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01.
arXiv (CS.AI) 2026-06-12

Learning What to Remember: A Cognitively Grounded Multi-Factor Value Model for Agentic Memory

arXiv:2606.12945v1 Announce Type: new Abstract: Long-running LLM agents accumulate interaction histories far larger than any context window, forcing a standing decision: what to encode deeply, what to forget, and what to retrieve under a fixed memory budget. Production systems answer with semantic similarity or recency – both mis-specified for the forgetting decision, which is made at consolidation time before the future query is known. We propose a multi-factor memory value function V(m)=\sum_i w_i f_i(m) over seven interpretable factors (emotional intensity, goal relevance, value alignment, self/user relevance, task utility, reliability, and usage history) drawn from cognitive psychology, whose weights are learned from a downstream objective by a gradient-free optimiser, and whose single scalar uniformly controls encoding depth, forget risk, and retrieval rank. We make a methodological point: on LongMemEval, scoring goal relevance against the held-out evaluation question saturates gold-evidence retention at \approx 0.98 – this measures retrieval, not forgetting. In the realistic blind regime, a learned multi-factor value retains 0.770 \pm 0.011 of gold evidence across 479 usable cases, versus 0.657 for uniform weights, 0.518 for the best single factor, and 0.368 for recency; every paired gap's 95% bootstrap CI is above zero, and a neural network over the same factors ties the linear model. The learned weights are interpretable – reliability, emotional intensity, and self/user relevance dominate, while query-time goal similarity is correctly down-weighted for the forgetting decision. A controlled synthetic task with planted confounds confirms the learner recovers a separating weighting (1.00 retention) where uniform weighting fails (0.62). The substrate is open-source; all experiments run on a single CPU with no API calls.

02.
arXiv (CS.CL) 2026-06-16

GePBench: Evaluating Fundamental Geometric Perception for Multimodal Large Language Models

Geometric shapes play important roles in both physical world and human cognition. While multimodal large language models (MLLMs) have made significant advancements in visual understanding, their abilities to recognize geometric shapes and their spatial relationships, which we term geometric perception, are not explicitly and systematically explored. To address this gap, we introduce GePBench, a novel benchmark specifically designed to assess the geometric perception capabilities of MLLMs. Our extensive evaluations reveal that even the current state-of-the-art MLLMs exhibit significant deficiencies in geometric perception tasks. Furthermore, we show that models trained with GePBench data demonstrate considerable improvements on a wide range of downstream tasks, highlighting the critical role of geometric perception in enabling advanced multimodal applications. Our code and datasets are available at \href{https://github.com/Changhao-Xiang/GePBench}{https://github.com/Changhao-Xiang/GePBench}.

03.
arXiv (CS.AI) 2026-06-16

SDFLoRA: Selective Decoupled Federated LoRA for Privacy-preserving Fine-tuning with Heterogeneous Clients

arXiv:2601.11219v3 Announce Type: replace-cross Abstract: Federated learning (FL) for large language models (LLMs) has attracted increasing attention as a privacy-preserving approach for adapting models over distributed data, where parameter-efficient methods such as Low-Rank Adaptation (LoRA) are widely adopted to reduce communication and memory costs. However, practical deployments often exhibit rank and data heterogeneity: clients operate under different low-rank budgets and data distributions, making direct aggregation of LoRA updates biased and unstable. Existing approaches either enforce a unified rank or align heterogeneous updates into a single shared subspace, which tends to mix transferable and client-specific directions and consequently undermines personalization. Moreover, under differential privacy (DP), perturbing such structurally mixed updates injects noise into directions that should remain purely local, leading to unnecessary utility degradation. To address these issues, we propose Selective Decoupled Federated LoRA (SDFLoRA), a structure-aware LoRA framework that decouples each client update into a shared component for aggregation and a private component that preserves client-specific semantics. Only the shared component participates in subspace alignment, while the private component remains local and uncommunicated, making the training DP-compatible and stabilizing aggregation under rank heterogeneity. By injecting noise only into the aggregated shareable update, this approach avoids perturbations to local directions and improves the utility-privacy trade-off. Experiments on multiple benchmarks demonstrate that SDFLoRA outperforms federated LoRA baselines and achieves a strong utility-privacy trade-off.

