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01.
arXiv (CS.CL) 2026-06-16

MosaicQuant: Inlier-Outlier Disaggregation for Unified 4-Bit LLM Quantization

4-bit quantization significantly reduces the memory footprint and accelerates the inference of large language models (LLMs). However, its limited bit-width representation struggles to faithfully capture both dense common values (inliers) and rare large-magnitude values (outliers), causing substantial accuracy degradation. Existing mixed-precision methods mitigate this by retaining outliers in high precision, but at the cost of breaking the uniformity of low-bit execution, introducing precision conversion and extra data movement that undermine practical speedup. We propose MosaicQuant, a unified 4-bit LLM quantization paradigm built on a novel principle of inlier–outlier disaggregation. Rather than elevating outlier precision, MosaicQuant quantizes the full weight matrix into a dense 4-bit base component, where inliers are captured faithfully while outlier are inevitably quantized. A sparse 4-bit residual component is then introduced to compensate for these quantization errors, selectively targeting the most error-critical weight blocks where output distortion is shown to be concentrated. However, a unified representation alone is insufficient, as naïvely executing the sparse residual as a separate kernel still breaks the unified low-bit inference pipeline. To bridge this gap, we introduce ZipperEngine, which fuses sparse block computation into the dense 4-bit GEMM kernel via an overlapped pipeline, unifying not only the representation but also the execution into a single coherent low-bit inference pipeline. Extensive experiments on LLaMA3 and Qwen3 demonstrate that MosaicQuant preserves near-FP16 accuracy while achieving up to $1.24\times$ speedup over the W16A16 baseline.

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

Atlas H&E-TME: Scalable AI-Based Tissue Profiling at Expert Pathologist-Level Accuracy

Hematoxylin and eosin (H&E) staining is the cornerstone of histopathology, yet scalable, quantitative analysis of H&E whole-slide images (WSIs) remains a central challenge in computational pathology. We present Atlas H&E-TME, an AI-based system built on the Atlas family of pathology foundation models that predicts tissue quality, tissue region, and cell type labels across multiple cancer types, yielding over 4,500 quantitative readouts per slide at cell-level resolution. A key challenge to validating such systems is overcoming morphological ambiguity inherent to H&E-only ground truth and the limited scalability of more informed references drawing on modalities such as immunohistochemistry (IHC). We address this with a dual validation framework combining biologically grounded depth with technical and morphological breadth. For depth, we propose an IHC-informed multi-pathologist consensus protocol that substantially improves inter-rater agreement over conventional H&E-only annotation. This yields a molecularly grounded reference against which we compare Atlas H&E-TME and pathologists working from H&E alone. For breadth, we benchmark Atlas H&E-TME on over 200,000 high-confidence H&E-only pathologist annotations across 1,500+ cases spanning eight cancer types and their most common metastatic sites, with subtypes covering >90% of clinical cases per cancer type, drawn from 25+ sources and 8+ scanner models. Benchmarked against the IHC-informed consensus, Atlas H&E-TME matches or exceeds pathologist H&E-only performance and generalizes consistently and robustly across this broad morphological and technical scope. In doing so, Atlas H&E-TME turns the H&E slide – the most ubiquitous data in pathology – into a scalable, quantitative window into the tumor and its microenvironment, laying a foundation for the next generation of tissue-based biomarkers in translational and clinical research.

03.
medRxiv (Medicine) 2026-06-22

UKBAnalytica: an integrated R package for scalable phenotyping and reproducible epidemiological analysis within the UK Biobank Research Analysis Platform

作者:

UK Biobank provides longitudinal health-related data for approximately 500,000 participants, and its Research Analysis Platform (RAP) has shifted large-scale analyses toward secure cloud-based computation. However, many existing tools address only specific steps of the analytical workflow, leaving a need for an integrated framework that connects multi-source disease phenotyping, survival-ready cohort construction, and downstream analysis on the RAP. Here, we present UKBAnalytica, an extensible R package for scalable phenotyping and integrated analysis of UK Biobank data within the RAP environment. It currently includes 52 predefined baseline variables and a built-in library of 331 curated disease definitions. These definitions are based on multiple UK Biobank data sources, including ICD-10, ICD-9, self-reported conditions, death registry records, algorithmically defined outcomes, and OPCS-4 procedure codes. UKBAnalytica distinguishes prevalent and incident cases, constructs follow-up time, generates analysis-ready survival datasets, and summarizes participant flow. Beyond phenotype construction, UKBAnalytica provides integrated modules for epidemiological analysis, omics analysis, and machine-learning-based modeling and interpretation. By linking endpoint definition with downstream modeling under a consistent data structure, UKBAnalytica reduces repetitive scripting and improves analytical transparency. Furthermore, we demonstrate the package's practical utility through a case study on chronic obstructive pulmonary disease (COPD) proteomics. The findings align closely with previously reported conclusions, underscoring the robustness and reliability of our analytical framework. This phenotype-centered framework complements existing UK Biobank tools and facilitates reproducible RAP-based biomedical research. UKBAnalytica is freely available at https://github.com/Hinna0818/UKBAnalytica.

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

A Unified Perspective on the Dynamics of Deep Transformers

arXiv:2501.18322v2 Announce Type: replace Abstract: Transformers, which are state-of-the-art in most machine learning tasks, represent the data as sequences of vectors called tokens. This representation is then exploited by the attention function, which learns dependencies between tokens and is key to the success of Transformers. However, the iterative application of attention across layers induces complex dynamics that remain to be fully understood. To analyze these dynamics, we identify each input sequence with a probability measure and model its evolution as a Vlasov equation called Transformer PDE, whose velocity field is non-linear in the probability measure. Our first set of contributions focuses on compactly supported initial data. We show the Transformer PDE is well-posed and is the mean-field limit of an interacting particle system, thus generalizing and extending previous analysis to several variants of self-attention: multi-head attention, L2 attention, Sinkhorn attention, Sigmoid attention, and masked attention–leveraging a conditional Wasserstein framework. In a second set of contributions, we are the first to study non-compactly supported initial conditions, by focusing on Gaussian initial data. Again for different types of attention, we show that the Transformer PDE preserves the space of Gaussian measures, which allows us to analyze the Gaussian case theoretically and numerically to identify typical behaviors. This Gaussian analysis captures the evolution of data anisotropy through a deep Transformer. In particular, we highlight a clustering phenomenon that parallels previous results in the non-normalized discrete case.

05.
arXiv (CS.LG) 2026-06-15

Cluster LOCO: Feature Importance For Interpreting Clusters

arXiv:2606.14592v1 Announce Type: cross Abstract: Clustering is widely used for exploratory analysis and scientific discovery, driving insights from market segmentation to biological data analysis, but its outputs can be difficult to interpret, audit, and reproduce as modern datasets become increasingly large and complex. Reliable use of clustering requires understanding which features drive the discovered structure, yet feature-level explanations for clustering remain scarce compared with methods in supervised learning. Furthermore, existing clustering feature importance scores are often tied to specific algorithms and data assumptions. To address these challenges, we propose Cluster LOCO (Leave-One-Covariate-Out), a family of model-agnostic feature importance scores for clustering. Cluster LOCO is built on feature occlusion and clustering generalizability, defined as whether cluster labels learned on one subset of the data can be accurately predicted on held-out samples. For any chosen clustering algorithm, Cluster LOCO quantifies a feature's importance by measuring how much its removal degrades generalizability. We first introduce Cluster LOCO-Split, which relies on data splitting, and then extend it to Cluster LOCO-MP, a minipatch ensemble-based version designed for large-scale data. Across synthetic simulations and an application to cell-type discovery in single-cell transcriptomics, we show that Cluster LOCO more reliably recovers informative features than existing clustering feature importance methods.

