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

CountZES: Counting via Zero-Shot Exemplar Selection

Object counting in complex scenes is particularly challenging in the zero-shot (ZS) setting, where instances of unseen categories are counted using only a class name. Existing ZS counting methods that infer exemplars from text often rely on off-the-shelf open-vocabulary detectors (OVDs), which in dense scenes suffer from semantic noise, appearance variability, and multi-instance proposals. Alternatively, random image-patch sampling is employed, which fails to accurately delineate object instances. Since counting is sensitive to exemplar quality, such selection strategies often yield poorly representative exemplars, leading to inaccurate count estimation. To address these issues, we propose CountZES, an inference-only approach for object counting via ZS exemplar selection. CountZES discovers diverse exemplars through three synergistic stages: Detection-Anchored Exemplar (DAE), Density-Guided Exemplar (DGE), and Feature-Consensus Exemplar (FCE). DAE refines OVD detections to isolate precise single-instance exemplars. DGE introduces a density-driven, self-supervised paradigm to identify statistically consistent and semantically compact exemplars, while FCE reinforces visual coherence through feature-space clustering. Together, these stages yield a complementary exemplar set that balances textual grounding, count consistency, and feature representativeness. Experiments on diverse datasets demonstrate CountZES superior performance among ZOC methods while generalizing effectively across domains.

02.
arXiv (CS.CL) 2026-06-18

Are LLMs Ready to Assist Physicians? PhysAssistBench for Interactive Doctor-Patient-EHR Assistance

The most plausible near-term role of medical LLMs is to assist rather than replace physicians, yet current evaluations often test isolated capabilities: clinical knowledge, EHR system interaction, or patient communication. Physician assistance instead requires coordinating these capabilities within the same interaction, where physicians issue underspecified requests, patients describe symptoms ambiguously, and EHR systems demand precise tool use. We introduce PhysAssistBench, a benchmark for interactive doctor-patient-EHR assistance. Built from real MIMIC-IV cases, PhysAssistBench uses a scalable pipeline to construct agentic patients: interactive, record-grounded agents that turn static EHR records into multi-turn clinical scenarios while preserving clinical factuality. PhysAssistBench provides a curated bilingual evaluation set of 1,296 manually reviewed and physician-validated turns. Experiments with leading LLMs show that current models remain unreliable in this setting, which exposes a key bottleneck for clinical LLMs: reliable assistance requires coordination across knowledge, communication, and systems, not isolated gains in any of them.

03.
arXiv (CS.AI) 2026-06-12

TerraBench: Can Agents Reason Over Heterogeneous Earth-System Data?

arXiv:2606.13148v1 Announce Type: new Abstract: Climate and environmental decision-making increasingly requires reasoning across heterogeneous inputs, including gridded physical data, satellite imagery, geospatial context, and simulator outputs. Weather and climate foundation models can forecast well, but do not reason interactively in language, while large language models (LLMs) reason in language but cannot operate directly on high-dimensional Earth-system data. As a result, real scientific workflows in Earth-science remain underserved. We introduce TerraBench, a benchmark for grounded Earth-science reasoning, built on TerraAgent, a ReAct-style executable framework that interleaves reasoning, tool calls, and observations to couple LLM planning with scientific tools for environmental retrieval, geospatial processing, simulation, and artifact-backed computation. TerraBench unifies analysis of Earth observation imagery, gridded data, GIS reasoning and simulation in a single executable interface, whereas prior benchmarks isolate these capabilities into narrow individual tasks. It is also the first in this space to pair process-level tool-use metrics with tolerance-aware numeric scoring. The benchmark comprises 403 extensive agentic tasks across three tracks (Fundamentals, Simulator-Grounded, and Document-Grounded Verification) and eight application domains with 24,500 verified execution steps. These results indicate that reliable Earth-science agents must go beyond tool access to coordinate heterogeneous workflows, parameterize tools precisely, and preserve artifact provenance.