04.
arXiv (CS.LG) 2026-06-12

A Privacy-Preserving Framework Using Remote Data Science for Inter-Institutional Student Retention Prediction

arXiv:2606.12845v1 Announce Type: cross Abstract: This study explores privacy-preserving machine learning (PPML) techniques using the PySyft platform to enable collaborative prediction of student retention between institutions. We developed a remote data science (RDS) framework with a semi-air-gapped architecture consisting of high-side and low-side servers, allowing researchers from three universities to build predictive models on sensitive student data without direct data access. Using historical data from a small private university (N=720), we evaluated three synthetic data generation approaches and validated the framework through inter-institutional collaboration. The results demonstrate consistent classification performance across institutions (Macro F1: 0.690–0.695) while maintaining strict Family Educational Rights and Privacy Act (FERPA) compliance. We also propose Data-Type-Aware Templates, a novel synthetic data method that prioritizes privacy over distributional fidelity. Our findings confirm that RDS-based PPML is technically feasible for educational settings and offers a practical alternative to federated learning for small-scale inter-institutional collaborations. The code is available at https://github.com/jtfields/NAIRR240195-Privacy-Preserving-Machine-Learning.

05.
arXiv (CS.CL) 2026-06-17

Toward Accessible Psychotherapy Training Using AI-Driven Interactive Patient Avatars

Training psychotherapists in evidence-based interventions such as Acceptance and Commitment Therapy (ACT) requires repeated practice with meaningful feedback, yet opportunities for safe, standardized training are limited by ethical, logistical, and resource constraints. We introduce a system designed to support ACT-oriented psychotherapy training through spoken dialogue with an embodied virtual patient. The system uses large language models to simulate patient behavior conditioned on profiles derived from real therapy sessions and configurable clinical scenarios, while a separate automated evaluator provides turn-by-turn feedback on therapist responses based on established ACT fidelity criteria. Rather than aiming to replace supervision, the system is intended to support deliberate practice by enabling experimentation, reflection, and immediate feedback in low-risk settings. Expert evaluation with practicing psychologists confirmed high realism in patient behavior and demonstrated that immediate turn-by-turn ACT feedback increased therapists' awareness of intervention choices and enabled effective experimentation with alternative responses. Quantitative evaluation across 49 therapy transcripts identified GPT-4o-mini as the optimal feedback model, achieving the lowest mean absolute error (MAE = 6.12) in replicating human supervisor ACT fidelity ratings with statistically significant agreement. This work demonstrates the potential of fidelity-aware simulated patients as a scalable complement to psychotherapy training.

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

Benchmarking Deep Learning Models for Laryngeal Cancer Staging Using the LaryngealCT Dataset

Laryngeal cancer imaging research lacks standardised public datasets to enable reproducible deep learning (DL) model development. We present LaryngealCT, a curated benchmark of 1,029 computed tomography (CT) scans aggregated from six collections from The Cancer Imaging Archive (TCIA). Uniform 1 mm isotropic volumes of interest encompassing the larynx were extracted using a weakly supervised parameter search framework validated by clinical experts. Six 3D DL architectures (custom 3D CNN, ResNet18,50,101, DenseNet121 and MedicalNet-pretrained ResNet50) were benchmarked on (i) early (Tis,T1,T2) vs. advanced (T3,T4) and (ii) T4 vs. non-T4 classification tasks. On the independent test set, the 3D CNN achieved the strongest overall performance across global and per-class metrics (Accuracy 0.854, F1-macro 0.841) in early vs. advanced classification. In the T4 task, AU-ROC values exceeded 0.82 for most models, but sensitivity for T4 disease remained limited (less than or equal to 0.412), with ResNet101 showing the most promising calibrated T4 recall (0.706. Model explainability assessed using GradCAMpp with thyroid cartilage overlays for T4 classification task revealed anatomically plausible peri-cartilage activations, although spatial overlap was modest. Through open-source data, pretrained models, and integrated explainability tools, LaryngealCT offers a reproducible foundation for AI-driven research to support future clinical decision-making in laryngeal oncology.

