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

ReCal: Reward Calibration for RL-based LLM Routing

arXiv:2606.12479v1 Announce Type: cross Abstract: Large language model (LLM) routing has emerged as an effective paradigm for leveraging the complementary strengths of multiple LLMs through dynamic model and reasoning-strategy selection. Recent reinforcement learning (RL)-based routing methods further improve routing quality by optimizing routing policies from interaction feedback. However, they still struggle to provide informative and comparable learning signals under heterogeneous tasks with varying difficulty. In practice, multiple objectives (e.g., correctness, format behavior) are aggregated into a single scalar reward, leading to ambiguous credit assignment and conflicting optimization signals. Moreover, reward signals exhibit significant variability across instances, where some instances produce higher or more variable rewards, introducing optimization bias that favors trivial samples over informative ones. To address these issues, we propose ReCal, a \underline{Re}ward \underline{Cal}ibration framework for RL-based LLM routing. We first introduce a hierarchical reward decomposition mechanism with component-wise advantage estimation. We further propose a distribution-aware optimization strategy that calibrates optimization variability through variance-aware reweighting and per-dataset normalization. Experiments on seven datasets demonstrate that ReCal consistently improves routing performance, and training stability over baselines. Code is available at https://anonymous.4open.science/r/ReCal.

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

From Explicit Elements to Implicit Intent: A Predefined Library for Auditable Behavioral Inference

We present SemantiClean, a modular framework for extracting structured semantic signals from e-commerce session data and driving pluggable inference targets including purchase intent, customer segmentation, and product affinity through a shared element library. Unlike conventional end-to-end predictors that optimise solely for accuracy, SemantiClean prioritises auditability, structural governance, and sigma=0 reproducibility, explicitly trading marginal predictive gains for element-level transparency and defensible decision trails. Built upon the Online Shoppers Purchasing Intention (OSPI) dataset, the framework organises twenty-four behavioural elements into a four-layer architecture (Functional, Interaction, Systemic, Contextual) and enforces signal quality through three anti-inflation mechanisms: RedundancyGroup contribution caps, TieredPenaltyCalculator bias penalties, and AdaptiveConstraintMode cold-start protection.This report introduces the LLM-Integrated Semantic Inference Engine, a fully implemented two-phase LLM-driven inference architecture that leverages complete element metadata at inference time. All quantitative results reported herein are produced by this engine. Deterministic engine outputs remain fully reproducible (sigma=0); LLM-dependent results (E8, E10) are subject to controlled output variability under fixed provider/model/temperature settings. The gender inference target remains non-functional in the current implementation and is excluded from all quantitative results.

03.
arXiv (CS.CL) 2026-06-18

Morpheus: A Morphology-Aware Neural Tokenizer and Word Embedder for Turkish

Turkish is agglutinative: meaning is carried by morphemes, yet the subword tokenizers that drive modern language models split words by corpus statistics, fragmenting semantically loaded suffixes and – in the case of WordPiece and rule-based analyzers – failing to decode their output back to the original text. This paper presents Morpheus, a neural morpheme-boundary model for Turkish that is at once a lossless, morphology-aware tokenizer and a word-embedding producer. A differentiable Poisson-binomial dynamic program turns per-character boundary probabilities into soft morpheme memberships during training and exact segments at inference, with no string normalization, so $\mathrm{decode}(\mathrm{encode}(w)) = w$ holds by construction. Because the model is neural, the same forward pass that tokenizes also emits a structured word embedding. Among reversible tokenizers – the only ones valid for generation – Morpheus attains the lowest bits-per-character ($1.425$), roughly doubles the gold morphological alignment of the subword family (MorphScore macro-F1 $0.61$ vs.\ ${\sim}0.32$), and uses ${\sim}19\%$ less GPU memory than 64K-vocabulary subword tokenizers. As an embedder, frozen Morpheus vectors lead on lexical retrieval (root-family MAP $0.85$) and same-root verification (ROC-AUC $1.00$), surpassing the multilingual retriever BGE-M3 and BERTurk; on context- and inflection-dependent tasks (NER, case/number probing) the heavier contextual encoders remain ahead – a trade-off we attribute to Morpheus's root-centric geometry. Code: https://github.com/lonewolf-rd/TurkishMorpheus; model: https://huggingface.co/lonewolflab/Morpheus-TR-50K; interactive demo: https://huggingface.co/spaces/lonewolflab/morpheus-tr-demo.

