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01.
PLOS Medicine 2026-05-21

Novel symptoms associated with eclampsia could improve detection and save lives

作者:
Alice Beardmore-Gray↗

by Alice Beardmore-Gray, Andrew Shennan Eclampsia is a life-threatening complication of pre-eclampsia, yet remains difficult to predict. In this Perspective, Alice Beardmore-Gray and Andrew Shennan highlight a recent study that identifies 10 novel prodromal symptoms of eclampsia, with potential to better predict which women are at risk and therefore reduce delays in intervention.

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

Patcher: Post-Hoc Patching of Backdoored Large Language Models

作者:
Anjun Gao↗Yueyang Quan↗Yufei Xia↗Zhuqing Liu↗Minghong Fang↗

arXiv:2606.02995v2 Announce Type: replace-cross Abstract: Large language models remain vulnerable to jailbreak backdoor attacks, where adversaries poison safety alignment data to embed hidden triggers that bypass safety mechanisms. Existing defenses often require comprehensive attack information or multiple triggered examples, making them impractical when defenders only observe a single reported failure case without knowing whether it stems from a backdoor attack or a natural alignment bug. This paper presents Patcher, a post-hoc defense framework that repairs backdoored language models using only a single reported failure case and the model parameters. Patcher operates in two stages. First, it localizes backdoor triggers by computing response-conditioned gradient-based saliency scores and applying adaptive clustering to separate triggers from benign context. Second, it patches the model through a constrained fine-tuning objective that breaks the trigger-response association while preserving benign-task utility and robustness to non-triggered jailbreak attacks through KL-divergence constraints. We conduct extensive evaluations across multiple backdoor attack strategies and demonstrate that Patcher successfully localizes triggers and neutralizes backdoors while maintaining model utility. We further show robustness against adaptive attacks designed to evade our defense. This work represents a significant step toward practical defenses against training-time attacks in deployed language models.

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03.
medRxiv (Medicine) 2026-06-17

Efficacy of a Gamified Digital Platform for Substance Use Education and Overdose Prevention Among College Students: a Pilot and Feasibility Study

作者:
Hilliard↗M. E↗Foreman↗Khan↗Zona↗Mishra↗Howse↗S. J↗

Background: For US young adults aged 18-25 in the 2018-2024 period, fentanyl was involved in 78.2% of the 44,020 unintentional or undetermined-intent overdose deaths, most often co-involving stimulants and other non-opioid substances. While fatal overdose rates in this age group have fallen to their lowest recorded level, emergency medical services-attended non-fatal overdose events have reached record highs, shifting the decisive variable toward bystander recognition and response. College students report near-universal alcohol education but minimal education on the substances actually driving overdose mortality. Methods: We conducted a single-group pre-post evaluation of the DopaGE Portal, a gamified, mastery-based digital platform covering cocaine, MDMA, benzodiazepines, and opioid overdose response, deployed at a public university (UNL) and a multi-campus volunteer network (TACO). Paired pre/post surveys (N=42) measured self-efficacy (7 items; primary), behavioral intentions, risk perception, and knowledge/attitudes on 5-point scales, plus four factual knowledge questions. Paired t-tests, exact McNemar tests, and Benjamini-Hochberg correction across eight primary tests were applied. Institutional naloxone distribution at UNL was tracked as an ecological behavioral outcome. A mandated high-school cohort (N=94) provided supplementary acceptability data. Results: Self-efficacy increased from 2.82 to 4.46 (d=2.00, 95% CI 1.46-2.55; adjusted p

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04.
arXiv (CS.AI) 2026-06-11

Position: Hippocampal Explicit Memory Is the Cornerstone for AGI

作者:
Sangjun Park↗

arXiv:2606.11245v1 Announce Type: new Abstract: Large Language Models (LLMs) have demonstrated remarkable capabilities across various tasks, raising expectations for Artificial General Intelligence (AGI). This position paper argues that integrating explicit memory is the cornerstone for advancing LLMs toward AGI. The key reason is that the underlying learning mechanism of LLMs is highly analogous to human implicit memory. However, higher-order cognitive functions necessary for AGI, such as long-term strategic planning, metacognition, and symbolic reasoning, heavily rely on hippocampal explicit memory and cannot arise solely from implicit statistical learning. Drawing on findings from neuroscience, I advance this perspective and complement it with computational requirements for artificial explicit memory systems, hoping to foster further research and lay the groundwork for explicit memory integration.

