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01.
arXiv (CS.AI) 2026-06-12

Multi-Field Hybrid Retrieval-Augmented Generation for Maritime Accident Root Cause Analysis

arXiv:2606.13249v1 Announce Type: new Abstract: Maritime accident adjudication reports contain critical tribunal findings for root cause analysis (RCA), yet retrieving relevant precedents and drafting consistent reports from decades of records remains labor-intensive. This paper proposes a multi-field hybrid retrieval-augmented generation (RAG) framework for automated maritime RCA, utilizing a comprehensive dataset of 13,329 Korea Maritime Safety Tribunal (KMST) reports (1971-2025). We transform raw adjudications into a structured knowledge base of "incident cards", indexing three distinct fields-Summary, Causes, and Disposition-alongside a hierarchical L1/L2 cause taxonomy. Our retrieval strategy employs a field-aware hybrid approach, fusing sparse and dense rankings via Reciprocal Rank Fusion (RRF). Given the lack of large-scale expert relevance labels, we evaluate retrieval performance using ceiling-normalized recall and nDCG based on a metadata-derived proxy relevance score. Experimental results demonstrate that our proposed retrieval significantly outperforms baseline methods, improving NormRecall@100 from 0.18 to 0.55. Furthermore, grounding the generator on the retrieved precedents enhances RCA generation quality over an LLM-only baseline, increasing the LLM-as-a-judge score from 3.34 to 3.72. These findings suggest that field-aware RAG can substantially streamline maritime safety investigation workflows by enabling faster precedent search and more consistent, evidence-based RCA drafting.

02.
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 (

03.
arXiv (CS.CV) 2026-06-17

High-Fidelity 3D Geometric Reconstruction of Pelvic Organs from MRI: A Hybrid Deep Learning and Iterative Optimization Approach

Patient-specific 3D reconstruction of pelvic organ geometry from MRI is important for pelvic floor modeling and downstream patient-specific analysis. However, while previous studies have focused primarily on either image segmentation or downstream use of 3D models, the reconstruction of high-fidelity, high-quality geometries remains labor-intensive and poorly standardized. The study introduced a hybrid deformable shape modeling framework that integrates deep learning prediction with iterative optimization for the reconstruction of the bladder, uterus, and rectum. The framework consists of three core components: a geometry-aware multi-level deep learning architecture that preserves topological consistency of pelvic organs; a two-stage amortized optimization training strategy that balances global shape capture and local surface refinement; and a holistic synergy mechanism–where iterative optimization provides supervision for deep learning during the training phase, and during inference, deep learning rapidly predicts the global organ morphology, followed by iterative optimization to refine local surfaces and mesh quality. This framework demonstrated marked superiority in geometric fidelity than current mainstream deep learning-based organ reconstruction models. For individual anatomical structures, the reconstructed 3D geometries for the bladder, rectum, and uterus achieved significantly lower Chamfer Distance values and higher Dice Similarity Coefficient scores. In addition, while maintaining high computational efficiency, the proposed architecture yielded superior overall volumetric mesh quality. At the patient level, the framework achieved higher mean values for the 10 worst elements for both minSICN and minSIGE compared to traditional geometric post-processing algorithms.

04.
arXiv (CS.AI) 2026-06-12

Is It You or Your Environment? A Bayesian Inference Framework for Genomically-Anchored Personalized Physiological Interpretation

