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01.
medRxiv (Medicine) 2026-06-22

Hyperlipidemia Pharmacotherapy in Skilled Nursing Facilities: A Real-World Evidence Study

作者:
Ashraf↗Mathers↗K. E↗Wagner↗Saumur↗

Objectives: To estimate hyperlipidemia medication order prevalence and associated variables in U.S. skilled nursing facility (SNF) residents. Design: Retrospective, observational study. Setting and Participants: Electronic Health Record data from 447,080 SNF residents with a hyperlipidemia diagnosis identified in PointClickCare's Life Sciences clinical database (January-April 2025) were reviewed. Methods: The presence and absence of medication orders for hyperlipidemia treatments recommended by the American Heart Association were assessed. Descriptive analyses summarized demographic and clinical characteristics, and a modified Poisson regression model was used to estimate risk ratios for having a medication order, adjusting for demographic, clinical, and facility characteristics. Results: Overall, 83.3% of residents diagnosed with hyperlipidemia had at least one hyperlipidemia medication order. Statins were ordered by 96.2% of active order residents, while other medication classes i.e., omega-3 fatty acids, cholesterol absorption inhibitors, fibrates were less common (

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02.
arXiv (CS.AI) 2026-06-25

Towards Understanding The Calibration Benefits of Sharpness-Aware Minimization

作者:
Chengli Tan↗Yubo Zhou↗Haishan Ye↗Guang Dai↗Junmin Liu↗Zengjie Song↗Jiangshe Zhang↗Zixiang Zhao↗Yunda Hao↗Yong Xu↗

arXiv:2505.23866v2 Announce Type: replace-cross Abstract: Deep neural networks have been increasingly used in safety-critical applications such as medical diagnosis and autonomous driving. However, many studies suggest that they are prone to being poorly calibrated and have a propensity for overconfidence, which may have disastrous consequences. In this paper, unlike standard training such as stochastic gradient descent, we show that the recently proposed sharpness-aware minimization (SAM) counteracts this tendency towards overconfidence. The theoretical analysis suggests that SAM allows us to learn models that are already well-calibrated by implicitly maximizing the entropy of the predictive distribution. Inspired by this finding, we further propose a variant of SAM, coined as CSAM, to ameliorate model calibration. Extensive experiments on various datasets, including ImageNet-1K, demonstrate the benefits of SAM in reducing calibration error. Meanwhile, CSAM performs even better than SAM and consistently achieves lower calibration error than other approaches

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

CaVe-VLM-CoT: An Interpretable Vision-Language Model Framework

作者:
Sneha Rao↗Shaina Raza↗Dhanesh Ramachandram↗

arXiv:2606.18385v1 Announce Type: new Abstract: Vision-Language Models (VLMs) remain prone to hallucinations, producing fluent but visually unfaithful outputs. Existing chain-of-thought and retrieval-augmented methods only partially address this, as they neither enforce step-level citation grounding nor route verification failures back to retrieval for correction. We present CaVe-VLM-CoT, a modular reflection-based agentic-RAG framework that enforces evidence-grounded reasoning through a five-stage closed-loop pipeline: Extractor, Retriever, Solver, Citation Injector, and Verifier, in which detected ungrounded claims trigger structured feedback to the Extractor for targeted re-retrieval. Since no existing framework jointly measures retrieval quality, step-wise citation faithfulness, and cross-modal grounding, we propose a suite of 23 component-wise metrics across all stages, anchored by CaVeScore, a composite metric weighting accuracy, citation precision and recall, attribution, and evidence grounding. Without any architectural or prompt modifications, CaVe-VLM-CoT achieves 87.1\% accuracy and 56.6\% CaVeScore on ScienceQA , and 55.2\% accuracy and 35.7\% CaVeScore on MMMU (30 subjects).

