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01.
arXiv (CS.AI) 2026-06-18

TLA-Prover: Verifiable TLA+ Specification Synthesis via Preference-Optimized Low-Rank Adaptation

arXiv:2606.06133v2 Announce Type: replace-cross Abstract: TLA+ is a formal specification language for verifying distributed systems and safety-critical protocols. Large language models (LLMs) frequently produce TLA+ specifications that fail the TLC model checker for semantic reasons. Across 25 LLMs, the best public baseline is 26.6% syntactic parse and 8.6% semantic model-check. We present TLA-Prover, a 20-billion-parameter model for TLA+ specification synthesis. Training combines supervised fine-tuning (SFT) on verified examples with repair-based group-relative policy optimization (GRPO). In the GRPO stage, the model learns to fix its own rejected specifications. We also train a direct preference optimization (DPO) variant from the same SFT checkpoint as an ablation. TLC provides the reward signal directly, with no learned reward model. Four tiers grade each output: Bronze (parses), Silver (no warnings), Gold (passes TLC), and Diamond. To reach Diamond, the model's correctness property is automatically altered in a small way; TLC must then detect a violation. If TLC still passes, the property was always-true and contributes nothing; the output fails Diamond. TLA-Prover reaches 9/30 (i.e. pass@1 = 30%) at both Gold and Diamond on a held-out 30-problem benchmark. This is roughly 3.5x the 8.6% untuned baseline. The DPO variant reaches 20% at Diamond. Gold and Diamond coincide at every checkpoint; this prevents the trivial-property failure mode.

02.
arXiv (CS.LG) 2026-06-11

Program Evaluation with Remotely Sensed Outcomes

arXiv:2411.10959v5 Announce Type: replace-cross Abstract: We study causal inference in experiments and quasi-experiments, where the economic outcome is imperfectly measured by a remotely sensed variable. The remotely sensed variable is low-cost, scalable, and predictive of the economic outcome in observational data; examples include satellite imagery and mobile phone activity. We model the remotely sensed variable as post-outcome: variation in the economic outcome causes variation in the remotely sensed variable. For example, changes in environmental quality cause changes in satellite imagery, not vice versa. Under this assumption, we propose a formula to nonparametrically identify the causal parameter by combining experimental and observational data. We develop a method for n^{-1/2} inference that is robust to misspecification and that does not restrict the algorithms used to process remotely sensed variables.

03.
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.

04.
arXiv (CS.LG) 2026-06-19

Optimal Deterministic Multicalibration and Omniprediction

arXiv:2606.20557v1 Announce Type: new Abstract: A model is multicalibrated on a collection of group weights $G$ if it is calibrated – i.e. unbiased even conditional on its prediction – not just overall, but also after reweighting contexts by each $g \in G$. It is a useful property for many downstream applications and is a basic desideratum of trustworthy machine learning. Before this work, all predictors known to attain the minimax-optimal $\widetilde O(\varepsilon^{-3})$ sample complexity rate for $\varepsilon$-multicalibration were randomized, while deterministic predictors were known only with substantially worse sample complexity. Whether randomization is necessary for optimal sample complexity in multicalibration was explicitly asked by [CLNR26] and implicitly in several prior works. We resolve this open problem by giving a minimax-optimal multicalibration algorithm that outputs a deterministic predictor. We then generalize the algorithm to produce optimal deterministic predictors that satisfy outcome indistinguishability (OI) with respect to finite or finitely covered collections of tests. As an application, this also gives deterministic omnipredictors and panpredictors with optimal sample complexity, resolving open problems posed by [OKK25] and [BHHLZ25].