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

DynaTok: Token-Based 4D Reconstruction from Partial Point Clouds

We address 4D reconstruction from partial point cloud sequences, where depth-sensor observations are incomplete, unordered, and lack explicit temporal correspondences. This geometry-only setting is challenging due to missing observations and ambiguous dynamics. While recent progress has largely relied on image-based methods, existing point-based approaches typically focus on single objects, assume relatively complete inputs, or require explicit correspondences. To address these limitations, we propose DynaTok, a point-based framework for correspondence-free 4D reconstruction from partial point cloud sequences without images. DynaTok encodes frames into compact latent tokens, aggregates incomplete observations over time with a Transformer-based spatiotemporal encoder, and decouples geometry and motion through residual tokens in a unified model. A flow-matching decoder then reconstructs complete, temporally consistent 4D point-cloud sequences conditioned on the latent tokens. Experiments on object- and scene-level benchmarks demonstrate improved reconstruction quality and temporal coherence from partial point cloud observations. Project page: https://wrchen530.github.io/dynatok/.

05.
arXiv (CS.CL) 2026-06-11

Pre-AF 13: An Interpretable Atrial Fibrillation Risk Score Mined from Discharge Reports

Background. Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia and a major determinant of prognosis. Established AF risk scores rely on factors (older age, hypertension) nearly ubiquitous among patients with cardiovascular disease (CVD), offering limited stratification in this high-risk group. Most target long-term (5-10 year) rather than medium-term prediction. We developed interpretable ML models predicting AF risk over a 24-month and entire follow-up horizon in CVD patients using routinely collected hospital data. Methods. Single-center retrospective study of electronic health records from the National Research Cardiology Center (Russia) for patients aged >=18 with CVD but without pre-existing AF, hospitalized more than once between January 2012 and May 2019. A custom NLP pipeline transformed unstructured discharge reports into 73 structured features, combining a rule-based parser with transformer-based NER. Using LightAutoML we built a full model (73 features), a simple model (reduced subset), and a linear model for a bedside risk score. Performance was assessed by ROC AUC, compared with CHARGE-AF, C2HEST, MHS, and HAVOC, and interpreted via SHAP. Results. Of 80,576 records from 45,000 patients, 17,562 met inclusion criteria; 1,438 (8.19%) developed AF. The full model reached ROC AUC 0.735 (24-month) and 0.696 (entire follow-up); the simple model was nearly identical (0.725, 0.696). All non-linear models outperformed the four clinical risk scores (ROC AUC 0.53-0.64). The simple model uses 13 features and is named Pre-AF 13. SHAP identified age and left atrial volume as dominant predictors. A linear risk score (Pre-AF 9) stratified observed 24-month AF incidence from ~7% to 36%. Conclusion. Interpretable ML models built from routinely collected EHR data identify high-AF-risk CVD patients, outperforming established clinical risk scores.

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

FUSE: Frequency-domain Unification and Spectral Energy Alignment for Multi-modal Object Re-Identification

Despite significant progress in multi-modal Re-Identification (ReID), existing methods tend to emphasize low-frequency cues. Consequently, they focus on attributes such as color, illumination, and coarse appearance, while overlooking mid and high-frequency structures that encode geometric, textural, and identity-discriminative details. This imbalance leads to incomplete spectral representations and unstable cross-modal alignment. To overcome these limitations, we introduce FUSE, a frequency-domain framework that reformulates multi-modal ReID as a two-stage process of spectral disentanglement and energy alignment. The proposed Spectral Decomposition Module (SDM) adaptively partitions features into low, mid, and high-frequency subspaces, enabling hierarchical spectral modeling. The Cross-Modal Alignment Module (CAM) further enforces energy alignment and subspace complementarity across modalities via frequency-consistency regularization. In addition, FUSE incorporates learnable frequency modulation to enhance robustness under varying illumination and heterogeneous sensor conditions. Extensive experiments on RGBNT201, RGBNT100, and MSVR310 show that FUSE achieves 9.1\% mAP and 9.5\% Rank-1 improvements, establishing an interpretable frequency-domain paradigm for multi-modal representation learning.

