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02.
bioRxiv (Bioinfo) 2026-06-11

An AI-Powered Trisomy 21 Research Assistant

作者:
NANDI↗Sundararajan↗Subirana-Granes↗Espinosa↗J. M↗Pividori↗Sullivan↗K. D↗Galbraith↗M. D↗Costello↗

Down syndrome, caused by trisomy 21, increases the risk of diverse co-occurring conditions. With more than 34,000 related publications indexed in PubMed as of early 2026, keeping pace with this expanding literature is challenging. While general-purpose large language models are widely used for information retrieval, they often rely on broad training data rather than specific evidence. Retrieval-augmented generation (RAG) improves rigor and reliability of responses by linking model outputs to source texts. In research, source texts are peer-reviewed articles. Standard implementations treat all manuscript sections equally, allowing background text to rank as highly as experimental results. To focus model outputs on experimentally supported responses, we developed the T21 Research Assistant, a section-aware RAG system that prioritizes Results sections to ground responses in primary experimental evidence. The system draws exclusively from 1,789 open-access Down syndrome publications from PubMed Central, including 327 NIH INCLUDE-funded studies, and uses a multistage pipeline for query validation, retrieval, reranking, synthesis, and citation verification. Built on NVIDIA Nemotron models, it generates structured, cited responses. Evaluation using expert-curated questions demonstrated strong performance, achieving a BERTScore F1 of 0.712 and recall of 0.758, comparable to or exceeding leading proprietary and open-source models. T21 Research Assistant is available at: https://bioinformatics.cuanschutz.edu/t21-res-assi/

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03.
arXiv (CS.AI) 2026-06-11

SAGE: Scalable AI Governance & Evaluation

作者:
Benjamin Le↗Xueying Lu↗Nick Stern↗Wenqiong Liu↗Igor Lapchuk↗Xiang Li↗Baofen Zheng↗Kevin Rosenberg↗Jiewen Huang↗Zhe Zhang↗Abraham Cabangbang↗Satej Milind Wagle↗…

arXiv:2602.07840v4 Announce Type: replace-cross Abstract: Evaluating relevance in large-scale search systems is fundamentally constrained by the governance gap between nuanced, resource-constrained human oversight and the high-throughput requirements of production systems. While traditional approaches rely on engagement proxies or sparse manual review, these methods often fail to capture the full scope of high-impact relevance failures. We present SAGE (Scalable AI Governance \& Evaluation), a framework that operationalizes high-quality human product judgment as a scalable evaluation signal. At the core of SAGE is a bidirectional calibration loop where natural-language Policy, curated Precedent, and an LLM Surrogate Judge co-evolve. SAGE systematically resolves semantic ambiguities and misalignments, transforming subjective relevance judgment into an executable, multi-dimensional rubric with near human-level agreement. To bridge the gap between frontier model reasoning and industrial-scale inference, we apply teacher-student distillation to transfer high-fidelity judgments into compact student surrogates at 92$\times$ lower cost. Deployed within LinkedIn Search ecosystems, SAGE guided model iteration through simulation-driven development, distilling policy-aligned models for online serving and enabling rapid offline evaluation. In production, it powered policy oversight that measured ramped model variants and detected regressions invisible to engagement metrics. Collectively, these drove a 0.25\% lift in LinkedIn daily active users.

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

RUB: Evaluating Residual Knowledge in Unlearned Models

作者:
Hao Xuan↗Xingyu Li↗

Machine Unlearning (MUL) has emerged as a key mechanism for privacy protection and content regulation, yet current techniques often fail to guarantee the complete removal of sensitive information. While most existing works focus on verifying the execution of unlearning, they overlook the critical question of whether models remain robust against adversarial attempts to recover forgotten knowledge. In this work, we advocate for the principle of Robust Unlearning, which requires models to be both indistinguishable from retrained counterparts and resilient against diverse adversarial threats. To instantiate this principle, we propose a unified benchmark, RUB (Robust Unlearning Benchmark), that systematically evaluates the robustness of unlearning algorithms across classification, image-to-image reconstruction, and text-to-image synthesis. Within this framework, we introduce the Unlearning Mapping Attack (UMA) as a generalizable method to detect residual information, and demonstrate how existing attack strategies can be adapted into this framework as long as they conform to the generic UMA framework. Our experiments across discriminative and generative tasks reveal that state-of-the-art unlearning methods remain vulnerable under these evaluations, even when passing standard verification metrics. By positioning robustness as the central criterion and providing a benchmark for adversarial evaluation, we hope RUB paves the way toward more reliable and secure unlearning practices. The codebase and model checkpoints in RUB will be published.

