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01.
arXiv (CS.LG) 2026-06-12

Aerial Wildfire Suppression Planning with a Hybrid CNN-Cellular Automata Fire Model

arXiv:2606.13633v1 Announce Type: cross Abstract: Aerial wildfire suppression requires not only predicting fire spread, but also designing effective intervention strategies under operational and environmental uncertainty. We present a modeling and optimization framework for aerial wildfire suppression that combines a hybrid neural-cellular automaton wildfire model with gradient-based design of targeted aerial drops. The wildfire model predicts spatially varying spread behavior from terrain, fuel, and wind data, while the intervention module determines binary drop actions with continuous-valued location and orientation parameters mapped to the simulation grid. Water and retardant are represented with distinct suppression effects, corresponding to immediate reduction of active burning and persistent reduction of future spread. To evaluate the robustness of the resulting suppression plans, we quantify both aleatoric uncertainty through Monte Carlo sampling of daily fire-state realizations and epistemic uncertainty through spatially correlated prediction-error perturbations. A case study based on the 2020 Bear Fire shows that the framework can generate coherent aerial suppression schedules for reducing total fire-affected area and can support uncertainty-aware analysis of wildfire intervention strategies.

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

TokenRatio: Principled Token-Level Preference Optimization via Ratio Matching

Direct Preference Optimization (DPO) is a widely used RL-free method for aligning language models from pairwise preferences, but it models preferences over full sequences even though generation is driven by per-token decisions. Existing token-level extensions typically decompose a sequence-level Bradley-Terry objective across timesteps, leaving per-prefix (state-wise) optimality implicit. We study how to recover token-level preference optimality using only standard sequence-level pairwise comparisons. We introduce Token-level Bregman Preference Optimization (TBPO), which posits a token-level Bradley-Terry preference model over next-token actions conditioned on the prefix, and derive a Bregman-divergence density-ratio matching objective that generalizes the logistic/DPO loss while preserving the optimal policy induced by the token-level model and maintaining DPO-like simplicity. We introduce two instantiations: TBPO-Q, which explicitly learns a lightweight state baseline, and TBPO-A, which removes the baseline through advantage normalization. Across instruction following, helpfulness/harmlessness, and summarization benchmarks, TBPO improves alignment quality and training stability and increases output diversity relative to strong sequence-level and token-level baselines.

03.
arXiv (CS.CV) 2026-06-15

Context-Guided Semantic Alignment for Feature Fusion Networks

Feature fusion networks are fundamental components in modern object detectors, aggregating multi-scale features to detect objects of varying sizes. However, directly fusing features from different pyramid levels often introduces semantic inconsistency due to their heterogeneous representations. In this paper, we propose Feature Interaction NEtwork (FINE), a lightweight semantic alignment module that refines low-level features via high-level contextual guidance using cross-level attention prior to fusion. To bridge the structural gap and ensure computational efficiency, we introduce an Alignment-Aware Token Sampling that aligns corresponding spatial regions across scales, reducing the attention complexity by an order of magnitude. The resulting attention weights generate a spatial-channel modulation map that is upsampled and applied to the low-level features via residual element-wise modulation. This mechanism ensures that the network selectively enhances semantically relevant pixels while preserving the sub-pixel localization accuracy necessary for dense prediction tasks. FINE is generally applicable to various detectors and consistently improves detection accuracy without compromising efficiency.

04.
arXiv (CS.CL) 2026-06-12

If LLMs Have Human-Like Attributes, Then So Does Age of Empires II

Much research has been carried out on large language models (LLMs) and LLM-powered agentic workflows. However, many works within the field state emergence of, ascribe to, or assume, generalised anthropomorphic attributes to them (e.g., morality or understanding of natural language). Our goal is not to argue in favour or against the existence of these attributes, but to point out that these conclusions could be incorrect. For this we build and train a simple neural network on the videogame Age of Empires II, and note that any entity in a sufficiently-powerful substrate, such as LEGO or the Greater Boston Area, could also present such attributes. Hence, the purported anthropomorphic attributes of LLMs are empirically non-unique: although some properties (e.g., responses to prompts) could remain invariant, others, such as the interpretation of their perceived behaviour, might change with the substrate. Thus, any empirically-grounded discussion on these attributes requires explicit measurement criteria; otherwise the interpretation is left to the representation. We then show that assuming that these attributes exist or not in a system, independent of the substrate and in a generalised way, leads to either circular or uninformative conclusions. This is regardless of the experimenter's viewpoint on the subject, or whether the outcome shows existence or non-existence. Finally we propose a 'null' assumption, where one assumes LLM non-uniqueness instead of assuming anthropomorphic attributes to set up an experiment, along with examples of it. We also discuss potential objections to our work, briefly survey the field, and prove that Age of Empires II is functionally- and Turing-complete.

