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01.
arXiv (CS.CV) 2026-06-24

PointVG-R: Internalizing Geometric Reasoning in MLLMs for Precise Pointing Localization via Visual Chain of Thought

Pointing-based visual grounding requires models to precisely locate target objects by deciphering complex spatial relationships between the visual scene and pointing gestures. Traditional methods typically encode input images into static feature representations and perform reasoning primarily within the linguistic domain, often overlooking the rich perceptual cues and explicit spatial geometry inherent in images. In this study, we aim to mitigate the cognitive vulnerability of models in interpreting gestural spatial relations by proposing PointVG-R, a reasoning-guided Multi-modal Large Language Model (MLLM). PointVG-R introduces geometric-aware reasoning for pointing-based grounding, enabling the model to think with images through the strategic integration of Reinforcement Learning (RL) and cold-start data. Specifically, we design a novel geometric reasoning pipeline that simulates the iterative cognitive process humans employ when interpreting pointing gestures. Furthermore, we construct EgoPoint-CoT, a high-quality visual Chain-of-Thought (CoT) dataset featuring detailed reasoning trajectories to guide the model via Supervised Fine-Tuning (SFT) and RL. To address the varying quality of learning signals encountered during training, we further propose an Adaptive Importance Weighting strategy based on Group Variance, which dynamically adjusts reward signals to optimize the learning process. Experimental results demonstrate that PointVG-R achieves SOTA performance, outperforming the baseline by $15.86$ points in mIoU. Extensive ablation studies further validate the efficacy of our proposed modules. Code: https://github.com/lingli1724/PointVG-R.

02.
arXiv (CS.CL) 2026-06-15

"I Didn't Make the Micro Decisions": Measuring, Inducing, and Exposing Goal-Level AI Contributions in Collaboration

As large language models (LLMs) increasingly shape how users form, refine, and extend their goals, attributing contributions in human-AI collaboration becomes critical for users calibrating their own reliance and for evaluators assessing AI-assisted work. Yet existing methods focus on final artifacts, missing the process through which goals themselves are jointly shaped. We introduce a goal-level attribution framework, CoTrace, that decomposes explicit goals into verifiable requirements and traces both direct contributions and indirect influences across dialogue turns. Applying CoTrace to 638 real-world collaboration logs, we find that while models account for only 11-26% of goal-shaping contribution, they contribute substantially more on introducing lower-level concrete requirements, and make various kinds of indirect contributions. Through controlled simulations, we show that interaction design choices significantly affect model goal-shaping behavior. In a user study, exposing participants to goal-level analyses shifts their perceived contributions by nearly 2 points on a 5-point scale, revealing systematic miscalibration in how users understand their own AI-assisted work.

03.
medRxiv (Medicine) 2026-06-23

Sex-Specific Hemostatic Responses and Diagnostic Potential of Platelet Distribution Width (PDW) and D-Dimer in Mild COVID-19, Malaria, and Co-Infection in a Tropical Setting: A Case-Control Study in Port Harcourt, Nigeria

