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01.
Nature Medicine 2026-06-22

<b>PROTEUS trial heralds perioperative therapy for prostate cancer</b>

作者:
Karen O’Leary↗

Perioperative androgen-deprivation therapy plus apalutamide could represent a new treatment option for patients with high-risk, localized prostate cancer. Perioperative androgen-deprivation therapy plus apalutamide could represent a new treatment option for patients with high-risk, localized prostate cancer.

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

Learning to Reason by Analogy via Retrieval-Augmented Reinforcement Fine-Tuning

作者:
Zilin Xiao↗Qi Ma↗Chun-cheng Jason Chen↗Xintao Chen↗Avinash Atreya↗Hanjie Chen↗Vicente Ordonez↗

Retrieval-augmented generation (RAG) has become a standard mechanism for grounding language models in external knowledge, yet conventional retrieval based on lexical or semantic similarity is poorly suited for complex reasoning tasks: a semantically similar problem may demand an entirely different solution strategy, while a superficially different problem may share the same underlying reasoning pattern. We propose Retrieval-Augmented Reinforcement Fine-Tuning (RA-RFT), a post-training framework that teaches language models to reason by analogy. RA-RFT uses gold-relevance distillation to train a retriever that ranks contexts by expected reasoning benefit rather than semantic overlap, and then fine-tunes the policy model via reinforcement fine-tuning methods with retrieved analogous demonstrations, so the model learns to leverage reasoning traces under verifiable outcome rewards. We further analyze the diversity of retrieved contexts and find that reasoning-aware retrieval surfaces complementary solution strategies that provide distinct reasoning scaffolds for individual problems. Across challenging mathematical reasoning benchmarks, RA-RFT consistently outperforms standard reinforcement fine-tuning methods. For example, it improves AIME 2025 average@32 accuracy by 7.1 and 2.8 points over GRPO for Qwen3-1.7B and Qwen3-4B respectively – suggesting that reasoning-aware retrieval is a complementary axis of improvement and orthogonal to advances in reward design or training curricula.

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

Adaptive Turn-Taking for Real-time Multi-Party Voice Agents

作者:
Soumyajit Mitra↗Prabhat Pandey↗Abhinav Jain↗Shanmukha Sahith↗K V Vijay Girish↗

Turn-taking in multi-party spoken conversations remains a fundamental challenge for voice-based agents, particularly under dynamic floor competition and varying user expectations. We propose ModeratorLM, a role-playing voice agent that conditions turn-taking behavior on an explicitly assigned role in multi-party settings. The system is built on a speech large language model operating in chunk-wise streaming manner. We further introduce a reasoning-augmented variant that incorporates chain-of-thought reasoning over conversational context and the assigned role. We construct RolePlayConv, a large-scale synthetic dataset of spoken multi-party conversations with diverse assistant roles. Experiments on real-world meeting data and RolePlayConv show improved turn-taking precision by over 40% and recall by more than 70%, while substantially reducing false-positive interruptions compared to non-role-conditioned baselines.

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04.
medRxiv (Medicine) 2026-06-18

Hospital staff views on the visibility, role and impact of Acute Learning Disability Liaison Services in Wales: a service evaluation

作者:
Sha'aban↗Mazzaschi↗F. I. M↗Alazizi↗McAulay↗Edwards↗Joseph-Williams↗N. I. M↗

People with a learning disability experience marked health inequalities. In Wales, Acute Learning Disability Liaison Services (ALDLS) are delivered by specialised learning disability services, and all roles within them are undertaken by Learning Disability Liaison Nurses (LDLN). These services aim to enable access to, and delivery of, secondary care by supporting reasonable adjustments, facilitating communication, and coordinating care for people with learning disability during hospital encounters. However, independent evidence of the impact of ALDLS on patient care remains limited. This evaluation tries to address this evidence gap by examining hospital staff perceptions of the visibility, role, and impact of ALDLS across Welsh Health Boards, with the aim of informing service design and development and improving secondary care access and care for people with learning disability. The service evaluation used a qualitative approach involving interviews and a focus group with hospital staff across the seven Welsh Health Boards who had experience working with or interacting with ALDLS staff to care for patients with learning disability. Findings cover six key areas including i) visibility and delivery of ALDLS, ii) Barriers and challenges to effective ALDLS delivery, iii) Enablers of effective ALDLS delivery, iv) Positive impacts for patients with learning disability, v) Negative impacts and unintended consequences when the service is absent or limited, and vi) Participants recommendations for future improvements of ALDLS. To synthesise the findings, we developed an overview diagram, which illustrates how ALDLS may influence care quality in acute hospitals. The overview places the liaison service at the centre, showing how organisational enablers and barriers shape its delivery, and how its core functions support improvements in safety, timeliness, effectiveness, efficiency, equity, and patient-centred care. From the findings we have identified recommendations for practice and policy. These include that ALDLS should be recognised as a core, safety-critical component of acute hospital care for people with a learning disability, rather than an optional add-on. In practice, services should be more visibly embedded within routine pathways, with consistent site-based presence, clear referral criteria, early identification through electronic flagging and notification systems, and routine involvement in multidisciplinary planning for complex admissions and procedures. At policy level, ALDLS provision should be recognised within equality and patient safety frameworks as an essential service requiring sustained investment, national minimum configuration standards, adequate staffing, and better-integrated digital systems to support continuity, equitable access, and person-centred care.