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

ChatPlanner: A Large Language Model Framework for Personalized Public Transit Routing

arXiv:2606.15315v1 Announce Type: new Abstract: Personalized public transit routing in public transit systems remains challenging due to the difficulty of capturing and integrating diverse user preferences into routing algorithms. This paper presents ChatPlanner, a novel framework that leverages Large Language Models (LLMs) to enable preference aware public transit routing. Our approach employs fine-tuned LLMs with Retrieval-Augmented Generation (RAG) to extract routing parameters and interpret nuanced user preferences from natural language queries, subsequently integrating these preferences into the objective function of a public transit routing algorithm. This study designs preference aware datasets incorporating eight personas and five contexts to establish scoring standards for both fine-tuning and RAG. This work conducted three experiments to validate the solutions' feasibility, extraction of routing information and preferences, and solution set quality and completeness. Results demonstrate that ChatPlanner generates feasible solutions reliably. Fine-tuning enforces the required output structure and learns general preference patterns, while RAG provides query-specific context to resolve imprecise or conversational expressions and calibrate continuous scores. The combination of both achieves the highest accuracy in routing information extraction and user preference interpretation. Results based on selected case studies show that by capturing user preferences, ChatPlanner identifies valuable solutions across different dimensions that existing route planners overlook, generating more valuable route alternatives. This research establishes a new paradigm for integrating natural language understanding into transportation optimization.

08.
arXiv (CS.CV) 2026-06-24

An LMM for Precisely Grounding Elements in Documents

Visual grounding in documents is a crucial ability for Large Multimodal Models (LMMs) in areas such as document understanding, deep research and document error detection. However, existing approaches exhibit poor grounding precision in text-rich document images, often failing to accurately locate the critical document elements needed for reliable reasoning. To address this gap, we introduce PreciseDoc, an LMM specifically designed for precise element grounding and can be further optimized for Document VQA tasks. Specifically, to enhance the basic localization capability, we construct challenging training data by two pipelines capable of mass-producing high-quality documents with paired metadata of fine-grained coordinates, including synthetic hand-filled documents with camera effects. The model develops more real-world functions beyond straightforward localization of single text, such as locating personal information from CVs. Furthermore, we introduce a training paradigm for visual grounded reasoning where the grounding and reasoning are supervised jointly with reinforcement learning to improve the contribution of the grounded evidence. A comprehensive evaluation on various benchmarks demonstrates the advantage of the proposed data and methods in document spatial grounding and document understanding.

09.
arXiv (CS.AI) 2026-06-12

Equivariant Flow Matching for Symmetry-Breaking Bifurcation Problems

arXiv:2509.03340v4 Announce Type: replace-cross Abstract: Bifurcation phenomena in nonlinear dynamical systems often lead to multiple coexisting stable solutions, particularly in the presence of symmetry breaking. Deterministic machine learning models are unable to capture this multiplicity, averaging over solutions and failing to represent lower-symmetry outcomes. In this work, we formalize the use of generative AI, specifically flow matching, as a principled way to model the full probability distribution over bifurcation outcomes. Our approach builds on existing techniques by combining flow matching with equivariant architectures and an optimal-transport-based coupling mechanism. We generalize equivariant flow matching to a symmetric coupling strategy that aligns predicted and target outputs under group actions, allowing accurate learning in equivariant settings. We validate our approach on a range of systems, from simple conceptual systems to physical problems such as buckling beams and the Allen–Cahn equation. The results demonstrate that the approach accurately captures multimodal distributions and symmetry-breaking bifurcations. Moreover, our results demonstrate that flow matching significantly outperforms non-probabilistic and variational methods. This offers a principled and scalable solution for modeling multistability in high-dimensional systems.

