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01.
medRxiv (Medicine) 2026-06-10

Documented clinical genetic testing among carriers of hereditary breast and ovarian cancer variants: Ancestry and socioeconomic disparities in the All of Us research program

Importance: Hereditary breast and ovarian cancer (HBOC) variant carriers benefit from risk-reducing interventions, but only if identified. The extent to which carriers are clinically recognized, and whether recognition is equitable across diverse populations, is poorly characterized in a single large U.S. cohort. Objective: To estimate P/LP HBOC carrier prevalence across genetic ancestry groups, quantify documented clinical genetic testing among carriers, and evaluate ancestry and socioeconomic disparities in testing. Design, Setting, and Participants: Cross-sectional analysis of the All of Us Research Program Controlled Tier (Curated Data Repository v8/C2024Q3R9), comprising participants with short-read whole genome sequencing and linked electronic health record (EHR) and survey data. Carriers were ascertained from research genomic data independent of clinical testing. Exposures: Genetically inferred ancestry (African [AFR], Admixed American [AMR], East Asian [EAS], European [EUR], Middle Eastern [MID], South Asian [SAS]); self-reported household income and educational attainment. Main Outcomes and Measures: (1) Carrier prevalence with Wilson 95% CIs; (2) documented clinical genetic testing (procedure codes) among carriers; (3) adjusted odds of documented testing among women, by ancestry, before and after socioeconomic adjustment, using multivariable logistic regression. Results: Among 414,830 participants, P/LP HBOC carrier prevalence was 1.42% (95% CI, 1.38-1.45) overall and similar across ancestry groups (AFR 1.24%, AMR 1.32%, EAS 1.19%, EUR 1.52%, MID 1.68%, SAS 1.33%; overlapping CIs). Among 250,071 women in the testing analysis, documented clinical genetic testing was rare: only 74 of 5,878 carriers overall (1.3%) and 59 of 3,572 European-ancestry carriers (1.7%) had a documented test, with counts below reportable thresholds in all other ancestry groups. African-ancestry women had lower adjusted odds of documented testing than European-ancestry women (Model 1 adjusted odds ratio [aOR], 0.32; 95% CI, 0.27-0.39), an association that attenuated but persisted after adjustment for income and education (Model 2 aOR, 0.48; 95% CI, 0.40-0.58; P < 0.001); Admixed American women also had reduced adjusted odds (aOR, 0.71; 95% CI, 0.61-0.84). Lower income and lower education were independently and dose-dependently associated with lower testing odds (income

02.
arXiv (CS.CL) 2026-06-12

WildIFEval: Instruction Following in the Wild

Recent LLMs have shown remarkable success in following user instructions, yet handling instructions with multiple constraints remains a significant challenge. In this work, we introduce WildIFEval - a large-scale dataset of 7K real user instructions with diverse, multi-constraint conditions. Unlike prior datasets, our collection spans a broad lexical and topical spectrum of constraints, extracted from natural user instructions. We categorize these constraints into eight high-level classes to capture their distribution and dynamics in real-world scenarios. Leveraging WildIFEval, we conduct extensive experiments to benchmark the instruction-following capabilities of leading LLMs. WildIFEval clearly differentiates between small and large models, and demonstrates that all models have a large room for improvement on such tasks. We analyze the effects of the number and type of constraints on performance, revealing interesting patterns of model constraint-following behavior. We release our dataset to promote further research on instruction-following under complex, realistic conditions.

03.
arXiv (CS.AI) 2026-06-16

AgenticRec: A Recommendation-Oriented Agentic Framework with Progressive Tool-Integrated Reasoning Optimization

arXiv:2603.21613v2 Announce Type: replace-cross Abstract: Recommender agents built on Large Language Models offer a promising paradigm for personalized recommendation. However, existing agents typically suffer from a misalignment between their tool-integrated reasoning trajectories and recommendation feedback, limiting their ability to distinguish fine-grained user preferences. To address these challenges, we propose AgenticRec, an agentic recommendation framework that formulates recommendation as a tool-integrated reasoning process over a recommendation-oriented tool suite. Built upon this framework, we further develop a dedicated two-stage training paradigm tailored for recommender agents. In the first stage, we introduce Recommendation-Oriented Trajectory Activation, optimize the agentic recommendation ability under implicit feedback. In the second stage, Progressive Preference Refinement further refines the agent through bidirectional preference reasoning over self-bootstrapped hard pairs, progressively sharpening preference boundaries. Theoretical analysis and extensive experiments demonstrate the effectiveness of AgenticRec. Our code is available at https://anonymous.4open.science/r/AgenticRec-FB16.