07.
arXiv (CS.CV) 2026-06-12

MinhwaNet: Faithful but Insufficient Object Grounding in Korean Folk Painting

Korean folk painting (minhwa) is built from a small vocabulary of auspicious symbols, a tiger for protection, a pair of birds for marital harmony, a peony for wealth, that recur across many of its painted genres. This suggests an obvious computational approach, identify which symbols appear in a painting and read the genre from the inventory. Working with a public corpus that pairs whole paintings, eight-field bilingual curatorial captions, and a separate set of expert object crops, we find that this approach does not work. A model given only a list of which symbols a painting contains predicts the genre far worse than a model that fuses the image with the curatorial text, and forcing the genre representation to be object-grounded actively hurts accuracy. The visual evidence on which the genre prediction rests is nonetheless localized and inspectable. A leakage-safe object evidence map projected from a part-level detector is spatially faithful to where curators isolated symbolic objects and to a patch-based surrogate's own gradient saliency. We name this configuration a faithful-but-insufficient dissociation. The part-level explanation is honest about what the part-level model sees, yet the genre target turns on how symbols are arranged rather than on which ones appear. The same lens separates a content label that survives transfer to held-out source institutions, genre, from a style label that does not, era, a prediction we confirm on two further labels in the corpus. We release the multimodal system, a worked-example reading of one painting's evidence map against its catalogue, and a set of evaluation cautions that recur in long-tailed heritage collections.

08.
arXiv (CS.LG) 2026-06-17

Learning from Biased and Costly Data Sources: Minimax-optimal Data Collection under a Budget

arXiv:2602.17894v2 Announce Type: replace-cross Abstract: Data collection is a critical component of modern statistical and machine learning pipelines, particularly when data must be gathered from multiple heterogeneous sources to study a target population of interest. In many use cases, such as medical studies or political polling, different sources incur different sampling costs. Observations often have associated group identities - for example, health markers, demographics, or political affiliations - and the relative composition of these groups may differ substantially, both among the source populations and between sources and target population. In this work, we study multi-source data collection under a fixed budget, focusing on the estimation of population means and group-conditional means. We show that naive data collection strategies (e.g. attempting to "match" the target distribution) or relying on standard estimators (e.g. sample mean) can be highly suboptimal. Instead, we develop a sampling plan which maximizes the effective sample size - the total sample size divided by $D_{\chi^2}(q\mid\mid\overline{p}) + 1$, where $q$ is the target distribution, $\overline{p}$ is the aggregated source distribution, and $D_{\chi^2}$ is the $\chi^2$-divergence. We pair this sampling plan with a classical post-stratification estimator and upper bound its risk. We provide matching lower bounds, establishing that our approach achieves the budgeted minimax optimal risk. Our techniques also extend to prediction problems when minimizing the excess risk, providing a principled approach to multi-source learning with costly and heterogeneous data sources.

09.
arXiv (CS.CL) 2026-06-25

LLM-ACES: Closed-Loop Discovery of Dynamical Systems with LLM-Guided Adaptive Search