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

LLM-as-Code Agentic Programming for Agent Harness

arXiv:2606.15874v1 Announce Type: new Abstract: Every major LLM agent framework gives the LLM the role of orchestrator; the model decides what to do next, when to call tools, and when to stop. We argue that token explosion, control-flow hallucination, and unreliable completion are not implementation bugs but architectural consequences of assigning the deterministic work of looping, branching, and sequencing to a probabilistic system. A better prompt or a stronger model cannot guarantee the reliability of the LLM agent. We therefore propose Agentic Programming, in which the program governs all control flow, and the LLM is itself part of it, an adaptive component we call LLM-as-Code and invoke only where a task calls for reasoning or generation. Within each call the model keeps full flexibility, but it cannot alter the program's execution path. With control in the program, the LLM's context is built from the execution history's call tree and forms a directed acyclic graph (DAG). Each call's context length is then determined by its call depth rather than by accumulation over steps. A case study of computer-use agents shows that the design is practical, not just a theoretical stance, substantially improving the stability of long visual operation sequences.

07.
arXiv (CS.CV) 2026-06-18

Pyramid Self-Contrastive Learning for Single-shot Test-time Ultrasound Image Denoising

The inherent electronic and speckle noise complicates clinical interpretation of ultrasound images. Conventional denoising methods rely on explicit noise assumptions whose validity diminishes under composite noise conditions. Learning-based methods are usually pretrained in a limited image domain using a labeled dataset, which implies inevitable domain shift in complex in vivo environments. This study proposes a Pyramid Self-Contrastive Learning (PSCL) framework for test-time ultrasound image denoising without pretraining. Given multiple noisy samples from only one-shot imaging, PSCL disentangles anatomical similarity and noise randomness into separate pyramid latent spaces. The clean image is then decoded from the anatomy space while discarding the noise space. We first apply PSCL to synthetic aperture ultrasound (SAU), where an Aperture-to-Aperture loop serves as a self-supervised proxy task to ensure denoising fidelity. Simulation experiments, including noise levels from 0 to 30 dB and inclusion geometries from simple to complex, demonstrated improvements of 69.3% in SNR and 34.4% in CNR. The in vivo results showed 84.8% SNR and 25.7% CNR gains using only two aperture data of the heart in six echocardiographic views, liver, and kidney. PSCL delivers clear images across diverse imaging targets and configurations, paving the way for more reliable anatomical visualization without domain shift and pretraining costs.

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

MGI: Member vs Generated Inference

arXiv:2606.23872v1 Announce Type: cross Abstract: As generative models increasingly produce samples that are indistinguishable from human-created content, it becomes difficult to determine whether a given data point was part of a model's natural training set or was generated by the model itself, especially when models memorize and reproduce training data. We formalize this challenge as Member vs Generated Inference (MGI): given a sample and a target generative model, infer whether the sample is a true training member or a generated output of that model. Focusing on image generation, we show that existing membership inference methods systematically misclassify generated samples as training members, while attribution-based methods often misclassify true members as generated. This failure arises because both approaches rely on likelihood-related signals that are similarly elevated for training examples and for the model's own outputs. To address MGI, we propose Data Circuit Breaker (DCB), a three-stage method that combines complementary signals from a generative model's autoencoder and latent generator to distinguish training members from generated samples. Across multiple generative models, including image autoregressive and diffusion models, DCB consistently addresses the shortcomings of membership inference and attribution methods, remains effective even when models reproduce near-duplicates of training samples, and generalizes to challenging model derivative settings in which new models are trained on generated data.

09.
medRxiv (Medicine) 2026-06-18

Consistency of sleep timing and duration are associated with more physical activity and favorable heart rate metrics in a naturalistic cohort