04.
medRxiv (Medicine) 2026-06-22

A Drug-Specific, Half-Life-Adjusted Framework for Classifying CNS-Active Systemic Therapy Exposure During and After Radiotherapy

Clinical oncology datasets often store systemic therapy as a regimen label with a start date and an end date. Those records are clinically recognizable but can be analytically incomplete when the research question concerns whether a patient was exposed to a concurrent CNS-active drug (cCNS-aD) or an adjuvant CNS-active drug (aCNS-aD) around radiotherapy. Contemporary CNS-oncology studies usually define CNS activity by empiric drug lists and define concurrency by fixed calendar windows, although the literature shows substantial heterogeneity across both concepts. This paper proposes a generalizable framework for converting raw systemic therapy records into reproducible cCNS-aD and aCNS-aD variables, useful in subgrouping for clinical studies. The framework uses a transparent CNS scoring model based on three clinical evidence components: intracranial objective response rate, consensus CNS endorsement, and intrathecal route of administration. It then defines a pharmacokinetic exposure proxy as the recorded end date plus five half-lives. Concurrent exposure is classified by overlap with the radiotherapy interval, while post-radiotherapy exposure is classified by overlap with a prespecified post-RT attribution window. The framework separately identifies post-RT pharmacokinetic persistence and post-RT treatment initiation, allowing investigators to distinguish continued exposure from true adjuvant initiation. This is a methodological framework and reference implementation. Implementation audits and endpoint-specific sensitivity analyses remain necessary before use as a definitive exposure classifier

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

Revisiting Outage for Edge Inference Systems

arXiv:2504.03686v3 Announce Type: replace-cross Abstract: One of the key missions of sixth-generation (6G) mobile networks is to deploy large-scale artificial intelligence (AI) models at the network edge to provide remote-inference services for edge devices. The resultant platform, known as edge inference, will support a wide range of Internet-of-Things applications, such as autonomous driving, industrial automation, and augmented reality. Given the mission-critical and time-sensitive nature of these tasks, it is essential to design edge inference systems that are both reliable and capable of meeting stringent end-to-end (E2E) latency constraints. Existing studies, which primarily focus on communication reliability as characterized by channel outage probability, may fail to guarantee E2E performance, specifically in terms of E2E inference accuracy and latency. To address this limitation, we propose a theoretical framework that introduces and mathematically characterizes the inference outage (InfOut) probability, which quantifies the likelihood that the E2E inference accuracy falls below a target threshold. Under an E2E latency constraint, this framework establishes a fundamental tradeoff between communication overhead (i.e., uploading more sensor observations) and inference reliability as quantified by the InfOut probability. To find a tractable way to optimize this tradeoff, we derive accurate surrogate functions for InfOut probability by applying a Gaussian approximation to the distribution of the received discriminant gain. Experimental results demonstrate the superiority of the proposed design over conventional communication-centric approaches in terms of E2E inference reliability.

06.
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).

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

Unsupervised Diffusion Solver for Combinatorial Optimization via Combinatorial Adjoint Matching

arXiv:2605.30920v2 Announce Type: replace Abstract: Diffusion-based neural solvers have shown strong promise for combinatorial optimization (CO), but existing methods typically rely on supervised training with large collections of near-optimal solutions. In this work, we extend adjoint-based trajectory optimization methods to discrete combinatorial domains. We formulate diffusion-based CO as a stochastic control problem over Continuous-Time Markov Chains and introduce discrete adjoint dynamics for propagating optimization signals through discrete generative trajectories. Building on this formulation, we propose Combinatorial Adjoint Matching (CAM), an unsupervised training framework for discrete diffusion solvers with structured and low-variance trajectory-level optimization signals. Empirically, CAM consistently outperforms existing unsupervised diffusion baselines and achieves performance competitive with strong supervised diffusion solvers and even traditional solvers across diverse combinatorial optimization problems. Our code is available at https://github.com/Shengyu-Feng/CAM.

