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01.
arXiv (CS.AI) 2026-06-19

Temporal Self-Imitation Learning

arXiv:2606.19752v1 Announce Type: cross Abstract: Long-horizon robot manipulation policies trained with reward shaping can still exploit dense rewards through inefficient interaction, while rare efficient behaviors may be forgotten during training. We argue that temporal efficiency itself provides a powerful and underutilized source of self-supervision for reinforcement learning. We introduce Temporal Self-Imitation Learning (TSIL), a reinforcement learning framework that mines temporally efficient successful trajectories generated during learning and converts them into reusable supervision for future policy improvement. TSIL progressively refines learning using configuration-conditioned adaptive temporal targets derived from fast successful trajectories, while preserving and replaying efficient behaviors through efficiency-weighted self-imitation learning. Across 15 distinct long-horizon manipulation tasks, TSIL consistently improves learning efficiency, task-completion efficiency, revisitation of fast successful behaviors, and robustness to unstable training conditions. More broadly, our results suggest that the temporal structure of successful behavior itself provides a scalable self-supervisory signal for reinforcement learning beyond manually engineered reward shaping alone.

02.
arXiv (CS.LG) 2026-06-16

Anomaly Detection via Mean Shift Density Enhancement

arXiv:2602.03293v2 Announce Type: replace Abstract: Unsupervised anomaly detection stands as an important problem in machine learning. Existing unsupervised anomaly detection algorithms rarely perform well across different anomaly types, often excelling only under specific structural assumptions. This lack of robustness also becomes particularly evident under noisy settings. We propose Mean Shift Density Enhancement (MSDE), a fully unsupervised framework that detects anomalies through their geometric response to density-driven manifold evolution. MSDE is designed as a general purpose anomaly detection framework, based on the principle that normal samples, being well supported by local density, remain stable under iterative density enhancement, whereas anomalous samples undergo large cumulative displacements as they are attracted toward nearby density modes. To operationalize this idea, MSDE employs a weighted mean-shift procedure with adaptive, sample-specific density weights derived from a manifold learning-based fuzzy neighborhood graph. We evaluate MSDE on an anomaly detection benchmark comprising 46 real-world tabular datasets, four realistic anomaly generation mechanisms, and six noise levels. Compared to 13 established unsupervised baselines, MSDE achieves consistently strong, balanced and robust performance for several standard classification metrics, at several noise levels and on average over several types of anomalies. These results demonstrate that displacement-based scoring provides a robust alternative to the existing state-of-the-art for unsupervised anomaly detection.

03.
medRxiv (Medicine) 2026-06-22

GCH1 p.Ser80Asn Confers Risk for Parkinson's Disease in East Asian Populations

Introduction: GCH1 has been implicated in Parkinson's disease (PD), but its risks variants and associations are not well defined. Objectives: To investigate the clinical relevance and PD risk associated with the GCH1 p.Ser80Asn variant. Methods: We first identified a segregating GCH1 p.Ser80Asn variant in a Malaysian Chinese PD family via whole genome sequencing (WGS). We assessed its risk association using multi-ancestry WGS data from the Global Parkinson's Genetics Program (GP2) (n=22,372PD vs n=8,826Controls) and meta-analysis of East Asian (EAS) cohorts (n=4,712PD vs 38,733Controls). Clinico-demographic details of affected variant carriers were collated. Results: The GCH1 p.Ser80Asn variant was enriched in GP2 EAS PD populations (n=9/2,757; 0.33%) but not detected in other ancestries. Meta-analysis revealed increased PD risk in EAS populations (odds ratio:5.1; 95%CI:2.3-10.7; p=2.89x10-5). Affected carriers (mean age at onset:56.3+-12.5 years) had additional occurrence of dystonia, while dementia was rare. Conclusions: The GCH1 p.Ser80Asn variant is a rare, EAS-enriched risk variant for PD.