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05.
arXiv (CS.CV) 2026-06-16

SUP-MCRL: Subject-aware Unified Pseudo-feature Coded Multimodal Contrastive Representation Learning for EEG Visual Decoding

作者:
Shengyu Gong↗Weiming Zeng↗Yueyang Li↗Zijian Kang↗Hongjie Yan↗Wai Ting Siok↗Nizhuan Wang↗

Non-invasive brain-computer interfaces suffer severe fidelity degradation in neural visual decoding when generalizing to natural visual experiences. Conventional multimodal contrastive representation learning solely optimizes geometric distance alignment, neglecting semantic consistency and subject selectivity, causing spurious zero-shot alignment. We propose SUP-MCRL, a unified framework integrating three collaborative mechanisms: (1) Semantic-entity Aware Visual Encoder (SAVE), learning spatial attention to extract semantic content without pre-trained saliency models; (2 Unified EEG Enhancer (UEE), employing multi-scale atrous convolutions and inter-band attention for adaptive cross-subject robustness; and (3) Prototype-based Progressive Augmenter (PPA), maintaining an EMA-updated pseudo-feature pool to prevent representation collapse. Zero-shot experiments on THINGS-EEG achieve 66.0%/91.9% (Top-1/Top-5) intra-subject and 24.0%/52.9% LOSO accuracy, surpassing state-of-the-art methods. Code is available at https://github.com/NZWANG/SUP-MCRL.

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

Zero-Shot Active Feature Acquisition via LLM-Elicitation

作者:
Binyamin Perets↗Natalie Mendelson↗Shiran Vainberg↗Yehuda Chowers↗Shai Shen-Orr↗Shie Mannor↗

arXiv:2606.18933v1 Announce Type: new Abstract: Active feature acquisition (AFA) sequentially selects which features to observe to reach a classification or ranking decision. Its central limitation is reliance on large amount of labeled data to fit probabilistic models guiding acquisition. Large language models (LLMs) supply unsupervised domain knowledge, but are poor sequential planners. Asking one to both know and decide conflates capabilities best kept separate. Here, we develop a framework for zero-shot AFA through disciplined elicitation: asking the LLM only for what it can be trusted to return, the unary deviations and pairwise co-variations that are the sufficient statistics of a Markov random field (MRF). We apply our framework to two settings: binary classification and top-$k$ identification. In practice, the LLM reliably returns only discriminative statistics, what distinguishes the classes rather than each class in isolation, which precludes classical AFA. We apply a maximum-entropy closure that resolves this gauge ambiguity. We evaluate on a cohort of Inflammatory Bowel Disease (IBD) patients, an active clinical setting where diagnostic ambiguity and patient heterogeneity obstruct stable treatment strategies. Our framework outperforms the LLM both on real labels and on its own extracted beliefs. Where it matters most, on the hardest patients, our top-$k$ acquisition policy markedly outperforms all existing methods.

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07.
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:
Tai Le-Gia↗

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.

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

The Market in the Model: Latent Diffusion as Neural Economy

作者:
Eryk Salvaggio↗

Valuable critique of generative image models within visual culture and the humanities has emphasized the role of datasets in shaping the images they produce. Yet, close studies of the ideological positions embedded into the mechanism of the models have been neglected, leaving them imagined as "black boxes." In a bid to expand, rather than replace, dataset critique, this paper examines the mechanisms of the latent diffusion model in terms of the problems they were brought in to solve on behalf of computer vision engineers, and the decisions each component was tasked with automating. I interpret that ensemble through the histories of its parts and the theory of vision the system inscribes into every generated image. Drawing on Impett and Offert's notion of neural exchange value, I offer this analysis to argue that the model operates as a neural economy: a contained symbolic system that abstracts social communication into commensurable vectors as it transfers the social sphere into parcels for sale. Tracing the training and generation pipelines component by component reveals what each operation displaces, and how it further entrenches the logics of platform and attention economies over social communication. The paper warns that any critique fixated exclusively on copyright and commodity defenses risks reaffirming the very fetishism the model produces, and argues instead for centering social exchange.