05.
arXiv (CS.CL) 2026-06-11

ASRU: Activation Steering Meets Reinforcement Unlearning for Multimodal Large Language Models

Multimodal large language models (MLLMs) may memorize sensitive cross-modal information during pretraining, making machine unlearning (MU) crucial. Existing methods typically evaluate unlearning effectiveness based on output deviations, while overlooking the generation quality after unlearning. This can easily lead to hallucinated or rigid responses, thereby affecting the usability and safety of the unlearned model. To address this issue, we propose ASRU, a controllable multimodal unlearning framework that incorporates generation quality as a core evaluation objective. ASRU first induces initial refusal behavior through activation redirection, and then optimizes fine-grained refusal boundaries using a customized reward function, thereby achieving a better trade-off between target knowledge unlearning and model utility. Experiments on Qwen3-VL show that ASRU significantly improves unlearning effectiveness (+24.6%) on average and generation quality (5.8X) on average while effectively preserving model utility, using only a small amount of retained supervision data.

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

Bounded Context Management for Tabular Foundation Models on Stream Learning

arXiv:2606.18677v1 Announce Type: cross Abstract: Tabular stream learning requires predictions on sequentially arriving examples under distribution shift. While standard methods adapt by updating model states, tabular foundation models (TFMs) make predictions conditioned on a labeled context in an in-context manner, making them a natural alternative for stream learning. This shifts the challenge from how to update the model to how to manage the context. We propose a future information view that yields three practical requirements for context management: preserve recent examples, retain uncertain examples, and remove redundant examples. We instantiate these requirements as CURE (Context management via Uncertainty-aware admission and Redundancy aware Eviction), a context-managing policy with entropy-gated admission and redundancy-aware eviction. Across seven streams, CURE shows up to 27.0% relative improvement over classical stream learners, remains robust across multiple TFM backbones, and ranks first among other policy variants. Code and datasets are available at https://github.com/morcellinus/CURE-ICML-FMSD.

07.
arXiv (quant-ph) 2026-06-16

Grid-state deformation in a no-jump non-Hermitian bosonic dimer

arXiv:2606.17036v1 Announce Type: new Abstract: We study the no-jump evolution of ideal grid states in a lossy bosonic dimer with differential decay. The effective non-Hermitian quadratic dynamics induces a complex symplectic flow in phase space that deforms both the primitive lattice vectors and the origin seed. The average decay rate controls common attenuation, while coherent hopping and differential decay control the reduced dimer deformation. The reduced sector contains elliptic, parabolic, and hyperbolic regimes with imaginary spectra, an exceptional point, and real spectra, producing oscillatory, linear, and exponential lattice deformations. Although projected lattice areas can change, the deformation comes from a determinant-one complex symplectic flow on the full four-dimensional phase space. For a Gaussian regularization of the origin seed, we derive the associated complex width matrix and identify the positivity conditions that preserve Gaussian form. For an initial two-mode qunaught product state, the lossless limit recovers the standard beam-splitter generation of a square GKP$+$ Bell pair, while the no-jump dynamics produces its non-Hermitian deformation with a postselection cost set by the no-jump probability.