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04.
arXiv (CS.AI) 2026-06-25

The Token Not Taken: Sampling, State, and the Stochasticity of AI Agents

作者:
Muhammad Zia Hydari↗Raja Iqbal↗

arXiv:2606.08998v2 Announce Type: replace Abstract: Agentic AI systems can behave differently across runs: the same request may produce a different plan, a different tool call, a different code edit, or a different final answer. Such variability arises from several layers that are often conflated. At the core of many current agents is a foundation model, a large pretrained model adaptable to many downstream tasks, embedded in an orchestration loop that plans, calls tools, observes results, and updates state. One explicit intrinsic source of variability in such systems is token generation: the model computes scores over possible next tokens, the scores are converted into probabilities, and a decoder may sample tokens using a pseudo-random number generator. A small sampled token difference can then propagate upward into a different tool call, code path, search query, or agent state. Other sources of variability are extrinsic to token sampling, including changing environments, live data, serving infrastructure, batch effects, and numerical details. By separating these layers, this tutorial clarifies what it means to call agentic AI systems stochastic, when such variability can be reproduced under matched conditions, and why deterministic execution need not imply identical behavior in deployed settings.

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05.
Nature (Science) 2026-06-24

Crude oil fractionation by means of mesoporous polyacrylonitrile membranes

作者:
Jihoon Choi↗

Atmospheric and vacuum distillation consume more than 1,100 TWh year−1 and emit more than 160 million metric tonnes of CO2 equivalent annually1,2, making membrane-based pre-fractionation a compelling retrofit strategy for lowering the energy and carbon intensity of petroleum refining3–10. Here we demonstrate that porous polyacrylonitrile (PAN) membranes, typically used as support layers, achieve effective molecular refining of crude oil at steady state. Under tangential flow, PAN membranes exhibited high crude oil permeances of up to 0.591 ± 0.040 l m−2 h−1 bar−1, a more than 23-fold increase over the previous benchmark (<0.1 l m−2 h−1 bar−1)1,11, selectively yielding enriched lighter hydrocarbon fractions such as naphtha and kerosene. This unexpected selectivity arises from the dynamic deposition of heavy hydrocarbons within the initially approximately 15-nm surface mesopores, which narrows the pore diameter to sub-2-nm dimensions. Depth-resolved chemical identification reveals selective accumulation of n-alkanes, suggesting a self-limiting pore constriction mechanism that stabilizes selective transport pathways. Once the n-alkane deposition is stabilized, selective enrichment of raw crude oils occurs with sustained stability over 4 weeks. Process simulations show that PAN-membrane-based pre-fractionation could reduce energy by 31.6%, cooling water by 20.7% and CO2 emissions by 37.6% compared with traditional atmospheric distillation. Porous polyacrylonitrile membranes—typically used as non-selective support layers—can be used to achieve effective molecular refining of crude oil at steady state, enabling substantial reductions in energy consumption, cooling water, and CO2 emissions compared with distillation processes.

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

Policy-Embedded Graph Expansion: Networked HIV Testing with Diffusion-Driven Network Samples

作者:
Akseli Kangaslahti↗Davin Choo↗Lingkai Kong↗Milind Tambe↗Alastair van Heerden↗Cheryl Johnson↗

arXiv:2601.16233v2 Announce Type: replace-cross Abstract: HIV is a retrovirus that attacks the human immune system and can lead to death without proper treatment. In collaboration with the WHO and the University of Witwatersrand, we study how to improve the efficiency of HIV testing with the goal of eventual deployment, directly supporting progress toward UN Sustainable Development Goal 3.3. While prior work has demonstrated the promise of intelligent algorithms for sequential, network-based HIV testing, existing approaches rely on assumptions that are impractical in our real-world implementations. Here, we study sequential testing on incrementally revealed disease networks and introduce Policy-Embedded Graph Expansion (PEGE), a novel framework that directly embeds a generative distribution over graph expansions into the decision-making policy rather than attempting explicit topological reconstruction. We further propose Dynamics-Driven Branching (DDB), a diffusion-based graph expansion model that supports decision making in PEGE and is designed for data-limited settings where forest structures arise naturally, as in our real-world referral process. Experiments on real HIV transmission networks show that the combined approach (PEGE + DDB) consistently outperforms baselines (e.g., 17.3% improvement in discounted reward and 15.4% more HIV detections with 25% of the population tested) and explore key tradeoffs that drive solution quality.

