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

SpatialSV: Internalizing Interpretable 3D Spatial Awareness in MLLMs via Task-Oriented Visual Supervision

Unlocking the spatial intelligence of multimodal large language model (MLLMs) is crucial for understanding and interacting with the 3D world. Prevailing approaches typically inject spatial priors via external tools, which impose significant inference overhead, or rely on latent feature distillation, which remains uninterpretable and lacks fine-grained geometric constraints. To address these issues, we propose SpatialSV, a framework designed to internalize robust 3D spatial awareness within MLLMs while simultaneously offering inherent interpretability. Deviating from passive feature imitation, SpatialSV employs task-oriented visual supervision, compelling the model to actively lift its 2D visual features into explicit 3D representations, including depth maps, camera poses, and point clouds. Crucially, this 2D-to-3D lifting process provides a transparent window into the model's representations: the resulting 3D reconstructions serve as an intuitive proxy for visualizing and diagnosing the quality of the model's intrinsic spatial knowledge. Extensive experiments across multiple models and benchmarks demonstrate the effectiveness of SpatialSV in enhancing and interpreting MLLMs' spatial intelligence. Furthermore, the framework exhibits strong generalization in semi-supervised settings, validating its potential to leverage unlabeled visual data for scalable, interpretable spatial representation learning.

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

Prompt Disentanglement via Language Guidance and Representation Alignment for Domain Generalization

Domain Generalization (DG) seeks to develop a versatile model capable of performing effectively on unseen target domains. Notably, recent advances in pre-trained Visual Foundation Models (VFMs), such as CLIP, have demonstrated considerable potential in enhancing the generalization capabilities of deep learning models. Despite the increasing attention toward VFM-based domain prompt tuning within DG, the effective design of prompts capable of disentangling invariant features across diverse domains remains a critical challenge. In this paper, we propose addressing this challenge by leveraging the controllable and flexible language prompt of the VFM. Noting that the text modality of VFMs is naturally easier to disentangle, we introduce a novel framework for text feature-guided visual prompt tuning. This framework first automatically disentangles the text prompt using a large language model (LLM) and then learns domain-invariant visual representation guided by the disentangled text feature. However, relying solely on language to guide visual feature disentanglement has limitations, as visual features can sometimes be too complex or nuanced to be fully captured by descriptive text. To address this, we introduce Worst Explicit Representation Alignment (WERA), which extends text-guided visual prompts by incorporating an additional set of abstract prompts. These prompts enhance source domain diversity through stylized image augmentations, while alignment constraints ensure that visual representations remain consistent across both the original and augmented distributions. Experiments conducted on major DG datasets, including PACS, VLCS, OfficeHome, DomainNet, and TerraInc, demonstrate that our proposed method outperforms state-of-the-art DG methods.

03.
arXiv (CS.CL) 2026-06-15

GitOfThoughts: Version-Controlled Reasoning and Agent Memory You Can Replay, Diff, and Merge

Large language model (LLM) reasoning is ephemeral: chains of thought vanish with the context window, pruned search branches leave no record, and memory buffers cannot be diffed, merged, or audited. Every other complex software process (code, infrastructure, data, experiments) is version-controlled; reasoning is not. We introduce GitOfThoughts, which stores an agent's reasoning tree as a git repository: every scored thought is a commit, scores are notes, outcomes are tags, and retrieval is "git log" over the agent's own history. This makes reasoning replayable, auditable, and mergeable across agents at near-zero engineering cost. We then ask the harder question: does memory, in any substrate, actually improve accuracy? Across five substrates (none, markdown, vector, graph, git), two benchmarks, two model scales, and pre-registered replications, the answer for novel problems is no. No memory format reliably helps, and a promising early result collapsed under its own pre-registered replication. Memory pays only above what we call the copyability threshold: when the retrieved case is a near-duplicate of the current problem (similarity >~ 0.8), accuracy jumps sharply; below it, nothing. The gain is answer retrieval, not method transfer: a 4.5x larger model doubles the near-duplicate payoff yet still cannot extract a transferable method from a worked example. The only general lever we find is test-time sampling. The case for git-as-substrate is therefore auditability, provenance, and mergeability at accuracy parity. We document a retracted result and a refuted hypothesis to model the evaluation standard we hold ourselves to.