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

Treatment Response Optimized Clinical Decision Support AI System via Digital Twin Simulation

arXiv:2606.17405v1 Announce Type: new Abstract: Clinical decision support AI systems (CDSASs) must adapt to evolving patient conditions in real-time while adhering to strict safety constraints. We present an online adaptive framework that integrates Treatment Effect (TE) estimation to quantify clinical benefits, a patient Digital Twin (DT) to simulate treatment trajectories, and Reinforcement Learning (RL) for sequential decision-making. The AI system is initially trained on historical medical records and operates in a continuous learning loop. To ensure safety, a rule-based module monitors vital signs and blocks contraindicated treatments. Cases with strong internal model disagreement are flagged for clinician review, simulated in our experiments via a pre-trained outcome model. We validate our framework using both a synthetic clinical simulator and a real-world ovarian cancer dataset from The Cancer Genome Atlas (TCGA). In both simulated and clinical settings, our method demonstrated superior effectiveness and stability in recommending treatments compared to standard computational baselines. Furthermore, the AI system maintains low latency and requires expert consultation for only a minority of cases in our experimental validation, demonstrating its potential as a safe, clinician-supervised tool for personalized medicine that continuously improves through practical use.

09.
arXiv (CS.LG) 2026-06-24

AsyncOPD: How Stale Can On-Policy Distillation Be?

arXiv:2606.24143v1 Announce Type: new Abstract: On-policy distillation (OPD) trains a student on its own rollouts guided by teacher feedback and is becoming increasingly important for large language model (LLM) post-training. Like reinforcement learning (RL), however, OPD faces an on-policy systems bottleneck, as rollouts can dominate training time for reasoning workloads. Asynchronous training pipelines can alleviate this bottleneck by decoupling rollout generation from learner updates, but doing so introduces stale-policy data. While prior work has studied stale data in asynchronous RL, its effects in OPD remain underexplored. We present the first systematic study of staleness in asynchronous OPD, focusing on a practical setting where teacher feedback is implemented through local KL losses and full-vocabulary teacher logits are too expensive to store or transfer, necessitating finite teacher-score caches. We first show that KL direction changes the stale-data problem: teacher-weighted forward KL is more robust to stale rollouts, whereas student-weighted reverse KL is vulnerable. Second, for this vulnerable reverse-KL case, we study whether methods designed to stabilize asynchronous RL can mitigate OPD staleness. In our experiments, they do not improve over a simpler OPD-specific surrogate: recomputing the reverse-KL signal under the current student at learner time. Third, we analyze how finite teacher-score caches create a bias-variance tradeoff for sparse and sampled reverse-KL OPD estimators. This motivates multi-sample Monte Carlo (MC), which preserves MC correctability while reducing one-sample variance. Finally, we present and open-source AsyncOPD, a fully asynchronous OPD training pipeline built from these estimator choices. Experiments show that AsyncOPD improves training throughput by $1.6\times$ to $3.8\times$ over strict synchronous training while reaching comparable accuracy.

10.
arXiv (quant-ph) 2026-06-15

Nanostructure modelling with early fault tolerant quantum computers

arXiv:2606.06442v2 Announce Type: replace Abstract: Semiconductor nanostructures are central to many developing technologies. Notably, double quantum dots are especially important for semiconductor spin-qubit architectures, quantum sensing applications, and quantum-dot solar cells. Accurate modelling is highly desirable but conventional methods can struggle when dynamics involve more than two interacting electrons. In this work, we present a quantum simulation framework capable of addressing multi-electron double quantum dots. We adopt an efficiently scaling 1$^st$ quantised representation of the system and develop algorithms based on both Trotterisation and Qubitisation. Incorporating insights from classical simulations enables us to produce resource estimates that are more realistic than those obtained from theoretical error bounds. Using a standard surface code model with physical noise at $10^{-3}$, our results indicate that the ground-state energy of four electrons in a double quantum dot can be estimated in approximately 22 hours using 226k physical qubits, or an eight-electron system in 3.3 days with 314k qubits (with runtimes falling dramatically when more qubits are available). We anticipate that incorporating recent advances in surface code architectures may reduce these costs significantly further. Our results suggest that early fault-tolerant quantum computers may become valuable tools for designing mature-era quantum technologies.

