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01.
Nature Medicine 2026-06-16

<b>Engineered heart muscle passes early clinical milestone</b>

Engineered heart muscle allografts derived from induced pluripotent stem cells show promising early outcomes in patients with treatment-refractory advanced heart failure with reduced left ventricular ejection fraction, in support of further clinical investigation. Engineered heart muscle allografts derived from induced pluripotent stem cells show promising early outcomes in patients with treatment-refractory advanced heart failure with reduced left ventricular ejection fraction, in support of further clinical investigation.

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

Discovering Lattice Reduction Strategies via Self-Play

arXiv:2606.15301v1 Announce Type: cross Abstract: The Lenstra-Lenstra-Lovász (LLL) algorithm is a seminal contribution to computer science used for lattice basis reduction, yet its polynomial-time outputs produce bases that are far from optimal as the dimension grows. We show that deep reinforcement learning can discover strictly superior, generalizable reduction strategies by interacting with the primitive action space of LLL. We formulate lattice reduction as a single-player Markov Decision Process (MDP) and train a deep residual network using an AlphaZero-style self-play pipeline augmented with adaptive-horizon MCTS (Monte Carlo Tree Search), which couples multi-step network predictions with an entropy-gated expansion mechanism. The resulting policy, DeltaStar, is trained exclusively on small $8$-dimensional $q$-ary lattices and requires fewer primitive row operations than LLL. Crucially, it generalizes zero-shot to unseen moduli and higher dimensions up to $n=32$ without retraining.

03.
arXiv (CS.LG) 2026-06-25

Simplify to Amplify: Achieving Information-Theoretic Bounds with Fewer Steps in Spectral Community Detection

arXiv:2602.17104v2 Announce Type: replace-cross Abstract: We propose a streamlined spectral algorithm for community detection in the two-community stochastic block model (SBM) under constant edge density assumptions. By reducing algorithmic complexity through the elimination of non-essential preprocessing steps, our method directly leverages the spectral properties of the adjacency matrix. We demonstrate that our algorithm exploits specific characteristics of the second eigenvector to achieve improved error bounds that approach information-theoretic limits, representing a significant improvement over existing methods. Theoretical analysis establishes that our error rates are tighter than previously reported bounds in the literature. Comprehensive experimental validation confirms our theoretical findings and demonstrates the practical effectiveness of the simplified approach. Our results suggest that algorithmic simplification, rather than increasing complexity, can lead to both computational efficiency and enhanced performance in spectral community detection.

04.
arXiv (math.PR) 2026-06-12

Counterintuitive problems in discrete probability

arXiv:2606.07516v2 Announce Type: replace Abstract: This manuscript contains a collection of counterintuitive problems in discrete probability, together with detailed solutions. The dataset was constructed as part of a broader research project investigating the capabilities of the latest-generation Large Language Models (LLMs) in solving discrete probability problems, in order to assess whether LLMs tend to make systematic reasoning errors associated with known cognitive biases. The problems collected here are specifically designed to challenge heuristic reasoning strategies that often lead to intuitively appealing but mathematically incorrect conclusions. The dataset combines several types of problems. Some are adapted from classical probabilistic paradoxes and cognitive-bias literature, while others originate from recreational mathematics sources or were developed by ourselves following similar principles. The primary purpose of this document is to provide a transparent and publicly accessible reference for the problems used in our experimental evaluation of language models, as well as providing detailed human-made solutions. At the same time, we believe that this collection may also prove useful for future research on probabilistic reasoning, cognitive biases, and the evaluation of reasoning capabilities in artificial intelligence systems.

05.
arXiv (quant-ph) 2026-06-19

Effects of interaction range on the mean-field dynamics of Bose polarons

arXiv:2606.20020v1 Announce Type: cross Abstract: We consider the three-dimensional Bose polaron problem in the regime of finite range interactions and competing length scales. Working in the reference frame of the impurity, we study both static and out of equilibrium properties of the system, in particular the transfer of momentum between the impurity and the host gas. We find that relaxation dynamics can occur via damped oscillations of the impurity velocity with simple dependence on the interaction strength. Furthermore, the equilibration process is sensitive to the type of the impurity-bath interaction. Specifically, interatomic forces describing ion-atom systems lead to much longer timescales and more pronounced oscillations in the strong coupling regime with respect to local interaction potentials. We also find that the effective masses can differ by a large amount between the two scenarios, even if the number of atoms in the polaron cloud remains similar for both cases.