Background: In malaria-endemic tropical regions, the overlapping coagulopathy in COVID-19 and malaria poses diagnostic and prognostic challenges, particularly with potential sex differences. This study evaluated sex-specific variations in platelet indices and fibrinolytic markers and assessed the utility of Platelet Distribution Width (PDW) and D-dimer in mild/asymptomatic cases. Methods: A case-control study was conducted with 220 participants (55 each in healthy controls, malaria-positive, COVID-19-positive, and COVID-19+malaria co-infected groups), aged 20-65 years, in Port Harcourt, Nigeria. Platelet indices were analysed using Sysmex XP-300 haematology analyser, while D-dimer and fibrinogen were measured by ELISA. Data were analysed using SAS 9.4 with ANOVA, Tukey's HSD, Pearson correlation, and sex-stratified comparisons. Results: PDW was significantly elevated in all infected groups compared to controls (malaria: 15.21 +/- 0.22 fL; COVID-19: 15.21 +/- 0.22 fL; co-infection: 15.61 +/- 0.21 fL vs. control: 13.26 +/- 0.17 fL; F=25.850, p < 0.001). D-dimer levels were highest in the co-infected group (553.42 +/- 59.74 ng/ml, F=2.816, p = 0.040). No significant changes were observed in other platelet indices or fibrinogen across groups. No significant correlation existed between platelet indices and the fibrinolytic markers. Males exhibited significantly higher D-dimer levels across all infected groups (p < 0.05) and higher fibrinogen in COVID-19 subjects (p = 0.036). Sex exerted a stronger influence on parameters than age. Conclusion: Males show heightened fibrinolytic activation in COVID-19 and malaria co-infection. PDW and D-dimer are promising, cost-effective biomarkers for screening mild infections in resource-limited tropical settings.

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

Entropy-Aware On-Policy Distillation of Language Models

On-policy distillation is a promising approach for transferring knowledge between language models, where a student learns from dense token-level signals along its own trajectories. This framework typically uses reverse KL divergence, encouraging the student to match the teacher's high-confidence predictions. However, we show that the mode-seeking property of reverse KL reduces generation diversity and yields unstable learning signals when the teacher distribution has high entropy. To address this, we introduce Entropy-Aware On-Policy Distillation. Our key idea is augmenting the standard reverse KL objective with forward KL when teacher entropy is high, capturing the full range of plausible outputs while retaining precise imitation elsewhere. It balances mode-seeking precision with mode-covering robustness without sacrificing on-policy training efficiency. Experiments show that our method maintains generation diversity (sustained token-level entropy) and improves student-teacher alignment (lower forward KL on high-entropy tokens). Across six math reasoning benchmarks, this yields Pass@8 accuracy gains of +1.37 for Qwen3-0.6B-Base, +2.39 for Qwen3-1.7B-Base, and +5.05 for Qwen3-4B-Base compared to baseline on-policy distillation methods. These results demonstrate that accounting for teacher uncertainty is essential for maintaining diversity and achieving effective knowledge transfer.

05.
medRxiv (Medicine) 2026-06-18

Distinct Neuronal, Proliferative, and Secretory Pathways are Perturbed in Cancer Survivors with Depressive Symptoms

Introduction Depression is highly prevalent among cancer survivors and may be biologically distinct, although clinical studies investigating these mechanisms remain limited. Thus, the aims of this study were to (1) identify perturbed biological pathways associated with depressive symptom severity in cancer survivors, and (2) investigate whether these pathways are common or distinct to those perturbed in an age-matched non-cancer cohort. Methods We analyzed cross-sectional self-reported and transcriptomic data from the Multi-Ethnic Study of Atherosclerosis (PHD #39341). Cancer survivors and an age-matched non-cancer cohort (target ratio 1:2) were identified. The 20-item Center for Epidemiologic Studies Depression Scale (CES-D) was used to split participants into low (CES-D

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

Graphical conditional generative modeling for digital twin modeling

arXiv:2606.16219v1 Announce Type: cross Abstract: Digital twin modeling, including control and data assimilation under model uncertainty, often faces an open-ended fidelity problem: adding variables, data streams, and time scales can indefinitely increase model complexity, ultimately producing systems that are difficult to maintain, validate, interpret, and use for stress or safety testing. As an alternative, one can seek parsimonious stochastic surrogate models built only on the variables needed to describe the relevant quantities of interest. We introduce a framework for discovering such variables from observational data by identifying which candidate inputs influence the full conditional law of a target quantity, rather than only its conditional mean. This distinction is essential in stochastic, coarse-grained, or partially observed systems, where dependencies may appear through changes in variability, tail behavior, multimodality, or uncertainty rather than through deterministic functional relationships. The framework couples conditional generative modeling, which learns the conditional distribution of the target given candidate inputs, with Gaussian-process-based analysis of variance (through kernel mode decomposition), which enables iterative pruning of non-influential inputs and interpretable structure discovery. In control settings, the resulting surrogate can be interpreted as a learned Markov decision process: the method identifies not only a transition model, but also the state, action, and memory variables needed to make the learned dynamics effectively Markovian. Across examples involving stochastic dynamical systems, missing variables, PDE control, reinforcement learning, and economic data, the discovered structures yield interpretable stochastic surrogates whose downstream performance is comparable to models trained on the full variable set.

