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01.
arXiv (CS.LG) 2026-06-17

MiniFool – Physics-Constraint-Aware Minimizer-Based Adversarial Attacks in Deep Neural Networks

arXiv:2511.01352v2 Announce Type: replace Abstract: In this paper, we present a new algorithm, MiniFool, that implements physics-inspired adversarial attacks for testing neural network-based classification tasks in particle and astroparticle physics. While we initially developed the algorithm for the search for astrophysical tau neutrinos with the IceCube Neutrino Observatory, we apply it to further data from other science domains, thus demonstrating its general applicability. Here, we apply the algorithm to the well-known MNIST data set and furthermore, to Open Data data from the CMS experiment at the Large Hadron Collider. The algorithm is based on minimizing a cost function that combines a $\chi^2$ based test-statistic with the deviation from the desired target score. The test statistic quantifies the probability of the perturbations applied to the data based on the experimental uncertainties. For our studied use cases, we find that the likelihood of a flipped classification differs for both the initially correctly and incorrectly classified events. When testing changes of the classifications as a function of an attack parameter that scales the experimental uncertainties, the robustness of the network decision can be quantified. Furthermore, this allows testing the robustness of the classification of unlabeled experimental data.

02.
arXiv (CS.CL) 2026-06-17

A Red-Team Study of Anthropic Fable 5 & Opus 4.8 Models

We evaluate the adversarial robustness of two frontier large language models (LLMs) developed by Anthropic, Fable 5 and Opus 4.8, against four families of automated jailbreak attack across 7 826 harmful intents spanning a ten-category harm taxonomy. Using the HackAgent red-teaming framework, hundreds of thousands of adversarial attempts were generated and every apparent success was independently re-adjudicated by a panel of three judge models (majority vote). Both models resist the majority of attacks, but the residual surface is larger than aggregate framing suggests: it is dominated by adaptive iterative attacks, while static obfuscation is near-fully neutralised. The strongest adaptive search (tree-of-attacks) breaks Opus 4.8 on 11.5% of intents overall, whereas Fable 5 stays in the single digits (6.1% worst-case). Aggregate rates therefore should not be read as reassurance. Even in these hardened configurations, the two models produced 1 620 (Opus 4.8) and 702 (Fable 5) panel-confirmed harmful completions spanning every harm category, located automatically, cheaply, and within the first one or two refinement steps by an attacker model with no human expert in the loop. The reasonable conclusion is that even the best, most-tested frontier models remain reliably breakable under sustained automated pressure.

03.
arXiv (CS.AI) 2026-06-17

Symplectic Transversality and Endpoint Green Estimates for Finite-Horizon Pontryagin Systems

arXiv:2606.17762v1 Announce Type: cross Abstract: We study horizon-uniform local branches of finite-horizon discrete-time Pontryagin boundary value systems after smooth control elimination. The central input is a two-point endpoint inverse for the linearization. We verify this inverse from scaled stable–unstable boundary transversality, prove the associated endpoint-corrected Green estimate, and combine it with weighted contractions to obtain existence, uniqueness, Lipschitz dependence, and first-order expansions with constants independent of the horizon. The framework covers smooth nonlinear endpoint maps, including the original Pontryagin rows that fix the initial state and couple the terminal costate to the terminal state. Symplectic and Riccati criteria verify the inverse hypothesis at the level of the matrix data; in particular, every stabilizable linear-quadratic system with invertible dynamics and definite weights is covered, including noncommuting coupled data. A numerical section illustrates the certificates and the horizon-uniform first-order expansion.

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

Improving Detection of Rare Nodes in Hierarchical Multi-Label Learning

arXiv:2602.08986v2 Announce Type: replace-cross Abstract: In hierarchical multi-label classification, a persistent challenge is enabling model predictions to reach deeper levels of the hierarchy for more detailed or fine-grained classifications. This difficulty partly arises from the natural rarity of certain classes (or hierarchical nodes) and the hierarchical constraint that ensures child nodes are almost always less frequent than their parents. To address this, we propose a weighted loss objective for neural networks that combines node-wise imbalance weighting with focal weighting components, the latter leveraging modern quantification of ensemble uncertainties. By emphasizing rare nodes rather than rare observations (data points), and focusing on uncertain nodes for each model output distribution during training, we observe improvements in recall by up to a factor of five on benchmark datasets, along with statistically significant gains in $F_{1}$ score. We also show our approach aids convolutional networks on challenging tasks, as in situations with suboptimal encoders or limited data.