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09.
arXiv (quant-ph) 2026-06-16

Entangled states are typically incomparable

作者:
Vishesh Jain↗Matthew Kwan↗Marcus Michelen↗

arXiv:2406.03335v2 Announce Type: replace Abstract: Consider a bipartite quantum system, where Alice and Bob jointly possess a pure state $|\psi\rangle$. Using local quantum operations on their respective subsystems, and unlimited classical communication, Alice and Bob may be able to transform $|\psi\rangle$ into another state $|\phi\rangle$. Famously, Nielsen's theorem [Phys. Rev. Lett., 1999] provides a necessary and sufficient algebraic criterion for such a transformation to be possible (namely, the local spectrum of $|\phi\rangle$ should majorise the local spectrum of $|\psi\rangle$). In the paper where Nielsen proved this theorem, he conjectured that in the limit of large dimensionality, for almost all pairs of states $|\psi\rangle, |\phi\rangle$ (according to the natural unitary invariant measure) such a transformation is not possible. That is to say, typical pairs of quantum states $|\psi\rangle, |\phi\rangle$ are entangled in fundamentally different ways, that cannot be converted to each other via local operations and classical communication. Via Nielsen's theorem, this conjecture can be equivalently stated as a conjecture about majorisation of spectra of random matrices from the so-called trace-normalised complex Wishart-Laguerre ensemble. Concretely, let $X$ and $Y$ be independent $n \times m$ random matrices whose entries are i.i.d. standard complex Gaussians; then Nielsen's conjecture says that the probability that the spectrum of $X X^\dagger / \operatorname{tr}(X X^\dagger)$ majorises the spectrum of $Y Y^\dagger / \operatorname{tr}(Y Y^\dagger)$ tends to zero as both $n$ and $m$ grow large. We prove this conjecture, and we also confirm some related predictions of Cunden, Facchi, Florio and Gramegna [J. Phys. A., 2020; Phys. Rev. A., 2021].

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10.
arXiv (CS.AI) 2026-06-12

MARS: Margin-Adversarial Risk-controlled Stopping for Parallel LLM Test-time Scaling

作者:
Wenbo Chen↗Puheng Li↗Mengyang Liu↗Weijie Su↗Tianpei Xie↗

arXiv:2606.12935v1 Announce Type: new Abstract: Parallel test-time scaling samples many reasoning traces and majority-votes their answers, improving LLM accuracy but requiring traces to run to completion, incurring substantial computational overhead. We observe that probing partial traces at intermediate checkpoints can extract current answers without disrupting generation, revealing an evolving aggregate vote. Based on this observation, we introduce MARS, a margin-adversarial stopping rule that estimates which active traces are likely to change their answers and stops once the leader remains safe under a conservative bound on future vote movement. The rule separates two sources of uncertainty. It learns the trace-level switch probabilities that determine how much of the current margin is likely to be retained, while handling the harder question of where switching traces land through an adversarial bound calibrated from warmup traces. With true switch probabilities, MARS guarantees with high probability that the early-stopped answer matches the full-budget vote. In practice, a five-feature logistic model closely matches oracle switching behavior. Across three reasoning models and three competition-math benchmarks, MARS saves 25-47% of self-consistency tokens and 14-29% on top of DeepConf Online, a strong confidence-weighted baseline that already filters and truncates weak traces, while matching the accuracy of the corresponding full-budget baselines.

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

Human Cognition in Machines: A Unified Perspective of World Models

作者:
Timothy Rupprecht↗Pu Zhao↗Amir Taherin↗Arash Akbari↗Arman Akbari↗Yumei He↗Tooba Imtiaz↗Sean Duffy↗Juyi Lin↗Yixiao Chen↗Rahul Chowdhury↗Enfu Nan↗…

This report of world models distinguishes prior works by the cognitive functions they innovate. Many works claim an almost human-like cognitive capability in their world models. To evaluate these claims requires a proper grounding in first principles from human and machine cognition theory. In moving towards human-like world models we present a conceptual unified framework for world models that fully incorporates all the cognitive functions (i.e., memory, perception, language, reasoning, imagining, motivation, and metacognition) and identify gaps in existing research as a guide for future states of the art. In particular, we find that motivation (especially intrinsic motivation) and metacognition remain drastically under-researched, and we propose concrete directions to address these gaps informed by active inference and global workspace theory. We also introduce epistemic world models, a new category encompassing agent frameworks for scientific discovery that operate over structured knowledge. Our taxonomy, applied to video, embodied, and epistemic world models, suggests research directions where prior taxonomies have not.