08.
arXiv (CS.AI) 2026-06-11

Automated Mediator for Human Negotiation: Pre-Mediation via a Structured LLM Pipeline

arXiv:2606.11379v1 Announce Type: new Abstract: Pre-mediation, the preparatory phase preceding direct human negotiation, plays a critical role in achieving mutually beneficial agreements, yet is often omitted due to cost, time, and limited access to trained mediators. We introduce an automated mediator for human negotiation, implemented as a structured pipeline of LLM modules, that supports pre-mediation in integrative negotiation settings. The pipeline decomposes preparation into specialized modules for dialogue, preference prediction, response-level critique, and structured summarization, separating inference, generation, and evaluation to address limitations of monolithic single-prompt approaches. We use the term "agent" for each module following common LLM-systems terminology, but the components are not autonomous and do not interact peer-to-peer; outputs are passed forward in a fixed sequence. We evaluate the system in two controlled human-subject experiments comparing AI-based pre-mediation with professional human mediators in a multi-issue negotiation scenario. On short-term self-reported measures, the automated mediator achieves preparation outcomes broadly comparable to human mediators, including trust in the mediator and confidence in reaching mutually beneficial agreements, while achieving substantially lower error on the preference-inference task under our scenario and prompts (36% lower RMSE). A second study shows that targeted prompt refinements reduce excessive affirmation patterns from 36.6% to 16.8%, matching human mediator baselines. Our findings suggest that structured LLM pipelines can provide scalable, low-effort pre-mediation support broadly comparable to human mediators on short-term self-reported preparation outcomes. The pipeline's single-party design mirrors how human mediators run pre-mediation today and enables parallel deployment across all parties to a dispute, supporting scalability.

09.
arXiv (CS.CL) 2026-06-16

DYNA : Dynamic Episodic Memory Networks for Augmenting Large Language Models with Temporal Knowledge Graphs in Continuous Learning

Large Language Models (LLMs) struggle to incorporate new knowledge without forgetting or costly retraining. We propose DYNA, a lightweight framework that augments a frozen LLM with a temporal knowledge graph where events are nodes and temporal relations are directed, timestamped edges. The graph serves as an external, updatable memory. At query time, DYNA retrieves relevant nodes via random walks and centrality measures, then augments the LLM's response. Evaluated on three temporal recall tasks, DYNA reduces catastrophic forgetting by ~7% compared to fine-tuning and improves temporal ordering by ~5% over standard RAG. Higher graph clustering coefficients correlate with better retrieval, showing that graph structure matters. Contributions: (1) episodic memory as temporal KG, (2) retraining-free LLM augmentation, (3) graph properties as predictors of retrieval performance.

10.
arXiv (CS.LG) 2026-06-17

The Implicit Bias of Steepest Descent with Mini-batch Stochastic Gradient

arXiv:2602.11557v2 Announce Type: replace Abstract: A variety of widely used optimization methods like SignSGD and Muon can be interpreted as instances of steepest descent under different norm-induced geometries. In this work, we study the implicit bias of mini-batch stochastic steepest descent in multi-class classification, characterizing how batch size, momentum, and variance reduction shape the limiting max-margin behavior and convergence rates under general entry-wise and Schatten-$p$ norms. We show that, without momentum, worst-case convergence and successful classification can only be guaranteed with full-batch gradient. In contrast, momentum enables small-batch convergence to an approximate max-margin solution through a batch-momentum trade-off, though it slows convergence. This approach provides fully explicit, dimension-free rates that improve upon prior results. Moreover, we prove that variance reduction can recover the exact full-batch implicit bias for any batch size, albeit at a slower convergence rate. Finally, we further investigate the batch-size-one steepest descent without momentum, and reveal its convergence to a fundamentally different bias via a concrete data example, which reveals a key limitation of purely stochastic updates. Overall, our unified analysis clarifies when stochastic optimization aligns with full-batch behavior, and paves the way for perform deeper explorations of the training behavior of stochastic gradient steepest descent algorithms.