05.
Science (Express) 2026-05-21

DNA polymerization activates RNA cleavage of a reverse transcriptase–like antiviral enzyme | Science

作者: 未知作者

Defense-associated reverse transcriptases (DRTs) transcribe noncoding RNAs (ncRNAs) for antiviral defense, but the mechanisms of ncRNA-independent DRTs remain unclear. In this work, we show that a single DRT4 mediates RNA-targeting antiphage defense by integrating DNA polymerase, exonuclease, and RNA endonuclease activities. First, through an equilibrium between its DNA polymerase and exonuclease activities, DRT4 senses phage infection, as elevated dNTP levels shift the equilibrium toward polymerase activity, thereby promoting protein-primed single-stranded DNA (ssDNA) synthesis. Second, ssDNA of sufficient length, phage DNA-binding proteins, and deoxyguanosine triphosphate collectively activate an unusual RNA endonuclease activity of DRT4, excising 3′–guanosine monophosphate from both phage and host RNA to terminate infection. These findings reveal a distinctive immune strategy combining nucleic acid synthesis and degradation, expanding the functional landscape of DRTs for new DNA- and RNA-processing technologies.

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

Confidence Calibration for Multimodal LLMs: An Empirical Study through Medical VQA

arXiv:2606.19950v1 Announce Type: cross Abstract: Multimodal Large Language Models (MLLMs) show great potential in medical tasks, but their elicited confidence often misaligns with actual accuracy, potentially leading to misdiagnosis or overlooking correct advice. This study presents the first comprehensive analysis of the relationship between accuracy and confidence in medical MLLMs. It proposes a novel method that combines Multi-Strategy Fusion-Based Interrogation (MS-FBI) with auxiliary expert LLM assessment, aiming to improve confidence calibration in Medical Visual Question Answering (VQA). Experiments demonstrate that our method reduces the Expected Calibration Error (ECE) by an average of 40\% across three Medical VQA datasets, significantly enhancing MLLMs' reliability. The findings highlight the importance of domain-specific calibration for MLLMs in healthcare, offering a more trustworthy solution for AI-assisted diagnosis.

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

When the Same Musical Knowledge Forgets Differently: A Clean Probe of Pathway-Dependent Forgetting

A model can learn that the piano piece Für Elise is calm and reflective by listening to the audio or by reading a text description, but does it matter which route that knowledge took when it is later at risk of being forgotten? Forgetting research in multimodal models measures what knowledge is lost under adaptation, yet has not asked whether acquisition route affects how easily that knowledge is forgotten. We call this untested premise the Pathway-Invariant Assumption. Music understanding enables a clean test because a music clip and a canonical text description can be aligned to the same perceptual content, allowing the same knowledge unit to enter a model through listening or reading while the target remains fixed. Across multiple architecturally distinct audio-language models, we observe a consistent asymmetry: text-pathway knowledge is forgotten more than matched audio-pathway knowledge under identical adaptation pressure. To attribute this effect to route rather than confounds, we introduce the Paired Pathway Controlled Protocol (PPCP), a three-phase design that establishes matched pathway baselines, activates both pathways under symmetric supervision on the same knowledge pool, and applies identical forgetting pressure to both pathways. The gap is stable across models and gain-controlled analyses, persists when contradictory overwrite is replaced by correct-label cross-domain learning, remains under single-modality pressure, and is not removed by lightweight replay. Two independent routing-depth controls confirm that the effect is not explained by architectural depth, pointing to input representation as the dominant factor. Under PPCP, our results demonstrate that forgetting is highly route-dependent, establishing acquisition route as a new analytical dimension for forgetting research and multimodal system design.