arXiv:2606.13556v1 Announce Type: new Abstract: Personalized health AI systems face a fundamental cold-start problem: machine learning models for physiological interpretation require weeks of individual behavioral data before they can distinguish constitutional variation from environmentally driven deviation. We propose a solution grounded in causal inference and Bayesian prior design. An individual's genomic profile serves as an exogenous genetic anchor – a domain-informed, personalized prior that is fixed at conception, immune to reverse causation, and available before a single behavioral observation is collected. The anchor initializes a Bayesian belief state over an individual's physiological set point G-hat = mu + sum(beta_i * g_i), where beta_i are GWAS-derived effect sizes and g_i are risk-allele counts. Each incoming physiological measurement P produces a non-constitutional deviation delta = P - G-hat that separates the signal attributable to environment and state from the constitutionally fixed baseline. As behavioral data accrue, the prior decays according to G-hat_t = w(t)*G-hat_genomic + [1-w(t)]*P-bar_t, transitioning from genome-dominated to empirical-baseline-dominated inference. The same observed HRV of 55 ms generates a suppression hypothesis for a person whose prior predicts 80 ms, and an enhancement hypothesis for a person whose prior predicts 30 ms – a reversal impossible without a personalized anchor. We develop this architecture across six physiological domains, grading genomic priors by evidence strength, distinguishing robustly replicated anchors (FTO, FADS1/2, FKBP5) from contested candidate genes (SLC6A4, MAOA, DRD2). We address the inference boundary between association, Mendelian randomization, and individual token causation, and define four constraints for deployment: evidence-graded priors, dynamic decay, ancestry-matched effect sizes, and attribution rather than deterministic output.

05.
Nature (Science) 2026-06-22

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

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

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

Toward Trustworthy AI: Multi-Target Adversarial Attacks and Robust Defenses for Continuous Data Summarization

arXiv:2606.11804v1 Announce Type: new Abstract: Trustworthy AI requires reliable data-processing pipelines, not only robust downstream predictive models. As an upstream component, data summarization determines which information is retained and passed to subsequent learning or decision modules. Therefore, adversarial perturbations to the summarization process can compromise trustworthy AI in an upstream manner: they may alter the selected summary, reduce its representativeness, and further degrade the utility of subsequent learning tasks. In this paper, we study adversarial attacks on continuous data summarization under similarity-level perturbations through DR-submodular optimization. We show that a class of multi-resolution image summarization objectives can be formulated as multilinear extensions of non-negative submodular set functions and satisfy DR-submodularity with $m$-weak monotonicity. We then formulate multi-target attack generation as a min-max problem, where one admissible perturbation of the similarity structure is optimized to degrade multiple target summarization models. To mitigate such perturbations, we formulate robust defense against mixed attack types as a regularized max-min problem. For both problems, we develop approximation algorithms with theoretical guarantees. Experiments on real-data and controlled clustered benchmarks show that the proposed attack is effective in representative low-to-moderate budget regimes and can induce downstream task-performance loss. The proposed defense improves the robustness–mitigation trade-off in structured settings, while also revealing the parameter sensitivity of robust protection on real data.

07.
arXiv (CS.CL) 2026-06-11

From Explicit Elements to Implicit Intent: A Predefined Library for Auditable Behavioral Inference

We present SemantiClean, a modular framework for extracting structured semantic signals from e-commerce session data and driving pluggable inference targets including purchase intent, customer segmentation, and product affinity through a shared element library. Unlike conventional end-to-end predictors that optimise solely for accuracy, SemantiClean prioritises auditability, structural governance, and sigma=0 reproducibility, explicitly trading marginal predictive gains for element-level transparency and defensible decision trails. Built upon the Online Shoppers Purchasing Intention (OSPI) dataset, the framework organises twenty-four behavioural elements into a four-layer architecture (Functional, Interaction, Systemic, Contextual) and enforces signal quality through three anti-inflation mechanisms: RedundancyGroup contribution caps, TieredPenaltyCalculator bias penalties, and AdaptiveConstraintMode cold-start protection.This report introduces the LLM-Integrated Semantic Inference Engine, a fully implemented two-phase LLM-driven inference architecture that leverages complete element metadata at inference time. All quantitative results reported herein are produced by this engine. Deterministic engine outputs remain fully reproducible (sigma=0); LLM-dependent results (E8, E10) are subject to controlled output variability under fixed provider/model/temperature settings. The gender inference target remains non-functional in the current implementation and is excluded from all quantitative results.