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

Shopping Reasoning Bench: An Expert-Authored Benchmark for Multi-Turn Conversational Shopping Assistants

作者:
Shuxian Fan↗Seonwoo Min↗Youna Hu↗Botao Xia↗Jayakrishnan Unnikrishnan↗Rowan Musselmann↗Yifan Gao↗Qingyu Yin↗Priyanka Nigam↗Bing Yin↗

Conversational shopping assistants now serve hundreds of millions of customers, yet no existing benchmark jointly evaluates the open-ended multi-turn reasoning, domain expertise, and criterion-level quality that real shopping conversations demand. Shopping reasoning is unique among language model applications. Unlike factual question answering or verifiable code generation, it requires balancing subjective preferences, budget constraints, and cross-product trade-offs across multi-turn dialogue, capabilities absent from previous e-commerce and general-purpose benchmarks. We introduce the Shopping Reasoning Bench, an expert-authored benchmark of 525 missions (232 single-turn, 293 multi-turn) with 10863 importance-weighted binary rubrics authored by retail domain experts. These criteria are organized under a taxonomy of five reasoning categories and fifteen subcategories covering diverse demands such as preference refinement, trade-off analysis, and compatibility assessment. An evaluation of nine models across three families (GPT, Claude, Gemini) shows that pass rates reach only 57–77% overall. On multi-turn missions, all models score 13–29 points lower on optional above-and-beyond criteria than on required ones, and performance degrades 4–18 points as conversations progress. These gaps show that current models handle basic shopping assistance but fall short of expert-level advice, making Shopping Reasoning Bench a challenging testbed for future shopping assistant development.

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

PROSE: Training-Free Egocentric Scene Registration with Vision-Language Models

作者:
Zhiang Chen↗Nahyuk Lee↗Boyang Sun↗Taein Kwon↗Marc Pollefeys↗Zuria Bauer↗Sunghwan Hong↗

Registering two captures of the same indoor space taken at different times underpins persistent spatial memory for robots and AR systems, yet the realistic version of this task is egocentric and its most scalable form is RGB-only. Head-mounted cameras yield blurry, fast-moving, partially overlapping views from which dense geometry is hard to recover. Classical registration leans on exactly the clean point clouds this setting lacks, while learned scene-graph methods require a pre-built or annotated graph and a trained matcher that we find brittle under egocentric data. We take a different route, using a pretrained vision-language model as the source of both scene understanding and cross-scan matching. Our method, PROSE (Prompted Scene rEgistration), lifts each RGB sequence into an object-level 3D scene graph using off-the-shelf foundation models for geometry, segmentation, and language, then prompts the same VLM to match object instances across the two RGB sequences. To make this matching tractable and reliable, we leverage object heights as a prior and verify each proposed match with a paired same/different query, then solve for the rigid transform by hypothesizing a candidate per matched object and selecting the one with the strongest geometric consensus. PROSE adds no learned parameters and requires no depth sensor, training, or annotated graph. On the egocentric Aria Digital Twin and Aria Everyday Activities benchmarks, it outperforms both geometric and learned scene-graph baselines in registration accuracy, on ground-truth and RGB-reconstructed point clouds alike, and the scene graph it produces transfers directly to downstream tasks.

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07.
arXiv (CS.CL) 2026-06-17

Top-Theta Attention: Sparsifying Transformers by Compensated Thresholding

作者:
Konstantin Berestizshevsky↗Renzo Andri↗Lukas Cavigelli↗

We present Top-Theta (Top-$\theta$) Attention, a training-free method for sparsifying transformer attention during inference. Our key insight is that static, per-head thresholds can be calibrated to retain the desired constant number of significant elements per attention row. This approach enables content-based sparsity without retraining, and it remains robust across data domains. We further introduce compensation techniques to preserve accuracy under aggressive sparsification, establishing attention thresholding as a practical and principled alternative to top-k attention. We provide extensive evaluation on natural language processing tasks, showing that Top-$\theta$ achieves 3-10x reduction in V-cache usage and up to 10x fewer attention elements during inference while degrading no more than 1% in accuracy.