08.
arXiv (quant-ph) 2026-06-17

Helical Dirac Current with Local Coupling to a Chiral Potential

arXiv:2606.17618v1 Announce Type: new Abstract: We show that exact Dirac eigenstates in cylindrical confinement carry a definite helical conserved-current texture even in the zero orbital angular momentum channel l = 0. For the lowest confined mode, the Dirac current contains a nonvanishing azimuthal component together with longitudinal transport and exhibits opposite handedness in the two spin-resolved sectors. The structure also persists into the evanescent region. We further derive the channel-resolved matrix-element kernel generated by a static chiral scalar potential acting on the confined l = 0 Dirac modes. The resulting spin-selective coupling arises from the Dirac current texture and the scalar chiral potential, and yields a geometric selection rule in which diagonal channels vanish while off-diagonal conversion channels survive. The coupling strength is governed by an internal sampled-current overlap Jchi(k), defined as the integral from 0 to R of f(rho) times jphi_up(rho, k) times rho d rho. This quantity measures the spatial overlap between the chiral radial profile and the spin-up azimuthal Dirac-current density. The mechanism is fully local and texture-based, without external magnetic fields or spin-orbit coupling. Within standard Dirac theory, this work identifies the minimal static Dirac-geometric kernel underlying spin-selective response, establishing a baseline structure from which dynamical-medium, scattering, and transport formalisms can be systematically developed toward a complete description of spin-polarization phenomena such as CISS.

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

MamBOA: State-Space Architecture for Video Recognition

Fine-grained action recognition demands temporal reasoning that general-purpose architectures address through different cost-accuracy tradeoffs: 3D dense operators couple computation to the input volume, while difference-based methods approximate motion through rigid, hand-crafted subtraction of uncontextualized features - each reflecting a deliberate design choice with corresponding limitations in expressiveness or flexibility. We present MamBOA, a backbone-agnostic temporal framework built upon a novel interleaved scan structure that recasts the selective state-space recurrence (S6) as a native motion synthesizer. By interleaving consecutive feature representations extracted from a pretrained backbone into a single alternating sequence, the proposed scan structurally drives the recurrence to encode both temporal observations of each position within a shared hidden state, separated by only a single decay step - rendering the inter-frame transition an intrinsic component of the state dynamics rather than an externally computed quantity. A cascade of dedicated alignment and decoding operations then distills this joint encoding into an explicit motion representation, which a dual-path pooling mechanism adaptively aggregates by balancing attention-driven selection with uniform temporal coverage. The framework interfaces seamlessly with CNN, Transformer, and Mamba backbone families, adding only ~2.1 GFLOPs per feature pair. On Diving48, MamBOA achieves 85.02% Top-1 accuracy with an image-pretrained backbone and 86.24% with a video-pretrained backbone processing the entire video in a single forward pass - demonstrating that structurally induced state-space dynamics constitute a principled and general foundation for motion modeling.

10.
medRxiv (Medicine) 2026-06-16

MRMU: A New Paradigm for Mendelian Randomization by Accounting for Measured Covariates and Unmeasured Confounders

Mendelian randomization (MR) is a powerful approach for causal inference, however, its reliability is frequently compromised by unadjusted covariates and unmeasured confounders, such as unmeasured pleiotropy and sample structure. To address these challenges, we introduce MRMU, a novel paradigm for the MR framework. Unlike traditional single-variable or multivariable MR methods, MRMU selects instrumental variables only from the exposure of interest and estimates one exposure effect at a time, while jointly accounting for measured covariates and unmeasured confounders. This design improves the reliability of MR analyses. In simulations and real data, MRMU achieved better type I error control, higher statistical power, and more accurate effect estimation than existing MR methods. Applying to coronary artery disease (CAD), MRMU identified robust cardiometabolic risk factors, including LDL-C, APOB, systolic blood pressure, body mass index, and smoking initiation, with consistent evidence across multiple CAD datasets. In contrast, traits such as HDL-C, height, and educational attainment, which were found to be significant by existing MR methods, were no longer supported by MRMU. MRMU further supported blood pressure-related traits, rather than lipid traits, as the more relevant pathway linking urate to CAD. Finally, by integrating large-scale plasma proteomics data, MRMU identified candidate CAD drug targets beyond established HMGCR- and PCSK9-related pathways, highlighting its utility for therapeutic target prioritization.