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

Quantum Machine Learning for Industrial Applications

arXiv:2606.14822v1 Announce Type: cross Abstract: Recent advances in Machine Learning have transformed numerous industrial sectors, yet classical paradigms face fundamental limitations: rapidly growing data volumes, rising computational costs, significant energy consumption, and the physical scaling limits of conventional hardware architectures. Quantum computing has emerged as a promising computational paradigm to address these challenges, giving rise to the field of Quantum Machine Learning (QML). In this thesis, the theoretical foundations of QML are investigated, with a focus on near-term and future practical applications. Three central challenges are addressed: the trainability of variational quantum circuits, their expressivity, and their resistance to efficient classical simulation. The trainability of Hamming-weight preserving variational quantum circuits is first studied, and theoretical guarantees are established that resolve an open conjecture on the absence of barren plateaus for this circuit family. Subspace-preserving QML algorithms are then introduced, including photonic circuits and quantum convolutional neural networks, and are designed to mimic classical ML subroutines while offering polynomial quantum advantage. Finally, variational quantum circuits are analyzed as quantum Fourier models, and a framework is derived to jointly characterize expressivity and trainability, from which conditions are obtained under which quantum models provably separate from their classical counterparts. These contributions are intended to advance the theoretical roadmap for harnessing near-term and future quantum technologies in real-world applications.

11.
arXiv (quant-ph) 2026-06-15

Correction scheme for molecular total energies from quantum phase estimation under limited qubit resources

arXiv:2603.02715v2 Announce Type: replace Abstract: We propose a practical method for accurately evaluating molecular total energies using a hybrid approach that integrates fault-tolerant quantum computers with classical computing. Our scheme consists of two complementary components: quantum dominant orbital selection (QDOS) and subspace dynamical correlation (SDC). QDOS extracts only the essential active orbitals from the complete active space (CAS) configuration interaction (CI) state on a quantum computer, yielding a compact active space suitable for classical CASCI calculations. SDC then evaluates dynamical-correlation corrections for the CASCI energy using this compact state, which remains tractable on classical machines. To demonstrate that the CAS energy obtained on a quantum computer can be post-corrected by SDC, we examine two frameworks: multireference perturbation theory and tailored coupled-cluster theory. Our scheme enables effective treatment of relatively large molecular systems by combining limited quantum and classical resources.

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

Natively Unlearnable Large Language Models

Unlearning aims to remove the influence of specific training data sources, but this has proved challenging because the contributions of different sources are entangled within the model. Isolating source contributions to disjoint parameters makes removal easier, though it obstructs joint learning across sources. We propose NULLs (Natively Unlearnable LLMs), a model class that satisfies the two opposing goals of isolating source-specific contributions and learning jointly across sources, by training a set of shared backbone neurons alongside a pool of sparsely activated sinks. During training, information specific to a source naturally concentrates in its sinks while information shared across sources accumulates in the backbone. A source is then unlearned at deployment by disabling its corresponding sinks, with no gradient updates and no access to the retained data. We show that NULLs scales to Wikipedia's ~6M articles, isolating each as an independent source. Unlearning a single article removes knowledge specific to it while preserving facts shared with semantically related articles, closely matching retraining from scratch. We note that unlearning with NULLs is also robust: in a case study of unlearning the Harry Potter books, NULLs resists both adversarial extraction and relearning that reverses post-hoc unlearning. Finally, NULLs preserves general language capabilities, matching a standard transformer on downstream benchmarks. Together, these results suggest that source-level unlearning need not be an afterthought. It can be built natively into LLM training while retaining the benefits of shared representation learning.

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

ScoutVLA: UAV-Centric Active Perception via a Dual-Expert VLA Model for Open-World Embodied Question Answering

