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01.
arXiv (CS.CV) 2026-06-11

Adv-TGD: Adversarial Text-Guided Diffusion for Face Recognition Impersonation Attacks

The widespread adoption of face recognition (FR) technologies raises serious privacy concerns, as facial data can be exploited without consent. To address this challenge, we propose Adv-TGD, a generative adversarial attack framework that synthesizes photorealistic faces capable of impersonating target identities and deceiving face recognition systems. Built upon Stable Diffusion, Adv-TGD performs per-sample LoRA fine-tuning conditioned on concise textual prompts to generate natural yet adversarially manipulated identities. Unlike conventional identity-attack approaches, our method optimizes lightweight cross-attention adapters for each source-target pair within a single-step denoising process. Latent blending is constrained by a face-local heatmap mask to ensure spatially precise identity manipulation while preserving non-sensitive regions. We introduce a composite objective that integrates masked epsilon-MSE reconstruction, thresholded identity divergence in FR embedding space, directional feature alignment, and source-similarity suppression to balance adversarial attack and visual realism. Optionally, LLaVA-generated attribute prompts enhance fine-grained semantic details without reintroducing identity cues. Under the black-box evaluation protocol, Adv-TGD attains an average attack success rate (ASR) of 85.90% across IR152, IRSE50, MobileFace, and FaceNet, surpassing the semantic SOTA baseline Adv-CPG by +6.25 points, diffusion-based makeup method DiffAIM by +3 points, and noise-based P3-Mask by +16 points. Despite its strong attack efficacy, Adv-TGD preserves high visual fidelity (PSNR = 27.15 dB, SSIM = 0.981). Furthermore, we demonstrate the flexibility of our framework by successfully extending it to in-the-wild datasets (LADN), general object classification (ImageNet), and transformer-based diffusion models (FLUX.1).

02.
arXiv (CS.CV) 2026-06-15

Dual Cross-Attention Siamese Transformer for Rectal Tumor Regrowth Assessment in Watch-and-Wait Endoscopy

Increasing evidence supports watch-and-wait (WW) surveillance for patients with rectal cancer who show clinical complete response (cCR) at restaging following total neoadjuvant treatment (TNT). However, accurate methods to early detect local regrowth (LR) from follow-up endoscopy images during WW are essential to manage care and prevent distant metastases. Hence, we developed a Siamese Swin Transformer with Dual Cross-Attention (SSDCA) to combine longitudinal endoscopic images at restaging and follow-up and distinguish cCR from LR. SSDCA leverages pretrained Swin Transformers to extract domain agnostic features and enhance robustness to imaging variations. Dual cross attention is implemented to emphasize features from the paired scans without requiring any spatial alignment to predict response. SSDCA as well as Swin-based baselines were trained using image pairs from 135 patients and evaluated on a held-out set of image pairs from 62 patients. SSDCA produced the best balanced accuracy (81.76% $\pm$ 0.04), sensitivity (90.07% $\pm$ 0.08), and specificity (72.86% $\pm$ 0.05). Robustness analysis showed stable performance irrespective of artifacts including blood, stool, telangiectasia, and poor image quality. UMAP clustering of extracted features showed maximal inter-cluster separation (1.45 $\pm$ 0.18) and minimal intra-cluster dispersion (1.07 $\pm$ 0.19) with SSDCA, confirming discriminative representation learning. Code and weights available at: https://github.com/Jotanator/SSDCA

03.
medRxiv (Medicine) 2026-06-22

Discovering Novel intracranial EEG Biomarkers of Seizure Generating Tissue through Time-Frequency Analysis

Objective: EEG biomarkers for seizure-generating tissue have historically been identified visually, which lacks objectivity and limits utility of automated approaches. For example, high frequency oscillations and interictal epileptiform discharges were promising markers to improve surgical outcomes for refractory epilepsy, but low specificity has hindered clinical implementation, and automated algorithms have not improved this. Methods: We developed Intracranial EEG Pattern Identification and Categorization, an automated, data-driven time-frequency framework for EEG biomarker discovery. It detects transient high-power intracranial EEG waveforms (1-500 Hz) and characterizes them using eight features. In seizure-free patients, waveforms occurring predominantly in resected intracranial EEG channels are candidate biomarkers. Results: In retrospective data from 14 seizure-free post-surgical patients from University of California, Los Angeles, we identified 9 waveform categories strongly associated with resected intracranial EEG channels. These included beta, gamma, and ripple band bursts, sometimes co-occurring with interictal epileptiform discharges; however, many were visually imperceptible in the broadband EEG. Using a support vector machine, we generated a unified classification metric based on these waveforms and tested it on 87 seizure-free subjects from Detroit Medical Center. This metric achieved higher area under the precision-recall curve than six state-of-the-art benchmark algorithms (p