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

Plan-and-Verify Video Reward Reasoning with Spatio-Temporal Scene Graph Grounding

Reward models for text-to-video (T2V) generation guide post-training but often fail at fine-grained semantic alignment. We trace this to two structural weaknesses in existing reasoning-based reward models: they do not systematically verify every condition described in the prompt, and the visual evidence supporting each judgment remains implicit in their free-form reasoning. We propose SG-PVR, a video reward model that addresses these limitations through plan-and-verify reasoning grounded in spatio-temporal scene graphs. The verification plan decomposes the prompt into atomic claims, ensuring every requirement is checked. The spatio-temporal scene graph, encoding entities, attributes, and temporally-grounded relations, is extracted from the video and maintained as a persistent structured visual reference throughout reasoning. Each claim is verified against both the video and the scene graph, anchoring judgments in explicit visual evidence. SG-PVR achieves strong performance on semantic alignment, including fine-grained temporal semantics. As a test-time reranker, it further enhances compositional alignment in T2V generation.

12.
arXiv (math.PR) 2026-06-16

Malliavin Calculus for the stochastic Cahn-Hilliard equation driven by fractional noise

arXiv:2601.10490v2 Announce Type: replace Abstract: The stochastic partial differential equation analyzed in this work is the Cahn-Hilliard equation perturbed by an additive fractional white noise (fractional in time and white in space). We work in the case of one spatial dimension and apply Malliavin calculus to investigate the existence of a density for the stochastic solution $u$. In particular, we show that $u$ admits continuous paths almost surely and construct a localizing sequence through which we prove that its Malliavin derivative exists locally, and that its law is absolutely continuous with respect to the Lebesgue measure on $\bf R$, establishing thus that a density exists. A key contribution of this work is the analysis of the stochastic integral appearing in the mild formulation: we derive sharp estimates for the expectation of the $p$-th power ($p \geq 2$) of the $L^{\infty}(D)$-norm of this stochastic integral as well as for the integral involving the $L^{\infty}(D)$-norm of the operator associated with the kernel appearing in the integral representation of the fractional noise, all of which are essential for this study.

13.
arXiv (math.PR) 2026-06-24

Genealogical processes of sequential Monte Carlo methods and other non-neutral population models under rapid mutation

arXiv:2406.16465v3 Announce Type: replace Abstract: We show that genealogical trees arising from a broad class of non-neutral models of population evolution converge to the Kingman coalescent under a suitable rescaling of time. As well as non-neutral biological evolution, our results apply to genetic algorithms encompassing the prominent class of sequential Monte Carlo (SMC) methods. The time rescaling we need differs slightly from that used in classical results for convergence to the Kingman coalescent, which has implications for the performance of different resampling schemes in SMC algorithms. In addition, our work substantially simplifies earlier proofs of convergence to the Kingman coalescent, and corrects an error common to several earlier results.

15.
arXiv (CS.CL) 2026-06-11

ChartFI: Benchmarking Faithfulness and Insightfulness of Chart Descriptions from Multimodal Large Language Models

Chart descriptions are essential for accessibility, cross-modal retrieval, and assisting readers in extracting insights from complex visualizations. As multimodal large language models (MLLMs) are increasingly adopted for automated chart description generation, a critical question arises: how faithfully and insightfully do these models actually describe charts? Current benchmarks fall short on two fronts: existing datasets consist of simple, homogeneous charts paired with shallow, fact-enumerating descriptions; and prevailing metrics fail to capture the multi-faceted nature of description quality. To address these gaps, we present the Chart Faithfulness and Insightfulness Benchmark (ChartFI-Bench). We first summarize four dimensions that characterize high-quality chart descriptions: factual accuracy, salient feature emphasis, domain-informed guidance, and chart-text complementarity. Guided by these dimensions, we construct a high-quality benchmark comprising 896 chart-description pairs, which feature visually complex charts and semantically rich descriptions. Furthermore, we design four aligned evaluation metrics – Faithfulness, Coverage, Informativeness, and Acuity – to systematically assess the quality of descriptions across these dimensions. Experiments conducted on mainstream MLLMs demonstrate the effectiveness of the proposed framework and reveal common weaknesses among existing models.