04.
medRxiv (Medicine) 2026-06-16

MRMU: A New Paradigm for Mendelian Randomization by Accounting for Measured Covariates and Unmeasured Confounders

Mendelian randomization (MR) is a powerful approach for causal inference, however, its reliability is frequently compromised by unadjusted covariates and unmeasured confounders, such as unmeasured pleiotropy and sample structure. To address these challenges, we introduce MRMU, a novel paradigm for the MR framework. Unlike traditional single-variable or multivariable MR methods, MRMU selects instrumental variables only from the exposure of interest and estimates one exposure effect at a time, while jointly accounting for measured covariates and unmeasured confounders. This design improves the reliability of MR analyses. In simulations and real data, MRMU achieved better type I error control, higher statistical power, and more accurate effect estimation than existing MR methods. Applying to coronary artery disease (CAD), MRMU identified robust cardiometabolic risk factors, including LDL-C, APOB, systolic blood pressure, body mass index, and smoking initiation, with consistent evidence across multiple CAD datasets. In contrast, traits such as HDL-C, height, and educational attainment, which were found to be significant by existing MR methods, were no longer supported by MRMU. MRMU further supported blood pressure-related traits, rather than lipid traits, as the more relevant pathway linking urate to CAD. Finally, by integrating large-scale plasma proteomics data, MRMU identified candidate CAD drug targets beyond established HMGCR- and PCSK9-related pathways, highlighting its utility for therapeutic target prioritization.

05.
arXiv (CS.LG) 2026-06-11

Categorical Robustness Assessment for Machine Learning based Network Intrusion Detection Systems

arXiv:2606.12075v1 Announce Type: cross Abstract: Network Intrusion Detection Systems (NIDS) heavily utlize Machine Learning (ML) but ML models can be manipulated via adversarial attacks. These attacks add carefully crafted perturbations to network traffic data that leads to misclassifications. While prior work has demonstrated adversarial vulnerabilities in isolated settings, systematic cross-architecture as well as class and category of attack based comparisons under controlled attack conditions remain limited, leaving practitioners without clear guidance on which models to deploy in adversarial environments. This paper asks a simple question: what type of classifier architectures actually hold up when attackers try to manipulate the systems? We put three popular architectures through their paces: a 1D Convolutional Neural Network, a Long Short-Term Memory (LSTM) network, and a Random Forest (RF) ensemble. Using the ACI-IoT-2023 dataset (over 1.2 million samples spanning 12 attack types), we subject each model with FGSM and PGD adversarial attacks, which apply gradient-based perturbations in normalized feature space consistent with established adversarial ML evaluation protocols, at perturbation budgets ranging from $\epsilon=0.01$ to $\epsilon=0.1$. Surprisingly, Random Forest achieved near-perfect baseline accuracy (99.98\%), yet collapsed catastrophically under attack, dropping 73 percentage points at the smallest perturbation we tested. CNN, on the other hand, retained 95.5\% accuracy at $\epsilon=0.01$ and degraded gracefully as perturbations increased. LSTM fell somewhere in between. These findings flip the conventional wisdom where high baseline accuracy means nothing if a model shatters at the first sign of adversarial pressure. For practitioners deploying intrusion detection in adversarial environments, we recommend CNN-based architectures and provide scenario-specific deployment guidance.