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

Propagating Structural Guidance: Synthesizing Fluorescein Angiography from Fundus Images and Sparse OCT Scans

Fundus fluorescein angiography (FFA) is critical for assessing retinal vascular abnormalities, but its acquisition is invasive and not always feasible. In contrast, color fundus photography (CFP) is non-invasive and widely accessible, which has motivated studies on CFP-to-FFA synthesis. However, prior works rely solely on CFP surface texture, fundamentally limiting the ability to reconstruct functional vascular information and subtle pathological changes. To address this, we propose a novel framework that synthesizes FFA from CFP with structural guidance provided by optical coherence tomography (OCT). We construct a multi-modal retinal imaging dataset with paired CFP, FFA, and OCT from 3,676 patient eyes–the first tri-modally aligned dataset in retinal imaging. To bridge the spatial gap between OCT and fundus modalities, we propose a Spatially Aligned Cross-Modal Fusion (SACMF) module that projects depth-resolved OCT features onto the fundus plane and injects them into the CFP encoder via adaptive layer normalization. Beyond feature fusion, we further introduce Token-wise Cross-Modality Alignment (TCMA), a token-level contrastive learning strategy that explicitly aligns CFP and FFA representations at corresponding spatial positions. Our method achieves superior synthesis performance compared to state-of-the-art methods. Moreover, extensive experiments demonstrate that the FFA images synthesized by our approach bring greater improvements in downstream disease diagnosis performance than existing methods, highlighting the clinical potential of our approach as a non-invasive decision-support tool in routine workflows. The code is available at https://github.com/while-plus/OCT-guide-FFA-Syn.

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

Reverse Flow Matching: A Unified Framework for Online Reinforcement Learning with Diffusion and Flow Policies

arXiv:2601.08136v2 Announce Type: replace Abstract: Diffusion and flow policies are gaining prominence in online reinforcement learning (RL) due to their expressive power, yet training them efficiently remains a critical challenge. A fundamental difficulty that distinguishes online RL from standard generative modeling is the lack of direct samples from the target Boltzmann distribution defined by the Q-function. To address this, two seemingly distinct families of methods have been proposed for diffusion policies: a noise-expectation family, which uses a weighted average of noise as the training target, and a gradient-expectation family, which employs a weighted average of Q-function gradients. However, it remains unclear how these objectives are formally related, or whether they can be synthesized into a more general formulation. In this paper, we propose a unified framework, reverse flow matching (RFM), which rigorously addresses the problem of training diffusion and flow models without direct target samples. By adopting a reverse inferential perspective, we formulate the training target as a posterior mean estimation problem given an intermediate noisy sample. Crucially, we introduce Langevin Stein operators to construct zero-mean control variates, deriving a general class of estimators that share the same expectation. We show that existing noise-expectation and gradient-expectation methods are simply two specific instances within this broader class. This unified view yields two key advancements: it extends the capability of targeting Boltzmann distributions from diffusion to flow policies, and it enables the principled combination of Q-value and Q-gradient information to form an effective estimator, thereby improving training efficiency and stability. We instantiate RFM to train a flow policy in online RL and demonstrate improved performance on continuous-control benchmarks compared to diffusion policy baselines.

08.
medRxiv (Medicine) 2026-06-22

Climatic Drivers of Malaria risk in Children Under Five: A Large-Scale Analysis of individual-level data for 350,000 children in 26 Sub-Saharan African Countries

Background Malaria risk is influenced by climatic conditions, and children under five are particularly vulnerable due to their limited acquired immunity. We investigate the association between climatic factors and malaria risk in 350,000 children aged 5-59 months in sub-Saharan Africa over 18 years. Methods We included children aged 5-59 months with malaria tests from Demographic and Health Surveys (DHS) in 26 sub-Saharan African countries between 2006 and 2023. We linked these data to high-resolution climate exposures: temperature, precipitation, soil moisture, actual evapotranspiration and specific humidity. We fitted a mixed-effect logistic regression model incorporating Distributed Lag Non-linear Models (DLNM) over 1-6 month lag window for each exposure, controlling for seasonality and long-term trends. We examined effect modification by maternal education, household wealth, residential type, water source, sanitation facility, child age and sex, use of insecticide-treated bed nets (ITNs), and the age of the household head. Results Malaria prevalence was 19.5%. Malaria risk was highest at 24 degrees (OR: 1.45, 95% CI: [1.36, 1.54]), followed by a decline at higher temperatures. This elevated risk was mainly driven by short-term exposures (1-2 months). Precipitation increased risk up to 59 ~ 120 mm (1.10, [1.07, 1.12]), after which heavier rainfall reduced risk, particularly at short- to medium-term lags (1-4 months). Soil moisture was associated with increasing risk up to ~80 mm (1.11, [1.08, 1.14]), with a plateau at higher levels. Evapotranspiration showed a strong, near-linear positive association with malaria risk. Higher specific humidity levels (>14 g/kg) presented a lower risk, reaching a 45% reduction at 17 g/kg (0.55, [0.49, 0.61]), with the strongest protective effects at short-term lags (1-2 months). Elevated malaria risk at low and moderate average temperatures was particularly evident among children who did not sleep under an ITN net. Conclusion Malaria risk in children under five is strongly shaped by climatic factors, with complex and delayed associations. The findings provide evidence to guide targeted interventions and early-warning strategies for vulnerable populations.