16.
medRxiv (Medicine) 2026-06-22

Demographic Calibration Gaps in Breast Cancer Risk Prediction: Introducing the Demographic Calibration Gap Score

作者:

ABSTRACT: Most breast cancer prediction studies skip calibration reporting entirely. Fewer still examine calibration by demographic subgroup. Predicted probabilities that are systematically off for specific racial or gender groups produce biased clinical decisions, and aggregate statistics will not catch that. Objective: To introduce the Demographic Calibration Gap Score (DCGS), a metric that measures how much calibration error varies across demographic subgroups, and to show how it performs across five classifiers, four calibration conditions, and two datasets. Methods: Five classifiers were trained on the Wisconsin Diagnostic Breast Cancer dataset (n=569) and evaluated on a breast cancer cohort from MIMIC-IV (n=1,316). Three global calibration methods were applied: no calibration, Platt scaling, and isotonic regression. A fourth condition, subgroup-targeted Platt scaling, was applied to the MIMIC cohort. DCGS was computed as across racial and gender subgroups, with 95% bootstrap confidence intervals. Conformal prediction coverage and Demographic Coverage Gap (DCG) were reported. Results: On Wisconsin, all five models achieved AUROC above 0.98 and ECE below 0.12. Performance fell sharply on the MIMIC external cohort: AUROC dropped to 0.45-0.57 for base and globally calibrated variants, confirming distributional shift. DCGS exceeded the 0.05 clinical significance threshold in 28 of 40 model-calibration combinations on the race axis. Neither global Platt nor isotonic calibration reliably reduced DCGS below that threshold. Conformal coverage collapsed to roughly 25% on MIMIC, and racial DCG exceeded 0.15 for all 20 model-variant combinations. Conclusions: Reducing population-level ECE through global recalibration does not reliably close demographic calibration gaps. DCGS gives researchers a direct, standardized way to detect and report those disparities. Code and the DCGS computation library are released as open-source Python under the MIT License.

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

Training-free sparse attention based on cumulative energy filtering

Sparse attention accelerates Diffusion Transformers (DiTs) for video generation by computing only the important tokens while skipping the rest. The token selection strategy is key to balancing sparsity and accuracy. We formulate the token filtering process as a dual-goal optimization problem: maximizing sparsity and minimizing accuracy degradation. Existing algorithms cannot fulfill both objectives simultaneously. For example, Top-p only considers the accuracy constraint, while Top-k maintains a fixed computational budget but loosens the accuracy constraint. This paper demonstrates that maintaining a fixed recall rate is sufficient for ensuring accuracy, whereas a fixed threshold is suboptimal for reducing computational cost. Therefore, we propose a dynamic thresholding scheme to improve sparsity while maintaining the same level of accuracy. Furthermore, our algorithm is deeply integrated with Flash Attention (FA), eliminating the need for any additional masking computation overhead. Experimental results on Wan 2.2 validate that, compared to the BLASST algorithm which is also integrated with FA, our dynamic thresholding strategy enhances sparsity from 61.42\% to 82\% with a VBench metric drop of less than 5\%. This results in an approximate 15\% in attention computation and a $1.61\times$ increase in computational efficiency, which is 1.18x higher than that of BLASST.

18.
arXiv (math.PR) 2026-06-24

On domains of elliptic operators with distributional coefficients

arXiv:2509.24950v2 Announce Type: replace-cross Abstract: We show how one can use recently gained insights from the study of singular SPDEs, more particularly the study of singular operators via the theory of Paracontrolled Distributions, to construct domains for (singular) elliptic operators. Formally we consider \[ A (u) = (1 - \Delta) u + \nabla V \cdot \nabla u + \xi u + {{div} (\rho u)}, \] where $V \in \mathcal{C}^{\delta}$, $\xi \in \mathcal{C}^{- 2 + \delta}$, $\rho \in \mathcal{C}^{- 1 + \delta}, {div} \rho = 0$} and which satisfy a structural assumption that is notably satisfied when $\xi$ is a sub-critical noise, see {[MvZ22]}. We also show that under this assumption, one can construct a continuous change of variables $\Theta$ which satisfies \[ A \Theta - (1 - \Delta) \in \mathcal{L} (H^{2 - \delta''} ; H^{\delta'}) \] which allows us to define $A$ rigorously and parametrise a domain. Moreover, for suitably regularised operators \[ A_{\varepsilon} (u) := (1 - \Delta) u + \nabla V_{\varepsilon} \cdot \nabla u + (\xi_{\varepsilon} + c_{\varepsilon}) \cdot u + {{div} (\rho_{\varepsilon} \cdot u)}, \] we show that for a strongly converging regularised change of variables $\Theta_{\varepsilon} \rightarrow \Theta$ we have \[ A_{\varepsilon} \Theta_{\varepsilon} \rightarrow A \Theta in \mathcal{L} (H^2 ; L^2) \] which in particular implies norm resolvent convergence to a limiting closed operator. Finally, we give a class of examples and show how to apply these results to prove strong analytical local well-posedness for a singular Schrödinger equation formally given by \[ i \partial_t u + (1 - \Delta) u + \nabla V \cdot \nabla u + \xi \cdot u = - | u |^2 u \] for singular $V, \xi$ and that its solution is the limit of the solution of the classical solutions of a regularised equation