07.
arXiv (CS.LG) 2026-06-11

Understanding Sample Efficiency in Predictive Coding

arXiv:2605.11911v2 Announce Type: replace Abstract: Predictive Coding (PC) is an influential account of cortical learning. Much of recent work has focused on comparing PC to Backpropagation (BP) to find whether PC offers any advantages. Small scale experiments show that PC enables learning that is more sample efficient and effective in many contexts, though a thorough theoretical understanding of the phenomena remains elusive. To address this, we quantify the efficiency of learning in BP and PC through a metric called ``target alignment'', which measures how closely the change in the output of the network is aligned to the output prediction error. We then derive and empirically validate analytical expressions for target alignment in Deep Linear Networks. We show that learning in PC is more efficient than BP, which is especially pronounced in deep, narrow and pre-trained networks. We also derive exact conditions for guaranteed optimal target alignment in PC and validate our findings through experiments. We study full training trajectories of linear and non-linear models, and find the predicted benefits of PC persist in practice even when some assumptions are violated. Overall, this work provides a mechanistic understanding of the higher learning efficiency observed for PC over BP in previous works, and can guide how PC should be parametrised to learn most effectively.

08.
arXiv (math.PR) 2026-06-16

Layerwise Terminal Discrepancy in Chen's Reverse-Heat Coupling on the Boolean Cube

arXiv:2606.04573v2 Announce Type: replace-cross Abstract: Recently, Chen [Chen2026] proved that Talagrand's Boolean convolution conjecture holds up to the dimension-free factor \((\log\log\eta)^{3/2}\), namely for every fixed \(\tau>0\), \[ \mu\{P_\tau f>\eta\|f\|_1\} \le C_\tau \frac{(\log\log\eta)^{3/2}}{\eta\sqrt{\log\eta}}, \qquad \eta>e^3. \] We revisit the terminal testing-discrepancy step in Chen's perturbed reverse-heat coupling. Chen estimates this discrepancy globally in terms of the remaining gap to the terminal level. We keep the same coupling and the same reverse-heat formulations, but localize the terminal discrepancy on each remaining-gap layer before summing the layers. This changes the fixed-time anti-concentration cost from order \((\log L)^{3/2}/\sqrt L\) to order \((\log L)/\sqrt L\), where \(L=\log\eta\). Consequently, we obtain a \((\log\log\eta)^{1/2}\) improvement as \[ \mu\{P_\tau f>\eta\|f\|_1\} \le C_\tau \frac{\log\log\eta}{\eta\sqrt{\log\eta}}, \qquad \eta>e^3. \]

09.
PLOS Medicine 2026-06-12

Placenta accreta spectrum in the 21st century: Challenging dogma and redefining disorder

by Eric Jauniaux, Helena C. Bartels, Yalda Afshar Placenta accreta spectrum (PAS) is a serious pregnancy complication caused by abnormal placental attachment to the uterus. In this Perspective, Eric Jauniaux and colleagues discuss emerging evidence that challenges our long-held pathophysiological understanding of PAS, and argue that a critical reassessment of definition, diagnosis, and management is overdue. In this Perspective, Jonathan Evans and colleagues discuss why restricting access to joint replacement surgery based on BMI alone is not supported by evidence, and highlight how such rest rictions risk exacerbating stigma, inequity and avoidable harm to those who would benefit from surgery.