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

PhysGuard: Fisher-Guided Gradient Projection for Sim-to-Real Neural PDE Surrogates

arXiv:2606.16602v1 Announce Type: new Abstract: Neural operator models trained on simulation data often lose accuracy when applied to experimental measurements due to the sim-to-real gap. Standard fine-tuning with limited real data can reduce this gap, but it may also damage the core physics-relevant representations learned during pretraining. Although knowledge-preserving adaptation has been widely investigated in vision or language tasks, it remains unclear whether these methods are suitable for neural operators whose architectures and protected knowledge are fundamentally different. Neural operators need to preserve core-scale physical structures rather than semantic or visual features. We propose PhysGuard, a physics-preserving framework for accurate sim-to-real adaptation of neural operators. Specifically, PhysGuard uses the empirical Fisher Information Matrix computed on simulation data to identify physics-critical parameter directions, then restricts fine-tuning updates to directions that do not interfere with them. A layer-wise Gram-matrix formulation makes this efficient for models with millions of parameters, while an adaptive threshold automatically determines the protected subspace size. A spectral probe experiment shows that the dominant Fisher directions are strongly associated with low-frequency output structures. Experiments on benchmark across four neural operator architectures and different physical systems show that PhysGuard performs strongly on most evaluation metrics compared to baselines. The benefits are most evident under severe domain shift, where it reduces low-frequency error by up to 32\% compared to standard fine-tuning while maintaining adaptability. Our code is available at https://github.com/ZhouChaunge/PhysGuard.

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

DenseControl: Instance-Level Controllable Synthesis of Dense Crowd Image

In this paper, we introduce DenseControl, a novel pipeline for generating dense crowd images. Specifically, DenseControl meticulously positions and sizes each generated instance to align precisely with the predefined coordinates and scales. Based on this, we further allow for control over the background, style, and attributes of instances. The motivation behind DenseControl stems from the observation of two main challenges in synthesizing crowd images: controlling signal embedding and maintaining topological integrity when imparting instance scale guidance. To address these, we first introduce the Isolated Object Embedding (IOE) map, a novel representation that facilitates spatial location control while mitigating the difficulties associated with learning projections for model. Secondly, we propose an Implicit Scale Embedding (ISE) strategy that seamlessly integrates with the IOE map to encode precise scale information. To further enhance the efficacy of combining ISE with the IOE map, we incorporate a Position Shortcut mechanism that enhances cross-attention to alleviate projection challenges. We evaluate DenseControl through two lenses: synthesis quality and applicability in latent applications. Experiments across different control conditions demonstrate DenseControl achieves state-of-the-art results in dense crowd image synthesis. Furthermore, we showcase applications in augmenting crowd analysis under data scarcity, transfer learning, and weather generalization scenes, to highlight the practical utility of DenseControl. The codebase will be released.

13.
arXiv (CS.CL) 2026-06-16

Automatic Summarization of Doctor-Patient Encounter Dialogues Using Large Language Model through Prompt Tuning

Automatic text summarization (ATS) is an emerging technology to assist clinicians in providing continuous and coordinated care. This study presents an approach to summarize doctor-patient dialogues using generative large language models (LLMs). We developed prompt-tuning algorithms to instruct generative LLMs to summarize clinical text. We examined the prompt-tuning strategies, the size of soft prompts, and the few-short learning ability of GatorTronGPT, a generative clinical LLM developed using 277 billion clinical and general English words with up to 20 billion parameters. We compared GatorTronGPT with a previous solution based on fine-tuning of a widely used T5 model, using a clinical benchmark dataset MTS-DIALOG. The experimental results show that the GatorTronGPT- 20B model achieved the best performance on all evaluation metrics. The proposed solution has a low computing cost as the LLM parameters are not updated during prompt-tuning. This study demonstrates the efficiency of generative clinical LLMs for clinical ATS through prompt tuning.