09.
arXiv (CS.CV) 2026-06-15

Explaining RhythmFormer: A Systematic XAI Analysis of Periodic Sparse Attention for Remote Photoplethysmography

Remote photoplethysmography (rPPG) transformers achieve low heart-rate error on benchmarks, yet their decisions remain opaque–a growing concern as rPPG moves toward clinical heart rate estimation. Existing rPPG XAI is dominated by qualitative heatmap inspection without quantitative faithfulness metrics or physiology-grounded validation, leaving a gap between visual plausibility and auditable evidence. We address this gap. First, we adapt four attribution methods (raw attention, rollout, flow, Beyond Intuition) to RhythmFormer's bi-level routing attention with top-$k$ selection. Second, we introduce a skin coverage metric quantifying how much attribution mass falls on skin regions. Third, we adapt the SaCo faithfulness coefficient from its original classification setting to rPPG regression by using the MAE between original and perturbed predicted rPPG waveforms as the perturbation impact. Applying these tools, we quantify a multi-hop leakage effect under sparse top-$k$ routing: attention rollout and flow almost completely restores the connections that individual refined-attention layers explicitly set to zero. Beyond Intuition mitigates this via its value-projection-weighted rollout and gradient-supported mask, attaining the highest median refined skin coverage ($0.83$ vs. $0.57$ for vanilla rollout) and faithfulness ($F=0.92$) among the evaluated methods on UBFC-rPPG. Validation across diverse datasets and model variants is needed. A case study on a low-SaCo outlier further shows all four methods recovering consistently once an artefactual region is replaced, suggesting consistent SaCo behavior across attribution families in this illustrative case. Together, these metrics move XAI for rPPG toward auditable numerical evidence about spatial alignment and perturbation faithfulness, i.e. trustworthy rPPG XAI.

10.
arXiv (quant-ph) 2026-06-19

Quantum-Accelerated Self-Consistent Field: A Hybrid Algorithm

arXiv:2606.20176v1 Announce Type: new Abstract: We present the Grover adaptive search self-consistent field (GAS-SCF) algorithm. GAS-SCF leverages quantum arithmetic to construct an efficient oracle that marks target states (Fock states) which improve upon some initial classical energy estimate. Amplitude amplification then increases the probability of measuring these states. This approach offers a theoretical quadratic speed-up for the optimization problem encountered in SCF quantum chemistry and establishes a baseline against which structured optimization algorithms, such as QAOA and DQI may be compared. In this work, we classically simulate three examples as proofs of concept of the algorithm, the largest consisting of 26 qubits. We then extend our analysis to two larger systems, with O3 representing the largest case at 330 qubits. These examples are chosen to probe classically challenging SCF regimes. Achieving chemically relevant applications of GAS-SCF will require large-scale, fault-tolerant quantum hardware.

11.
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.

12.
arXiv (quant-ph) 2026-06-19

Exploiting More Than Symmetry in Variational Quantum Machine Learning

arXiv:2606.20316v1 Announce Type: new Abstract: The success of variational quantum learning models crucially depends on choosing parametrizations that reflect the structure of the problem at hand. Symmetries provide one of the clearest such structures: whenever transformations of the input leave the desired outcome unchanged, this invariance should be built into the model rather than discovered during training. However, imposing a symmetry does not by itself determine a useful ansatz. Even within the symmetry-preserving space, one must decide where the trainable degrees of freedom should be placed. In this work, we study this remaining design freedom in equivariant variational quantum circuits. Building on symmetry-based parameter sharing, we disentangle two architectural choices: how much symmetry should be enforced, and which symmetry-respecting interactions should be trainable. Using Tic-Tac-Toe as a fully enumerable and structurally transparent test case, we find that suitable subgroups preserve most of the generalization benefit. By contrast, the dominant gains arise from gates acting directly on decisive task motifs. Thus, symmetry defines the admissible design space, while effective ansatze require an additional task-informed choice of trainable interactions.