04.
arXiv (CS.AI) 2026-06-18

Recursive Joint Simulation in Games

arXiv:2402.08128v3 Announce Type: replace Abstract: Game-theoretic dynamics between AI agents could differ from traditional human-human interactions in various ways. One such difference is that it may be possible to accurately simulate an AI agent, for example because its source code is known. Such an agent would then be fundamentally uncertain whether it is in the real world or in a simulation. Our aim is to explore ways of leveraging this possibility to achieve more cooperative outcomes in strategic settings. In this paper, we study an interaction between AI agents where the agents run a recursive joint simulation. That is, the agents first jointly observe a simulation of the situation they face. This simulation in turn recursively includes additional simulations (with a small chance of failure, to avoid infinite recursion), and the results of all these nested simulations are observed before an action is chosen. We show that the resulting interaction is strategically equivalent to an infinitely repeated version of the original game, allowing a direct transfer of existing results such as the various folk theorems. As evidence that the equivalence is robust, we show that it holds even when we relax some of the assumptions and that it also holds ``from the inside'' – meaning, for an agent that finds itself inside the game and has self-locating uncertainty.

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

The Containment Gap: How Deployed Agentic AI Frameworks Fail Public-Facing Safety Requirements

arXiv:2606.12797v1 Announce Type: new Abstract: Agentic large language model systems that autonomously invoke tools, maintain persistent memory, and execute multi-step plans are increasingly deployed in public-facing domains, including government services, healthcare triage, and financial advising. We ask whether the frameworks used to build these systems provide architectural-level structural safety guarantees. Applying six containment principles derived from a compositional model of agentic architectures, we audit three dominant frameworks (LangChain, AutoGPT, and OpenAI Agents SDK) and find no native compliance in any of them. Memory integrity, a defense against one of the most prevalent vulnerability classes, is not observed in any of the three evaluated frameworks. We validate these findings empirically: in a simulated government benefits agent built on LangChain, a single memory-poisoning write induces persistent targeted corruption across all tested seeds and backends, increasing the wrongful denial rate for targeted applicants to 88.9%. Under a complex five-factor policy, the same attack preserves aggregate accuracy while increasing targeted wrongful denials by 3.5x, rendering the corruption difficult to detect through standard monitoring. We then introduce two lightweight containment mechanisms: a memory integrity validator and a policy gate, which eliminate both attack vectors with sub-millisecond overhead (

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

WavSLM: Single-Stream Speech Language Modeling via WavLM Distillation

Large language models show that simple autoregressive training can yield scalable and coherent generation, but extending this paradigm to speech remains challenging due to the entanglement of semantic and acoustic information. Most existing speech language models rely on text supervision, hierarchical token streams, or complex hybrid architectures, departing from the single-stream generative pretraining paradigm that has proven effective in text. In this work, we introduce WavSLM, a speech language model trained by quantizing and distilling self-supervised WavLM representations into a single codebook and optimizing an autoregressive next-chunk prediction objective. WavSLM jointly models semantic and acoustic information within a single token stream without text supervision or text pretraining. Despite its simplicity, it achieves competitive performance on consistency benchmarks and speech generation while using fewer parameters, less training data, and supporting streaming inference.

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

Mental-R1: Aligning LLM Reasoning for Mental Health Assessment

arXiv:2606.13176v1 Announce Type: new Abstract: Mental health problems such as anxiety, depression, and suicide remain urgent global challenges, where timely and accurate assessment is critical for effective intervention. Recently, large language models have been explored for mental health assessment. However, existing general-purpose post-training methods do not align with the cognitive processes of human assessment, which may lead to unreliable reasoning outcomes. To bridge this gap, we propose Cognitive Relative Policy Optimization (CRPO), a reinforcement learning framework tailored for the mental health domain. CRPO extends group relative policy optimization by integrating stage-dependent uncertainty modeling into the policy optimization process. Specifically, we introduce a stage-wise entropy regularization mechanism that encourages broad exploration in early reasoning phases and progressively enforces confident decision-making in later stages, mimicking the human cognitive shift from uncertainty to certainty. In addition, inspired by cognitive appraisal theory, we formalize cognitive reasoning stages, thereby guiding theory-grounded interpretable inference. Experiments on 8 mental health datasets show that CRPO achieves an average improvement of 10.4 percentage points in weighted F1-score over the best reinforcement learning baseline. Furthermore, the CRPO-trained model Mental-R1 demonstrates clear advantages compared with existing large language models on reasoning-intensive cases, suggesting that CRPO enhances reasoning capabilities for mental health assessment.

