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01.
arXiv (CS.AI) 2026-06-19

Grounded Inference: Principles for Deterministically Encapsulated Generative Models

arXiv:2606.19753v1 Announce Type: new Abstract: The incorporation of generative models into traditional computational systems presents both enormous opportunity and tremendous peril. Although many early adopters have realized these perils at great expense, the field still requires foundational frameworks to de-risk incorporation of AI into traditional systems. This manuscript establishes this foundation through the definition of four specific primitives of AI blended architecture, designed to enable deterministic encapsulation of probabilistic models. It further establishes two overarching anti-patterns broadly represented across industry to serve as warnings for engineers in this field. This framework was designed to enable successful integration of AI into traditional systems while providing a foundation upon which generative model providers could build the next generation of generative model interfaces.

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

When Correct Edges Cannot Be Verified: A Provenance Gap in Incomplete KGQA and a Provenance-Favoring Completion Policy

Incomplete Knowledge Graph Question Answering (IKGQA) requires completing missing edges to continue reasoning. A growing line of work verifies completed edges against retrieved text, treating textual support as a proxy for edge quality. We ask a question that, to our knowledge, has not been systematically tested: does textual verifiability actually track correctness? Exploiting the gold deleted triples provided by the standard random-deletion protocol, we measure both. The finding is counterintuitive: among gold-correct completed edges, 76-96% have no supporting passage even under exhaustive retrieval, robustly across deletion rates (20%/40%), datasets (CWQ/WebQSP), and relation types (structural, commonsense, long-tail). Most Freebase-style facts simply do not occur as head-tail co-mentions in text. Textual faithfulness therefore measures provenance, not correctness – separated by a paradigm-level gap no in-corpus retrieval closes. This reframes edge completion. Since most completed edges – correct or not – are causally redundant for the answer (95-97% of correct answers do not depend on any unsupported edge), the central question shifts from "is the edge correct?" to "admit or abstain under provenance uncertainty?" Within this framing we present TGComplete, a provenance-favoring admission policy that retrieves evidence at a reasoning breakpoint, verifies a candidate through a lightweight loop, and abstains when support is absent. Against the generate-to-complete baseline GoG, it attains higher edge precision against gold (15-21% vs 3-14%), with no statistically detectable EM loss and 3.1-7.4 times higher strict faithfulness of admitted edges – at the cost of lower recall. We position TGComplete not as uniformly better, but as a principled point on a precision/provenance-recall trade-off, appropriate when auditability matters.

03.
bioRxiv (Bioinfo) 2026-06-14

Generative design of antigen-specific T-cell receptor sequences with a conditional diffusion model

T cell receptor (TCR)-based immunotherapy holds immense potential for treating cancers and infectious diseases, where highly antigen-specific TCR recognition is crucial for adaptive immunity against tumors and pathogens. Engineering or de novo generation of the complementarity-determining region 3 (CDR3) loops of TCRs using artificial intelligence offers a powerful alternative to designing reactive TCRs rather than laborious experimental screening. However, current in silico approaches are constrained by weak conditional guidance, limited flexibility, and a lack of rigorous functional validation. To address these limitations, we introduce TCRDiff, a generative diffusion framework for designing antigen-specific TCRs conditioned on peptide-MHC (pMHC) targets and germline-encoded variable genes. By leveraging pre-trained knowledge from massive T-cell repertoires and TCR-pMHC recognition data, TCRDiff generates CDR3{beta} sequences with state-of-the-art fidelity to native binding TCRs through a denoising diffusion process. Furthermore, incorporating the interface geometry features generated TCR-pMHC complexes with superior structural plausibility. As a proof of concept, we deployed TCRDiff in a systematic pipeline to design candidate TCRs for immunotherapy. In vitro activation assays validated that TCRDiff-generated TCRs specifically recognize the MAGE-A3 epitope with minimized off-target cross-reactivity. Together, TCRDiff establishes a powerful, validated computational paradigm to accelerate the development of TCR-based immunotherapies.