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

Gaussian Spatial Priors for Anatomy-Aware Object Detection in Surgical Videos

Detecting anatomical structures in surgical video is essential for intraoperative safety frameworks such as the Critical View of Myopectineal Orifice (CVMPO) in inguinal hernia repair. While prominent structures like the Cooper's Ligament and Triangle of Doom are reliably detected by standard methods, smaller structures such as the epigastric vessels remain challenging due to their visual ambiguity and intermittent visibility. We observe that the spatial relationship between structures is anatomically constrained, and propose a Gaussian Spatial Prior (GSP) module that encodes this relationship as a compact, parametric bias injected into the self-attention of a DAB-DETR decoder. The prior is computed offline from training annotations as a small set of frozen Gaussian parameters and recomputed at each decoder layer using the iteratively refined reference points. On a dataset of inguinal hernia repair videos with 5-fold cross-validation, GSP improves dependent class detection by $+33.5\%$ ($AP_{50}$) over DAB-DETR and $+53.9\%$ over YOLOv26, while also improving anchor detection by $+6.0\%$. These gains are statistically significant across all folds ($p=0.012$, paired $t-$test).

05.
arXiv (CS.AI) 2026-06-16

Medical Heuristic Learning: An LLM-Driven Framework for Interpretable and Auditable Clinical Decision Rules

arXiv:2606.16337v1 Announce Type: new Abstract: Predictive modeling for clinical tabular data is central to clinical decision support and therefore requires not only strong predictive performance but also transparent decision logic. Although deep learning and tree-based ensemble methods can achieve high accuracy, their black-box nature remains a major obstacle to clinical deployment. This challenge is further compounded by common characteristics of medical data, including limited sample sizes, severe class imbalance, and feature evolution arising from changes in diagnostic criteria and clinical documentation. To address these issues, we propose Medical Heuristic Learning (MHL), an instantiation of the learning-beyond-gradients paradigm for clinical tabular prediction. Instead of relying on neural network weight updates, MHL uses a large language model (LLM)-driven workflow that integrates statistical probes, medical knowledge probes, rule synthesis, and code-level iterative refinement to optimize a deterministic and executable decision system. The resulting model is expressed not as opaque parameters, but as versioned pure-Python decision rules that are explicitly interpretable, fully auditable, and clinically grounded. MHL also supports continual learning by starting from previously validated rules and iteratively revising them using updated feature information under data drift or feature evolution. Comprehensive experiments on medical datasets show that MHL achieves performance comparable to state-of-the-art methods while maintaining strong behavior in small-sample and highly imbalanced settings. The results further indicate that this explicit rule update mechanism can help alleviate catastrophic forgetting under feature evolution. Overall, these findings suggest that non-gradient-based heuristic systems offer a transparent and adaptable alternative for high-stakes clinical decision support.

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

Closing the Feedback Loop: From Experience Extraction to Insight Governance in Verbal Reinforcement Learning

arXiv:2606.17591v1 Announce Type: new Abstract: Training-free verbal reinforcement learning enables LLM agents to learn from world feedback – objective signals such as dynamic task outcomes, market returns, or demand forecasts – by extracting verbal rules from experience and injecting them as context, updating the agent's behavior without parameter changes. However, in non-stationary environments these agents face a retention-forgetting dilemma: retaining stale insights causes negative transfer, while discarding them causes catastrophic forgetting when conditions recur. We identify four requirements for navigating this dilemma – outcome-driven evaluation, persistent structured evidence, non-monotonic knowledge lifecycle, and compositional governance – and show that existing methods invest heavily in experience extraction while underinvesting in insight governance. We propose a three-layer architecture – rules, evidence, and skills – connected by a feedback-driven curation loop that closes the governance gap. Rules capture distilled experience from world outcomes; evidence logs track each rule's reliability across episodes; skills govern which rules to apply, how to resolve conflicts, and when to abstain. On financial forecasting as a case study, where world feedback is naturally abundant, noisy, and non-stationary, we show that the same accumulated experience either degrades performance below the zero-shot baseline or dramatically improves accuracy and risk-adjusted returns, depending on whether the curation loop is present.