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

The Language You Ask In: Language-Conditioned Ideological Divergence in LLM Analysis of Contested Political Documents

Authors:

Large language models (LLMs) are increasingly deployed as analytical tools across multilingual contexts, yet their outputs may carry systematic biases conditioned by the language of the prompt. This study presents an experimental comparison of LLM-generated political analyses of a Ukrainian civil society document, using semantically equivalent prompts in Russian and Ukrainian administered to two frontier models from different developers, ChatGPT 5.2 and Claude Opus 4.5. Despite identical source material and parallel query structures, both models diverged along the same axis: Russian-language outputs leaned toward delegitimizing framings, characterizing civil society actors as externally funded elites constraining a democratic mandate, while Ukrainian-language outputs treated the same actors as legitimate stakeholders in democratic contestation. The magnitude of this divergence, however, was model-dependent. ChatGPT's Russian output reproduced vocabulary characteristic of Russian state discourse; Claude Opus's stayed in a mainstream critical idiom and hedged its judgments in both languages. These findings demonstrate that prompt language alone can systematically shift the ideological orientation of an unchanged model analyzing identical content. The shift is a general property of multilingual LLMs whose severity, and whose alignment with propaganda narratives, varies across systems. The implications reach AI deployment in polarized information environments, cross-lingual research, and AI governance in multilingual societies.

12.
arXiv (CS.CL) 2026-06-17

Scaling Enterprise Agent Routing: Degradation, Diagnosis, and Recovery

Production LLM assistants route user requests to growing libraries of specialized tools, but how does routing accuracy degrade as the catalog scales? We study single-step routing on a 110-agent, 584-tool catalog from a deployed enterprise productivity assistant, evaluating three frontier models from 10 to 110 agents. Routing F1 on under-specified requests drops 16–23 percentage points across models. An oracle analysis decomposes the degradation into a retrieval gap (the model cannot surface the right tool) and a confusion gap (even with perfect retrieval, the oracle ceiling drops 10pp). Embedding-based shortlisting recovers +10–11pp F1 at full scale across all three models and two providers. A production annotation study (1,435 human-labeled utterances, three annotators) confirms the recovery on real traffic at +10–17pp despite 10–15pp lower absolute performance.

13.
arXiv (CS.CV) 2026-06-15

Stream3D: Sequential Multi-View 3D Generation via Evidential Memory

View-conditioned 3D generators such as SAM 3D, TRELLIS, and Hunyuan3D produce high-quality object reconstructions from a single view, but real-world visual observation often arrives as long monocular streams. Naively applying these generators to each streaming frame independently leads to severe temporal inconsistency in the generated results. To address this problem, we propose Stream3D, the first training-free streaming mechanism that turns a frozen view-conditioned 3D generator into a streaming generator with constant cross-chunk memory. Stream3D achieves this by maintaining a compact evidential memory, which selectively caches the most informative historical frames based on a proposed evidence score mechanism. As the stream progresses, the memory dynamically updates to retain a fixed number of informative frames, preventing the memory footprint from growing linearly with sequence length. This also prevents degradation over long sequences and keeps the underlying generator completely unchanged without retraining, architectural modifications, or auxiliary losses. Evaluated on both realistic and synthetic streaming benchmarks, Stream3D outperforms latent-transport baselines, including KV-cache reuse and flow-based feature editing, across both photometric and geometric metrics. More details can be found at: https://stream-3d.github.io/stream3d.github.io/.

