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01.
medRxiv (Medicine) 2026-06-16

Higher Population Coverage with Typhoid Conjugate Vaccine is Needed to Induce Herd Protection: Evidence from a Cluster-Randomized Trial in Urban Bangladesh

Introduction: A cluster randomized trial (CRT) in Bangladesh found that Vi-tetanus toxoid (Vi-TT) vaccine conferred 85% protection to vaccinees at 18 months of follow-up; however, it failed to confer significant herd protection to non-vaccinees. Methods: In the CRT, children aged 9 months to

02.
medRxiv (Medicine) 2026-06-22

AI-driven Multimodal Representation Learning for Latent Mediation Structure Discovery of Socioeconomic Disadvantage, Psychosocial Factors, and Cardiometabolic Multimorbidity

作者:

Social disadvantage is associated with multimorbidity, but the pathways linking social conditions to disease burden remain poorly understood. We developed an AI-driven multimodal mediation framework that integrates socioeconomic, psychosocial, clinical, laboratory, behavioral, and genomic data from the All of Us Research Program. Modality-specific variational autoencoders were used to derive latent representations of each data domain, and mediation analyses were subsequently performed in latent space to evaluate indirect associations between socioeconomic disadvantage, psychosocial factors, and multimorbidity. The final analytic cohort included 20,804 participants with complete multimodal data. Across 800 exposure–mediator–outcome combinations, mediation signals were concentrated within a small number of latent dimensions. The strongest indirect association linked a socioeconomic disadvantage dimension, a psychosocial vulnerability dimension, and a cardiometabolic multimorbidity dimension (NIE = 0.002517). The psychosocial dimension was characterized by poorer mental health, greater loneliness, lower social well-being, and lower health literacy, whereas the outcome dimension was associated with hypertension, diabetes, hyperlipidemia, obesity, chronic kidney disease, and heart disease. Bootstrap analyses supported the stability of the leading pathway. These findings suggest that psychosocial vulnerability may contribute to the association between socioeconomic disadvantage and cardiometabolic multimorbidity. More broadly, the proposed framework illustrates how AI-based representation learning can be used to investigate complex relationships across high-dimensional multimodal health data.

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

Counterfactual Credit Policy Optimization for Multi-Agent Collaboration

arXiv:2603.21563v5 Announce Type: replace Abstract: Collaborative multi-agent large language models (LLMs) can solve complex reasoning tasks by decomposing roles, but reinforcement learning for such systems is limited by credit assignment: shared terminal rewards obscure individual contributions and can encourage free-riding. We introduce two optimizer-agnostic credit assignment methods for converting joint outcomes into agent-specific learning signals. Counterfactual Credit for Policy Optimization (CCPO) estimates an agent's marginal contribution by comparing the realized joint outcome with a counterfactual outcome where that agent is removed. Self-Evaluated Credit for Policy Optimization (SEPO) uses constrained self- and peer-evaluations as a verifier-anchored credit signal while keeping the external task outcome dominant. Both operate at the reward-construction layer rather than as policy optimizers, producing role-specific rewards or advantages for GRPO, GSPO, or REINFORCE++. We instantiate these credit signals in a sequential Think–Solve setting and evaluate them on mathematical reasoning benchmarks. Results show that explicit credit assignment often improves dual-agent reasoning, especially on MATH500 and several out-of-distribution settings, while gains vary across models and datasets. Our code is available at: https://github.com/bhai114/ccpo.