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

Incentives and Evidence in Learned Service Orchestration

arXiv:2606.16555v1 Announce Type: cross Abstract: Reinforcement learning for service orchestration has been the subject of sustained research for over a decade, yet it is not used in production at scale. The usual explanation is that learned controllers degrade under delayed and noisy telemetry, workload shifts, and uncontrolled tenants. We test whether existing evidence supports that explanation. We evaluate three highly influential RL-based orchestration systems spanning resource allocation, DAG scheduling, and autoscaling, using pre-registered predictions about comparative degradation under production-relevant perturbations and paired inference with family-wise error correction. Across the tests, most predicted performance reversals do not occur. Diagnostic analyses show that these outcomes often reflect comparator collapse, artefact limitations, or evaluation choices rather than evidence that learned controllers tolerate the perturbations. One apparent advantage under observation lag is roughly fortyfold compared to a Kubernetes HPA-equivalent controller. Another widely cited result cannot be reconstructed from its released artefact, and the strongest reproducible margin is far smaller than the published results. Conclusions also reverse under changes in perturbation magnitude and evaluation mode. Based on these results and broader patterns in the literature, we identify an institutional problem. Publication and review incentives favour benchmark gains against convenient comparators, even when those gains provide little evidence of deployment performance. We argue that the problem is not solely technical. Rather, it is institutional, so learned orchestration needs production-grade comparators, registered perturbation models, separate operational metrics, and publication criteria that reward reproducible operational evidence. Without these changes, the literature can grow without establishing whether learning improves orchestration.

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

Evaluation Sovereignty in Metadata-Driven Classification: A Multi-Track Framework for Weakly Supervised Information Systems

arXiv:2606.13436v1 Announce Type: new Abstract: Evaluation in machine learning is typically treated as a neutral measurement process. However, in operational information systems, evaluation outcomes are often conditioned by the processes used to generate labels. This paper does not seek to improve classification performance. Instead, it examines the validity of performance measurement under differing label-authority regimes. This issue is particularly relevant in large-scale metadata-driven systems, where labels are often incomplete, inconsistent, or weakly supervised. We introduce evaluation sovereignty, defined as the degree to which performance metrics are independent of label authority and supervision regime, and propose a multi-track evaluation framework that systematically varies training and evaluation label sources. Using hierarchical multi-label classification on large-scale scientific metadata, we demonstrate that models exhibiting strong performance under operational ("silver") evaluation degrade substantially under independent ("gold") evaluation, particularly for fine-grained classification. For example, Micro-F1 decreases from approximately 0.54 to 0.03. Notably, ranking-based metrics remain above baseline, revealing a divergence between latent model signal and classification validity. These findings suggest that commonly reported performance metrics may reflect alignment with labeling processes rather than true predictive capability. We therefore reconceptualize evaluation validity as a system-level property shaped by label governance and provide a practical methodology for auditing intelligent systems operating under weak supervision.

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

Sub-Token Routing for KV Cache Compression

Transformer inference often requires a large KV cache, especially for long-context language modeling and multimodal generation. Existing compression methods usually reduce cache cost by selecting, evicting, quantizing, or compressing cached tokens, or by reducing the visual-token sequence before language-model inference. We introduce sub-token routing, a KV-compression method that adds a finer control axis inside retained tokens. It splits each retained value vector into groups and keeps only selected groups, while leaving query and key states unchanged. The method is designed to work after token-level reduction. First, a token-reduction method determines which tokens are retained. Then, sub-token routing compresses the value states inside those retained tokens. Experiments under matched KV budgets show that adding sub-token routing improves token-level reduction performance in both LLM and VLM settings, including Quest on LLaMA-2-7B and Qwen2.5-7B, and FastV/VisionZip across LLaVA and Qwen-VL models. The gains are larger at smaller KV budgets, suggesting that value-group routing is especially useful when further token removal becomes costly. Overall, token-level reduction and sub-token routing provide complementary ways to reduce KV cost.