08.
arXiv (CS.CV) 2026-06-17

RT-Counter: Real-Time Text-Guided Open-Vocabulary Object Counting

Text-guided open-vocabulary object counting (TOOC) aims to count objects belonging to the categories specified by natural language descriptions. Although vision-language pre-trained models have been successful applied to TOOC tasks, they still struggle with fine-grained spatial understanding and real-time inference requirements in counting scenarios. To address these limitations, this paper proposes a real-time TOOC framework, called the Real-Time Counter (RT-Counter), that achieves not only good counting accuracy but also high computational efficiency. RT-Counter designs a novel Visual Prototype Textualization (VPT) module that can project learned visual features into a text feature space and then generate features containing the abstract information that is hard to capture with visual prototypes and the detailed prototype information that is difficult to describe in text, enhancing the object-level visual-language model's counting capabilities. Additionally, RT-Counter incorporates our Weaving Transformer (Weaformer) layers, maintaining high descriptive power at a fraction of the computational cost. The Weaformer layer adopts a novel hybrid attention mechanism that can efficiently weave together local and global visual features. Extensive experiments on three public datasets show that RT-Counter successfully breaks the accuracy-speed trade-off in TOOC. While achieving a competitive MAE of 13.30 on FSC147, RT-Counter operates at 112.48 FPS, making it 7.4x faster and over 4$\times$ more parameter-efficient than the existing leading methods in TOOC. Our work aims at balancing high accuracy and real-time performance in TOOC. Code is available at: https://github.com/Jason-Mar1/RT-Counter.

09.
arXiv (CS.AI) 2026-06-17

Handling Feature Heterogeneity with Learnable Graph Patches

arXiv:2606.17667v1 Announce Type: cross Abstract: In recent years, the rapid development of foundation models and graph pre-training technologies has spurred increasing interest in constructing a universal pre-trained graph model or Graph Foundation Model (GFM). However, a significant challenge is that existing models are unable to address feature heterogeneity in graph data without textual information, which hinders the transferability of graph models across different datasets. To bridge this gap, we propose the concept of learnable graph patches, which we regard as the smallest semantic units of any graph data. We decompose the graph into learnable graph patches by unfolding the node features and constructing corresponding patch structures separately. We then design a framework that mines transferable information from graph data across domains. Specifically, after extracting graph patches, we propose a patch encoder to extract knowledge from each unit and a patch aggregator to learn how the units are combined into a whole. Due to its domain-agnostic nature, the model can be applied to downstream data across different domains. Furthermore, we analyze the connection between our method and existing graph models, as well as the transferability of the node embeddings it generates. Empirically, our method not only achieves the capability to use multi-domain graphs for pre-training, but also shows enhanced performance across various downstream datasets and tasks. Moreover, we observe consistent improvement in downstream performance as the volume of pre-training data increases.

10.
arXiv (CS.AI) 2026-06-12

GeoNatureAgent Benchmark: Benchmarking LLM Agents for Environmental Geospatial Analysis Across Frontier and Open-Weight Foundation Models