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05.
arXiv (math.PR) 2026-06-18

Finite free perpetuities

作者:
Julia Le Bihan↗Bartosz Ko{\l}odziejek↗

arXiv:2606.19115v1 Announce Type: new Abstract: We introduce and study finite free perpetuities, defined as monic polynomial solutions of degree $n$ to the affine fixed-point equation \[ p(z) = \mathbb{E}\!\left[ A^{n}\,p\!\left(\frac{z-B}{A}\right)\mathbf{1}_{\{A\neq0\}} \right] + \mathbb{E}\!\left[ (z-B)^n\mathbf{1}_{\{A=0\}} \right], \] where $A$ and $B$ are complex-valued random variables with finite moments up to order $n$. Equivalently, if $p(z)=\mathbb{E}[(z-X)^n]$, then $p$ encodes a truncated moment version of the classical perpetuity equation $X\stackrel{d}{=}AX+B$ with $X$ and $(A,B)$ independent. This places finite free perpetuities between classical perpetuities and free-probabilistic fixed-point laws. We prove existence and uniqueness under weak conditions, and we identify a broad class of admissible pairs $(A,B)$ for which the resulting polynomial has only real, nonnegative zeros. Our approach uses finite free additive and multiplicative convolutions together with a probabilistic representation via the $U$-transform. As a motivating example, we exhibit an explicit family of finite free perpetuities expressed in terms of Jacobi polynomials and show that their empirical root distributions converge to a free-beta-prime law. More generally, for admissible sequences of parameters, we prove weak convergence of the empirical root distributions of finite free perpetuities to the law of a free perpetuity characterized by the corresponding free fixed-point equation. This yields a finite-degree polynomial model approximating free perpetuities and clarifies the connection between classical affine recursions, finite free convolutions, and free probability.

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

Can Neural Networks Achieve Optimal Computational-statistical Tradeoff? An Analysis on Single-Index Model

作者:
Siyu Chen↗Beining Wu↗Miao Lu↗Zhuoran Yang↗Tianhao Wang↗

arXiv:2606.15219v1 Announce Type: new Abstract: In this work, we tackle the following question: Can neural networks trained with gradient-based methods achieve the optimal computational-statistical tradeoff in learning Gaussian single-index models? Prior research has shown that any polynomial-time algorithm under the statistical query (SQ) framework requires $\Omega(d^{s^\star/2}\lor d)$ samples, where $s^\star$ is the generative exponent representing the intrinsic difficulty of learning the underlying model. However, it remains unknown whether neural networks can achieve this sample complexity. Inspired by prior techniques such as label transformation and landscape smoothing for learning single-index models, we propose a unified gradient-based algorithm for training a two-layer neural network in polynomial time. Our method is adaptable to a variety of loss and activation functions, covering a broad class of existing approaches. We show that our algorithm learns a feature representation that strongly aligns with the unknown signal $\theta^\star$, with sample complexity $\widetilde{O} (d^{s^\star/2} \lor d)$, matching the SQ lower bound up to a polylogarithmic factor for all generative exponents $s^\star\geq 1$. Furthermore, we extend our approach to the setting where $\theta^\star$ is $k$-sparse for $k = o(\sqrt{d})$ by introducing a novel weight perturbation technique that leverages the sparsity structure. We derive a corresponding SQ lower bound of order $\widetilde{\Omega}(k^{s^\star})$, matched by our method up to a polylogarithmic factor. Our framework, especially the weight perturbation technique, is of independent interest, and suggests potential gradient-based solutions to other problems such as sparse tensor PCA.

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

Do we have the knowledge we need? Rethinking human-AI decision-making in corporations

作者:
Anne S. R. Marx↗Ricardo M. Avelino↗Torbj{\o}rn Netland↗Mennatallah El-Assady↗

arXiv:2606.15575v1 Announce Type: new Abstract: Organizational knowledge is fragmented across a variety of software systems, tacit expertise, and manual documents that have traditionally been designed for human consumption. As AI systems are increasingly deployed and granted decision-making roles, they require access to this knowledge. This raises two questions: how should organizations store and maintain knowledge so that it remains accessible to both humans and future AI systems, and how should agency be allocated between humans and AI across tasks with different risks and levels of uncertainty? In this position paper, we describe how organizational knowledge evolves and contribute a framework that maps task attributes and knowledge availability to recommended agency allocations and control mechanisms. We illustrate the applicability of the framework on two different manufacturing tasks: a routine operation (visual quality inspection) and a one-off strategic decision (factory location), and conclude with opportunities for future research.