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

Temporally Consistent Graph Q-Networks for Intelligent Network Control

arXiv:2606.13848v1 Announce Type: cross Abstract: Mobile networks continue to grow in complexity and next generation networks are expected to support both increasing traffic loads and more diverse services. As network complexity rises, optimizing antenna parameters under dynamic or changing objectives becomes increasingly challenging. We propose a novel multi-agent reinforcement learning (MARL) algorithm for high-level control and orchestration of mobile networks. The Temporally Consistent Graph Q-Network (TC-GQN) algorithm learns a self-predicting representation of the whole network that is task-independent and aggregates information from all base-stations. A graph neural network is trained using a global reward function to assign coordinated local actions based on the learned encoding of the global network state. We evaluate the algorithm in a simulated environment to orchestrate an energy-saving feature across multiple sectors and multiple carriers under different quality of service (QoS) constraints. The proposed algorithm outperforms state-of-the-art graph-based baselines and a competitive rule-based controller by improving hardware sleep time while maintaining QoS. Moreover, the learned representation enables rapid adaptation to changing intents.

07.
arXiv (CS.CV) 2026-06-16

Redirecting the Flow: Image Customization through Attention Distribution Shift

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.

08.
arXiv (CS.LG) 2026-06-16

Incentives and Evidence in Learned Service Orchestration

arXiv:2606.16555v1 Announce Type: cross Abstract: Reinforcement learning for service orchestration has been the subject of sustained research for over a decade, yet it is not used in production at scale. The usual explanation is that learned controllers degrade under delayed and noisy telemetry, workload shifts, and uncontrolled tenants. We test whether existing evidence supports that explanation. We evaluate three highly influential RL-based orchestration systems spanning resource allocation, DAG scheduling, and autoscaling, using pre-registered predictions about comparative degradation under production-relevant perturbations and paired inference with family-wise error correction. Across the tests, most predicted performance reversals do not occur. Diagnostic analyses show that these outcomes often reflect comparator collapse, artefact limitations, or evaluation choices rather than evidence that learned controllers tolerate the perturbations. One apparent advantage under observation lag is roughly fortyfold compared to a Kubernetes HPA-equivalent controller. Another widely cited result cannot be reconstructed from its released artefact, and the strongest reproducible margin is far smaller than the published results. Conclusions also reverse under changes in perturbation magnitude and evaluation mode. Based on these results and broader patterns in the literature, we identify an institutional problem. Publication and review incentives favour benchmark gains against convenient comparators, even when those gains provide little evidence of deployment performance. We argue that the problem is not solely technical. Rather, it is institutional, so learned orchestration needs production-grade comparators, registered perturbation models, separate operational metrics, and publication criteria that reward reproducible operational evidence. Without these changes, the literature can grow without establishing whether learning improves orchestration.

09.
arXiv (CS.CV) 2026-06-12

Visual Place Recognition in Forests with Depth-Aware Distillation

Visual place recognition in natural forest environments remains challenging due to repetitive vegetation, weak structural cues, and significant appearance variation across traversals. To address this limitation, this paper proposes a lightweight depth-aware distillation framework that injects geometric cues into a DINOv2-based place recognition model, while maintaining its pre-trained descriptor space. Evaluated on the recent WildCross benchmark, the proposed approach yields gains over an appearance-only counterpart, providing robustness to appearance variations. These results demonstrate the importance of depth as a strong complementary modality for place recognition in natural environments and identify depth-aware distillation as a promising direction for more robust forest perception.

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

m2sv: A Scalable Benchmark for Map-to-Street-View Spatial Reasoning

Vision–language models (VLMs) achieve strong performance on many multimodal benchmarks but remain brittle on spatial reasoning tasks that require aligning abstract overhead representations with egocentric views. We introduce m2sv, a scalable benchmark for map-to-street-view spatial reasoning that asks models to infer camera viewing direction by aligning a north-up overhead map with a Street View image captured at the same real-world intersection. We release m2sv-20k, a geographically diverse benchmark with controlled ambiguity, along with m2sv-sft-11k, a curated set of structured reasoning traces for supervised fine-tuning. Despite strong performance on existing multimodal benchmarks, the best evaluated VLM achieves only 65.2% accuracy on m2sv, below human annotators who reach 72.0% on average (and 95% for an expert) with strong inter-annotator agreement ($\kappa$ up to 0.76). While supervised fine-tuning and reinforcement learning yield consistent gains, cross-benchmark evaluations reveal limited transfer. Beyond aggregate accuracy, we systematically analyze difficulty in map-to-street-view reasoning using both structural signals and human effort, and conduct an extensive failure analysis of adapted open models. Our findings highlight persistent gaps in geometric alignment, evidence aggregation, and reasoning consistency, motivating future work on grounded spatial reasoning across viewpoints.