04.
arXiv (CS.CL) 2026-06-16

Can LLM Agents Infer World Models? Evidence from Agentic Automata Learning

We propose agentic automata learning to evaluate the extent to which tool-calling LLM agents can uncover hidden environments through interaction. In our setup, an agent should uncover a hidden deterministic finite automaton (DFA) by interacting with an oracle through (1) membership queries ("Does this string belong to the target language?") and (2) equivalence queries ("Is this the target DFA?"). This yields a scalable testbed with controlled task complexity, measurable interaction efficiency, and strong baselines (classic automata-learning algorithms). Evaluating state-of-the-art LLMs, we find that performance drops sharply as DFA size increases. Reasoning models are markedly stronger than non-reasoning models, yet trajectory analyses reveal recurring failures in query planning, evidence integration, and hypothesis construction. Overall, our results show that current LLM agents can sometimes perform non-trivial interactive discovery, but remain far less robust and efficient than classic algorithms for the task.

05.
arXiv (CS.LG) 2026-06-18

A physical adaptive material motor unit neural network: a hygromorph composite material machine

arXiv:2606.18275v1 Announce Type: cross Abstract: Advances in novel materials science enable structures to function as intelligent machines by embedding memory and learning capabilities directly into materials. Our work introduces a physical adaptive material motor unit neural network,leveraging a new generation of controllable actuators composed of wood- and carbon black-based composites, sensitive to temperature and relative humidity. These material actuators are assembled into a motor unit-like structure inspired by muscle contraction trigger, forming an intelligent machine capable of dynamic shading control that can be used, for example, in buildings. The machine is governed by a neural network trained on over 350 experimental data points collected under diverse environmental conditions. By establishing a new data-aware backpropagation training, we show that the machine predicts shading responses and learns to predict appropriate behaviour incrementally as the database expands. We also demonstrate the ability of the machine to optimise configurations to achieve similar shading outputs under two distinct conditions.

06.
arXiv (quant-ph) 2026-06-24

Accurate computation of the energy variance and $\langle\langle \mathcal{L}^\dagger \mathcal{L} \rangle\rangle$ using iPEPS

arXiv:2511.22669v2 Announce Type: replace-cross Abstract: Infinite projected entangled-pair states (iPEPS) provide a powerful tensor network ansatz for two-dimensional quantum many-body systems in the thermodynamic limit. In this paper we introduce an approach to accurately compute the energy variance of an iPEPS, enabling systematic extrapolations of the ground-state energy to the exact zero-variance limit. It is based on the contraction of a large cell of tensors using the corner transfer matrix renormalization group (CTRMG) method, to evaluate the correlator between pairs of local Hamiltonian terms. We show that the accuracy of this approach is substantially higher than that of previous methods, and we demonstrate the usefulness of variance extrapolation for the Heisenberg model, for a free fermionic model, and for the Shastry-Sutherland model. Finally, we apply the approach to compute $\langle \langle \mathcal{L}^\dagger \mathcal{L} \rangle \rangle$ for an open quantum system described by the Liouvillian $\mathcal{L}$, in order to assess the quality of the steady-state solution and to locate first-order phase transitions, using the dissipative quantum Ising model as an example.

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

Policies Permitting LLM Use for Polishing Peer Reviews Are Currently Not Enforceable

A number of scientific conferences and journals have recently enacted policies that prohibit LLM usage by peer reviewers, except for polishing, paraphrasing, and grammar correction of otherwise human-written reviews. But, are these policies enforceable? To answer this question, we assemble a dataset of peer reviews simulating multiple levels of human-AI collaboration, and evaluate five state-of-the-art detectors, including two commercial systems. Our analysis shows that all detectors misclassify a non-trivial fraction of LLM-polished reviews as AI-generated, thereby risking false accusations of academic misconduct. We further investigate whether peer-review-specific signals, including access to the paper manuscript and the constrained domain of scientific writing, can be leveraged to improve detection. While incorporating such signals yields measurable gains in some settings, we identify limitations in each approach and find that none meets the accuracy standards required for identifying AI use in peer reviews. Importantly, our results suggest that recent public estimates of AI use in peer reviews through the use of AI-text detectors should be interpreted with caution, as current detectors misclassify mixed reviews (collaborative human-AI outputs) as fully AI generated, potentially overstating the extent of policy violations.