04.
arXiv (CS.AI) 2026-06-11

Artificial Intelligence in Ship Finance: Applications, Opportunities, and a Case Study in AI-Augmented Loan Origination

arXiv:2606.11238v1 Announce Type: cross Abstract: Ship finance is a data-intensive and document-heavy segment of asset-based lending, requiring the integration of financial, technical, contractual, and regulatory information from heterogeneous and largely unstructured sources. Increasing environmental regulation and ESG reporting requirements are adding further complexity to underwriting and loan-origination processes. Recent advances in artificial intelligence (AI), particularly large language models (LLMs), create new opportunities for processing and analysing such information. This paper reviews potential applications of AI in ship finance, with a particular focus on LLM-based systems for document comprehension, information extraction, and workflow automation. We present ShipFinance.ai, a modular agentic architecture to support loan application workflows in ship finance. The proposed system combines an LLM-based extraction module, financial analysis components, external maritime data services, and a controlled document-generation module with a chatbot interface to support the preparation of standardized financing applications. The paper discusses the key challenges for using such models in production. We argue that AI-assisted systems can support maritime finance professionals in managing increasingly complex information and reporting requirements.

05.
arXiv (CS.AI) 2026-06-12

Representing Time Series as Structured Programs for LLM Reasoning

arXiv:2606.12481v1 Announce Type: cross Abstract: Large language models (LLMs) have demonstrated strong reasoning and instruction-following capabilities, making them potentially powerful tools for time-series analysis. However, time series lie outside their native textual modality, raising a fundamental question: how should time series be represented so that LLMs can reason about them effectively? Existing work typically serializes raw numerical sequences or fine-tunes pre-trained LLMs on time-series data. These approaches place the burden of extracting temporal structure directly on the LLM, creating a modality mismatch that often degrades performance on long sequences and introduces substantial computational overhead. In this work, we introduce Time-Series-to-Structured-Program representation (T2SP), a deterministic, training-free method that represents a time series as a structured symbolic program. T2SP decomposes time series into trends, periods, and salient events, expressing them in a program-friendly format aligned with the textual and code-like modalities on which LLMs are natively trained. By shifting temporal-structure extraction from the model to the representation itself, T2SP enables off-the-shelf LLMs to leverage their existing reasoning capabilities for time-series understanding. We evaluate T2SP on three reasoning tasks – editing, captioning, and question answering – where it consistently improves performance, reduces reasoning time, and lowers failure rates compared with raw-string representations. Our results demonstrate that T2SP provides an effective interface between time series and LLMs.

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

Prefill Awareness in Large Language Models

arXiv:2606.12747v1 Announce Type: new Abstract: Safety-relevant studies of language models, including alignment and jailbreaking evaluations and AI control protocols, often rely on prefilling model outputs. If AI models can recognize and act on the fact their prior assistant messages have been inserted or edited, the effectiveness and validity of these methods could be compromised. We investigate whether frontier language models can distinguish between tampered and untampered assistant-side context, a capability we call prefill awareness. To do so, we construct a binary preference benchmark across three prefill mechanisms, filtering for cases where models show consistent stances. We find that frontier models show substantial prefill awareness: Claude Opus 4.5 detects prefills opposing its preferences in 9-35% of cases with a 0% false positive rate when prompted; additionally, models often revert towards baseline behavior without explicitly reporting that the prefill was foreign. Controlled ablations later also show that detection and resistance rely on different cues, where stylistic mismatch mainly affects whether models flag a prefill as foreign, while preference mismatch mainly affects whether they revert toward their baseline answer. We also examine more realistic agentic settings such as misalignment-continuation evaluations and SWE-bench trajectories, where frontier models sometimes disavow prefilled assistant turns in ways that depend strongly on dataset, task success, and hidden formatting artifacts. Our results indicate that prefill awareness is already a substantial confound for some prefill-based methods. We recommend that model developers track this capability in frontier systems.

07.
arXiv (CS.AI) 2026-06-12

Interaction-Centered Intelligence: Toward an Interaction-Based Theory of Human-AI Co-Creation