08.
bioRxiv (Bioinfo) 2026-06-16

DynamicDemiLog: A Single Sketch for Ultrafast Similarity, Frequency, and Cardinality Estimation

Probabilistic cardinality estimators (HyperLogLog), similarity sketches (MinHash), and frequency estimators (Count-Min Sketch) are fundamental approximate data structures that each target one primary problem. We present DynamicDemiLog (DDL), a sketch that unifies cardinality estimation, set similarity, containment, element frequency and composition in one tiny data structure built from a single pass over the input stream. Using an inverted index over 200,687 RefSeq sketches (159,567 organisms), DDL performs all-to-all sketch similarity comparison of the full database in 30 seconds (128 threads, indexed) - over 375x faster per query than Mash's brute-force all-to-all comparison of 91,282 sketches, or 31x faster without the index, at double the sketch resolution. DDL extends the LogLog register with a mantissa: each register stores a floating-point-encoded hash value consisting of an integer exponent (the leading-zero count) and a fractional mantissa (the sub-leading-zero bits), rather than the integer leading-zero count alone. This preserves enough hash information for meaningful register-by-register comparison - a property that standard 6-bit registers lack - while improving on LogLog's cardinality estimation machinery, including DynamicLogLog's early exit mask for high-throughput streaming. With a default 10 mantissa bits (16-bit registers, 2,048 buckets, 4 KB), DDL achieves a per-register false-match rate of 0.018% on unrelated random same-size sets (compared to 17.0% for LL6, a basic HyperLogLog implementation), enabling Weighted Kmer Identity (WKID), Average Nucleotide Identity (ANI), containment, and completeness estimation from register comparison alone. A 16-bit per-register observation counter provides element frequency information at trivial additional computation cost, and an additional byte tracks element composition (GC content, for biological data). Furthermore, DDL's high-specificity registers enable an inverted index structure (DDLIndex) that answers similarity queries against a database of N sketches in O(B + M) time, where M is the number of matching index entries, compared to O(NxB) for pairwise comparison.

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

Direction-Conditioned Policies via Compositional Subgoal Scoring for Online Goal-Conditioned Reinforcement Learning

arXiv:2606.16515v1 Announce Type: cross Abstract: Hamilton-Jacobi-Bellman theory implies that the optimal goal-conditioned action depends on the goal only through the gradient of the goal-reaching distance at the current state, yet standard online GCRL still conditions the actor on the raw goal – a signal that is geometrically uninformative when the goal is far from the data distribution. We propose Direction-Conditioned Policies (DCP), a fully online method that decomposes goal-reaching into two components sharing one InfoNCE representation $\psi$: a subgoal-scoring step that selects a visited state $z_t$ aligned with the final goal $g$ in $\psi_g$, and a direction-conditioned actor that consumes the unit direction $d_t$ and magnitude $r_t$ from $\psi(s_t)$ to $\psi(z_t)$. The two components train jointly, factor cleanly at deployment (subgoal scoring is removed, while direction conditioning remains with $g$ in place of $z_t$), and admit independent modification at the same $(d_t,r_t)$ interface. We prove three results. First, direction sufficiency under HJB: the optimal action under control-affine dynamics depends on the goal only through the value gradient. Second, a quantitative bound showing that, under mild conditions on the learned representation and assuming the scoring rule returns an on-path $z_t$, the actor's conditioning input at training and at deployment coincide up to representation error and geodesic slack. Third, a controllable-subspace characterization of when directional conditioning fails. Across nine environments, DCP improves over Contrastive RL on most final metrics, with the largest gains on manipulation and obstacle-interaction tasks; a qualitative analysis of the learned $\psi$-distance landscape shows the contrastive representation behaves as an online quasimetric encoding environment topology, and the single failure case (AntSoccer) localizes to a learned-gradient pathology that the theory anticipates.