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07.
arXiv (CS.AI) 2026-06-19

ZeSTA: Zero-Shot TTS Augmentation with Domain-Conditioned Training for Data-Efficient Personalized Speech Synthesis

作者:
Youngwon Choi↗Jinwoo Oh↗Hwayeon Kim↗Hyeonyu Kim↗

arXiv:2603.04219v2 Announce Type: replace-cross Abstract: We investigate the use of zero-shot text-to-speech (ZS-TTS) as a data augmentation source for low-resource personalized speech synthesis. While synthetic augmentation can provide linguistically rich and phonetically diverse speech, naively mixing large amounts of synthetic speech with limited real recordings often leads to speaker similarity degradation during fine-tuning. To address this issue, we propose ZeSTA, a simple domain-conditioned training framework that distinguishes real and synthetic speech via a lightweight domain embedding, combined with real-data oversampling to stabilize adaptation under extremely limited target data, without modifying the base architecture. Experiments on LibriTTS and an in-house dataset with two ZS-TTS sources demonstrate that our approach improves speaker similarity over naive synthetic augmentation while preserving intelligibility and perceptual quality. Audio samples are available on our web page.

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08.
arXiv (CS.AI) 2026-06-15

PRISM: Perception Reasoning Interleaved for Sequential Decision Making

作者:
Mohamed Salim Aissi↗Clemence Grislain↗Clement Romac↗Laure Soulier↗Mohamed Chetouani↗Olivier Sigaud↗Nicolas Thome↗

arXiv:2605.05407v2 Announce Type: replace Abstract: Scaling LLM-based embodied agents from text-only environments to complex multimodal settings remains a major challenge. Recent work identifies a perception-reasoning-decision gap in standalone Vision-Language Models (VLMs), which often overlook task-critical information. In this paper, we introduce PRISM, a framework that tightly couples perception (VLM) and decision (LLM) through a dynamic question-answer (DQA) pipeline. Instead of passively accepting the VLM's description, the LLM critiques it, probes the VLM with goal-oriented questions, and synthesizes a compact image description. This closed-loop interaction yields a sharp, task-driven understanding of the scene. We evaluate PRISM on the ALFWorld and Room-to-Room (R2R) benchmarks. We show that: (1) PRISM significantly outperforms state-of-the-art image-based models, (2) our Interactive goal-oriented perception pipeline yields systematic and substantial gains, and (3) PRISM is fully automatic, eliminating the need for handcrafted questions or answers.

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09.
arXiv (CS.LG) 2026-06-18

Some Complexity Results for Robustness Verification for Binarized Neural Networks

作者:
Harshit Goyal↗Sudakshina Dutta↗

arXiv:2606.18918v1 Announce Type: new Abstract: This paper studies the computational complexity of verification problems for Binarized Neural Networks (BNNs), where activations (and sometimes weights) are binary. We analyze two problems: satisfiability and robustness under uniform image occlusion. We show that BNN satisfiability is NP-complete via a reduction from Boolean satisfiability problem (SAT), and that uniform occlusion induces a piecewise-constant structure in the network output, enabling a polynomial-time robustness-checking algorithm.

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11.
medRxiv (Medicine) 2026-06-15

Unveiling the Awareness of Private Health Insurance Coverage among Healthcare Professionals in Freetown, Sierra Leone: Insights Extracted from Their Perspectives.