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08.
arXiv (CS.LG) 2026-06-18

Generative models for decision-making under distributional shift

作者:
Xiuyuan Cheng↗Yunqin Zhu↗Yao Xie↗

arXiv:2604.04342v2 Announce Type: replace Abstract: Many data-driven decision problems are formulated using a nominal distribution estimated from historical data, while performance is ultimately determined by a deployment distribution that may be shifted, context-dependent, partially observed, or stress-induced. This tutorial presents modern generative models, particularly flow- and score-based methods, as mathematical tools for constructing decision-relevant distributions. From an operations research perspective, their primary value lies not in unconstrained sample synthesis but in representing and transforming distributions through transport maps, velocity fields, score fields, and guided stochastic dynamics. We present a unified framework based on pushforward maps, continuity, Fokker-Planck equations, Wasserstein geometry, and optimization in probability space. Within this framework, generative models can be used to learn nominal uncertainty, construct stressed or least-favorable distributions for robustness, and produce conditional or posterior distributions under side information and partial observation. We also highlight representative theoretical guarantees, including forward-reverse convergence for iterative flow models, first-order minimax analysis in transport-map space, and error-transfer bounds for posterior sampling with generative priors. The tutorial provides a principled introduction to using generative models for scenario generation, robust decision-making, uncertainty quantification, and related problems under distributional shift.

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09.
arXiv (CS.CL) 2026-06-19

Quantifying Aleatoric Uncertainty of In-Context Learning for Robust Measure of LLM Prediction Confidence

作者:
Jinseok Chung↗Minkyoung Song↗Hyunji Jung↗Namhoon Lee↗

In-Context Learning (ICL) allows LLMs to adapt to new tasks from a few demonstrations, but its reliability remains a concern: predictions are highly sensitive to both prompt design and the model's ability to understand the context, obscuring whether failures arise from data properties or model limitations. Uncertainty decomposition-separating aleatoric from epistemic sources-is particularly crucial in this setting, yet existing methods, designed for standard generation tasks, fail to capture the unique dynamics of ICL. To address this, we introduce a concept of self-function vectors, built upon Bayesian views and the mechanistic interpretability of ICL. These vectors leverage internal model representations to model the latent concept learned during in-context prompting, thereby enabling a direct estimation of aleatoric uncertainty within a Bayesian framework and circumventing the reliance on brittle input or decoding manipulations. Given the lack of established benchmarks and suitable evaluation protocols, we also propose the first and rigorous evaluation protocol, in which data is manipulated in controlled ways so as to quantify aleatoric uncertainty precisely and separately from epistemic uncertainty. With this new evaluation framework, initially grounded in synthetic tasks for conceptual development and subsequently extended to real-world datasets, we show that our proposed methodology can measure uncertainty of LLM predictions made under ICL more reliably than existing alternative methods. Moreover, we show it can be used as a practical tool for trustworthy-related applications, such as hallucination detection. Our findings pave a new direction for connecting the quantitative view of uncertainty with the mechanistic understanding of model behavior.

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10.
bioRxiv (Bioinfo) 2026-06-19

Nickel-Driven Dynamics of Urease in Sporosarcina pasteurii: Integrated Computational and Experimental Insights

作者:
Al-Thawadi↗S. M↗

Urease is a nickel-dependent enzyme that plays an important role in urea hydrolysis and in a process named as microbial-induced calcium carbonate precipitation (MICP), which is widely used in sustainable environmental biotechnology. Despite its ecological importance, urease powers Biogrout (biocementation), a promising green technology for soil stabilization and infrastructure repair. Yet, the relationship between nickel availability, enzyme activation, and bacterial fitness remains poorly understood. In this study, we reveal a striking dual effect of nickel on Sporosarcina pasteurii: while high Ni2+ concentrations strongly inhibit growth (IC50 {approx} 637.7 {micro}M), they simultaneously boost specific urease activity up to six-fold. This uncoupling between biomass and enzymatic efficiency highlights a previously overlooked adaptive strategy under metal stress. Using structural bioinformatics and molecular docking, we show that Ure1–the catalytic subunit–exhibits the strongest nickel affinity (-4.3 kcal{middle dot}mol-1), supported by highly conserved active-site residues, whereas accessory proteins UreE and UreG display moderate and weak binding, consistent with their roles in metal delivery and GTP-dependent maturation. In addition, microscopic observations confirmed that calcium carbonate precipitation was most pronounced at intermediate nickel concentrations (approximately 400-1000 {micro}M), whereas higher concentrations ([&ge;]1000-1300 {micro}M) led to reduced mineral formation due to loss viable cells. Taken together, these results indicates that nickel availability controls both urease activation and bacterial fitness, and that an optimal balance is required to maximize biomenerilization efficiency in environmental applications, particularly in biocementation technology.