10.
bioRxiv (Bioinfo) 2026-06-17

Posterior-calibrated multimodal motor states reveal longitudinal and imaging-associated heterogeneity in Parkinson's disease

Parkinson's disease (PD) motor heterogeneity is commonly summarized by hard subtype labels, although clinical states vary longitudinally, severity can dominate unsupervised structure, and model uncertainty is rarely calibrated. We developed a posterior and refit-stability calibrated multimodal motor state framework that assigns probabilistic MDS-UPDRS-III motor states, aggregates them at the patient level, separates global burden from residual tremor-axial profile, and tests whether imaging can recover the resulting posterior distribution. In 29,366 aligned PPMI motor-posterior visits spanning 4,773 participant identifiers, patient-level state families were stable on average (modal-family fraction 0.925; 95% CI 0.921 - 0.930), but 25.5% of patients transitioned state over follow-up (95% CI 24.1 - 26.7%). PD-only cohort definitions produced smaller denominators and are reported as sensitivity cohorts with rerun calibration and imaging-posterior checks. Severity and covariates explained substantial motor-domain variance, especially bradykinesia (rsecond=0.850), but residual profile modeling retained five active components across total-severity, principal-component, leave-one-domain, non-target-burden, and clinical-only severity axes. Refit-stability calibration with 250 patient-blocked bootstrap refits showed high nominal posterior confidence (0.989) but lower empirical label consistency (0.849), quantifying overconfidence rather than hiding it. Patient-held-out temporal modeling predicted future axial burden (best XGBoost rsecond=0.605) and future state transition (XGBoost AUC=0.830; 95% CI 0.822 - 0.837). DaTSCAN plus FreeSurfer ROI features predicted patient-level soft motor posterior vectors (RF jsd=0.209; 95% CI 0.199 - 0.220; macro-AUROC=0.692), while severity/demographic-adjusted imaging features further improved soft posterior recovery (jsd=0.188). BioFIND transfer reproduced clinically meaningful endpoint gradients after state assignment in 225 external patients, supporting external face validity rather than definitive transportability. These results support PD motor phenotypic states as calibrated, dynamic, clinically interpretable profiles with convergent imaging associations, not as definitive biological subtypes.

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

Track2View: 4D-Consistent Camera-Controlled Video Generation via Paired 3D Point Tracks

Re-rendering an existing video from a novel camera viewpoint requires the output to follow the prescribed camera trajectory while preserving the appearance and dynamics of the original scene across every frame. Existing methods rely on per-frame pose embeddings, noisy point-cloud renderings, or implicit learned correspondences, none of which provides an explicit, temporally continuous link between source and target pixels. We propose Track2View, which conditions a video diffusion transformer on paired 3D point tracks: sparse trajectories of scene points projected into both the source and target camera views. These tracks provide explicit spatiotemporal correspondences that are temporally continuous by construction, encoding what content should appear where and when. At the core of Track2View is a dual-view track conditioner that transfers visual context from source to target view through parameter-free geometric operations and learned temporal aggregation, ensuring generalization to arbitrary camera trajectories without memorizing specific motions. We further introduce a data curation pipeline that extracts one-to-one track correspondences by running a 3D point tracker on temporally concatenated multi-camera view pairs. On a 400-video benchmark spanning static and dynamic scenes, Track2View achieves state-of-the-art results across visual quality, view synchronization, and camera accuracy, reducing rotation error by 30-65% and translation error by 61-72% relative to leading baselines. Project page is available at this https URL: https://qjizhi.github.io/track2view

12.
arXiv (quant-ph) 2026-06-16

Simulation of Non-Hermitian Hamiltonians with Bivariate Quantum Signal Processing

arXiv:2605.12450v2 Announce Type: replace Abstract: We achieve query-optimal quantum simulations of non-Hermitian Hamiltonians $H_{\mathrm{eff}} = H_R + iH_I$, where $H_R$ is Hermitian and $H_I \succeq 0$, using a bivariate extension of quantum signal processing (QSP) with non-commuting signal operators. The algorithm encodes the interaction-picture Dyson series as a polynomial on the bitorus, implemented through a structured multivariable QSP (M-QSP) circuit. A constant-ratio condition guarantees scalar angle-finding for M-QSP circuits with arbitrary non-commuting signal operators. A degree-preserving sum-of-squares spectral factorization permits scalar complementary polynomials in two variables. Angles are deterministically calculated in a classical precomputation step, running in $\mathcal{O}(d_R \cdot d_I)$ classical operations. Operator norms $\alpha_R\,,\beta_I$ contribute additively with query complexity $\mathcal{O}((\alpha_R + \beta_I)T + \log(1/\varepsilon)/\log\log(1/\varepsilon))$ matching an information-theoretic lower bound in the separate-oracle model, where $H_R$ and $H_I$ are accessed through independent block encodings. The postselection success probability is $e^{-2\beta_I T}\|e^{-iH_{\mathrm{eff}}T}|\psi_0\rangle\|^2\cdot (1 - \mathcal{O}(\varepsilon))$, decomposing into a state-dependent factor $\|e^{-iH_{\mathrm{eff}}T}|\psi_0\rangle\|^2$ from the intrinsic barrier and an $e^{-2\beta_I T}$ overhead from polynomial block-encoding.