08.
arXiv (CS.CV) 2026-06-12

OR-Action: Multi-Role Video Understanding with Fine-Grained Actions

Fine-grained understanding of operating room (OR) activity could enable workflow-aware assistance, yet remains difficult due to clutter, occlusions, and limited sensing. The prevailing approach to model this environment is scene graphs as an interpretable representation of OR interactions. Converting their frame-wise relational predictions into temporally extended, fine-grained actions however, is challenging without explicit temporal modeling. To enable a principled temporal evaluation of current OR understanding methods, we introduce the first action-centric benchmark built on a publicly available ego-exocentric OR dataset by defining a fine-grained, multi-role action taxonomy and generating dense action segments via distillation from ground-truth scene graph state changes. Experiments on this benchmark show that current scene graph prediction methods struggle to model temporal structure, even when adding explicit modeling through Graph Neural Networks. We therefore introduce a vision-only temporal model that outperforms graph-based methods significantly when using all available egocentric video as input. Building on this model we also introduce a novel multi- to single-view feature alignment strategy that improves single-view performance on multi-role action recognition, mitigating the need for extensive egocentric video capture. Benchmark and code will be released upon acceptance.

09.
bioRxiv (Bioinfo) 2026-06-12

The Geometry of Allostery: A Laplacian Minor Hierarchy for Many-Body Protein Communication

Quantifying how cooperative, many-body relationships drive allostery in protein networks remains a major challenge. To address this, we develop the Laplacian minor hierarchy, a mathematical framework that characterizes the geometric invariants of a protein network. Lower-order minors yield standard metrics including the partition function and effective distances, whereas higher-order minors define novel topological measures: cooperation indices, each bounded between zero and one, that characterize pathway correlations at increasing levels of complexity, the third-order minor determines whether allosteric pathways are correlated or uncorrelated, and the fourth-order minor quantifies how distinct pathways communicate through intermediary residues. We apply this framework to analyze the evolutionary adaptation of the PSD95pdz3 domain from Class I to Class II ligand specificity via mutations G330T and H372A. The cooperation index demonstrates a distinct evolutionary hierarchy: the G330T mutation establishes distributed pathway couplings that the H372A mutation subsequently exploits, whereas H372A alone produces minimal global changes. Furthermore, the fourth-order analysis identifies His317 as a critical intermediary node bridging the class-switching (330-372) and class-bridging (330-400) allosteric pathways. These results demonstrate that allosteric dependencies emerge only when mutations accumulate in specific combinations, with a hierarchical organization of pathways structured around position 330 and intermediary nodes His317 and Phe400. Rather than predicting allosteric mechanisms, this framework provides a mechanistic explanation for why and how allostery emerges during protein evolution.

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

Recursive Scaling in Masked Diffusion Models

arXiv:2606.18022v1 Announce Type: new Abstract: Masked diffusion models (MDMs) have recently emerged as a promising paradigm for sequence generation. Scaling MDMs is conventionally achieved by increasing the parameter count or the number of denoising steps. We introduce Recursive Masked Diffusion Models (R-MDMs), which add recursive depth as a third scaling axis by repeatedly applying the same denoising transformer within each diffusion step. Recursion enables iterative refinement of the output through parameter reuse, increasing effective model depth without increasing parameter count. Across structured generation tasks, including Sudoku and Countdown, we show that R-MDMs achieve substantially improved parameter efficiency: a model with $L$ recursive iterations often matches the performance of non-recursive baselines with roughly $L\times$ more parameters. Moreover, recursive refinement can partially substitute for additional denoising steps, allowing recursive models to reach the same generation quality with fewer forward passes at inference time. These results suggest that recursive depth is a practically useful scaling mechanism for MDMs, improving both parameter efficiency and the allocation of test-time compute.