14.
arXiv (CS.LG) 2026-06-12

Accelerating Speculative Diffusions via Block Verification

arXiv:2606.13426v1 Announce Type: new Abstract: Speculative decoding speeds up LLM inference by using a draft model to generate tokens, with an acceptance-rejection scheme that ensures that the output matches the target distribution. Adapting this to continuous diffusions is difficult because speculative sampling requires drawing from a residual distribution. While straightforward in discrete spaces, efficiently sampling this residual in continuous space is non-trivial. Consequently, existing diffusion adaptations either use computationally inefficient sampling techniques or rely on an alternative scheme. In this work, we introduce a novel scheme that efficiently implements the original speculative sampling mechanism for diffusion models. Our approach offers a critical advantage over current methods: it enables us to adapt block verification from LLMs to diffusions – which provably improves the acceptance rate of drafts. Furthermore, we formalize and analyze the Free Drafter, a heuristic self-speculative drafter for diffusions that requires no training. By enabling block verification, our Free Drafter yields up to a 6.3% speedup over existing speculative methods with no additional training and negligible overhead beyond the existing parallel verification pass.

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

Entropy Estimation in Multi-Qutrit Systems via Variational and Classical Neural Networks

arXiv:2606.20504v1 Announce Type: cross Abstract: We present a systematic study of von Neumann entropy estimation in multi-qutrit quantum systems using two complementary approaches: variational quantum algorithms (VQAs) and classical convolutional neural networks (CNNs), evaluated using an ideal (noise-free) quantum simulator. For systems up to three qutrits, we construct and evaluate 11 hardware-efficient SU(3)-inspired ansatzes. A parameter sweep shows that estimation accuracy is primarily determined by the number of trainable parameters, provided sufficient entanglement is present. Based on this study, we fix the parameter count to approximately 120 for subsequent experiments, observing that increasing entangling-gate counts beyond a threshold yields only marginal improvements. For larger systems (two to five qutrits), we use a CNN trained on measurement outcomes from tensor-product mutually unbiased bases. The model achieves accurate and stable predictions and exhibits a systematic improvement in performance with system size, with the highest errors for two-qutrit systems and the lowest for five-qutrit systems. Notably, using only 12.5% of the measurements required for full state tomography is sufficient to reach 90th-percentile absolute errors of approximately 0.13-0.16 nats for both four- and five-qutrit systems. The CNN model is also robust to shot noise and generalizes well to out-of-distribution states. Overall, within the simulated settings studied here, our results indicate a transition in practical methods: VQAs are effective for small systems, while CNN-based estimators offer improved scalability and robustness for larger qutrit systems.

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

AgentFinVQA: A Deployable Multi-Agent Pipeline for Auditable Financial Chart QA

Financial chart question answering in regulated settings demands more than accuracy: practitioners must know which answers to trust before acting on them, and many institutions cannot send client data to external model providers. Yet existing chart-QA agents are accuracy-focused and opaque, and most assume proprietary API access; to our knowledge, none combines auditability with on-premise deployability without significant accuracy compromise. We present AgentFinVQA, a multi-agent pipeline that decomposes each query into planning, OCR, legend grounding, visual inspection, and verification, recording every step in a traceable Model Evaluation Packet (MEP) per sample. On FinMME, AgentFinVQA improves $+7.68$ pp over a primary-backbone matched zero-shot baseline with a proprietary backbone (Gemini-3 Flash; 71.24% vs. 63.56%, McNemar $p \approx 1.1 \times 10^{-16}$), and $+4.84$ pp with open-weights Qwen3.6-27B-FP8 served locally. The verifier's verdict also serves as a useful confidence signal (68.2% vs. 55.6% exact accuracy on confirmed vs. revised answers), enabling human-in-the-loop review routing. Error analysis shows that question misunderstanding, legend confusion and extraction error account for nearly two-thirds of failures and are the categories least detected by the verifier, identifying clear directions for future work. Together these results show that auditable, on-premise financial chart QA is practical and that the open-weights system keeps most of the accuracy gains while enabling full data residency. We release our code to support reproducible evaluation.