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11.
arXiv (CS.CV) 2026-06-17

SegTME-UNI2: A Foundation Model-Based Framework for Generalisable Multiclass Cell Segmentation and LLM-Driven Tumour Microenvironment Characterisation in Histopathology

作者:
Wan Siti Halimatul Munirah Wan Ahmad↗Faris Syahmi Samidi↗Mohammad Badal Ahmmed↗Vimal Angela Thiviyanathan↗Selvam James Thavaraj↗Anwar P. P. Abdul Majeed↗

Characterising the tumour microenvironment (TME) from routine H&E-stained histology images requires simultaneous cell segmentation, feature extraction, and interpretable clinical reporting. We present SEGTME-UNI2, a unified framework addressing these requirements. Its core is UNI2-UPERHOVER, a dual-head segmentation model pairing the UNI2-H pathology foundation model (ViT-Giant, pretrained on >100M tiles from 100K slides) with two parallel UperNet decoders: one for six-class semantic segmentation and one for horizontal-vertical gradient regression enabling watershed-based nuclear instance separation. To address the lack of pixel-level annotations in large real-world repositories, UNI2-UPERHOVER undergoes a three-stage progressive pseudo-label curriculum. Each stage trains a fresh model without weight transfer, driving improvement entirely via increased pseudo-label quality: Stage 1: Uses human-annotated PanNuke (7,901 images, 189,744 nuclei, 0.25 um/pixel). Stage 2: Uses entropy-filtered pseudo-labels from the Stage 1 model on 271,711 TCGA-UT scale-0 patches (0.5 um/pixel). Stage 3: Uses pseudo-labels from the Stage 2 model on all 1,608,060 TCGA-UT patches across six resolution scales (0.5-1.0 um/pixel). Segmentation outputs feed a structured TME feature extraction pipeline computing 20+ per-patch compositional, morphological, spatial entropy, and intercellular distance metrics. These are encoded as JSON and passed to a fine-tuned NVIDIA BioNeMo GPT model to generate clinically interpretable TME narratives. Preliminary validation on held-out PanNuke and TCGA-UT partitions demonstrates framework feasibility and internal consistency. The pseudo-labelled TCGA-UT dataset and UNI2-UPERHOVER checkpoint are publicly released to support large-scale TME profiling and spatial biology research.

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12.
arXiv (CS.CV) 2026-06-16

Redirecting the Flow: Image Customization through Attention Distribution Shift

作者:
Jie Li↗Suorong Yang↗Jian Zhao↗Furao Shen↗

Subject-driven image customization aims to generate images that not only follow textual instructions but also preserve the identity of a given reference subject. Existing approaches, including test-time fine-tuning, encoder-based methods, and token competition in shared attention spaces, suffer from limited efficiency, misalignment between extracted reference features and the generative process, and interference from irrelevant information. To address these limitations, we formulate the customization task as a distribution shift induced by incorporating reference images into text-to-image generation, and derive a Conditional Attention Distribution Shift formulation grounded in maximum entropy theory. Building on this formulation, we propose CustomShift, a dual-branch architecture based on Stable Diffusion 3. The Reference-Alignment Branch leverages self-attention between reference images and subject names to achieve layer-wise alignment with latent representations, while the Cross-Guidance Branch integrates textual and reference cues to guide generation. Experiments on the DreamBooth and Custom101 benchmarks demonstrate that our method consistently outperforms state-of-the-art approaches, achieving a better balance between semantic fidelity and subject consistency.

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

OpenMedReason: Scientific Reasoning Supervision for Medical Vision-Language Models

作者:
Negin Baghbanzadeh↗Pritam Sarkar↗Michael Colacci↗Abeer Badawi↗Adibvafa Fallahpour↗Arash Afkanpour↗Leonid Sigal↗Ali Etemad↗Elham Dolatabadi↗

High-stakes clinical use of large vision-language models (LVLMs) requires reasoning that is grounded in visual evidence and clinical knowledge, not just correct final answers. We introduce OpenMedReason, a large-scale, open multimodal medical reasoning corpus comprising approximately 450K image-question-answer instances whose reasoning traces are primarily derived from curated biomedical, human-authored scientific articles. OpenMedReason provides high-fidelity supervision beyond synthetic chains of thought, covering diverse medical domain vision modalities such as radiological scans, microscopic images, visible light photographs, charts, and others. We complement it with OpenMedReason-Bench, a held-out benchmark that allows fine-grained evaluation of LVLMs along three complementary axes of capability, including perception, medical knowledge, and rationale, enabling diagnostic evaluation beyond final-answer accuracy. OpenMedReason is a rich training resource that exhibits its effectiveness in both supervised fine-tuning (SFT) and reinforcement-based alignment. Training with OpenMedReason yields a 20% average improvement in VQA accuracy over the base model and achieves performance within 4.2% of the strongest comparable-scale medical LVLMs. Fine-grained performance analysis confirms that the gains are not concentrated in any single axis: OpenMedReason improves perception, medical knowledge, and rationale jointly, and its reasoning traces are preferred over those of the base model in 86.1% of pairwise comparisons. We release the code and dataset at huggingface.co/datasets/neginb/OpenMedReason.