05.
arXiv (CS.AI) 2026-06-12

Standardized Methods and Recommendations for Green Federated Learning

arXiv:2602.00343v2 Announce Type: replace-cross Abstract: Federated learning (FL) enables collaborative model training over privacy-sensitive, distributed data, but its environmental impact is difficult to compare across studies due to inconsistent measurement boundaries and heterogeneous reporting. We present a practical carbon-accounting methodology for FL CO2e tracking using NVIDIA NVFlare and CodeCarbon for explicit, phase-aware tasks (initialization, per-round training, evaluation, and idle/coordination). To capture non-compute effects, we additionally estimate communication emissions from transmitted model-update sizes under a network-configurable energy model. We validate the proposed approach on two representative workloads: CIFAR-10 image classification and retinal optic disk segmentation. In CIFAR-10, controlled client-efficiency scenarios show that system-level slowdowns and coordination effects can contribute meaningfully to carbon footprint under an otherwise fixed FL protocol, increasing total CO2e by 8.34x (medium) and 21.73x (low) relative to the high-efficiency baseline. In retinal segmentation, swapping GPU tiers (H100 vs.\ V100) yields a consistent 1.7x runtime gap (290 vs. 503 minutes) while producing non-uniform changes in total energy and CO2e across sites, underscoring the need for per-site and per-round reporting. Overall, our results support a standardized carbon accounting method that acts as a prerequisite for reproducible 'green' FL evaluation. Our code is available at https://github.com/Pediatric-Accelerated-Intelligence-Lab/carbon_footprint.

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

An Improved Generative Adversarial Network for Micro-Resistivity Imaging Logging Restoration

An improved GAN-based imaging logging image restoration method is presented in this paper for solving the problem of partially missing micro-resistivity imaging logging images. The method uses FCN as the generative network infrastructure and adds a depth-separable convolutional residual block to learn and retain more effective pixel and semantic information; an Inception module is added to increase the multi-scale perceptual field of the network and reduce the number of parameters in the network; and a multi-scale feature extraction module and a spatial attention residual block are added to combine the channel attention. The multi-scale module adds a multi-scale feature extraction module and a spatial attention residual block, which combine the channel attention mechanism and the residual block to achieve multi-scale feature extraction. The global discriminative network and the local discriminative network are designed to gradually improve the content and semantic structure coherence between the restored parts and the whole image by playing off each other and the generative network. According to the experimental results, the average structural similarity measure of the five sets of imaged logging images with different sizes of missing regions in the test set is 0.903, which is an improvement of about 0.3 compared with other similar methods. It is shown that the method in this study can be used for the restoration of micro-resistivity imaging log images with good improvement in semantic structural coherence and texture details, thus providing a new deep learning method to ensure the smooth advancement of the subsequent interpretation of micro-resistivity imaging log images.

07.
arXiv (quant-ph) 2026-06-17

Dimension-Free Approximate Tensorization of Quantum Hypercontractivity for Qudit Depolarizing Semigroups

arXiv:2606.17729v1 Announce Type: new Abstract: We prove almost tensorization for hypercontractivity and logarithmic-Sobolev constants for a class of reversible quantum Markov semigroups satisfying the positive off-diagonal scaling (PODS) property. This class includes qubit examples and generalized depolarizing semigroups with respect to full-rank states in arbitrary finite dimensions. For any such semigroup $(\Phi_t)_{t\ge 0}$ and every tensor power $n$, we show that the log-Sobolev constant of the product semigroup $\Phi_t^{\otimes n}$ is at least $2/(3\ln 2)$, approximately 0.96, times the log-Sobolev constant of the single-site semigroup $\Phi_t$, independently of $n$ and the local dimension $d$. The proof first establishes exact tensorization of the $(q,2)$-hypercontractive inequality for integer $q$, in particular $q=3$, and then extends the estimate to all real $q>2$ by complex interpolation; the standard implication from hypercontractivity to logarithmic-Sobolev inequalities yields the stated almost tensorization result. As an application of the same method, we also obtain sharp $(q,2)$-hypercontractivity estimates for qubit depolarizing channels.

08.
arXiv (CS.CL) 2026-06-11

Lius: Translation Model Based Instructional Lingustic Using Continual Instruction Tuning In Kupang Malay

Large Language Models (LLMs) offer new potential for translation tasks but often experience performance degradation when handling low-resource languages. To address this limitation, we propose an approach for fine-tuning LLMs on a low-resource language, Kupang Malay. Our approach involves designing a set of instructions by leveraging explicit lexical and semantic features from a bilingual dictionary, and introducing Continual Instruction Tuning (CIT), a training paradigm that enables iterative instruction-based training. Experimental results demonstrate that our model, named Lius, yields notable improvements over standard instruction-tuned models by outperforming 4-6 points, and surpassing both Neural Machine Translation (NMT) and Multilingual LLM models by 10-13 points on several evaluation metrics. These findings highlight the potential of our approach to mitigate the reliance on large-scale parallel data in low-resource language translation.