arXiv:2606.12821v1 Announce Type: new Abstract: Environmental scientists spend disproportionate effort on data wrangling rather than analysis, and AI agents that automate geospatial workflows remain unvalidated: no benchmark evaluates agents operating through structured tool calling against real APIs. We introduce the GeoNatureAgent Benchmark, the first benchmark for environmental analysis agents that operate via structured tool calls to a production-style geospatial API. It comprises 93 tasks across 18 categories, covering municipality analysis, multi-turn conversation, spatial reasoning, cross-indicator synthesis, error handling and recovery, ranking, comparison, multilingual understanding, habitat analysis, and task rejection. Tasks are evaluated against an open, self-hostable API serving three environmental indicators across Spain and Portugal via sixteen tools. We evaluate seven LLMs (Claude Sonnet 4, DeepSeek V3.2, GLM-5, Gemini 2.5 Pro, Qwen3-235B, GPT-OSS-120B, Llama 4 Scout) under three temperature-1.0 seeds, reporting capability and per-case cost as orthogonal axes. We find: (1) Claude Sonnet 4 leads at 60.8% +/- 0.8%, followed by DeepSeek V3.2 at 56.3% +/- 3.1%, with no other model above 51%; (2) the cost-accuracy Pareto frontier is occupied mostly by open-weight models, with DeepSeek V3.2 offering 93% of Claude's capability at 11x lower cost ($0.011/case); (3) comparison tasks remain universally unsolved (0% on close-value comparisons), exposing systematic reasoning limits; and (4) structured tool calling against a real API is more discriminative than general-purpose GIS benchmarks, with accuracies 25-35 points lower. We further show extensibility by integrating BigEarthNet V2 land cover for Portugal alongside Spanish CO2 and erosion indicators. The benchmark, harness, and self-hostable API are publicly available.

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

Progressive Knowledge-Guided Large Language Model Framework for Bearing Fault Diagnosis

Vibration-based bearing fault diagnosis requires resolving three interrelated measurement challenges, including the trade-off between global statistical feature efficiency and local transient signal fidelity, insufficient traceability of measurement features to underlying fault physics, and ineffective multi-source measurement information fusion across diagnostic scales. This paper presents a progressive physics-guided multi-scale vibration signal processing framework that addresses all three challenges within a unified diagnostic pipeline. An 81-dimensional measurement descriptor, derived from bearing kinematic theory and characteristic defect frequencies, establishes a physically traceable feature space enabling real-time fault screening at approximately 20 ms per sample. A fault-adaptive signal segmentation mechanism then directs analytical attention toward fault-relevant waveform regions guided by physics-based priors, without manual feature engineering. Structured fault mechanism knowledge is further encoded implicitly in model parameters during training, enabling autonomous multi-scale measurement fusion without external knowledge dependencies at inference. Validated on four public benchmark datasets under diverse operating conditions, the framework achieves 98.49% diagnostic accuracy with a 12.6-fold reduction in computational cost relative to signal-level baselines. Interpretability analysis confirms that diagnostic feature activations align with established bearing fault mechanics, supporting measurement traceability in safety-critical industrial systems.

12.
PLOS Computational Biology 2026-06-11

Catecholamine precursor modulation of human exploration: Evidence from a large gender-balanced sample

by Angela Mariele Brands, Kilian Knauth, David Mathar, Tim Roedder, Kerstin Lisner, Jan Peters The catecholamine precursor Tyrosine has been linked to improved cognitive performance, but investigations into decision-making and reinforcement learning processes known to be under catecholamine control are sparse. We examined the impact of a single dose of Tyrosine (2g) on reinforcement learning and exploration in a large (n = 63) gender-balanced sample in a within-subjects preregistered study. Reinforcement learning performance was significantly improved under Tyrosine. Based on previous work, we preregistered the hypotheses that Tyrosine would reduce directed exploration, response times, and physiological arousal. However, neither response times nor physiological arousal revealed the predicted reductions. Computational modelling using an established pre-registered reinforcement learning model revealed that the performance improvement under Tyrosine was due to an increase value-driven exploitation, without affecting directed exploration. Non-preregistered modelling analyses then revealed that accounting for higher-order perseveration substantially improved model fit, and substantiated the observation of increased value-driven exploitation under Tyrosine. Furthermore, it revealed reliable reductions in directed exploration and value-independent perseveration under Tyrosine. Tyrosine thus improved reinforcement learning performance by stabilizing choice patterns in the service of optimizing reward accumulation, modulating several computational mechanisms thought to be under catecholamine control.