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12.
arXiv (math.PR) 2026-06-11

Convergence of a Critical Multitype Bellman–Harris Process with One Infinite-Mean Lifetime

作者:
Ram\'irez-Gonz\'alez J. H↗Prates Machado Fabio↗

arXiv:2606.11511v1 Announce Type: new Abstract: We study a critical multitype Bellman–Harris branching particle system in $\mathbb R^N$ with a finite type space $\mathbb K=\{1,\dots,K\}$. Particles of type $i$ move according to a symmetric $\alpha_i$-stable process and reproduce according to a critical offspring law whose mean matrix is irreducible and stochastic. The lifetime distribution of type $1$ is assumed to have infinite mean with regularly varying tail $$ 1-F_1(t)\sim c_1t^{-\gamma},\, 0 \frac{\gamma}{\beta}, $$ and a local increment condition on the heavy lifetime distribution, we prove convergence of the system to a Poisson random measure concentrated on the infinite-mean type.

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13.
bioRxiv (Bioinfo) 2026-06-18

fuzzyfold: a high-performance framework for stochastic RNA folding kinetics

作者:
Badelt↗

The analysis of nucleic acid secondary structures is overwhelmingly dominated by methods that analyze the thermodynamic equilibrium distribution and which ignore all dynamic aspects of nucleic acid folding. Yet, there are numerous popular examples of nucleic acid folding that rely on kinetic models, such as RNA riboswitches or DNA strand displacement systems. Here, I am presenting fuzzyfold, a Rust-based software package for nucleic acid secondary structure analysis with an explicit focus on stochastic modeling. The framework introduces three-way and four-way shift moves with a biophysically motivated rate-model parameterization, and it is developed with an emphasis on both model flexibility and performance, e.g. allowing for the generation of single co-transcriptional trajectories for thousand-nucleotide long RNA molecules in just a few minutes. The main strength of the fuzzyfold package, however, is its focus on user and developer interfaces for long-term development. It provides easily installable command-line interfaces, e.g. for aggregating data from multiple parallel trajectories efficiently into an ensemble-level dynamic analysis. For developers, the code-base supports straight-forward substitution of thermodynamic and kinetic free-energy models, and a flexible library interface with Python bindings, enabling integration of individual components into custom computational workflows.

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14.
Nature Medicine 2026-06-08

Apitegromab for lean mass preservation during tirzepatide-induced weight loss: a randomized, double-blind, placebo-controlled phase 2 trial

作者:
Richard E. Pratley↗

Loss of lean mass in proportion to total weight loss is observed with incretin mimetic therapies such as tirzepatide and has the potential to adversely affect health and function. Apitegromab is an investigational, fully human monoclonal antibody that selectively inhibits myostatin activation and is, thereby, capable of increasing muscle mass. In the randomized, double-blind, placebo-controlled phase 2 EMBRAZE study, adults with overweight or obesity (n = 102) were randomized 1:1 to receive tirzepatide plus apitegromab (10 mg kg−1) or tirzepatide plus placebo. At week 24, apitegromab resulted in a least square mean (80% confidence interval (CI)) of 1.9 (1.2−2.7) kg less lean mass loss than placebo (P = 0.001), despite similar total body weight loss between groups, representing a 54.9% retention of lean mass relative to placebo. In participants receiving apitegromab, trough concentrations of apitegromab and total latent myostatin, a pharmacodynamic marker, both increased over time and reached a plateau after approximately 16 weeks. Incidence of adverse events (AEs) (% (95% CI)) was generally similar across apitegromab-treated participants and placebo-treated participants, with 39 of 51 (76% (63−86%)) and 36 of 51 (71% (57−81%)) participants experiencing an AE, respectively. Serious adverse events (SAEs) were balanced and experienced by one of 51 (2% (0−10%)) participants in each arm. In summary, this proof-of-concept study demonstrated that selective targeting of myostatin by apitegromab was well tolerated and effective in preserving lean mass when combined with tirzepatide. ClinicalTrials.gov identifier: NCT06445075 . In the phase 2 EMBRAZE study, participants receiving tirzepatide and apitegromab lost less lean mass compared to participants receiving tirzepatide and placebo.

