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01.
Nature Medicine 2026-06-11

Microglia at a key inflection point in Alzheimer’s disease

Authors: Unknown Author

We analyzed brains from octogenarians and cognitively resilient centenarians to understand why some individuals with substantial Alzheimer’s disease pathology develop dementia whereas others remain cognitively intact. Spatial transcriptomics revealed gene expression changes in discrete tissue domains surrounding amyloid plaques and tau pathology that distinguish early, clinically silent, disease from later stages associated with cognitive decline.

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02.
arXiv (quant-ph) 2026-06-12

Trading symmetry for Hilbert-space dimension in Bell-inequality violation

Authors:
Hsin-Yu Hsu↗Gelo Noel M. Tabia↗Kai-Siang Chen↗Mu-En Liu↗Tam\'as V\'ertesi↗Nicolas Brunner↗Yeong-Cherng Liang↗

arXiv:2601.02893v3 Announce Type: replace Abstract: In quantum information, asymmetry, i.e., the lack of symmetry, is a resource allowing one to accomplish certain tasks that are otherwise impossible. Similarly, in a Bell test using any given Bell inequality, the maximum violation achievable using quantum strategies respecting or disregarding a certain symmetry can be different. In this work, we focus on the symmetry involved in the exchange of parties and explore when we have to trade this symmetry for a lower-dimensional quantum strategy in achieving the maximal violation of given Bell inequalities. For the family of symmetric Collins-Gisin-Linden-Massar-Popescu inequalities, we provide evidence showing that there is no such trade-off. However, for several other Bell inequalities with a small number of dichotomic measurement settings, we show that symmetric quantum strategies in the minimal Hilbert space dimension can only lead to a suboptimal Bell violation. In other words, there exist symmetric Bell inequalities that can only be maximally violated by asymmetric quantum strategies of minimal dimension. In contrast, one can also find examples of asymmetric Bell inequalities that are maximally violated by symmetric correlations. The implications of these findings on the geometry of the set of quantum correlations and the possibility of performing self-testing therefrom are briefly discussed.

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03.
PLOS Medicine 2026-05-14

Antibody fine specificity correlates with protection from malaria for the RTS,S vaccine in young African children: A post hoc analysis of a phase IIb randomised controlled trial

Authors:
Alessia Hysa↗

by Alessia Hysa, D. Herbert Opi, Joshua Waterhouse, Sandra Chishimba, Jessica L. Horton, Natalie Kingston, Hans J. Netter, David Wetzel, Michael Piontek, Gaoqian Feng, Jahit Sacarlal, Carlota Dobaño, Liriye Kurtovic, James G. Beeson Background The RTS,S/AS01 malaria vaccine was recently approved for implementation in children, but only provides modest and short-lived efficacy against malaria. RTS,S targets a portion of the Plasmodium falciparum (Pf) circumsporozoite protein (CSP), comprising the central NANP-repeat region and C-terminal domain. Mechanisms of immunity and correlates of protection for the RTS,S vaccine are not well defined, hindering progress towards generating highly effective CSP-based vaccines. Methods and findings We investigated epitope specificity and cross-reactivity of vaccine-induced antibodies to six peptides representing CSP epitopes in the N-terminal and central NANP-repeat region. We evaluated antibody reactivity in preclinical mouse vaccine studies, among CSP-specific monoclonal antibodies (mAbs), and in a large RTS,S phase IIb clinical trial in young children 1–4 years old (n = 735).The preclinical mouse vaccine studies and CSP-specific mAbs were used to initially evaluate IgG responses to the six peptides. Mice immunised with the central NANP-repeat region had IgG with cross-reactivity to an epitope in the N-terminal region. Additionally, we demonstrated that a single CSP-specific mAb could display cross-reactivity to several CSP epitopes. Through post hoc quantification and analysis of antibody responses in the RTS,S phase IIb clinical trial, we found that a subset of children generated IgG with specificity for a short NANP-repeat epitope (NANP2; amino acid sequence: NANPNANP) and cross-reactivity to an N-terminal epitope (J1; amino acid sequence: KQPADGNPDPNANPN). Notably, children with high IgG responses to NANP2 and J1 had a significantly reduced risk of clinical malaria, compared to children with low responses (IgG to NANP2 (aHR: 0.838 (95% CI [0.716, 0.981]; p = 0.028)) and J1 (aHR: 0.718 (95% CI [0.611, 0.844]; p 