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

Automated Creativity Evaluation of Language Models Across Open-Ended Tasks

Large language models (LLMs) have achieved remarkable progress in language understanding, reasoning, and generation, sparking growing interest in their creative potential. Realizing this potential requires systematic and scalable methods for evaluating creativity across diverse tasks. However, most existing creativity metrics are tightly coupled to specific tasks, embedding domain assumptions into the evaluation process, and limiting scalability and generality. To address this gap, we introduce an automated, domain-agnostic framework for quantifying LLM creativity across open-ended tasks. Our approach separates the measurement apparatus from the creative task itself, enabling scalable, task-agnostic assessment. Divergent creativity is measured using semantic entropy, a reference-free and robust metric for novelty and diversity, validated against human annotations, LLM-based novelty judgments and baseline diversity measures. Convergent creativity is assessed via a novel retrieval-based multi-agent judge framework that delivers context-sensitive evaluation of task fulfilment with over 60% improved efficiency. We validate our framework in three qualitatively distinct domains: problem-solving (MacGyver), research ideation (HypoGen), and creative writing (BookMIA), using a broad suite of LLMs. Empirical results show that our framework reliably captures key facets of creativity, including novelty, diversity, and task fulfilment, and reveal how model properties, such as size, temperature, recency, and reasoning, impact creative performance. Our work establishes a reproducible and generalizable standard for automated LLM creativity evaluation, paving the way for scalable benchmarking and accelerating progress in creative AI.

14.
arXiv (CS.CL) 2026-06-19

Thermodynamic Signatures of Reasoning: Free-Energy and Spectral-Form-Factor Diagnostics for Hallucination Detection in Large Language Models

作者:

Hallucination detection in large language models (LLMs) is deployment-critical, and recent work shows that the spectrum of attention-derived graph Laplacians carries strong signal about reasoning quality. Prior spectral diagnostics, however, summarize the Laplacian spectrum by a handful of eigenvalues or hand-picked scalars, leaving most of its structure unused. We propose Free-Energy Signatures (Fes), a spectral descriptor that treats each layer's attention Laplacian as a Hamiltonian and extracts its thermodynamic potentials partition function, free energy, spectral entropy, heat capacity together with the random-matrix-theory (RMT) spectral form factor. We prove three results: (i)~Lipschitz stability of Fes under attention perturbation; (ii)~an expressiveness result showing that Fes enriches finite spectral summaries and approximates moment-derived spectral functionals under explicit regularity and grid-resolution assumptions; and (iii)~a finite-sample PAC bound on the AUROC of a training-free detector built from Fes. Empirically, across six open-weight LLMs and six benchmarks, a lightweight probe on Fes descriptors achieves the strongest aggregate AUROC among attention-spectral baselines, improving over LapEig by $+6.5$ AUROC points and over GoR-4 by $+2.4$ points on average, while requiring no update to the underlying LLM. In the fully unsupervised setting, an RMT-deviation score achieves mean AUROC $0.71$, providing a label-free but weaker detector. A complementary RMT analysis shows that correct generations exhibit more Wigner-Dyson like spectral statistics, whereas hallucinations exhibit more Poisson-like statistics. The anonymized code and config are provided in the supplementary material.

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

A Study of Belief Revision Postulates in Multi-Agent Systems (Extended Version)

arXiv:2605.02249v2 Announce Type: replace Abstract: We investigate the belief revision problem in epistemic planning, i.e., what will be the beliefs of all agents in a multi-agent system after an agent gains the belief in some state property. Based on the standard representation in epistemic planning of agents' beliefs via a single multi-agent Kripke model, we generalize the classical AGM belief revision postulates to the multi-agent setting, with the aim to provide a formal framework for evaluating dynamic epistemic reasoning frameworks in which the beliefs of all agents as the result of actions are computed. As an example of a simple operator that satisfies all of the generalized AGM postulates, we present generalized full-meet multi-agent belief revision. We moreover define a generalization of the standard postulates for iterated revision, present a more sophisticated, event model based revision operator, and discuss the potential issues in defining an epistemic operator on Kripke models that can satisfy all of the generalized postulates for iterated multi-agent belief revision.