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

SiGnature: Explicit Motion Diffusion for Stylized Semantic Gesture

While recent advances in co-speech gesture generation have achieved impressive rhythmic synchronization, synthesizing gestures that are both semantically meaningful and faithful to a speaker's unique non-verbal style remains an open challenge. Semantic gestures, such as iconic shapes or deictic pointing, are statistically sparse, making them difficult to learn effectively within standard generative models. We present SiGnature, a framework for Stylized and Semantic Gesture generation that reconciles precise semantic control with high-fidelity style preservation. Unlike prevalent methods that rely on entangled latent representations, SiGnature operates in an explicit joint-rotation space. This design enables our core contribution, Joint Motion Integration (JMI), a training-free inference mechanism capable of injecting any external motion sequence, particularly in-the-wild semantic gestures, directly into the diffusion process. JMI automatically identifies the specific ``active joints'' conveying a semantic action and injects them into the generation, while relying on the diffusion backbone to synthesize the remaining body dynamics, including posture and flow, in accordance with the pre-learned style of the target speaker. This allows for the plug-and-play integration of arbitrary motions, including complex semantic gestures, without retraining or introducing the ``Frankenstein'' artifacts typical of cut-and-paste methods. Extensive experiments and perceptual studies demonstrate that SiGnature offers superior semantic motion control while maintaining smooth and natural co-speech gesture generation and preserving the distinct characteristics of the speaker, thereby outperforming state-of-the-art baselines.

12.
Nature Medicine 2026-06-15

Activity-dependent adaptive deep brain stimulation improves gait in Parkinson’s disease

Parkinson’s disease leads to a spectrum of locomotor deficits that vary in severity with the nature of daily activities and the fluctuating physiology of patients. Many of these deficits remain inadequately addressed by existing deep brain stimulation therapies that rely on activity-agnostic parameters optimized for cardinal motor symptoms. By contrast, therapies embedding activity-specific parameters have the potential to better address the entire range of symptoms. Here we expose physiological principles that enable real-time decoding of ongoing locomotor activities across motor fluctuations from the neural dynamics of the subthalamic nucleus. This decoding steered activity-dependent adaptations of deep brain stimulation therapies that improved locomotor deficits while preserving efficacy for cardinal motor symptoms across activities of daily living. Our activity-dependent framework provides a blueprint for next-generation neuromodulation therapies that continuously select parameters optimized to the behavioral context and fluctuating physiology of each patient. ClinicalTrials.gov registration NCT06791902 . Neural decoding algorithms that leverage physiological principles of locomotor encoding support activity-dependent deep brain stimulation therapies that improve locomotor deficits in people with Parkinson’s disease.

13.
arXiv (CS.CV) 2026-06-16

Semantic Flip: Synthetic OOD Generation for Robust Refusal in Embodied Question Answering and Spatial Localization

Detecting unanswerable user queries remains essential for the reliable deployment of real-world embodied agents. However, modern vision-language models (VLMs) often generate overly confident answers even when the available visual memory cannot support the query. Such overconfidence poses various task-dependent risks. The agent may provide misleading information to the user in Embodied Question Answering and select an arbitrary coordinate and physically guide the user there in spatial reasoning for navigation. Despite these high stakes, only a few prior studies directly address when and how an embodied VLM should respond with "I do not know." This work proposes Semantic Flip, a simple yet effective framework that synthesizes auxiliary out-of-distribution (OOD) samples for embodied refusal without requiring external OOD annotations. The key idea is to independently transform the query and video memory to construct auxiliary OOD pairs that lack sufficient visual grounding. These synthesized pairs enable training a lightweight rejection module on top of a frozen pretrained VLM. The module attaches to any existing VLM-based pipeline without retraining the underlying model. Across two complementary benchmarks, Semantic Flip consistently outperforms strong prompting baselines. This work also introduces SpaceReject, a new refusal benchmark for spatial localization with deliberately unanswerable queries over long video memory, where Semantic Flip achieves an $F_1$ score of 0.9559. The source codes and datasets are publicly available at https://github.com/ndb796/SemanticFlip.