17.
arXiv (quant-ph) 2026-06-16

Hardy-type self-testing and exposedness of tripartite GHZ correlations

arXiv:2512.16242v2 Announce Type: replace Abstract: Nonlocality can be witnessed either through Bell-inequality violations or through logical contradictions such as Hardy's paradox. In the bipartite two input two outcome scenario, these two routes have distinct geometric behavior: CHSH-maximal correlations are exposed points of the quantum set, whereas known Hardy-type self-testing correlations on the no-signaling boundary are non-exposed. Here we show that this bipartite intuition fails in the tripartite two input two outcome scenario. We study the tripartite instance of a multipartite Hardy-type paradox and prove that the correlation attaining the maximal Hardy success probability self-tests the Greenberger–Horne–Zeilinger state and the associated measurements. Although this correlation lies on the no-signaling boundary, we show that it is an extremal and exposed point of the quantum correlation set. Moreover, it coincides with the correlation attaining the maximal violation of the Mermin inequality. Thus, in the tripartite GHZ scenario, the logical-paradox and Bell-inequality routes to nonlocality select the same exposed quantum boundary point. We also establish a robust version of the self-test, showing that small deviations from the ideal Hardy constraints imply quantitative closeness to the target state and measurements. Our results reveal a qualitative geometric difference between bipartite and tripartite Hardy-type nonlocality and suggest a broader investigation of exposedness for multipartite Hardy correlations in the multiparty setting.

18.
arXiv (CS.AI) 2026-06-15

DiffusionBlocks: Block-wise Neural Network Training via Diffusion Interpretation

arXiv:2506.14202v4 Announce Type: replace-cross Abstract: End-to-end backpropagation requires storing activations throughout all layers, creating memory bottlenecks that limit model scalability. Existing block-wise training methods offer means to alleviate this problem, but they rely on ad-hoc local objectives and remain largely unexplored beyond classification tasks. We propose $DiffusionBlocks$, a principled framework for transforming transformer-based networks into genuinely independent trainable blocks that maintain competitive performance with end-to-end training. Our key insight leverages the fact that residual connections naturally correspond to updates in a dynamical system. With minimal modifications to this system, we can convert the updates to those of a denoising process, where each block can be learned independently by leveraging the score matching objective. This independence enables training with gradients for only one block at a time, thereby reducing memory requirements in proportion to the number of blocks. Our experiments on a range of transformer architectures (vision, diffusion, autoregressive, recurrent-depth, and masked diffusion) demonstrate that DiffusionBlocks training matches the performance of end-to-end training while enabling scalable block-wise training on practical tasks beyond small-scale classification. DiffusionBlocks provides a theoretically grounded approach that successfully scales to modern generative tasks across diverse architectures. Code is available at https://github.com/SakanaAI/DiffusionBlocks .

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

Disentangling Linguistic Relatedness from Task Alignment in Cross-Lingual Transfer

We study cross-lingual transfer by fine-tuning seven large language models (4B–671B parameters) on Arabic and evaluating zero-shot reading comprehension on Semitic languages and non-Semitic controls. Across dense and Mixture-of-Experts architectures, we find no evidence of Semitic-specific transfer: models with weak baselines improve dramatically across all languages, while strong-baseline models show only marginal gains regardless of language family. A chain-of-thought ablation reinforces this finding – the same models that benefit most from fine-tuning benefit equally from inference-time reasoning, suggesting both mechanisms address task-format alignment rather than cross-lingual knowledge transfer.

20.
PLOS Medicine 2026-06-18

Association between initial benzodiazepine prescribing patterns and time to benzodiazepine discontinuation: A population-based retrospective cohort study