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

Non-frontal face recognition using GANs and memristor-based classifiers

Face recognition systems have advanced significantly through deep learning techniques, delivering high performance and robustness in complex scenarios. However, these approaches incur substantial computational overhead, limiting their in situ applicability in resource-constrained platforms such as drones, where they can address challenges including non-frontal facial imagery. Memristor-based neuromorphic systems have emerged as a compelling approach for edge AI applications, combining biologically inspired processing with efficient and scalable computation. In this work, we propose a facial recognition framework that addresses non-frontal pose variations by integrating lightweight generative adversarial network (GAN)-based pose frontalisation with memristor-based neuromorphic recognition. The experimental results on two datasets demonstrate the effectiveness of combining adversarial learning with memristive technology, achieving up to 96% identification accuracy. The proposed approach alleviates the computational bottlenecks of conventional AI and offers a scalable, efficient solution for face recognition in dynamic real-world environments.

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

Boosting Direct Preference Optimization with Penalization

作者:

arXiv:2606.12505v1 Announce Type: cross Abstract: Offline preference optimization has become a practical substitute for reinforcement learning from human feedback, but pairwise objectives such as Direct Preference Optimization (DPO) and its variants use only the chosen and rejected responses stored in a static dataset. This leaves a useful signal unused: the response that the reference model itself would generate for the same prompt. We propose Direct Preference Optimization with Penalization (DPOP), a simple extension of DPO that augments the base preference loss with a gated penalty on reference-greedy responses. DPOP activates this penalty only when the current policy still assigns a lower likelihood to the preferred response than to the rejected response. On AlpacaEval 2.0, DPOP improves length-controlled win rate over DPO, SimPO, and AlphaDPO on both Llama-3-8b-it and Gemma-2-9b-it, achieving relative gains of 5.3\% and 4.4\% over baselines on the two models, respectively. Ablations further show that a SimNPO-style length-normalized penalty is stronger than NPO and token-level unlikelihood in this setting.

15.
arXiv (CS.AI) 2026-06-16

A Definition of Good Explanations and the Challenges Explaining LLM Outputs

arXiv:2606.14838v1 Announce Type: new Abstract: How to define a good explanation is a long-standing philosophical debate which has found recent renewed interest in the context of AI outputs. Explainability is crucial for AI adoption in many contexts, but in order to produce good explanations of AI systems, we must first have an understanding of what good explanations are. In this paper we propose a definition inspired by the notion of counterfactual explanations, however we argue that one must also take into account the interlocutor's prior beliefs in each fact that could be offered in an explanation. We explore the ramifications of this definition for AI explainability and, in particular, why LLM outputs are difficult to produce good explanations for.

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

ReMMD: Realistic Multilingual Multi-Image Agentic Verification for Multimodal Misinformation Detection

arXiv:2606.24112v1 Announce Type: new Abstract: Multimodal misinformation detection is increasingly important because viral posts now combine long multilingual narratives, several images, mixed provenance, and subtle text–image framing errors. Existing benchmarks and methods remain poorly matched to this setting: they usually isolate short captions, single images, binary labels, or one manipulation source, while agentic verification remains costly under realistic evidence search. We present ReMMD, a realistic multilingual multi-image agentic verification framework for multimodal misinformation detection. ReMMD includes ReMMDBench, a real-world multimodal misinformation detection benchmark with 500 samples, 2,756 images, five monolingual languages, two cross-lingual settings, three text-length tiers, multi-image posts, five-way veracity labels, eight distortion labels, evidence provenance, and rationales. It also includes ReMMD-Agent, a persistent-memory verifier that decomposes posts into atomic points, builds a reusable evidence set, and predicts structured L1/L2/L3 outputs. Across proprietary systems, open LVLMs, MMD-Agent, and T2-Agent, ReMMD-Agent obtains the best five-way veracity performance, with 41.80% accuracy and 39.12% macro-F1 using GPT-5.2, while reducing cost by 17.5% relative to MMD-Agent and 79.9% relative to T2-Agent. The project is available at https://dang-ai.github.io/ReMMD.