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

Dissociating Decodability and Causal Use in Bracket-Sequence Transformers

When trained on tasks requiring an understanding of hierarchical structure, transformers have been found to represent this hierarchy in distinct ways: in the geometry of the residual stream, and in stack-like attention patterns maintaining a last-in, first-out ordering. However, it remains unclear whether these representations are causally used or merely decodable. We examine this gap in transformers trained on the Dyck language (a formal language of balanced bracket sequences), where the hierarchical ground truth is explicit. By probing and intervening on the residual stream and attention patterns, we find that depth, distance, and top-of-stack signals are all decodable, yet their causal roles diverge. Specifically, masking attention to the true top-of-stack position causes a sharp drop in long-distance accuracy, while ablating low-dimensional residual stream subspaces has comparatively little effect. These results, which extend to a templated natural language setting, suggest that even in a controlled setting where the relevant hierarchical variables are known, decodability alone does not imply causal use.

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

Stochastic trace estimation with tensor train random vectors

arXiv:2606.15679v1 Announce Type: cross Abstract: Stochastic trace estimation is a standard tool for approximating the trace of a large-scale matrix available only through matrix-vector products. However, in tensor-structured settings, unstructured Gaussian or Rademacher test vectors may be prohibitively expensive to store and compute with, while cheaper rank-one tensor-product vectors can require sample complexities that grow exponentially with the tensor order. This work studies Gaussian random tensor train vectors as a structured alternative for stochastic trace estimation. We show that, with a suitable choice of the tensor train rank, random tensor train vectors recover dimension-independent guarantees for the Girard–Hutchinson estimator. In particular, a median-of-means variant with tensor train rank $r \geq d-1$ achieves the same dependence on the accuracy $\varepsilon$ and failure probability $\delta$ as the classical estimator based on unstructured Gaussian vectors. We further prove an oblivious subspace injection result for sketches formed from independent Gaussian random tensor train vectors: tensor train rank $r\geq d-1$ and $\mathcal{O}(\varepsilon^{-2}(k+\log(1/\delta)))$ samples suffice for a $k$-dimensional target subspace. Finally, we investigate the use of such sketches within the Nystr\"{o}m++ framework. We show that the resulting estimator can achieve the desired $\mathcal{O}(\varepsilon^{-1})$ sample complexity under an additional spectral-tail condition. These results provide clarififcation on both the potential and the limitations of random tensor train vectors in stochastic trace estimation.

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

MCR-VQGAN: A Scalable and Cost-Effective Tau PET Synthesis Approach for Alzheimer's Disease Imaging

Tau positron emission tomography (PET) is a critical diagnostic modality for Alzheimer's disease (AD), but its widespread clinical adoption is hindered by radiation exposure, limited availability, high clinical workload, and substantial financial costs. To address these limitations, we propose the Multi-scale CBAM Residual Vector Quantized Generative Adversarial Network (MCR-VQGAN) to synthesize high-fidelity tau PET images from structural T1-weighted MRI. MCR-VQGAN advances the standard VQGAN architecture through three enhancements: multi-scale convolutions, ResNet blocks, and Convolutional Block Attention Modules (CBAM), which collectively improve the capture of local and global features. Using 222 paired T1-weighted MRI and tau PET scans from the ADNI database, we trained and compared MCR-VQGAN against cGAN, WGAN-GP, CycleGAN, and baseline VQGAN. MCR-VQGAN achieved superior image synthesis performance across all metrics (MSE = 0.0056 +/- 0.0061, PSNR = 30.65 +/- 4.47 dB, SSIM = 0.9263 +/- 0.0469). A CNN-based AD classifier trained on real tau PET achieved comparable accuracy on real (63.64%) and synthetic (65.91%) images, indicating that diagnostically relevant features are preserved. Regional SUVR-equivalent analysis across Braak-defined ROIs further indicated strong agreement between real and synthetic tau PET (Pearson r = 0.78-0.88; ICC = 0.71-0.84), with the strongest agreement in Braak V/VI (ICC = 0.838). Together, these results suggest that MCR-VQGAN offers a promising and scalable surrogate for conventional tau PET imaging, potentially improving the accessibility of tau biomarkers for AD research and clinical workflows.