11.
arXiv (quant-ph) 2026-06-17

Entanglement transition in unitary system-bath dynamics

arXiv:2512.06081v3 Announce Type: replace Abstract: The evolution of a system coupled to baths is commonly described by a master equation that, in the long-time limit, yields a steady-state density matrix. However, when the same evolution is unraveled into quantum trajectories, it is possible to observe a transition in the scaling of entanglement within the system as the system-bath coupling increases - a phenomenon that is invisible in the trajectory-averaged reduced density matrix of the system. Here, we go beyond the paradigm of trajectories from master equations and explore whether a qualitatively analogous entanglement-scaling transition emerges in a single unitary evolution of the combined system-bath setup, without monitoring the dynamics of the system. We investigate the scaling of entanglement in a unitary quantum setup composed of a two-dimensional lattice of free fermions, where each site is coupled to a fermionic bath. As the system-bath coupling increases, the logarithmic fermionic negativity reveals an entanglement transition from logarithmic-law to area-law scaling. This occurs while the system's steady-state properties are trivial, highlighting that the signatures of these different scalings are within the bath-bath correlations. Evidence of the transition is also found in the mutual information and the correlations of the full system-bath setup, suggesting that the entanglement transition is underpinned by a change in the spatial structure of quantum information.

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

Candidate overtone shear horizontal SAW resonators in thin-film lithium niobate for intermodal acousto-optic modulation

arXiv:2606.12853v1 Announce Type: cross Abstract: The merits of thin-film surface acoustic wave (SAW) devices are pivotal to develop the high-performance intermodal acousto-optic modulators. In this work, we have proposed shear-horizontal (SH) SAW resonators for anticipated intermodal acousto-optic modulation on the thin-film lithium niobate platform. Through optimization of the cut angle of LN films, the SAW wavelength, and the thickness of interdigital transducer (IDT) electrodes, the calculated acousto-optic overlap factors utilizing SH0 modes are improved by more than an order of magnitude compared with those of Rayleigh modes. Furthermore, we have fabricated and characterized three kinds of proof-of-principle SH0 mode devices without/with grating reflectors. The electromechanical coupling coefficients (keff^2) and quality factors (Q) in the overtone resonators with grating reflectors are systematically evaluated, featuring the highest Q of 843 with the compromised keff^2 of 0.96%-4.72%. The results reveal that the temperature coefficients of frequency (TCF) of Rayleigh modes vary across various overtones, whereas the SH0 modes exhibit TCFs in the range of 32.3-68.9 ppm/C. Our fabricated SH0-mode overtone resonators demonstrate the capability of operating at power levels up to 29 dBm without electrode damage, offering a promising paradigm for robust and high-efficiency intermodal acousto-optic modulators with potential applications in integrated optical signal processing, microwave photonics,and quantum information technologies.

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

Planning under Distribution Shifts with Causal POMDPs

arXiv:2602.23545v2 Announce Type: replace Abstract: In the real world, planning is often challenged by distribution shifts. As such, a model of the environment obtained under one set of conditions may no longer remain valid as the distribution of states or the environment dynamics change, which in turn causes previously learned strategies to fail. In this work, we propose a theoretical framework for planning under partial observability using Partially Observable Markov Decision Processes (POMDPs) formulated using causal knowledge. By representing shifts in the environment as interventions on this causal POMDP, the framework enables evaluating plans under hypothesized changes and actively identifying which components of the environment have been altered. We show how to maintain and update a belief over both the latent state and the underlying domain, and we prove that the value function remains piecewise linear and convex (PWLC) in this augmented belief space. Preservation of PWLC under distribution shifts has the advantage of maintaining the tractability of planning via $\alpha$-vector-based POMDP methods.