Background: Regularity of sleep patterns over time has increasingly gained traction as an important axis of sleep health. Since sleep habits are under some degree of behavioral control, understanding such patterns in naturalistic settings is particularly important. We quantified sleep variability and tested the hypothesis that regularity correlates with physical activity, resting heart rate (rHR), and heart rate variability (HRV). Methods: We analyzed real-world digital health data from over 81,000 participants (over 18 million nights) who provided informed consent to participate in the Apple Heart and Movement Study and elected to contribute sleep, activity, and heart rate data to the study. Variability was quantified using the standard deviation (SD) computed from total sleep time (TST), sleep start time (S-start), end time (S-end), and midpoint time (MP), as well as the Sleep Regularity Index (SRI). Results: The SD-based variability metrics correlated with one another (R values 0.74-0.92), and with the SRI metric (R values 0.62-0.64). More consistent sleep, by any metric, was associated with more activity and better rHR and HRV. The most consistent tertile for TST variability had higher median TST (6.9 vs 5.9 hours), more daily exercise (32.8 vs 20.4 minutes), lower rHR (62.4 vs 65.6 beats per minute), and higher HRV (40.6 vs 37.3), all p

11.
bioRxiv (Bioinfo) 2026-06-11

Calibrated Uncertainty Quantification for Patient-Level AML Drug Sensitivity Prediction Using Split Conformal Prediction

Accurate prediction of ex vivo drug sensitivity in acute myeloid leukemia (AML) patients from transcriptomic data is a critical challenge for precision oncology. Existing computational approaches have explored uncertainty quantification in cancer drug response prediction primarily using cell line data, while patient-level AML models typically rely on heuristic confidence measures rather than statistically calibrated uncertainty estimates. Here, we present a framework applying split conformal prediction to patient-level AML drug response modeling using the BeatAML 2.0 cohort. We trained Elastic Net and XGBoost regressors on bulk RNA-seq gene expression profiles from 318 AML patients, analyzing 34,764 patient-drug observations across 122 compounds. Baseline models achieved median Pearson R values of 0.291 (Elastic Net) and 0.281 (XGBoost) across 122 drugs. Wrapping these models with split conformal prediction yielded well-calibrated prediction intervals across three confidence levels: empirical coverages of 81.4%, 90.7%, and 95.5% against nominal targets of 80%, 90%, and 95%, respectively. Analysis of prediction interval widths revealed substantial drug-class-specific uncertainty patterns, with HDAC and BCL-2 inhibitors exhibiting markedly higher uncertainty than MDM2 inhibitors, suggesting a potential association between transcriptomic predictability and drug mechanism of action, although several drug classes were represented by only a small number of compounds. Predictive uncertainty was not significantly associated with ELN2017 molecular risk classification (Kruskal-Wallis p=0.395) or NPM1 mutation status (p=0.788). These results demonstrate that statistically valid uncertainty quantification can be achieved for patient-level AML drug response prediction despite substantial biological heterogeneity. to the best of our knowledge, no published study has applied split conformal prediction to patient-level ex vivo drug sensitivity prediction in the BeatAML cohort, providing a principled alternative to heuristic confidence scoring approaches. Keywords: Acute myeloid leukemia (AML); Ex vivo drug sensitivity; Conformal prediction; Uncertainty quantification; Precision oncology; BeatAML; Transcriptomic biomarkers; Machine learning.

12.
arXiv (CS.CV) 2026-06-24

Ill-Posed by Design: Probing Evidence Use in VLMs

Counterfactual analysis is widely used to study evidence use in vision-language models, but its diagnostic value is limited on well-posed tasks: when several cues independently support the same answer, removing one may not change the prediction. We propose monocular metric object-size estimation as an ill-posed diagnostic setting for evidence selection: because physical size cannot be determined from a single uncalibrated image, models must rely on imperfect cues category priors, target appearance, local context, apparent image size, and scene geometry. We assemble Metric VQA ($10{,}813$ dimension queries from Objectron and $331$ tape-measured in-the-wild scenes) and evaluate $12$ open-weight VLMs ($3$–$397$\,B parameters) with counterfactual analysis decomposing six visual and language evidence channels. Even the largest VLMs tested (Qwen3-VL-235B, Qwen3.5-397B, InternVL3.5-241B) trail a text-only frontier LLM on the in-the-wild split. The diagnostic analysis shows: target identity is the most load-bearing cue, target pixels and local context help only some models, apparent size shifts predictions without a directional readout, and global scene geometry is largely unused. We analyze LoRA fine-tuning as an actionable intervention specific to metric estimation: while the task is learnable, the models do not learn to leverage scene geometry.