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

PVF:Understanding AI Vulnerability Against SDCs

arXiv:2405.01741v4 Announce Type: replace-cross Abstract: Reliability of AI systems is a fundamental concern for the successful deployment and widespread adoption of AI technologies. Unfortunately, the escalating complexity and heterogeneity of AI hardware systems make them increasingly susceptible to hardware faults, e.g., silent data corruptions (SDC), that can potentially corrupt model parameters. When this occurs during AI inference/servicing, it can potentially lead to incorrect or degraded model output for users, ultimately affecting the quality and reliability of AI services. In light of the escalating threat, it is crucial to address key questions: How vulnerable are AI models to parameter corruptions, and how do different components (such as modules, layers) of the models exhibit varying vulnerabilities to parameter corruptions? To systematically address this question, we propose a novel quantitative metric, Parameter Vulnerability Factor (PVF), inspired by architectural vulnerability factor (AVF) in computer architecture community, aiming to standardize the quantification of AI model vulnerability against parameter corruptions. We define a model parameter's PVF as the probability that a corruption in that particular model parameter will result in an incorrect output. In this paper, we present several use cases on applying PVF to three types of tasks/models during inference – recommendation (DLRM), vision classification (CNN), and text classification (BERT), while presenting an in-depth vulnerability analysis on DLRM. PVF has been a critical metric used for making key error management design decisions in productionizing Meta's in-house AI chip - MTIA.

07.
arXiv (CS.CL) 2026-06-24

From Task-Guided Conversational Graphs to Goal-Oriented Dialogue Runtimes

Graph and multi-agent orchestration frameworks make production large language model (LLM) workflows practical, but they do not by themselves solve conversational continuity when users maintain several interdependent objectives. This conceptual systems paper focuses on the high-complexity end of that design space, where goals can be suspended, resumed, revised, and invalidated by actions in other goals. We introduce the Goal-Oriented Dialogue Runtime (GODR), a framework-neutral design pattern that treats goals, task frames, lifecycle state, invalidation rules, and resumption contracts as first-class runtime objects while delegating bounded execution to graph runtimes, agents, tools, or application programming interfaces (APIs). GODR is not proposed as a replacement for workflow graphs in simple guided processes; it is intended for complex, multi-domain, interruptible conversations where objective continuity cannot be recovered reliably from agent identity, chat history, or execution-graph position alone. The paper formalizes the problem, proposes runtime objects and architecture-selection criteria, and frames evaluation as an agenda for future empirical validation rather than as a measured performance claim.

08.
arXiv (CS.CL) 2026-06-11

Context-Aware Multimodal Claim Verification in Spoken Dialogues

Every day, millions absorb claims from podcasts and streams that no fact-checker ever sees. Spoken misinformation is built through conversation, where credibility comes not from facts alone but from how claims are framed, reinforced, or left unchallenged across turns. Yet fact-checking has focused on isolated text, leaving dialogue audio under-studied. We introduce MAD2, a new Multi-turn Audio Dialogues benchmark for spoken claim verification, containing 1,000 two-speaker dialogues with 3,368 check-worthy claims and approximately 10 hours of audio, and propose calibrated multimodal fusion of a context-aware audio encoder and a dialogue-aware text model. Across settings, adding dialogue context improves verification, but the gains depend on scenario type. Using only preceding context often matches offline performance, supporting live-moderation settings, and audio contributes most when transcript-based models are destabilized by additional context. Overall, conversational structure matters more for verification than misinformation framing.