08.
arXiv (quant-ph) 2026-06-25

Klein–Gordon Dynamics from Intrinsic Phase Periodicity

arXiv:2606.25929v1 Announce Type: new Abstract: This work develops a phase-based formulation of relativistic wave dynamics, demonstrating that the Klein–Gordon equation emerges naturally from the foundational assumption of intrinsic phase periodicity in material fields. Mapping the phase directly onto the classical action, we postulate that localized excitations possess an invariant rest-frame oscillation governed by a proper frequency $\omega_0$. This physical condition establishes an operational mass-frequency relation, $m = \hbar \omega_0 / c^2$, without requiring rest energy as an independent, axiomatic input. We show that the Klein–Gordon equation arises as the minimal local, linear, Lorentz-invariant field equation compatible with this internal phase structure. Within this framework, mass acts as an intrinsic frequency scale governing wave propagation, and relativistic kinematics is fully recovered as a structural consequence of phase coherence. This approach provides a unified wave-mechanical interpretation where particle dynamics maps onto the group velocity of dispersive wave packets, offering an intuitive account of free propagation, dispersion, and tunneling across potential barriers.

09.
Nature (Science) 2026-06-17

How the zebrafish brain weaves recent experiences into future decisions

作者: 未知作者

Animals often use recent experience to guide future choices. Whole-brain imaging in larval zebrafish (Danio rerio) reveals a dedicated neural circuit that governs history-biased decisions: the thalamus maintains the most recent event as a stable pattern of neuronal activity, and the brainstem integrates recent experiences into a continuous signal that biases future action. Whole-brain calcium imaging in the zebrafish reveals how information about events in the recent past drives future behaviour.

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

Multi-Turn Reflective Masking Elicits Reasoning in Mask Diffusion Models

While reasoning on autoregressive (AR) models is often performed by chain-of-thought reasoning and reflection, their refinement of previous outputs still relies on fully sequential generation, even when only local edits are needed. In contrast, the masking mechanism in Mask Diffusion Models (MDMs) naturally supports explicit local edits on previous outputs, allowing selective refinement without discarding previous answers and generating another from scratch. While this property more closely aligns with how humans correct mistakes by iterative local refinement, existing MDMs do not support multi-turn masking and denoising. We propose Reflective Masking (RM), which elicits such an intrinsic reasoning capability in MDMs via lightweight post-training. RM provides a native test-time scaling, where an MDM iteratively revisits and revises its prior outputs based on evolving context. To exploit insights from previous turns like AR reasoning, we further introduce History Reference, a parameter-free mechanism that leverages intermediate denoising states during revision. Our approach requires no architectural changes and is easily applicable to existing MDMs. Across diverse tasks and modalities, including text generation, Sudoku, and image editing, Reflective Masking consistently outperforms standard masking-based baselines and demonstrates strong generality, positioning RM as a fundamental primitive for reasoning on MDMs.

11.
medRxiv (Medicine) 2026-06-23

Linking mpox wastewater surveillance with reported clinical cases in three countries in Sub-Saharan Africa