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14.
bioRxiv (Bioinfo) 2026-06-21

Antibody-Antigen Affinity Prediction with Chain-Aware Protein Language Modeling

作者:
Singh↗Malhotra↗Srivastava↗S. P↗R. K↗Gorantla↗

Motivation: Antibody-antigen affinity determines which antibodies advance in therapeutic discovery, repertoire analysis and affinity maturation, but experimental measurements are sparse relative to the scale of sequence libraries. Structure-based predictors can exploit interface geometry when reliable complexes are available, yet early discovery often requires ranking many heavy-light chain pairs against antigens for which no complex structure exists. Existing sequence-based models are scalable, but frequently compress heavy and light chains into a single antibody representation or concatenate antibody and antigen features obscuring the chain-specific and epitope-specific signals that drive binding. Results: We present AbAffinity, a sequence-only chain-aware three-stream architecture that maintains heavy chain, light chain and antigen as distinct streams. It integrates frozen ESM-2 embeddings with heavy-chain CDR-focused pooling, heavy-light self-attention, adaptive fusion gating and gated cross-attention, training only a compact interaction module. On the SAAINT-DB benchmark, AbAffinity achieves strong predictive performance under ten-fold cross-validation and maintains robust accuracy on novel antigens. It consistently outperforms recent sequence-based models across external benchmarks including SAbDab, AB-Bind and SKEMPI 2.0. Ablation studies highlight the contributions of chain-specific representations, CDR-focused pooling and the gated interaction pathway. Integrated Gradients attributions recover known paratope and epitope residues at structurally validated interfaces. AbAffinity provides a lightweight, explainable sequence-first framework for antibody triage and prioritisation when structural information is limited or unavailable.

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

PsyScore: A Psychometrically-Aware Framework for Trait-Adaptive Essay Scoring and ZPD-Scaffolded Feedback

作者:
Wei Xia↗Jin Wu↗Haoran Shi↗Xiangyu Wang↗Chanjin Zheng↗

Effective Automated Essay Scoring (AES) are expected to support both reliable assessment and actionable instructional feedback. However, existing approaches often treat scoring and feedback as separate components: neural scoring models provide limited interpretability, while Large Language Model (LLM)-based feedback is typically insensitive to learners proficiency levels. To address this fragmentation, this work proposes PsyScore, a psychometrically-aware framework that integrates diagnostic assessment with instructional scaffolding through a shared latent ability representation. PsyScore comprises three key modules: a Trait-Adaptive Neural IRT Scorer that incorporates the Graded Partial Credit Model (GPCM) into a neural architecture, enabling the precise estimation of student ability while maintaining psychometric interpretability, a ZPD-Scaffolded Feedback Generator, which conditions multi-agent feedback strategies on the diagnosed ability parameter to adapt instructional focus across different proficiency levels, and a Multi-Perspective Feedback Evaluation Strategy that assesses feedback quality via pairwise preference judgements and student revision simulations. Experiments on the ASAP++ dataset demonstrate that PsyScore achieves competitive scoring performance while providing more pedagogically aligned feedback.

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

Geometry of Reason: Spectral Signatures of Valid Mathematical Reasoning

作者:
Valentin No\"el↗

Verifying whether a language model is genuinely reasoning or pattern-matching remains an open problem: learned verifiers are expensive, and output-based heuristics are brittle. We show that valid mathematical reasoning induces a measurable, training-free spectral signature in transformer attention. By treating each attention matrix as a weighted token graph, we extract four diagnostics: Fiedler value, High-Frequency Energy Ratio (HFER), spectral entropy, and smoothness, that require no learned parameters. Experiments across seven models from four architectural families yield effect sizes up to Cohen's $d = 3.30$ ($p < 10^{-116}$), enabling $85$–$96\%$ single-threshold classification accuracy. Two findings sharpen the interpretation. First, Platonic validity: the spectral signal tracks logical coherence rather than compiler acceptance, proofs rejected for timeouts or missing imports are correctly classified as valid, a distinction confirmed by a manual audit ($\kappa = 0.82$, $n = 51$). Second, architectural determinism: Sliding Window Attention shifts the discriminative feature from HFER to smoothness ($d = 2.09$, $p < 10^{-48}$), showing that attention design governs which spectral channel encodes reasoning quality. Causal ablation confirms the signature traces induction-head circuits. The method generalises to informal chain-of-thought ($d = 0.78$, $p < 10^{-3}$), and in proof search, HFER reranking improves Best-of-16 Pass@1 by $+4.4$–$6.6$\%, matching $98\%$ of the AUC of fully supervised probes with zero labels. Spectral graph analysis is a principled, architecture-aware primitive for reasoning verification.