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

Do Large Language Models Have Emotions?

arXiv:2606.14742v1 Announce Type: cross Abstract: Do LLMs have emotions? A recent paper from Anthropic reports finding internal representations of emotion concepts in Claude Sonnet 4.5, concluding that the LLM has 'functional emotions.' We evaluate this claim against what is known about how emotions actually function in biological systems. We argue that emotions serve two core functions: the context-sensitive interpretation of situations, and the reorganization of processing across multiple systems in response to those interpretations. The Anthropic findings offer partial support for the first function, though the consistent, discrete emotional representations identified in Claude sit uneasily with affective neuroscience findings that human emotion is characterized by variable rather than uniform neural signatures. On the second function, the evidence is mixed: Claude's representations modulate output without producing the dynamic reorganization of attention, decision speed, and motivational state that defines emotion in biological systems. We close by proposing what it would take for an LLM to have emotions.

10.
arXiv (CS.LG) 2026-06-18

Diffusion-Proof: Recipe for Formal Theorem Proving Beyond Auto-Regressive Generation

arXiv:2606.19315v1 Announce Type: new Abstract: Enhancing the formal math reasoning capabilities of Large Language Models (LLMs) has become a key focus in both mathematical and computer science communities in recent years. While significant progress has been made in using state-of-the-art Auto-Regressive (AR) LLMs for formal theorem proving, these models suffer from inherent limitations. Their next-token prediction generation methods may yield suboptimal performance due to the challenges of long-range coherence and the compounding of errors over long sequences. Recent advancements in diffusion LLMs (dLLMs), which generate text through iterative denoising of a multi-token block, offer a promising alternative. However, the application of dLLMs to formal mathematics, where maintaining long-range coherence is critical, remains largely understudied. To address the challenges above, we propose **Diffusion-Proof**, to the best of our knowledge, the first framework to train and apply dLLMs for formal theorem proving. Our frameworks contain training and inference methods for two models. The first one is *dLLM-Prover-7B*, which performs whole-proof writing with long-range coherent tactic usage. The second one is *dLLM-Corrector-7B*, which is a novel large block diffusion-based correction model. It leverages the in-filling capabilities of dLLMs to perform local proof correction using bi-directional information. Extensive experiments demonstrate that **Diffusion-Proof** relatively significantly outperforms the AR LLM baseline trained under the same dataset. **Diffusion-Proof** achieves an absolute improvement of **1.61%** on ProofNet-Test and **6.14%** on MiniF2F-Test benchmarks compare to the baseline. Notably, **Diffusion-Proof** successfully resolves one IMO problem that more advanced thinking model DeepSeek-Prover-V2-7B could not solve, showcasing the unique advantage of dLLMs in formal theorem proving.

11.
bioRxiv (Bioinfo) 2026-06-22

Few-Shot Classification of C. elegans Developmental Stages via Explainable Hierarchical Hyperbolic Graph Embeddings

Automated, accurate, and fast developmental-stage classification of C. elegans from microscopy-based morphological images is essential for aging research, drug screening, and disease modeling. However, it remains challenging due to morphological similarities between stages and the limited annotated data. In this work, we propose HyperDev, a hyperbolic few-shot learning framework that addresses these limitations by directly encoding developmental hierarchies in the embedding space, unlike conventional Euclidean approaches that treat stages as independent classes. HyperDev uses Poincare ball geometry, combined with a biologically informed developmental prior, to naturally represent stage relationships. We introduce our selfcurated C. elegans dataset spanning seven developmental stages (Egg, L1-L4, Adult, Dauer) with extreme class imbalance (6-8 samples per minority class). HyperDev achieves competitive classification accuracy (76.9-88.3%) while providing intrinsic explainability across nine 7-way few-shot evaluation settings. The learned embeddings exhibited strong biological alignment (Pearson r = 0.669, p < 0.001), while significantly outperforming ProtoNet (r = 0.187), MatchingNet (r = 0.235), and RelationNet (r = 0.464). These results establish hyperbolic geometry as a principled approach to explainable few-shot learning in biological imaging, where understanding learned representations is as critical as predictive performance. Clinical Relevance–By enabling explainable, data-efficient developmental staging from scarce samples, HyperDev supports improved phenotype quantification for aging research, disease modeling, and drug screening. Index Terms–Hyperbolic learning, few-shot classification, developmental staging, Caenorhabditis elegans, interpretability, explainability.