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

Superhuman Safe and Agile Racing through Multi-Agent Reinforcement Learning

arXiv:2605.22748v2 Announce Type: replace-cross Abstract: Autonomous systems have achieved superhuman performance in isolation or simulation, yet they remain brittle in shared, dynamic real-world spaces. This failure stems from the dominant single-agent paradigm for physical applications, where other actors are ignored or treated as environmental noise, preventing effective coordination. Here we show that multi-agent reinforcement learning provides the essential safety scaffolding required for real-world interaction. Using high-speed quadrotor racing as a high-stakes testbed, we train agents to navigate complex aerodynamic interactions and strategic maneuvering with a variable number of racers. Through league-based self-play, agents evolve sophisticated anticipatory behaviors, including proactive collision avoidance, overtaking, and handling multi-agent physical interactions, including aerodynamic downwash. Our agents outperform a champion-level human pilot in multi-player races at speeds exceeding 22 m/s, while simultaneously reducing collision rates by 50 % compared to state-of-the-art single-agent baselines. Crucially, training with diverse artificial agents enables zero-shot generalization to safer human interaction. These results suggest that the path to robust robotic co-existence lies not in isolated safety constraints, but in the rigorous demands of multi-agent interaction. Multimedia materials are available at: https://rpg.ifi.uzh.ch/marl

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

FEnc$^2$: Unifying Data Packing for Efficient Private Inference via Convolution and Architecture-Aware Fragment Encoding

arXiv:2606.16359v1 Announce Type: cross Abstract: Fully Homomorphic Encryption (FHE) enables privacy-preserving machine learning but incurs extreme computational and memory overhead. These costs come not only from expensive low-level primitives, including Number Theoretic Transform (NTT), rotation, and key-switching, but also from inefficient ciphertext packing at the application level. Existing packing strategies typically preserve either neighboring data elements or feature grouping, but not both, leading to wasted ciphertext slots, excessive rotations, and inflated ciphertext counts. We propose FEnc2, a unified and principled fragment-based encoding framework for CKKS-based private convolutional neural network inference. FEnc2 optimizes slot utilization, rotation complexity, and ciphertext density through two components: 1)Conv-aware Encoding, which analytically selects an optimal fragment size to decouple spatial dependencies and jointly minimize inner-outer rotations across layers, and 2)Arch-aware Ct Compression, which restores ciphertext density after feature- or channel-reduction layers. Together, these transformations reshape encrypted workload structure and reduce homomorphic operations by one to two orders of magnitude. With full memory capacity utilized, i.e., at maximum batch size, FEnc2 achieves end-to-end latency speedups over the state-of-the-art Orion of up to 228.83x on GPU and 226.06x on CPU for LeNet on MNIST, and up to 4.55x on GPU and 9.43x on CPU for MobileNet on ImageNet. FEnc2 is hardware-agnostic yet architecturally transformative: by optimizing encrypted tensor layout before execution, it reduces ciphertext count and workload pressure on hardware, complementing primitive-level optimizations such as NTT and keyswitch accelerators. These results show that application-level data layout is a first-order architectural design dimension for encrypted inference and an important enabler for next-generation FHE systems.

12.
arXiv (CS.CL) 2026-06-17

Guidelines for the Annotation and Visualization of Legal Argumentation Structures in Chinese Judicial Decisions

This Guideline presents a systematic and operationalizable annotation framework for representing legal argumentation structures in judicial decisions. Grounded in theories of legal reasoning and argumentation, the framework aims to reveal the logical organization of judicial reasoning and provide a reliable foundation for computational analysis. At the element level, the Guideline distinguishes between the non-propositional layer and the propositional layer. The non-propositional layer consists of two elements: Issue and Non-argumentative Component. At the propositional level, the Guideline defines four proposition types: General Normative Judgment, Particular Normative Judgment, General Factual Judgment, and Particular Factual Judgment. At the relational level, five relation types are defined to represent argumentative structures: Support, Attack, Joint, Match, and Identity. These relations capture positive and negative argumentative connections, conjunctive reasoning structures, correspondences between legal norms and case facts, and identity or semantic equivalence between propositions. The Guideline further specifies formal representation rules and visualization conventions for both basic and nested structures, enabling consistent visualization of complex argumentation patterns. In addition, it establishes a standardized annotation workflow and consistency control mechanisms to ensure the reproducibility and reliability of annotated data. By providing a clear conceptual model, formal representation rules, and practical annotation procedures, this Guideline supports large-scale analysis of judicial reasoning and future research in legal argument mining, computational modeling of legal reasoning, and AI-assisted legal analysis.