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

STaR-DRO: Stateful Tsallis Reweighting for Group-Robust Structured Prediction

arXiv:2604.09737v2 Announce Type: replace-cross Abstract: Structured prediction with large language models requires outputs that are label-accurate, ontology-constrained, structurally valid, and evidence-grounded under label imbalance and heterogeneous group difficulty. We present a unified framework for ontology-constrained generation. First, we introduce a modular prompt-engineering architecture combining XML-style structure, expert disambiguation rules, chain-of-thought reasoning, metadata-aware decision logic, schema contracts, and a self-validation gate. It targets recurrent in-context failures, including format drift, label ambiguity, evidence hallucination, and metadata-conditioned confusion. Second, we propose STaR-DRO, combining Tsallis mirror ascent, sparse entmax-style primal mapback, EMA-smoothed group-loss tracking, rescaled ascent signals, and bounded excess-only multipliers. Unlike conventional DRO, which relies on dense Shannon-entropy exponentiated-gradient updates, can introduce high-variance stochastic reweighting, assigns positive adversarial mass to groups that are not persistently hard, and incurs costs through simplex competition, STaR-DRO upweights only persistently hard groups without suppressing easier ones. We evaluate the framework on EPPC Miner, a clinically grounded high-stakes structured-prediction task requiring hierarchical label prediction and evidence-span extraction from patient-provider secure messages. Across 1B-70B Llama models, prompt engineering improves zero-shot extraction, yielding an average label F1 gain of +14.46 and a Span F1 gain of +17.40. Building on supervised fine-tuning, STaR-DRO further improves accuracy and robustness, increasing average label F1 by +1.08 and +2.20 while reducing mean groupwise validation cross-entropy by 21.3% and 14.8% relative to SFT and standard DRO, respectively. These results advance reliable automated communication mining for patient-centered clinical care analysis.

15.
arXiv (CS.CV) 2026-06-17

Learning QoE from Packet-Level Measurements in Encrypted Video Conferencing Traffic

The quality of the user experience has become one of the most important aspects in todays world, as it directly influences individuals willingness to continue using or abandon a product or service. In this context, video conferencing applications (VCAs), which experienced widespread adoption following the COVID-19 pandemic, must deliver excellent performance to remain competitive in an increasingly crowded market. Although content providers (CPs) such as Zoom, WhatsApp, Telegram, and Google Meet can assess conversation quality by comparing transmitted and received data. The widespread use of end-to-end encryption in VCAs makes quality-of-experience (QoE) evaluation by internet service providers (ISPs) far more challenging. Since ISPs do not have access to the encrypted content, they must rely on passive measurements of unencrypted traffic characteristics on the data path. In this work, we present a simple yet effective QoE prediction framework based on an almost stock convolutional neural network (CNN) architecture that uses only the packet sizes extracted from the communication between two participants in a video conferencing (VC) call to predict two QoE metrics: BRISQUE and MOS. The proposed framework is simple, easy to implement, and does not require high-end computational resources, yet it provides superior prediction performance, as shown in our experiments on two custom datasets collected from WhatsApp and Zoom, which achieve substantial improvements over previous models for the QoE prediction task.

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

Intermittent time series forecasting: local vs global models

arXiv:2601.14031v2 Announce Type: replace-cross Abstract: Forecasting intermittent time series, which contain zeros, is a crucial challenge in supply chains as inventory policies require probabilistic forecasts to establish safety levels. Intermittent time series are commonly forecast using local models, trained individually on each time series. In the last years global models, trained on a large collection of time series, have become popular for time series forecasting. Global models are often based on neural networks or gradient boosted trees. We carry out the first study comparing state-of-the-art probabilistic local and global models on intermittent time series. For global models we consider three different distribution heads suitable for intermittent time series: negative binomial, hurdle-shifted negative binomial and Tweedie. To the best of our knowledge, this is the first use of the latter two with neural networks. We perform experiments on five datasets comprising overall more than 40'000 real-world time series. Among global models, TiDE, a simple neural network architecture, achieves the best accuracy; it also consistently outperforms local models and has lower computational requirements. Large global models are instead much more computationally demanding and less accurate. Among the distribution heads, the Tweedie provides the best estimates of the highest quantiles.