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

Rethinking One-Step Image Editing through ChordEdit: Reproduction, Simplification, and New Insights

One-step image editing is important for making text-guided editing fast, practical, and easy to deploy, but its underlying mechanism is still not fully understood. We revisit ChordEdit through reproduction, ablation, and simplification. Our analysis shows that a) the chord window $\delta$ largely acts as an effective timestep shift from $t$ to $t - \delta$; b) chord transport acts on high-noise images and mainly performs low-frequency semantic editing; and c) proximal alignment acts on low-noise images and complements it by adding high-frequency target details. In this view, ChordEdit naturally decomposes editing into a coarse low-frequency transport stage and a fine high-frequency alignment stage. These findings suggest a path toward prompt-conditioned dynamic timestep selection for adaptive image editing. All code and results can be found at \href{https://github.com/Harvard-AI-and-Robotics-Lab/ChordEdit-Reproduction}{link}.

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

Lung-SRAD: Spectral-Aware Regularized Audio DASS with Dual-Axis Patch-Mix Contrastive Learning for Respiratory Sound Classification

arXiv:2606.11922v1 Announce Type: cross Abstract: Recent respiratory sound classification (RSC) studies largely rely on CLS-token driven self-attention architectures such as the Audio Spectrogram Transformer (AST). While effective at modeling global context, recent analyses suggest a low-pass filtering behavior that may reduce sensitivity to localized abnormal patterns. In this work, we investigate State Space Models (SSMs) as an alternative backbone for RSC. Using the Distilled Audio State Space model, we analyze intermediate representations through spectral response curves and observe stronger preservation of mid-to-high spatial-frequency components. Based on these observations, we introduce spectral-aware layer regularization using Gaussian convolution applied to selected layers. We further propose Dual-Axis Patch-Mix contrastive learning tailored to SSM-based audio models for robust representation learning. Experiments on the ICBHI benchmark show that our approach achieves 64.48% score, outperforming the AST baseline by 5%. Code is available at https://github.com/RSC-Toolkit/Lung-SRAD.

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

Connect the Dots: Training LLMs for Long-Lifecycle Agents with Cross-Domain Generalization Via Reinforcement Learning

This work presents a general framework for training large language models (LLMs) to "Connect the Dots" (CoD), a meta-capability required by long-lifecycle agents: as an LLM-based AI agent gets deployed in an environment, it solves a long sequence of tasks while continuously exploring the environment, learning from its own experiences, and iteratively self-updating its context about the environment, thereby achieving progressively better performance on future tasks conditioned on the updated context. Major components of the CoD framework include: (1) algorithm design and infrastructure for end-to-end reinforcement learning (RL) with long rollout sequences interleaving solve-task and update-context episodes; (2) tasks and environments for incentivizing and eliciting the targeted meta-capability in LLMs during training, as well as for faithfully measuring progress during evaluation. We present proof-of-concept implementations of the CoD framework, including a GRPO-style RL algorithm with fine-grained credit assignment, as well as tasks and environments tailored to the targeted meta-capability (rather than domain-specific LLM capabilities or standard task-by-task RL). Empirical results validate the efficacy of end-to-end RL training in the CoD setting, and demonstrate the potential for out-of-distribution generalization – within the training domains, across different domains, and from CoD to Ralph-loop settings – of the elicited meta-capability. Our investigation of CoD connects several lines of prior works, and opens up new opportunities for advancing LLMs and AI agents. To facilitate further research and applications, we release our implementations at \url{https://github.com/agentscope-ai/Trinity-RFT/tree/research/cod/examples/research_cod}.