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

TrustedARI: Towards Trust-Native Agentic Routing Infrastructure for Agentic AI

作者:
Qi Li↗Zhenhua Zou↗Shuo Li↗Mingwei Xu↗Zhuotao Liu↗

arXiv:2606.15822v1 Announce Type: new Abstract: AI agents increasingly access external models, tools, and services through Agentic Routing Infrastructure (ARI) to manage the overhead of heterogeneous interfaces and fragmented subscriptions. Yet, the architecture of ARI introduces fundamental trust risks: it obtains plaintext access to agent queries and service responses, while leaving agents unable to verify that their queries are routed to intended service providers or that requests and responses remain untampered. To address this problem, we present TrustedARI, the first trust-native agentic routing infrastructure for agentic AI. Architecturally, TrustedARI is built upon three core innovations: (i) an ARI-adapted three-party TLS handshake that enables the agent and ARI to jointly authenticate the service provider through role-specific distribution of TLS key materials; (ii) a privacy-preserving query-construction protocol that allows the agent and ARI to collaboratively construct well-formed queries without exposing their respective private inputs; and (iii) a verifiable billing protocol that supports fair usage-based settlement while preserving the integrity and confidentiality of service responses. We implemented and extensively evaluated a prototype of TrustedARI to validate its performance. Experiments confirm that TrustedARI is highly efficient: our ARI-adapted handshake protocol reduces communication overhead by 39.34% compared to the existing three-party TLS handshake. Furthermore, the privacy-preserving query-construction protocol imposes negligible overhead-averaging 0.19 seconds in computation time and 0.58 MB in communication costs-while the verifiable billing protocol speeds up proof generation by 28.20x. Crucially, TrustedARI is readily deployable without any modification to the service providers.

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

A Pragmatic VLA Foundation Model

作者:
Wei Wu↗Fan Lu↗Yunnan Wang↗Shuai Yang↗Shi Liu↗Fangjing Wang↗Qian Zhu↗He Sun↗Yong Wang↗Shuailei Ma↗Yiyu Ren↗Kejia Zhang↗…

Offering great potential in robotic manipulation, a capable Vision-Language-Action (VLA) foundation model is expected to faithfully generalize across tasks and platforms while ensuring cost efficiency (e.g., data and GPU hours required for adaptation). To this end, we develop LingBot-VLA with around 20,000 hours of real-world data from 9 popular dual-arm robot configurations. Through a systematic assessment on 3 robotic platforms, each completing 100 tasks with 130 post-training episodes per task, our model achieves clear superiority over competitors, showcasing its strong performance and broad generalizability. We have also built an efficient codebase, which delivers a throughput of 261 samples per second with an 8-GPU training setup, representing a 1.5~2.8$\times$ (depending on the relied VLM base model) speedup over existing VLA-oriented codebases. The above features ensure that our model is well-suited for real-world deployment. To advance the field of robot learning, we provide open access to the code, base model, and benchmark data, with a focus on enabling more challenging tasks and promoting sound evaluation standards.

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

Prototyping an AI-powered Tool for Energy Efficiency in New Zealand Homes

作者:
Abdollah Baghaei Daemei↗

arXiv:2509.05364v2 Announce Type: replace-cross Abstract: Residential buildings contribute significantly to energy use, health outcomes, and carbon emissions. In New Zealand, housing quality has historically been poor, with inadequate insulation and inefficient heating contributing to widespread energy hardship. Recent reforms, including the Warmer Kiwi Homes program, Healthy Homes Standards, and H1 Building Code upgrades, have delivered health and comfort improvements, yet challenges persist. Many retrofits remain partial, data on household performance are limited, and decision-making support for homeowners is fragmented. This study presents the design and evaluation of an AI-powered decision-support tool for residential energy efficiency in New Zealand. The prototype, developed using Python and Streamlit, integrates data ingestion, anomaly detection, baseline modeling, and scenario simulation (e.g., LED retrofits, insulation upgrades) into a modular dashboard. Fifteen domain experts, including building scientists, consultants, and policy practitioners, tested the tool through semi-structured interviews. Results show strong usability (M = 4.3), high value of scenario outputs (M = 4.5), and positive perceptions of its potential to complement subsidy programs and regulatory frameworks. The tool demonstrates how AI can translate national policies into personalized, household-level guidance, bridging the gap between funding, standards, and practical decision-making. Its significance lies in offering a replicable framework for reducing energy hardship, improving health outcomes, and supporting climate goals. Future development should focus on carbon metrics, tariff modeling, integration with national datasets, and longitudinal trials to assess real-world adoption.