19.
bioRxiv (Bioinfo) 2026-06-15

SMLMFlow: Improving Structural Resolution in Single Molecule Localization Microscopy with Flow Matching

While Single Molecule Localization Microscopy (SMLM) aims to generate precise coordinates of molecular targets in cells, the resulting point clouds are inherently blurred by additive noise sources across the experimental, imaging, and processing workflow. This blurring often limits SMLM's ability to accurately quantify complex assembled structures required to address biological issues, despite reported localization precision down to a couple of nanometers. Here, we present SMLMFlow, a machine learning framework for improving structural resolution in SMLM datasets that combines a graph neural network and a hierarchical transformer with flow matching. We show that SMLMFlow improves structural resolution and downstream quantification across different structures, including filaments and protein nano-clusters, and generalizes to new unseen photophysics models.

20.
arXiv (CS.AI) 2026-06-12

AI-Automation Tooling in Computer Engineering Education: Mixed-Methods TAM/UTAUT Evidence for a General Acceptance Attitude

作者:

arXiv:2606.12424v1 Announce Type: cross Abstract: As generative AI and low-code workflow platforms become routine in software practice, a key educational question is whether the next generation of computer engineers will accept these tools as useful, usable, and worthy of sustained engagement. This paper reports a mixed-methods, cross-sectional study of undergraduate computer engineering students' acceptance of AI automation tooling, instantiated through the open-source platform n8n across three identically scripted workshops in Thailand (n = 103). A 12-item, five-point Likert instrument mapped to six TAM/UTAUT constructs - Performance Expectancy (PE), Effort Expectancy (EE), Behavioral Intention (BI), Self-Efficacy (SE), Hedonic Motivation (HM), and Output Quality (OQ) - was complemented by inductive thematic analysis of open-ended feedback. Analyses combined ordinal reliability estimation, bootstrap confidence intervals, non-parametric tests, multiple-comparison-controlled correlations, polychoric dimensionality diagnostics, a common-method-bias check, and between-session comparisons. Acceptance was favorable across all six constructs with large effect sizes, with PE emerging as the strongest construct and HM as the weakest. Dimensionality diagnostics further revealed that canonical TAM/UTAUT sub-facets collapsed into a single general acceptance factor in this short-form post-workshop context, a finding with important methodological and theoretical implications. Qualitative themes converged with the quantitative profile regarding usefulness and enthusiasm but diverged on output quality, revealing a small yet articulate reliability-skeptical minority. The findings support the curricular adoption of AI automation tooling in undergraduate computing education and identify three theory-grounded instructional levers: instruction-sequencing scaffolds, self-efficacy supports, and trust-calibration interventions.

21.
arXiv (CS.AI) 2026-06-19

FlowEdit: Associative Memory for Lifelong Pronunciation Adaptation in Flow-Matching TTS

arXiv:2606.20518v1 Announce Type: new Abstract: Flow-matching text-to-speech systems achieve remarkable zero-shot quality but remain static after deployment: pronunciation errors on out-of-vocabulary proper nouns persist unless the model is retrained. We introduce FlowEdit, a life-long adaptation framework for frozen flow-matching TTS that learns pronunciation corrections as latent conditioning edits rather than weight updates. When corrective feedback is provided, FlowEdit optimizes a token-level perturbation in the text embedding space, then stores the correction in a Modern Hopfield Network serving as content-addressable episodic memory. At inference, corrections are retrieved via soft attention with a similarity gate, enabling fuzzy morphological matching. On our curated benchmark of 312 multilingual proper nouns across 18 language families, FlowEdit reduces target-word Phoneme Error Rate by 92.7% relative to the zero-shot baseline while maintaining identical general-speech quality. Corrections complete in approximately 15 seconds on a single GPU.