13.
arXiv (quant-ph) 2026-06-12

Vacuum photon emission and mean electromagnetic field in pair-creating external backgrounds

arXiv:2606.12547v1 Announce Type: cross Abstract: We develop a perturbative description of vacuum radiative processes in quantum electrodynamics with a prescribed external electromagnetic background capable of producing electron-positron pairs. Since the initial vacuum is then unstable and the in- and out-vacua are inequivalent, radiative observables require a real-time formulation beyond the ordinary in-out approach of vacuum-stable QED. Using the Keldysh-Schwinger-Fradkin nonequilibrium technique, we derive the mean number density of emitted photons through the second nonvanishing order in the fine-structure constant. The leading term, of order $\alpha$, reproduces the known vertex and tadpole mechanisms, while the complete order-$\alpha^2$ correction contains interference, loop, and induced-current contributions. We also give an independent derivation based on the spectral decomposition of the identity operator in the in-Fock space, where the photon number density is represented as a sum of squared transition amplitudes and vacuum-disconnected terms are canceled by the optical theorem generalized to an unstable vacuum. In addition, we compute the mean electromagnetic field through order $e^3$, including the electromagnetic dressing of the induced vacuum current, and verify it using the corresponding Schwinger-Dyson equations. The final formulas are expressed in terms of exact solutions and propagators of the Dirac equation in the external background and apply to general spacetime-dependent field configurations.

14.
arXiv (CS.CV) 2026-06-16

MAND: Modality-Aware Novelty Detection for Open-World Egocentric Activity Recognition

Multimodal egocentric activity recognition integrates visual and inertial cues for robust first-person behavior understanding. However, deploying such systems in open-world environments requires detecting novel activities while continuously learning from non-stationary data streams. Existing methods rely on the main fused logits for novelty scoring, without fully exploiting the complementary evidence available from individual modalities. Because these logits are often dominated by RGB, cues from other modalities, particularly IMU, remain underutilized, and this imbalance worsens as catastrophic forgetting accumulates. To address this, we propose MAND, a modality-aware framework for multimodal egocentric open-world continual learning. At inference, Modality-aware Adaptive Scoring (MoAS) adaptively adjusts modality contributions using sample-wise reliability and refines novelty scoring with deviation and disagreement penalties. During training, Modality-aware Representation Stabilization Training (MoRST) preserves the discriminative capacity of each modality across tasks through modality-specific heads and modality-wise logit distillation. Experiments on a public multimodal egocentric benchmark show that MAND consistently improves novel activity detection and known-class accuracy while substantially reducing FPR95, indicating more reliable open-world recognition. The source code is available at \href{https://github.com/HyeJeongIm/MAND}{github.com/HyeJeongIm/MAND}.

15.
medRxiv (Medicine) 2026-06-23

Agentic Autodiscovery of Diastolic Dysfunction Phenotypes from Surface Electrocardiogram