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

Geometric Algebra Quantum Gate Decomposition

arXiv:2606.12480v1 Announce Type: new Abstract: Quantum gates are usually described through matrix and tensor-product formalisms that often obscure their geometric structure. In this work, we formulate the Pauli and Clifford groups within the complex Geometric Algebra (GA) framework. We show that the Pauli group is naturally identified with the group of blades up to a global phase, thereby providing a geometric interpretation of Pauli operators and their commutation relations in terms of oriented subspaces. We further prove that Clifford operators are generated by products of {\pi}/4-Pauli rotors and introduce a greedy Pauli rotor decomposition algorithm whose empirical behavior suggests unexpectedly compact decompositions for Clifford operators. Finally, we show that Clifford+T universality admits a natural geometric interpretation through {\pi}/8-rotors within this framework.

14.
arXiv (quant-ph) 2026-06-19

Exact Markovian Dissipation Requires Singular Energy Resources

arXiv:2606.19510v1 Announce Type: new Abstract: The Gorini–Kossakowski–Lindblad–Sudarshan (GKLS) equation describes irreversible quantum dynamical semigroups. We show that this description cannot be exact under physically regular energy conditions. We prove that the open-system survival probability under physically regular energy conditions has sublinear decay, whereas any dissipative GKLS semigroup has a linear short-time decay. Hence exact Markovian dissipation requires singular energy resources: an unbounded-below total Hamiltonian or infinite initial energy, and a divergent interaction-energy moment. Therefore, a dissipative time-independent GKLS equation should be regarded as an effective description rather than the exact reduced dynamics of a Hamiltonian dilation satisfying physically regular energy conditions.

15.
arXiv (CS.CV) 2026-06-16

Lesion-DDPM: Lesion-Enhanced 3D Diffusion for MS MRI Synthesis

3D FLAIR MRI is widely recommended as one of the standard MRI sequences for brain imaging in multiple sclerosis (MS), but publicly available MS datasets remain relatively small and vary across scanners, acquisition protocols, and lesion patterns. This scarcity and variability hinder the development of robust neuroimaging machine learning models and are particularly challenging for generative models that aim to synthesize images while preserving small, sparse lesions. We propose Lesion-DDPM, a 3D conditional diffusion framework for lesion-aware FLAIR synthesis that incorporates multi-level anatomical mask injection together with a lesion-weighted reconstruction loss to emphasize lesion voxels while maintaining global brain structure. Using a curated subset of the MSLesSeg dataset, we compare Lesion-DDPM with representative state-of-the-art GAN- and diffusion-based models, assessing both image-generation metrics and downstream 3D U-Net segmentation. In our experiments, Lesion-DDPM achieved the lowest lesion-region reconstruction error among all methods. In a downstream 3D U-Net lesion segmentation task, a model trained only on Lesion-DDPM-generated scans and evaluated on real MRIs reached a Dice score of 0.616 compared with 0.569 for the best competing synthetic dataset. When Lesion-DDPM images were added to the real training set, the Dice score further increased to 0.685.

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

Precision Physical Activity Prescription via Reinforcement Learning for Functional Actions

arXiv:2605.19208v2 Announce Type: replace-cross Abstract: Physical activity (PA) plays an important role in maintaining and improving health. Daily steps have been a key PA measure that is easily accessible with common wearable devices. However, methods are lacking to recommend a personalized optimal distribution of daily steps over a period of time for the best of certain health biomarkers. In this paper, we fill this void based on the data from the All of Us Research Program which includes months of step counts as well as repeated measurements of key health biomarkers. We develop a new offline reinforcement learning (RL) algorithm to learn personalized and optimal PA distributions associated with cardiometabolic risk, where the action is a function representing the daily step distribution over a period of time. Simulation studies demonstrate the advantage of the proposed approach over existing continuous-action RL methods. The learned optimal policy from the All of Us data generally suggests people take more daily steps and also follow a more consistent pattern of PA over time while offering tailored recommendations for subgroups in blood glucose level, body mass index, blood pressure, age, and sex.