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

Few shot chain-of-thought driven reasoning to prompt LLMs for open ended medical question answering

In this paper, we propose a modified version of the MedQA-USMLE dataset, named MEDQA-OPEN, which contains open-ended medical questions without options to mimic clinical scenarios, along with clinician-approved reasoned answers. Additionally, we implement a prompt driven by Chain of Thought (CoT) reasoning, CLINICR, to mirror the prospective process of incremental reasoning, reaching a correct response to medical questions. We empirically demonstrate how CLINICR outperforms the state-of-the-art 5-shot CoT-based prompt (Liévin et al., 2022). We also present an approach that mirrors real-life clinical practice by first exploring multiple differential diagnoses through MCQ-CLINICR and subsequently narrowing down to a final diagnosis using MCQ-ELIMINATIVE. Finally, emphasizing the importance of response verification in medical settings, we utilize a reward model mechanism, replacing the elimination process performed by MCQ-ELIMINATIVE.

23.
PLOS Medicine 2026-06-23

Parental body mass index and offspring childhood body size and eating behaviour: A structural equation modelling analysis in the Norwegian Mother, Father and Child Cohort Study

作者:

by Tom A. Bond, Tom A. McAdams, Nicole M. Warrington, Laurie J. Hannigan, Espen Moen Eilertsen, Ziada Ayorech, Fartein A. Torvik, George Davey Smith, Deborah A. Lawlor, Eivind Ystrom, Alexandra Havdahl, David M. Evans Background The intergenerational transmission of obesity-related traits could propagate an accelerating cycle of obesity, if parental adiposity causally influences offspring adiposity. The extent to which intergenerational obesity associations are due to such causal effects, as opposed to genetic confounding (inheritance), is unclear. We aimed to establish whether associations between parental peri-pregnancy body mass index (BMI) and offspring birth weight (BW), BMI until 8 years of age, and 8-year-old eating behaviour are due to genetic confounding. Methods and findings Data were from the Norwegian Mother, Father and Child Cohort Study, a prospective population-based birth cohort born between 1999 and 2009 at 50 out of 52 hospital maternity units in Norway. We compared the strength of the associations of maternal pre-pregnancy BMI versus paternal BMI during pregnancy, with offspring outcomes including birth weight and BMI assessed between age 6 months and 8 years of age, and appetite-related eating behaviour traits assessed at age 8 years via the Child Eating Behaviour Questionnaire (CEBQ), adjusting for potential confounders including parity, parental/grandparental language group and parental age, smoking, education and income). We then used an extended children of twins structural equation model (SEM) to quantify the extent to which associations were due to genetic confounding. Up to 85,866 children (51.3% male) were included in linear regression models, whereas SEM models included up to 50,999 children. Maternal BMI was more strongly associated than paternal BMI with offspring BW, but the maternal-paternal difference decreased for offspring BMI after birth. Greater parental BMI was associated with obesity-related offspring eating behaviours. SEM results indicated that genetic confounding did not explain the association between parental BMI and offspring BW, but explained the majority of the association with offspring BMI from 6 months onwards. For 8-year BMI, genetic confounding explained 79% (95% CI [62, 95]; p = 1.9 × 10−12) of the covariance with maternal BMI and 94% (95% CI [72, 113]; p = 2.7 × 10−14) of the covariance with paternal BMI. Limitations of this study include selective recruitment and attrition, potential bias due to parental assortative mating, and that findings may not generalise beyond high-income country settings with high obesity prevalence. Conclusions We found strong evidence that parent–child BMI associations may primarily be due to genetic confounding. When considered alongside prior evidence, this finding may argue against a strong causal effect of maternal or paternal adiposity on childhood adiposity via intrauterine or periconceptional mechanisms.