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

DualGauge: Automated Joint Security-Functionality Benchmarking of Specification-Only Code Generation by LLMs and Coding Agents

arXiv:2511.20709v2 Announce Type: replace-cross Abstract: Large language models (LLMs) and LLM-based coding agents are now used to generate code from natural-language specifications, yet ensuring such code is both functionally correct and secure remains a challenge. We present DualGauge, the first fully automated framework for jointly evaluating correctness and security of specification-only code generation, supported by DualGauge-Bench, a language-agnostic benchmark of 307 coding tasks each paired with functional and security tests derived from the same specification. Evaluating 10 representative LLMs across Python, C++, and JavaScript, we find that functional correctness substantially overestimates reliable code generation: even the strongest model remains below 15% joint security-functionality success in every language. Common model-side factors–scale, extended thinking, quantization, instruction tuning, and code specialization–do not reliably improve joint performance, suggesting secure-and-correct code generation does not simply emerge from stronger coding capability. Evaluation of 3 leading agentic coding systems (Codex, OpenHands, and Claude Code) shows that iterative scaffolding provides no advantage over direct (LLM-based) generation on specification-only tasks. A qualitative audit reveals failures concentrate at the output contract boundary and in guards that exist but are insufficient–patterns that only joint benchmarking reliably exposes.

15.
arXiv (CS.CL) 2026-06-19

Your Mouse and Eyes Secretly Leak Your Preference: LLM Alignment using Implicit Feedback from Users

To align a Large Language Model (LLM), most existing methods collect explicit human feedback and train a reward model to predict the human preference based on the response text. These existing methods have two key limitations. First, the users rarely provide explicit feedback for LLM responses, which makes the high-quality preference annotation expensive to collect. Second, the methods do not leverage implicit human feedback, which has proven vital to the economic moats of Internet giants. To quantify the value of implicit feedback, we build a new dataset called IFLLM, which collects 1336 multi-turn questions from the 59 Mechanical Turk workers, their mouse trajectories, and eye gazing points to the LLMs' responses from their webcams. IFLLM shows that the users have very diverse types of gazing behavior and mouse trajectories. Our reward model based on the implicit user feedback boosts the accuracy of the text-based reward model from 55% to 64% and nearly triples the relative response quality improvements after applying the DPO to eight LLMs, demonstrating the value of implicit feedback in the wild. Our data collection website, dataset, and codes can be found at https://github.com/themehulpatwari/llm-implicit-feedback/.

16.
PLOS Computational Biology 2026-06-01

Supervised deep learning with gene functional annotation for cell classification

作者:

by Zhexiao Lin, Yuanyuan Gao, Wei Sun Gene-by-gene differential expression analysis is a widely used supervised approach for interpreting single-cell RNA-sequencing (scRNA-seq) data. However, modern scRNA-seq datasets often contain large numbers of cells, leading to the identification of many differentially expressed genes with extremely small p-values but negligible effect sizes, thus making biological interpretation difficult. To overcome this challenge, we developed Supervised Deep learning with gene functional ANnotation (SDAN), a method that integrates gene functional annotation information (e.g., protein-protein interaction) with gene-expression profiles through a graph neural network. SDAN identifies functionally coherent gene sets that optimally classify cells, and the resulting cell-level classification scores can be aggregated to make individual-level predictions. We evaluated SDAN alongside three representative existing methods in three real-data applications aimed at identifying gene sets associated with severe COVID-19, dementia, and cancer immunotherapy response. Across all applications, SDAN consistently outperformed the alternative approaches by achieving two objectives simultaneously: accurate outcome classification and clear assignment of genes to functionally related gene sets.

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

From Correlation to Causation in Lane Change Prediction for Automated Driving: A Causal Explanation Framework

arXiv:2606.15756v1 Announce Type: cross Abstract: Lane-change prediction is a central task in intelligent vehicles, where early maneuver anticipation can support safer decision-making. However, many existing approaches mainly learn statistical associations between observed driving variables and future maneuvers, while overlooking the causal dependencies among the input variables themselves. This limits interpretability, especially when physically related variables such as longitudinal gap, relative longitudinal velocity, and Time-To-Collision (TTC) are treated as independent flat inputs. This article presents a causal-inference-based framework for lane-change prediction and explanation. The proposed approach combines linguistic feature construction, expert-constrained causal discovery, deep structural causal modeling with Deep End-to-end Causal Inference (DECI), intervention-based effect analysis, refutation testing, and recursive causal-chain explanation. The objective is not only to predict the future maneuver, but also to identify candidate variables that directly contribute to the prediction, the upstream factors influencing them, and the causal chains through which these effects propagate. The framework achieves average F1-scores above 95% during the first three seconds before the lane-marking crossing event. Beyond prediction accuracy, the framework uses intervention-based effect analysis to distinguish influential from weakly influential variables under the learned causal structure. It further distinguishes candidate direct contributors from mediated effects and generates contrastive causal-chain explanations that clarify why the predicted maneuver is favored and why the alternative maneuvers are less supported. The main contribution is therefore a mechanism-aware lane-change prediction pipeline that moves beyond correlation-based classification toward more interpretable causal reasoning for maneuver prediction.

