledge Distillation framework for efficient fire classification. Two datasets, FlameVision and Dataset-II, containing 8,600 and 31,309 images, are used. Various CNN and transformer baselines are applied under standard preprocessing, online augmentation, Gaussian noise and motion blur robustness conditions. The proposed HumP-KD model distills knowledge from two frozen heterogeneous transformer teachers, Swin-Tiny and ViT-Base, along with their Meta-MLP ensemble, into a lightweight MobileViT-S student via three tightly integrated components. Hierarchical Progressive Knowledge Distillation employs a Hierarchical Feature Builder. It generates a fused spatial attention mask to guide distillation toward discriminative regions selectively. Multi-Stage Knowledge Distillation progressively activates three distillation stages across training. On Dataset-II, HumP-KD achieves a mean F1 score of $0.9876 \pm 0.0063$ across 10 independent trials, significantly outperforming the MobileViT-S baseline trained without distillation ($0.9537 \pm 0.0351$), with statistical significance confirmed by both independent t-test ($p = 0.0195$) and Wilcoxon signed-rank test ($W = 1$, $p = 0.0039$). The proposed method also demonstrates strong generalization across datasets and robustness under degraded visual conditions. The student model retains only 4.94M parameters and 19.01Mb model size, representing a $5.7\times$ parameter reduction over Swin-Tiny and a $17.5\times$ reduction over ViT-Base, while achieving 37.72 CPU FPS, making it suitable for real-time deployment.

13.
arXiv (quant-ph) 2026-06-16

Microscopic exceptional points in the post-selected open Jaynes–Cummings model

arXiv:2606.14982v1 Announce Type: new Abstract: Phenomenological non-Hermitian Hamiltonians track selected signatures of complex reservoir dynamics, while post-selected no-jump effective Hamiltonians derived from microscopic open-system theory reveal the underlying system–reservoir physics. We derive such a Hamiltonian for the open Jaynes–Cummings model using a Moore–Penrose normalized $\mathrm{su}(2)$ representation that removes the vacuum-sector singularity and diagonalizes the full Hamiltonian by one operator rotation. Starting from a zero-temperature bosonic reservoir, we obtain a Gorini–Kossakowski–Sudarshan–Lindblad master equation under the Born–Markov approximation with full Bohr-frequency resolution. We use partial Bohr-frequency resolution to build a consistent post-selected no-jump Hamiltonian near exceptional points, where decay rates become comparable to Rabi frequencies and remove the scale separation behind full resolution. The normalized $\mathrm{su}(2)$ form of the resulting non-Hermitian Jaynes–Cummings Hamiltonian reveals the effects of Lamb-shifted detuning, diagonal loss imbalance, and reservoir-modified coupling. Our microscopic exceptional-point analysis recovers the experimentally reported single-excitation exceptional point for unequal independent losses and identifies regimes absent from the standard phenomenological model; for example, equal correlated losses with orthogonal channel phase produce a second-order exceptional point at the same loss-to-coupling ratio in every excitation sector.

14.
arXiv (quant-ph) 2026-06-16

On-Demand Coherent Mapping of Telecom Optical States onto Erbium Hyperfine Spins

arXiv:2606.15009v1 Announce Type: new Abstract: Optical quantum memories operating directly at telecom wavelengths are a key enabling technology for long-distance quantum networks, yet on-demand storage onto long-lived ground-state spins in this spectral region has remained elusive due to the challenge of coherently transferring optical excitations to hyperfine spin states. Here we demonstrate spin-wave storage in $^{167}$Er$^{3+}$:Y$_2$SiO$_5$ at 0.8 K and 1.1 T, establishing the core operational primitive required for on-demand telecom quantum memories. Using classical optical control pulses, we coherently transfer collective optical excitations to erbium hyperfine states with transfer efficiency exceeding 12%, enabling on-demand retrieval. We measure a hyperfine population lifetime of 25 s and demonstrate spin-wave storage for up to 25 $\mu$s. By identifying hyperfine inhomogeneous broadening as the dominant present limitation, our measurements define a clear pathway toward second-scale storage through improved spectral tailoring and dynamical decoupling. The results highlight the application of erbium-based solid-state memories for scalable fiber-compatible quantum repeater architectures.