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

Interpretable Alzheimer's Diagnosis via Multimodal Fusion of Regional Brain Experts

Accurate and early diagnosis of Alzheimer's disease (AD) is critical for effective intervention and requires integrating complementary information from multimodal neuroimaging data. However, conventional fusion approaches often rely on simple concatenation of features, which cannot adaptively balance the contributions of biomarkers such as amyloid PET and MRI across brain regions. In this work, we propose MREF-AD, a Multimodal Regional Expert Fusion model for AD diagnosis. It is a Mixture-of-Experts (MoE) framework that models mesoscopic brain regions within each modality as independent experts and employs a gating network to learn subject-specific fusion weights. Utilizing tabular neuroimaging and demographic information from the Alzheimer's Disease Neuroimaging Initiative (ADNI), MREF-AD achieves competitive performance over strong classic and deep baselines while providing interpretable, modality- and region-level insight into how structural and molecular imaging jointly contribute to AD diagnosis. The source code is available at https://github.com/PennShenLab/mref-ad.

13.
arXiv (quant-ph) 2026-06-12

Generalized two-qubit Hamiltonian for Projective Quantum Feature Maps

arXiv:2606.13641v1 Announce Type: new Abstract: Projected quantum feature maps provide a strategy for using quantum processors as feature generators for classical machine-learning models. Building on counterdiabatic Ising-glass and one-dimensional Heisenberg PQFMs, we introduce a generalized two-qubit Hamiltonian-based PQFM that provides a unified way to encode classical features through local Pauli fields and pairwise two-qubit Pauli interactions. This construction allows distinct classical variables to be embedded along different Pauli axes of the same qubit, increasing the information density of shallow circuits while remaining compatible with hardware constraints. We develop and implement these methods in pqfmlib, a publicly available Python library for constructing, executing, and benchmarking Hamiltonian-based PQFMs.We then benchmark the generalized Hamiltonian PQFMs against reference PQFMs on four biomedical classification datasets under a nested cross-validation protocol with paired statistical tests. Quantum features are generated using both IBM quantum processors with up to 156 qubits and statevector simulations. Our results show that the generalized two-qubit Hamiltonian family provides the most consistent pattern of statistically supported gains over matched classical baselines, although the performance of all methods depends on the dataset, encoding strategy, measured observables, and hardware conditions. These findings support generalized Hamiltonian PQFMs as a promising route toward near-term quantum utility.

14.
arXiv (CS.CV) 2026-06-18

Show, Don't Ask: Generative Visual Disambiguation for Composed Image Retrieval with Turn-Valid Coverage

Composed image retrieval (CIR) uses a reference image and a text modification to search for a target image. However, such queries often describe several possible images rather than one exact target, making the user's intent ambiguous. Recent methods address this by using conformal prediction to estimate ambiguity and by asking users clarifying text questions. However, these methods have two limitations: their coverage guarantee only holds at the first interaction, and text questions are often insufficient for resolving fine-grained visual differences such as appearance, attributes, or viewpoint. We propose CLARA, a clarification framework that resolves ambiguity by showing users a small panel of visual alternatives. Instead of answering text questions, the user simply selects the prototype image closest to the intended target. This provides a direct visual signal and avoids relying on a model to predict the user's answer. To maintain valid conformal guarantees across multiple interaction rounds, CLARA reweights calibration using the likelihood ratio induced by the user's selection. The displayed prototypes are also constrained to represent the current candidate set and are snapped to real corpus images, ensuring that generated images cannot artificially improve coverage. Experiments on open-domain and fashion benchmarks show that CLARA matches single-turn state-of-the-art retrieval performance, maintains nominal coverage across interaction rounds, and finds the intended target in fewer rounds than strong text-question baselines. Its advantage is especially clear when ambiguity involves viewpoint or fine-grained attributes, where visual clarification is more effective than textual questioning.