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

DRIFT: Refining Instruction Data via On-Policy Data Attribution

Authors:
Zefan Wang↗Lincheng Li↗Tianyu Yu↗Yuan Yao↗

arXiv:2606.18307v1 Announce Type: cross Abstract: Optimizing the training data distribution for Supervised Fine-Tuning (SFT) dictates the capability of Large Language Models (LLMs). While existing data curation methods excel at accelerating training under constrained budgets, they are less suited to elevating the capability upper bound. The challenge here is no longer to identify a smaller subset that preserves performance, but to refine the data distribution toward instances most capable of improving the final model. To address this problem, we explore instance-level data attribution using Influence Functions (IF). We identify that standard IF formulations struggle in this setting due to two structural limitations: a proximity gap caused by off-policy validation targets, and a severe bias towards gradient norm. We propose DRIFT (Data Refinement via On-Policy Influence Functions for Supervised Fine-Tuning). Instead of relying on external reference data, DRIFT utilizes the model's on-policy rollouts as validation targets, which empirically minimizes the parameter proximity gap and better aligns with the local neighborhood assumption of IF. It further applies signed weighting based on trajectory correctness and debiases influence scores against the gradient hacking issue, allowing a small set of validation queries to act as reliable anchors for attributing the full dataset. Experiments on 7B-parameter instruction and reasoning models show that DRIFT consistently raises the performance ceiling on both, outperforming existing data curation baselines.

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05.
medRxiv (Medicine) 2026-06-22

Artificial Intelligence-Enabled Cardiac Function Estimation from Phone Videos of Echocardiograms

Authors:
Modi↗Kim↗Ye↗Eusuff↗Ieki↗Ambrosy↗A. P↗Kwan↗A. C↗He↗Zou↗Cheng↗…

Importance: Mobile phone-recorded echocardiogram videos are commonly used in point of care, telemedicine, and resource-limited workflows, but artificial intelligence models for left ventricular ejection fraction (LVEF) estimation have primarily been evaluated on native Digital Imaging and Communications in Medicine (DICOM) videos. Objective: To evaluate whether previously described artificial intelligence models for LVEF estimation retain performance when applied to mobile phone-recorded echocardiographic videos. Design: Multicenter model validation study comparing model-estimated LVEF with clinician reported LVEF. Setting: Three medical centers: Kaiser Permanente Northern California, Beth Israel Deaconess Medical Center through MIMIC-IV-ECHO, and Cedars-Sinai Medical Center. Participants: Source studies with clinician reported LVEF and apical 4-chamber or apical 2-chamber views, yielding 6209 phone-recorded videos from 2648 studies and 2611 patients. Exposures: Mobile phone recording of native echocardiographic videos and fine-tuning of pretrained models using mobile phone-recorded videos from the Kaiser Permanente Northern California training cohort. Main Outcomes and Measures: Mean absolute error in ejection fraction percentage points, R^2 for continuous estimation, and area under the receiver operating characteristic curve for identifying ejection fraction greater than 50%. Results: The study included 6209 mobile phone recorded echocardiographic videos from 2648 studies and 2611 patients; the weighted mean age was 68.4 years, and 1031 patients were male (39.5%). Without phone-video fine-tuning, the primary model achieved a mean absolute error of 7.00 percentage points, coefficient of determination of 0.49, and area under the receiver operating characteristic curve of 0.91 on phone-recorded videos; corresponding native DICOM performance was 6.08 percentage points, 0.60, and 0.93, respectively. On the 2396-video fine-tuning evaluation cohort, fine-tuning improved primary model performance to a mean absolute error of 6.96 percentage points, coefficient of determination of 0.61, and area under the receiver operating characteristic curve of 0.93. Fine-tuning the public EchoNet-Dynamic model improved performance from 9.36 percentage points, 0.37, and 0.84 to 7.86 percentage points, 0.50, and 0.89, respectively. Progressive central zoom preprocessing degraded model performance. Conclusions and Relevance: These findings suggest that artificial intelligence assisted left ventricular ejection fraction estimation from mobile phone-recorded echocardiograms may be feasible when native image export is unavailable, although prospective evaluation is needed before clinical deployment.