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18.
arXiv (CS.AI) 2026-06-16

Boosting Knowledge Graph Foundation Models via Enhanced Negative Sampling

作者:
Yinan Liu↗Wenjin Xu↗Zhiyuan Zha↗Xiaochun Yang↗Bin Wang↗

arXiv:2605.27023v2 Announce Type: replace Abstract: Knowledge graphs (KGs) have become the core backbone of numerous downstream tasks such as question answering and recommender systems. However, despite all this, KGs are often very incomplete. To perform zero-shot knowledge graph completion in unseen KGs, which have different relational vocabularies from those used for pre-training, KG foundation models (KGFMs) receive a wide range of attention. Existing KGFMs often perform training using random negative triples, which are constructed by replacing the head or tail entity of a positive triple with a random entity. However, these negative triples are often constructed with limited quality, providing weak supervision for KGFM training. In this paper, we propose a simple yet effective adaptive negative sampling approach, KMAS, to enhance existing KGFMs. KMAS constructs hard negative triples through the updated relation embeddings generated from the existing KGFM's relation encoder. To further adaptively align with the evolving capability of the KGFM during the training process, KMAS adjusts the ratio of hard negative triples dynamically throughout the whole training process: after a warmup phrase, it increases the ratio linearly and then decreases linearly. Extensive experiments are conducted over 44 data sets. Experimental results demonstrate that our proposed negative sampling method can enhance many SOTA KGFMs without requiring excessive additional time or memory consumption.

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19.
medRxiv (Medicine) 2026-06-22

Starting, stopping and restarting. Patterns of Methylphenidate Use over 14 years in a large public health system

作者:
Richards↗McDonald↗Ramanjam↗Lawrence↗Donald↗

Background Persistence with stimulant medication is poor in children and adolescents with ADHD, and the evidence base is derived predominantly from high-income countries. We describe methylphenidate utilisation patterns and predictors of 12-month retention across 14 years in a large South African public health service. Methods Retrospective cohort study using routine pharmacy data from the Western Cape provincial health service (2011-2024). Children aged 5-18 at first prescription were included. Treatment episodes were defined as continuous prescription sequences with no gap exceeding 90 days and classified as initiations or restarts. Logistic regression modelled 12-month retention against early visit frequency and formulation type as pre-specified exposures. Findings 421,925 prescription events for 23,243 children across 115 facilities generated 65,885 treatment episodes. Median age at first prescription was 10 years (IQR 8-12); 77.6% were male. Kaplan-Meier 12-month survival was 28.2% for initiations and 15.4% for restarts, substantially below high-income country comparators. A quarter of all initiating prescriptions were not followed by a subsequent dispensing event; nearly 40% of patients had three or more treatment episodes. Early visit frequency was the strongest predictor of 12-month retention (high vs low: OR 2.85, 95% CI 2.65-3.06). The sustained-release formulation effect was present but attenuated on multivariable adjustment. Treatment re-initiations showed a marked seasonal pattern consistent with the South African school calendar. Interpretation Twelve-month retention was markedly lower than high-income country rates. Against a backdrop of high attrition, both early visit frequency and sustained-release formulation access predicted persistence; clinical engagement and reducing structural barriers to access are modifiable factors in this setting. Funding None.

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20.
medRxiv (Medicine) 2026-06-17

Accounting for Human Movement to Improve Exposure-Health Models

作者:
Tahir↗Smart↗Cai↗Ng↗Vande Hey↗Lucas↗T. C↗

Background. Current exposure-health models rely on averaged, residential-based environmental exposures, failing to account for human movement. This aggregation can lead to exposure misclassification and biased exposure-response estimates, potentially distorting our understanding of the true health effects of environmental conditions. We developed exposure disaggregation regression models that explicitly account for human movement when linking environmental exposures to health outcomes. Methods. By weighting pixel-level exposures according to distance from home as a simple proxy for human movement, our model linked disaggregated environmental exposures to individual-level health outcomes. Weights were either fixed a priori or derived from a latent distance-decay power parameter learned from the data. We additionally evaluated model performance under a nonlinear exposure-response relationship. Model performance was assessed across multiple sample sizes (N = 1,114; 50,000; and 100,000). A simulation study examined parameter recovery using bias, empirical standard error (EmpSE), and credible interval coverage. As a case study, Demographic and Health Surveys (DHS) data from Albania were used to link acute respiratory infection (ARI) outcomes among children under five to pixel-level NDVI within a 3 km buffer around DHS cluster centroids, and the proposed models were applied to these data. Results. Across all models (fixed-weight, learned-weight, and restricted cubic spline models), parameter recovery improved with increasing sample size. At N = 1,114, estimates were biased and imprecise, with incorrect effect direction for exposure-response parameters (e.g., learned-weight {beta}1 bias = - 0.79; EmpSE = 2.61; coverage = 0.88). In contrast, the models accurately recovered parameters at larger sample sizes, including the latent distance-decay parameter (bias = - 0.02; EmpSE = 0.15; coverage = 0.95 at N = 100,000), demonstrating their ability to reliably learn movement-based exposure weights when sufficient data were available. Conclusion. Instead of relying on arbitrarily-sized buffers, this statistical framework provides a novel method for studying environmental exposure-health relationships whilst accounting for human movement. With sufficiently large sample sizes, it can accurately estimate the influence of disaggregated environmental exposures on individual-level health and help address exposure misclassification arising from residential-only metrics. This methodological framework remains scalable, interpretable, and adaptable to other exposures and outcomes, offering a foundation for future work that integrates richer mobility-informed exposure-health research.