arXiv:2606.00807v2 Announce Type: replace Abstract: Traditional artificial intelligence has largely conceptualized intelligence as isolated computation occurring within bounded agents. Across classical AI, machine learning, and many generative systems, the dominant unit of analysis remains the individual model or autonomous system evaluated through outputs, benchmarks, prediction accuracy, or optimization performance. While these approaches have produced major advances, they often under-theorize the role of interaction in the emergence of intelligence, creativity, meaning, and adaptive behavior. This paper proposes interaction as the primary unit of analysis for co-creative AI and interaction-centered intelligence more broadly. Drawing from distributed cognition, embodied cognition, enaction, participatory sense-making, human-computer interaction, and computational creativity, the paper traces a historical progression toward increasingly relational accounts of intelligence. Building upon prior work in Creative Sense-Making, quantified co-creation, and co-creative systems such as the Drawing Apprentice and AI Drawing Partner, it argues that intelligence emerges through evolving interaction dynamics among agents, environments, and socio-technical systems rather than solely through internal computation. The paper introduces Interaction-Centered Intelligence as a framework for understanding human-AI co-creation, collaborative emergence, adaptive participation, and interactional dynamics. Rather than evaluating intelligence solely through generated outputs, the framework emphasizes interaction trajectories, coordination patterns, participatory engagement, adaptive regulation, and interactional drift unfolding through time. Implications for explainable co-creative AI, hybrid intelligence, enactive AI, and future human-AI systems are discussed.

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

MentisOculi: Revealing the Limits of Reasoning with Mental Imagery

Frontier models are transitioning from multimodal large language models (MLLMs) that merely ingest visual information to unified multimodal models (UMMs) capable of native interleaved generation. This shift has sparked interest in using intermediate visualizations as a reasoning aid, akin to human mental imagery. Central to this idea is the ability to form, maintain, and manipulate visual representations in a goal-oriented manner. To evaluate and probe this capability, we develop MentisOculi, a procedural, stratified suite of multi-step reasoning problems amenable to visual solution, tuned to challenge frontier models. Evaluating visual strategies ranging from latent tokens to explicit generated imagery, we find they generally fail to improve performance. Analysis of UMMs specifically exposes a critical limitation: While they possess the textual reasoning capacity to solve a task and can sometimes generate correct visuals, they suffer from compounding generation errors and fail to leverage even ground-truth visualizations. Our findings suggest that despite their inherent appeal, visual thoughts do not yet benefit model reasoning. MentisOculi establishes the necessary foundation to analyze and close this gap across diverse model families.

09.
medRxiv (Medicine) 2026-06-10

Developmental Associations Linking Childhood Trauma and Early Cannabis Use to Adolescent DNA Methylation and Psychotic-Like Experiences

Background. Psychotic-like experiences (PLEs) index early risk for psychotic disorders and are consistently associated with childhood trauma, yet underlying biological mechanisms remain poorly understood. DNA methylation (DNAm) may capture the biological embedding of early adversity, while adolescent exposures such as cannabis use may modify these processes. We examined epigenome-wide associations of childhood trauma and PLEs, tested the moderating role of early cannabis use, and evaluated DNAm as a potential mediator. Methods. We analysed data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK population-based birth cohort. Childhood trauma was assessed prospectively and retrospectively. Epigenome-wide DNAm was measured in peripheral blood at ~17 years using the Illumina 450K array, and PLEs were assessed at 18 using a structured interview. Epigenome-wide association studies were conducted for trauma-DNAm and DNAm-PLEs associations in the final sample (n = 1,457), adjusting for demographic, biological, and technical covariates. Differentially methylated regions (DMRs) were identified using DMRff, followed by functional enrichment analyses. Cannabis use at 15.5 was modelled as a moderator with multiple imputation for missing data. Mediation was tested using the Divide-Aggregate Composite-null Test (DACT). Results. Childhood trauma was associated with widespread DNAm differences, primarily at the regional level, with enrichment in pathways related to cellular stress responses. In contrast, DNAm associated with PLEs was more limited and implicated loci involved in epigenetic regulatory processes. These signatures were largely distinct, and there was no evidence supporting mediation after multiple testing correction. Incorporating cannabis use altered the pattern and extent of DNAm associations, with stronger and more significant signals observed at both CpG and regional levels, although these did not translate into evidence of mediation. Conclusion. Childhood trauma and PLEs show distinct DNAm signatures in adolescence, with trauma-related DNAm reflecting broad stress-related processes and PLE-associated DNAm implicating regulatory mechanisms. We found little evidence that DNAm mediates the trauma-PLE association. Instead, adolescent exposures, particularly cannabis use, may distinctly influence trauma-related epigenetic variation with limited detectable downstream effects on PLEs. These findings support a context-dependent model of epigenetic risk and highlight the need for larger longitudinal studies to clarify causal pathways linking early adversity to psychosis.