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07.
arXiv (CS.LG) 2026-06-19

The Hidden Cost of Approximation in Online Mirror Descent

Authors:
Ofir Schlisselberg↗Uri Sherman↗Tomer Koren↗Yishay Mansour↗

arXiv:2511.22283v2 Announce Type: replace Abstract: Online mirror descent (OMD) is a fundamental algorithmic paradigm that underlies many algorithms in optimization, machine learning and sequential decision-making. The OMD iterates are defined as solutions to optimization subproblems which, oftentimes, can be solved only approximately, leading to an inexact version of the algorithm. Nonetheless, existing OMD analyses typically assume an idealized error free setting, thereby limiting our understanding of performance guarantees that should be expected in practice. In this work we initiate a systematic study into inexact OMD, and uncover an intricate relation between regularizer smoothness and robustness to approximation errors. When the regularizer is uniformly smooth, we establish a tight bound on the excess regret due to errors. Then, for barrier regularizers over the simplex and its subsets, we identify a sharp separation: negative entropy requires exponentially small errors to avoid linear regret, whereas log-barrier and Tsallis regularizers remain robust even when the errors are only polynomial. Finally, we show that when the losses are stochastic and the domain is the simplex, negative entropy regains robustness-but this property does not extend to all subsets, where exponentially small errors are again necessary to avoid suboptimal regret.

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08.
arXiv (quant-ph) 2026-06-17

Quantum statistical enhancement of collective behaviour in a bosonic active Ising model

Authors:
Kian L. Assent↗Emil Strauch↗Sabine H. L. Klapp↗Andr\'e Eckardt↗Alexander Schnell↗

arXiv:2606.18091v1 Announce Type: new Abstract: Collective behaviour such as flocking (the collective motion of a spontaneously formed group along a common direction) or aster formation (the binding of opposing flocks, inhibiting each others motion) are intriguing emergent phenomena in active systems with local alignment rules. Until recently, their occurrence was mainly studied for classical systems, a prime example being the active Ising model (AIM), which translates the main ingredients of flocking and aster formation (i.e., alignment and self-propulsion) to a lattice framework. Here we introduce and study a one-dimensional (1D) quantum lattice variant of the AIM, based on ideal bosons with a spin degree of freedom. We find that both the collective behaviours of the 1D classical model, flocking and aster formation, are markedly enhanced by the bosonic quantum statistics. This contrasts with a recent quantum generalization of the AIM based onto hard-core bosons [Khasseh et al., Phys. Rev. Lett. 135, 248302 (2025)], where flocking, but neither its quantum-statistical stabilization nor aster states were observed as a consequence of interactions. Moreover, we investigate the competition of this quantum statistical stabilization of collective phases with their suppression by the quantum fluctuations induced by a transverse external magnetic field.

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09.
bioRxiv (Bioinfo) 2026-06-19

Accurate detection of tumor clonality and ongoing expansion mode from genomic data

Authors:
Chen↗Jaksik↗Terranova↗El Baghdadi↗Koval↗Kurpas↗M. K↗Tavare↗Kimmel↗Dinh↗K. N↗

Recent evidence shows that despite considerable effort, currently available algorithms for estimating intra-tumor heterogeneity (ITH) remain limited. We developed DECODE (Deciphering Cancer Origin from DNA Evolution), a novel mutation clustering method that incorporates the impact of sample-specific sequencing coverage and mutation calling biases. On synthetic data, DECODE outperformed existing methods across multiple clonality metrics and accurately detected and characterized the neutral tail in the site frequency spectrum (SFS), which encodes the tumor's ongoing expansion mode. In acute myeloid leukemia, accounting for the neutral tail enabled DECODE to yield more parsimonious clonal decompositions that align more closely with known subclonal dynamics that drive relapse. Applied to data from The Cancer Genome Atlas, DECODE not only detected a neutral SFS tail in most samples across tumor types but also uncovered a clinically meaningful link between ITH and survival in low-grade glioma. By jointly inferring clonality and expansion mode, DECODE provides two complementary and prognostically relevant readouts of tumor evolution from single tumor genomic samples.

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10.
arXiv (CS.CL) 2026-06-11

FORT-Searcher: Synthesizing Shortcut-Resistant Search Tasks for Training Deep Search Agents

Authors:
Jia Deng↗Yimeng Chen↗Xiaoqing Xiang↗Ziyang Zeng↗Shuo Tang↗Wayne Xin Zhao↗Feng Chang↗Chuan Hao↗Yuan Wei↗Ran Tao↗Bryan Dai↗Ji-Rong Wen↗…

Training deep search agents requires verifiable questions whose answers remain unavailable until sufficient evidence has been acquired through search. Existing synthesis methods often increase apparent difficulty by enriching graph structures, but structural complexity alone does not guarantee realized search difficulty: the intended search process can collapse through a cheaper identifying route. We formalize this gap with a shortcut-aware difficulty framework and identify four actionable shortcut risks: evidence co-coverage, single-clue selectivity, exposed constants, and prior-knowledge binding. To diagnose their realized effects, we use trajectory signatures including solving cost, answer hit time, and prior-shortcut rate. Guided by this framework, we introduce FORT, a Framework of Shortcut-Resistant Training-Data Synthesis. FORT constructs shortcut-resistant training data by controlling shortcut risks across entity selection, evidence graph construction, question formulation, and adversarial refinement. Experiments show that FORT induces longer pre-answer search and fewer shortcut patterns than existing open-source deep search datasets. Using the resulting trajectories, we train FORT-Searcher with supervised fine-tuning (SFT) only, and it achieves the best overall performance among comparable-size open-source search agents on challenging deep search benchmarks. Relevant resources will be made available at https://github.com/RUCAIBox/FORT-Searcher.