13.
arXiv (CS.CV) 2026-06-11

A2SG:Adaptive and Asymmetric Surrogate Gradients for Training Deep Spiking Neural Networks

Training deep spiking neural networks (SNNs) remains challenging due to sharp loss landscapes and temporal inconsistency caused by surrogate gradients. To address these challenges, we propose a unified framework: adaptive and asymmetric surrogate gradients A2SG. The adaptive gradients adjust an effective window for spatio-temporal adaptation, reducing spatial gradient variation and maintaining directional consistency of gradients over time. The asymmetric gradients reflect neuronal dynamics by assigning larger gradients to neurons with higher membrane potentials, and we prove that they yield lower variation than symmetric surrogates. Our analysis further establishes a direct connection between local gradient variation and the curvature of the loss landscape, providing a principled explanation for how A2SG promotes convergence to flatter minima and improves generalization. We conduct extensive experiments on diverse models, including CNN-based and Transformer-based SNNs, across various tasks such as image classification using both static and neuromorphic datasets, as well as segmentation. The results demonstrate that A2SG consistently improves accuracy and energy efficiency, establishing it as a general and reliable solution for training deep SNNs. Our code is available at https://github.com/KIST-NCL/A2SG.git.

14.
arXiv (CS.LG) 2026-06-17

Maximin Relative Improvement: Fair Learning as a Bargaining Problem

arXiv:2602.04155v2 Announce Type: replace-cross Abstract: When deploying a single predictor across multiple subpopulations, we propose a fundamentally different approach: interpreting group fairness as a bargaining problem among subpopulations. This game-theoretic perspective reveals that existing robust optimization methods such as minimizing worst-group loss or regret correspond to classical bargaining solutions and embody different fairness principles. We propose relative improvement, the ratio of actual risk reduction to potential reduction from a baseline predictor, which recovers the Kalai-Smorodinsky solution. Unlike absolute-scale methods that may not be comparable when groups have different potential predictability, relative improvement provides axiomatic justification including scale invariance and individual monotonicity. We establish finite-sample convergence guarantees under mild conditions.

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

Multi-entropy in random tensor networks

arXiv:2606.04470v2 Announce Type: replace-cross Abstract: We study the evaluation of Rényi multi-entropies $S^{(q)}_n$ in Random Tensor Network (RTN) states in the large bond-dimension limit. For the case of Rényi index $n=2$ and arbitrary number of parties $q$, we prove that that multi-entropies are determined by minimal multiway cuts through the network. When the minimal multiway cut is degenerate, we characterize the full minimizer set via compatible families of minimal cuts and give a criterion for all minimizers to come from ordinary cut partitions. For $n=2$, this gives a natural generalization of the minimal cut description of bipartite entanglement to multipartite systems with arbitrarily many parties. For the case of integer $n>2$, we show that the minimal multiway cut conjecture is in general not true by providing explicit counter examples for both the single random tensor and for the network built from isometric tilings. We discuss the implication for our results on the multipartite entanglement structures in RTN and holography.

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

Who Should Lead Decoding Now? Tracking Reliable Trajectories for Ensembling Masked Diffusion Language Models

Masked Diffusion Language Models (MDLMs) have emerged as a distinct paradigm for sequence generation. As MDLMs become diverse in capabilities and knowledge coverage, an important question is how to combine their knowledge. Toward this, we first investigate the unique decoding dynamics of MDLMs. We find that successful generations exhibit stable confidence dynamics over answer-relevant positions, while unreliable trajectories can often be corrected by injecting promising intermediate states from other models. Guided by this observation, we propose $TIE$ ($T$rajectory-based $I$terative $E$nsembling), a knowledge fusion framework in which MDLMs iteratively identify reliable decoding trajectories and relay them across models. TIE tracks confidence dynamics over answer-relevant positions to determine which model currently follows a more reliable trajectory and selectively transfers partially denoised sequences across models. As the model on the more promising trajectory often changes across denoising steps, TIE allows different models to contribute complementary strengths at different stages of generation. Strong performance across diverse reasoning tasks, along with our analyses, suggests that TIE offers a practical approach to the underexplored problem of MDLM ensembling.