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

ActiTect: A Generalizable Machine Learning Pipeline for REM Sleep Behavior Disorder Screening through Standardized Actigraphy

arXiv:2511.05221v3 Announce Type: replace Abstract: Isolated rapid eye movement sleep behavior disorder (iRBD) is a major prodromal marker of $\alpha$-synucleinopathies, often preceding the clinical onset of Parkinson's disease, dementia with Lewy bodies, or multiple system atrophy. While wrist-worn actimeters hold significant potential for detecting RBD in large-scale screening efforts by capturing abnormal nocturnal movements, they become inoperable without a reliable and efficient analysis pipeline. This study presents ActiTect, a fully automated, open-source machine learning tool to identify RBD from actigraphy recordings. To ensure generalizability across heterogeneous acquisition settings, our pipeline includes robust preprocessing and automated sleep-wake detection to harmonize multi-device data and extract physiologically interpretable motion features characterizing activity patterns. Model development was conducted on a cohort of 78 individuals, yielding strong discrimination under nested cross-validation (AUROC = 0.95). Generalization was confirmed on a blinded local test set (n = 31, AUROC = 0.86) and on two independent external cohorts (n = 113, AUROC = 0.84; n = 57, AUROC = 0.94). To assess real-world robustness, leave-one-dataset-out cross-validation across the internal and external cohorts demonstrated consistent performance (AUROC range = 0.84-0.89). A complementary stability analysis showed that key predictive features remained reproducible across datasets, supporting the final pooled multi-center model as a robust pre-trained resource for broader deployment. By being open-source and easy to use, our tool promotes widespread adoption and facilitates independent validation and collaborative improvements, thereby advancing the field toward a unified and generalizable RBD detection model using wearable devices.

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

Tail-Shape Estimation in LLM Evaluation Is Fragile: A Protocol for Diagnosing False Positives

作者:

arXiv:2606.16511v1 Announce Type: new Abstract: Recent work motivates moving large language model (LLM) evaluation from mean-based to tail-aware metrics, including conditional value-at-risk and tail-index estimates of reward-model error. We ask whether the canonical extreme-value-theory tail-index parameter, which isolates how heavy a tail is from how large the tail mass is, adds discriminative information beyond the mean and a standard tail-magnitude statistic in LLM evaluation. We pre-register a protocol covering admissibility, goodness-of-fit, threshold-stability, and effect-size requirements for any positive tail-shape claim. The protocol is the contribution of this paper; the empirical study below is a demonstration of what its gates catch. Applied to a standard LLM toxicity-evaluation setup under two structurally different scorer families, the protocol catches three distinct modes of false positives that a naive analysis would have published, and rejects the headline tail-shape claim on both scorers. We conclude that tail-shape estimation in the LLM toxicity-evaluation setups we examined is more fragile than the recent literature suggests, and recommend the protocol as a starting point for tail-index claims in similar setups.

20.
arXiv (CS.AI) 2026-06-24

Skills for the future software profession: beyond agentic AI!

arXiv:2606.21894v2 Announce Type: replace-cross Abstract: As coding agents are rapidly changing software engineering, a natural question is: what are the core skills needed by future software engineers? To identify where software engineering is headed and thus what skills will be needed, we summarize the results of two round-tables with researchers and industrial practitioners, held in 2026 in New York and Singapore. One key finding is that verification and validation is increasing in importance as agents handle implementation, as highlighted by anecdotes from the events. From our observations, we identify the skills developers need in the agentic era of development, with implications for training and educating future software engineers in coming years.