17.
bioRxiv (Bioinfo) 2026-06-20

RNAStabFormer: Region-Aware Multi-Task Hybrid Learning for RNA Stability Prediction from Pulse-Chase Transcriptomics

作者:

RNA stability is a central layer of post-transcriptional gene regulation, yet large-scale stability labels derived from pulse-chase transcriptomics depend strongly on quantification region, time-window definition, and replicate quality control. We present RNAStabFormer, a controlled learning framework for predicting human RNA stability proxies from transcript sequence. Its core model, RAMHT, combines region-specific nucleotide Transformer encoders for CDS, and sequence, a CDS codon stream, engineered sequence-grammar features, gated fusion, and four task-specific regression heads. We construct four strict consensus labels from ENCODE BrU-seq/BruChase-seq data by crossing gene-sense and exon-sense quantification with late-chase 6 h/2 h and total-chase 6 h/0 h retention ratios, and evaluate all models on fixed repeated-random and chromosome-holdout splits. Across chromosome holdouts, XGBoost remains the strongest standalone model, with median Pearson correlations of 0.504, 0.544, 0.546, and 0.778 on the four labels. RAMHT is competitive with raw-sequence deep models but does not universally exceed engineered-feature baselines. A strict nested RAMHT–XGBoost blend nevertheless improves gene total-chase prediction by 0.017 mean Pearson and exon late-chase prediction by 0.004 mean Pearson over XGBoost. Region and mechanism analyses show that CDS, local k-mer composition, and codon-sensitive signals dominate predictive information. RNAStabFormer therefore provides both a multi-task neural model and a leakage-controlled evaluation protocol for RNA stability prediction from pulse-chase data.

18.
arXiv (quant-ph) 2026-06-16

Efficient Implementation of a Single-Qutrit Gate Set via Coherent Control

arXiv:2507.06860v2 Announce Type: replace Abstract: Qutrits offer the potential for enhanced quantum computation by exploiting an enlarged Hilbert space. However, the synthesis of high-fidelity and fast qutrit gates, particularly for single qutrits, remains an ongoing challenge, as it involves overcoming intrinsic constraints in quantum platforms. Here, we develop a novel framework for the efficient implementation of a single-qutrit gate set via coherent control, leveraging SU(3) dynamics while obviating platform-specific constraints such as those arising from the selection rule. As a proof-of-principle demonstration, we realize 35-ns qutrit Hadamard and X gates using a superconducting transmon, achieving an average fidelity of 99.5\%, as verified by randomized benchmarking. We further demonstrate two paradigmatic quantum circuits, which can be naturally extended to scalable qudit algorithms for phase estimation and parity check. In addition, we propose an SU(3)-based decomposition strategy for an arbitrary single-qutrit gate and numerically demonstrate its substantial efficiency improvement over conventional SU(2)-based protocols. By addressing the challenge of efficiently implementing single-qutrit gates, our protocol paves the way for realizing high-performance qutrit processors in diverse quantum platforms.

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

Linear Recurrent Unit with Semantic Modulation for Image Super-Resolution

Linear recurrent unit (LRU), designed with a principled formulation for stable linear recurrence, has demonstrated promising accuracy and robustness on long-range dependency tasks. However, its static parameterization and single-scan method limits its applicability to 2D vision tasks. In this study, we propose a LRU-based restoration network with a semantic modulating unit (SMU) to achieve a harmonious balance between performance and efficiency in single-image super-resolution. The SMU plays three key roles: LRU modulation, spatial categorization, and feature enhancement through learned prototype. Extensive experiments demonstrate that our method quantitatively and qualitatively surpasses recent state-of-the-art methods. Notably, our approach achieves superior performance with computational complexity on par with existing methods. The source code and models are available at https://github.com/MingyuChoi-run/LSM