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

From Theory to Application: A Practical Introduction to Neural Operators in Scientific Computing

arXiv:2503.05598v2 Announce Type: replace-cross Abstract: This review examines neural operator architectures for learning solution operators of parametric partial differential equations (PDEs), with an emphasis on conceptual clarity and practical implementation. The work analyzes key models, including DeepONet, PCANet, and the Fourier Neural Operator, highlighting their underlying representations, computational structures, and comparative performance. These architectures are demonstrated on three canonical PDE problems: the Poisson equation, a linear elasticity problem, and a hyperelasticity problem. To make the presentation self-contained, key foundational topics are introduced, including finite-dimensional representations of function spaces, singular-value decomposition, and sampling from infinite-dimensional function spaces. Beyond forward modeling, the review discusses the use of neural operators as surrogate models within a Bayesian inverse-problem framework, including prior specification, forward-map approximation, and posterior computation. The performance of the three neural-operator architectures is evaluated on in-distribution samples, out-of-distribution samples, and Bayesian inference tasks. The review also discusses challenges related to prediction accuracy and generalization, outlining emerging strategies such as residual-based error correction and multi-level training. The review concludes by positioning neural operators within broader scientific-computing workflows and by identifying directions for reliable, scalable operator learning.

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

Neural quantum states for entanglement depth certification from randomized Pauli measurements

arXiv:2512.13121v2 Announce Type: replace Abstract: Entanglement depth quantifies how many qubits share genuine multipartite entanglement, but certification typically relies on tailored witnesses or full tomography, both of which scale poorly with system size. We recast entanglement-depth and non-$k$-separability certification as likelihood-based model selection among neural quantum states whose architecture enforces a chosen entanglement constraint. A hierarchy of separable neural quantum states is trained on finite-shot local Pauli outcomes and compared against an unconstrained reference model trained on the same data. When all constrained models are statistically disfavored, the data certify entanglement beyond the imposed limit directly from measurement statistics, without reconstructing the density matrix. We validate the method on simulated six- and ten-qubit datasets targeting GHZ, Dicke, and Bell-pair states, and demonstrate robustness for mixed states under local noise. Finally, we discuss lightweight interpretability diagnostics derived from trained parameters that expose coarse entanglement patterns and qubit groupings directly from bitstring statistics.

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

Towards Engineering Scaling Laws with Pretraining Data Composition

arXiv:2606.19781v1 Announce Type: cross Abstract: Neural scaling laws describe how model performance improves as a power law in compute, model size, and dataset size. While well-established for large language models, these relationships are emerging for large models in particle physics. As with language, empirical studies show that the performance scales as a power law. However, unlike natural language or image domains, fundamental physics has high-fidelity simulators that produce synthetic data cheaply. This favors scaling regimes where additional data is cheaper than additional parameters, and allows the pretraining dataset itself to be engineered to influence the scaling. For the task of classifying hadronic jets produced in collisions of high-energy particle beams, we show that the scaling behavior can be engineered towards requiring more data rather than larger models by inclusion of pretraining data which is more diverse and better aligned with the downstream classification task.