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

Quantification of Uncertainty with Adversarial Models in Medical Image Segmentation

Reliable pixel-level uncertainty quantification holds the potential to transform clinical workflows by enabling high-fidelity longitudinal monitoring and distinguishing true pathological changes from artifacts. Ideally, these models provide the stability required for critical treatment planning and surgical intervention. However, standard deep learning models often suffer from miscalibration, yielding overconfident predictions that mask underlying vulnerabilities at subtle pathological boundaries. To address this, we propose QUAM-SM, a post-hoc framework using targeted adversarial search to identify "adversarially fragile" pixels. By actively seeking perturbations that expose predictive instability, our method highlights regions where decisions are most vulnerable to being flipped. Importantly, the framework disentangles epistemic uncertainty from aleatoric uncertainty. Experiments on two public datasets with multiple expert annotations demonstrate that QUAM-SM outperforms both standard and recent uncertainty estimation approaches in terms of reliability and boundary sensitivity. Code is available at https://github.com/HanaJebril/quam_sm

19.
arXiv (math.PR) 2026-06-12

Quenched and Annealed CLTs for the one-periodic Aztec diamond in random environment

arXiv:2510.11846v2 Announce Type: replace Abstract: We study the asymptotic behavior of random dimer coverings of the one-periodic Aztec diamond in random environment. We investigate quenched limit theorems for the height function and we extend annealed limit theorems that were recently studied in [arXiv:2507.08560]. We consider more general choices of random edge weights (independence is not assumed) and we distinguish two cases where the random edge weights satisfy the Central Limit Theorem (CLT) under different scalings. For both cases, we prove convergence to the Gaussian Free Field for the quenched fluctuations. For the annealed version, it had been shown in [arXiv:2507.08560], that Gaussian Free Field fluctuations can be dominated by the much larger fluctuations of the random environment. To access quenched fluctuations we analyze the Schur process with random parameters in a way that allows to prove the annealed CLT for the height function for non i.i.d. weights. We consider specific examples where we determine the asymptotic fluctuations.

20.
arXiv (CS.CV) 2026-06-11

Ouroboros-Spatial: Closing the Data-Model Loop for Spatial Reasoning

Spatial reasoning remains a persistent challenge for multimodal large language models (MLLMs). Existing approaches largely rely on large-scale, statically curated datasets, where all training samples are treated uniformly regardless of the model's evolving capabilities. This static paradigm is inherently data-inefficient: training capacity is often spent on samples that are either trivial or overly difficult for the model at its current stage. To address this limitation, we propose Ouroboros-Spatial, a self-evolving training framework in which the model plays dual roles as a proposer and a solver. In each iteration, a frozen proposer generates spatial question-answer (QA) pairs from 3D scene metadata and raw video frames, together with executable code for deriving reliable ground truth. A learnable solver is then fine-tuned on the accepted samples, and its per-sample prediction confidence is used as a difficulty signal. This signal is fed back to the proposer in the next iteration, guiding it to generate questions better matched to the solver's current capabilities. Through this closed-loop design, the training distribution co-evolves with model ability, reducing redundant trivial examples while filtering out ambiguous or uninformative samples with limited learning value. Across six spatial reasoning benchmarks, Ouroboros-Spatial substantially improves Qwen3-VL-4B and Qwen3-VL-8B while using an order of magnitude fewer training examples than recent large-scale curated datasets. On VSI-Bench, it yields absolute gains of 9.9 and 6.8 points for the 4B and 8B models, respectively, enabling both to outperform a wide range of strong open-source and proprietary baselines.