作者:
Gary↗L. P↗Kamara↗A. N↗Jimmy↗A. I↗Lebbie↗A. P↗

Our study is an assessment of the knowledge, personal coverage, and related determinants of private health insurance as revealed by healthcare professionals in Freetown, the urban capital of Sierra Leone. This study stands as a precursor for Low- and Middle-Income Countries (LMICs), like Sierra Leone, seeking to establish Universal Health Coverage (UHC) to provide healthcare access and coverage through publicly arranged risk pooling, designed to help protect against unmanageable medical costs. In parallel, such countries face significant challenges with achieving sustainable universal coverage due to limited public resources, inefficient allocation systems, uneasy reliance on out-of-pocket payments, and large struggling populations. Our research sheds particular light on how healthcare professionals view their own participation with private healthcare options. A cross-sectional, analytical study was conducted, openly recruiting individuals from various facilities in Freetown. Using the Yamane Formula, a sample size of 109 participants was calculated. STATA 14.0 was used for data analysis. Our findings revealed that 96 (88.9%) participants did not have private health insurance, while 12 (11.1%) did have private coverage. However, 105 (97.2%) reported other modes of health insurance, with only 3 (2.8%) uninsured. Notably, 97.2% expressed willingness to join a private health insurance scheme. Our study found no statistically significant associations between selected indicators (demographic or socioeconomic fac tors) and current insurance coverage among study participants. These results highlight a low prevalence and understanding of private health insurance among healthcare professionals in a representative urban center in Sub-Saharan Africa (SSA), while acknowledging high willingness to enroll. The lack of any significant determinants suggests other unexamined factors, such as cost, accessibility, or awareness, capable of influencing the adoption and implementation of a universal health program.

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12.
arXiv (CS.CL) 2026-06-18

Attention as Frustrated Synchronization

作者:
Joshua Nunley↗

A network of oscillators that synchronizes perfectly computes nothing further, so an attention architecture built from synchronization must locate its computation in structured departures from agreement. We introduce the Frustrated Synchronization Network (FSN), whose token states are phases on a torus and whose entire value pathway is one learned complex coupling kernel over harmonics and a one-step delay. Each component of the kernel is a frustration in the sense of the synchronization literature. The complex phases are static Kuramoto-Sakaguchi frustration angles, the signed harmonics are repulsive Daido components, and the delay term, which couples each token to the successors of the tokens it attends to, is algebraically identical to Kuramoto-Sakaguchi coupling whose frustration angle is the data's own transition, so next-token prediction is implemented as synchronization frustrated by the data. At matched one-million-parameter and training budgets on character-level text and code, the FSN's validation loss is below a tuned RoPE-SwiGLU transformer's at every epoch measured, and the comparison survives training the baseline to convergence: every thirty-epoch enwik8 seed finishes below the transformer's converged fifty-epoch loss of 1.611, and the FSN's completed fifty-epoch runs converge to 1.5953 +/- 0.0014. A variant with every feed-forward block replaced by mean-field coupling to learned collective modes, leaving no multilayer perceptron in the stack, tracks the transformer. On natural text the unfrustrated base layer falls behind the converged transformer at every copy depth, worst on long-range copy events; the kernel reverses the deficit at every depth of four and beyond. Headline comparisons are at the one-million-parameter scale; a scale ladder is complete through four million parameters with the advantage persisting, and remaining arms are marked as in progress.

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13.
arXiv (quant-ph) 2026-06-15

Experimental violation of a Bell-like inequality for causal order

作者:
Yu Guo↗Hao Tang↗Bo-Xuan Wang↗Min-Yu Lv↗Jia-Wen↗Fan↗Xiao-Min Hu↗Yun-Feng Huang↗Chuan-Feng Liu↗Guang-Can Guo↗Giulio Chiribella↗Bi-Heng Liu↗…

arXiv:2506.20516v2 Announce Type: replace Abstract: Quantum mechanics is compatible with scenarios where physical processes happen in an indefinite order. In theory, this feature could be detected through violations of inequalities on the observed correlations, analogous to Bell inequalities. However, experimental demonstrations of such violations have been missing until recently due to the complexity of the required setup. Here we report an experimental violation of a Bell-like inequality involving the correlations of four parties, one of which is spacelike separated from the others. Our demonstration employs 3 km fiber spools to simulate spacelike separation, and achieves high-speed operations in photonic time-bin encoding, nanosecond synchronization, and accurate temperature stabilization. These experimental advances enable a violation by 5.7 standard deviations and open a path towards a certification of indefinite order in conditions that guarantee spacelike separation with existing state-of-the-art devices. However, the certification is not device-independent, as it relies on knowledge about the setup to exclude bidirectional signaling–a loophole inherent to implementations in classical acyclic spacetimes, which may be resolved in future quantum-spacetime tests.