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08.
arXiv (CS.LG) 2026-06-16

Unlocking Latent Dimensions: Exploring Representations of Large-Scale X-ray Scattering Data using Variational Autoencoders

作者:
Monika Choudhary↗Xiaoya Chong↗Runbo Jiang↗Wiebke Koepp↗Petrus H. Zwart↗Damon English↗Gregory M. Su↗Eric Schaible↗Chenhui Zhu↗Mostafa Nassr↗Noah P. Wamble↗Kelvin Kam-Yun Li↗…

arXiv:2606.14999v1 Announce Type: new Abstract: Scientific user facilities generate X-ray scattering data faster than traditional workflows can process them. We address this challenge across two settings, offline dataset exploration and live on-the-fly analysis. We train a domain-specific attention-based Convolutional Variational Autoencoder (C-VAE) on 1.5 million X-ray scattering images to learn low-dimensional representations capturing structural variation across diverse experimental conditions. The learned latent space reveals well-organized clusters and smooth trajectories reflecting experimental progression. It further supports controlled synthetic scattering image generation across diverse structural states. When deployed without retraining, the model organizes time-resolved film formation experiments at two synchrotron facilities into interpretable latent structures. Benchmarking against DINOv3 (ViT-7B), a general-purpose vision foundation model, demonstrates that domain-specific training yields more interpretable latent organization for scattering data. Both workflows are integrated within Latent Space Explorer, a component of the MLExchange platform, supporting interactive structural exploration across archived datasets and live experiments.

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

Using AI in engineering education: a balancing act, driven by clear purpose

作者:
Olya Kudina↗

arXiv:2606.16626v1 Announce Type: cross Abstract: Based on a questionnaire of 100 higher-education students, predominantly from engineering-related fields, and a critical review of recent literature, this chapter examines how students use and perceive Large Language Models (LLMs) in engineering education. Students primarily value LLMs for writing support, conceptual clarification, coding assistance, and brainstorming, while simultaneously expressing concerns about inaccuracies, bias, overreliance, academic integrity, and the burden of verification. Through an analysis of two dominant metaphors, namely LLMs as an "oracle" and as a "tutor," the chapter shows how these systems cultivate expectations of authority, expertise, and personalized learning that often exceed their actual capabilities. The chapter further argues that students' attachment to the promises of efficiency and personalized support reflects a form of "cruel optimism," where the perceived benefits of LLMs often depend on the very skills, vigilance, and expertise that students are still developing. Overall, the chapter argues for a purpose-driven and context-sensitive approach to AI integration in engineering education, emphasizing critical AI literacy, reflective assessment design, pedagogical caution, and consideration of broader ethical and environmental impacts.

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

XAI-Grounded Explanation Generation for Speech Deepfake Detection with Training-Free Multimodal Large Language Models

作者:
Yupei Li↗Qiyang Sun↗Xiaoliang Wu↗Chenxi Wang↗Berrak Sisman↗Bj\"orn W. Schuller↗

Speech deepfake detection (SDD) systems require trustworthy explanations for reliable decision-making. Existing explanation ways mainly fall into two categories. Traditional explainable AI (XAI), such as gradient-based attribution, produces low-level attribution signals tightly coupled with model decisions, and harder to be understood by human than natural language explanations. Meanwhile, large language model (LLM)-based explanation generation often produces generic and ungrounded descriptions due to the lack of heuristic evidence and task-specific supervision, stemming from limited grounded explanation datasets for SDD. We therefore propose a training-free explanation framework that integrates XAI evidence with multimodal LLMs to generate grounded and specific explanations. Using the PartialSpoof dataset, we construct a grounded explanation dataset and show that methods with XAI increase inside accuracy by over 45\%, verified through human evaluation and faithfulness checks.