10.
arXiv (CS.AI) 2026-06-15

Shift-Invariant Attribute Scoring for Kolmogorov-Arnold Networks via Shapley Value

arXiv:2510.01663v2 Announce Type: replace-cross Abstract: For many real-world applications, understanding feature-outcome relationships is as crucial as achieving high predictive accuracy. While traditional neural networks excel at prediction, their black-box nature obscures underlying functional relationships. Kolmogorov–Arnold Networks (KANs) address this by employing learnable spline-based activation functions on edges, enabling recovery of symbolic representations while maintaining competitive performance. However, KAN's architecture presents unique challenges for network pruning. Conventional magnitude-based methods become unreliable due to sensitivity to input coordinate shifts. We propose ShapKAN, a pruning framework using Shapley value attribution to assess node importance in a shift-invariant manner. Unlike magnitude-based approaches, ShapKAN quantifies each node's actual contribution, ensuring consistent importance rankings regardless of input parameterization. Extensive experiments on synthetic and real-world datasets demonstrate that ShapKAN preserves true node importance while enabling effective network compression. Our approach improves KAN's interpretability advantages, facilitating deployment in resource-constrained environments.

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

Hey Chat, Can You Teach Me? Structuring Socratic Dialogue for Human Learning in the Wild

Large language models are now widely used for everyday learning, but the underlying interactions are typically unstructured chats rather than following a curriculum. Unlike formal online learning systems, these interactions carry no prior record of the student, so any estimate of what the student already knows must be inferred from the dialogue itself. We show that this gap is not closed by scaling models alone. Frontier and education-tuned LLMs perform poorly when asked to tutor a student over an extended session, because doing so requires three things at once. The tutor must sequence a curriculum, conduct Socratic dialogue, and infer the student's knowledge state from that dialogue. We propose separating these responsibilities. Given a student query, our system constructs a prerequisite knowledge graph in which subtopics are nodes and dependencies are edges, and frames tutoring as deciding which node to teach next and how many dialogue turns to spend on it before moving on. A lightweight PPO policy handles this sequencing decision, while an LLM conducts the Socratic exchange at the chosen node and returns a signal of student progress. Across held-out STEM and non-STEM topics, our PPO-paired tutor outperforms heuristic baselines, frontier general-purpose models, and a model specialised for Socratic dialogue: on both the rate at which students reach full curriculum mastery and the number of turns required. Explicit curriculum structure delivers gains that scaling the underlying model does not.

12.
Nature (Science) 2026-06-22

Why heritage sites are at risk in a warming world — and how to save them

As rising seas and intensifying disasters threaten historic sites worldwide, new ways to understand, preserve and adapt these places are needed urgently. As rising seas and intensifying disasters threaten historic sites worldwide, new ways to understand, preserve and adapt these places are needed urgently.

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

When Roleplaying, Do Models Believe What They Say?

Language models can state that "the Earth orbits the Sun" and, when role-playing Aristotle, assert the opposite. Recent work argues that persona adoption is fundamental to how language models operate, with models constantly selecting the most appropriate persona for a given context. Does such role-playing merely change the model's outputs, or does it also affect what the model internally represents as truthful? We study this question with linear truth probes, applying them to LLMs role-playing historical personas whose likely beliefs differ from modern consensus. For each persona, we compare false claims the persona would likely have endorsed (*era-believed*) with topic-matched false claims they would not have endorsed (*era-false*). Across prompting, in-context learning, and supervised fine-tuning, persona induction suppresses era-believed statements less than equally false alternatives, yet they remain classified as false overall. Role-play therefore shifts what these models say more than what they internally represent as true. We contrast this with models trained on harmful advice that exhibit Emergent Misalignment (EM). Across three model families (Qwen 2.5 14B, Qwen 3 8B, and Llama 3.3 70B), their false claims move substantially toward the true region of probe space, are defended under challenge roughly half the time versus about a sixth for role-play, and are used in downstream reasoning. Role-play and Emergent Misalignment thus are points on a spectrum of belief internalization, where role-play changes what a model says with little representational change, while Emergent Misalignment shifts the internal representation of false claims without fully marking them as true.