The emergence of the novel monkeypox virus (MPXV) clade Ib in the Democratic Republic of the Congo (DRC) and neighboring countries in late 2023 highlighted the need for rapid, scalable surveillance approaches to support outbreak detection and response. As part of the ODIN-Mpox project, wastewater surveillance (WWS) systems were established as an emergency public health measure in three Sub-Saharan African countries (DRC, Tanzania, and Burkina Faso) to evaluate the feasibility of wastewater-based monitoring for mpox and strengthen local surveillance capacity. Between January 2025 and April 2026, 117 wastewater samples were collected from selected sites and analyzed for MPXV DNA using targeted qPCR assays. Clinical mpox data were obtained from national surveillance systems and WHO reports to assess epidemiological linkages between wastewater detections and reported infections. Six wastewater samples tested positive for MPXV DNA. During the study period, DRC experienced the highest disease burden, with weekly reported cases peaking at about 3,000 in January 2025, while Tanzania reported a peak of 20 weekly cases in March 2025. No confirmed clinical cases were reported in Burkina Faso. No clear relationship was observed between reported case numbers and qPCR Ct values in positive wastewater samples. Despite the low detection frequency, the project demonstrated the operational feasibility of implementing MPXV wastewater surveillance in resource-limited settings and established laboratory capacity for environmental monitoring of emerging infectious diseases. Given the early stage of WWS implementation in the region, the study identified opportunities for further system strengthening, including optimization of sample processing and reporting workflows, improved access to laboratory supplies, and enhanced integration of environmental and clinical surveillance data streams. These findings highlight the value of WWS as a complementary component of integrated public health surveillance systems and emphasize the need for continued investment in laboratory capacity, harmonized methodologies, governance frameworks, and knowledge exchange to enhance outbreak preparedness and response in low-resource settings.

12.
arXiv (CS.CL) 2026-06-25

CLEF HIPE-2026: Evaluating Accurate and Efficient Person-Place Relation Extraction from Multilingual Historical Texts

HIPE-2026 is a CLEF evaluation lab dedicated to person-place relation extraction from noisy, multilingual historical texts. Building on the HIPE-2020 and HIPE-2022 campaigns, it extends the series toward semantic relation extraction by targeting the task of identifying person-place associations in multiple languages and time periods. Systems are asked to classify relations of two types – $at$ ("Has the person ever been at this place?") and $isAt$ ("Is the person located at this place around publication time?") – requiring reasoning over temporal and geographical cues. The lab introduces a three-fold evaluation profile that jointly assesses accuracy, computational efficiency, and domain generalization. By linking relation extraction to large-scale historical data processing, HIPE-2026 aims to support downstream applications in knowledge-graph construction, historical biography reconstruction, and spatial analysis in digital humanities.

13.
arXiv (CS.CV) 2026-06-24

Segmentation and Classification of Pap Smear Images for Cervical Cancer Detection Using Deep Learning

Cervical cancer remains a significant global health concern and a leading cause of cancer-related deaths among women. Early detection through Pap smear tests is essential to reduce mortality rates; however, the manual examination is time consuming and prone to human error. This study proposes a deep learning framework that integrates U-Net for segmentation and a classification model to enhance diagnostic performance. The Herlev Pap Smear Dataset, a publicly available cervical cell dataset, was utilized for training and evaluation. The impact of segmentation on classification performance was evaluated by comparing the model trained on segmented images and another trained on non-segmented images. Experimental results showed that the use of segmented images marginally improved the model performance on precision (about 0.41 percent higher) and F1-score (about 1.30 percent higher), which suggests a slightly more balanced classification performance. While segmentation helps in feature extraction, the results showed that its impact on classification performance appears to be limited. The proposed framework offers a supplemental tool for clinical applications, which may aid pathologists in early diagnosis.

14.
arXiv (CS.LG) 2026-06-15

Recovery thresholds for hidden weighted sparse graphs

arXiv:2606.14335v1 Announce Type: cross Abstract: Recovering structural information from noisy high-dimensional data is a fundamental task in statistical inference. We investigate the recovery thresholds for a graph hidden in a randomly weighted complete graph. Specifically, an unknown graph $H^* \in H_n$ is chosen uniformly at random, and hidden in a complete graph of $n$ vertices as follows: the weight of an edge $e \in H$ is distributed independently according to $P_n$; otherwise the weight is distributed independently according to $Q_n$. The goal is to recover almost all of $H$ from these edge weights. Assuming a local Lipschitzness of the Rényi divergence between distributions $P_n$ and $Q_n$, and a mild density condition for the graphs $H_n$, we give a unified characterization of the information-theoretic limit for recovering almost all of $H$ (also known as almost exact recovery). Our characterization connects the KL divergence between $P_n$ and $Q_n$ to the logarithm of the first moment threshold of $H$ in the Erdős-Rényi random graph model $G(n,p)$. Our lower bound also extends to the task of partial recovery, in which only a constant $\lambda$-fraction of $H$ needs to be recovered. Last but not least, for certain Bernoulli and Exponential regimes, and for Gaussian distributions, we are able to show an All-or-Nothing (AoN) threshold phenomenon at the exponential scale.