Recovering governing Ordinary Differential Equations (ODEs) from data is a central challenge in modeling dynamical systems across scientific domains. Existing approaches cast discovery as a static inference problem over fixed datasets, assuming that the observed trajectories are sufficiently informative. However, dynamical systems evolve over large state spaces, and limited data can make multiple equations observationally indistinguishable, leading to identifiability gaps and the recovery of incorrect governing equations. To address this, we introduce LLM-ACES, or LLM-guided Active Closed-loop Equation Search, a closed-loop framework that jointly optimizes symbolic hypothesis construction and adaptive data acquisition. In LLM-ACES, a large language model (LLM) proposes operator priors that partition the large search space into distinct regions, within which candidate equations are fit to the observed data. The disagreement among these candidates guides the acquisition of informative trajectories, creating a feedback loop that iteratively refines both the hypothesis space and the discovered dynamics. On 122 ODE systems spanning ODEBench and ODEBase, LLM-ACES achieves the lowest median NMSE, outperforming state-of-the-art baselines by several orders of magnitude while achieving a high symbolic accuracy of 46.2% and 52.4%, respectively. Our analysis further shows that LLM-ACES is sample-efficient, achieving better performance with one-tenth the data. Furthermore, LLM-ACES's feedback-driven data acquisition makes it robust to noise and recovers the correct symbolic structure, while baselines introduce spurious terms that fit the data locally but obscure the true governing relationships.

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

Stability of a Generalized Debiased Lasso with Applications to Resampling-Based Variable Selection

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arXiv:2405.03063v3 Announce Type: replace-cross Abstract: We propose a generalized debiased Lasso estimator based on a stability principle. When a single column of the design matrix is perturbed, the estimator admits a simple update formula that can be computed from the original solution. Under sub-Gaussian designs with well-conditioned covariance, this approximation is asymptotically accurate for all but a vanishing fraction of coordinates in the proportional growth regime. The proof relies on concentration and anti-concentration arguments to control error terms and sign changes. In contrast, establishing comparable distributional limits (e.g., Gaussianity) under similar assumptions remains open. As an application, we show that the approximation significantly reduces the computational cost of resampling-based variable selection procedures, including the conditional randomization test and a local knockoff filter.

11.
arXiv (CS.LG) 2026-06-19

Towards Modality-imbalanced Federated Graph Learning: A Data Synthesis-based Approach

arXiv:2606.20382v1 Announce Type: new Abstract: MultiModal Federated Graph Learning (MM-FGL) offers a natural collaborative training paradigm, but its practical deployment is challenged by two granularities of modality imbalance. Client-level imbalance occurs when certain clients lack entire modalities, while node-level imbalance occurs when individual nodes exhibit missing visual or textual attributes. While several relevant studies exist, our investigation reveals that they predominantly target graph-agnostic or centralized scenarios, rendering them difficult to adapt directly. To address these challenges, we formalize modality-imbalanced MM-FGL as an implicit graph-aware latent semantic representation synthesis problem. This paradigm recovers missing modal semantics directly within the representation space, thereby maximizing alignment with the original data's semantic distribution and mitigating the high variance induced by missing modalities. To this end, we propose FedMGS (Federated Modality-aware Graph Synthesis), which integrates three core components. The availability-aware graph encoder prevents missing modalities from contaminating local structural propagation. The prototype-guided latent semantic synthesizer establishes cross-client semantic anchors for unavailable modalities. The reliability-calibrated semantic fusion mechanism regulates the impact of recovered latent representations prior to predictive readout. Extensive experiments on four tasks show that FedMGS consistently outperforms competitive baselines with gains up to 17.41% with best efficiency-performance tradeoff.

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

Overcoming the Impedance Mismatch: A Theoretical Roadmap for Fusing Foundation Models and Knowledge Graphs

arXiv:2606.15656v1 Announce Type: new Abstract: Modern artificial intelligence remains fundamentally divided between the continuous, probabilistic spaces of Foundation Models and the discrete, deterministic structures of Knowledge Graphs. While Retrieval-Augmented Generation (RAG) attempts to connect them by serializing graph data into text, we argue this lexical bridging is merely a superficial patch. In this paper, we formalize the underlying structural and geometric friction as the Impedance Mismatch. By categorizing current neuro-symbolic integration strategies into a three-tiered hierarchy, we demonstrate that neither surface-level prompt injection nor continuous representation alignment can preserve the strict logical motifs required for reliable multi-hop reasoning. We define the specific mathematical limits, such as the Lexical Bottleneck and Topological Collapse, that show current architectures will eventually hallucinate or conflate semantic nodes. To achieve true semantic fusion, we propose a rigorous theoretical roadmap. We advocate for natively internalizing discrete symbolic structures through Structured Residual Streams, utilizing Vector Symbolic Architectures for latent sub-graph injection, and performing model updates via Orthogonal Subspace Editing. This actionable framework paves the way for models that seamlessly fuse the precision of symbolic logic with the expressivity of parametric memory.