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

Is ChatGPT Fair for Recommendation? Evaluating Fairness in Large Language Model Recommendation

The remarkable achievements of Large Language Models (LLMs) have led to the emergence of a novel recommendation paradigm – Recommendation via LLM (RecLLM). Nevertheless, it is important to note that LLMs may contain social prejudices, and therefore, the fairness of recommendations made by RecLLM requires further investigation. To avoid the potential risks of RecLLM, it is imperative to evaluate the fairness of RecLLM with respect to various sensitive attributes on the user side. Due to the differences between the RecLLM paradigm and the traditional recommendation paradigm, it is problematic to directly use the fairness benchmark of traditional recommendation. To address the dilemma, we propose a novel benchmark called Fairness of Recommendation via LLM (FaiRLLM). This benchmark comprises carefully crafted metrics and a dataset that accounts for eight sensitive attributes1 in two recommendation scenarios: music and movies. By utilizing our FaiRLLM benchmark, we conducted an evaluation of ChatGPT and discovered that it still exhibits unfairness to some sensitive attributes when generating recommendations. Our code and dataset can be found at https://github.com/jizhi-zhang/FaiRLLM.

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

Reassessing High-Performing LLMs on Polish Medical Exams: True Competence or Bias-Driven Performance?

Large language models (LLMs) in medicine are mainly evaluated using multiple-choice question answering (MCQA), which can overestimate real clinical ability due to guessing strategies and answer biases. To address these limitations, we introduce an expanded and more challenging benchmark based on Polish medical exams, adding over 15,000 questions, two new domains, and four structural modifications that reduce MCQA-specific artifacts and better test reasoning. We evaluate 21 LLMs and show that evaluation design strongly affects results. Under our harder setup, the best model (Qwen3.5-122B) drops by 28.4 and 31 pp on English and Polish exams, respectively. Despite low evidence of data contamination, standard MCQA scores do not reliably reflect true medical competence. To facilitate further research, we make our benchmark publicly available.

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

ConsistencyPlanner: Real-time Planning with Fast-Sampling Consistency Models

arXiv:2606.11569v1 Announce Type: cross Abstract: Closed-loop planning in complex, real-world driving scenarios presents a critical challenge for autonomous driving systems. While traditional rule-based methods are interpretable, their predefined heuristics lack the adaptability for dynamic traffic environments. Learning-based approaches have shown considerable promise. Conversely, learning-based approaches, despite their promise, struggle to balance the modeling diverse and multimodal driving behaviors and real-time planning, often leading to indecisive or unsafe actions. To address this limitation, we propose Consistency Planner, a real-time planning framework with fast-sampling consistency models. Our approach is built upon two key technical contributions. Efficient Multimodal Sampling: We employ fast-sampling consistency models to generate a diverse set of plausible future trajectories. This enables efficient, real-time exploration of multimodal actions, overcoming the computational bottlenecks of previous iterative generative methods. Heterogeneous Feature Fusion: We introduce an attention-enhanced decoder that dynamically integrates heterogeneous input features (including scene feature and action token) into a cohesive representation for robust planning. Extensive evaluation in the Waymax simulator demonstrates superior performance in safety metrics compared to existing methods, with particularly strong results in challenging dynamic scenarios.

17.
medRxiv (Medicine) 2026-06-16

A MULTICENTER SWEDISH HISTOPATHOLOGY IMAGE DATASET OF PEDIATRIC CENTRAL NERVOUS SYSTEM TUMORS

Refined detection methods, more detailed tumor characterization, and adequate distinction between different pediatric tumor subtypes are necessary to improve diagnosis and treatment, enable precision medicine, and advance patient prognosis. However, the application of computational approaches to pediatric brain tumors remains limited, largely due to the lack of accessible datasets. To address part of this gap, we provide whole slide images (WSIs) of hematoxylin and eosin (H&E)-stained tissue sections from all pediatric central nervous system (CNS) samples collected in Sweden between 2013 and 2023. These data represent a population-based national cohort encompassing all six pediatric oncology centers in Sweden and are available through the Swedish Childhood Tumor Biobank (BTB). The dataset includes 1,446 WSIs of sufficient image quality with confirmed CNS tumor diagnoses, derived from 537 unique subjects (562 cases). In addition, diagnosticrelevant clinical information is included. Corresponding whole-genome sequencing (WGS), wholetranscriptome sequencing (WTS), and methylation array data are available for most tumor samples through separate resources. This H&E dataset has been specifically curated to support artificial intelligence-based analyses, while also serving broader applications in medical research and education. When combined with matched molecular data, it provides a valuable resource for advancing multimodal and precision diagnostic approaches in the pediatric population. Refined detection methods, more detailed tumor mapping and adequate distinction between different subtypes of pediatric tumors are necessary to improve treatment, enable precision medicine and improve patient prognosis. Application of computational algorithms for pediatric brain tumors is very limited mainly due to the unavailability of pediatric histology brain tumor data sets. To enable the development of AI models comprehensive datasets covering a wide range of pediatric brain tumors are needed.