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14.
arXiv (CS.LG) 2026-06-25

Supervised Reinforcement Learning for the Coordination of Distributed Energy Resources

作者:
Haoyuan Deng↗Yihong Zhou↗Thomas Morstyn↗Yi Wang↗

arXiv:2606.24947v1 Announce Type: new Abstract: The increasing integration of distributed energy resources (DERs) is crucial for power system decarbonization, yet unlocking DERs' flexibility is challenged by their inherent uncertainties and modelling complexity. As traditional optimization methods struggle with such uncertainty and complexity of DERs, reinforcement learning (RL) has emerged as a promising alternative for DER management. However, standard RL methods suffer from sample inefficiency and sub-optimality when trained from scratch. Inspired by the training paradigms in large language models, this paper proposes a Supervised Reinforcement Learning (SRL) framework for learning DER coordination policies. This framework first pre-trains a policy on demonstration data in a supervised-learning fashion, which is then further fine-tuned using RL. Furthermore, we propose a two-step fine-tuning process: offline fine-tuning for enhancing policy performance and online fine-tuning for adapting it to the real-world dynamics. Experiments demonstrate that RL implementations based on the proposed framework significantly outperform all benchmarks, achieving high cost efficiency even under low-quality demonstration data.

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15.
arXiv (CS.CV) 2026-06-25

Efficient Remote Sensing Instance Segmentation with Linear-Time State Space Distilled Visual Foundation Models

作者:
Qinzhe Yang↗Keyan Chen↗Jia Xu↗Zhenwei Shi↗Zhengxia Zou↗

The computational complexity of Transformers scales quadratically with the number of tokens, which significantly constrains the efficiency of vision models, particularly recent ViT-based foundation models in dense prediction tasks. Instance segmentation, a typical dense visual prediction task in the remote sensing field, faces similar challenges. In this paper, inspired by the recent advances of knowledge distillation in large language models, we introduce RS4D - a new remote sensing instance segmentation method with linear computational complexity, which addresses the inefficiency of long sequence modeling through distilled state space modeling (SSM). We propose an adaptive noise and masking knowledge distillation training method for pre-training lightweight SSM backbones, which effectively compresses knowledge from the vast self-attention space into a compact, dense linear state space. We also design a remote sensing image instance segmentation architecture based on this lightweight visual encoder, where we explore variants of three different backbones and two segmentation heads. Extensive experiments are conducted on multiple benchmark datasets, including SSDD, WHU, and NWPU. Compared to ViT-based approaches, our proposed SSM backbone achieves an 8x reduction in parameters and a 9x reduction in FLOPs while maintaining comparable or superior accuracy to both ViT- and CNN-based instance segmentation methods. The implementation codes have been publicly available at https://github.com/QinzheYang/RS4D.

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

Adaptive Multi-Resolution Procedural Knowledge Compression for Large Language Models

作者:
Changyue Wang↗Weihang Su↗Qingyao Ai↗Yichen Tang↗Runzhong Qiao↗Xuancheng Li↗Min Zhang↗Yiqun Liu↗

Large language models (LLMs) are widely used to tackle complex tasks with autonomous workflows. Recently, reusable natural language skills have emerged as a popular paradigm to inject procedural knowledge into LLM applications. Since popular skills are often invoked repeatedly, placing their full text in every context significantly increases prefill cost and latency. While text compression techniques have the potential to solve this problem, most existing methods are designed to compress factual knowledge in documents instead of procedural knowledge, making them insufficient for skill compression. In this paper, we argue that an effective skill compression method should: 1) preserve logical dependencies among workflows and tool protocols, 2) enable lightweight, offline compression for frequently updated community skills, and 3) be adaptable to varying complexities across skills. To address this, we present SKIM (SKIll coMpression), an adaptive multi-resolution soft token compression framework for procedural skills. Depending on the complexity of each skill, SKIM creates different numbers of soft tokens that not only improve the efficiency of LLM inference, but also preserve the effectiveness of skill usage. Experiments indicate that SKIM compresses skills to 30 to 60 percent of their original token length while preserving task performance better than existing compression methods.We have released our code at https://github.com/bebr2/SKIM .