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

Weighted Bayesian Conformal Prediction

arXiv:2604.06464v2 Announce Type: replace Abstract: Conformal prediction provides distribution-free prediction intervals with finite-sample coverage guarantees, and recent work by Snell \& Griffiths reframes it as Bayesian Quadrature (BQ-CP), yielding powerful data-conditional guarantees via Dirichlet posteriors over thresholds. However, BQ-CP fundamentally requires the i.i.d. assumption. Meanwhile, weighted conformal prediction handles distribution shift via importance weights but remains frequentist, producing only point-estimate thresholds. We propose Weighted Bayesian Conformal Prediction (WBCP), which generalizes BQ-CP to arbitrary importance-weighted settings by replacing the uniform Dirichlet $\Dir(1,\ldots,1)$ with a weighted Dirichlet $\Dir(\neff \cdot \tilde{w}_1, \ldots, \neff \cdot \tilde{w}_n)$, where $\neff$ is Kish's effective sample size. We prove four theoretical results: (1)~$\neff$ is the unique concentration parameter matching frequentist and Bayesian variances; (2)~posterior standard deviation decays as $O(1/\sqrt{\neff})$; (3)~BQ-CP's stochastic dominance guarantee extends to per-weight-profile data-conditional guarantees; (4)~the HPD threshold provides $O(1/\sqrt{\neff})$ improvement in conditional coverage. We instantiate WBCP for spatial prediction as Geographical BQ-CP, where kernel-based spatial weights yield per-location posteriors with interpretable diagnostics. Experiments on synthetic and real-world spatial datasets demonstrate that WBCP maintains coverage guarantees while providing substantially richer uncertainty information.

16.
arXiv (CS.CL) 2026-06-19

Closing the Calibration Gap in Semantic Caching

Semantic caching cuts LLM inference costs by serving a cached response to semantically similar queries. Standard practice evaluates these systems using PR-AUC, a metric that only measures how well scores rank and ignores whether they are usable at a fixed threshold. We show this mismatch leads to systematically poor deployment choices, as models with the highest PR-AUC are often the worst in operation. We introduce Precision-Cache Hit Ratio (P-CHR) AUC, a cache-aware metric that measures precision across cache utilization levels, and Calibration Retention Rate (CRR), which captures how much offline ranking quality survives at deployment. We decompose the operational gap between offline and deployed quality into a recoverable calibration component and an irreducible structural component fixed by the dataset's positive rate. Our experiments show that the calibration gap is governed by the training objective rather than data scale, and post-hoc calibration only partially closes it. Ultimately, model selection for semantic caching is a calibration problem, not a ranking one, and measuring it is the first step to closing the gap.

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

DREAM: Extending Vision-Language Models with Dual-Objective Encoding for Cross-Modal Retrieval

In today's media-driven world, the exponential growth of video content across domains such as surveillance, education, and entertainment has made retrieving semantically relevant videos via natural language queries increasingly critical. Early video retrieval systems relied on handcrafted features or shallow cross-modal mappings, limiting their ability to capture complex semantics and temporal dynamics. While large-scale vision-language models have improved cross-modal alignment, challenges remain in modeling fine-grained temporal dependencies and nuanced linguistic structures. In this paper, we introduce DREAM: Dual-path Representation Enhancement and Alignment Model, a novel multimodal framework that addresses these limitations through enhanced visual and textual encoding. DREAM incorporates a hybrid language modeling strategy that combines masked and permuted language modeling objectives to capture both local and global linguistic semantics. On the visual side, we design a hierarchical vision encoder with cascaded group attention, which integrates spatial and temporal information through multi-stage token interaction and coarse-to-fine attention refinement. We validate DREAM through comprehensive evaluations on the widely-used MSRVTT, MSVD and LSMDC benchmark datasets, where it achieves new state-of-the-art R1 scores of 49.4%, 49.7% and 27.3%, respectively. Qualitative analyses further show the model's ability to maintain coherent attention across frames and align complex queries with dynamic video content. These findings underscore the effectiveness of hierarchical attention and dual-objective textual modeling in enabling robust, context-aware video retrieval, and pave the way for future research in advancing cross-modal representation learning.