15.
arXiv (CS.CL) 2026-06-17

Rethinking Groups in Critic-Free RLVR

Reinforcement learning (RL) has become a central paradigm for post-training large language models. Existing critic-free RL methods typically generate a group of rollouts for the same question to estimate value baselines for advantage computation. However, this design suffers from data inefficiency, group synchronization barriers, and inflexibility with structured rollouts. In this work, we revisit the role of the ``group'' and show that its underlying function is not merely to estimate baselines but to prevent false penalties on negative samples. Building on this insight, we propose negative token filtering, a simple and effective strategy that enables stable single-rollout training. We apply it to two batch-level advantage methods, achieving comparable performance on reasoning tasks and stronger performance on agentic tasks relative to group-based RL techniques.

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

Non-Autoregressive Minimum Bayes' Risk Decoding for Fast Speech Recognition

Non-autoregressive (NAR) decoding generates output tokens in parallel, making speech recognition faster than autoregressive decoding, which generates them sequentially from left to right. However, the recognition performance is degraded because NAR decoding cannot resolve uncertainty by conditioning on previously generated tokens. To address this issue, we propose a novel NAR decoding framework based on minimum Bayes' risk (MBR) decoding, termed NAR-MBR decoding, that maximizes the expected utility calculated from samples drawn from the output probability of an NAR model rather than maximizing the output probability. Notably, by leveraging the nature of NAR models, multiple samples are obtained efficiently with a single forward computation. Our experiments across LibriSpeech, Switchboard, AMI, and web presentation corpus demonstrated that our NAR-MBR decoding outperformed previous NAR decoding and ran faster than AR decoding.

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

Beyond Scalar Rewards by Internalizing Reasoning into Score Distributions

Reward models are central to text-to-image post-training, but visual preference is subjective and better represented as a distribution over rubric scores than as a deterministic scalar. Existing scalar, score-token, and pairwise reward models over-compress uncertainty and fine-grained score differences, while reasoning-based generative rewards provide stronger judgments but are costly to deploy and difficult to use as direct optimization signals. We propose Z-Reward, a teacher-student reward modeling framework that decouples reasoning-heavy judgment from efficient reward deployment. The teacher is a large VLM that uses reasoning to infer rubric-aligned score distributions, and is trained with Group-wise Direct Score Optimization (GDSO), which combines policy-gradient rewards from distribution expectations with direct pointwise and pairwise supervision on score distributions and score gaps. The student is trained with Reasoning-Internalized Score Distillation (RISD), which transfers the teacher's reasoning-conditioned score distribution into a compact VLM without requiring explicit reasoning chains at inference time. On our internally annotated evaluation set, the 27B GDSO teacher reaches 89.6% human preference accuracy, outperforming SFT, RewardDance, and GRPO, while the 9B RISD student reaches 88.6%, outperforming the OPD baseline and closely matching the larger teacher. We further show that Z-Reward can serve as a differentiable reward signal for text-to-image optimization, yielding a 41.3% net human-preference improvement over the SFT baseline.

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

Adversarial Dependence Minimization

arXiv:2502.03227v2 Announce Type: replace Abstract: Minimally redundant representations are typically learned by minimizing feature covariance. However, covariance-based methods fail to eliminate all dependencies/redundancies, as linearly uncorrelated variables can still exhibit nonlinear relationships. To address this, we introduce ADM, a differentiable algorithm that minimizes statistical dependence between feature dimensions through an adversarial game: auxiliary networks identify dependencies, while the encoder removes them. We prove that mutual independence is achieved at the global optimum, empirically verify convergence, and study three potential applications: extending PCA to nonlinear decorrelation, improving generalization in image classification, and preventing dimensional collapse in self-supervised learning. By promoting statistically independent representations, ADM paves the way for learning more robust, compressed, and generalizable representations across diverse applications.