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

Toward Instructions-as-Code: Understanding the Impact of Instruction Files on Agentic Pull Requests

作者:
Ali Arabat↗Mohammed Sayagh↗

arXiv:2606.13449v1 Announce Type: cross Abstract: AI-agents (e.g., GitHub Copilot) collaborate as teammates in different software engineering tasks, including code generation proposed through pull requests (Agentic-PRs). For better agent efficiency, developers create instruction files that guide the AI-agents, including how to navigate the project, locate the right components, run tests, respect best practices, and more. In this paper, we investigate the relationship between the creation of these instructions and the performance of AI-agents in creating better pull requests, which have a higher chance of success (i.e., the merge rate), address more complex tasks (e.g., code churn), and require less effort to be merged (e.g., time to merge). To this end, we analyze 15,549 agentic PRs from 148 projects in the AIDev dataset. Using the three dimensions, we compare each project before and after the creation of the instruction files. We find that specifying instructions for AI-agents does not necessarily lead to better results. With the instruction files, 27.7\% of the projects increased their merge rate by at least 20\%, while 26.35\% decreased it. The same observation is seen with the amount of changes (e.g., code churn, number of modified files) and with the efforts to merge an agentic PR (e.g., merge time and number of comments). From a first exploration, we find that projects that managed to increase their merge rate have substantially longer instruction files, which are also well structured into a higher number of sections and sub-sections. Our results motivate the need for research to assist practitioners in framing the development of instruction files as a software engineering activity (aka, Instructions-as-Code).

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12.
arXiv (CS.AI) 2026-06-16

CAP: Towards PPG Universal Representation Learning with Patient-level Supervision

作者:
Chenyang He↗Xinyi Shao↗Shun Huang↗Bosong Huang↗Daoqiang Zhang↗Ming Jing↗Cheng Ding↗

arXiv:2606.15284v1 Announce Type: cross Abstract: Photoplethysmography (PPG) plays a central role in wearable health monitoring and clinical decision support. Yet existing approaches to universal PPG representation learning largely focus on signal-level objectives and often overlook patient-level health context, which limits generalization to complex clinical tasks and heterogeneous cohorts. To address this gap, we construct a large-scale paired PPG-EHR multimodal dataset by distilling fragmented medical histories and clinical records into cohesive, patient-level electronic health records (EHR). Building on this resource, we propose Clinical Anchored Pretraining for PPG (CAP). During pretraining, CAP performs cross-modal contrastive alignment that anchors PPG representations to patient-level clinical semantics, guiding the encoder beyond waveform fitting toward modeling consistency in a patient's overall physiological state. During downstream adaptation, the pretrained PPG encoder provides clinically grounded representations that strengthen inductive bias and improve robustness and transferability. Experiments demonstrate that CAP consistently outperforms strong baselines on four diverse downstream tasks. CAP achieves a particularly large gain on respiratory rate prediction (up to +87.6% relative improvement over the state-of-the-art baseline) and delivers an average relative +26.7% across all tasks. We further enhance the interpretability of our approach through comprehensive analyses, including ablations and multiple complementary visualizations of the learned representations. The code for our experiments is available at: https://github.com/gody123gody/CAP .

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13.
arXiv (CS.AI) 2026-06-15

When Should Agent Trust Be Conditional? Characterizing and Attacking Skill-Conditional Reputation in Agent Swarms

作者:
Yihan Xia↗Taotao Wang↗

arXiv:2606.14200v1 Announce Type: new Abstract: Open platforms increasingly route tasks among heterogeneous LLM agents–differing in base model, scaffold, and tool stack–whose competence varies sharply by skill: an agent excellent at one skill may be useless at another. The standard reputation approach summarizes each agent by a single global trust score, but that scalar is the wrong object here, because routing every task to the globally most-trusted agent leaves the value of specialization unclaimed. We study skill-conditional trust R(i | k)–the trust to place in agent i for a task requiring skill k, rather than one score per agent–and pose three falsifiable questions: when is conditioning worth it, how much cross-skill evidence should be borrowed, and whether that borrowing is safe. A controlled phase-diagram analysis answers the first two: conditional trust wins only in a specific regime–high agent heterogeneity, sparse per-skill evidence, and correlated skills–and the coupling strength beta that buys this data efficiency is dual-use, because the same cross-skill borrowing is also a laundering channel. On a public benchmark of 14 genuinely heterogeneous AppWorld agents, real pools land inside the beneficial regime–a small but genuine gain, with the per-skill best agent genuinely changing across skills. We then show that an attacker with cheap evidence in one skill and none in a target skill hijacks the conditional router, driving routing regret from 0 to 0.94 on a pool our zero-cost Conditional Information Value Test (CIVT) rates GREEN–while the ungated trust verdict it contaminates reads -0.06 instead of the honest +0.19. A zero-evidence gate bounds the attack but does not eliminate it; we characterize the residual cost under an explicit budget. We do not claim Sybil-resistance–we quantify the trade-off.