Background: Left ventricular diastolic dysfunction (LVDD) is a major determinant of heart failure (HF), yet its assessment relies on multiparametric echocardiography, limiting scalability. We previously demonstrated that generative artificial intelligence (AI) can synthesize tissue Doppler imaging (TDI) waveforms from the 12-lead ECG. The growing complexity of candidate architecture creates a need for automated model-discovery frameworks. Objectives: To evaluate agentic AI-based auto-discovery for ECG-based LVDD assessment using either raw ECG or synthetic TDI waveforms. Methods: Two attention-based agentic AI architectures were developed using an automated large language model-driven refinement framework that optimized transfer-learning and multimodal architectures through autonomous proposal, validation, and selection of candidate model configurations. Development was performed in 1,011 paired ECG-echocardiography studies and externally validated in 983 patients using two reference frameworks: (i) data-driven phenogroups and (ii) the 2025 ASE Diastolic Function Guidelines. External validation was performed in CODE-15% (n=219,567) for HF-related mortality and EchoNext (n=35,718) for structural heart disease associations. Results: Despite the modest cohort size, the ECG-based agentic search achieved area under the receiver operating characteristic curve (AUCs) of 0.87 (95% CI: 0.85-0.89) and 0.83 (95% CI: 0.80-0.86) for phenogroup and guideline-based LVDD severity classification. Corresponding AUCs for the synthetic TDI-based model were 0.82 (95% CI: 0.80-0.85) and 0.80 (95% CI: 0.77-0.84), respectively. In large-scale external validation, both models stratified incident HF mortality with subdistribution hazard ratios ranging 5.5 to 9.5 (Gray's p

16.
arXiv (quant-ph) 2026-06-12

Roto-Reflection Geometry of Pure Two-Qubit Entanglement

arXiv:2606.12637v1 Announce Type: new Abstract: Pure two-qubit entanglement is usually characterized by scalar quantities such as concurrence. Here we show that it also has a natural geometric form. In the Pauli correlation tensor, maximally entangled states appear as improper orthogonal maps between two local Bloch spheres. These maps are roto-reflections. For partially entangled pure states, the same roto-reflection geometry is recovered after separating the contraction associated with concurrence. We call the corresponding geometric object the Entanglement Roto-Reflection Plane (ERRP). It organizes the maximally correlated directions of the two-qubit state and provides a covariant geometric complement to the scalar magnitude of entanglement.

17.
bioRxiv (Bioinfo) 2026-06-23

Multi-Scale Machine Learning for Antibody-Antigen Binding Affinity Prediction Using Deep Mutational Scanning and Structural Features

Predicting how mutations alter antibody-antigen binding affinity is essential for antibody engineering and vaccine design, yet current methods generalize poorly to unseen complexes. We present a multi-scale machine learning framework integrating 93 descriptors across four modalities: physicochemical, structural, ESM-2 protein language model, and solvent-accessible surface area (SASA)/{Delta}{Delta}G_fold features. Under leave-one-complex-out deep mutational scanning (LOCO-DMS) cross-validation on AbAgym (36,541 mutations, 68 experiments, 13 pathogens), gradient boosting achieved MCC = 0.206; a confidence-stratified ensemble reached MCC = 0.374 (83.5% accuracy, 25.5% coverage). No single modality exceeds the majority baseline alone; only multi-scale fusion succeeds. Boltzmann ceiling analysis shows 45.9% of mutations are near-neutral (|{Delta}{Delta}G| < k_BT), bounding theoretical maximum MCC at 0.473; our method achieves 79.1% of this limit. Five deep learning architectures benchmarked under LOCO-DMS showed self-attention matching gradient boosting (MCC = 0.200). Cross-pathogen transfer failed systematically (mean 46.7%), confirming universal binding predictors remain an open challenge.

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

Measuring Whether LLM Tutors Teach or Solve: A Diagnostic for Educational Impact

Large language models are increasingly proposed as educational tutors, yet stronger task-solving ability does not necessarily imply stronger learning support. Motivated by recent calls to measure the social impact of NLP systems in practice, we study whether public LLM tutoring benchmarks distinguish learning-supportive behavior from mere answer production. We propose a lightweight diagnostic based on the gap between solving-oriented and pedagogy-oriented benchmark performance. Using public MathTutorBench leaderboard results, we show that these dimensions are only partially aligned: across eight publicly reported models, the correlation between solving and pedagogy composites is 0.421, and several models shift meaningfully in rank when evaluation moves from solving to pedagogy. We then analyze the public TutorBench sample and show that agency-relevant behaviors are explicitly encoded in benchmark rubrics, especially in active-learning settings that reward guiding questions, calibrated hints, and non-disclosive scaffolding. Together, these findings suggest that educational-impact evaluation should not treat task success as a sufficient proxy for learning support. We argue that public tutoring benchmarks can better support positive-impact evaluation by reporting solving-oriented and pedagogy-oriented scores separately and by making disclosure-sensitive, student-agency-preserving criteria more explicit.