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

Learning a Sampling-Free Variational DNN Plugin from Tiny Training Sets to Refine OOD Segmentation With Uncertainty Estimation

Deep neural networks (DNNs) frequently fail to generalize to out-of-distribution (OOD) medical images because of variations in scanners and acquisition protocols. Retraining DNN models to address these distribution shifts is often impractical due to the high cost of acquiring and annotating new medical datasets. To address this, we introduce VarDeepPCA, a novel lightweight variational DNN framework designed to restore/refine degraded segmentation maps by leveraging intrinsic geometric priors. Unlike existing approaches that require target-domain data or extensive pre-training, our VarDeepPCA explicitly learns a distribution of valid anatomical geometries using only small in-distribution (ID) datasets. Theoretically, our novel variational learning framework leverages a reinterpretation of the softmax mapping to implicitly perform exact distribution modeling, thereby enabling computationally efficient, sampling-free learning and inference. This also enables VarDeepPCA to provide uncertainty estimates associated with its restored segmentation maps. We empirically validate our framework across 4 distinct clinical applications, using 14 publicly available datasets, involving segmentation of the myocardium, neuroretinal rim, prostate, and fetal head. Comparisons against 15 existing methods demonstrate that VarDeepPCA consistently restores segmentation maps produced by the existing methods on OOD data to (i) significantly improve anatomical plausibility of geometries and clinical utility of the segmentations, and (ii) significantly reduce errors, without needing any more training data than that used by existing methods.

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

Evaluating LLM Personalization via Semantic Constraint Verification

Current evaluation paradigms for Large Language Model (LLM) personalization rely heavily on brittle surface-matching metrics or computationally expensive LLM-as-a-judge protocols, both of which lack interpretability. To address these limitations, we introduce Natural Language Inference Constraint Verification (NLICV), a scalable, semantically invariant framework that maps sentence meanings to truth-condition sets to verify personalization constraints via a Natural Language Inference (NLI) model. Moving beyond binary scoring, NLICV categorizes LLM behaviors into four distinct modes: personalization, generalization, sycophancy, and failure. Extensive experiments demonstrate that NLICV aligns closely with human annotations while drastically reducing the latency and token costs associated with LLM judges (up to 2100 inference speedup). Finally, through an ablation-based procedure, NLICV pinpoints the exact sentences driving the constraint verification, yielding faithful, understandable evidence for its evaluations.

20.
arXiv (CS.CL) 2026-06-19

LaViSA: A Language and Vision Structural Ambiguity Benchmark

Structural ambiguity arises when a single sentence admits multiple valid interpretations due to its syntactic structure, posing a fundamental challenge for language understanding. Visual scenes serve as useful cues for resolving such ambiguity, and Vision and Language Models (VLMs) need to be capable of deriving possible semantic interpretations from visual scenes. We introduce Language and Vision Structural Ambiguity (LaViSA), a benchmark designed to evaluate the ability of VLMs to resolve structural ambiguity leveraging visual scenes. LaViSA consists of ambiguous sentences, their disambiguated sentences, and corresponding images of these disambiguated sentences across seven ambiguity categories. Using LaViSA, we conduct a comprehensive evaluation of diverse VLMs, including both proprietary and open-source models with varying parameter scales and reasoning capabilities. Experimental results show that although recent VLMs can leverage visual scenes to resolve structural ambiguity to a some extent, they still struggle with certain ambiguity types and visually subtle semantic distinctions, indicating remaining limitations in resolving structural ambiguity using visual scenes.