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11.
arXiv (CS.CV) 2026-06-18

Cross-Lingual Learning within Arabic Script for Low-Resource HTR

Authors:
Sana Al-azzawi↗Elisa Barney↗Marcus Liwicki↗

Handwritten Text Recognition (HTR) with limited labeled data remains a challenging problem, particularly for Arabic-script languages. Although modern sequence-based recognizers perform well in high-resource settings, their accuracy degrades sharply as training data becomes scarce. Arabic-script languages share a common writing system with substantial character overlap, motivating cross-lingual learning as a strategy to mitigate data scarcity. We conduct a controlled line-level study of cross-lingual joint training for Arabic-script HTR under low-resource regimes (number of samples K = 100, 500, 1000 labeled lines) on Arabic (KHATT), Urdu (NUST-UHWR) and Persian (PHTD). CRNN and Vision Transformer-based HTR-VT models are trained on the union of multiple related Arabic-script datasets to mitigate the data scarcity and are evaluated on individual target languages. Both architectures benefit from cross-language training under low-resource conditions. CRNN remains more effective under extremely limited target-language data, whereas the benefits of cross-language training for HTR-VT become less consistent as larger amounts of target-language data become available. On Persian (PHTD), joint training achieves a Character Error Rate (CER) of 9.99 , surpassing previously reported results despite not using the full available training data. On an additional Urdu dataset (UNHD), joint training reduces CER from 17.20 to 14.45.

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12.
medRxiv (Medicine) 2026-06-10

Impact of Early Treatment on Symptom Improvement and Procedural Events among Men with BPH and Bothersome Lower Urinary Tract Symptoms: A Contemporary Analysis of the American Urological Association Quality (AQUA) Registry

Authors:
Ernandez↗Najafi↗Roehrborn↗C. G↗Lerner↗L. B↗

PURPOSE: As the armamentarium of BPH therapies continues to expand, it remains imperative to maximize patient satisfaction and minimize decisional regret. We sought to determine the impact of time from BPH diagnosis to index treatment on symptom improvement and subsequent procedural events. MATERIALS AND METHODS: We queried the American Urological Association Quality Registry for men [&ge;] 40 years old with BPH, available IPSS data, and no receipt of prior BPH treatment. Index treatment included medication, surgery, or minimally invasive surgical therapy (MIST). Outcomes included IPSS over 3 years of follow-up, change in percentage of mild lower urinary tract symptoms (LUTS) by 3 months, and time to procedural event. Patients were stratified by time from index diagnosis to treatment by 3 years. Outcomes were compared across time-to-treatment cohorts with appropriate statistical tests with p < 0.05 as significant. RESULTS: 43,919 patients met criteria with 19,642 pursuing treatments. Patients pursued treatment at comparably lower baseline IPSS compared to prior prospective series. Patients undergoing surgery and MIST had significantly higher baseline IPSS, while medical comorbidities were significantly more common among men initiating pharmacotherapy. Early surgery and MIST were associated with significant improvement in IPSS within 6-12 months and an increase in mild LUTS by 3 months. All forms of early treatment were associated with delayed time to procedural events, including catheterization and fulguration. CONCLUSIONS: Early procedural intervention for BPH is associated with early symptom improvement and delayed time to procedural events among real-world, contemporary practice.

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

FronTalk: Benchmarking Front-End Development as Conversational Code Generation with Multi-Modal Feedback

Authors:
Xueqing Wu↗Zihan Xue↗Da Yin↗Shuyan Zhou↗Kai-Wei Chang↗Nanyun Peng↗Yeming Wen↗