19.
Nature Medicine 2026-06-25

Teclistamab-based induction treatment in transplant-eligible, newly diagnosed multiple myeloma: a phase 2 trial

作者:

Advancements in frontline therapies have substantially improved outcomes in newly diagnosed multiple myeloma (NDMM); however, many patients will not achieve deep responses and will relapse. Teclistamab, a BCMA×CD3 bispecific antibody, in combination with daratumumab, has demonstrated strong efficacy in relapsed/refractory multiple myeloma versus standard of care as early as first relapse. This ongoing phase 2 GMMG-HD10/DSMM-XX (MajesTEC-5) study evaluates teclistamab-based regimens in transplant-eligible NDMM. In this prespecified pooled analysis of three cohorts, 49 patients received teclistamab/daratumumab/lenalidomide (Tec-DR; arms A and A1) or Tec-DR with bortezomib (Tec-DVR; arm B). Primary endpoints were incidence and severity of adverse events (AEs) and serious AEs; secondary endpoints included overall response rate (ORR), minimal residual disease (MRD) negativity and MRD-negative complete response (CR). The current analysis spans the induction and autologous stem cell transplantation phases until the premaintenance timepoint. Grade 3 or 4 treatment-emergent AEs (TEAEs) occurred in 91.8% (45/49); most were hematologic (lymphopenia (59.2%; 29/49), neutropenia (59.2%; 29/49) and leukopenia (18.4%; 9/49)). No grade 5 TEAEs were reported. Serious AEs occurred in 55.1% (27/49); pyrexia (12.2% (6/49)) was most common. Any-grade and grade 3 or 4 infections occurred in 81.6% (40/49) and 36.7% (18/49), respectively, the most common grade 3 or 4 infections being COVID-19 and pneumonia (6.1% (3/49) each). Cytokine release syndrome occurred in 67.3% (33/49); all were grade 1 or 2, all resolved and none led to discontinuation of any study treatment. No treatment-related immune effector cell-associated neurotoxicity syndrome (ICANS) events occurred. Across arms, the MRD-negative CR rate was 91.8% (45/49) by the premaintenance timepoint; the MRD negativity rate was 100% in evaluable samples at postinduction cycle 3 (1 × 10−5 (46/46)), cycle 6 (1 × 10−5 (46/46) and 1 × 10−6 (46/46)) and premaintenance (1 × 10−5 (40/40)); the ORR was 100% (49/49). Total median stem cell yield was 8.1 × 106 per kg. Data support the feasibility of Tec-D(V)R induction in transplant-eligible NDMM, with a consistent safety profile compared with individual regimen components and notable early MRD negativity rates. ClinicalTrials.gov identifier: NCT05695508 . In the ongoing phase 2 GMMG-HD10/DSMM-XX (MajesTEC-5) trial in patients with transplant-eligible, newly diagnosed multiple myeloma, induction with the BCMA×CD3 bispecific engager teclistamab in combination with daratumumab plus lenalidomide, with or without bortezomib, had a similar toxicity profile to other bispecific regimens with an encouraging and deep response rate.

20.
arXiv (CS.AI) 2026-06-15

Capability Minimization as a Safety Primitive: Risk-Aware Causal Gating for Least-Privilege LLM Agents

arXiv:2606.13884v1 Announce Type: new Abstract: Modern decision systems increasingly rely on learned components whose outputs may be confident yet wrong, exposing downstream actions to costly errors. We introduce Risk-Aware Causal Gating (RACG), a framework that decides whether to act on, defer, or abstain from a model's prediction by combining causal effect estimation with calibrated risk control. RACG models the causal pathway from candidate actions to outcomes and gates each decision according to an estimated counterfactual risk rather than raw predictive confidence. To make gating reliable, we derive distribution-free bounds on the probability of acting under high-risk conditions and show how these bounds translate into operating thresholds that satisfy user-specified safety constraints. We further propose an adaptive gating policy that adjusts to distribution shift by monitoring discrepancies between predicted and realized outcomes, tightening the gate when causal assumptions appear violated. Across simulated interventions and real-world decision benchmarks, RACG reduces high-cost errors substantially while preserving most of the utility of an ungated policy, and it outperforms confidence-based and selective-prediction baselines at matched abstention rates. Our results indicate that explicitly separating causal risk from predictive uncertainty yields decision systems that are both safer and more transparent, offering a principled mechanism for trustworthy automation in high-stakes settings.