17.
arXiv (CS.CV) 2026-06-18

Toward Training-Free Zero-Shot Anomaly Detection in 3D Medical Images: A Batch-Based Approach Using 2D Foundation Models

作者:

Zero-shot anomaly detection (ZSAD) is attractive for medical imaging because clinical systems must handle heterogeneous acquisition protocols, changing patient populations, and pathologies for which annotated training data may be unavailable. Most existing zero-shot anomaly detection methods are designed for 2D images, and their direct extension to 3D medical volumes is limited by the scarcity of large-scale volumetric foundation models or by the difficulty of utilizing volumetric context. We propose CS3F, a training-free batch-based framework for ZSAD in 3D medical images using 2D foundation models. Each volume is decomposed along multiple anatomical axes and encoded slice-wise by a 2D vision transformer. These are then converted into localized volumetric tokens by pooling neighboring slice features. Anomaly scores are obtained from cross-subject mutual similarity: tokens that lack close analogues in other subjects are assigned higher anomaly scores. To reduce the attenuation of focal lesion signals caused by depth pooling, we introduce a coarse-to-fine tokenization strategy that enables fine-resolution volumetric scoring without exhaustive matching. CS3F is evaluated on brain MRI across metastases, glioma, and stroke, as well as validated on lung CT to test generalizability beyond atlas-aligned brain MRI. The results show that frozen 2D foundation models can support anomaly localization in 3D medical images, and that the benefit of fine tokenization depends strongly on lesion contrast and imaging modality.

18.
medRxiv (Medicine) 2026-06-12

A Machine Learning Pipeline for Scalable Annotation of Patient-Ventilator Dyssynchrony from Bedside Ventilator Data

Objective: Patient-ventilator dyssynchrony (PVD) is a common and clinically consequential problem in critically ill patients receiving invasive mechanical ventilation. Yet automated identification of PVD subtypes at scale remains an unmet clinical need, owing to the lack of large annotated bedside waveform datasets. Methods: We developed and validated a semi-supervised algorithm for automated annotation of PVD. In two medical ICUs at a tertiary academic center, bedside devices continuously collected airway flow and pressure waveforms from the ventilators. We developed a software interface with an information retrieval system that grouped similar breaths for expert human review, yielding 1,542,296 labeled breaths across eight categories: 2 labels for breath delivery mode, 5 labels for PVD subtypes, and 1 label denoting a normal breath. Two pulmonary physicians with expertise in ventilator training and education provided the expert reference labels. We trained an initial classification model on a model-derivation set of 771,148 breaths (divided into training and validation) and evaluated it on a hold-out test set of 771,149 breaths A semi-supervised approach was utilized to extend labeling to an additional 12,965,000 unlabeled breaths. Results: The supervised model performed well across all labels, with Macro-F1 scores between 0.96 and 1.00. Semi-supervised learning across 12 rounds expanded the training set from 771,148 to 8,563,995 breaths without significant performance degradation. Conclusion: We developed a practical and scalable system for automated PVD annotation that performed well across all subtypes. This work provides a reproducible foundation for automated PVD labeling to support the development of machine-learning-based clinical decision support systems for identifying patient-level asynchrony.