21.
medRxiv (Medicine) 2026-06-10

Development of an Open-Access Action Observation Video Library for Upper Limb Motor Rehabilitation

Background: Occupational therapists can improve stroke survivors hand and arm movement and participation in daily activities through action observation (AO). AO involves watching another persons hand or arm complete a movement or task. While research generally supports the use of AO with stroke survivors, there are limited AO videos are available to occupational therapists which makes applying AO challenging. Objective: The purpose of this work is to develop structured and widely accessible tool to support access to AO for stroke survivors, occupational therapists, and researchers. Methods: To develop an AO video library for stroke rehabilitation, functional and non-functional upper limb task deficits were first identified through clinical observations and clinician interviews to establish a prioritized list of daily activities. In collaboration with media production specialists, healthy adult volunteers were recruited and filmed performing these tasks from both first- and third-person perspectives. The recorded videos were then systematically edited, enhanced with instructional title slides, and distributed via a public YouTube channel for clinical application and a categorized digital repository for research purposes. Results: Initial assessments revealed a complete lack of familiarity, awareness, and utilization of AO resources among local occupational therapists, despite high perceived clinical utility. To address this gap, a final library of 150 tasks was established, resulting in the production of 419 finalized, standardized videos featuring six healthy volunteers. For clinical application, these videos were hosted on a free, public YouTube channel organized into 18 functional playlists, while a parallel set was structured into distinct movement categories for research repository storage. Conclusion: By providing a structured and highly accessible tool, this repository enables clinicians, researchers, and caregivers to readily implement evidence-based action observation interventions in both clinical and home settings.

22.
medRxiv (Medicine) 2026-06-16

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

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

23.
arXiv (CS.CL) 2026-06-19

JAMER: Project-Level Code Framework Dataset and Benchmark on Professional Game Engines

Current AI-driven game development has made substantial progress in asset generation, gameplay design, and web-based game coding, yet project-level code engineering on professional game engines remains largely unexplored due to the absence of large-scale datasets and deterministic evaluation methods. We present JamSet and JamBench, the first project-level game code framework dataset and benchmark built on a professional game engine. Our key insight is that Game Jam competitions, community events where developers build complete games under tight time constraints, yield thousands of open-source projects suitable for this purpose. Building on the Godot engine's text-based format and headless execution mode, we design a deterministic verification pipeline from file integrity to runtime behavior collection, distilling 8,133 verified projects from over 240,000 repositories. Of these, 300 manually verified projects form JamBench; the rest constitute JamSet. JamBench defines theme-driven generation and code completion tasks, evaluated through a pipeline combining compilation pass rates, Structural Completeness Score (SCS), and Behavioral Alignment Score (BAS). Evaluation of 9 frontier models reveals a capability cliff as project scale increases, with runtime pass rates dropping from 80.4% on small projects to 5.7% on large ones (Task2a). Code Agents improve compilation rates yet yield no gains in runtime behavioral quality, indicating that the bottleneck lies in architectural design rather than syntactic correctness. Experiments validate JamSet as effective training data. All data and code are publicly available.

25.
medRxiv (Medicine) 2026-06-17

Nickel and Dimed: How a Common Earth Element is Short-Changing Our Health

Nickel has been studied for a long time as an environmental contaminant but less so in its connection to population health. It does not announce itself as loudly as its transition metal brethren like mercury and cadmium, but its chemical properties permit it to be deleterious as a low-dose, chronic exposure, particularly among those with immune systems sensitized to it. There is a growing evidence base and vocabulary to discuss nickel's affect on health. However, in the U.S., there are not recent, reliable estimates of the share of the population with a nickel allergy, let alone how much nickel Americans are exposed to through their diet. This paper seeks to close this evidence gap by creating a new dataset of dietary nickel and other heavy metal exposure and assessing how high levels of dietary nickel exposure shape local demand for health care services. We use soil data from the U.S. Geological Survey and data on agricultural product transport from FoodFlows.org to create a county-level dietary nickel exposure index. We then use a large electronic health record database and double machine learning to estimate how demand for primary care services varies across levels of dietary nickel exposure. We find that counties with high nickel exposure experience an increase in the share of primary care office visits for symptoms highly suggestive of nickel poisoning. This result survives multiple hypothesis test corrections and placebo tests. Our research suggests that nickel has harmful effects on individual health whose exposure can be measured at a population level, and is shaping primary care across the U.S.