21.
arXiv (CS.AI) 2026-06-25

A Hybrid TGN-SEAL Model for Dynamic Graph Link Prediction

arXiv:2602.14239v3 Announce Type: replace-cross Abstract: Predicting links in sparse, continuously evolving networks is a central challenge in network science. Conventional heuristic methods and deep learning models, including Graph Neural Networks (GNNs), are typically designed for static graphs and thus struggle to capture temporal dependencies. Snapshot-based techniques partially address this issue but often encounter data sparsity and class imbalance, particularly in networks with transient interactions such as telecommunication call detail records (CDRs). Temporal Graph Networks (TGNs) model dynamic graphs by updating node embeddings over time; however, their predictive accuracy under sparse conditions remains limited. In this study, we improve the TGN framework by extracting enclosing subgraphs around candidate links, enabling the model to jointly learn structural and temporal information. Experiments on a sparse CDR, email, message dataset show that our approach increases average precision by at least 2% over standard TGNs, demonstrating the advantages of integrating local topology for robust link prediction in dynamic networks.

22.
medRxiv (Medicine) 2026-06-10

Frozen elephant trunk repair in heritable thoracic aortic disease: Impact of genetic aortopathy on long-term outcomes - A multicenter analysis

Aims This multicenter study aims to compare outcomes of total aortic arch replacement (TAR) using the frozen elephant trunk (FET) technique in patients with and without heritable thoracic aortic disease (HTAD) and to assess whether HTAD influences postprocedural adverse aortic events (AAEs). Methods From 06/2007 to 05/2024, aortic databases from 13 European centers were screened for HTAD patients undergoing TAR with FET. All consecutive dissection and aneurysm non-HTAD patients from the four core centers served as comparator. The primary outcome was AAE, a composite of diameter progression, distal stent graft induced new entry (dSINE), malperfusion, rupture and pseudoaneurysm at 5 years after FET implantation. Results Of 2739 FET patients, 196 (7.2%) were diagnosed with HTAD. The control group consisted of 867 non-HTAD FET patients. Marfan syndrome was the most common condition (72%), followed by Loeys-Dietz syndrome (11%), vascular Ehlers-Danlos syndrome (5.6%) and Turner syndrome (2.0%). Seventeen (8.8%) patients were diagnosed with ns-HTAD. At 5 years 46 (24%) AAEs occurred in the HTAD group, 169 (20%) in the non-HTAD group (p=0.2). Diameter progression was the most common event (10% vs. 12%; p=0.6), followed by dSINE (5.8% vs. 4.5%; p=0.5), malperfusion (4.2% vs. 3.3%; p=0.5), rupture (2.1% vs. 0.7%; p=0.09) and pseudoaneurysm (0.5% vs. 0.2%; p=0.5). Conclusions The FET technique appears safe and effective for acute and chronic aortic disease in HTAD patients, with outcomes comparable to non-HTAD cases and no increase in graft-related complications, challenging traditional concerns about stent graft use in genetically mediated aortic disease.

23.
arXiv (CS.AI) 2026-06-12

Creating and Evaluating K-12 GenAI Assessment Graders Through Context Engineering

arXiv:2606.12422v1 Announce Type: cross Abstract: The integration of large language models (LLMs) into educational assessment represents a transformative shift in classroom grading practices. While automated scoring systems and machine learning techniques have existed for decades, generative AI (GenAI) now enables educators to implement standards-based grading (SBG) with unprecedented efficiency and scale. This paper examines the theoretical foundations and evaluates an LLM grader that uses commercially available foundation models with context and prompt engineering to score student work against a rubric. Drawing on an empirical interrater agreement study using Massachusetts Comprehensive Assessment System (MCAS) data, we observed the Quadratic Weighted Kappa (QWK) and Proportional Reduction in Mean-Squared Error (PRMSE) across mathematics, science, and ELA, using Claude Sonnet 4, Haiku 4.5, GPT-5, and GPT-5 Mini. The results demonstrate that LLM graders, especially when based on foundational models with more parameters, achieve substantial agreement with human raters in mathematics and science assessments, while the performances vary in ELA, suggesting generic foundation models can be effective at scoring in given contexts. Additional analysis of teacher and student feedback reveals strong acceptance of AI-generated narrative feedback but skepticism toward numerical scores, suggesting that LLMs function most effectively as formative tools rather than summative evaluators. Our findings indicate that thoughtfully designed hybrid models that combine AI efficiency with teacher judgment can reduce workload, enhance feedback quality, and support equitable assessment practices without displacing professional expertise.