by Nikki Bozinoff, Tanya S. Hauck, Robert A. Kleinman, Matthew E. Sloan, Beth A. Sproule, Simone N. Vigod, Jennifer Wyman, Priscila Pequeno, Tara Gomes Background Long-term benzodiazepine use has been associated with increased risk of morbidity and mortality. Preventing long-term use through safer prescribing practices has received little attention to date. We sought to better understand associations between initial prescription characteristics and duration of benzodiazepine use. Methods and findings This was a retrospective population-based cohort study of 1,820,808 adults in Ontario with incident benzodiazepine prescriptions between January 1, 2013 and December 31, 2020, with follow-up to December 31, 2021. The primary exposure was duration of the index prescription (≤7 days—referent group, 8–14 days, 15–30 days, or >30 days). Secondary exposures were: (a) duration of action of index benzodiazepine(s) prescription (short-acting, long-acting or both); (b) number of benzodiazepine dispensed on index (1 or 2+); and (c) mean daily dose of the index prescription in Diazepam Milligram Equivalents (DMEs). The primary outcome was time to benzodiazepine discontinuation in days. Multivariable models were adjusted for age, sex, anxiety, insomnia, and substance use disorders as well as other important comorbidities and socio-demographic characteristics. The median age at index was 53 years (Interquartile Range (IQR) 38–67), and 62.6% were women. The median time to discontinuation in women was 16 days (IQR: 6–29) while the median time to discontinuation in men was 19 days (IQR: 6–29). Lorazepam was the most commonly prescribed benzodiazepine on index (63.9%), followed by clonazepam (17.3%) and diazepam (5.8%). In multivariable Cox Proportional Hazards Models, longer index prescriptions were associated with a lower likelihood of benzodiazepine discontinuation (adjusted Hazard Ratio (aHR) 0.54 (95% Confidence Interval (CI) [0.54,0.54]) for 8–14 days; aHR 0.26 (95% CI [0.25,0.26] for 15–30 days and aHR 0.14 (95% CI [0.14,0.14]) for >30 days, compared to ≤7 days, respectively). Being prescribed two or more benzodiazepines versus 1 was also associated with a reduced likelihood of discontinuation (aHR 0.59 (95% CI [0.57,0.61])), as was being prescribed long-acting benzodiazepines (aHR 0.80 (95% CI [0.80,0.80])) or a combination of short and long acting benzodiazepine (aHR 0.84 (95% CI [0.80,0.88])) versus short-acting benzodiazepines alone. Mean daily doses of >5 to ≤10 DME and >10 to ≤20 DME were associated with an increased likelihood of discontinuation (aHR 1.03 (95% CI [1.03,1.03]); aHR: 1.03 (95% CI [1.03,1.04])), whereas doses >20 DME were associated with a reduced likelihood of discontinuation (aHR 0.98 (95% CI [0.97,0.98])) compared with ≤5 DME. Findings may be subject to bias from unmeasured confounding. Conclusion This large population-based cohort study found that prescribing shorter courses of benzodiazepines, use of a single benzodiazepine, use of a short-acting agent, were associated with reduced likelihood of long-term benzodiazepine use. Findings suggest that simple changes to prescribing practices could reduce prolonged benzodiazepine use and the morbidity and mortality associated with long-term use of these medications.

22.
arXiv (CS.AI) 2026-06-17

LLM-as-Judge in Education: A Curriculum-Grounded Marking Pipeline

arXiv:2606.17507v1 Announce Type: new Abstract: Generative AI and large language models (LLMs) are increasingly applied to question generation and automated assessment. However, deploying LLMs in preparation for high-stakes exams requires more than prompt engineering; it demands software pipelines that systematically ground model outputs in authorised curriculum artefacts and marking guidelines issued by education authorities. This paper presents a curriculum-grounded, configurable LLM-as-Judge pipeline for question-level marking, co-developed with an industrial partner, to support exam preparation for university admission. The pipeline identifies the relevant topics, subtopics, and cognitive demand of a question, and assembles verifiable and authorised context to support LLM judgement. Curriculum intent is operationalised through concrete syllabus artefacts, including prescribed verbs and outcomes, performance band descriptors, glossary definitions, and marking-guideline principles. A staged LLM workflow is employed to first generate question-specific rubrics, capturing structured expectations of performance, and then derive and evaluate marking criteria used to allocate marks to student responses. This design improves consistency, transparency, and alignment with official marking practices. Preliminary evaluation shows that the proposed LLM-as-Judge pipeline delivers marking outcomes comparable to human tutors, while yielding justifications that are more traceable to authorised curriculum artefacts and marking standards. The pipeline has also been integrated into an online study platform, where early deployment data provide initial insights into operational usage and manual overrides.