We present FronTalk, a benchmark for front-end code generation that pioneers the study of a unique interaction dynamic: conversational code generation with multi-modal feedback. In front-end development, visual artifacts such as sketches, mockups and annotated creenshots are essential for conveying design intent, yet their role in multi-turn code generation remains largely unexplored. To address this gap, we focus on the front-end development task and curate FronTalk, a collection of 100 multi-turn dialogues derived from real-world websites across diverse domains such as news, finance, and art. Each turn features both a textual instruction and an equivalent visual instruction, each representing the same user intent. To comprehensively evaluate model performance, we propose a novel agent-based evaluation framework leveraging a web agent to simulate users and explore the website, and thus measuring both functional correctness and user experience. Evaluation of 20 models reveals two key challenges that are under-explored systematically in the literature: (1) a significant forgetting issue where models overwrite previously implemented features, resulting in task failures, and (2) a persistent challenge in interpreting visual feedback, especially for open-source vision-language models (VLMs). We propose a strong baseline to tackle the forgetting issue with AceCoder, a method that critiques the implementation of every past instruction using an autonomous web agent. This approach significantly reduces forgetting to nearly zero and improves the performance by up to 9.3% (56.0% to 65.3%). Overall, we aim to provide a solid foundation for future research in front-end development and the general interaction dynamics of multi-turn, multi-modal code generation. Code and data are released at https://github.com/shirley-wu/frontalk

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14.
arXiv (CS.LG) 2026-06-17

When Dynamics Models Read the Wrong Time Steps: Label-Free Event Credit Re-Anchoring for Robust Global Readouts

Authors:
Yifan Wang↗

arXiv:2606.17572v1 Announce Type: new Abstract: Learned dynamics models often answer global physical questions, such as fault severity or impact stiffness, by pooling a per-step feature sequence into one readout vector. This sequence-to-global interface creates an under-studied temporal credit problem: with only trajectory-level supervision, a model can predict accurately in training conditions while reading from abundant smooth correlates rather than the brief physical events that determine the target. We call this failure temporal credit dilution. It is not exposed by the training loss and is not removed by standard physics-informed residuals, because the error lies in where the global readout assigns functional credit. We introduce Credit-in-Event, an interface-level probe for measuring how much pooled credit lands on event steps, and prove in closed form that a pooled linear reader routes credit to a spurious background channel as the event fraction shrinks. We then propose CREST, a training-free and label-free readout that estimates a transient event core from learned features and re-anchors the pooled representation through event-versus-rest contrast. Across simulated gear and impact systems, recurrent and attention encoders, and public bearing vibration data, CREST reduces out-of-distribution error while restoring event credit. Ablations show that stable-step selection and receptive-field shrinking fail, confirming that the gain comes from event-core credit re-anchoring rather than a generic locality or stability prior.

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15.
arXiv (quant-ph) 2026-06-11

Planted-Solution Pauli Hamiltonians as a Quantum Benchmarking Primitive

Authors:
Amir Kalev↗Itay Hen↗

arXiv:2606.11455v1 Announce Type: new Abstract: We introduce a construction of Pauli Hamiltonians with exactly known ground-state energies, intended as reference instances for ground-state energy estimation algorithms. The construction embeds a planted block-product state as the simultaneous ground state of a sum of frustration-free local clauses on overlapping supports, exposes the resulting model only as a polynomial-size linear combination of Pauli operators, and admits optional Clifford conjugation that preserves the spectrum. The framework subsumes classical planted constraint-satisfaction problems as a diagonal special case, providing a direct embedding channel through which classical hardness properties can be inherited. Open-source software, certification keys, and example instances are made publicly available.

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

Deontic Policies for Runtime Governance of Agentic AI Systems

Authors:
Anupam Joshi↗Tim Finin↗Karuna Pande Joshi↗Lalana Kagal↗

arXiv:2606.19464v1 Announce Type: new Abstract: Autonomous agentic AI systems driven by Large Language Models (LLMs) introduce a new class of security, privacy, and compliance challenges: an agent that can invoke tools, manipulate data, install software, and coordinate with peer agents across organizational boundaries must be constrained not just by authentication and access control, but by the full structure of enterprise governance. This includes specifying what agents are permitted and prohibited from doing, what they areobliged to do after certain actions (e.g., notify the CISO), under what conditions a standing obligation may be waived, and which rules take precedence when policies conflict. This governance problem exceeds what current policy engines provide. Systems such as XACML, Rego, and Cedar address only the permit/prohibit subset of this governance structure. They do not provide obligation lifecycle management, meta-policy conflict resolution, dispensations that waive obligations in specific circumstances, and ontological reasoning over domain class hierarchies commonly found in applications such as healthcare, cybersecurity, or data privacy. We propose AgenticRei, which realizes key governance requirements such as obligations, dispensations, policy conflict resolutions, and reasoning over policies, as well as the basic permit/prohibit constraints. We use a deontic policy language built on the Rei framework, expressed as OWL (Web Ontology Language) and evaluated at runtime by a high-performance logic engine entirely outside the LLM. The same pipeline governs both tool invocations by the agent and agent-to-agent messages. We show through examples that deontic policies capture governance constraints around security and privacy that mostly cannot be expressed in current production engines. Our approach composes naturally with industry-standard frameworks like A2AS.