20.
medRxiv (Medicine) 2026-06-15

Diabetes and the Life-Course: Evidence from Panel Data and Electronic Health Records

Incidence of type 2 diabetes is increasing at ages when education, work, family, and financial transitions are taking place, yet we lack robust evidence of whether earlier treatment changes life-course outcomes and over which time span this takes place. This paper uses the medical cutoff for diabetes diagnosis (HbA1c of 6.5 percent) as a natural experiment to study the effects of diabetes treatment using electronic health records (EHR) and panel data. This paper has three main findings. First, using EHR data, we find that there is a sharp increase in the probability of both diagnosis of diabetes and prescription when the HbA1c equals 6.5 percent. Second, we find that treating diabetes reduces HbA1c levels, weight, BMI, and blood pressure and increases the amount of care received, proxied by the number of HbA1c tests. Both the diagnosis and a prescription are independently able to produce positive changes in metabolic health, although a prescription is more effective in this regard. Third, we conclude that treating diabetes does not have a significant effect on life-course outcomes for a cohort of young Americans aged 24-32, although it does result in a reduction in HbA1c levels that are seen even eight years after the intervention. Taken together, these findings suggest that receiving a diagnosis and prescription are both effective treatments for diabetes, but they do not translate to significant alterations in the lives of young adults in the medium-term.

21.
arXiv (CS.AI) 2026-06-17

Reversal Q-Learning

arXiv:2606.17551v1 Announce Type: cross Abstract: Iterative generative modeling techniques, such as flow matching, provide powerful tools to model complex behaviors for effective offline reinforcement learning (RL). In this work, we propose a new off-policy RL algorithm that trains a flow policy based on prior data. Our idea starts from the "expanded" Markov decision process (MDP) framework, which treats individual flow refinement steps as separate actions in an MDP. To enable off-policy RL within this framework, we apply two techniques: we generate virtual on-policy trajectories (by "reversing" flows) to make this framework compatible with prior data, and we apply a bias-and-variance reduction technique to mitigate the curse of horizon in off-policy RL. We call the resulting algorithm Reversal Q-learning (RQL). RQL has several advantages over previous flow-based RL methods: it does not suffer from backpropagation through time, makes better use of the learned value function, and directly trains the full, expressive flow policy. Through our experiments on 50 challenging simulated robotic tasks, we show that RQL leads to the best average offline RL performance compared to state-of-the-art flow-based offline RL algorithms.

22.
medRxiv (Medicine) 2026-06-16

The biological clock of multimorbidity: temporal dynamics of disease co-occurrence in primary care

Multimorbidity is the dominant clinical reality of primary care, yet the temporal dynamics governing when and how persistent comorbidity associations emerge remain poorly characterised. Most large-scale comorbidity studies adopt a single observation window after an index diagnosis, implicitly assuming that associations detectable at one year are equally detectable at five. Using 11 years of electronic health records from 5,821,197 individuals in Catalan primary care, we applied a matched cohort design across nine complementary follow-up windows, five cumulative (0-1 to 0-5 years) and four conditional (1-2 to 4-5 years), to 1,315 index diseases, identifying 144,030 significant directed comorbidity associations in the five-year network. We found that 60.1% of these associations required at least three years of follow-up and were undetectable in shorter-window analyses, demonstrating that observation window length is a primary determinant of which comorbidities can be observed. To organise this temporal heterogeneity, we introduce the biological clock of multimorbidity: a two-dimensional framework that positions ICD-10 disease categories according to their rates of cumulative signal attenuation and the persistence of conditional risk. This framework identifies four reproducible temporal patterns (episodic, chronic stable, chronic progressive, and transient-persistent) that are robust under bootstrap resampling, leave-one-disease-out sensitivity analysis, and alternative clustering approaches. The biological clock is systematically modulated by sex, with Blood/Immune and Musculoskeletal disorders showing the largest sex differences in temporal dynamics. Network analysis identified 19 disease "initiators" that generate broad downstream comorbidity burdens and 21 "sinks" representing convergent endpoints of multiple disease trajectories. Comparison with hospital-based Danish data from 6,909,676 individuals showed that shared associations were 2.7-fold enriched over chance expectation (hypergeometric test, p