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14.
arXiv (CS.AI) 2026-06-11

TAHOE: Text-to-SQL with Automated Hint Optimization from Experience

作者:
Zhiyi Chen↗Jie Song↗Peng Li↗

arXiv:2606.12387v1 Announce Type: cross Abstract: Large Language Models (LLMs) have democratized database access through Text-to-SQL, but moving from prototypes to production remains difficult. Real deployments must handle strict SQL dialects, massive schemas, and evolving user preferences, while supervised fine-tuning is costly and rigid and agentic test-time scaling is expensive. We present Tahoe, a system that treats prompt optimization as a dynamic data management problem. Tahoe uses an error-driven hint learning pipeline across Development and Deployment to consolidate debugging traces into a structured Hint Bank. Compiler feedback is distilled into reusable Syntax Hints for dialect-specific rules, while execution and user feedback are converted into Semantic Hints for schema- and user-specific logic. Tahoe further introduces a Strategy Layer that models conflicting user intents as competing strategies under shared natural-language triggers, with recency signals and post-learning attribution statistics that summarize empirical success, harm, inertness, and support. At inference time, Tahoe retrieves relevant hints and guides the LLM through Logic Planning followed by SQL Synthesis. We implement and evaluate the development-phase workflow, leaving deployment-time human-feedback updates for future work. On Spider 2.0-Snow, Tahoe substantially improves Text-to-SQL without updating model parameters. On 113 supervised Spider 2.0-Snow-0212 examples using GPT-5.5, Tahoe raises pass rate from 61.95 percent to 79.42 percent and pass-at-4 from 72.57 percent to 87.61 percent, achieves 100 percent Snowflake syntax pass rate, and reduces average compiler-feedback critic rounds from 2.79 to 0.12 per sampled candidate. The same Hint Bank also transfers to weaker backbones, including a 19.7 percentage-point pass-rate gain on Doubao-2.0-lite.

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

Generativism: Toward a Learning Theory for the Age of Generative Artificial Intelligence

作者:
Shan Li↗Juan Zheng↗

arXiv:2606.12441v1 Announce Type: cross Abstract: The four dominant learning theories of behaviorism, cognitivism, constructivism, and connectivism show significant conceptual limitations as generative artificial intelligence (AI) proliferates in educational settings. These frameworks were formulated before the emergence of AI systems capable of generating, synthesizing, and reasoning about knowledge. This article critically examines each learning theory and identifies assumptions challenged by generative AI's affordances. Drawing on research in distributed cognition, extended mind, human-AI collaboration, AI literacy, cognitive offloading, and metacognition, the article proposes Generativism as a learning theory for the generative AI age. Generativism posits that learning increasingly occurs through the iterative co-construction of knowledge between human learners and AI systems. The proposed framework is organized around four principles: epistemic partnership, distributed agency, generative literacy, and adaptive metacognition. The framework offers a foundation for rethinking instructional design, learning, assessment, and expertise development in contexts where generative AI plays an integral role in cognition.

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

AQ4SViT: An Automated Quantization Framework with Search Gating Policy for Compressing Spiking Vision Transformers