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17.
bioRxiv (Bioinfo) 2026-06-16

DMcloud: Macromolecular Structure Modeling Using Local Structure Fitting for Medium to Low Resolution cryo-EM maps

作者:
Terashi↗Wang↗Zhang↗Zhu↗Hong Park↗Kihara↗

Cryogenic electron microscopy (cryo-EM) has become an essential experimental approach in structural biology for determining macromolecular structures. When the resolution of a cryo-EM map is worse than approximately 5[A], fitting known or predicted molecular models into the map becomes a common strategy for interpretation. However, accurately fitting biomolecular models into cryo-EM maps, particularly for large macromolecular complexes, remains challenging when the input structure models contain errors or are in a conformation different from that represented in the map. Here, we present DMcloud, a method for local structure fitting of proteins and nucleic acids in cryo-EM maps. Instead of forcing an entire input model into the map, DMcloud divides input structures into local regions, identifies regions that are supported by the density, removes unsupported regions, and assembles the retained regions into a final model. We benchmarked DMcloud on 176 cryo-EM maps, including intermediate and high-resolution maps that include proteins, DNAs, or RNAs. For EM maps in the 5.0-10.0 [A] and 2.5-5.0 [A] resolution ranges, DMcloud achieved average sequence modeling coverage of 0.49 and 0.70, respectively. For DNA/RNA maps, DMcloud achieved an average sequence coverage of 0.75. Across all datasets, DMcloud consistently outperformed existing methods in model accuracy, map-model correlation, and modeling coverage.

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

Do Time Series Foundation Model Benchmarks Hide Regime-Dependent Failures? Evidence from Traffic Speed Forecasting

作者:
Yingshuo Wang↗Xian Sun↗Lingdong Kong↗Wei Gao↗Yanhang Li↗Zhichao Fan↗Zexin Zhuang↗

arXiv:2606.18367v1 Announce Type: new Abstract: Standard benchmarks evaluate time series foundation models (TSFMs) using aggregate metrics, but these can mask severe failures in critical operating regimes. We introduce regime-stratified evaluation and apply it to three TSFMs on two standard traffic speed benchmarks. Traffic exhibits abrupt regime switching between free-flow and congested states, producing bimodal speed distributions during transitions. When we stratify by traffic regime, both accuracy and prediction-interval coverage degrade sharply during transitions: transition-regime MAE reaches 11 mph (versus 3 mph overall), and empirical coverage of 90% prediction intervals drops as low as 55%. These failures are invisible in aggregate metrics because free-flow observations dominate the sample. A simple historical conditional baseline (sampling from per-sensor training distributions) achieves better transition coverage than any TSFM, but has far worse overall accuracy. We propose bimodal mixture augmentation (BMA), a post-hoc method that combines TSFM forecasts with historical distributional knowledge, approaching the historical baseline's transition coverage while preserving the TSFM's accuracy. Our results suggest that TSFM benchmarks should incorporate regime-aware evaluation to surface failures that aggregate metrics hide.

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

Cluster LOCO: Feature Importance For Interpreting Clusters

作者:
Claire M. He↗Genevera I. Allen↗

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.

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

Towards Version-aware Operations and Transaction Memories for Multi-layer MeMo

作者:
Peiran Li↗

MeMo proposes language models with explicit multi-layer correlation matrix memories (CMMs), where memorization, retrieval, and forgetting are architectural operations. This paper asks how such memories can reduce the need for retraining when knowledge changes. For changes expressible as MeMo memory associations, the model's accessible knowledge can be updated by editing explicit memories rather than retraining the whole model. We propose a version-aware operation layer in which high-level operations such as replace, obsolete, keep-history, rollback, and trace are compiled into MeMo-native primitive calls over sequences and tokens. The key observation is that a version-aware operation is rarely a single MeMo association. It is an ordered transaction of primitive edits, for example forgetting one sequence-token chain, memorizing another, preserving a historical chain, and recording an inverse program. The framework introduces two auxiliary CMMs: a Version CMM (V-CMM) for mapping version transitions to transaction handles, and a Transaction CMM (T-CMM) for storing reusable change contents and inverse programs. It supports both direct sequence-level edits and structured diff-level inputs, and outlines an evaluation route for update success, rollback, traceability, locality, and transaction reuse.