18.
arXiv (CS.LG) 2026-06-17

Monotonic Kolmogorov-Arnold Networks: A Theoretical and Empirical Study of Monotonicity as an Inductive Bias

arXiv:2606.17886v1 Announce Type: new Abstract: Monotonicity has been a long-running architectural inductive bias for neural networks, motivated by tabular, scientific, and economic settings where outputs are known to respond monotonically to certain inputs. Existing approaches are MLP- or flow-based and lack per-edge functional transparency; the only Kolmogorov–Arnold Network (KAN) variant with monotonicity, MonoKAN, enforces the constraint only on a restricted parameter subset and requires a projection-style training procedure. We close this gap with MKAN, a KAN with hard monotonicity guaranteed for all parameter values via exponential reparameterization of B-spline coefficients, positive edge weights, and a monotone base activation. Training reduces to standard unconstrained gradient descent. Our headline theoretical contribution is a representation-cost theorem: any $C^K, K >0$ feature extractor inducing a ball-shaped semantic-neighborhood partition admits a monotone realization of the equivalent neighborhood structure at $N' = N^* + k \le 2N^*$, where $k$ is the number of non-monotone coordinates of the original. The bound is architecture-agnostic and gives a principled sizing rule for monotone encoders. Empirically, MKAN is competitive with state-of-the-art monotone NNs on the SMM/ICML-2024 benchmark while being the only method that combines hard unconstrained monotonicity with KAN's per-edge functional transparency; the $2N^*$ prediction is validated in a self-supervised feature-size sweep on four real datasets, and on a controlled monotone-generative dataset MKAN recovers ground-truth factors with substantially higher Spearman alignment than KAN, MLP, and linear baselines.

19.
arXiv (CS.AI) 2026-06-16

Deep Q-Learning on Hölder Spaces

作者:

arXiv:2606.16846v1 Announce Type: cross Abstract: We study the operator-theoretic core of Q-learning in continuous-time stochastic control with continuous states and actions. In value-based reinforcement learning, each Q-learning or DQN update is built from a Bellman optimality target; our analysis isolates this target in a diffusion setting and studies its regularity and approximation complexity. Under uniform ellipticity and Hölder-regular coefficients, we show that a Bellman update maps bounded inputs into an anisotropic regularity class, smoothing the state variable while leaving only Lipschitz dependence on the action variable. This yields a compact family of Bellman iterates and motivates a tensor-product DeepONet architecture adapted to the mixed regularity of the problem. We then derive explicit approximation and resource bounds, together with a stiffness–complexity trade-off as the time step $\delta \to 0$. The resulting theory makes a direct contribution to Q-learning theory at the level of Bellman target regularity and approximation in continuous stochastic control. At the same time, we do not claim a full convergence theorem for practical sampled Q-learning with exploration, replay, and stochastic gradient updates.

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

Hybrid Open-Ended Tri-Evolution Makes Better Deep Researcher

arXiv:2606.13710v1 Announce Type: new Abstract: Deep research and agent evolution serve as de-facto tasks for AI agents in real-world applications toward artificial general intelligence. The former enables autonomous retrieval and integration of information in open-ended environments to tackle open-ended research tasks, yet it is constrained by the static parametric deep research capabilities of agent systems. The latter allows agents to autonomously interact with the environment to gain experiences that evolve model capabilities. However, its effectiveness has been widely validated only on verifiable tasks with standard answers, leaving a gap with open-ended research tasks. To bridge these two critical tasks, we propose the Hybrid Open-Ended Tri-Evolution (HOTE) framework, which leverages hybrid-mode reinforcement learning to facilitate the collaborative evolution of a proposer, solver and judge based on web-scale knowledge, moving toward autonomous evolving agents in open-ended tasks and environments. Extensive experiments on three long-form deep research benchmarks demonstrate that the 8B model trained via HOTE surpasses the strongest static open 8-32B models as well as those trained by state-of-the-art deep research training methods with less time overhead, and further verify that the evolution of all three modules in HOTE is indispensable.