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

Self-Supervised Multisensory Pretraining for Contact-Rich Robot Reinforcement Learning

arXiv:2511.14427v4 Announce Type: replace-cross Abstract: Effective contact-rich manipulation requires robots to synergistically leverage vision, force, and proprioception. However, Reinforcement Learning agents struggle to learn in such multisensory settings, especially amidst sensory noise and dynamic changes. We propose MultiSensory Dynamic Pretraining (MSDP), a novel framework for learning expressive multisensory representations tailored for task-oriented policy learning. MSDP is based on masked autoencoding and trains a transformer-based encoder by reconstructing multisensory observations from only a subset of sensor embeddings, leading to cross-modal prediction and sensor fusion. For downstream policy learning, we introduce a novel asymmetric architecture, where a cross-attention mechanism allows the critic to extract dynamic, task-specific features from the frozen embeddings, while the actor receives a stable pooled representation to guide its actions. Our method demonstrates accelerated learning and robust performance under diverse perturbations, including sensor noise, and changes in object dynamics. Evaluations in multiple challenging, contact-rich robot manipulation tasks in simulation and the real world showcase the effectiveness of MSDP. Our approach exhibits strong robustness to perturbations and achieves high success rates on the real robot with as few as 6,000 online interactions, offering a simple yet powerful solution for complex multisensory robotic control. Website: https://msdp-pearl.github.io/

22.
medRxiv (Medicine) 2026-06-23

Differential Recovery Trajectories of Emergency Otolaryngologic Conditions across the COVID-19 Pandemic: A Six-year Longitudinal Study from an Urban Emergency Center

作者:

Objective: The COVID-19 pandemic markedly altered social activity patterns, healthcare utilization, and the epidemiology of infectious diseases. However, its long-term impact on emergency otolaryngologic conditions remains incompletely understood. This study investigated long-term trends in emergency otolaryngologic conditions before, during, and after the COVID-19 pandemic using comprehensive data from a large urban emergency clinic in Osaka, Japan. Methods: All new otolaryngologic outpatients who visited the Chuo Emergency Medical Clinic (CEMC) in Osaka City between 2019 and 2024were retrospectively analyzed. Annual trends in absolute numbers and relative proportions of emergency otolaryngologic conditions were examined by anatomical region and disease category, using 2019 as the pre-pandemic baseline. Results: A total of 99,324 new otolaryngologic outpatients were analyzed. Overall emergency visits declined sharply to approximately half of baseline in 2020, followed by a gradual but incomplete recovery toward pre-pandemic levels by 2024. Most anatomical categories declined to 45-61% of baseline in 2020 and exhibited gradual yet incomplete recovery through 2023; in stark contrast, laryngeal conditions diverged sharply, surging beyond pre-pandemic levels after 2022. Acute infectious otorhinolaryngologic diseases fell to 23-50% of baseline in 2020 and showed variable recovery (69-103%) by 2024. Notably, laryngitis exceeded the baseline, reaching 132% in 2023, whereas epiglottic edema exhibited only a transient increase approaching the baseline in 2021. Non-infectious emergency conditions generally showed only a marginal decrease in 2020 and remained relatively stable throughout the study period, except for sudden sensorineural hearing loss (SSNHL), which dropped sharply to 39% of the baseline in 2020 and remained persistently reduced through 2024. Traumatic emergencies declined variably to 53-81% of the baseline in 2020, followed by an incomplete recovery, reaching only 55-69% by 2024. Conclusion: Emergency otolaryngologic conditions demonstrated heterogeneous recovery trajectories following the COVID-19 pandemic. While most infectious and traumatic conditions gradually but incompletely normalized, laryngeal conditions showed a distinct post-pandemic surge, and SSNHL remained persistently suppressed. These findings reveal heterogeneous, condition-specific recovery trajectories that reflect both genuine shifts in community pathogen burden, true traumatic incidence, and persistent alterations in healthcare-seeking behaviors, insights essential for resource allocation during future public health emergencies.