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

CogCanvas: A Benchmark for Evaluating Multi-Subject Reference-Based Image Generation

Multi-subject reference-based image generation requires jointly preserving multiple human identities, binding per-person objects and fashion items, and respecting a specified background scene, a regime where current diffusion models remain brittle. Existing benchmarks evaluate only one axis at a time and none jointly captures multi-identity composition with human-object interaction, background grounding, and spatial plausibility. We introduce CogCanvas, a benchmark of 1,952 curated reference images spanning 100 celebrity identities, 115 distinctive objects and fashion items, and 29 real-world background scenes including landmarks, from which we construct 1,361 compositional prompts covering 2-5 person group sizes. The curation pipeline combines DINOv2-based deduplication, two-stage aesthetic filtering, and automated derivation of structured interaction and position graphs that serve as ground-truth supervision. CogCanvas supports three tasks, reference-based multi-human-object generation (primary), text-to-image compositional generation, and reference retrieval, under a unified six-axis evaluation protocol. We introduce two metrics tailored to the multi-reference setting: BG-Sim, which scores background fidelity on SAM 3-masked regions via DINOv3 feature similarity, and Attr-VQA, which uses a multimodal LLM to verify per-subject attribute binding and inter-person interactions against the structured graphs. Benchmarking five SOTA methods reveals that every model degrades substantially as group size grows from 2 to 5, with near-complete failure on object/fashion binding beyond three subjects.

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

Ternary Mamba: Grouped Quantization-Aware Training of W1.58A16 State Space Models

arXiv:2606.18114v1 Announce Type: cross Abstract: State Space Models (SSMs) such as Mamba-2 offer linear-time inference but their memory footprint limits edge deployment. Prior ternary SSM work (Slender-Mamba) trains from scratch on 150B tokens; we show a pretrained checkpoint suffices, reducing the marginal token budget by 1,000x. Using grouped quantization-aware training (QAT) with knowledge distillation from a frozen FP16 teacher, we compress Mamba-2 1.3B to 3.61x (2,687 to 744 MB) and achieve 48.1% zero-shot accuracy (7-task average) in just 102M tokens (4 GPU-hours, single H100) – approaching Bi-Mamba's 48.4% (within +/-0.9pp CI). This QAT-from-pretrained setting reveals zero-ratio collapse, a novel instability caused by learnable quantization scales that does not arise in from-scratch training. We further show that post-hoc correction strategies effective for Transformers fail for SSMs due to error accumulation through the recurrence. These results demonstrate that ternary SSMs do not require expensive from-scratch training: QAT from pretrained checkpoints with KD is a data-efficient alternative.

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

Where Did the Variability Go? From Vibe Coding to Product Lines by Regeneration

arXiv:2606.19042v1 Announce Type: cross Abstract: In vibe coding, an emerging AI-driven paradigm, an LLM generates an entire program from a natural language prompt, but what happens to the variability that traditional software engineering carefully builds into code? To answer this question, we conducted an exploratory analysis on 10 vibe coded C/C++ projects, which suggests that there is near-zero in-artifact variability, i.e., at compile and runtime. All variability decisions are resolved at a single new binding time, generation time, the moment the LLM produces the source code. Rather than treating this as a defect to fix, we propose Variability by Regeneration (VbR), to our knowledge the first product-line approach in which the LLM acts as the derivation engine, generating a purpose-built, free of dead code binary for each variant from a declarative specification, while a variant dispatcher transparently routes user requests to the matching binary. We formalise VbR, contrast it with classical SPL derivation, and demonstrate its full pipeline on a wc product family. For SPL engineering, variability in AI-generated software belongs in the specification, not in the code.