24.
medRxiv (Medicine) 2026-06-19

Extraction of Glaucoma Diagnosis, Type, and Severity from Clinical Notes using Secure Cloud-based Large Language Models

Purpose: To evaluate the performance of secure cloud-based large language models (LLMs) in extracting glaucoma diagnosis, type, and severity from free-text clinical notes in the electronic health record (EHR). Design: Retrospective chart review analysis. Participants: 1,250 subjects from the Bascom Palmer Ophthalmic Repository. Methods: Clinical notes of glaucoma-related encounters between 2014 and 2024 were extracted from the Bascom Palmer Ophthalmic Repository. Two fellowship-trained glaucoma specialists annotated clinical notes for glaucoma presence, type, and severity at the eye level. The dataset was split into development (10%), validation (10%), and test (80%) sets. Development and validation sets were used for prompt engineering and refinement, and the held-out test set was used for evaluation. Five LLMs (Claude Opus 4.6, DeepSeek-V3.2, GPT-5.2, Grok 4.1, and Qwen3.6-35B-A3B) were accessed via Azure AI Foundry within HIPAA-compliant containers. Model performance was assessed using standard metrics. Clinician-entered ICD-10 codes were also compared with adjudicated labels. Main Outcome Measures: Gwet AC1, accuracy, sensitivity, specificity, and F1-score. Results: Inter-grader agreement was high for glaucoma detection (Gwet AC1= 0.930 (95% CI: 0.917-0.945), type classification (Gwet AC1= 0.917 (95% CI: 0.904-0.930), and severity staging (Gwet AC1= 0.901 (95% CI: 0.884-0.916). For glaucoma diagnosis, LLMs demonstrated high overall accuracy, with Claude achieving 97.5%, DeepSeek 96.0%, GPT 96.2%, Grok 94.4%, and Qwen 95.5%. F1 scores for glaucoma detection ranged from 95.4% to 98.9% across models. For glaucoma type classification, accuracies were 97.1%, 94.2%, 94.2%, 94.0%, and 94.4% for Claude, DeepSeek, GPT, Grok, and Qwen, respectively. F1 scores for the most prevalent type (POAG) ranged from 96.3% to 98.9%. For severity staging, accuracies were 95.0%, 94.8%, 94.5%, 94.0%, and 95.2%, respectively, with F1 scores ranging from 89.7% to 96.3% across severity categories and models. ICD-10 codes demonstrated substantially lower performance for type and severity staging, with overall accuracies of 89.2% and 58.5%, respectively. Conclusions: Secure cloud-based LLMs accurately extracted glaucoma diagnosis, type, and severity information from free-text ophthalmology notes, achieving performance approaching expert clinician adjudication while substantially outperforming ICD-based phenotyping approaches, particularly for disease severity classification. These findings demonstrate the potential of LLMs to transform unstructured clinical documentation into scalable, research-ready phenotypic data for large-scale glaucoma cohort development and EHR-based ophthalmic research.

25.
arXiv (CS.CV) 2026-06-11

Brain-IT-VQA: From Brain Signals to Answers

Decoding visual content from fMRI signals recorded while a person views images, and specifically answering questions about the seen images, is a long-standing challenge. While significant progress has been made in recent years in visual question answering (VQA) from fMRI, performance remains limited. Moreover, although recent models can make increasingly accurate predictions, they have rarely been used as tools for understanding the structure of visual representations in the brain. We present Brain-IT-VQA, a framework for visual question answering from fMRI. Building on the Brain Interaction Transformer (Brain-IT), our method decodes language tokens from brain activity and integrates them with a language model to answer visual questions. Our model substantially outperforms previous fMRI-based captioning and VQA approaches. We further introduce NSD-VQA, a new dataset and benchmark for visual question answering from fMRI. Unlike existing image-fMRI VQA datasets, which typically provide only a few broad and weakly controlled questions per image, NSD-VQA provides on average 20 question-answer pairs per image across 20 controlled question categories that disentangle multiple levels of visual understanding. This enables more reliable and interpretable evaluation despite limited fMRI test data. Together, Brain-IT-VQA and NSD-VQA provide both a strong predictive framework and a tool for studying brain representations. Using this benchmark, we quantify which forms of visual and semantic information can be reliably decoded from fMRI responses to natural images. We further analyze the contributions of different brain regions across question types.