21.
medRxiv (Medicine) 2026-06-11

PCRAgent: A Multi-Agent Framework for Transforming Noisy clinical conversations into Structured Pre-Consultation Medical Records and Reusable Clinical Data Resources

In primary care and outpatient settings, clinically important patient information is often embedded in fragmented, ambiguous, repetitive, and noisy communication between physicians and patients. This limits physicians ability to obtain a clear preconsultation overview of symptoms, history of present illness, and visit intent, while also preventing real world clinical dialogues from being reused in hospital information systems and medical artificial intelligence applications. To address this challenge, we developed PCRAgent, a centrally coordinated multi agent framework for preconsultation clinical information organization. Guided by physician inquiry logic, PCRAgent identifies, extracts, corrects, and standardizes patient-reported information from noisy consultations. Its coordinated modules including error detection, semantic editing, output control, contextual memory, and intent recognition enable robust parallel handling of spelling errors, repetitions, grammatical inconsistencies, medical ambiguities, and non-medical interference. A traceable edit list records intermediate corrections and context, allowing iterative refinement without redundant modifications. PCRAgent generates two complementary outputs. One is a PreConsultation Clinical Report for rapid physician review. The other is a Structured Clinical Conversation Dataset for hospital data construction and downstream AI applications. In evaluations using 220000 strongly perturbed consultations, PCRAgent maintained high robustness, achieving a clinical information accuracy of 4.99 out of 5 and key element completeness of 5 out of 5, outperforming GPT4o. Expert review of Chinese and English dialogues confirmed high clinical accuracy of 4.85 out of 5 and high safety of 4.79 out of 5. Multicenter validation in real-world outpatient workflows further demonstrated practical utility. These findings indicate that PCRAgent can efficiently transform noisy and unstructured consultations into physician ready reports and AI ready structured data, improving outpatient efficiency, reducing cognitive burden, ensuring information completeness, supporting precise decision-making, and enabling high-quality reuse of clinical data.

22.
arXiv (CS.CL) 2026-06-11

Context-Driven Incremental Compression for Multi-Turn Dialogue Generation

Modern conversational agents condition on an ever-growing dialogue history at each turn, incurring redundant attention and encoding costs that grow with conversation length. Naive truncation or summarization degrades fidelity, while existing context compressors lack cross-turn memory sharing or revision, causing information loss and compounding errors in long dialogues. We revisit the context compression under conversational dynamics and empirically present its fragility. To improve both efficiency and robustness, we introduce Context-Driven Incremental Compression (C-DIC), which treats a conversation as interleaved contextual threads and stores revisable per-thread compression states in a single, compact dialogue memory. At each turn, a lightweight retrieve, revise, and write-back loop shares information across turns and updates stale memories, stabilizing long-horizon behavior. In addition, we adapt truncated backpropagation-through-time (TBPTT) to our multi-turn setting, learning cross-turn dependencies without full-history backpropagation. Extensive experiments on long-form dialogue benchmarks demonstrate superior performance and efficiency of C-DIC; notably, C-DIC shows stable inference latency and perplexity over hundreds of dialogue turns, supporting a scalable path to high-quality dialogue modeling.

23.
medRxiv (Medicine) 2026-06-17

A multistate model of frailty progression after severe infections in adults >=65 years in England: a matched-cohort study

Background Evidence on frailty progression following severe infections is limited. We compared rates of transition to greater frailty or death between adults with and without severe infection in England. Methods We conducted a matched-cohort study among adults aged [≥]65 years (1,452,117: median age 76 years, 45% male) in Clinical Practice Research Datalink Aurum (2006-2019). Adults with severe infection (hospitalised primarily due to infection) were matched on calendar time to individuals without severe infection on age, sex, and primary care practice. The admission date was used as index date and same was assigned to matched unexposed adults. We measured frailty using Electronic Frailty Index, a proportion of 36 health deficits in validated categories (Fit 0-0.12, Mild >0.12-0.24, Moderate >0.24-0.36, Severe >0.36). In a time-varying Markov multistate model, we focused on forward transitions from baseline or intermediate frailty states to higher states or death. For each transition, we used Cox regression to estimate cause-specific transition hazard ratios (HR) with 95% confidence intervals (CIs), comparing adults with and without severe infection. We adjusted for baseline frailty score, age, sex, deprivation, harmful alcohol use, smoking, and primary care infection history 5 years before index date. We estimated state occupancy probabilities, and expected length of stay (ELOS) in each state at year five among adults with and without severe infection. We explored effect modification by infection type. Results Across all transitions, severe infection was associated with higher adjusted hazards of transitioning to worsening frailty or death, HR, 95% CI: (fit to: mild[1.56, 1.54-1.58], moderate[2.51, 1.79-3.51], death[4.57, 4.50-4.65]; mild to: moderate[1.52, 1.50-1.53], severe[1.90, 1.43-2.52], death[2.67, 2.64-2.70]; moderate to: severe[1.40, 1.38-1.42], death[1.87, 1.85-1.90]; severe to death[1.48, 1.46-1.50]). Transition hazard ratios were strongest for lower respiratory tract infections, followed by sepsis, urinary tract infections, meningitis/encephalitis, gastroenteritis, and skin and soft tissue infections. At five years, adults with severe infection had higher probabilities of transitioning to greater frailty or death across all transitions and lower ELOS in each frailty state than those without severe infection. Interpretation Severe infections may accelerate frailty deterioration in older age. Prevention through vaccination, early detection, and prompt management may help mitigate this decline.