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

DEFINED: A Data-Efficient Computational Framework for Fine-Grained Creativity Assessment in Debate Scenarios

Authors:
Tongzhou Yu↗Mingjia Li↗Hong Qian↗Wenkai Wang↗Zongbao Zhang↗Yaoyu Jiang↗Xiangfeng Wang↗Aimin Zhou↗Jiajun Guo↗

Human creativity has emerged as a critical competency in the era of large language models. Assessing creativity in complex, open-ended environments is a grand challenge in data mining, currently hindered by a reliance on standardized simple tasks and the scarcity of fine-grained expert data. As an ecologically valid assessment context, debate reflects multiple dimensions of creativity, encompassing both divergent thinking and convergent thinking. Moreover, debate is a data-rich domain, with a large volume of publicly accessible materials. Current mainstream automated scoring methods are poorly suited to complex settings such as debate, and therefore still rely on costly human evaluation. To this end, this paper proposes DEFINED, a data-efficient computational framework for fine-grained creativity assessment in debate scenarios. DEFINED operationalizes debate creativity through a hierarchical eight-dimensional metric system, implemented via a pre-trained autoregressive language model with a hierarchical scoring head that supports both fine-grained and coarse-grained evaluation. Statements and their associated expert scores were obtained from authentic debate competitions, and a constrained data augmentation strategy was employed to address the elite bias inherent in the original data. DEFINED adopts a mixed-granularity training strategy enabling robust learning from limited fine-grained supervision annotated by trained graduate experts. To rigorously validate ecological validity beyond synthetic benchmarks, we incorporate an empirical study with debate-naive participants, utilizing these authentic data to serve as a qualitative case study for mid-to-low proficiency populations. Across our evaluation protocol, our scoring model achieves accurate and stable scoring, outperforming prompt-based large language model evaluators and existing debate scoring methods.

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18.
arXiv (CS.LG) 2026-06-11

Counterexample Guided Learning in the Large using Reasoning Agents

Authors:
Hongyi Liu↗Frederic Sala↗Thomas Reps↗Adithya Murali↗

arXiv:2606.11521v1 Announce Type: new Abstract: LLMs and LLM agents should improve when given feedback, but identifying when they are able to do so is difficult: feedback is heterogeneous, domain-specific, and difficult to control. We approach this challenge by asking LLMs to perform regular-expression induction, a classical symbolic learning problem where precise mechanisms for feedback exist in the form of counterexamples. In counterexample-guided learning, a learner (LLM) proposes candidate regular expressions from positive/negative-labeled strings, and the teacher (verifier) returns counterexamples showcasing the difference between the candidate and target languages. We identify novel counterexample-guided refinement strategies that enable effective regex learning, such as regularization and symbolic counterexample clusters. We also explore agentic strategies such as reflection and repair loops. Empirically, we find that verifier feedback substantially improves sample efficiency on challenging regex-induction tasks, reducing the number of labeled examples required and enabling learning of complex target expressions where standard prompting fails. For example, on the hardest task groups, our counterexample-guided framework improves success from 3.2% to 38.1% and from 38.9% to 74.1% on two different regex domains. These results suggest that LLMs can benefit from rich feedback beyond treating it as additional data, opening the door for robust verifier-guided methods for LLM-based program synthesis and formal reasoning.

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

Hierarchical Modeling of ICD Codes in EHR Foundation Models

Authors:
Megha Thukral↗Dong Gyun Kang↗Rudra Pratap Singh↗Shruthi Kashinath Hiremath↗Katrin H\"ansel↗Thomas Pl\"otz↗