18.
arXiv (CS.AI) 2026-06-16

Unifying Acoustic Features and Text with Multimodal LLMs for Neurodegenerative Screening

arXiv:2606.14788v1 Announce Type: cross Abstract: Voice-based screening offers a scalable and non-invasive way to assess neurodegenerative diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD), but their staging remains challenging due to the difficulty of integrating heterogeneous data. This paper presents NeurMLLM, an efficient multimodal generative framework for neurodegenerative disease staging. NeurMLLM first encodes the spectrograms and Mel-frequency cepstral coefficients of audio data with vision transformers and projects their representations into the embedding space of a large language model (LLM), where they are concatenated with transcript and demographic instruction tokens as a single unified sequence. The LLM is then instruction-tuned via Low-Rank Adaptation using task prompts to autoregressively predict a constrained label token, enabling a generative classification. By evaluating on the Bridge2AI-Voice dataset for fine-grained staging of AD and PD, we observe that NeurMLLM achieves strong performance, consistently outperforming classical machine learning methods and existing LLM-based approaches. The results show the high potential of multimodal LLMs in neurodegenerative disease staging, improving staging accuracy and supporting accessible deployment.

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

Compatibility-Aware Dynamic Fine-Tuning for Large Language Models

Supervised Fine-Tuning (SFT) is the predominant paradigm for aligning large language models (LLMs), yet it suffers from optimization instability and limited generalization. Recent work attributes this issue to pathological gradient scaling and proposes Dynamic Fine-Tuning (DFT) to correct it at the token level. However, DFT assumes all demonstrations are equally suitable learning targets, an assumption violated by the strong heterogeneity of large-scale instruction data, where demonstration-policy mismatch induces high-variance updates at the sample level. We introduce Compatibility-Aware Dynamic Fine-Tuning (CADFT), a principled extension of DFT that controls sample-level optimization variance. CADFT derives a dynamic, policy-dependent compatibility signal from model likelihoods to modulate supervised updates, suppressing high-variance gradients from incompatible demonstrations. We further propose a delayed, low-frequency compatibility-guided rewriting strategy to transform persistently incompatible demonstrations into learnable targets. We show that CADFT can be interpreted as a variance-controlled estimator that generalizes token-level stabilization in DFT to the sample level. Extensive experiments demonstrate improved stability, generalization, and cold-start reinforcement learning initialization, while remaining fully supervised and independent of explicit reward modeling.

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

Learning Variable-Length Tokenization for Generative Recommendation

arXiv:2605.17779v2 Announce Type: replace Abstract: Generative recommendation reformulates recommendation as next-token prediction over discrete semantic identifiers (IDs). A fundamental yet unexplored design choice is that existing methods employ fixed-length tokenization for all items, implicitly assuming uniform encoding capacity regardless of item characteristics. Through systematic experiments across four datasets, we discover the Popularity-Length Paradox: popular items achieve optimal performance with short IDs, while tail items require substantially longer codes to capture discriminative semantics. This reveals a critical mismatch where popular items benefit from abundant collaborative signals and require minimal semantic detail, whereas tail items must rely on fine-grained content features due to sparse interaction data. To address this, we propose VarLenRec, a framework for learning variable-length tokenization. We develop Popularity-Weighted Information Budget Allocation (PIBA), an information-theoretic framework proving that optimal ID length should scale as a negative power of popularity. Directly implementing variable-length allocation faces two technical challenges: standard Euclidean residual quantization lacks geometric capacity to support diverse code lengths without distortion, and discrete length decisions are non-differentiable. We address these through Hyperbolic Residual Quantization, which leverages the exponential volume growth of the Poincaré ball to naturally stratify encoding capacity, and a Soft Length Controller, which enables differentiable length prediction via continuous layer retention probabilities regularized by PIBA-derived priors. Extensive experiments demonstrate that VarLenRec achieves significant improvements over state-of-the-art methods in recommendation accuracy and training/inference efficiency, revealing the importance of adaptive encoding capacity in generative recommendation.

