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01.
arXiv (CS.CV) 2026-06-25

EchoStyle: Unlocking High-Fidelity Video Stylization with Reverse Data Synthesis

While image stylization has been studied extensively, video stylization remains a critical and largely unsolved challenge in the field of intelligent content creation. Existing methods, usually utilizing a reference image as the style prior, suffer from content leakage, data scarcity and limited adaptability to long videos, leading to suboptimal results with severe style drift and motion distortion. For these issues, we present EchoStyle, a scalable text-driven framework to achieve high-quality stylization of videos with arbitrary lengths. To start with, we construct a video-to-video architecture to appropriately re-fuse the video content and the text style. To address data scarcity, we pioneer an automatic reverse-synthesis pipeline to establish V-Style20k, a large-scale stylization dataset of 20k high-quality video pairs. To facilitate long video stylization, we devise an init-follow-mode mechanism along with a sliding-window inference strategy. Extensive experiments demonstrate EchoStyle's excellent performance across a wide range of artistic styles, even comparable to leading closed-source solutions.

03.
arXiv (CS.LG) 2026-06-24

The Cost Geometry of Belief: finite-resource inference under noisy observation

arXiv:2606.21585v2 Announce Type: replace Abstract: A finite machine's digital twin of a system observes the territory through finite, noisy sensors; we model its coherent output as a belief, a probability density over states, the Bayes posterior, never a point. Certainty, the perfect twin, is denied twice, by observation and by physics, both read off the Fisher information. To make this finiteness geometric, we model what it costs to change a belief: a belief-cost geometry, optimal transport in Wasserstein space reweighted conformally by Fisher information. The framework rests on two posed commitments: that revision cost is a scalar price on transport (the arena), and that the price is honest: one nat costs the same length everywhere. Honesty selects the Fisher reweighting because transport demotes the Fisher information from the metric ruler of distinguishability to the slope of entropy, the move that sets transport apart from Fisher-Rao. From these two postulates, three results follow on the conformal class (essentially location-scale), all invariants of one change of cost unit. A wall: a well-posed inference rejects certainty to infinite distance as soon as the cost dominates the Fisher information (necessity conjectured beyond power laws). An honest family: the eikonal price where each nat the same length everywhere, is equivalent to proportionality U=cJ, the Fisher family. A rigidity: these geometries are hyperbolic, and the Stam bound crowns the Gaussian, the most hyperbolic location-scale belief; -1/4 is one image of a relativity of cost. The cost of reaching a given precision then has a geometric cost floor diverging at certainty. Thermodynamics fixes the cost unit and motivates the framework; the results are geometric, in nats.

04.
arXiv (CS.CV) 2026-06-15

FBSDiff++: Improved Frequency Band Substitution of Diffusion Features for Efficient and Highly Controllable Text-Driven Image-to-Image Translation

With large-scale text-to-image (T2I) diffusion models achieving significant advancements in open-domain image creation, increasing attention has been focused on their natural extension to the realm of text-driven image-to-image (I2I) translation, where a source image acts as visual guidance to the generated image in addition to the textual guidance provided by the text prompt. We propose FBSDiff, a novel framework adapting off-the-shelf T2I diffusion model into the I2I paradigm from a fresh frequency-domain perspective. Through dynamic frequency band substitution of diffusion features, FBSDiff realizes versatile and highly controllable text-driven I2I in a plug-and-play manner (without need for model training, fine-tuning, or online optimization), allowing appearance-guided, layout-guided, and contour-guided I2I translation by progressively substituting low-frequency band, mid-frequency band, and high-frequency band of latent diffusion features, respectively. In addition, FBSDiff flexibly enables continuous control over I2I correlation intensity simply by tuning the bandwidth of the substituted frequency band. To further promote image translation efficiency, flexibility, and functionality, we propose FBSDiff++ which improves upon FBSDiff mainly in three aspects: (1) accelerate inference speed by a large margin (8.9$\times$ speedup in inference) with refined model architecture; (2) improve the Frequency Band Substitution module to allow for input source images of arbitrary resolution and aspect ratio; (3) extend model functionality to enable localized image manipulation and style-specific content creation with only subtle adjustments to the core method. Extensive qualitative and quantitative experiments verify superiority of FBSDiff++ in I2I translation visual quality, efficiency, versatility, and controllability compared to related advanced approaches.