作者:
Rachmad Vidya Wicaksana Putra↗Saad Iftikhar↗Muhammad Shafique↗

arXiv:2606.15523v1 Announce Type: cross Abstract: Spiking Vision Transformers (SViTs) have emerged as alternative low-power ViT models, but their large sizes hinder their deployments on resource-constrained embedded AI systems. To address this, state-of-the-art works proposed quantization techniques to compress SViT models, but their manual, human-guided approach needs a huge design time and power/energy consumption to find the appropriate quantization setting for each given network, making this approach not scalable for quantizing multiple networks. Toward this, we propose AQ4SViT, a novel automated quantization framework for SViTs that can provide quick quantization settings with good trade-offs between accuracy and memory. To achieve this, AQ4SViT employs the following key ideas: quantization search strategy that evaluates the quantization setting candidates while considering the accuracy constraint; and search gating policy that quickly evaluates and selects promising quantization candidates by leveraging membrane potential drift as a performance proxy. In the search gating policy, AQSViT employs two search algorithm variants to provide trade-off options: Greedy search, which performs fast but may lead to local optima; and Beam search, which performs slower but has better performance in finding global optima selection due to a wider search space. Experimental results show that AQ4SViT-Greedy quickly finds the appropriate quantization settings, achieving up to 6.6x faster search time and up to 82.5% memory saving compared to the state-of-the-art; while AQ4SViT-Beam further reduces the memory footprint by up to 90% compared to the state-of-the-art, but with 4.5x longer search time; all these results are obtained while maintaining high accuracy within 1.5% from the original/non-quantized models on the ImageNet dataset. These results highlight that AQ4SViT framework offers advancements toward SViT deployments on embedded AI systems.

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17.
arXiv (math.PR) 2026-06-15

Real-order moments, tail representations, and logarithmic means

作者:
Roberto Vila↗Eduardo Nakano↗

arXiv:2606.14019v1 Announce Type: cross Abstract: This paper develops a unified framework for the study of real-order moments of arbitrary random variables. General integral representations are established in terms of cumulative distribution functions and survival functions, covering continuous, discrete, and mixed distributions supported on the whole real line. These formulas extend the classical tail-integral identities for nonnegative random variables and provide a common treatment of positive, fractional, and negative moments. For discrete distributions, explicit series representations are derived in terms of cumulative probabilities, yielding simple criteria for the existence of moments. Applications are presented for the zeta and Skellam distributions, illustrating how tail behavior determines moment finiteness and how moments can be represented geometrically through cumulative distribution functions. In addition, a representation for logarithmic moments is obtained, linking logarithmic means, Laplace transforms, and the classical Frullani identity. The results provide a unified perspective on moment representations and establish useful connections between tail probabilities, distribution functions, Laplace transforms, and moment existence.

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18.
medRxiv (Medicine) 2026-06-17

Perceptions of aging well among older adults with heart failure: insights from a qualitative study

作者:
Reid↗R.-J↗Ofosu↗Goyal↗De Main↗Lambert↗W. M↗Navarro-Millan↗Sterling↗M. R↗Rajan↗Soroka↗…

Background: Heart failure (HF) is a prevalent and often debilitating cardiovascular condition among older adults, frequently accompanied by multimorbidity, functional limitations, and the need to age in place. Traditional models of successful aging emphasize disease absence and preserved function, yet most individuals with HF live with ongoing symptoms and chronic health challenges. How older adults with HF define aging well, particularly across different socioeconomic contexts, remains underexplored. Objectives: To explore how older adults with HF conceptualize aging well and to identify perceived facilitators and barriers across more and less resourced New York City neighborhoods. Methods: We conducted semi-structured interviews with 20 adults diagnosed with HF residing in Manhattan and Brooklyn neighborhoods classified by 2019 United States Census data. Interviews were guided by Rowe and Kahn's model. Transcripts were analyzed using an inductive-deductive thematic approach and interpreted in alignment with the Healthy People 2030 framework. Results: Participants had a mean age of 69 years; 50% identified as Black and 50% were women. Despite functional limitations, 65% reported aging well. Five themes emerged: maintaining physical function, maintaining cognitive function, sustaining social relationships, avoiding pain, and promoting overall well-being. Avoiding pain and promoting well-being extended beyond traditional models. Neighborhood context shaped priorities, with financial stability emphasized in more affluent areas and social cohesion prioritized in less affluent communities. Conclusions: Older adults with HF frequently perceive themselves as aging well despite chronic illness, reframing successful aging beyond disease avoidance. These findings support a patient-centered, place-informed model of aging well with implications for healthcare delivery and policy.

