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

Who Pays the Price? Stakeholder-Centric Prompt Injection Benchmarking for Real-world Web Agents

arXiv:2606.13385v1 Announce Type: cross Abstract: Web agents driven by large language models (LLMs) are increasingly deployed in real-world environments, where they operate over untrusted web content and execute actions with direct consequences. This makes them vulnerable to prompt-injection attacks, in which seemingly benign content embeds adversarial instructions that manipulate agent behaviour. Existing security benchmarks adopt an attack-centric perspective, focusing on the technical feasibility of injections while overlooking the nuanced distribution of resulting harms. In practice, however, prompt-injection risk is victim-dependent: a single exploit can produce asymmetric consequences for different stakeholders, and the same attack pattern may exhibit substantially different effectiveness depending on whom it targets. To capture these properties, we introduce \sysname, a stakeholder-centric benchmark to systematically categorize and attribute harm in real-world web agent systems. It distinguishes between affected entities (e.g., user, seller, platform), decomposes the attacks into concrete objectives, and evaluates each case with complementary outcome- and process-level metrics. Our results reveal substantial and heterogeneous vulnerabilities: not a single attack objective is reliably resisted by current agents, and failures distribute across qualitatively distinct modes ranging from stealthy parasitism (attack succeeds without disrupting the user's delegated task) to misaligned disruption (task disrupted without attack success) and compounded failure (both adversarial objective and task integrity simultaneously violated). These patterns are missed by conventional evaluation, highlighting the need for stakeholder-aware assessment of LLM-based agents in real-world deployments. Benchmark is available at https://github.com/StakeBench/SBC.

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

Evaluation of Alternative-Based Information Systems for Deliberative Polling using an Agentic Simulator

arXiv:2606.11692v1 Announce Type: cross Abstract: Deliberative polling promises to improve collective decision-making by exposing shareholders to a broad range of arguments before they vote. Yet ensuring that every voter encounters a representative sample of the reason space, the coverage problem, remains an open challenge, particularly at scale and in adversarial or strategically motivated electorates. This paper introduces a way of evaluating solutions using the LLM-based Agentic Bipolar Argumentation Simulator, grounded in a framework which formalises a poll as a six-tuple of endorsing and opposing justifications, attack and enhance relations, and shareholder- and relation-weights. ABAS simulates N autonomous shareholder agents, each assigned a latent opinion according to desired distributions in [-1, 1], who sequentially vote, choose or author justifications, and optionally submit argumentation-graph links. The simulator implements recommendations that rank existing justifications by their observable endorsement mass. It evaluates the mechanism's success by coverage, namely the fraction of the corpus reason-tag set represented in the K recommendations presented to each shareholder, as a solution to the NP-hard Subsuming Justification Problem. Reported experiments characterise how creativity rate (pown), recommendation size (K), argumentation density (plinks), and population size (N) affect coverage and corpus diversity. In an authenticated electorate where Sybil attacks are impossible and only the relation graph is gameable, we stress-test the scoring with coordinated strategic voting attacks: a tag-flood attack collapses coverage, while author-count relation weighting through a reversed-PageRank rule resists the flood markedly better than uniform weights.

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

Approximating Whittle-Matern Fields over Discretized Manifolds

arXiv:2606.13827v1 Announce Type: cross Abstract: Markovian Whittle-Matérn fields have been convergently approximated by discrete Gauss Markov Random Fields (GMRFs) with sparse precision matrices using a Finite Element approximation of the two-parameter family, \[ (\kappa^2 - \Delta)^{\alpha/2} u = \mathcal{W}, \;\; \kappa \in \mathbb{R}, \; \alpha \in \mathbb{N}. \] of SPDEs. Using recent developements in the analysis of Discrete Exterior Calculus (DEC), we present a different, yet closely related, convergent GMRF approximation to these Matérn fields over complete, boundaryless Riemannian manifolds discretized as well-centered simplicial complexes. This convergent method (i) is agnostic to $\alpha, \kappa$ and thus allows a universal approximation scheme for the precision and covariance matrices of the entire $(\alpha, \kappa)$-family of GMRFs, so they may be inferred rather than guessed. (ii) inherently models pointwise and piecewise-smoothed measurements of a random field and approximates both equally well (iii) is computationally independent of the interpolants used - it suffers no overhead if one convergent interpolant were replaced with another suitable interpolant over the same mesh. Furthermore, we show that, on discretizations that are well-connected in a precise sense, and volume-concentrated, the precision matrices are spectral functions of a graph-laplacian. We provide a low rank approximator to the family of such Matérn GMRFs and mention a use case: reducing the number of measurements needed to model the GMRF by compressed-sensing.

04.
arXiv (CS.AI) 2026-06-16

Feature Attribution in Directed Acyclic Graphs Using Edge Intervention

arXiv:2606.15273v1 Announce Type: new Abstract: Shapley value-based feature attribution methods face challenges in scenarios involving complex feature interactions and causal relationships, even when a causal structure is provided. Existing methods typically adopt a node-centric view, attributing importance solely to individual features. Consequently, they often fail to simultaneously capture the externality and exogenous influence of features, leading to unreasonable interpretations. To overcome these limitations, we propose a novel feature attribution method called DAG-SHAP, which is based on edge intervention. DAG-SHAP treats each feature edge as an individual attribution object, ensuring that both externality and exogenous contributions of features are appropriately captured. Additionally, we introduce an approximation method for efficiently computing DAG-SHAP. Extensive experiments on both real and synthetic datasets validate the effectiveness of DAG-SHAP. Our code is available at https://github.com/ZJU-DIVER/DAG-SHAP.