17.
Nature Medicine 2026-06-22

Biological aging and generational shifts in early-onset cancer risk

作者:

Incidence of early-onset cancer is rising globally in recent generations, which underscores the need to elucidate the influence of emerging generational risk factors. Systemic and organ-specific aging reflects the cumulative impact of exposures and may provide an integrative and complementary approach to understand early-onset cancer risk. Here among 154,169 young adults from the United Kingdom Biobank, systemic aging measured by PhenoAge increased across birth cohorts, with 23% s.d. increase for those born 1965–1974 versus 1950–1954, and was associated with early-onset solid cancer risk (hazard ratio (HR)per s.d. 1.08; 95% confidence interval (CI), 1.03–1.13), driven by lung, gastrointestinal and uterine cancers, independent of genetic risks of aging and cancer. Patterns were consistent using alternative systemic aging measures, including the Klemera–Doubal method-defined age gap and metabolomic-based age gap. These findings were validated partially among 10,262 participants in the United States All of Us Research Program. Proteomics-based organ-specific aging analyses linked immune aging with early-onset lung cancer (HRper s.d. 1.89; CI, 1.20–2.97) and adipose tissue aging to early-onset colorectal cancer (HR 1.60; CI, 1.11–2.32). Greater age gap, reflecting more advanced biological aging relative to chronological age, may serve as a driver associated with risk of early-onset solid cancers, highlighting the importance of uncovering underlying mechanisms to guide effective prevention strategies. Analyses of population cohorts found that young adults exhibited earlier systemic and organ-specific aging, which was associated with increased risk of early-onset cancer compared with older adults born decades earlier.

18.
arXiv (CS.CL) 2026-06-12

Can Factual Opinions Be Edited (Manipulated) in Large Language Models?

Large Language Models (LLMs) are increasingly integrated into various domains, making knowledge editing techniques crucial yet potentially hazardous. Current editing methods primarily target atomic facts, overlooking the significant risks associated with manipulating factual opinions, e.g., documented stances of public figures on societal issues. Such manipulation could reshape public images, influence elections, and alter societal views. To systematically assess this threat, we introduce the Factual Opinion Editing with Evidence (FOE) benchmark, which encompasses 261 public figures, 19 issue categories, and 2,178 complete opinion records. Our evaluations demonstrate that current editing techniques struggle significantly with factual opinions, often achieving only superficial changes while failing to preserve consistency between the edited opinion and the supporting evidence generated by the model. To address this limitation, we further propose a simple yet effective Self-Generated Evidence-Aligned method that achieves opinion-evidence alignment without relying on explicit instructions. Together, our benchmark and method provide a foundation for understanding the emerging security implications of factual opinion editing in LLMs.

19.
arXiv (quant-ph) 2026-06-11

A Geometric Family of Correlations Containing the Quantum Singlet

arXiv:2606.12045v1 Announce Type: new Abstract: We introduce a geometrically constrained hidden-variable framework that generates a family of correlations parametrized by a boundary function, within which the quantum singlet correlation appears as a particular member. Exact expressions for the correlation function are derived. Several structural results are established, including admissibility conditions, symmetry properties, a universal stationary point of the associated CHSH function, and an exact relation between the CHSH value at $\nu=\pi/4$ and a geometric contrast measure defined on the underlying hidden-variable distributions. Rather than treating the quantum singlet correlation as an isolated target to be reproduced, the present framework places it within a broader geometric structure of correlations. These results suggest the existence of a nontrivial geometric structure underlying the family of correlations and motivate the search for a principle capable of selecting the quantum singlet solution from within that family.