05.
medRxiv (Medicine) 2026-06-23

Estimating vaccine-prevented disease outcomes when vaccination has only direct effects

Vaccination can be a useful intervention for reducing infectious disease burden. Estimating numbers of vaccine-prevented health outcomes is one approach to quantifying the benefits of vaccination. Here we improve a method described by Foppa et al. (1) that assumes vaccination has only direct effects, that is, it cannot prevent infection or onward transmission of the disease. We rederive this method and derive an improved method that increases estimation accuracy with minimal additional analytical complexity. To evaluate the improved method, we simulated disease outbreaks and compared the accuracy of the two methods for estimating prevented disease outcomes. In 84% of simulations performed over a wide parameter space, the improved method had an equal or smaller estimation error compared to the original Foppa method, with 7.9-fold smaller mean error and 44-fold smaller standard deviation of errors. Our study improves a method for estimating prevented burden when assuming vaccination has only direct effects.

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

AI Economist Agent: An Agentic Framework for Model-Grounded Economic Analysis with RAG, Knowledge Graphs, and Large Language Models

arXiv:2606.20041v1 Announce Type: cross Abstract: We propose a model-grounded RAG-based AI economist with an agentic framework for economic scenario analysis using large language models (LLMs) and knowledge graphs. While LLMs can generate fluent economic narratives, economists are often required to make economic claims grounded by economic theory and real-world data. Based on this motivation, this study proposes an RAG-based AI economist, which utilizes knowledge graphs including economic data and theory and LLM-based agents to plan the analysis, retrieve relevant evidence, select appropriate models, and generate reports. In our framework, we do not produce quantitative claims directly with the language model alone; instead, we generate narratives grounded in explicit model-based computations and linked to the retrieved evidence via AI agents. We refer to our framework as an AI economist agent. We evaluate the AI economist agent in two applications: economist report generation for U.S. inflation persistence and Federal Reserve policy, and bank stress-test narrative generation for U.S. commercial real estate refinancing stress. The results illustrate how grounding the generated reports improves their economic coherence and traceability.

07.
arXiv (CS.AI) 2026-06-19

Triangular Consistency as a Universal Constraint for Learning Optical Flow

arXiv:2606.19938v1 Announce Type: cross Abstract: We propose triangular consistency as a first-principled constraint for optical flow, which is agnostic to network architecture, supervision type, and dataset, and applies to both image-pair and multi-frame settings. This simple but powerful constraint is to compose two flows to induce a third flow and enforce consistency among the three. The composed flows may arise from (i) image pairs, yielding cycle consistency; (ii) multiple video frames, producing longer-range motion through temporal chaining; or (iii) image pairs combined with controlled synthetic transformations, which becomes data augmentation. This triangular consistency introduces negligible computational overhead and requires no additional annotations. Since it is derived directly from the geometry of optical flow, it does not rely on model-specific assumptions and serves as a ``universal'' plug-and-play component for optical flow training. Experiments show consistent improvement across supervised, unsupervised, and transfer learning settings.

08.
arXiv (quant-ph) 2026-06-11

On-Chip Quantum Randomness Amplification

arXiv:2606.12173v1 Announce Type: new Abstract: Randomness amplification, the task of extracting uniform private bits from biased seeds that may be partly known by a malicious third party, is of central importance in cryptography. The highest security in this task is provided by a class of quantum protocols known as device-independent, which however are challenging to integrate into scalable devices. Semi-device-independent (SDI) protocols are a promising alternative that guarantees security under few natural assumptions, such as bounds on the amount of energy used by the devices. Here, we provide the first demonstration of SDI randomness amplification on an integrated silicon photonic chip, achieving a throughput rate of 20 Mbps suitable for practical applications. This rate is achieved through a novel technique for SDI entropy certification, which delivers strictly tighter von Neumann entropy bounds compared to existing methods and remains valid even if the preparation and measurement devices share quantum correlations. Overall, the methods developed in this work enable the integration of SDI technology into portable telecom devices, opening up a new generation of quantum cryptographic hardware.