19.
arXiv (CS.LG) 2026-06-12

Is Spurious Correlation Removal Always Learnable?

arXiv:2606.12930v1 Announce Type: new Abstract: Invariant learning can fail even when the invariant structure is statistically identifiable. We show a conditional computational barrier: under a black-box samplable supervised sparse recovery primitive motivated by average-case sparse-recovery reductions, there exist samplable multi-environment instances with a one-dimensional predictive invariant subspace ($k=1$) that are learnable with polynomial samples by exhaustive search, while any polynomial-time constant-accuracy recovery algorithm would contradict the primitive. We further quantify environment diversity by a separation parameter $\gamma$, which controls identifiability and the curvature of invariance objectives. Under sufficient diversity and local Gaussian regularity, the minimax risk is $\mathbb{E}[\dist(\hat{V},V_{\mathrm{inv}})^2]=\Theta(k(d-k)/(n|\mathcal{E}|))$, and under label-induced shifts a phase transition occurs at $n^*\propto k(d-k)/(|\mathcal{E}|\gamma^2)$ with refined estimation error scaling proportional to $1/\gamma^2$. Synthetic and real datasets illustrate the predicted gaps and transitions and motivate simple diversity diagnostics.

20.
medRxiv (Medicine) 2026-06-17

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

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

21.
arXiv (CS.CV) 2026-06-11

Plan-and-Verify Video Reward Reasoning with Spatio-Temporal Scene Graph Grounding

Reward models for text-to-video (T2V) generation guide post-training but often fail at fine-grained semantic alignment. We trace this to two structural weaknesses in existing reasoning-based reward models: they do not systematically verify every condition described in the prompt, and the visual evidence supporting each judgment remains implicit in their free-form reasoning. We propose SG-PVR, a video reward model that addresses these limitations through plan-and-verify reasoning grounded in spatio-temporal scene graphs. The verification plan decomposes the prompt into atomic claims, ensuring every requirement is checked. The spatio-temporal scene graph, encoding entities, attributes, and temporally-grounded relations, is extracted from the video and maintained as a persistent structured visual reference throughout reasoning. Each claim is verified against both the video and the scene graph, anchoring judgments in explicit visual evidence. SG-PVR achieves strong performance on semantic alignment, including fine-grained temporal semantics. As a test-time reranker, it further enhances compositional alignment in T2V generation.

22.
arXiv (CS.AI) 2026-06-16

Rescaling Confidence: What Scale Design Reveals About LLM Metacognition

arXiv:2603.09309v2 Announce Type: replace Abstract: Verbalized confidence, in which LLMs report a numerical certainty score, is widely used to estimate uncertainty in black-box settings, yet the confidence scale itself (typically 0–100) is rarely examined. We show that this design choice is not neutral. Across six LLMs and three datasets, verbalized confidence is heavily discretized, with more than 78\% of responses concentrating on just three round-number values. To investigate this phenomenon, we systematically manipulate confidence scales along three dimensions: granularity, boundary placement, and range regularity, and evaluate metacognitive sensitivity using $meta-d'$. We find that a 0–20 scale consistently improves metacognitive efficiency over the standard 0–100 format, while boundary compression degrades performance and round-number preferences persist even under irregular ranges. These results demonstrate that confidence scale design directly affects the quality of verbalized uncertainty and should be treated as a first-class experimental variable in LLM evaluation.

23.
medRxiv (Medicine) 2026-06-22

Study protocol: Feasibility and clinical implications of real-time cerebral autoregulation monitoring in major noncardiac surgery with the Medtronic Cotrending algorithm (AUTOREGULATE-NONCARDIAC-COTRENDING)