21.
PLOS Medicine 2026-06-09

Molecular Tumor Boards clinical impact on patient care and structural features: A systematic review and meta-analysis

作者:

by Luigi Russo, Erika Giacobini, Nicolò Lentini, Tommaso Osti, Maud Kamal, Stefania Boccia, Roberta Pastorino Background Molecular Tumor Boards (MTBs) bring together multidisciplinary experts to translate genomic data into clinical decisions in oncology, however, their overall clinical impact remains unclear. The aim of this systematic review is to assess the clinical impact of MTB-recommended therapies on patients with cancer outcomes. Methods and findings In this systematic review and meta-analysis, we searched PubMed, Embase, Scopus, and CENTRAL up to July 2025. We included studies of any design, both single-arm studies and studies with a comparator group, that reported the clinical impact of MTBs in patients who received MTB-guided therapy. Meta-analyses were performed separately by study design, using hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS), relative risks (RRs) for objective response rate (ORR) and disease control rate (DCR), and pooled proportions for PFS ratio ≥1.3. All meta-analyses were conducted using random-effects models based on the inverse variance method. We evaluated the risk of bias using the RoB 2.0 for RCTs and ROBINS-I for non-randomized studies.From 6,846 records, 78 studies (9,195 patients; 4,569 treated per MTB recommendations) were included. MTB-guided therapies were associated with reduced risk of death (HR 0.87; 95% CI [0.76, 1.01]; p = 0.069; I2 = 0.0% in RCTs; 0.62 in retrospective studies) and disease progression (HR 0.73; 95% CI [0.64, 0.84]; p 

22.
medRxiv (Medicine) 2026-06-11

Conversational Speech for Respiratory Triage in Primary Care: A Pilot Study

作者:

Background. Respiratory complaints account for a substantial share of adult ambulatory care visits, and triaging them accurately has direct consequences for antibiotic stewardship and pathogen-specific therapy. Prior work has investigated voice as a triage signal, but that literature is dominated by single-condition detection from scripted speech in crowdsourced or controlled clinical settings and has not been evaluated at primary care scale on conversational ambient audio. Methods. A dataset of 514,377 ambient-recorded primary care visits from 379,225 adult patients at a US clinic network was used, with per-visit clinically assigned ICD-10 diagnosis codes and de-identified demographic and geographic metadata. Patient audio was extracted from each doctor-patient conversation, and spectral, voice quality, and prosodic features were computed. Eleven binary classification tasks were defined, aligned with a respiratory triage cascade (e.g., acute respiratory versus acute non-respiratory illness, and lower versus upper respiratory tract infection). An acoustic model (feed-forward network) was trained independently for each task using patient-stratified five-fold cross-validation and evaluated on a held-out test set. Each task's model was also compared against six non-acoustic baselines using a single demographic, geographic, or temporal variable. The 11 trained classifiers were composed into a hierarchical cascade and illustrated as case studies on selected patients. Results. Test-set AUC across the 11 tasks ranged from 0.602 (95% CI: 0.588-0.614) to 0.745 (95% CI: 0.742-0.748), with a mean expected calibration error of 0.018. Six of eleven binaries outperformed all confounder baselines. Four binaries showed median within-stratum AUC of 0.62-0.70 when the confounder was held fixed, indicating acoustic discrimination beyond what the confounder alone explains. The exception was the pneumonia versus non-pneumonia lower respiratory tract infection binary, which failed against the patient-city confounder baseline, plausibly reflecting a clinic-level difference in ICD-10 coding. Conclusion. Conversational primary care audio carries acoustic signal that discriminates clinically meaningful respiratory contrasts. Absolute performance is moderate, but the conditions are stricter than prior work: conversational speech and differential-diagnosis contrasts among sick patients. This pilot study is a baseline for voice-based clinical AI moving beyond sick-versus-healthy detection toward differential-diagnosis panels and a proof-of-concept for hierarchical reasoning.