21.
medRxiv (Medicine) 2026-06-16

Validating an Early Pregnancy HbA1c as the Screening Test for Gestational Diabetes Mellitus: Findings from PRISMA Pakistan Cohort

Background: Early identification of gestational diabetes mellitus (GDM) is critical to improving maternal and neonatal outcomes, particularly in resource-constrained settings where universal oral glucose tolerance testing (OGTT) is burdensome. We assessed whether early-pregnancy HbA1c alone or combined with common risk factors can predict GDM and reduce the burden of OGTT requirements in a peri-urban cohort in Karachi, Pakistan. Methods: We conducted a secondary analysis of the Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA) Pakistan cohort. Women enrolled before 20 weeks' gestation with available early-pregnancy HbA1c and a 2-hour 75g OGTT at 24 to 28 weeks were included. We externally validated GDM prediction models originally developed in the STRiDE-India cohort. Model performance was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC). We assessed four models: HbA1c alone (Model 1a); age, BMI, and family history of diabetes mellitus (FH DM) (Model 1b); HbA1c combined with age, BMI, and FH DM (Model 2); and an extended model, i.e., Model 2 combined with socioeconomic status, gestational age, parity, systolic and diastolic blood pressure (Model 3). A dual-threshold approach was applied to assess rule-in and rule-out performance. Results: Among 2,489 women, GDM incidence was 7.5% (n=186). Models with a broader set of predictors demonstrated higher AUC values, with Model 2 achieving an AUC of 0.61 (95% CI: 0.57, 0.66). Including additional factors (Model 3) did not further improve predictive ability (AUC: 0.62; 95% CI: 0.58, 0.66). In addition, at predefined thresholds, Model 2 achieved sensitivity of 73.7% (rule-out) and specificity of 83.5% (rule-in), with the potential to reduce OGTT requirements (58.5%). Conclusions: Early-pregnancy risk stratification using HbA1c combined with simple clinical predictors offers a pragmatic approach to streamline GDM screening among high-risk pregnant women. A dual-threshold strategy using Model 2 could reduce reliance on universal OGTT while prioritizing high-risk women for confirmatory testing.

22.
Nature (Science) 2026-06-17

Towards Conversational AI for Disease Management

While large language models (LLMs) have shown promise in diagnostic dialogue1, their capabilities for effective management reasoning—including disease progression, therapeutic response, and safe medication prescription—remain under-explored. We advance the previously demonstrated diagnostic capabilities of the Articulate Medical Intelligence Explorer (AMIE)1−3 through a new LLM-based agentic system optimized for multi-visit clinical management and dialogue. To ground its reasoning in authoritative clinical knowledge, AMIE leverages Gemini’s long-context capabilities4, combining in-context retrieval with structured reasoning to align its output with up-to-date clinical practice guidelines and drug formularies. In a randomized, blinded virtual Objective Structured Clinical Examination (OSCE) study, AMIE was compared to 21 primary care physicians (PCPs) across 100 multi-visit case scenarios designed to reflect UK NICE Guidance and BMJ Best Practice guidelines. AMIE was non-inferior to PCPs in management reasoning as assessed by specialists and scored better in both preciseness of treatments and investigations, and in its alignment with and grounding in clinical guidelines. To benchmark medication reasoning, we developed RxQA, a multiple-choice question benchmark derived from two national drug formularies (US, UK) and validated by board-certified pharmacists. Though AMIE and PCPs both benefited from the ability to access external drug information, AMIE outperformed PCPs on higher difficulty questions. While further research would be needed before real-world translation, AMIE’s strong performance across evaluations marks a significant step towards conversational AI as a tool in disease management.

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

Correct When Paired, Wrong When Split: Decoupling and Editing Modality-Specific Neurons in MLLMs

Although Knowledge Editing provides an efficient mechanism for updating the knowledge of Multimodal Large Language Models (MLLMs), we find that current paradigms still suffer from an important yet remain underexplored issue : editing decoupling failure, where entity-related knowledge can be updated when the model is triggered by multimodal inputs (text–image query pairs), however, it often reverts to outdated pre-edit facts when the paired inputs are split into unimodal ones. Our in-depth empirical analysis reveals that the entity knowledge in MLLMs is not stored as a unified representation, but is instead distributed across disentangled modality-specific pathways. As a result, updates biased toward multimodal queries fail to propagate effectively to unimodal circuits. To bridge this gap, we propose DECODE, which explicitly disentangles and localizes modality-specific neuron groups for targeted knowledge. Extensive experiments demonstrate that DECODE consistently achieves effective knowledge updates under different modality triggers, thereby mitigating editing decoupling failures.