23.
medRxiv (Medicine) 2026-06-22

Histologically validated diffusion MRI signatures of neuroinflammation and neurodegeneration in Alzheimer disease

Noninvasive neuroinflammation measurement remains a major barrier for Alzheimer disease (AD) therapeutics. We present generalized diffusion basis spectrum imaging (g-DBSI), a diffusion MRI framework that decomposes the tissue signal into biologically interpretable microstructural compartments. In postmortem Knight ADRC brains, g-DBSI-derived restricted isotropic fraction (RIF) and restricted anisotropic fraction (RAF) mapped cellularity and neurofilament density, while their ratio (RIF/RAF) tracked inflammatory cell density and peri-plaque amyloid-beta with higher specificity and regional consistency than RIF alone. In 112 living Knight ADRC participants stratified by PET amyloid, g-DBSI metrics showed amyloid-dependent trajectories: in low-amyloid individuals, RIF and RAF rose together with amyloid, consistent with early neuropil expansion and glial elaboration, whereas in high-amyloid individuals, RIF/RAF increased, and RAF declined, indicating established neuroinflammatory remodeling and neurofilament loss. CSF proteomics linked RIF/RAF to glia-enriched immune and vascular pathways, supporting g-DBSI as a clinically compatible MRI biomarker of neuroinflammation and neurodegeneration in AD.

24.
arXiv (CS.AI) 2026-06-15

I'm Sorry Driver, I'm Afraid I Can't Do That: Appraising the Safety of LLMs within Automotive Contexts

arXiv:2606.14327v1 Announce Type: cross Abstract: This paper appraises recent frameworks within AI development to integrate LLMs into control tasks in automotive contexts from the perspective of safety assurance. This work has built upon the rapid integration of LLMs across automotive settings. However, we find that at present, these frameworks face significant challenges, limiting their efficacy in real-time safety-critical contexts. Firstly, we consider conceptual challenges, including the fact that deployers are faced with a dual challenge, wherein they must assure a model which has been developed upstream, i.e. as general-purpose tools by the large AI labs, in a downstream context, i.e. into specific vehicle architectures. Secondly, we consider concrete challenges from across existing standards. We show that there are currently both fundamental engineering constraints covered in ISO21448, such as latency, and novel LLM-specific issues, such as alignment-related issues covered in ISO/PAS8800. We ground both examples in a concrete introductory, experimental case study exploring an existing open-source repository, Talk2Drive. We present a safety argument in order to make explicit the limitations of existing solutions. Nonetheless, given that the use of LLMs in automotive contexts is being explored at a technical level and operationalised, we propose potential assurance mechanisms for LLM-related hazardous events going forward.

25.
arXiv (CS.LG) 2026-06-16

A Compositional Framework for Open-ended Intelligence

arXiv:2606.15386v1 Announce Type: new Abstract: Open-ended intelligence is the capacity to adapt to novel problems and environments that are substantially different from those in training. We formalize open-ended intelligence as the closure induced by a finite primitive set \(P\) and a set of composition operators \(C\). We characterize properties of the induced closure \(\mathcal{L}(P,C)\) that support unbounded compositional generation across families of tasks and worlds. A mathematics of open-ended intelligence requires two pillars: a minimal set of representational primitives (e.g., states, actions) and algorithmic primitives (e.g., nearest neighbor), together with composition motifs (e.g., recursion, sequencing) that reflect an acquired compositional grammar. The closure of these two pillars enables the generation of infinite adaptive responses across a wide range of settings. The mathematics supports complementary research agendas, including evaluation metrics for explanation and interpretability, as well as building architectures where compositional generalization is native. We propose next primitive prediction as a novel architectural objective, where the training objective encourages the acquisition of reusable algorithmic primitives and their compositional grammar, such that new solutions are generated through recombination. Curriculum learning and self-play enable lifelong learning and expansion of the closure by discovering reusable primitives and transition motifs across families of tasks and worlds. We ground the framework through case studies in physics, evolution, and neuroscience.