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

Deep Learning and Elicitability for McKean-Vlasov FBSDEs With Common Noise

arXiv:2512.14967v2 Announce Type: replace Abstract: We present a novel numerical method for solving McKean–Vlasov forward–backward stochastic differential equations (MV–FBSDEs) with common noise, combining Picard iterations, elicitability and deep learning. The key innovation involves elicitability to derive a pathwise loss function, enabling efficient training of neural networks to approximate both the backward process and the conditional expectations arising from common noise, without requiring computationally expensive nested Monte Carlo simulations. The mean-field interaction term is parameterized via a recurrent neural network trained to minimize an elicitable score, while the backward process is approximated through a hybrid feedforward and recurrent network representing the decoupling field. We validate the algorithm on a systemic-risk inter-bank borrowing and lending model, where analytical solutions exist, demonstrating accurate recovery of the true solution. We further extend the model to quantile-mediated interactions, showcasing the flexibility of the elicitability framework beyond conditional means or moments. Finally, we apply the method to a non-stationary Aiyagari–Bewley–Huggett economic growth model with endogenous interest rates, illustrating its applicability to complex mean-field games without closed-form solutions.

17.
arXiv (quant-ph) 2026-06-16

TENSO: Software Package for Numerically Exact Open Quantum Dynamics Based on Efficient Tree Tensor Network Decomposition of the Hierarchical Equations of Motion

arXiv:2603.17711v2 Announce Type: replace-cross Abstract: TENSO is a versatile and powerful open-source software package for numerically exact simulations of the dynamics of quantum systems immersed in structured thermal environments. It is based on a tree tensor network decomposition of the hierarchical equations of motion (HEOM) that efficiently curbs its curse of dimensionality with bath complexity. As such, TENSO enables exact non-Markovian open quantum dynamics simulations even with complex environments typical of chemistry and quantum information science. TENSO allows for time-dependent drive in the system, and for non-commuting fluctuations. More generally, TENSO efficiently propagates the dynamics for any method with a generator of the dynamics that can be expressed in a sum-of-products form, including the HEOM and multi-layer multiconfigurational time-dependent Hartree methods. TENSO enables simulations using tensor trees and trains of arbitrary order, and implements three propagation strategies for the coupled master equations; two fixed-rank methods that require a constant memory footprint during the dynamics and one adaptive rank method with a variable memory footprint controlled by the target level of computational error. In contrast to the accompanying theory and algorithmic paper [J. Chem. Phys. 163, 104109 (2025)] the focus here is on the practical usage and applications of TENSO with underlying theoretical concepts introduced only as needed.

18.
arXiv (CS.CL) 2026-06-15

AdaSR: Adaptive Streaming Reasoning with Hierarchical Relative Policy Optimization

Large reasoning models typically follow a read-then-think paradigm: they observe the complete input, reason over a static context, and then produce the answer. Yet many real-world scenarios are inherently dynamic, such as audio and video stream, where information arrives as a continuous stream and models must reason, update, and respond under partial observations. Recent streaming reasoning methods allow models to think while reading, but they largely rely on supervised imitation of pre-constructed trajectories, which limits their flexibility. In this paper, we propose AdaSR, an adaptive streaming reasoning framework that enables models to reason during input streaming and perform final deliberation once the stream is complete, learning when to think, and how much computation to allocate across different stages. To optimize this hierarchical reasoning process, we introduce Hierarchical Relative Policy Optimization (HRPO), which decomposes policy optimization into streaming reasoning and deep reasoning phases, providing more fine-grained advantage assignment instead of uniformly distributing a single sequence-level advantage over all tokens. HRPO integrates format, accuracy, and adaptive thinking rewards to enforce valid reasoning protocols, preserve final task performance, and encourage latency-aware computation allocation. Experiments show that AdaSR achieves a better balance among reasoning accuracy, computational efficiency, and streaming latency compared with supervised fine-tuning baseline. We release our code at https://github.com/EIT-NLP/StreamingLLM/tree/main/AdaSR.