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

Deep Neural Networks: A Formulation Via Non-Archimedean Analysis

arXiv:2402.00094v3 Announce Type: replace-cross Abstract: We introduce a new class of deep neural networks (DNNs) with multilayered tree-like architectures. The architectures are codified using numbers from the ring of integers of non-Archimdean local fields. These rings have a natural hierarchical organization as infinite rooted trees. Natural morphisms on these rings allow us to construct finite multilayered architectures. The new DNNs are robust universal approximators of real-valued functions defined on the mentioned rings. We also show that the DNNs are robust universal approximators of real-valued square-integrable functions defined in the unit interval.

25.
medRxiv (Medicine) 2026-06-17

Treatment of Multi-Drug-Resistant Tuberculosis with Second-Line All-Oral Drugs in Ghana: Incidence of Adverse Events.

Introduction: The treatment of multidrug-resistant tuberculosis (MDR-TB) remains challenging due to the toxicity of second-line medications and suboptimal treatment outcomes. This study aimed to determine the incidence of adverse events and identify factors associated with these events in patients undergoing treatment for MDR-TB with second-line all-oral drugs in Ghana. Methods: This retrospective cohort study reviewed the medical records of 384 MDR-TB patients treated with second-line all-oral drugs at selected health facilities in Ghana, including the Greater Accra Regional Hospital, Eastern Regional Hospital, and Kumasi South Hospital. Data were extracted using the Kobo Collect tool, capturing patient demographics, baseline clinical and laboratory characteristics, treatment regimens, and adverse events. The study period spanned from 2020 to August 2024. Results: The study included a total of 384 MDR-TB patients, with a mean age of 45 years (SD = 15). The majority of patients were male (65.78%), and most were within the 45-64 years age group (33.85%), followed by those aged 25-44 years (31.25%). Regionally, the highest number of cases were reported from the Greater Accra Region (39.06%), followed by the Eastern Region (31.25%) and Kumasi South Hospital (29.69%). Approximately one in four patients (25%) presented with comorbidities, with HIV being the most common (19.5%). The most frequently reported adverse events were diarrhea (14%), dizziness (13.7%), and vomiting (12.3%). Most of these were mild to moderate in severity and tended to decrease as treatment progressed. Severe adverse events, such as leukopenia and acute kidney injury, were rare, occurring in less than 5% of patients. Over the course of treatment, gastrointestinal adverse events such as vomiting and nausea showed a significant decline, indicating possible patient adaptation or improved clinical management. Results from the multivariate Poisson regression analysis revealed that age and comorbidities were significant predictors of adverse events. Patients aged 65 years and above had a 56% lower risk of developing adverse events compared to younger patients (Adjusted Risk Ratio [aRR] = 0.44, 95% CI: 0.25-0.79, p = 0.005). Conversely, patients with comorbid conditions such as diabetes or hypertension were approximately 2.6 times more likely to experience adverse events compared to those without comorbidities (aRR = 2.65, 95% CI: 1.58-4.43, p < 0.001). The effect of sex was not statistically significant after adjustment (aRR = 1.03, 95% CI: 0.70-1.50, p = 0.86). At the end of the treatment period, 74.9% of patients achieved successful outcomes, including both those who were cured and those who completed treatment without being classified as cured. However, 25.1% had unsuccessful outcomes, which included treatment failure, relapse, or death. Conclusion: In conclusion, adverse events are common in the treatment of MDR-TB with second-line All-Oral drugs, with gastrointestinal adverse events being the most prevalent. These findings highlight the importance of monitoring and managing adverse events to optimize treatment outcomes for MDR-TB patients in Ghana.