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

Multi-Turn Reflective Masking Elicits Reasoning in Mask Diffusion Models

作者:
Yanming Zhang↗Yihan Bian↗Jingyuan Qi↗Yuguang Yao↗Lifu Huang↗Tianyi Zhou↗

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

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18.
medRxiv (Medicine) 2026-06-17

Non-Medical COVID-19 Impacts and Hearing Status: A Global Study of Differential Health Impact Among Deaf, Hard of Hearing, and Hearing Populations

作者:
Siddiqi↗Murray↗Hall↗Koplitz↗Dye↗T. D. V↗

Background: Deaf and hard of hearing (HoH) experienced complex challenges during the COVID19 pandemic, including obscured visual communication from mask mandates, inaccessible public health messaging, and inadequate interpreter availability. We examined whether hearing status predicted nonmedical COVID19 impact on a global level. Methods: We conducted a nested cross-sectional analysis within a global study collecting data across two waves (April to May 2020 and July to August 2022) from 184 countries. Participants (N=7,998) were categorized as Deaf (n=304), Hard of Hearing (HoH; n=951), or Hearing (n=6,743). The primary outcome was a composite COVID-related non-medical Personal Impact TScore derived from 14 items across employment, resource access, and healthcare domains. Multinomial logistic regression models progressively adjusted for demographic, structural, and psychosocial variables. Results: Deaf participants reported substantially higher rates of pandemic-related job loss (28.9% vs. 9.6% hearing), healthcare cancellations (39.9% vs. 24.6%), and inability to obtain basic supplies. Over half (55.9%) of Deaf participants scored above the median composite impact index, compared to 39.2% of hearing participants. In the fully adjusted model, Deaf status remained an independent predictor of high non-medical impact (aOR=1.6, 95% CI: 1.1 to 2.4). HoH status showed no statistically significant difference from hearing participants in any model. Conclusions: People identifying as Deaf experienced significant disparities during COVID19 when compared with HoH or hearing people, driven by language access barriers and institutional exclusion rather than hearing loss per se. These experiences underscore the importance for systemic interventions centering on accessible communication, Deaf-centered needs, and reducing audism in Deaf-hearing interaction.

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19.
medRxiv (Medicine) 2026-06-18

Cost analysis of overseas versus domestic vaccination of US-bound refugees

作者:
Joo↗Maskery↗Klosovsky↗Marquez↗Taher↗Dalal↗Weinberg↗Mitchell↗

Context: To ensure healthy resettlement and protect US health security, the Vaccination Program for US-bound Refugees (VPR) offers some recommended vaccines to refugees overseas before resettlement to the United States. The selected vaccines and number of doses vary by country of departure. VPR was found to be cost-saving in 2018 but had since expanded to more sites. Objective: Assess VPR's current costs and impact on post-arrival domestic vaccination needs and costs. Setting and Participants: A model-based analysis of the Federal government costs for VPR and post-arrival (US) vaccination of resettled refugees separated across five regions: Africa, Asia, the Middle East and North Africa/Republic of Turkiye and Middle East, Europe, and the Americas using fiscal year 2024 data. Design: We quantified and compared full vaccination costs for refugees under two scenarios: (1) 'No VPR' and (2) 'VPR'. Refugees would receive no vaccines overseas and be fully vaccinated after US arrival under 'No VPR'. Under 'VPR', refugees receive one or two doses of selected vaccines overseas before completing vaccination schedules after arrival. Main Outcomes: Costs were reported in 2023 US dollars for 'VPR' and 'No VPR' scenarios and further subdivided by grouping countries/sites depending on whether the International Organization for Migration (IOM) provides vaccination services for refugees (IOM sites) versus non-IOM providers (non-IOM sites). Results: 'VPR' resulted in average net cost savings of $147 per person or $14.7 million per 100,000-refugee cohort compared to providing all vaccines after US arrival ('No VPR'). 'VPR' was cost-saving across most regions, except for IOM sites in Europe, where a net cost of $44 per person was observed. Net cost savings per person were highest for IOM sites in Africa ($333). Conclusions: VPR remains a cost-saving strategy, while protecting US-bound refugees' health and US health security by preventing disease outbreaks during resettlement.

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20.
arXiv (CS.CV) 2026-06-16

Selective Synergistic Learning for Video Object-Centric Learning

作者:
WonJun Moon↗Jae-Pil Heo↗

Typical video object-centric learning (VOCL) approaches employ slot-based frameworks that rely on reconstruction-driven encoder-decoder architectures, where learning is mediated by two spatial maps: attention maps from the encoder and object maps from the decoder. As these two distinct maps exhibit different properties, a recent dense alignment strategy attempted to reconcile this discrepancy by enforcing agreement across all spatio-temporal patches via contrastive learning. However, this indiscriminate alignment inadvertently propagates the inherent weaknesses of each module, such as noisy encoder predictions and blurred decoder boundaries. Moreover, computing dense similarities across all pairs incurs a computational cost quadratic in the total number of spatio-temporal patches, severely limiting scalability. Motivated by this, we propose Selective Synergistic Learning (SSync). Instead of exhaustive patch-to-patch alignment, SSync prevents error propagation by selectively distilling only the most reliable cues: leveraging the encoder strictly for boundary refinement and the decoder for interior denoising. This is realized via a pseudo-labeling with linear complexity, eliminating the need for quadratic spatial comparisons. Also, to prevent the reinforcement of architectural biases like slot redundancy, we introduce a transitive pseudo-label merging that consolidates overlapping slots based on spatio-temporal activation consistency. Extensive studies demonstrate that SSync improves decomposition quality and serves as a versatile, plug-and-play module while also exhibiting exceptional robustness to slot configurations. Code is available at github.com/wjun0830/SSync.