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21.
arXiv (CS.LG) 2026-06-18

Decomposing Prediction Mechanisms for In-Context Recall

作者:
Sultan Daniels↗Dylan Davis↗Dhruv Gautam↗Wentinn Liao↗Gireeja Ranade↗Anant Sahai↗

arXiv:2507.01414v2 Announce Type: replace Abstract: We introduce a new family of toy problems that combine features of linear-regression-style continuous in-context learning (ICL) with discrete associative recall. We pretrain transformer models on sample traces from this toy, specifically symbolically-labeled interleaved state observations from randomly drawn linear deterministic dynamical systems. We study if the transformer models can recall the state of a sequence previously seen in its context when prompted to do so with the corresponding in-context label. Taking a closer look at this task, it becomes clear that the model must perform two functions: (1) identify which system's state should be recalled and apply that system to its last seen state, and (2) continuing to apply the correct system to predict the subsequent states. Training dynamics reveal that the first capability emerges well into a model's training. Surprisingly, the second capability, of continuing the prediction of a resumed sequence, develops much earlier. Via out-of-distribution experiments, and a mechanistic analysis on model weights via edge pruning, we find that next-token prediction for this toy problem involves at least two separate mechanisms. One mechanism uses the discrete symbolic labels to do the associative recall required to predict the start of a resumption of a previously seen sequence. The second mechanism, which is largely agnostic to the discrete symbolic labels, performs a "Bayesian-style" prediction based on the previous token and the context. These two mechanisms have different learning dynamics. To confirm that this multi-mechanism (manifesting as separate phase transitions) phenomenon is not just an artifact of our toy setting, we used OLMo training checkpoints on an ICL translation task to see a similar phenomenon: a decisive gap in the emergence of first-task-token performance vs second-task-token performance.

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

Structured Nonparametric Variational Inference for Dependent Latent Modeling

作者:
Yuda Shao↗Zhiling Gu↗Shan Yu↗

arXiv:2606.15458v1 Announce Type: cross Abstract: Variational inference (VI) is a core engine of modern AI, enabling scalable approximate Bayesian learning and uncertainty-aware training of large probabilistic and generative models. In this paper, we propose Structured Nonparametric Variational Inference (SN-VI), a novel framework for modeling complex dependencies among latent variables in posterior approximation, leveraging multivariate spline techniques. Unlike traditional methods that rely on the mean-field assumption, SN-VI preserves intricate latent variable dependencies, providing a flexible and accurate approximation of posteriors with arbitrary shapes. We establish rigorous theoretical guarantees, including the derivation of the lower bound for the variational objective and proof of asymptotic consistency in posterior estimation. To facilitate practical implementation, we develop an algorithm that automatically identifies dependent latent variables and their underlying dependence structure, without requiring manual specification. Simulation studies validate the effectiveness of SN-VI in approximating posterior distributions with bounded support and complex dependencies. The proposed method has been successfully applied to high-dimensional structured data, including computer vision datasets and spatial transcriptomics. In these applications, SN-VI demonstrates improved generative model performance and effectively uncovers coupled biological signals through the learned dependency structure.