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19.
medRxiv (Medicine) 2026-06-18

Cost analysis of overseas versus domestic vaccination of US-bound refugees

作者:
Joo↗Maskery↗Klosovsky↗Marquez↗Taher↗Dalal↗Weinberg↗Mitchell↗

Context: To ensure healthy resettlement and protect US health security, the Vaccination Program for US-bound Refugees (VPR) offers some recommended vaccines to refugees overseas before resettlement to the United States. The selected vaccines and number of doses vary by country of departure. VPR was found to be cost-saving in 2018 but had since expanded to more sites. Objective: Assess VPR's current costs and impact on post-arrival domestic vaccination needs and costs. Setting and Participants: A model-based analysis of the Federal government costs for VPR and post-arrival (US) vaccination of resettled refugees separated across five regions: Africa, Asia, the Middle East and North Africa/Republic of Turkiye and Middle East, Europe, and the Americas using fiscal year 2024 data. Design: We quantified and compared full vaccination costs for refugees under two scenarios: (1) 'No VPR' and (2) 'VPR'. Refugees would receive no vaccines overseas and be fully vaccinated after US arrival under 'No VPR'. Under 'VPR', refugees receive one or two doses of selected vaccines overseas before completing vaccination schedules after arrival. Main Outcomes: Costs were reported in 2023 US dollars for 'VPR' and 'No VPR' scenarios and further subdivided by grouping countries/sites depending on whether the International Organization for Migration (IOM) provides vaccination services for refugees (IOM sites) versus non-IOM providers (non-IOM sites). Results: 'VPR' resulted in average net cost savings of $147 per person or $14.7 million per 100,000-refugee cohort compared to providing all vaccines after US arrival ('No VPR'). 'VPR' was cost-saving across most regions, except for IOM sites in Europe, where a net cost of $44 per person was observed. Net cost savings per person were highest for IOM sites in Africa ($333). Conclusions: VPR remains a cost-saving strategy, while protecting US-bound refugees' health and US health security by preventing disease outbreaks during resettlement.

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21.
arXiv (CS.CV) 2026-06-17

Revisiting LLM Adaptation for 3D CT Report Generation: A Study of Scaling and Diagnostic Priors

作者:
Vanshali Sharma↗Andrea M. Bejar↗Halil Ertugrul Aktas↗Quoc-Huy Trinh↗Debesh Jha↗Gorkem Durak↗Ulas Bagci↗

Recent advances in multimodal learning, including large language models (LLMs) and vision-language models (VLMs), have demonstrated strong adaptability to natural images. However, extending their use to the medical domain, particularly for volumetric (3D) images, is challenging due to high computational complexity, volumetric dependencies and the semantic gap between visual features and clinical terminology. Naively fine-tuning LLMs on limited medical data often leads to overfitting and clinical hallucination, where linguistic fluency is prioritized over clinical factuality. In this study, we investigate parameter-efficient adaptation strategies for volumetric CT report generation and introduce RAD3D-Prefix, a lightweight diagnostic-prior conditioning framework that minimizes the need for extensive parameter training. This module integrates image embeddings with multi-label diagnostic classification logits, preserving critical clinical details while bridging the semantic gap. By keeping the LLM frozen, our method requires minimal trainable parameters and mitigates the risk of overfitting on small, domain-specific datasets. Through a systematic study spanning LLMs from 96.1M to 1.6B parameters, we find that fine-tuning is most beneficial for smaller LLMs, whereas freezing larger (~1B+ LLMs and training only lightweight projection layers provides a superior trade-off between performance, generalization, and computational efficiency. Across multiple automatic metrics and a clinical reader study, RAD3D-Prefix outperforms comparable parameter-efficient baselines and demonstrates strong out-of-domain generalization while using substantially fewer trainable parameters than fully fine-tuned alternatives.

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22.
arXiv (CS.CL) 2026-06-19

Segment-Level Mandarin Chinese Speech-Based Cognitive Impairment Detection via an Autoencoder with Contrastive Learning

作者:
Yongqi Shao↗Hong Huo↗Flavio Bertini↗Danilo Montesi↗Tao Fang↗

\noindentBackground and Objective: Speech has emerged as a low-cost and non-invasive digital biomarker with considerable potential for cognitive impairment detection. However, limited labeled data and cross-dataset variability remain major challenges for robust speech-based screening systems. \par\noindentMethods: We developed a segment-level representation learning framework for speech-based cognitive impairment detection. Speech recordings were divided into short segments and converted into spectrogram representations. To improve robustness under limited-data conditions, offline and online augmentation strategies were combined with autoencoder-based representation learning and contrastive objectives to enhance discriminative latent representations. \par\noindentResults: Experiments conducted on four independent Mandarin Chinese speech datasets demonstrated stable and competitive performance in both binary and three-class classification tasks, with particularly notable improvements in the clinically challenging three-class setting. Ablation studies further supported the effectiveness of the proposed framework. \par\noindentConclusions: The findings suggest that segment-level speech representation learning may provide a scalable and practical approach for cognitive impairment screening in resource-constrained clinical settings.