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21.
PLOS Medicine 2026-05-22

Differences in tuberculosis prevalence by sex in low- and middle-income countries over 1993–2025: A systematic review and meta-analysis

作者:
Nicole A. Swartwood↗

by Nicole A. Swartwood, Nanki Singh, Seyed Alireza Mortazavi, Melike Hazal Can, Hening Cui, Do Kyung Ryuk, Peter MacPherson, Katherine C. Horton, Nicolas A. Menzies Background Global and national initiatives to combat tuberculosis (TB) have expanded over recent years. Despite this, the TB burden remains high in some population groups, with men recognized as having elevated TB risks. Summary measures of sex differences in TB prevalence were last estimated in 2016. Since then, many additional prevalence surveys have been conducted, including in the highest TB burden countries. We conducted a systematic review of sex-stratified TB prevalence survey data published over 1993–2025, to provide updated estimates of male-to-female (M:F) TB prevalence ratios and determine whether sex-related disparities in TB burden have closed over time. Methods and findings We identified surveys reporting community-representative, sex-stratified estimates of pulmonary TB prevalence in low- and middle-income countries (LMICs), including surveys from an earlier review (covering January 1993–March 2016) and a new systematic review (covering 1st December 2015–13th October 2025). This review was prospectively registered with PROSPERO (CRD42024503853) and included searches of PubMed, Embase, Global Health, the Cochrane Library, Africa Index Medicus, LILACS, and SciELO. We extracted data on bacteriologically confirmed and smear-positive TB prevalence among adults (aged ≥ 15 years), stratified by sex. Risk of bias was evaluated using eight criteria specific to prevalence surveys. We fit multi-level Bayesian regression models with study- and country-level random effects to estimate the M:F ratio of TB prevalence (male prevalence divided by female prevalence), overall and for key subgroups. In meta-regression analyses, we estimated how prevalence ratios varied over time and according to known TB risk factors and TB case definitions.We identified 10,124 publications and extracted data from 100 eligible studies representing 102 unique prevalence surveys and 4,658,310 participants (45.6% male) in 33 LMICs. TB prevalence was higher in men than women in 90/102 of the included surveys, with a pooled M:F prevalence ratio of 2.02 (95% credible interval (CrI): 1.71, 2.34) for bacteriologically confirmed TB and 2.38 (95% CrI: 1.91, 2.90) for smear-positive TB. Time trend analyses showed a 2.0% (95% CrI: −0.2, 4.5%) average annual change in the M:F ratio of bacteriologically confirmed TB over the study period. The M:F prevalence ratio was estimated to be higher for countries with greater excess HIV prevalence among men, and countries with greater gender equity (as measured by the United Nation’s Gender Development Index). The estimated M:F prevalence ratio was also higher for surveys that did not restrict testing to individuals reporting TB symptoms. Study limitations include heterogeneity in survey methods and definitions, as well as limited data from the Americas, Eastern Mediterranean, and Europe WHO world regions and post-COVID-19 period. Conclusions Men in LMICs consistently experience TB at a higher prevalence than women. Time trend estimates are uncertain, but consistent with widening sex differences in TB prevalence over the last three decades, despite efforts to address the risk factors underlying this excess TB burden.

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22.
arXiv (CS.AI) 2026-06-19

PrototypeNAS: Rapid Design of Deep Neural Networks for Microcontroller Units

作者:
Mark Deutel↗Simon Geis↗Axel Plinge↗

arXiv:2603.15106v2 Announce Type: replace Abstract: Enabling efficient deep neural network (DNN) inference on edge devices with different hardware constraints is a challenging task that typically requires DNN architectures to be specialized for each device separately. To avoid the huge manual effort, one can use neural architecture search (NAS). However, many existing NAS methods are resource-intensive and time-consuming because they require the training of many different DNNs from scratch. Furthermore, they do not take the resource constraints of the target system into account. To address these shortcomings, we propose PrototypeNAS, a zero-shot NAS method to accelerate and automate the selection, compression, and specialization of DNNs to different target microcontroller units (MCUs). We propose a novel three-step search method that decouples DNN design and specialization from DNN training for a given target platform. First, we present a novel search space that not only cuts out smaller DNNs from a single large architecture, but instead combines the structural optimization of multiple architecture types, as well as optimization of their pruning and quantization configurations. Second, we explore the use of an ensemble of zero-shot proxies during optimization instead of a single one. Third, we propose the use of Hypervolume subset selection to distill DNN architectures from the Pareto front of the multi-objective optimization that represent the most meaningful tradeoffs between accuracy and FLOPs. We evaluate the effectiveness of PrototypeNAS on 12 different datasets in three different tasks: image classification, time series classification, and object detection. Our results demonstrate that PrototypeNAS is able to identify DNN models within minutes that are small enough to be deployed on off-the-shelf MCUs and still achieve accuracies comparable to the performance of large DNN models.