19.
arXiv (CS.AI) 2026-06-12

Mod-Guide: An LLM-based Content Moderation Feedback System to Address Insensitive Speech toward Indigenous Ethnic and Religious Minority Communities

arXiv:2606.13397v1 Announce Type: cross Abstract: Language operates as a mechanism of both marginalization and resistance, especially for minority communities navigating insensitive and harmful speech online. As content moderation increasingly depends on large language models (LLMs), concerns arise about whether these systems can recognize culturally insensitive speech-language that disregards or marginalizes the cultural and religious perspectives of historically underrepresented communities, often through implicit erasure, misrepresentation, or normative framing, rather than overt hostility. Focusing on Bangladesh's Hindu and Chakma communities – the country's largest religious and Indigenous ethnic minorities, respectively – this paper investigates the epistemic limits of LLM-based moderation systems and explores methods for incorporating minority perspectives. We co-created a culturally grounded corpus of insensitive speech with community members and integrated their narratives into moderation pipelines using retrieval augmented generation (RAG). Our tool, Mod-Guide, improves LLM sensitivity to minority viewpoints by leveraging contextual cues derived from lived experience. Through mixed-method evaluations involving both minority and majority participants, we demonstrate that RAG-enhanced moderation responses are more contextually accurate and perceived differently across ethnic lines. This work advances research in human-computer interaction, AI ethics, and social computing by foregrounding restorative justice and hermeneutical inclusion in the design of content moderation systems.

20.
bioRxiv (Bioinfo) 2026-06-22

PanRes: A database of latent and acquired antimicrobial resistance allowing 3D-based protein homology search

Antimicrobial resistance databases are central to genomic surveillance, but resistance determinants remain distributed across resources with different scopes, structures, and annotations. We developed PanRes, a curated resistance database of 11,717 genes integrating acquired and latent determinants of antibiotic, biocide, and metal resistance within a unified ontology. We predicted representative protein structures and clustered them by structural similarity, grouping proteins into 598 structurally conserved clusters coherent despite sequence divergence. Their structure-guided alignments were used to build Hidden Markov Models (HMMs) for remote homology search. In wastewater metagenomes from seven European cities, PanRes 3D-based HMMs expanded detection beyond high-confidence BLAST, with 35.2% of retained hits identified only by the HMMs and generally showing greater divergence from known proteins. For beta-lactamases, several proteins retained beta-lactamase-like folds and catalytic geometry despite weak sequence similarity. PanRes is available through an interactive web platform (https://panres.rambio.dk/), a structure-informed resource for exploring the whole resistome.

21.
arXiv (CS.AI) 2026-06-11

\texttt{Range-Arithmetic}: Verifiable Deep Learning Inference on an Untrusted Party

arXiv:2505.17623v2 Announce Type: replace-cross Abstract: Verifiable computing (VC) has gained prominence in decentralized machine learning systems, where resource-intensive tasks like deep neural network (DNN) inference are offloaded to external participants due to blockchain limitations. This creates a need to verify the correctness of outsourced computations without re-execution. We propose \texttt{Range-Arithmetic}, a novel framework for efficient and verifiable DNN inference that transforms non-arithmetic operations, such as rounding after fixed-point matrix multiplication and ReLU, into arithmetic steps verifiable using sum-check protocols and concatenated range proofs. Our approach avoids the complexity of Boolean encoding, high-degree polynomials, and large lookup tables while remaining compatible with finite-field-based proof systems. Experimental results show that our method not only matches the performance of existing approaches, but also reduces the computational cost of verifying the results, the computational effort required from the untrusted party performing the DNN inference, and the communication overhead between the two sides.