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23.
arXiv (CS.CL) 2026-06-11

Benchmarking Large Language Models for Safety Data Extraction

作者:
Jonas Grill↗Thomas Bayer↗S\"oren Berlinger↗

Accurate extraction of structured information from Safety Data Sheets (SDS) remains challenging in industrial safety due to heterogeneous document formats and the limitations of traditional rule-based methods. This study benchmarks state-of-the-art Large Language Models (LLMs) for automated SDS data extraction, comparing text-based and multimodal processing pipelines. We systematically evaluate four models: Gemini 1.5 Pro, GPT-4o, Claude 3.7 Sonnet, and Llama 3.1-70B, across three prompting strategies: zero-shot, few-shot, and chain-of-thought. The evaluation framework assessed accuracy, latency, and cost across more than 50,000 extracted data fields. Results show that text-based extraction consistently outperforms multimodal processing across all metrics. Gemini 1.5 Pro combined with a Chain-of-Thought prompt achieved the highest accuracy (84%), outperforming GPT-4o (81%) and Claude 3.7 Sonnet (79%). However, no model surpassed the 90% accuracy threshold commonly required for reliable real-world deployment. These findings indicate that general-purpose LLMs are not yet robust enough for unsupervised industrial use, though performance suggests strong potential with task-specific fine-tuning. Future research should focus on domain-adapted training, model calibration, and the integration of Human-in-the-Loop verification to ensure safety-critical reliability.

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24.
arXiv (CS.AI) 2026-06-17

Conservation Laws for Modern Neural Architectures

作者:
Viet-Hoang Tran↗Vinh Khanh Bui↗Tan Lai Ngoc↗Nam Nguyen↗Tuan Dam↗Tan M. Nguyen↗

arXiv:2606.17816v1 Announce Type: cross Abstract: Understanding gradient descent dynamics is key to explaining the success of over-parameterized models, where implicit bias manifests through conservation laws in gradient flow. While such laws are well understood for linear and ReLU networks, they remain largely unexplored for modern architectures. This work develops a unified framework to characterize conservation laws for contemporary models, including feedforward networks with GELU, SiLU, and SwiGLU activations, multihead attention with sinusoidal and rotary positional encodings, and Mixture-of-Experts architectures under diverse gating designs. Our theoretical findings are supported by experiments that validate the predicted invariants.

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25.
arXiv (CS.CL) 2026-06-19

EndoCoT: Scaling Endogenous Chain-of-Thought Reasoning in Diffusion Models

作者:
Xuanlang Dai↗Yujie Zhou↗Long Xing↗Jiazi Bu↗Xilin Wei↗Yuhong Liu↗Beichen Zhang↗Kai Chen↗Yuhang Zang↗

Recently, Multimodal Large Language Models (MLLMs) have been widely integrated into diffusion frameworks primarily as text encoders to tackle complex tasks such as spatial reasoning. However, this paradigm suffers from two critical limitations: (i) MLLMs text encoder exhibits insufficient reasoning depth. Single-step encoding fails to activate the Chain-of-Thought process, which is essential for MLLMs to provide accurate guidance for complex tasks. (ii) The guidance remains invariant during the decoding process. Invariant guidance during decoding prevents DiT from progressively decomposing complex instructions into actionable denoising steps, even with correct MLLM encodings. To this end, we propose Endogenous Chain-of-Thought (EndoCoT), a novel framework that first activates MLLMs' reasoning potential by iteratively refining latent thought states through an iterative thought guidance module, and then bridges these states to the DiT's denoising process. Second, a terminal thought grounding module is applied to ensure the reasoning trajectory remains grounded in textual supervision by aligning the final state with ground-truth answers. With these two components, the MLLM text encoder delivers meticulously reasoned guidance, enabling the DiT to execute it progressively and ultimately solve complex tasks in a step-by-step manner. Extensive evaluations across diverse benchmarks (e.g., Maze, TSP, VSP, and Sudoku) achieve an average accuracy of 92.1%, outperforming the strongest baseline by 8.3 percentage points. The code and dataset are publicly available at https://internlm.github.io/EndoCoT/.

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