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

CoAgent: Concurrency Control for Multi-Agent Systems

arXiv:2606.15376v1 Announce Type: cross Abstract: Multi-agent LLM systems – coding agents, devops agents, document agents – now routinely run several agents in parallel against the same git tree, Kubernetes cluster, or document. As soon as two of them mutate shared state, they enter the regime classical concurrency control has studied for decades, but classical mechanisms fit LLM agents poorly. A single agent transaction spans minutes of inference, read sets are broad and opaque rather than statically inferable, and the live state agents act on admits neither fork nor buffer, so writes take effect the moment they execute. Locks block long inference intervals; OCC abort-and-retry discards minutes of work on every conflict. This paper builds concurrency control on a capability classical transactions lack: the LLM inside each agent can judge whether a conflicting write invalidates its plan, and can repair exactly the operations that depended on it. Control therefore turns advisory: the runtime informs, the agent repairs. Our protocol, MTPO (Monotonic Trajectory Pre-Order), fixes a serialization order at launch, serves each read the order-filtered value, and applies writes speculatively in place; a one-way notification asks an affected reader to re-judge and patch its plan, while the framework mechanically undoes and reorders misplaced writes through the saga-style inverse each tool registers in advance. At quiescence the run is serializable in the pre-decided order. We realize MTPO as CoAgent, toolcall middleware whose privileged ToolSmith grows footprint-declared, undoable tools online. On ten contended workloads, CoAgent stays within 5\% of serial correctness at a $1.4\times$ speedup and near-serial token cost, where 2PL and OCC surrender nearly all concurrency gains; on a bash-only target system, it grows a 25-tool library online and lifts the task pass rate from 45/71 to 63/71 at $0.80\times$ the time and $0.86\times$ the cost.

20.
medRxiv (Medicine) 2026-06-18

Can Vision-Language Models See the Vital Signs? Benchmarking and Fine-Tuning for Intraoperative Monitor Reading

Background Vital-sign deterioration is a leading contributor to preventable perioperative death, yet manual monitor reading is intermittent, error-prone, and subject to alarm fatigue. Automating this perceptual step could enable continuous surveillance, but existing solutions depend on device-specific hardware integration or cloud-hosted vision-language models (VLMs), which raise privacy, cost, and connectivity barriers in resource-limited healthcare facilities. Methods We constructed a benchmark of 200 in-the-wild intraoperative monitor photographs (spanning multiple vendors, angles, and illumination conditions) annotated for eight vital-sign parameters: heart rate, SpO2, ETCO2, respiratory rate, systolic/diastolic/mean blood pressure, and temperature. We evaluated an optical character recognition (OCR)-based pipeline, nine instruction-tuned VLMs (four commercial, five open-weight ranging from [≤]4B to 31B parameters) under two prompting regimes, and a compact open model (Qwen3.5-9B) adapted via low-rank fine-tuning (LoRA, 0.46% of parameters updated). Results Under a domain-aware prompt, frontier VLMs reached 0.98-0.997 exact-match accuracy zero-shot, whereas the OCR pipeline and [≤]4B model scored approximately 0.20 lower, defining a 9B-class usable floor. LoRA fine-tuning Qwen3.5-9B on 80-120 images raised accuracy from 0.953 to 0.994 (statistically indistinguishable from the best commercial model) and reduced the critical-error rate fivefold (0.0313 [->] 0.0063). Ablations showed that performance saturated at 80 training images and rank-8 adapters. Conclusion Monitor reading is a solved perception problem for VLMs above the 9B scale. A lightweight fine-tuned open model achieves frontier accuracy while running entirely on local hardware, preserving data privacy, offline capability, and near-zero marginal cost. Residual errors stem from blood-pressure source ambiguity and are addressable with explicit disambiguation logic.