Aerial Embodied Question Answering (EQA) requires Unmanned Aerial Vehicles (UAVs) to actively perceive the environment and answer natural language questions. Existing outdoor EQA systems usually stop once the target enters the UAV's field of view, leaving the fine-grained viewpoint adjustment needed for evidence-seeking questions largely unresolved. To address this issue, we introduce FG-EQA, a fine-grained active perception EQA benchmark with more than 40K simulated trajectories and 1K real-world trajectories. Drawing inspiration from the ``waggle dance'' of scout bees, which iteratively adjust their flight paths to verify target information, we propose ScoutVLA, an evidence-driven Vision-Language-Action model for outdoor EQA. To emulate this active exploration behavior, ScoutVLA features a decoupled dual-expert architecture: a vision-language expert infers the semantic intent to identify missing evidence, while an independent action expert employs high-DoF flow matching to generate continuous viewpoint-refinement trajectories. To balance the competing demands of continuous control and semantic reasoning, we devise a decoupled training strategy with a knowledge insulation mechanism that prevents the action gradients from erasing the model's multimodal reasoning ability. Extensive simulated experiments and a qualitative real-world field study both verify the superiority of ScoutVLA over the state-of-the-art baselines, demonstrating a 10.48$\boldsymbol{\times}$ higher average strict success rate and a 7.72$\boldsymbol{\times}$ higher average QA correctness.

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

Heteroskedastic Signals in Budgeted LLM Verification: Structural Heterogeneity Limits Optimization Gains

作者:

arXiv:2606.15841v1 Announce Type: new Abstract: Large language model (LLM) systems increasingly use uncertainty signals to allocate limited computation across verification, test-time scaling, tool execution, and other selective-compute decisions. Such policies rely on a global signal comparability assumption: equal scores should carry comparable decision value across inputs. Using budgeted verification as a controlled diagnostic setting, we identify a failure mode of this assumption: uncertainty quality is heteroskedastic across cost strata, with some regions exhibiting near-random discriminability despite concentrating many errors. Under an explicit local model, we characterize the resulting distortion of global allocation and show that its upper bound scales with cross-stratum signal-quality dispersion. We separate weak signals, optimization instability, and structural heterogeneity through a controlled intervention hierarchy: Threshold, MP-Adapt, MP-Strat, and a deliberately simple cost-stratified thresholding intervention (CST). Across MBPP and MATH using Qwen3-8B, LLaMA3-8B, and GPT-4o-mini, global online adaptation yields inconsistent gains over static thresholding; MP-Strat partially recovers performance, while CST improves hit rate by up to 17 percentage points in strongly heterogeneous settings without gradient updates. These results identify structural heterogeneity, rather than optimizer weakness alone, as the primary bottleneck in the observed settings. More broadly, misaligned feedback structure cannot always be repaired by stronger optimization.

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

Extreme value theory for geometric Brownian motion and pricing of short maturity options

作者:

arXiv:2505.08036v2 Announce Type: replace Abstract: We investigate the limiting distribution of geometric Brownian motion conditional on its running maximum taking large values. The Freidlin-Wentzell large deviations theory predicts that the conditional distribution of the sample paths converge weakly to a deterministic exponential curve. We complement this result by showing that the conditional sample paths in fact converge in strong sense, and obtain quantitative bounds on the rate of convergence. As an application of our results to financial mathematics, we obtain new closed form asymptotic formulae for the fair price of barrier options with general path dependent payoff in the short maturity limit, with quantitative error estimates. We provide exact formulae for Asian and lookback style payoffs.

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

Enhanced Low-Density Region Exploration in Classifier-Guided Diffusion Models Through Modified Reverse Diffusion Sampling

arXiv:2606.13347v1 Announce Type: new Abstract: Diffusion models have emerged as state-of-the-art generative models for high-fidelity image synthesis, particularly in their classifier-free guided and classifier-guided forms. However, standard classifier guidance concentrates probability mass around high-density class mean, leading to poor coverage of rare samples in the tails of the class-conditional distributions. Recent work on diffusion-based tail sampling mitigates this by training an additional low-density-seeking classifier with a synthetic-vs-real discriminator, at the cost of additional networks and training. In parallel, a number of samplers and distillation techniques accelerate or refine diffusion sampling, but do not explicitly address long-tail coverage. We propose a purely sampling-time, density-aware extension of classifier-guided conditional diffusion model that targets low-density regions without any additional training. We have applied guidance at noisy images not on predicted noise like most diffusion models. Starting from a pretrained conditional diffusion model and classifier on ImageNet, we modify the guided reverse dynamics by steering trajectories toward low-confidence regions via the modified classifier gradient, and at each time step, we also guide the sampling process toward the predicted real image. 1st guidance helps explore low-probability samples, and 2nd guidance helps to generate samples to be close to the real data manifold. The proposed sampler consistently improves ADM model recall at 64x64 resolution while maintaining a comparable FID, and with a 256x256 ADM model, we showed the results visually with different combinations of both guidance. We also showed that standard ADM classifier guidance, combined with predicted real image guidance, helps generate high perceptual quality samples with a 256x256 ADM model on ImageNet.