20.
medRxiv (Medicine) 2026-06-23

Antibodies against influenza A/H1N1pdm2009 and B/Victoria strains but not A/H3N2 are increased in recent onset type 1 narcolepsy versus matched controls

Study Objectives: Onsets of Narcolepsy type-1 (NT1) increased following A/H1N1 vaccination with PandemrixTM in Europe and with A/H1N1pdm2009 infections in China and other countries. To test if other strains could trigger narcolepsy, we measured strain-specific antibodies in patients with recent onset NT1 compared to controls. Methods: Antibodies against hemagglutinin (HA) and neuraminidase (NA) were tested in 62 patients with very recent onset (onset and blood collection following a single flu season, mean +/- SEM: 0.44 +/- 0.06 years since onset) and 100 controls matched by age, sex, season and year of collection (2000-2025). Results were next extended to 181 recent onset patients (mean +/- SEM: 1.00 +/- 0.05 years) versus 260 controls, matched by sex, season and year, but having a slightly higher mean age. HA inhibition (HAI) and NA inhibition (NAI) assays were conducted using flu strains known to circulate during the corresponding flu seasons. HAI results are shown as % positive (titers >= 40) and NAI results as geometric mean titers. Odds ratio (OR) and coefficient were used to compare antibody titers in NT1 versus controls. The contribution of each assay to prediction was finally quantified in the larger sample set using Shapley decomposition. Results: NT1 patients had increased anti-HA and anti-NA antibodies against A/H1N1pdm2009 (anti-HA OR = 3.86, anti-NA coefficient = 0.35) and B/Victoria (anti-HA OR =1.90, anti-NA coefficient = 0.22), but not A/H1N1pre2009, A/H3N2, or B/Yamagata, independent of HLA-DQB1*06:02 status, age, sex, and flu season. Correlations between anti-HA and anti-NA antibodies titers were weak to moderate but significant (r2=-0.10 to 0.34). Multivariable model outperformed age-only baseline (McFadden R2 = 0.19 vs. 0.03; AUC = 0.79 vs. 0.64; likelihood-ratio test X2 = 51, p

21.
medRxiv (Medicine) 2026-06-12

Design, Implementation, and Evaluation of a Shadowing Program for Medical Students in the Basic Sciences Phase

Introduction Shadowing, as an educational method based on active observation, can foster a realistic understanding of professional roles and enhance the communication skills of medical students. This study aimed to design, implement, and evaluate a shadowing program for basic sciences medical students. Methods This development study was conducted based on the ADDIE model in five phases. The study population consisted of 799 medical students in semesters 2 to 5. The stages included Analysis (determining needs through literature review and expert panels), Design (specifying learning environments and evaluation methods), Development (preparing guides and educational tools), Implementation (within the Medical Ethics course), and Evaluation (using questionnaires and reflection forms). Findings This study aimed to design and evaluate an educational shadowing program based on the ADDIE model. In the Analysis phase, the profiles of 799 students and learning objectives were determined. In the Design phase, a structured program for four types of shadowing was designed. In the Development phase, all guides and educational tools were prepared. In the Implementation phase, the program was carried out with complete coverage and adherence to ethical considerations. Finally, the program evaluation showed that "Motivation to become a good physician" (3.75-3.95) and "Enhancing empathy" (3.50-3.94) received the highest scores, while "Increasing understanding of the basic science-clinical connection" (2.53-2.89) and "Willingness to attend on holidays" (1.87-2.31) received the lowest scores. Conclusion The findings indicate that implementing the shadowing program is an effective method for strengthening the professional attitudes and academic motivation of medical students. However, the program did not significantly improve students perception of the basic science-clinical connection, indicating a need for curricular refinement. The continuation and extension of this program to other levels and fields of medical sciences are recommended.

22.
medRxiv (Medicine) 2026-06-16

Deployment-readiness audit of calibration, clinical utility, and fairness in perioperative infection prediction

Objective: Clinical risk scores intended to guide patient-level decisions can show strong average performance. However, predicted probabilities can be systematically too high or too low in specific subgroups even when overall performance is strong. We audited deployment readiness of a strong end-of-surgery postoperative infection model across clinically relevant subgroups and tested mitigation strategies in miscalibrated subgroups. Materials and Methods: We analyzed out-of-fold predictions for 10,719 surgical procedures at a Swiss tertiary hospital, with 504 postoperative bacterial infection events. Prespecified axes were recorded sex, age stratum, and an EHR-derived physiological-reserve proxy. Within subgroups and pairwise intersections, we evaluated discrimination, calibration, threshold-specific errors, and decision-curve net benefit at the prespecified operating threshold. We compared group-specific isotonic recalibration with Wasserstein-barycenter postprocessing and demonstrated portability in SUPPORT2. Results: Overall AUROC was 0.876. While sex-marginal discrimination was similar in women and men (0.878 vs 0.875), age and reserve stratification revealed deployment-readiness failures. Calibration-in-the-large ranged from -0.86 in frail patients to -2.47 in non-frail patients. At the 0.10 operating threshold, decision-curve net benefit was positive in frail patients but negative in pre-frail and non-frail patients. Isotonic recalibration corrected average physiological-reserve-stratified calibration without worsening Brier scores, whereas Wasserstein postprocessing worsened calibration in most procedure clusters. Discussion: Discrimination-only or sex-marginal evaluation would have missed subgroup failures with clinical-utility implications. Conclusion: Subgroup fairness audits for clinical deployment should jointly evaluate discrimination, calibration, and utility. We implemented the audit as the open-source isitfair framework for identifying deployment-relevant subgroup failures, comparing mitigation strategies, and generating structured reports.