20.
arXiv (CS.AI) 2026-06-24

Assessing Distribution Shift in Human Activity Recognition for Domain Generalization

arXiv:2606.24781v1 Announce Type: new Abstract: While the field of Human Activity Recognition (HAR) continues to draw interest from researchers and advance in important ways, some key challenges remain. One of the most difficult aspects of building HAR models that show good performance in real-world settings is dealing with data diversity from device and sensor heterogeneity, and contextual changes that are intrinsic to real-world applications. While data diversity in HAR has been well-acknowledged in the literature, there remains a gap in understanding the effect of various types of distribution shifts on HAR models and the domain generalization problem that arises. Towards that end, this paper systematically evaluates 4 different types of distribution shifts, including variations in device type, sensor placement, sampling rate, and user behavior. Quantifying their effects, we illustrate that diversity shifts predominantly define all types of shifts, indicating the existence of unique features that are not shared across different domains. We then introduce a uniform HAR-based distribution shift benchmarks and conduct a comprehensive evaluation of up to 28 domain generalization methods. Our analysis exposes the limitations of current domain generalization algorithms in achieving model generalizability, marginally outperforming the empirical risk minimization baseline. This work represents the first systematic exploration of domain generalization and adaptation concerning specific distribution shifts in sensor-based HAR, offering an open-source benchmark platform and datasets to spur further research.

21.
medRxiv (Medicine) 2026-06-19

Within-host pathogen population diversity predicts treatment response in tuberculosis

Background: Tuberculosis (TB) treatment outcomes remain suboptimal, and standard clinical diagnostics cannot reliably identify patients at high risk of treatment failure or relapse at the time of diagnosis. While within-host Mycobacterium tuberculosis genetic diversity is hypothesized to reflect the viable bacterial burden and adaptive capacity of the infection, its clinical prognostic value remains unknown. Methods: We conducted a prospective cohort study of 364 patients with newly diagnosed, rifampicin-susceptible pulmonary TB in South Africa. Patients received standard 6-month therapy and were monitored for up to two years to ascertain composite unfavorable outcomes (treatment failure, death, or relapse). To accurately detect low-frequency (unfixed) genetic variants and eliminate reference bias artifacts, we mapped medium to high depth short-read sequences against matched, patient-specific long-read assemblies. The association between baseline pathogen genetic diversity and clinical outcomes was evaluated using multivariable Cox proportional-hazards models. Results: After bioinformatic filtering, true unfixed variants were relatively rare but significantly enriched in genes mediating pathogen adaptation and drug tolerance, including transporter proteins and two-component regulatory systems. Within-host bacterial genetic diversity (i.e., the total number of unfixed variants) ranged from 0-20, with a median of 1 per patient. In survival analysis adjusting for known clinical risk factors–including HIV status, prior TB, baseline smear positivity, and radiographic lung involvement–baseline within-host genetic diversity emerged as a strong, independent predictor of unfavorable treatment outcomes. For patients with greater than 3 unfixed variants at diagnosis, each increase of 5 unfixed variants was associated with more than double the risk of a composite unfavorable outcome (adjusted Hazard Ratio, 2.36; 95% CI, 1.27 to 4.39; p=0.007). Conclusions: Baseline within-host pathogen genetic diversity is an independent predictor of unfavorable TB treatment outcomes. As sequencing becomes increasingly integrated into routine diagnostics, quantifying unfixed variants is an accessible approach that promises to risk-stratify patients and guide the duration of individualized regimens.

22.
arXiv (CS.AI) 2026-06-24

BioPIE: A Biomedical Protocol Information Extraction Dataset for Experiment Understanding

arXiv:2601.04524v2 Announce Type: replace Abstract: Understanding biomedical experiments provides a foundation for downstream tasks, e.g., laboratory automation, and facilitates effective cross-disciplinary communication. Two challenges, High Information Density (HID) and Multi-Step Reasoning (MSR), pose unique difficulties for precise experimental understanding. Extracting structured knowledge, e.g., Knowledge Graphs (KGs), is an effective approach to address the HID and MSR. However, existing biomedical datasets for structured knowledge information extraction are limited to a general or coarse-grained level, hindering fine-grained experimental understanding. To address this gap, we introduce Biomedical Protocol Information Extraction Dataset (BioPIE), a dataset providing procedure-centric KGs that capture entities, actions, and relations at a scale sufficient for reasoning across biomedical protocols. We evaluate information extraction methods on BioPIE and implement a question answering system leveraging the dataset for validation, demonstrating improved understanding performance on test sets as well as on the HID and MSR question sets.