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

Montreal Forced Aligner and the state of speech-to-text alignment in 2026

The Montreal Forced Aligner (MFA) was released in 2016 and has since become the most widely used tool for forced alignment in research and industry. In the decade since, MFA has undergone substantial development, including expanded coverage across more languages and dialects using larger open-source datasets, harmonized IPA dictionaries, model adaptation, cross-language phone remapping, and support utilities. This paper documents MFA 3.0's developments since version 1.0 and evaluates MFA's performance across English, Japanese, and Korean, benchmarked against classic and neural forced aligners. MFA 3.0 achieves state-of-the-art or near state-of-the-art performance across all four benchmark datasets with mean boundary errors below 15 ms. Adaptation and cross-language remapping are effective for languages outside MFA's training distribution, and pronunciation probability modeling and phonological rules provide gains in specific conditions.

18.
arXiv (CS.AI) 2026-06-19

Hierarchical Control in Multi-Agent Games: LLM-based Planning and RL Execution

arXiv:2606.20014v1 Announce Type: cross Abstract: Reinforcement learning (RL) has achieved strong performance in sequential decision-making, yet scaling to complex multi-agent environments remains challenging due to sparse rewards, large state-action spaces, and the difficulty of learning coordinated strategies. We propose a hierarchical architecture where a pretrained large language model (LLM) acts as a centralized strategic controller that selects among specialized RL skill policies for a team of agents, while RL policies handle reactive low-level execution. We evaluate this hybrid system in a competitive 2v2 King of the Hill environment against behavior tree (BT) and ``Flat'' RL (end-to-end training without skill decomposition) baselines. The LLM+RL system achieves task performance statistically equivalent to hand-crafted BT (46.4\% vs 51.5\% win rate, $p=0.103$) while both significantly outperform Flat RL trained without skill decomposition. A user study ($n=15$) reveals that 60\% of participants perceive LLM+RL agents as the most human-like ($p=0.027$), citing behavioral adaptability and tactical variability. These results demonstrate that pretrained LLM reasoning can effectively orchestrate pretrained RL skills, achieving competitive multi-agent coordination and superior perceived believability without manual rule engineering.

19.
PLOS Medicine 2026-06-01

The NIH 2025 Public Access Policy: Immediate access, unequal costs

by Caitlin R. Ryus, Caroline Raymond King, Edward R. Melnick The NIH 2025 Public Access Policy eliminates embargo periods for federally funded research, expanding who can read science. Yet without addressing article processing charges and market concentration, the policy risks creating new barriers to who can afford to perform and publish their science. In this Perspective, Caitlin Ryus and colleagues discuss the NIH 2025 Public Access Policy, highlighting that while expanding who can read science, the policy risks creating new barriers to who can afford to perform and publish their science.

20.
medRxiv (Medicine) 2026-06-15

Therapeutic efficacy study on shoulder impingement syndrome in swimmers: a network meta-analysis