16.
bioRxiv (Bioinfo) 2026-06-16

Evidence for recombination in dengue virus genomes

Recombination is a key driver of RNA virus evolution, yet its extent and evolutionary implications in dengue virus (DENV) remain incompletely understood. We conducted a comprehensive, genome-wide recombination screen across 6,905 complete DENV genomes representing all four serotypes, 82 countries, and eight decades of sampling (1944-2023) retrieved from the Bacterial and Viral Bioinformatics Resource Center. Using seven complementary recombination detection methods implemented in RDP5, we identified 66 recombination events across 53 unique recombinant sequences, of which 29 are newly described. Events included intra-genotypic (n = 18), inter-genotypic (n = 32), and inter-serotypic (n = 16) exchanges spanning 14 genotypes and four continents, with no meaningful serotype-level enrichment (Cramer's V = 0.054). Recombination was concentrated in non-structural genes, most frequently NS3 (19 events), NS5 (17), and NS2 (12), while the capsid gene contained no recombination events, consistent with strong functional constraint. Single-nucleotide polymorphism analyses confirmed low divergence between recombinants and their inferred parents in both recombinant and non-recombinant regions. Phylogenomic analysis of 6,642 sequences revealed that recombinants cluster significantly closer to their major parents (p = 8.9 x 10-6 ) and that their removal does not significantly alter tree topology (p = 0.898), suggesting that the short length of recombinant regions limits phylogenetic conflict. We also introduce RECOSIM, an unsupervised machine-learning tool for recombination detection that achieved higher precision than RDP5 on both simulated (93.4% vs. 80.0%) and empirical (98.1% vs. 39.3%) datasets. Collectively, these results establish recombination as a widespread, pan-serotypic phenomenon in DENV with implications for genomic surveillance, vaccine evaluation, and evolutionary inference.

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

Optimism Stabilizes Thompson Sampling for Adaptive Inference

arXiv:2602.06014v2 Announce Type: replace-cross Abstract: Thompson sampling (TS) is widely used for stochastic multi-armed bandits, yet its inferential properties under adaptive data collection are subtle. Classical asymptotic theory for sample means can fail because arm-specific sample sizes are random and coupled with the rewards through the action-selection rule. We study adaptive inference for Thompson sampling with Gaussian randomized indices in $K$-armed stochastic bandits with independent sub-Gaussian reward noises, and identify optimism as a key mechanism for restoring stability, meaning that each arm's pull count concentrates around a deterministic scale. This stability yields asymptotically valid Wald inference despite adaptive sampling. First, we prove that variance-inflated TS is stable for any $K \ge 2$, including the challenging regime where multiple arms are optimal, with asymptotically uniform allocation over optimal arms and sharp logarithmic pull-count asymptotics for suboptimal arms. This resolves the $K$-armed extension question raised by \citet{halder2025stable}, using new winner-map and Lyapunov-drift techniques to control allocation among multiple optimal arms. Second, we analyze an alternative optimistic modification that keeps the Gaussian index variance unchanged but adds an explicit mean bonus to the index center, and establish a similar stability conclusion. In summary, suitably implemented optimism stabilizes Thompson sampling and enables asymptotically valid Wald inference in multi-armed bandits, while incurring only a mild additional regret cost.

18.
medRxiv (Medicine) 2026-06-15

Sociodemographic Disparities in Tafamidis Initiation and Clinical Outcomes in ATTR-CM Across the United States

BACKGROUND Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive, life-threatening disease. Sociodemographic factors may influence time to treatment initiation and resulting clinical outcomes, yet these relationships are poorly characterized. OBJECTIVE Assess the effects of sex and race on tafamidis initiation and subsequent outcomes and their interaction with factors such as ATTR-CM type and social deprivation measures. METHODS A retrospective cohort analysis was conducted using the US Komodo Healthcare Map (01/2016-06/2024) among patients with amyloidosis, identified by ICD-10-CM diagnosis codes. Cumulative incidence of treatment initiation and survival probabilities for cardiovascular-related hospitalization (CVH) or death were estimated by Kaplan-Meier, stratified by sex and race. Cox proportional hazards models were fitted for both endpoints to estimate hazard ratios, adjusting for demographics and clinical characteristics. RESULTS Of 11,311 patients identified, White and Black patients (n=9,223) were included in subsequent analyses. Within 12 months of diagnosis, White women had the lowest cumulative incidence of tafamidis initiation (11.4%), followed by Black women (22.0%), Black men (26.7%), and White men (31.0%). Event-free survival at 12 months was lowest in Black women (42.9%), followed by Black men (46.8%), White women (48.6%), and White men (54.4%). Median (95% CI) time to CVH or death was shortest for Black women (8.0 months [6.8-10.0]) followed by Black men (9.9 months [8.8-12.0]), White women (11.0 months [9.6-13.0]), and White men (15.0 months [14.0-16.0]). CONCLUSIONS In this large, real-world cohort of US patients with ATTR-CM, sex and race contributed to disparities in tafamidis initiation and survival, underscoring compounded disparities in both access and outcomes.