09.
arXiv (CS.AI) 2026-06-17

Shattering the Autoregressive Curse: Dynamic Epistemic Entropy Orchestrated Erasable Reinforcement Learning for LLMs

arXiv:2606.17735v1 Announce Type: new Abstract: Although reinforcement learning (RL) has expanded the cognitive boundaries of large language models (LLMs), it often remains vulnerable to the autoregressive curse in long-horizon logical reasoning: small epistemic perturbations introduced early in generation can propagate irreversibly along the Markov decision process flow, triggering cascading failures that drive the reasoning trajectory toward collapse. To overcome this autoregressive cascade, in which a single early mistake can compromise all subsequent reasoning steps, we propose dynamic epistemic entropy orchestrated erasable reinforcement learning ($E^3RL$). $E^3RL$ eliminates reliance on external signals by grounding the model's endogenous local autoregressive cross-entropy as an intrinsic coordinate of epistemic uncertainty. By introducing segment-level adaptive dynamic thresholds and advantage allocation, $E^3RL$ enables the model to precisely excise localized logical defects while reusing historical key-value (KV) cache streams, thereby endowing the reasoning process with a self-healing capability. We train $E^3RL$ on the DeepMath-103k dataset. Experimental results show that $E^3RL$ reshapes the exploration efficiency of long-sequence reasoning and improves sample efficiency while maintaining linear memory overhead. On mathematical reasoning benchmarks such as AIME, $E^3RL$ achieves substantial performance gains, with the 4B and 8B parameter models surpassing previous state-of-the-art (SOTA) results by 5.349\% and 6.514\%, respectively. These findings suggest that $E^3RL$ shatters the autoregressive curse in long-sequence reasoning and establishes a theoretical and systems-level foundation for the next generation of self-healing artificial general intelligence (AGI).

10.
arXiv (CS.AI) 2026-06-15

Design Methodology and Performance Trade-offs Management for Distributed and Compound AI Systems

arXiv:2606.14350v1 Announce Type: cross Abstract: Artificial Intelligence (AI) systems must typically satisfy service-level objectives including accuracy, latency, and cost. The prevailing model-centric approaches select a monolithic model at design time and apply identical computation regardless of input difficulty, cannot decompose tasks across specialized components, and have knowledge that is fixed at training time. During runtime, this can lead to performance degradation and increasing costs. Because the model is the main design variable, it determines the majority of system behavior, coupling operational objectives to a single design-time choice. Addressing these limitations requires shifting from model-centric to system-centric design. Compound AI systems realize this shift by orchestrating multiple models, algorithms, and tools as distributed AI systems through explicit control logic. The performance of such systems depends on their workflow topology, the models assigned to each task, and the parameters governing runtime behavior. We present a design methodology that organizes this space along two dimensions, workflow topology and configuration selection, and identifies eight design patterns, each consolidating techniques to address a specific limitation of monolithic deployment. We validate our methodology through three case studies. Across our case studies, Compound AI configurations approach accuracy of monolithic models within 2.5 to 4 percentage points while reducing latency by up to 60% and cost by up to 71%. We show that model selection and parameter configuration jointly determine system performance, but the resulting design space grows combinatorially, as workflows compose more patterns and components. Thus, we identify five open challenges that define a roadmap from manually configured prototypes towards systems that automatically discover and maintain SLO-compliance in Compound and Distributed AI systems.

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

TAROT: Task-Adaptive Refinement of LLM-prior Graphs for Few-shot Tabular Learning

arXiv:2606.11640v1 Announce Type: cross Abstract: Few-shot tabular learning provides a cost-effective approach for real-world applications where annotation is costly and collecting sufficient samples for new tasks is difficult. Existing Traditional and LLM-based methods have demonstrated effectiveness in few-shot scenarios. However, traditional methods need additional training on unlabeled or generated data, which incur significant computational overhead. In addition, LLM-based methods that directly feed raw tabular data into LLMs raise privacy and compliance concerns. More importantly, both paradigms largely overlook the semantic relationships between features, which provide structural and semantic prior for constructing a semantic graph. Semantic graph is essential for modeling meaningful feature interactions in few-shot scenarios. In this paper, we propose TAROT, a GNN-based framework that encodes the structural and semantic prior by constructing and refining a task-adaptive semantic graph from this prior, thereby improving predictive performance in few-shot tabular learning. TAROT first encodes heterogeneous tabular data into unified node semantic representations via a Unified Semantic Tabular Node Encoder (USTNE). Then, it prompts LLMs to infer the semantic relationship between features based on the task description and feature names to construct a semantic graph. To mitigate structural noise introduced by the hallucination of LLMs, TAROT introduces Task-adaptive Semantic Graph Refinement that prunes spurious or task-unrelated edges and adds missing task-related ones, aligning the graph structure with the downstream objective. Finally, a GNN performs message passing over the refined graph to capture task-related semantic dependencies for prediction. Extensive experiments on various few-shot tabular learning benchmarks demonstrate the superior performance of TAROT, establishing it as a state-of-the-art approach in this domain.