Shoulder impingement syndrome (SIS), including subacromial impingement and rotator cuff tendinitis, is commonly caused by repetitive swimming movements and associated shoulder joint dysfunction. Despite numerous available treatment options, no consensus exists on the most effective treatment option. Therefore, this systematic review and network meta-analysis aimed to investigate treatment methods for SIS in swimmers. Using a frequentist framework and Cochrane PICOS principles, we compared SIS treatments, constructed network evidence diagrams, and assessed heterogeneity. A total of 45 studies were included in the qualitative synthesis, and 42 contributed to the network meta-analysis, comprising 1752 participants, 9 treatment categories, and outcome measures. For pain outcomes, some adjunctive interventions combined with exercise showed favorable ranking probabilities, although several estimates were accompanied by wide confidence intervals. For shoulder range-of-motion outcomes, taping, acupuncture, manual therapy, and sport-specific training showed favorable effects in selected comparisons, particularly for external and internal rotation. According to surface under the cumulative ranking curve (SUCRA) rankings, exercise combined with medium-frequency therapy ranked highly for pain reduction, whereas exercise combined with acupuncture or extracorporeal shock wave therapy ranked highly for shoulder flexion. Exercise combined with taping ranked highly for external rotation, and exercise combined with manual therapy ranked highly for internal rotation. However, the interpretation of ranking results should remain cautious because uncertainty and inconsistency were present in some comparisons. Exercise-based rehabilitation appears to remain central to the management of SIS in swimmers. Several adjunctive interventions showed favorable findings for selected outcomes, especially pain relief and shoulder rotational function. However, the available evidence was affected by heterogeneity, inconsistency, and imprecision across some treatment comparisons. More rigorously designed swimmer-specific randomized controlled trials are needed before firm treatment hierarchies can be established. Trial registration: The protocol for this systematic review is registered with PROSPERO (www.crd.york.ac.uk/PROSPERO; registration number: CRD42024498851). The first submission of PROSPERO was on January 15, 2024, and it was revised and updated on March 25, 2026.

21.
medRxiv (Medicine) 2026-06-18

Hard to Halt: Automation Bias in Agent-Driven Sequencing Prior Authorization Workflows

Purpose: Prior authorization (PA) for exome or genome sequencing is a time-consuming process that impedes timely rare disease diagnosis. Large language model-based browser agents offer potential for automating these workflows, but their clinical reliability remain uncharacterized. Methods: We developed a sandbox compromising a simulated ES/GS PA submission payer portal and a synthetic EHR containing 836 patient records spanning compliant profiles and deficient profiles with different types of issues. Gemini 3 Pro, Gemini 3 Flash, and Claude Opus 4.5 were evaluated on task completion rate, form completion accuracy, and appropriate withholding for deficient profiles. Results: Larger models achieved much higher task completion rates (Gemini 3 Pro 95.45%, Claude Opus 4.5 93.67%) compared to Gemini 3 Flash (56.05%), but nearly universally failed to withhold submission for deficient profiles whereas Gemini 3 Flash ironically demonstrated superior withholding performance (17.33%). In a non-agentic setting, Gemini 3 Pro correctly identified 91% of the issues in deficient profiles, indicating that withholding failure is attributable to the browser interaction rather than the model's reasoning limitations. Conclusion: Current LLM-based browser agents exhibit a systematic bias towards form submission that poses risks in PA workflows. A modular, multi-agent architecture with human supervision is necessary for a safe clinical deployment.

22.
arXiv (CS.CL) 2026-06-12

Influcoder: Distilling Decoders' Gradient Influence Rankings into an Encoder for Data Attribution

With the growth of LLMs' (Large Language Models) capabilities, there has been an increasing push to curate high quality datasets by filtering samples in the training data. In general, Data Attribution (DA) methods aim to estimate how individual samples in a training dataset can precondition a model to generate certain outputs. As an example, one might be interested in which samples in the data could be the source of toxic behavior after training the LLM. Many methods quantify this conditioning through the paradigm of influence functions. While methods of this family are effective in its function, they lack the necessary processing speed and storage compactness to be practically implemented on large datasets. We propose a method, Influcoder, as a quick and cost-effective approach to influence-based Data Attribution at scale.