13.
medRxiv (Medicine) 2026-06-10

Optimisation of steatotic liver disease screening algorithm for resource-poor settings using machine learning

Background The European Association for the Study of the Liver (ESAL) - Steatotic Liver Disease (SLD) screening algorithm involves two steps; initial screening with FIB-4 followed by referral for vibration-controlled transient elastography (VCTE) in patients likely to have significant fibrosis (SF). However, VCTE is not widely available in resource-limited settings. Aim To optimise the EASL SLD screening algorithm for resource-poor settings using machine learning (ML). Methods We analysed data from 964 adults aged [≥]35 years who underwent VCTE at a tertiary referral centre in Sri Lanka between November 2024 and 2025. Multiple ML models using different methods and variable combinations were trained on 80% of the dataset and tested on the remaining 20%. Best models were selected based on performance and externally validated using data from 430 patients who underwent VCTE before November 2024. Model performance was compared with the FIB-4 using confusion matrices. Results A Random Forest model incorporating age, AST, ALT, and platelet count separately, rather than using FIB-4, outperformed. The all-variable ML model showed the best predictive performance for SF, with accuracy of 77.2%, recall of 0.762, precision of 0.778, and AUC-ROC of 0.818. The variables used in the model, in descending order of feature importance, were AST, platelet count, BMI, ALT, age, diabetes mellitus, hypertension, dyslipidaemia, sex, family history, hypothyroidism, diabetes complication and smoking. External validation demonstrated 75.1% accuracy and an AUC of 0.779. When used as the first step of the SLD screening algorithm, the all-variable ML model identified 37 (17.1%) additional true positives and reduced false-negative diagnoses by 50% compared with FIB-4. Conclusions ML-based models were more effective than the FIB-4 score as the first-line screening tool for VCTE referral, substantially improving the identification of patients with significant fibrosis in this South Asian cohort.

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

Toward Generalist Autonomous Research via Hypothesis-Tree Refinement

Scientific progress depends on a repeated loop of exploration, experimentation, and abstraction. Researchers test candidate directions, interpret the evidence, and carry the resulting lessons into later attempts. We study how an AI agent can run this loop autonomously over long horizons. We introduce Arbor, a general framework for autonomous research that combines a long-lived coordinator, short-lived executors, and Hypothesis Tree Refinement (HTR), a persistent tree that links hypotheses, artifacts, evidence, and distilled insights across time. The coordinator manages global research strategy over the tree, while executors implement and test individual hypotheses in isolated worktrees. As results return, Arbor updates the tree, propagates reusable lessons, refines the search frontier, and admits verified improvements. This design turns autonomous research from a sequence of local attempts into a cumulative process in which strategy, execution, and evidence are carried across time. We evaluate Arbor under Autonomous Optimization (AO), an operational setting where an agent improves an initial research artifact through iterative experimentation without step-level human supervision. Across six real research tasks in model training, harness engineering, and data synthesis, Arbor achieves the best held-out result on all six tasks, attaining more than 2.5x the average relative held-out gain of Codex and Claude Code under the same task interface and resource budget. On MLE-Bench Lite, Arbor reaches 86.36% Any Medal with GPT-5.5, the strongest result in our comparison.

15.
Nature (Science) 2026-06-10

Human migration has surged since 2000 — these maps reveal where people are going

Modelling with artificial-intelligence tools has filled gaps in migration data, revealing detailed global population movements from 1990 to 2023. Modelling with artificial-intelligence tools has filled gaps in migration data, revealing detailed global population movements from 1990 to 2023.