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

Applicability Condition Extraction for Therapeutic Drug-Disease Relations

arXiv:2606.14031v1 Announce Type: new Abstract: Identifying conditions that a certain drug takes therapeutic effect on a target disease is crucial for clinical decision-making support. However, most existing biomedical information extraction methods have focused on identifying only relations between drugs and diseases, while largely overlooking the context-specific conditions where such relations can apply. To address this problem, we introduce the task of applicability condition extraction for therapeutic drug–disease relations from biomedical research literature. We create the first dataset that has manually annotated triples of drugs, diseases, and applicability conditions on biomedical paper abstracts with 1,119 drug-disease pairs. Using this dataset, we systematically evaluate the performance of a range of existing methods. In addition, we propose a new method that enhances LoRA to consider relations between drugs and diseases. Our method consistently outperforms strong baselines across different evaluation settings. The source code and dataset of this paper can be obtained from: https://github.com/guantingluo98/Drug-ACE

13.
medRxiv (Medicine) 2026-06-17

Brain age gap correlates with DTI-derived microstructural abnormalities in multiple sclerosis.

Background: Brain age gap (BAG) is increased in multiple sclerosis (MS), but whether it reflects microstructural pathology beyond conventional atrophy remains unclear. Objective: To test whether BAG is elevated in MS and correlates with conventional and diffusion tensor imaging (DTI) abnormalities relative to healthy controls. Methods: A case-control study of 43 people with MS and 18 healthy controls was performed. BAG was estimated from T1-weighted MRI using brainageR. Controls were used as MRI reference distributions. MRI values were expressed as deviation z-scores and correlated with BAG within MS. Conventional MRI and DTI domains were analysed using age/sex-adjusted partial correlations with domain-wise Benjamini-Hochberg FDR correction, where appropriate. Results: BAG was higher in MS than controls (4.79 vs -2.58 years; p

14.
arXiv (CS.LG) 2026-06-12

Mirror Descent on Riemannian Manifolds

arXiv:2603.17527v2 Announce Type: replace-cross Abstract: Mirror Descent (MD) is a scalable first-order method widely used in large-scale optimization, with applications in image processing, policy optimization, and neural network training. This paper generalizes MD to optimization on Riemannian manifolds. In particular, we develop a Riemannian Mirror Descent (RMD) framework via reparameterization and further propose a stochastic variant of RMD. We also establish non-asymptotic convergence guarantees for both RMD and stochastic RMD. As an application to the Stiefel manifold, our RMD framework reduces to the Curvilinear Gradient Descent (CGD) method proposed in [26]. Moreover, when specializing the stochastic RMD framework to the Stiefel setting, we obtain a stochastic extension of CGD, which effectively addresses large-scale manifold optimization problems.

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

LifeSentence: Language models can encode human life course trajectories from longitudinal panel data

Forecasting human life outcomes is important to gain insights into how individuals attain long and healthy lives. Conventional statistical approaches yield limited accuracy, potentially due to discarding the sequential structure of the life course. Modern methods such as transformer architectures require large scale training data that most longitudinal panel studies lack. Here we introduce LifeSentence, a model for life-course reasoning that bridges large language models with longitudinal panel data. By representing each life event as a structured natural-language record and instruction-tuning a pretrained 24-billion-parameter language model across an 18-task evaluation taxonomy spanning prediction, robustness and reasoning, LifeSentence supplements panel data with distributional knowledge already encoded during pretraining. Trained on approximately 65,000 individuals from the German Socio-Economic Panel - roughly 45 times fewer than prior transformer-based approaches - LifeSentence outperforms classical and deep learning baselines across all task families, achieving a threefold improvement in joint event-and-timing prediction from best baselines and 91.2% Kendall's tau when reconstructing chronological order from timestamp-stripped event sets. Without explicit supervision, the model recovers documented patterns of social stratification, including the education premium, the gender wage gap and the motherhood penalty, from discrete event sequences alone. A natural-language interface further enables qualitatively new research queries, such as connecting an early-life history to a specified late-life endpoint, establishing LifeSentence as both a predictive tool and a probe for counterfactual exploration of human biographies.