23.
medRxiv (Medicine) 2026-06-17

Proteomics Uncovers Cryptic JPH2 Loss in Paediatric Dilated Cardiomyopathy

Despite recent advances in next-generation sequencing, genetic diagnostic rates for dilated cardiomyopathy (DCM) remain low. Among paediatric DCM, causes are often heritable, with a greater frequency of de novo, recessive and syndromic causes of disease. Novel diagnostic methods are therefore required to solve monogenic cases. To assess the value of proteomics as a diagnostic tool for paediatric DCM, we obtained left ventricle myocardial samples from paediatric patients undergoing heart transplantation at the Royal Children's Hospital, Melbourne. We performed genome sequencing and proteomics and leveraged this multi-omics dataset to uncover the molecular cause of disease in a gene elusive proband. The proband carried a heterozygous JPH2 frameshift variant identified on clinical exome sequencing. However, proteomic analysis showed a pronounced downregulation of JPH2, suggestive of biallelic loss-of-function. Closer inspection of the genomic data revealed a large inversion (~8.34 Mb) with a breakpoint falling within intron 5 of JPH2 that displaces the 3'UTR from the coding transcript. The two variants were confirmed to be in trans using long read DNA sequencing, consistent with a diagnosis of JPH2 autosomal recessive DCM. Finally, we applied RNA sequencing with total RNA library preparation to show that transcripts containing a 3'UTR were reduced to ~10% relative to controls. As a proof-of-principle, we present the first reported use of proteomics from explanted cardiac tissue to provide a genetic diagnosis. Our methodology has broad relevance to patients with genetically unsolved Mendelian diseases, who might undergo organ transplantation as part of clinical management.

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

Temporal Self-Imitation Learning

arXiv:2606.19752v1 Announce Type: cross Abstract: Long-horizon robot manipulation policies trained with reward shaping can still exploit dense rewards through inefficient interaction, while rare efficient behaviors may be forgotten during training. We argue that temporal efficiency itself provides a powerful and underutilized source of self-supervision for reinforcement learning. We introduce Temporal Self-Imitation Learning (TSIL), a reinforcement learning framework that mines temporally efficient successful trajectories generated during learning and converts them into reusable supervision for future policy improvement. TSIL progressively refines learning using configuration-conditioned adaptive temporal targets derived from fast successful trajectories, while preserving and replaying efficient behaviors through efficiency-weighted self-imitation learning. Across 15 distinct long-horizon manipulation tasks, TSIL consistently improves learning efficiency, task-completion efficiency, revisitation of fast successful behaviors, and robustness to unstable training conditions. More broadly, our results suggest that the temporal structure of successful behavior itself provides a scalable self-supervisory signal for reinforcement learning beyond manually engineered reward shaping alone.

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

Attention-Based Estimation of the Individual Treatment Benefit Probability under Dose Variation

arXiv:2606.13821v1 Announce Type: new Abstract: Estimating the probability that a treatment outperforms a control for an individual patient, called the Individual Probability of Treatment Benefit (IPTB), offers a clinically intuitive alternative to population-average metrics. However, existing methods for IPTB estimation are largely confined to binary treatment settings, despite the prevalence of dose-varying interventions in clinical practice. We propose a general framework for IPTB estimation with ordinal outcomes under discrete dose assignments, called Dose-AIPTB (Dose Attention-based IPTB). Our approach recasts the problem as binary classification over the unobserved sign of the individual treatment effect, constructing pseudo-labels from covariate-similar pairwise comparisons and aggregating them via attention mechanisms or Nadaraya-Watson kernel regression. This formulation naturally accommodates multiple discrete dose levels, extending beyond the binary treatment paradigm. Through numerical experiments on real-world and synthetic data under covariate shift, varying sample sizes, and heterogeneous outcomes, we demonstrate that attention-based aggregation consistently outperforms kernel alternatives. The framework provides a foundation for personalized dose selection grounded in individual-level benefit probabilities. Codes implementing the model are publicly available at https://github.com/NTAILab/AIPTBDose.