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23.
medRxiv (Medicine) 2026-06-18

The relationship between serotonin transporter occupancy and extracellular serotonin concentration is hyperbolic, not linear: implications for safely tapering antidepressants

作者:
Cohrs↗Shapiro↗

Background: Hyperbolic tapering is an increasingly recognized approach for discontinuing serotonin reuptake inhibitor (SRI) antidepressants that involves non-linear dose reductions with equal stepwise reductions in serotonin transporter (SERT) occupancy to mitigate withdrawal symptoms. Its theoretical basis is the hyperbolic relationship between SRI dose and SERT occupancy reported in radioligand imaging studies. Hyperbolic tapering implicitly assumes that changes in SERT occupancy approximate changes in biologic effect and withdrawal risk. Because SERT occupancy plateaus across the therapeutic dose range of SRIs, this framework predicts relatively small biologic effects and withdrawal risk within this range. However, SERT occupancy influences serotonergic activity only indirectly via its effects on extracellular serotonin concentrations, and the relationship between these two variables is poorly characterized. Methods: We developed a two-pathway clearance model derived from mass-action kinetics to evaluate the steady-state relationship between SERT occupancy and extracellular serotonin concentrations under chronic SRI treatment. Results: Our analysis indicates that serotonin concentrations increase hyperbolically as transporter occupancy increases, suggesting that biologically meaningful differences in serotonergic signaling persist across the therapeutic dose range of SRIs despite plateauing occupancy. Conclusions: Our model predicts a hyperbolic relationship between SERT occupancy and extracellular serotonin concentrations, suggesting that changes in occupancy may not map proportionally onto serotonergic effect. These findings provide a potential mechanistic explanation for dose-dependent clinical effects of SRIs despite plateauing transporter occupancy and generate testable hypotheses regarding antidepressant tapering strategies. Empirical validation is warranted.

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

Who Drifted: the System or the Judge? Anytime-Valid Attribution in LLM Evaluation Pipelines

作者:
Yitao Li↗

arXiv:2606.15474v1 Announce Type: new Abstract: Continuous evaluation of LLM products relies on a strong LLM judge treated as ground truth: a cheap monitor scores every interaction and a team is paged when the score drifts down. But the judge is itself a model behind an API, and a silent version bump or scoring-prompt update changes how it scores – so every drift alarm is ambiguous between a worse product and a changed judge. We resolve the ambiguity with a fixed, human-labeled anchor set that the current judge re-scores at a steady interleave, a second betting e-process on the judge-versus-human gap, and a guard-window rule returning a verdict in {none, system, judge}. We prove anytime-validity, one-way identification (only the judge can move the anchors), an attribution race whose design law is that the anchors must out-run the main process they guard, and process orthogonality. On two real judge changes, a silent version bump is detected as judge drift in 60/60 runs with zero judge-to-system misattribution, and a contaminating strict-prompt change is correctly attributed on 110 of 120 runs at guard width 300 – while the industry-default rolling z-test false-alarms on 75% of drift-free streams. Every experiment replicates on a second domain (TL;DR summarization) with nothing re-tuned, and where the domains differ the differences are the ones the race predicts: the strict-prompt change shifts scores harder there, so the anchors fire faster and attribution becomes perfect (240/240). The monitor runs at approximately 0.64 of the cost of strong-judging every item, or 0.21 in a cheaper-but-deafer regime.

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

AP-GRPO: Anchor-Gated Phonetic Alignment with Policy Optimization for Pathological Speech Reconstruction

作者:
Pengfei Zhang↗Hoang H Nguyen↗Yutong Song↗Wenjun Huang↗Tahmid Imtiaz Imu↗Henry Peng Zou↗Jiang Wu↗Honghui Xu↗Amir M. Rahmani↗

arXiv:2606.15540v1 Announce Type: cross Abstract: Pathological speech from patients with neurodegenerative and neuromotor disorders is often acoustically distorted and linguistically fragmented, making pathological speech reconstruction necessary to recover intended textual content from distorted and incomplete speech recordings. Crucially, such recordings are rarely uniformly degraded: some words or short phrases remain reliable and can serve as audible anchors for reconstructing the corrupted surrounding content. We introduce Anchor-gated Phonetic Group Relative Policy Optimization (AP-GRPO), a GRPO framework with phonetic reward that aligns speech language models (SLMs) through audible-anchor preservation and inter-anchor phonetic compatibility to the original speech signal. AP-GRPO consists of: (i) an anchor-gated reward that matches reliable audible anchors in clear regions; and (ii) an inter-anchor phonetic alignment reward that evaluates whether recovered contents are phonetically supported by the corresponding corrupted inter-anchor speech span. Across four disease conditions, AP-GRPO improves faithful speech reconstruction, and the learned anchor constraint automatically adapts to each condition and thus reveals interpretable disease-specific profiles: conditions with severe articulatory degradation require stronger anchor enforcement, whereas milder impairment or linguistically impaired conditions rely more on phonetic alignment for inter-anchor recovery.

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