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

SciText2Eq: Assessing LLMs for Explainable Equation Generation for Scientific Creativity

arXiv:2606.16003v1 Announce Type: new Abstract: This work investigates the ability of large language models (LLMs) to generate mathematical equations from scientific texts. Prior work faces challenges in unstructured grounding, multi-equation dependency, and humanaligned evaluation. To this end, we construct a dataset of AI research papers, pairing contextual passages with ground-truth equations and variable descriptions. We develop an explainable equation generation workflow and evaluate it across diverse open- and closed-source LLM backbones. We introduce an evaluation protocol combining automatic metrics, LLM-based rubrics, and human judgments to assess accuracy, explainability, and human-LLM alignment. Results indicate that LLMs perform moderately on lexical- and syntactic-based similarity, while struggling with semantic accuracy. Comparisons between LLM-based evaluations and human judgments reveal limited alignment, highlighting challenges in using LLMs to assess equation quality. These findings offer insights for improving equation generation models and developing more reliable evaluation methods for scientific text. We provide code and data for reproducibility.

25.
medRxiv (Medicine) 2026-06-22

Leishmaniasis on YouTube: a critical appraisal of the quality, reliability, and transparency of educational content

Background: Leishmaniasis is a neglected tropical disease of significant global public health importance, for which accurate information is essential to support prevention and early care-seeking, particularly in endemic, resource-limited settings. YouTube is a widely used source of health information, but the quality and reliability of leishmaniasis-related content have not been evaluated. We aimed to assess the quality, reliability, and transparency of English-language YouTube videos on leishmaniasis. Methods: We conducted a cross-sectional analysis of YouTube videos retrieved via the YouTube Data API on 15 June 2026 using the terms "leishmaniasis," "cutaneous leishmaniasis," and "visceral leishmaniasis." After applying eligibility criteria and screening the 150 most-viewed eligible videos, 48 videos were included. Two reviewers independently assessed each video using the modified DISCERN (mDISCERN) tool, the Global Quality Score (GQS), and the JAMA benchmark criteria, with disagreements resolved by consensus. Inter-rater agreement was assessed using the intraclass correlation coefficient (ICC), and associations were examined using Spearman's rank correlation. Results: Of 402 videos retrieved, 48 met the inclusion criteria. The median GQS was 3.00 (IQR 2.00-4.00) and median mDISCERN was 3.00 (IQR 2.38-4.50), indicating moderate quality and reliability, while the median JAMA score was 2.00 (IQR 1.00-2.00), reflecting limited transparency; no video met all four JAMA criteria. The overwhelming majority of videos (47/48, 97.9%) were of professional or institutional origin. Inter-rater agreement was good to excellent (ICC 0.883 for GQS, 0.896 for mDISCERN, 1.000 for JAMA). The instruments were strongly inter-correlated (mDISCERN-GQS rho = 0.841, p < 0.001). Quality scores did not correlate positively with views, likes, or video duration; comments correlated weakly and negatively with mDISCERN (rho = -0.337, p = 0.031) and JAMA (rho = -0.381, p = 0.014). Conclusions: YouTube videos on leishmaniasis are of moderate quality and reliability but limited transparency, and are produced almost exclusively by professional sources. Video popularity, length, and age were not indicators of quality. There is a need for experts and institutions to produce clearly authored, well-sourced, and transparent educational content on this neglected tropical disease.