arXiv:2606.15447v1 Announce Type: new Abstract: Electronic health record foundation models typically treat ICD diagnosis codes as flat tokens, overlooking the clinically meaningful hierarchical structure that captures disease families, subcategories, and fine-grained diagnostic detail. As a result, existing EHR representation learning methods do not explicitly exploit the hierarchical structure already present in the coding system. In this work, we study ICD-10-CM hierarchy as a general inductive bias for clinical representation learning. We investigate two complementary mechanisms for incorporating hierarchy: first, by augmenting diagnosis sequences in a BERT-style transformer with tokens corresponding to different levels of the ICD hierarchy, and second, by injecting hierarchy into graph-based code representations through hierarchy-aware edges combined with diagnosis co-occurrence structure. Across these settings, we evaluate whether explicit hierarchy improves downstream prediction, which levels of the hierarchy are most useful, whether hierarchy encoding improves transfer across datasets, and how hierarchy reshapes embedding similarity structure. We conduct experiments on two large-scale real-world clinical datasets: MIMIC-IV, used for pretraining and in-domain evaluation, and eICU, used to assess cross-dataset transfer via frozen encoder probing. Our findings show that explicitly encoding ICD hierarchy improves over flat code representations in both in-domain and cross-dataset settings, while revealing that the most useful level of hierarchy depends on both the task and the modeling approach. More broadly, we focus on hierarchy-aware EHR representation learning and show that the benefits of encoding hierarchy are generalizable across modeling settings and hierarchy levels.

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20.
arXiv (math.PR) 2026-06-17

Critical spectral behavior and large deviations for geometric $\alpha$-stable processes

Authors:
Kaneharu Tsuchida↗

arXiv:2606.17501v1 Announce Type: new Abstract: In this paper, we study the Schrödinger-type operator associated with geometric stable processes on $\mathbb{R}^{d}$, especially the differentiability of spectral function. Let $\mathcal{H}$ be the generator of the geometric stable process and $\mu$ a smooth measure on $\mathbb{R}^{d}$. Then the spectral function $C(\theta)$ is defined as $C(\theta) = -\inf \sigma(-\mathcal{H} - \theta \mu)$, where $\sigma(\mathcal{A})$ denotes the spectrum of $\mathcal{A}$ and $\theta$ is a real parameter. Since the geometric stable process exhibits severe local singularities in its Lévy measure, its transition semigroup lacks ultracontractivity, which invalidates classical methods for proving the differentiability. To overcome this obstacle, we use the compact embedding of the extended Dirichlet space into $L^2(\mu)$. As a primary application of this differentiability, we establish a large deviation principle for a positive continuous additive functional associated with the smooth measure $\mu$.

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21.
medRxiv (Medicine) 2026-06-12

Immunologically Optimized Zmp1 Peptides Reveal a Translational Serological Biomarker Platform for Tuberculosis Diagnosis Across Disease Manifestations

Authors:
Zade↗O. S↗Yandrapally↗Choudhari↗Gaikwad↗A. V↗Panda↗Neela↗V. S. K↗Devalraju↗K. P↗Eedara↗…

Tuberculosis (TB) diagnosis remains challenging, particularly for extrapulmonary TB (EPTB), where invasive sampling, low bacillary burden, and suboptimal sensitivity of nucleic acid-based tests in peripheral specimens hinder timely detection. Here, we report an immunology-driven strategy for biomarker discovery and development of a peptide-based serological assay targeting Mycobacterium tuberculosis zinc metalloprotease-1 (Zmp1). Leveraging fundamental principles of adaptive immunity that antigenic regions containing overlapping B-cell and CD4 T-helper cell epitopes would preferentially generate high antibody titers through linked recognition and cognate T-cell help, we used an immunoinformatics pipeline to identify two nested immunodominant peptide regions within Zmp1 (Mtb-Zp-NT and Mtb-Zp-CT) enriched for overlapping B- and T-cell epitopes. The diagnostic potential of these peptides was evaluated through ELISA-based serological assays. A blinded pilot study (N=137) demonstrated a clear discrimination between active TB and TB-recovered individuals. The assay was subsequently validated in an expanded cohort (N=875) by screening 6,086 individuals, which identified 457 TB-positive cases. The cohort included pulmonary TB (PTB), EPTB, TB-recovered individuals, household contacts, non-specific infections, and healthy controls. Receiver operating characteristic analyses, supported by DeLong and bootstrap comparisons, revealed superior diagnostic performance of the peptide-based assays relative to full-length Zmp1. Mtb-Zp-CT exhibited the highest accuracy (AUC=0.93; specificity >90%), while Mtb-Zp-NT also demonstrated strong discriminatory power (AUC{approx}0.89). These findings establish that the immunologically optimized Zmp1 peptides are highly promising serological biomarkers for TB and EPTB. More broadly, they demonstrate how mechanistically informed epitope selection can accelerate translation of pathogen-specific immune signatures into sensitive, minimally invasive, and potentially point-of-care diagnostic platforms for resource-limited settings.

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22.
medRxiv (Medicine) 2026-06-11

What level of expertise is necessary to generate ACLS training test questions: pre-med students vs. artificial intelligence?