23.
medRxiv (Medicine) 2026-06-12

Cancer care disruption during the COVID-19 pandemic in Ontario, Canada: A sequential mixed-methods study

Introduction The COVID-19 pandemic profoundly disrupted healthcare delivery worldwide, with cancer care among the most affected services. Prior studies documented delays in referrals, reduced specialist access, and increased provider burden. However, the extent to which these experiences were reflected at the system level remains unclear. Objective To document cancer care experiences and examine whether these experiences were reflected in population-level health system indicators across Ontario, Canada. Methods We used an exploratory sequential mixed-methods design. Qualitative data were collected through focus groups and semi-structured interviews with 32 participants, including patients with cancer (n=8), caregivers (n=5), healthcare providers (n=14), and decision-makers (n=5) across two hospital settings in Ontario, Canada. Emergent themes informed the development of quantitative indicators. We then conducted a retrospective population-based analysis of linked administrative health databases for cancer patients in Ontario (n=87,786) to assess the prevalence of identified themes. Results Four themes emerged: (I) delays in diagnosis and screening; (II) disrupted access to primary care; (III) barriers to specialist and mental health services; and (IV) fragmented care for patients with multimorbidity. Quantitative findings corroborated major themes. Screening rates declined for cervical (64.8% to 57.5%) and breast cancer (64.5% to 57.2%). While in-person primary care shifted almost entirely to virtual modalities (8.5% to 95.4%), overall visit volumes remained stable. Specialist care showed uneven patterns, with increased oncology visits but declines in cardiology and mental health services. Patients with multiple comorbidities experienced the largest reductions in non-oncology specialist care. Conclusion The pandemic disrupted key components of cancer care, particularly screening, access to certain specialist services, and care for patients with complex needs. Integrating qualitative and quantitative evidence highlights areas of system vulnerability and underscores the need for coordinated, resilient cancer care capable of maintaining essential services during future crises.

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

TMASC: Transmasculine Attitude and Speech Corpus

作者:

We introduce the Transmasculine Attitudes and Speech Corpus (TMASC), a multimodal corpus of 196 transmasculine individuals, including questionnaire responses and 66 audio recordings. The questionnaire includes items exploring the vocal health of transmasculine individuals. The audio recordings include cough and throat-clearing samples, a reading passage, and additional session-specific questions. This paper outlines the development of this corpus and the data collection procedures. To illustrate the utility of this corpus, we present three case studies demonstrating how this crowd-sourced multimodal corpus can be used to support transmasculine individuals. These include the integration of perceptual and acoustic data, the identification of group-level characteristics, and the calibration of acoustic measurements.

25.
bioRxiv (Bioinfo) 2026-06-16

Integrative Transfer Network: Deep Transfer Learning Across Populations and Prediction Targets

作者:

Large-scale clinical and biomedical datasets increasingly contain both diverse subgroup attributes (e.g., demographic or clinical subgroups) and multiple prediction targets. Although various machine learning approaches can address subgroup differences or multi-target prediction, they often consider these aspects independently rather than jointly. To more effectively capture the shared and subgroup-specific information in such complex datasets, we propose the Integrative Transfer Network (ITN), a deep neural network designed to leverage data across subgroups and multiple related outcomes simultaneously. In extensive experiments, including time-to-event and classification tasks where demographic subgroups and multiple disease endpoints are prevalent, ITN demonstrates consistent improvements in subgroup-specific prediction by borrowing strength from other subgroups and outcomes. We envision ITN as a unified framework for learning from heterogeneous datasets where subgroup-specific insights are critical.