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

ASRU: Activation Steering Meets Reinforcement Unlearning for Multimodal Large Language Models

Multimodal large language models (MLLMs) may memorize sensitive cross-modal information during pretraining, making machine unlearning (MU) crucial. Existing methods typically evaluate unlearning effectiveness based on output deviations, while overlooking the generation quality after unlearning. This can easily lead to hallucinated or rigid responses, thereby affecting the usability and safety of the unlearned model. To address this issue, we propose ASRU, a controllable multimodal unlearning framework that incorporates generation quality as a core evaluation objective. ASRU first induces initial refusal behavior through activation redirection, and then optimizes fine-grained refusal boundaries using a customized reward function, thereby achieving a better trade-off between target knowledge unlearning and model utility. Experiments on Qwen3-VL show that ASRU significantly improves unlearning effectiveness (+24.6%) on average and generation quality (5.8X) on average while effectively preserving model utility, using only a small amount of retained supervision data.

23.
arXiv (CS.CL) 2026-06-15

Can Post-Training Turn LLMs into Good Medical Coders? An Empirical Study of Generative ICD Coding

Automated International Classification of Diseases (ICD) coding is a core medical-coding task for billing, epidemiology, and clinical decision support. Generative large language models (LLMs) are often reported as weak medical coders, but this finding mainly comes from inference-time settings such as prompting, retrieval, reranking, or tool use, leaving the role of task-specific post-training underexplored. We present a controlled empirical study of post-training for generative ICD coding, comparing discriminative baselines with LLM coders across prompting, supervised fine-tuning, and reinforcement learning under a common protocol and metric set. To our knowledge, this is the first study to evaluate RL-based post-training for generative LLM coders in ICD coding. We further introduce PHI, a diagnostic curriculum that extends GRPO to refine missed-code cases. Our results show that prompting-only evaluation substantially underestimates the potential of LLMs for ICD coding. SFT provides the main capability jump, GRPO further improves code-set prediction beyond SFT, and PHI provides targeted gains on macro-level performance. These findings suggest that the main bottleneck is not the generative formulation alone, but how the model is adapted and optimized for full-taxonomy recall. We release our code, data splits, and checkpoints at https://github.com/AlexandreWANG915/LLM4ICD.

24.
arXiv (CS.AI) 2026-06-12

Brick: Spatial Capability Routing for the Mixture-of-Models (MoM) Paradigm

arXiv:2606.13241v1 Announce Type: new Abstract: Defining query difficulty is one of the hardest problems in deployment engineering. Existing LLM routers rely on surface features such as domain labels, keywords, and token count, ignoring the within-domain variance that actually determines model success. Frontier models cost ten to one hundred times more than local open-weight models, so at production scale even small per-request savings become a direct cloud-bill lever. We present Brick, a multimodal router that scores each model on six capability dimensions, combines this with a per-query difficulty estimate, and dispatches via a cost-penalized geometric rule. A continuous preference knob lets operators slide between max-quality and max-saving profiles at deploy time. On a benchmark of 5,504 queries, Brick at max-quality reaches 76.98% accuracy, beating the best single model (75.02%) and all tested routers. At a neutral cost-quality profile, Brick achieves 74.11% accuracy at 4.71x lower cost than always using the strongest model. At min-cost, it cuts cost 22.15x with 11.85 points accuracy loss. Median latency drops from 51.2s to 22.8s.

25.
arXiv (CS.LG) 2026-06-18

Sequential Hiring of Contingent Workers Through Learning-Based Optimization

arXiv:2606.18438v1 Announce Type: cross Abstract: In this paper, we study a sequential workforce management problem in a contingent labor setting with uncertainty in both worker production and labor supply. A firm seeks to maximize cumulative profit by maintaining an active team of fixed size while learning worker productivity over time. We emphasize two critical operational frictions in this problem: replacing workers is costly, and workers may not be available immediately for hiring because of, for example, prior job commitments, scheduling constraints, or onboarding procedures. Thus, hiring decisions take effect only after a random delay. We formulate this problem as a stochastic multi-play bandit with costly switching and delayed actions, and develop a learning-based hiring policy, DR-UCB (DelayedReplacement-UCB), that makes replacement and hiring decisions sequentially through learning cycles. In each cycle, the policy uses real-time production data to determine when to initiate workforce changes and which workers to replace and hire. We show that the leading-order regret of the proposed policy matches its lower bound in its dependence on the time horizon. Our numerical experiments show that DR-UCB outperforms benchmark policies.