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

A Machine-Learned Comorbidity Index

arXiv:2606.17450v1 Announce Type: new Abstract: Traditional comorbidity scores (e.g., Charlson and Elixhauser) are widely used for risk adjustment and patient stratification, but they have two key limitations: (i) they are largely mortality-centric and do not align well with other clinical outcomes, and (ii) their linear, rule-based structure cannot capture nonlinear, outcome-specific risk relationships. We propose a Machine-Learned Comorbidity Index (MLCI) that maps diagnosis codes to a single scalar by maximizing the normalized Hilbert-Schmidt Independence Criterion (nHSIC) between the learned score and multiple clinical outcomes. MLCI captures nonlinear risk-outcome dependence and is supported by a theory that characterizes when a unified, informative admission-level ordering can be achieved across outcomes. Empirical results on multiple benchmark electronic health record (EHR) datasets show that MLCI outperforms strong baselines across multiple evaluation metrics.

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

HERO: Hindsight-Enhanced Reflection from Environment Observations for Agentic Self-Distillation

arXiv:2606.11559v1 Announce Type: new Abstract: Reinforcement learning typically improves multi-turn agent capabilities through the terminal outcome of the trajectories, which makes it difficult to determine credit assignments for each intermediate turns. Recent on-policy self-distillation methods offer a promising alternative by converting privileged feedback into dense token-level supervision through a self-teacher. Our study is motivated by the unexpected performance degradation observed when naively extending this paradigm to multi-turn settings, which we attribute to a lack of alignment between privileged feedback, such as successful trajectories or terminal outcomes, and the student's current decision context. We introduce HERO, a hindsight-enhanced self-distillation framework that uses next environment observations as locally aligned feedback. After each rollout, HERO reflects on the completed interaction to convert each observation into a compact turn-level diagnosis, that captures actionable feedback about the original action such as its necessity, validity or failure cause. On TauBench and WebShop, HERO improves task success and reduces unnecessary turns over environment-feedback-only self-distillation and GRPO. It is especially effective under limited training turn budgets, where successful rollouts are rare and GRPO provides weak reward-contrast signals.

18.
Nature Medicine 2026-06-11

Microglia at a key inflection point in Alzheimer’s disease

作者: 未知作者

We analyzed brains from octogenarians and cognitively resilient centenarians to understand why some individuals with substantial Alzheimer’s disease pathology develop dementia whereas others remain cognitively intact. Spatial transcriptomics revealed gene expression changes in discrete tissue domains surrounding amyloid plaques and tau pathology that distinguish early, clinically silent, disease from later stages associated with cognitive decline.

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

Towards Provably Fair Machine Learning: Bayesian Approaches For Consistent and Transparent Predictions

arXiv:2606.12615v1 Announce Type: new Abstract: ML classifiers deployed in high-stakes domains produce predictions whose quality varies systematically across subgroups. For granular subgroups defined by intersections of multiple features, predictions are often inconsistent with the observed data: the model's outputs contradict the evidence available for that subgroup. This problem is exacerbated by regularisation, which improves aggregate performance by collapsing small subgroups into larger groups, disproportionately affecting demographic minorities. We define two requirements for consistent prediction: determinism (identical individuals receive identical predictions) and statistical consistency (we cannot reject, at significance level alpha, the hypothesis that the predictions for a subgroup were drawn from the Bayesian optimal target distribution inferred for that subgroup). From these requirements we derive the Fair Bayesian classifier, which enforces both across every group and subgroup simultaneously and abstains whenever no consistent deterministic prediction is possible. On three benchmark datasets (Adult, COMPAS, and Bank Marketing), standard classifiers produce statistically inconsistent predictions for a substantial proportion of subgroups. Our classifier achieves zero consistency error by construction while exceeding baseline accuracy and multicalibration on every dataset tested. Statistical consistency provides a principled foundation for prediction quality with direct implications for algorithmic fairness. Minority demographics are disproportionately concentrated in small subgroups, precisely where frequentist inference is least reliable; addressing this inference problem is therefore a necessary step toward fair ML. By enforcing Bayesian consistency at the finest resolution the data supports, the our classifier demonstrates that exhaustive subgroup fairness with principled abstention is achievable in practice.