21.
arXiv (CS.AI) 2026-06-19

Multi-LCB: Extending LiveCodeBench to Multiple Programming Languages

arXiv:2606.20517v1 Announce Type: new Abstract: LiveCodeBench (LCB) has recently become a widely adopted benchmark for evaluating large language models (LLMs) on code-generation tasks. By curating competitive programming problems, constantly adding fresh problems to the set, and filtering them by release dates, LCB provides contamination-aware evaluation and offers a holistic view of coding capability. However, LCB remains restricted to Python, leaving open the question of whether LLMs can generalize across the diverse programming languages required in real-world software engineering. We introduce Multi-LCB, a benchmark for evaluating LLMs across twelve programming languages, including Python. Multi-LCB transforms Python tasks from the LCB dataset into equivalent tasks in other languages while preserving LCB's contamination controls and evaluation protocol. Because it is fully compatible with the original LCB format, Multi-LCB will automatically track future LCB updates, enabling systematic assessment of cross-language code generation competence and requiring models to sustain performance well beyond Python. We evaluated 24 LLMs for instruction and reasoning on Multi-LCB, uncovering evidence of Python overfitting, language-specific contamination, and substantial disparities in multilingual performance. Our results establish Multi-LCB as a rigorous new benchmark for multi-programming-language code evaluation, directly addressing LCB's primary limitation and exposing critical gaps in current LLM capabilities.

23.
Nature Medicine 2026-06-10

Dual-target gene therapy in Parkinson’s disease: a multicenter phase 1 trial

作者:

Restoring striatal dopamine synthesis is a promising gene therapy strategy for Parkinson’s disease. Previous adeno-associated virus-mediated aromatic L-amino acid decarboxylase (AADC) monotherapies remain dependent on exogenous levodopa, whereas multigene delivery is constrained by strict adeno-associated virus packaging limits. A ‘dual approach’ targeting the two rate-limiting enzymes, tyrosine hydroxylase (TH) and AADC, offers the potential for autonomous dopamine synthesis. We report the 12-month primary safety and tolerability outcomes of a multicenter, open-label, dose-escalation, phase 1 trial evaluating BBM-P002, a new adeno-associated virus vector—AAVT42—codelivering constitutively active TH and AADC. Ten participants with moderate-to-advanced Parkinson’s disease were enrolled and received bilateral intraputaminal infusions across doses of 4.0 × 1011 vg (Cohort 1; n = 1), 6.0 × 1011 vg (Cohort 2; n = 2), 1.0 × 1012 vg (Cohort 3; n = 2) and 1.2 × 1012 vg (Cohort 4; n = 5). The trial achieved its primary outcome, as BBM-P002 demonstrated a favorable safety and tolerability profile within 12 months post-treatment. No dose-limiting toxicities or drug-related serious adverse events occurred. A total of 23 adverse events were reported, all judged unrelated to BBM-P002 and primarily mild and transient. Systemic toxicity and clinically meaningful immunogenicity were absent. In conclusion, intraputaminal delivery of BBM-P002 was safe and well tolerated in this phase 1 trial, supporting continued clinical development. ClinicalTrials.gov registration: NCT05822739 . Phase 1 results reveal that BBM-P002, a dual-target gene therapy co-delivering TH and DDC, is safe and well tolerated in Parkinson’s disease, with 12-month motor improvements signaling therapeutic potential.

24.
medRxiv (Medicine) 2026-06-19

Reassessing Instrument Strength in Two-Sample Mendelian Randomization Analysis

Mendelian randomization (MR) analysis is widely used to estimate causal relationships between risk factors and outcomes of interest. Two-sample MR approaches have gained increasing attention in genetic epidemiology due to the growing availability of Genome-Wide Association Study (GWAS) summary statistics from public databases. A critical step in two-sample MR is the selection of genetic variants as instrumental variables (IVs). Although genome-wide significant variants are typically preferred, the inclusion of variants with weaker association p-values is considered, as they may potentially improve power through an increased instrument number of instruments, while they may introduce weak instrument bias and attenuate effect estimates towards the null. Our simulation results show that even modest levels of pleiotropy substantially increase the variability of causal effect estimates, while the inclusion of weak IVs does not substantially affect the direction and variability of causal effect estimates in most cases. In real data analyses, we used two released versions of FinnGen GWAS summary statistics with different sample sizes as exposure GWASs to assess the influence of weak IVs. Here, the inclusion of IVs with higher exposure-association p-values resulted in weakened estimated effect sizes, particularly when the exposure GWAS sample size was small. These findings suggest that incorporating weak IVs is reasonable when the exposure GWAS sample size is large, but it poses a risk of falsely concluding null associations when the exposure GWAS sample size is small.

25.
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.