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

Generalised Medical Phrase Grounding

作者:
Wenjun Zhang↗Shekhar S. Chandra↗Aaron Nicolson↗

Medical phrase grounding (MPG) maps textual descriptions of radiological findings to corresponding image regions. These grounded reports are easier to interpret, especially for non-experts. Existing MPG systems mostly follow the referring expression comprehension (REC) paradigm and return exactly one bounding box per phrase. Real reports often violate this assumption. They contain multi-region findings, non-diagnostic text, and non-groundable phrases, such as negations or descriptions of normal anatomy. Motivated by this, we reformulate the task as generalised medical phrase grounding (GMPG), where each sentence is mapped to zero, one, or multiple scored regions. To realise this formulation, we introduce the first GMPG model: MedGrounder. We adopted a two-stage training regime: pre-training on report sentence–anatomy box alignment datasets and fine-tuning on report sentence–human annotated box datasets. Experiments on PadChest-GR and MS-CXR show that MedGrounder achieves strong zero-shot transfer and outperforms REC-style and grounded report generation baselines on multi-region and non-groundable phrases, while using far fewer human box annotations. Finally, we show that MedGrounder can be composed with existing report generators to produce grounded reports without retraining the generator.

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22.
medRxiv (Medicine) 2026-06-18

Instantaneous-Frequency EEG Microstate Dynamics Stratify Motor Subtypes in Parkinson's Disease

作者:
Nobukawa↗Watanabe↗

Parkinson's disease (PD) is clinically heterogeneous, yet objective electrophysiological markers of its postural-instability/gait-difficulty (PIGD) and tremor-dominant (TD) motor subtypes are lacking. We tested whether the temporal dynamics of instantaneous-frequency (IF) microstates in resting-state electroencephalography (EEG) distinguish these subtypes from each other and from healthy controls (HC). In a publicly available cohort (OpenNeuro ds007526) comprising 28 HC and 97 PD patients classified as PIGD (n=50) or TD (n=47), the spatial distribution of the IF was reduced by principal component analysis and modeled with a Gaussian hidden Markov model, yielding three recurrent microstates. Per-participant mean dwell time, occupancy, and state-transition probabilities were compared across the three groups and, within PD, correlated with clinical scores. We found that the dynamics of one microstate varied systematically across groups: its dwell time, occupancy, and self-transition probability increased monotonically from HC through TD to PIGD, while outgoing transitions decreased, so that the state became an increasingly persistent attractor. For dwell time, all three pairwise contrasts survived correction (HC versus PIGD, Hedges' g=1.06; HC versus TD, g=0.59; PIGD versus TD, g=0.40). None of the dynamic indices was associated with clinical severity, disease duration, or medication dose within PD. IF-microstate dynamics thus stratify the PD motor subtypes along a graded continuum without tracking continuous disease severity. The approach offers a candidate objective EEG marker for motor-subtype stratification, complementing spectral characterizations of PD.

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23.
medRxiv (Medicine) 2026-06-17

Waning protection of long-acting RSV monoclonal antibodies in infants: a Bayesian analysis of clesrovimab and nirsevimab trial data