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

When, Where, and How: Adaptive Binning for Tabular Self-Supervised Learning

arXiv:2606.19827v1 Announce Type: cross Abstract: Medical tabular data are ubiquitous in clinical research, but deep learning for tables remains underexplored because reliable labels often require costly expert adjudication, even though structured clinical variables are routinely available in tabular form. Self-supervised learning can leverage these unlabeled tables, and recent binning-based pretexts offer a promising inductive bias, but existing objectives fix a single global quantile discretization and apply feature-agnostic supervision. We propose Adaptive Binning, a training-adaptive discretization pretext for tabular SSL that couples discretization to learning through a feature-wise coarse-to-fine curriculum. Motivated by the spectral bias of neural networks and the principles of curriculum learning, our method progressively refines discretization per feature upon plateau detection and selects representation-aware splits to jointly improve value-space concentration and representation-space coherence. A heterogeneity-aware objective unifies categorical reconstruction with ordinal supervision for numerical features, and experiments on public medical tabular datasets under unified evaluation protocols show consistent gains for linear probing and fine-tuning without dataset-specific discretization tuning. We further introduce a medical tabular SSL benchmark with standardized protocols to support reproducible progress in this underexplored domain. Our code is available at https://github.com/labhai/Adaptive-Binning.

24.
arXiv (CS.LG) 2026-06-19

Insulin4RL: Real-Time Insulin Management in the Intensive Care Unit for Offline Reinforcement Learning

arXiv:2606.19481v1 Announce Type: new Abstract: Offline reinforcement learning (ORL) offers the potential to improve the quality of clinical decision-making using historical electronic health record (EHR) data. Current training and evaluative practices in this field rely heavily on EHR datasets that have been temporally discretised into fixed, regular time intervals. Discretisation creates fictional representations of complex clinical scenarios and compromises the generalisability of retrospective model evaluations. In this paper, we introduce Insulin4RL, a healthcare ORL dataset featuring naturally irregular inputs and actions from real clinical trajectories. Derived from MIMIC-IV, Insulin4RL comprises over 375,000 labelled decisions across 12,209 patients requiring insulin infusion titration in the Intensive Care Unit. The dataset can thus be used for research into ORL model performance under realistic clinical sampling assumptions. We provide a description of the dataset's structure and characteristics, baseline performance metrics using model-free offline reinforcement learning, and a standardised evaluation protocol using fitted Q-evaluation. We conclude with suggested areas for future research that could be addressed using this resource.

25.
arXiv (CS.LG) 2026-06-19

Environment-Adaptive Covariate Selection: Learning When to Use Spurious Correlations for Out-of-Distribution Prediction

arXiv:2601.02322v2 Announce Type: replace-cross Abstract: A common approach to out-of-distribution prediction restricts models to causal or invariant covariates to avoid spurious associations that may change across environments. Despite its theoretical appeal, this strategy can underperform empirical risk minimization when only a subset of the causal parents of the outcome is observed. In such settings, non-causal covariates can serve as proxies for unobserved causal parents and improve prediction when the proxy relationship is stable, but they can hurt when shifts disrupt that relationship. Thus, the optimal covariate set can depend on the specific shift encountered. Because different shifts leave signatures in the unlabeled covariate distribution, we propose an environment-adaptive covariate selection algorithm that maps environment-level summaries to environment-specific covariate sets. These summaries may be hand-crafted or learned from multi-environment data, and prior causal knowledge can be incorporated as constraints. Across simulations and applied datasets, the proposed method improves over static causal, invariant, and other non-adaptive rules under diverse shifts.