Background: Perioperative hypotension is associated with postoperative organ injury. However, trials of hypotension avoidance have not found meaningful improvements in postoperative cardiovascular, renal, neurological or functional outcomes. One possible explanation is that organ perfusion depends on patients individual autoregulatory ranges. Hence, technology enabling monitoring of the autoregulatory status of vital organs, e.g. the brain, could provide a physiologic basis for personalising of blood pressure targets. However, current established methodologies for monitoring cerebral autoregulation in noncardiac surgery, e.g. the cerebral oximetry index (COx), are limited by performance and usability. The Medtronic Cotrending algorithm has been developed to provide automated, near real-time assessment of cerebral autoregulation. While feasibility was demonstrated in cardiac surgery, its applicability in major noncardiac surgery remains unknown. This study aims to evaluate the technical feasibility and clinical implications of Cotrending-based cerebral autoregulation monitoring in major noncardiac surgery. Objectives: Primary objective: To evaluate the technical feasibility of using the Medtronic Cotrending algorithm to monitor intraoperative cerebral autoregulation in real-time during major noncardiac surgery, drawing comparisons to the COx algorithm. Secondary objectives: to investigate the potential clinical implications of Cotrending-based cerebral autoregulation monitoring. Design: Single-centre, prospective cohort study. Setting: Swiss tertiary care centre Patients: Patients enrolled in AUTOREGULATE-NONCARDIAC who were monitored intraoperatively with the Medtronic INVOS(TM) 5100 near-infrared spectroscopy (NIRS) system. Outcomes: Technical feasibility outcomes include success rate of determination of the lower limit of cerebral autoregulation, intraoperative uptime, time to first estimate of the lower limit of cerebral autoregulation, sensitivity to external factors and to data artefacts; agreement of Cotrending-derived lower limit of cerebral autoregulation with COx-derived lower limit of cerebral autoregulation. Conclusions: N/A Trial registration: Clinicaltrials.gov NCT07630129

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

Dual-Uncertainty Guided Policy Learning for Multimodal Reasoning

Reinforcement learning with verifiable rewards (RLVR) has advanced reasoning capabilities in multimodal large language models. However, existing methods typically treat visual inputs as deterministic, overlooking the perceptual ambiguity inherent to the visual modality. Consequently, they fail to distinguish whether a model's uncertainty stems from complex reasoning or ambiguous perception, preventing the targeted allocation of exploration or learning signals. To address this gap, we introduce DUPL, a dual-uncertainty guided policy learning approach for multimodal RLVR that quantifies and leverages both perceptual uncertainty (via symmetric KL divergence) and output uncertainty (via policy entropy) to guide policy updates. By establishing an uncertainty-driven feedback loop and employing a dynamic branch prioritization mechanism, DUPL recalibrates the policy advantage to focus learning on states with high perceptual or decisional ambiguity, enabling effective targeted exploration beyond passive data augmentation. Evaluated on diverse multimodal reasoning benchmarks spanning mathematical and general domains, DUPL achieves solid gains. It improves Qwen2.5-VL accuracy by up to $12.3%$ (3B) and $7.9%$ (7B), and Qwen3-VL-Instruct by up to $10.7%$ (4B) and $12.4%$ (8B), consistently outperforming GRPO, while seamlessly generalizing to alternative algorithms (DAPO, $+6.5%$ avg) and architectures (LLaVA-OneVision-1.5, $+4.7%$ avg). These results demonstrate that DUPL is an effective and generalizable approach for multimodal RLVR.

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

Measuring Whether LLM Tutors Teach or Solve: A Diagnostic for Educational Impact

Large language models are increasingly proposed as educational tutors, yet stronger task-solving ability does not necessarily imply stronger learning support. Motivated by recent calls to measure the social impact of NLP systems in practice, we study whether public LLM tutoring benchmarks distinguish learning-supportive behavior from mere answer production. We propose a lightweight diagnostic based on the gap between solving-oriented and pedagogy-oriented benchmark performance. Using public MathTutorBench leaderboard results, we show that these dimensions are only partially aligned: across eight publicly reported models, the correlation between solving and pedagogy composites is 0.421, and several models shift meaningfully in rank when evaluation moves from solving to pedagogy. We then analyze the public TutorBench sample and show that agency-relevant behaviors are explicitly encoded in benchmark rubrics, especially in active-learning settings that reward guiding questions, calibrated hints, and non-disclosive scaffolding. Together, these findings suggest that educational-impact evaluation should not treat task success as a sufficient proxy for learning support. We argue that public tutoring benchmarks can better support positive-impact evaluation by reporting solving-oriented and pedagogy-oriented scores separately and by making disclosure-sensitive, student-agency-preserving criteria more explicit.