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

Composing Linear Layers from Irreducibles

arXiv:2507.11688v4 Announce Type: replace Abstract: Contemporary large models often exhibit behaviors suggesting the presence of low-level primitives that compose into modules with richer functionality, but these fundamental building blocks remain poorly understood. We investigate this compositional structure in linear layers by asking: can we identify/synthesize linear transformations from a minimal set of geometric primitives? Using Clifford algebra, we show that linear layers can be expressed as compositions of bivectors – geometric objects encoding oriented planes – and introduce a differentiable algorithm that decomposes them into products of rotors. This construction uses only O(log^2 d) parameters, versus O(d^2) required by dense matrices. Applied to the key, query, and value projections in LLM attention layers, our rotor-based layers match the performance of strong baselines such as block-Hadamard and low-rank approximations. Our findings provide an algebraic perspective on how these geometric primitives can compose into higher-level functions within deep models.

17.
arXiv (CS.LG) 2026-06-18

Unlocking air traffic flow prediction through microscopic aircraft-state modeling

arXiv:2605.10083v2 Announce Type: replace Abstract: Short-term air traffic flow prediction in terminal airspace is essential for proactive air traffic management. Existing approaches predominantly model traffic flow as aggregated time series. However, traffic dynamics are governed by aircraft states and their interactions in continuous airspace. Such aggregation obscures fine-grained information, including aircraft kinematics, boundary interactions, and control intent. Here we present AeroSense, a state-to-flow modeling paradigm that predicts future traffic flow directly from instantaneous airspace situations represented as dynamic sets of aircraft states derived from ADS-B trajectories. By establishing an end-to-end mapping from microscopic aircraft states to future regional traffic flow, AeroSense preserves aircraft-level dynamics while naturally accommodating varying traffic density without relying on historical look-back windows. Experiments on a large-scale real-world dataset show that AeroSense exhibits admirable predictive accuracy and robustness over aggregation-based forecasting approaches, particularly during high-density traffic periods. These findings suggest that aircraft-state situation modeling provides a promising alternative to conventional time-series forecasting in air traffic flow management.

19.
medRxiv (Medicine) 2026-06-23

Respiratory support with Continuous Positive Airway Pressure in preterm neonates: an analysis of coverage and quality of care in 66 neonatal units in Kenya, Malawi, Nigeria and Tanzania implementing with the NEST360 Alliance

Background: Prematurity is the leading cause of child deaths worldwide, with the highest neonatal mortality in sub Saharan Africa. Respiratory distress syndrome (RDS) is the leading mortality pathway in preterm neonates, but continuous positive airway pressure (CPAP) has high impact. This analysis reports CPAP coverage and quality of care for preterm neonates admitted to 66 neonatal units in Kenya, Malawi, Nigeria and Tanzania. Methods: Analyses used individually linked neonatal inpatient data and cross-sectional health systems data. All admitted neonates were eligible for inclusion (January 2021 through December 2024). Service readiness for CPAP delivery and mean CPAP coverage were described for CPAP eligible newborns (weighing 1500g). Quality of care cascades were constructed to illustrate key indicators. Survival among CPAP eligible neonates was analysed using regression models, stratified by clinical severity scores. Results: 375,255 newborn admissions were analysed in 66 neonatal units. Functional CPAP availability varied with median 16% of days (IQR: 4 to 47%) classified as high demand (>1.5 eligible newborns per CPAP). Of 64,761 CPAP eligible neonates, 22,006 (34%, 95% CI 33 to 34%) received CPAP. All countries showed improvement in CPAP coverage, with Tanzanian hospitals recording 63% increase in mean coverage (p-value=0.001) over time. Quality of care cascades showed treatment was initiated 1 day for 42% (95% CI 41 to 43%) of eligible neonates receiving CPAP. Only 10% of neonates

20.
arXiv (CS.CV) 2026-06-16

Double-Helix Vision (DH-V2): A Geometry-Based Visual Sampler for Bandwidth-Constrained Perception