19.
medRxiv (Medicine) 2026-06-11

A global cross-sectional survey of health professionals' interest-confidence gaps in value-based health care implementation: a learning needs assessment

Abstract Objectives Value-Based Health Care (VBHC) increasingly guides health system redesign internationally. Despite the increasing availability of VBHC education, gaps remain between health professionals' conceptual understanding of VBHC and their confidence to implement it in practice. This study assessed perceived learning needs and preferences of healthcare professionals across foundational topics essential to VBHC implementation. Design Cross-sectional online survey study Setting and participants The survey was distributed to the global VBHC community and yielded 518 responses. Most respondents were based in the UK and Ireland (51%) and 65% had more than 10 years of experience in the health sector. Participants represented a variety of professional backgrounds, including clinicians (34%), operational or executive managers and leaders (22%), and life sciences or procurement professionals (13%). Primary and secondary outcome measures Primary outcome measures included self-reported interest and confidence across 15 VBHC domains and the magnitude of the gap between them. Secondary outcomes included perceived implementation challenges and preferred VBHC learning approaches, including prior engagement with VBHC-related learning. Results Respondents identified substantial VBHC implementation challenges, including implementing outcome measurement (62.4%), conflicting priorities (57.7%), and resistance to change (56.8%). Interest in all VBHC domains was high (median >= 80/10), while confidence to implement remained substantially lower across most domains (median

20.
Nature (Science) 2026-06-10

A thalamus–brainstem attractor network drives history-biased decisions

作者:

Natural environments often change gradually, making it adaptive to bias decisions on the basis of the recent past — a phenomenon known as serial dependence1–3. Large-scale recordings during behaviour have identified that serial dependence is a common motif for decision-making, with neural representations of past experiences found throughout the brain4–11. However, it remains unclear whether this bias arises from dedicated neural circuits with history-specific computations. Using whole-brain, cellular-resolution imaging in zebrafish performing memory-guided evasive manoeuvres12–14, we identified a hierarchical circuit that maintains past information and biases future choices. Discrete attractors in the dorsal thalamus encoded the position of the most recent obstacle, maintaining a categorical memory via persistent activity lasting 10–20 s. Optogenetic manipulation of the dorsal thalamus abolished or imposed serial bias. A downstream hindbrain integrator received input from the thalamus and combined it with current sensory cues to produce graded responses reflecting multi-trial history. Leveraging a comprehensive brain atlas in zebrafish15, we constructed a whole-brain computational model that recapitulated behaviour and also predicted a key role for heterogeneous inhibitory subtypes in enabling flexible state transitions. This attractor–integrator architecture reveals a hierarchical and modular computation that unifies robust memory retention with flexible sensory integration, providing a general principle for history-biased decisions. Whole-brain, cellular-resolution imaging reveals a hierarchical thalamus–brainstem attractor network that encodes recent history and shapes behavioural bias in zebrafish.

21.
arXiv (CS.CV) 2026-06-17

NTIRE 2024 Challenge on Image Super-Resolution (x4): Methods and Results

This paper reviews the NTIRE 2024 challenge on image super-resolution ($\times$4), highlighting the solutions proposed and the outcomes obtained. The challenge involves generating corresponding high-resolution (HR) images, magnified by a factor of four, from low-resolution (LR) inputs using prior information. The LR images originate from bicubic downsampling degradation. The aim of the challenge is to obtain designs/solutions with the most advanced SR performance, with no constraints on computational resources (e.g., model size and FLOPs) or training data. The track of this challenge assesses performance with the PSNR metric on the DIV2K testing dataset. The competition attracted 199 registrants, with 20 teams submitting valid entries. This collective endeavour not only pushes the boundaries of performance in single-image SR but also offers a comprehensive overview of current trends in this field.