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

PolyKV: Heterogeneous Retention and Allocation for KV Cache Compression

arXiv:2606.15157v1 Announce Type: cross Abstract: KV cache compression is essential for reducing the memory cost of long-context large language model inference. Existing approaches, however, typically apply a single compression policy and a uniform cache budget across all transformer layers. This uniform design ignores the fact that different layers can play different roles during prefill and decoding, and may therefore require different eviction strategies and cache capacities. We present PolyKV, a layer-wise KV cache optimization framework that considers design space with method selection and budget allocation. PolyKV routes each layer to a suitable KV compression policy based on layer-level signals, while assigning non-uniform budgets under a fixed total budget. This formulation enables heterogeneous compositions of existing KV cache methods. Experiments on LLaMA-3.1-8B and Qwen3-8B show that, under the same 512-token average KV budget, PolyKV recovers 54.5% and 25.7% of the LongBench performance gap between the strongest single-policy baseline and FullKV, respectively. Across 128-1024 budget sweep, PolyKV consistently improves over the strongest baseline by 1.7%-6.4%, corresponding to 40.0%-54.5% recovery of the FullKV gap.

25.
medRxiv (Medicine) 2026-06-15

Specialty Choice Attitudes Among Medical Interns: Evidence from Hormozgan University of Medical Sciences

Background: Choosing a medical specialty is a critical career decision that affects both physicians future professional lives and the composition of the healthcare workforce. Specialty preferences are shaped by multiple personal, educational, and socioeconomic factors, yet evidence from senior medical students in southern Iran remains limited. This study aimed to assess willingness to pursue specialty training among medical interns at Hormozgan University of Medical Sciences, identify their preferred specialties, and examine factors associated with their decisions. Methods: This descriptive-analytical cross-sectional study was conducted in 2023 among medical interns at Hormozgan University of Medical Sciences in Bandar Abbas, Iran. Using a convenience census approach, all eligible interns were invited to participate, and 83 students completed an online questionnaire. The instrument collected demographic, academic, and occupational data, as well as reasons for willingness or unwillingness to pursue specialty training and specialty preferences. Content and face validity were assessed by faculty members and students, and internal consistency reliability in the present study was acceptable (Cronbach alpha = 0.82). Data were analyzed using descriptive statistics and logistic regression in SPSS version 27. Results: Of the 83 participants, 50 (60.2%) reported willingness to pursue specialty training, while 33 (39.8%) did not. Among students willing to continue, the most frequently cited reasons were achieving a better economic position, broader job opportunities, and higher social status. Among those unwilling to continue, the most common reasons were fatigue from prolonged studying, financial problems, and the desire to start working after graduation. Radiology was the most common first-choice specialty, followed by otorhinolaryngology, dermatology, and cardiology. In regression analyses, no demographic or academic variable remained independently associated with willingness to pursue specialty training in the final multivariable model. Conclusions: A majority of medical interns were interested in pursuing specialty training, with preferences concentrated in a limited number of specialties perceived as offering favorable financial prospects, prestige, and lifestyle. Economic concerns and educational fatigue were the dominant factors influencing willingness and unwillingness to continue specialty education. These findings highlight the need for structured career counseling, broader exposure to different specialties, and policy measures to address financial and structural barriers to residency training. Keywords: medical specialty choice; medical interns; residency training; medical education; Hormozgan university of medical sciences