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We present Double-Helix Vision (DH), a geometry-based visual sampler that compresses 2D images into compact 1D signals using paired golden-ratio-inspired spiral trajectories. Rather than processing every pixel uniformly, DH employs two phase-shifted helices (Alpha and Beta, offset by 180 degrees) to sample the image with biologically-inspired foveation: high density at the center, sparse coverage at the periphery. At 4K resolution, DH achieves a 1,433x compression ratio (99.93% reduction) while preserving the geometric structure of the scene. The full perception pipeline – including spatial mapping, temporal collision detection, and intra-frame structural disparity estimation – runs in 0.52 ms at 1080p on CPU-only hardware, with no neural network dependencies. On CIFAR-10 at extreme sampling budgets (K=128 points per helix), DH achieves a +6.03% accuracy gain over uniform random sampling. A JSON-serializable Robotics API is provided, delivering sub-millisecond spatial perception reports in 2.7 KB packets. Code and benchmarks are available under the MIT License.

21.
medRxiv (Medicine) 2026-06-24

A Systematic Review of Sex Differences in Postoperative Nausea and Vomiting

Background: Postoperative nausea and vomiting (PONV) is a common consequence of anaesthesia, affecting up to 30% of postoperative patients. Female sex is one of the strongest risk factors for PONV, yet no dedicated analysis has examined how this association varies across surgical settings and timepoints. This systematic review and meta-analysis aimed to quantify sex differences in PONV incidence across different surgical contexts. Methods: A systematic search was conducted using PRISMA guidelines across Medline and Embase from inception to September 1, 2025. Eligible studies were observational cohort studies (n[≥]500) of adult patients that conducted multivariate regression analyses including sex as a variable. Two reviewers independently screened, extracted data, and assessed risk of bias using ROBINS-E. A random-effects meta-analysis was performed. Subgroup analyses and multiple sensitivity analyses were completed. Results: From 4620 identified studies, 23 met the inclusion criteria, including 462,828 patients across various surgical settings and specialties (52% female). The pooled incidence of PONV was 21% (95% CI[16-27%]), with high heterogeneity (I2=99.9%). Meta-analysis confirmed females had a higher risk of developing PONV compared to males (pooled OR=2.40, 95% CI[2.06-2.79], I2=93.1%, p

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

Exploration Structure in LLM Agents for Multi-File Change Localization

arXiv:2606.11976v1 Announce Type: cross Abstract: Software engineering tools increasingly rely on LLM based agents to localize files to change to resolve a software issue. Most AI agents explore repositories linearly, that is, visiting one directory or file per step. We postulate that this is a structural mismatch for changes that span several subsystems. We compare linear sequential exploration against non-linear, domain-scoped parallel agentic exploration. Using SWE Bench Pro as initial benchmark, we focus on ansible as an exemplar. We construct an approach for persistent-session evaluation of GitHub issues anchored at a single base commit. We compare our non-linear domain-agent file traversal system against a base LLM without direct repository access, a single agent Recursive Language Model (RLM) baseline with a persistent Python REPL and an external CLI baseline using Codex 5.5 High. Domain scoped parallel agent spawning with a small Haiku-class model achieves the highest micro F1 among Haiku class models by a large margin. Domain-agents is the second highest behind only the much larger Codex 5.5 High on our own expanded benchmark including over more recent PRs from 2025 and 2026. On the original, curated, 2020 SWE-bench Pro benchmark, a larger Sonnet plain LLM baseline attains higher micro F1 by predicting few files, leading to higher precision, but at significantly lower all gold recall. We also present three additional findings. First, documentation evolution is a latent dependency unresolved by any approach. Second, naive file system access can degrade localization driven by test-file over prediction. Lastly, forced multi-agent consultation does not measurably help and raises token cost substantially.