23.
medRxiv (Medicine) 2026-06-11

Genetic Susceptibility to Incisional Hernia: Evaluation of Hernia Polygenic Risk Scores

Objectives: Incisional hernia (IH) affects 13-30% of people after abdominal surgery, resulting in substantial morbidity and costs. While clinical risk factors have been studied extensively, genomic risk for IH is incompletely understood. We aimed to evaluate the impact of polygenic risk scores (PRS) on IH risk prediction. Methods] We created and evaluated three PRS for abdominal hernia, ventral hernia and latent hernia susceptibility for prediction of IH in an institutional biobank. The primary outcome was defined as the diagnosis or repair of an IH based on ICD-9/10-CM/PCS and CPT codes. Clinical covariates included age, sex, body mass index (BMI), smoking status, index procedure type, and perioperative surgical site infection. A phenome-wide association study (PheWAS) was performed to assess clinical associations with increased PRS. We then tested the ability of the PRS to improve prediction for IH by modeling clinical covariates with and without PRS in patients who underwent abdominal surgery. Model performance was assessed using 10 iterations of 5-fold cross-validation to estimate Brier scores and area under the receiver operating characteristic curve (AUROC), which were compared using cross-model Bayesian analysis of variance. Results: In 55,809 subjects, assessed PRS was significantly associated with incisional, umbilical, and ventral hernia on PheWAS, with 1.19 greater odds of developing IH per 1-SD increase in PRS (95% CI: 1.13-1.25, P < 0.001). Of 9,909 subjects who underwent qualifying abdominal surgery, 706 developed IH. In this cohort, the latent hernia susceptibility PRS was associated with a 16% increased hazard of developing IH per 1-SD increase (HR 1.16; 95% CI: 1.07-1.26; P < 0.001). Compared to a predictive model using clinical covariates (Brier score = 0.047, 95% CI: 0.046-0.048; AUROC = 0.660, 95% CI: 0.653-0.666), addition of the PRS showed similar Brier score and AUROC estimates (Brier score = 0.047, 95% CI: 0.046-0.048; AUROC: 0.667, 95% CI: 0.661-0.673) at five years. Cross-model Bayesian analysis demonstrated >99% probability of practical equivalence when trying to detect a difference of [&ge;] 0.02. Conclusion: All three PRS for hernia were independently associated with IH, suggesting that genomic factors contribute significantly to IH development. However, none of the three PRS meaningfully improved clinical IH risk prediction in patients who underwent abdominal surgery. This suggests that clinical comorbidities and surgical techniques may be equally as important as genomic architecture.

24.
arXiv (CS.CL) 2026-06-16

Revisiting the Systematicity in Negation in the Era of In-Context Learning

Understanding the meaning of negated sentences remains one of the challenges for language models, even in the era of large language models (LLMs). We analyze systematicity regarding LLM understanding of negation from two perspectives: behavioral systematicity and representational systematicity. For behavioral systematicity, we confirm that through demonstrations and in-context learning, LLMs can recognize negation expressions and scope within sentences to some extent, but they fail to achieve perfect performance. In particular, the difficulty of the negation scope recognition for models varies depending on the output format. For representational systematicity, we analyze the extent to which function vectors can be robustly constructed from in-context examples for tasks that are essential to understanding negation. The experiments suggest that while function vectors can be composed for negation cue extraction tasks, extracting function vectors for recognizing scope is more challenging.

25.
arXiv (CS.LG) 2026-06-16

A Multimodal Approach to Alzheimer's Diagnosis: Geometric Insights from Cube Copying and Cognitive Assessments

arXiv:2512.16184v2 Announce Type: replace Abstract: Early and accessible detection of Alzheimer's disease (AD) remains a critical clinical challenge, and cube-copying tasks offer a simple yet informative assessment of visuospatial function. This work proposes a multimodal framework that converts hand-drawn cube sketches into graph-structured representations capturing geometric and topological properties, and integrates these features with demographic information and neuropsychological test (NPT) scores for AD classification. Cube drawings are modeled as graphs with node features encoding spatial coordinates, local graphlet-based topology, and angular geometry, which are processed using graph neural networks and fused with age, education, and NPT features in a late-fusion model. Experimental results show that graph-based representations provide a strong unimodal baseline and substantially outperform pixel-based convolutional models, while multimodal integration further improves balanced classification performance and discriminative ability. SHAP-based interpretability analysis identifies specific graphlet motifs associated with corner integrity and edge continuity as key predictors, closely aligning with clinical observations of distorted cube drawings in AD. Together, these findings establish graph-based analysis of cube-copying behavior as an interpretable, non-invasive, and scalable framework for Alzheimer's disease screening.