22.
medRxiv (Medicine) 2026-06-18

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

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.

23.
arXiv (CS.CL) 2026-06-16

Mechanistic Analysis of Catastrophic Forgetting in Large Language Models During Continual Fine-tuning

Sequential fine-tuning of Large Language Models (LLMs) adaptation to target tasks often triggers catastrophic forgetting, where the acquisition of novel target skills degrades ancestral capabilities. This paper presents a systematic comparative study of catastrophic forgetting across twenty premier models representing the state-of-the-art in mid-2026. We categorize our investigation into two primary research lines: (i) a behavioral and semantic output drift analysis of ten leading closed-source models (including Claude Fable 5, GPT-5.5 High, and Gemini 3.5 Flash), and (ii) a deep mechanistic interpretation of ten prominent open-weight architectures (such as DeepSeek-V4-Pro, Llama 4 Maverick, and Qwen 3.6-27B). Through weight-space trajectory tracking, Centered Kernel Alignment (CKA), and routing gate drift calculations in Mixture-of-Experts (MoE) layers, we localize the neural circuits highly susceptible to parameter overwriting. Our findings indicate that early-layer attention heads exhibit systemic entropic dispersion, while mid-to-deep feed-forward networks (or sparse expert blocks) suffer localized representation collapse. Informed by these insights, we introduce Low-Rank Circuit Projection (LRCP), a subspace-regularized training intervention. Empirical evaluations show that LRCP successfully mitigates up to 94.2% of ancestral capabilities in open-weight configurations and matches the adaptation velocity of standard PEFT baselines.

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

NEXUS: Neural Energy Fields for Physically Consistent Contact-Rich 3D Object Dynamics

Physics-grounded video generation requires controllable 3D object dynamics that remain physically consistent under contact, deformation, and external forcing. Existing trajectory-based methods often model isolated physical effects, making it difficult to compose conservative and non-conservative dynamics in contact-rich 3D scenes. We present NEXUS, a neural energy-field framework for contact-rich 3D object dynamics. NEXUS represents each object as a structural graph and constructs dynamic object-object and object-environment contact graphs. Inspired by Hamiltonian Neural Networks, NEXUS formulates motion through scalar energy and dissipation terms rather than directly predicting states or accelerations. Conservative effects, including gravity and elastic deformation, are composed as additive energy terms, while non-conservative effects such as damping and impact-induced energy loss are modeled with learned Rayleigh-style dissipation. Forces are derived by differentiating the energy and dissipation functions and rolled out with a multi-substep semi-implicit integrator. Across controlled trajectory benchmarks, NEXUS improves long-horizon accuracy over representative learned and physics-structured dynamics baselines under varying mechanical properties and physical-effect compositions. We further show that NEXUS trajectories provide effective guidance for contact-rich video generation, improving physical plausibility while maintaining competitive visual quality.

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

EMS: Multi-Agent Voting via Efficient Majority-then-Stopping

arXiv:2604.02863v2 Announce Type: replace Abstract: Majority voting is the standard for aggregating multi-agent responses into a final decision. However, traditional methods typically require all agents to complete their reasoning before aggregation begins, leading to significant computational overhead, as many responses become redundant once a majority consensus is achieved. In this work, we formulate efficient multi-agent voting as a reliability-aware agent scheduling problem and propose Efficient Majority-then-Stopping (EMS) to improve reasoning efficiency. EMS first estimates a Task-Conditioned Reliability Ordering (TCRO) for each agent by retrieving its historical consensus evidence on semantically similar queries, and then invoking agents in descending reliability order. Next, Adaptive Incremental Voting (AIV) terminates the process once the current leading answer cannot be overturned by any possible votes from the remaining agents, and returns this answer. Finally, Reliability History Updating (RHU) updates only the invoked agents according to their consensus with the final decision. Extensive evaluations across five benchmarks show that EMS preserves the accuracy of Majority Voting while reducing the average number of invoked agents by 35% and token consumption by 44%, respectively. The code is available at https://github.com/fuyu66/EMS.