23.
medRxiv (Medicine) 2026-06-16

Reporting patterns of adverse drug withdrawal events using individual case safety reports in United States and European databases

Introduction: Adverse drug withdrawal events (ADWEs) are a key safety concern with deprescribing but are infrequently reported in trials. Although pharmacovigilance systems have advanced our understanding of medication-related harms, it is unclear how extensively these systems have been used for ADWEs. Objectives: To examine the reporting patterns of ADWEs for all drugs recorded in United States and European pharmacovigilance databases between 2004 and 2023. Methods: A retrospective study was conducted using two pharmacovigilance databases, the publicly available FDA-FAERS dataset and EMA-EV Level 2A (individual-level) dataset. ADWE cases were identified using relevant MedDRA preferred terms. Data on patient characteristics, reporter type, drugs, indication, ADWE outcomes, dechallenge/rechallenge, seriousness criteria, time to onset, duration, and causality were summarised. Results: A total of 158,505 ADWE reports were analysed (FDA-FAERS: 145,514; EMA-EV: 12,987), with mean ages of 46.1 (FDA; 55.3% female) and 45.5 years (EMA; 57.1% female). The frequently reported drug classes were opioids (FDA: oxycodone, 29.8%; EMA: buprenorphine, 19%), antidepressants (FDA: duloxetine, 32%; EMA: venlafaxine, 25.9%) and gabapentinoids (FDA: pregabalin, 6.7%; EMA: pregabalin, 6.0%). The most common adverse outcomes were other serious medical conditions (FDA=63.9%; EMA=46.0%), hospitalisation (FDA=15.9%; EMA=28.3%), and disability (FDA=13.3%; EMA=6.2%) and these outcomes varied significantly based on sex and age group (p

24.
arXiv (CS.CV) 2026-06-18

Toward Training-Free Zero-Shot Anomaly Detection in 3D Medical Images: A Batch-Based Approach Using 2D Foundation Models

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Zero-shot anomaly detection (ZSAD) is attractive for medical imaging because clinical systems must handle heterogeneous acquisition protocols, changing patient populations, and pathologies for which annotated training data may be unavailable. Most existing zero-shot anomaly detection methods are designed for 2D images, and their direct extension to 3D medical volumes is limited by the scarcity of large-scale volumetric foundation models or by the difficulty of utilizing volumetric context. We propose CS3F, a training-free batch-based framework for ZSAD in 3D medical images using 2D foundation models. Each volume is decomposed along multiple anatomical axes and encoded slice-wise by a 2D vision transformer. These are then converted into localized volumetric tokens by pooling neighboring slice features. Anomaly scores are obtained from cross-subject mutual similarity: tokens that lack close analogues in other subjects are assigned higher anomaly scores. To reduce the attenuation of focal lesion signals caused by depth pooling, we introduce a coarse-to-fine tokenization strategy that enables fine-resolution volumetric scoring without exhaustive matching. CS3F is evaluated on brain MRI across metastases, glioma, and stroke, as well as validated on lung CT to test generalizability beyond atlas-aligned brain MRI. The results show that frozen 2D foundation models can support anomaly localization in 3D medical images, and that the benefit of fine tokenization depends strongly on lesion contrast and imaging modality.

25.
arXiv (CS.CL) 2026-06-18

Sumi: Open Uniform Diffusion Language Model from Scratch

Diffusion models have become a promising alternative to autoregressive models. Among these, uniform diffusion language models (UDLMs) permit any token to be updated at any step, in principle enabling more flexible generation. However, no UDLM has yet been pretrained from scratch at both large parameter scale and large token budget. Both autoregressive modeling and masked diffusion modeling already have capable models at scale that the community can study and build on; uniform diffusion has none. A scratch-pretrained UDLM at scale would provide a clean reference point for studying scaling behavior, generation dynamics, controllability, and trade-offs against established autoregressive and masked diffusion models. To this end, we introduce Sumi ("ink" in Japanese), a fully open 7B uniform diffusion language model pretrained from scratch on 1.5T tokens. Sumi performs competitively with autoregressive models trained at comparable token budgets on knowledge, reasoning, and coding benchmarks, while under-performing on commonsense benchmarks, where our education-heavy data mixture is a likely contributor. We release our model weights, checkpoints, and full training recipe, including a complete specification of the data mixture over publicly available corpora. We hope this release enables the community to study native uniform diffusion at scale and catalyzes work on its as-yet poorly understood aspects.