20.
arXiv (quant-ph) 2026-06-25

Quantum Detectability in Invisibility Cloaks

arXiv:2606.25666v1 Announce Type: new Abstract: Classical invisibility cloaks are designed to suppress selected scattering signatures and thereby make an object appear absent to external electromagnetic probes. However, the suppression of a classical scattering observable does not, by itself, establish that all information about the concealed object has been removed from the detected quantum state of light. Here we formulate the detectability of classically cloaked objects as a quantum-state distinguishability problem. Treating a linear passive cloak as an effective Gaussian quantum channel acting on the accessible detected modes, we show that local quantum undetectability requires the detected first and second moments to be independent of the hidden-object parameter. In this framework, quantum Fisher information provides an operational criterion for whether the concealed parameter remains estimable from the detected output state. We derive displacement- and covariance-level detectability conditions and show that a nonzero parameter imprint surviving in the detected Gaussian state leads to a nonzero accessible quantum Fisher information. To connect the criterion with a physical cloaking model, we analyze a regularized cylindrical transformation-optical cloak in the Born limit and compare the scaling of the classical scattering response with the derivative-based quantum sensitivity. The analysis shows that reducing a scattering amplitude is not equivalent to eliminating local quantum-state sensitivity. Loss, environmental noise, and finite numerical aperture degrade the accessible information, but quantum undetectability is reached only when the parameter imprint is removed from the detected state or projected entirely outside the accessible subspace. These results provide a Gaussian-channel framework for assessing when classical cloaking does, and does not, imply quantum-state undetectability.

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

Integral Formulation of QENDy for Robust Nonlinear System Identification

arXiv:2606.11629v1 Announce Type: cross Abstract: This manuscript proposes an integral formulation of the newly defined quadratic embedding method for identifying nonlinear systems (QENDy). In the original algorithm, trajectory data points along with their time derivatives are used. Methods for calculating time derivatives make the algorithm sensitive to noise. Our integral formulation does not use the time derivatives. This results in a more robust method to learn the dynamics.

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

Space-sampled Value Decay: Forgetting Mechanisms for Non-stationary Deep Reinforcement Learning

arXiv:2606.11797v1 Announce Type: new Abstract: Studies on rodents such as mice have shown the capabilities to adapt their behavior when dealing with changing parameters (``drift'') of the environment even if no information about change is provided (uncertainty) – a behavior that can be modeled by forgetting mechanisms. Non-stationary Reinforcement Learning (NSRL) deals with adapting state-of-the-art RL methods to deal with changing environments: these however usually require (partially) perfect information about the drift such as ``task IDs'' or ``context''. To mitigate the effects of drift, this work develops Space-sampled Value Decay as an explicit forgetting mechanism for value-based deep RL architectures as a simple yet effective approach. In particular we demonstrate and discuss positive effects but also limitations in achieved returns for modifications of Deep Q-networks (DQN) and Soft Actor-Critic (SAC) when evaluated on non-stationary environments.

23.
arXiv (CS.AI) 2026-06-24

HiPath: Hierarchical Vision-Language Alignment for Structured Pathology Report Prediction

arXiv:2603.19957v2 Announce Type: replace-cross Abstract: Pathology reports are structured, multi-granular documents encoding diagnostic conclusions, histological grades, and ancillary test results across one or more anatomical sites; yet existing pathology vision-language models (VLMs) reduce this output to a flat label or free-form text. We present HiPath, a lightweight VLM framework built on frozen UNI2 and Qwen3 backbones that treats structured report prediction as its primary training objective. Three trainable modules totalling 15M parameters address complementary aspects of the problem: a Hierarchical Patch Aggregator (HiPA) for multi-image visual encoding, Hierarchical Contrastive Learning (HiCL) for cross-modal alignment via optimal transport, and Slot-based Masked Diagnosis Prediction (Slot-MDP) for structured diagnosis generation. Trained on 749K real-world Chinese pathology cases from three hospitals, HiPath achieves 68.9% strict and 74.7% clinically acceptable accuracy with a 97.3% safety rate, outperforming all baselines under the same frozen backbone. Cross-hospital evaluation confirms generalisation with only a 3.4pp drop in strict accuracy while maintaining 97.1% safety.