23.
arXiv (CS.AI) 2026-06-15

When and How Severely: Scenario-Specific Safety Envelopes for Driving VLAs

arXiv:2606.14238v1 Announce Type: cross Abstract: Safety certification of Vision-Language-Action (VLA) driving planners under ISO 21448 (SOTIF) rests on an Operational Design Domain (ODD) specification that answers two complementary questions: when does the planner start to fail, and how severely does it fail once it does? We evaluate Alpamayo R1, a 10B-parameter open-weight driving VLA, on 15,968 (clip, attack) pairs. We find a conservative-aggregate gap: an aggregate safe threshold of $\sigma \leq 50$ under a 15% average displacement error (ADE) budget masks well-sampled scenarios that tolerate the top of the tested grid ($\sigma = 70$). A Gaussian Mixture Model (GMM) on the changed-explanation subset identifies six discrete severity bands (BIC-optimal $k{=}6$), so two perturbation conditions with the same mean error can differ materially in their share of high-severity (C4/C5) failures. Joining the two analyses on the same corpus surfaces a finding neither yields in isolation: the scenarios with the loosest noise thresholds are not those with the lowest high-severity rate: STOP_SIGNAL concentrates roughly $4\times$ the C4/C5 share of LANE_KEEPING despite tolerating a larger $\sigma$. A deployable SOTIF ODD specification for driving VLAs therefore requires a two-dimensional safety envelope, not a single aggregate value per hazard.

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

VDE Bench: Evaluating The Capability of Image Editing Models to Modify Visual Documents

In recent years, image editing models have made significant progress, enabling users to manipulate visual content in a flexible and interactive manner through natural language instructions. However, an important yet underexplored research direction remains dense visual document image editing, which involves modifying textual content within images while faithfully preserving the original text style and background context. Existing methods primarily focus on English scenarios and images with relatively sparse text, and thus cannot adequately address dense, structurally complex documents or non-Latin scripts such as Chinese. To bridge this gap, we propose VDE Bench (Visual Doc Edit Bench), a rigorously human annotated and evaluated benchmark specifically designed to assess the performance of image editing models on bilingual Chinese-English and complex visual document editing tasks. The benchmark comprises a high quality dataset of 942 instruction based image editing samples, whose seed images encompass dense Chinese and English text documents including academic papers, posters, presentation slides, examination materials, and newspapers. Furthermore, we introduce a novel evaluation framework that systematically quantifies editing performance at the OCR parsing level, thereby enabling fine grained assessment of text modification accuracy. Based on this benchmark, we conduct a comprehensive evaluation of representative image editing models. Human verification demonstrates a high degree of consistency between human judgments and automated evaluation metrics. VDE Bench constitutes the first systematic benchmark for evaluating the performance of image editing models on bilingual dense text visual documents.

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

Explainable Task-Oriented Token Communication for AI-Native 6G Networks

The integration of Foundation Models (FMs) and wireless communications is driving the evolution of image communication from bit-accurate transmission toward task-oriented transmission. However, existing task-oriented image communication methods still face three major challenges: insufficient task-oriented Token representation, inadequate collaboration between Visual Tokens and Task Tokens, and limited interpretability of task decisions. To address these challenges, we propose an Explainable Task-Oriented Token Communication (ET-TokenCom) framework. By treating Tokens as unified units for information representation and transmission, the proposed framework constructs an end-to-end communication link that spans visual perception, wireless transmission, and task reasoning. At the transmitter, the ET-TokenCom framework extracts Visual Tokens from images to preserve low-level visual information. Meanwhile, Task Tokens generated by the FM are introduced to represent the target information and decision intent required by the current task. A Cross-Modal Attention (CMA) fusion mechanism is further designed, enabling Task Tokens to explicitly guide the selection, weighting, and transmission of Visual Tokens. At the receiver, the framework integrates Token decoding with an explainable output mechanism, where attention heatmaps are generated to highlight critical perceptual regions under different task objectives and reveal the influence of Task Tokens on the outputs. Finally, simulation results validate the effectiveness and robustness of the proposed ET-TokenCom framework.