Authors:
LoGalbo↗S. S↗Richman↗Wang↗Saji↗Traore↗Oliva↗Wu↗Drudi↗Foster↗Bhandari↗Delfillo↗…

Abstract Introduction In-hospital cardiac arrest carries high mortality despite standardized ACLS training. Educators face increasing time constraints in developing assessment tools for ACLS training. Two possible solutions to this problem are using pre-medical students or using artificial intelligence to generate test questions. This study compared the quality of pre-medical student-generated ACLS test questions vs. AI-generated ACLS test questions, testing the hypothesis that AI-generated questions are non-inferior to student-generated questions. Methods Ten pre-medical students created ACLS questions following predefined criteria, while an AI model (Northwell's Artificial Intelligence Hub) generated comparable questions. A blinded ACLS-certified physician evaluated questions on the qualities of Alignment, Clarity, Cognitive Level, and Question Design using a standardized rubric (Likert scale: 1 = poor quality, 5 = excellent). Student's T-test and Chi-square analysis were used to compare the quality of questions on different rubric domains within each arm (student vs. AI) and within one domain (eg, question Clarity) between arms. The Student's T test was used when 2 comparator groups were compared (eg, Clarity of student-generated vs. AI-generated questions) within one arm. The ANOVA test was used when comparing more than 2 comparator groups (eg, Alignment vs. Clarity vs. Cognitive Level) within one arm. Statistical significance was set as a priority at p

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23.
arXiv (CS.CL) 2026-06-17

SpeechDx: A Multi-Task Benchmark for Clinical Speech AI

Authors:
Sejal Bhalla↗Larry Kieu↗Aina Merchant↗Eyal de Lara↗Alex Mariakakis↗

Speech offers a uniquely informative window into health by simultaneously engaging neurological, motor, respiratory, and vocal systems. Current clinical speech AI methods have largely progressed through isolated condition-specific studies, making results difficult to compare and generalization difficult to assess. We introduce SpeechDx, a large-scale benchmark for clinical speech AI spanning 12 datasets and 27 tasks across diverse health conditions. To enable evaluation across shared clinical mechanisms, SpeechDx structures tasks by the stage of speech production they disrupt: conceptualization, formulation, and articulation. The benchmark tests generalization by including tasks with limited labeled data and evaluating the same health condition across multiple datasets, distinguishing clinically meaningful patterns from dataset artefacts. We systematically evaluate 12 state-of-the-art audio encoders across all tasks and under zero-shot cross-condition transfer. Results show that large-scale speech models represent the strongest overall baselines, domain-specific models improve performance only on closely matched tasks, and no current representation generalizes reliably across the clinical speech landscape. SpeechDx establishes a shared evaluation framework for tracking progress toward general-purpose clinical speech representations

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

BASENet: Band-Adapted Speech Enhancement Network with Cross-Band Attention

Authors:
Damien Martins Gomes↗Fran\c{c}ois Capman↗

arXiv:2606.12662v1 Announce Type: cross Abstract: Speech enhancement models typically apply uniform capacity across all frequencies, disregarding the non-uniform spectral resolution of human hearing. We propose BASENet, a frequency-adapted architecture that partitions the spectrum into Bark-scale bands and assigns each a scaled-capacity encoder derived from critical-band density, automatically granting deeper branches to perceptually dense low frequencies and lighter ones to high frequencies. A cross-band attention module captures harmonic dependencies across bands through compact frequency-pooled representations at linear complexity. Built on inverted residual blocks with dense connectivity and a convolutional recurrent network, BASENet achieves 3.55 PESQ and STOI~96% on VoiceBank+DEMAND with only 0.83M parameters and 7.3 G~MACs, the fewest parameters among all methods with PESQ > 3.50. A causal variant (3.44 PESQ) surpasses several non-causal baselines, confirming suitability for real-time streaming on resource-constrained devices.

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25.
arXiv (math.PR) 2026-06-12

Sphere Packings in Higher Dimension (after Boaz Klartag)

Authors:
Guillaume Aubrun↗

arXiv:2606.13313v1 Announce Type: cross Abstract: Let $\delta_n^L$ be the maximal density of a lattice sphere packing in the $n$-dimensional Euclidean space. We explain how Boaz Klartag proved the inequality $\delta_n^L \geq c n^2 2^{-n}$ where $c>0$ is a universal constant. In higher dimension, even for non-lattice sphere packings, this new lower bound is a substantial improvement. Klartag's proof uses the probabilistic method in two different ways. The first, very standard, relies on the statistical properties of a uniformly chosen random lattice. The second, completely new, studies the stochastic evolution of an ellipsoid constrained to contain non nonzero lattice points in the interior.

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