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

EDEN: A Large-Scale Corpus of Clinical Notes for Italian

We present EDEN (Emergency Department Electronic Notes), a new and unique large-scale corpus of clinical notes produced in Emergency Departments of Italian hospitals. The corpus, in its current version, is composed of approximately 4 million clinical notes fully anonymized, covering diverse phases of patient care during the stay in the emergency department. In addition, a subset of about six thousand notes has been manually annotated by clinical experts through a structured Case Report Form (CRF) containing 132 items relevant for two patient situations in emergency departments, dyspnea and loss of consciousness. Items may assume numerical values (e.g., for blood saturation), categorical (e.g., for level of consciousness ), binary (e.g., for presence of traumas), and mixed value types. The annotation process involved multiple clinicians and underwent iterative revision to resolve ambiguities in item formulation, resulting in a richly structured (although high imbalanced) resource. The dataset aims to fill a relevant gap of data able to support both the development and the use of Large Language Models in concrete medical applications. We describe the data collection protocol, the on-site anonymisation pipeline, corpus statistics, and the annotation scheme. Finally, we propose CRF-filling as a novel structured information extraction benchmark, and provide zero-shot baseline resulting from Gemma-27B and MedGemma-27B. To the best of our knowledge, the EDEN dataset is the largest freely available corpus of clinical notes existing for the Italian language.

25.
medRxiv (Medicine) 2026-06-24

Durability and Seasonal Variation in the Effectiveness of Nirsevimab over Three Seasons in Connecticut

Background Nirsevimab has been widely administered in the United States since 2023 to protect infants and young children from severe disease caused by respiratory syncytial virus (RSV). Although early post-licensure studies have shown high effectiveness against medically attended RSV infection, uncertainty remains about the durability of protection, effectiveness beyond the first RSV season, and the extent to which changing RSV seasonality influences real-world effectiveness. Objective To estimate the effectiveness of nirsevimab against medically attended RSV infection across three consecutive RSV seasons and to examine how effectiveness varies by season and time since immunization. Methods We conducted a test-negative case-control study utilizing electronic health records of infants and young children tested for RSV by polymerase chain reaction in outpatient and inpatient settings within the Yale New Haven Health System between October 1, 2023, and March 1, 2026. Effectiveness of nirsevimab was estimated using multivariable logistic regression, adjusting for age, weekly RSV activity, pre-existing risk factors, and other potential confounders. Variation in effectiveness was examined by season, encounter setting, and time since immunization up to 24 months. Results Overall, 17,755 infants and young children were tested for RSV infection, of whom 2,388 (13.4%) were cases and 15,367 (86.6%) were controls. The overall effectiveness of nirsevimab was 67.3% (95% confidence interval [CI]: 59.8, 73.3%) against all medically-attended RSV infections, 60.2% (95% CI: 49.6, 68.5%) against RSV-associated outpatient visits, and 88.9% (95% CI: 82.3, 93.0%) against RSV-associated hospitalization. Effectiveness against medically attended RSV infection declined across seasons, from 76.7% (95% CI: 60.5, 86.3%) in 2023/24 to 54.4% (95% CI: 33.0, 68.9%) in 2025/26. Lower season-specific effectiveness in later seasons corresponded with progressively delayed RSV activity over. Protection against RSV-associated hospitalization declined with increasing time since immunization, from 92.5% (95% credible interval [CrI]: 85.9, 96.4%) at 1 month, to 77.2% (95% CrI: 60.4, 87.6%) at 6 months, and 39.9% (95% CrI: 2.4, 63.3%) at 12 months post-immunization, after which effectiveness plateaued. Conclusions Nirsevimab remained effective against RSV-associated hospitalization through 6 to 12 months after immunization. Delayed RSV activity was associated with lower effectiveness, highlighting the importance of aligning administration with local RSV circulation.