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

An Ensemble Deep Learning Approach for Reliable and Scalable Lemon Leaf Disease Classification

Early detection of plant diseases is crucial to plants and for the farmers. Plant diseases reduce fruit yield and quality, and plants are more susceptible to other stresses when they are infected. The lemon leaf disease dataset contains 1354 images. The dataset has 9 classes. Among the 9 classes only one class is for healthy leaf, and the other 8 classes are leaf diseases. The dataset was split into training (70%), testing (15%) and validation (15%) sets after comprehensive preprocessing. Two pretrained models (InceptionV3 and MobileNetV2) were applied and then combined these models using an ensemble technique to boost robustness. Ensemble models showed a promising performance of 99.27% accuracy. Adversarial Training is applied to improve models' ability and ensure reliable predictions under noisy data. Grad-CAM visualization highlights the important regions of leaf images that validate the model prediction with confidence level.

24.
arXiv (CS.CL) 2026-06-18

Learning Robust Pair Confidence for Multimodal Emotion-Cause Pair Extraction

Multimodal emotion-cause pair extraction (MECPE) requires reliable pair confidence over candidate pairs. Existing pair scorers commonly use pair-level cross entropy over valid candidates, which treats links mostly independently. This leaves the relative confidence geometry among competing causes under-constrained, allowing gold pairs to stay close to hard negatives or rely on incidental non-gold context. We study this vulnerability as pair-confidence brittleness and propose RPCL (Robust Pair Confidence Learning), a training-only framework for pair-confidence learning. RPCL encourages pair confidence to be both discriminative and stable: gold pairs are separated from row-wise hard negatives through a confidence-difference margin constraint, and clean pair predictions are aligned with predictions from a corrupted view where non-gold contextual utterance representations are partially corrupted. The original clean pair scorer and decoding pipeline are used unchanged at inference time. On ECF, MECAD, and MEC4, RPCL improves the three-seed mean Pair F1 over a matched base model by 2.58 to 2.83 percentage points in the full text-audio-video setting, and improves mean Pair AUPRC on all three datasets. Diagnostic analysis further shows larger gold-negative confidence gaps and lower margin-violation severity. These results suggest that explicitly shaping pair confidence is an effective training strategy for MECPE.

25.
arXiv (CS.CV) 2026-06-24

EPEdit: Redefining Image Editing with Generative AI and User-Centric Design

The demand for image manipulation has seen a significant increase recently. Traditional tools like Photoshop and Capture One, while powerful, require considerable expertise to use effectively. Generative AI has introduced alternative platforms, such as Luminar Neo, Pixlr X, and Canva. However, many of these solutions, including resource-heavy models like Stable Diffusion, often require substantial retraining and fine-tuning, leading to high costs for users. To address these challenges, we introduce Efficient Photo Editor (EPEdit), an application that integrates a robust backend framework with a user-friendly front-end interface. EPEdit supports a wide range of creative image editing tasks, including image generation, object replacement, object removal, background modification, changes in object pose or perspective, region-specific editing, and thematic collection design, all guided by masks and prompts. Users can interact with the system through simple text commands or by marking areas for precise adjustments, making it accessible even to those without technical expertise. At its core, EPEdit leverages zero-shot image editing algorithms based on Stable Diffusion model, removing the need for additional fine-tuning. This approach enables efficient image manipulation and thematic collection creation. User evaluations for tasks of image editing, thematic design, and overall system performance demonstrate that EPEdit outperforms existing solutions, offering a user-friendly, cost-effective solution for comprehensive image editing.