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

Text region detection in historical astronomical diagrams

作者:
Zeynep Sonat Baltac{\i}↗Rapha\"el Baena↗Fei Meng↗Somk\'eo Norindr↗Florence Somer↗Matthieu Husson↗Mathieu Aubry↗

Text detection is a crucial task in the analysis of historical documents. While datasets and benchmarks exist for text detection in manuscripts and maps, the study of text in mathematical diagrams has received little attention. To address this, we introduce a large-scale, diverse, open-access dataset of 948 historical astronomical diagrams containing 10,940 oriented polygonal text regions. Our dataset spans ten centuries (8th to 18th) and seven main linguistic traditions: Arabic and Persian (115), Chinese (332), Byzantine (233), Latin (185), Hebrew (48), and Sanskrit (35). It captures a wide range of diagram styles and textual content, from symbols to multi-line paragraphs. Each text instance is annotated with ordered polygons that precisely delineate text regions and encode the reading direction. In addition, we annotated the 2,293 regions in Latin diagrams with 20 class labels. We evaluated several strong baselines on our dataset, including TESTR, DeepSolo++, and Poly-DETR, a simple extension of DINO-DETR that we design to predict ordered polygon vertices. Poly-DETR achieves state-of-the-art performance on the MTHv2 and cBAD2019 benchmarks and provides a solid, simple baseline on our dataset. Code and dataset available online.

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

Can I Buy Your KV Cache?

作者:
Luoyuan Zhang↗

arXiv:2606.13361v1 Announce Type: new Abstract: Right now, across the world, AI agents are repeating the same absurd act: to read one document, they each recompute it from scratch. Every agent re-runs prefill, the most compute-intensive step a large model takes, over identical text, only to rebuild a key-value (KV) cache identical to the one the agent before it just built. The same answer, computed a million times. We make a proposal that is almost offensively simple: compute it once. Let a publisher precompute a document's KV cache, and let every other agent buy the right to load it and skip prefill. It works, and it is token-exact: loading a precomputed KV and continuing matches prefilling from scratch (24/24 greedy tokens, and at the logits level), with no accuracy cost. On Qwen3-4B, reuse is 9-50x cheaper in compute than prefill, and the gap widens with length (prefill's attention scales with L^2), so a single reuse already pays it back. Then the part that matters: where the KV lives. Shipping it fails, because KV is nearly incompressible, so per-load egress costs more than the prefill it saves. Hosting it provider-side, exactly as production prompt-caching works, removes egress entirely. The size of the prize is set by our measured compute saving: serving one hot 3774-token document to 80M agents costs ~$1.5M to re-prefill but only ~$0.03M of reuse compute (49.7x less). The 0.1x cache-read tariff APIs charge passes a 10x discount to users while sitting inside this measured envelope, so the 10x is a floor that the measured ~50x compute saving clears, and the gap to the physical ~50x is provider margin: millions of dollars per popular document. We frame the resulting agent-native prefill CDN and leave lossless KV compression and a cross-party payment layer as the open problems.

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

Reasoning in Computer Vision: Taxonomy, Models, Tasks, and Methodologies

作者:
Ayushman Sarkar↗Zhenyu Yu↗Mohd Yamani Idna Idris↗

Visual reasoning matters for many computer vision tasks that go beyond surface-level object detection and classification. Despite progress in relational, symbolic, temporal, causal, and commonsense reasoning, existing surveys typically cover only one part of the problem, such as visual question answering, scene-graph generation, neuro-symbolic AI, or multimodal chain-of-thought, and rarely analyze reasoning types, methodologies, and evaluation protocols together. This survey addresses that gap. Following a structured literature review, we group visual reasoning into five major types (relational, symbolic, temporal, causal, and commonsense) and examine how each is implemented across methods that range from graph-based models, memory networks, attention mechanisms, and neuro-symbolic systems to reasoning with vision-language models (VLMs) and multimodal large language models (MLLMs), including visual chain-of-thought, visual programming, and tool-augmented and test-time reasoning. We then review evaluation protocols for functional correctness, structural consistency, and causal validity, and we analyze their limits in generalizability, reproducibility, faithfulness, and explanatory power. We also identify open challenges: scaling to complex scenes, integrating symbolic and neural paradigms more deeply, the shortage of comprehensive benchmarks, language-prior shortcuts and hallucination in foundation models, and reasoning under weak supervision. Finally, we set out a research agenda for vision systems and argue that connecting perception and reasoning is necessary for transparent, trustworthy, and cross-domain models, especially in high-stakes settings such as autonomous driving and medical diagnostics.

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