作者:
Gong↗Flasche↗Hodgson↗

Clesrovimab and nirsevimab are long-acting monoclonal antibodies used to prevent respiratory syncytial virus (RSV) disease in infants, but waning protection in the first year of life is incompletely characterised. We applied a published Bayesian inference framework to clesrovimab and pooled nirsevimab trial data to estimate time-varying efficacy against medically attended RSV lower respiratory tract infection (LRTI) and RSV-associated hospitalisation, accounting for differences in placebo-arm event timing between trials. Estimated clesrovimab efficacy declined from 60.7% (95% CrI: 46.3-72.6) shortly after dosing to 38.3% (8.6-52.9) at six months against medically attended RSV LRTI, and from 87.1% (71.2-96.2) to 49.6% (10.4-70.7) against RSV-associated hospitalisation. For nirsevimab, corresponding estimates declined from 86.9% (75.4-95.0) to 53.8% (27.4-69.7) against LRTI, and from 77.5% (52.6-91.8) to 49.7% (15.7-68.3) against hospitalisation. After accounting for differences in RSV exposure timing and LRTI endpoint definitions between trials, we found no evidence of a difference in efficacy or waning between clesrovimab and nirsevimab.

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24.
arXiv (CS.CV) 2026-06-15

Hierarchical Consistency Learning for Test-time Adaptation in Camouflage Perception

作者:
Mingfeng Zha↗Tianyu Li↗Guoqing Wang↗Yunqiang Pei↗Chaofan Qiao↗Jiening Zhang↗Yang Yang↗Heng Tao Shen↗

Camouflaged object detection (COD) aims to localize targets that exhibit minimal perceptual differences from backgrounds through physical attributes. Existing methods, constrained by the static train-then-freeze paradigm, suffer from domain rigidity and annotation dependency, limiting their adaptability to scene variations and unseen camouflage patterns. To overcome these, we propose the hierarchical consistency learning (HCL) framework, which integrates test-time adaptation for dynamic representation recalibration. Specifically, we design the hierarchical representation reconstruction (HRR) to alleviate feature entanglement by synergizing spatial reconstruction with dual-stream frequency-domain decomposition, enhancing robustness against appearance homogenization. The pixel and spectrum inference provide structural and contextual priors. We further introduce task affinity guidance (TAG) to propagate knowledge across branches via channel-wise affinity, aligning local discriminative cues and mitigating semantic drift. To ensure semantic invariance, we formulate the prototype consistency calibration (PCC), which aggregates region features into compact prototypes and establishes prototype-feature similarity. This imposes implicit and hierarchical constraints that bridge task and representation gaps. Extensive experiments across four camouflaged and four underwater object benchmarks, under three degradation settings, demonstrate that our method consistently outperforms state-of-the-art approaches, highlighting its robustness and generalization under distribution shifts.

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

SpatialWorld: Benchmarking Interactive Spatial Reasoning of Multimodal Agents in Real-World Tasks

作者:
Hongcheng Gao↗Hailong Qu↗Jingyi Tang↗Jiahao Wang↗Zihao Huang↗Hengkang Qiao↗Shihong Huang↗Junming Yang↗Yi Li↗Hongyixuan Yuan↗Wenjie Li↗Bohan Zeng↗…

Spatial reasoning is a foundational capability for multimodal large language models (MLLMs) to perceive and operate within the physical world. However, existing benchmarks predominantly rely on passive evaluation (e.g., static VQA) or simulator-specific pipelines, failing to assess general interactive spatial understanding. We introduce SpatialWorld, a unified benchmark designed specifically for evaluating the interactive spatial understanding of multimodal agents in complex real-world tasks. Integrating eight heterogeneous simulation backends under a shared, simulator-agnostic protocol, SpatialWorld features 760 human-annotated tasks across diverse domains (e.g., household routines, travel, social collaboration). Agents must solve tasks under vision-only partial observability, actively gathering egocentric visual evidence and expressing decisions via a unified, text-based action interface native to MLLMs. For reliable evaluation, each task includes a human-validated initial state, a reference trajectory, and a terminal-state verifier. Evaluating 15 advanced agents reveals that robust spatial task solving remains challenging: the strongest model, GPT-5, achieves an average task success rate (TSR) of only 17.4%, while the leading open-source model, Qwen-3.5, reaches 14.1%. Further analysis exposes a clear mismatch between task success and execution efficiency, alongside substantial domain-specific performance variations. These bottlenecks in active exploration and long-horizon planning position SpatialWorld as a rigorous testbed for future spatial agents.

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