05.
arXiv (quant-ph) 2026-06-11

Tensor-Network Algorithm for Many-Body Trace Norms

arXiv:2606.11882v1 Announce Type: new Abstract: Trace norms are fundamental to quantum information theory, yet in many-body systems their evaluation remains a major computational bottleneck, as it generally requires diagonalizing exponentially large operators. Here, we overcome this bottleneck by introducing a controlled tensor-network algorithm for estimating the trace norm of matrix product operators without full diagonalization. The key idea is to combine Zolotarev's rational approximation to the sign function with a variational formulation solved using a density-matrix-renormalization-group-like algorithm. The resulting approximation is systematically improvable, with its accuracy controlled by the rational approximation parameters and the spectral weight near zero. Beyond the reach of exact diagonalization, we demonstrate controlled trace-norm calculations for entanglement negativity, quantum fidelity and quantum Fisher information, achieving substantially improved accuracy over polynomial-based Lanczos approaches. Our results establish trace-norm-based quantities as practical tensor-network observables, opening a route toward tensor-network studies of quantum information in mixed states.

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

LLM-Assisted Stance Detection in Scientific Discourse: A Test Case in Bayesian Cognitive Science

Qualitative coding is central to social science, but expert annotation is difficult to scale. LLMs offer a possible extension, yet require careful validation when the target construct is interpretive, theoretically loaded, and only indirectly expressed. We study this problem in a difficult case: detecting whether authors treat Bayesian models as descriptions of mental and neural mechanisms (realism) or as useful mathematical tools (instrumentalism). Our method combines a theory-driven codebook, expert-coded reference annotations, a diagnostic-gated prompt-optimization search yielding a shared zero-shot prompt for three frontier LLMs (GPT-5.1, Claude Sonnet 4.6, Gemini 3 Pro Preview), and multi-rater reliability analysis. The final prompt achieved a held-out combined reliability score of 0.76 (harmonic mean of ICC = 0.79 and $\alpha$ = 0.74), with all diagnostics satisfied. Deployed on 6,858 quotes from 210 articles, the three LLMs reached substantial quote-level agreement (ICC = 0.80; $\alpha$ = 0.76; combined = 0.78) and near-perfect article-level rank stability ($r$ = 0.96-0.97 across rater pairs). The corpus was predominantly weakly realist, but article-level stances were rarely uniform: only 1.4% of articles used a single band, while 59.5% spanned four or more. Low-level perception/motor articles scored 8.8 Realism points higher than high-level cognition articles ($p < .001$, $d = 0.60$), quantifying a long-held qualitative intuition. We present this as an expert-led case study; the framework is intended to generalize to similar theoretically demanding tasks, not to all qualitative analysis.

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

DF-ExpEnse: Diffusion Filtered Exploration for Sample Efficient Finetuning

arXiv:2606.19656v1 Announce Type: cross Abstract: A natural recipe for intelligent robotic decision-making is initializing from pretrained generative control policies, which have summarized offline experience, and adapting them to self-collected online experience. We present DF-ExpEnse, an exploration technique that improves the quality of online experience collection, thus increasing finetuning sample-efficiency. DF-ExpEnse leverages the multimodal modeling capabilities of the generative control policy to create an expressive and tractably evaluatable candidate set. It then utilizes an ensemble of critics to identify the action that best balances quality with high exploration interest. In fleet settings, DF-ExpEnse further enables cross-agent communication to facilitate collaborative exploration as a group. DF-ExpEnse can be seamlessly integrated with existing strategies that finetune pretrained generative control policies via reinforcement learning. We experimentally validate consistent sample-efficiency benefits through DF-ExpEnse across a variety of manipulation and locomotion tasks, compared to default finetuning and alternative action selection schemes. Project can be found at https://df-expense.github.io.

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

Remember, Don't Re-read: Stateful ReAct Agents for Token-Efficient Autonomous Experimentation

arXiv:2606.14945v1 Announce Type: new Abstract: The autoresearch pattern enables autonomous experimentation by having a large language model (LLM) iteratively modify code to optimize a target metric. Its stateless design, however, reconstructs experimental context from scratch at every iteration, incurring $O(n)$ token cost per iteration and $O(n^{2})$ total. This work reformulates the pattern as a stateful ReAct agent using LangGraph, where typed persistent state carries experimental history across iterations via a tool-calling interface. Two benchmarks are evaluated: hyperparameter tuning (15 iterations, small per-iteration observations) and code performance optimization (40 iterations, large per-iteration observations containing full source code and benchmark results). On hyperparameter tuning, the stateful agent consumes 90\% fewer tokens (2{,}492 vs.\ 24{,}465). On code optimization, the stateful agent consumes 52\% fewer tokens (627K vs.\ 1{,}275K) while achieving comparable optimization quality on both tasks. The token reduction is structural: the stateless agent re-reads the full history at $O(n)$ cost per iteration, while the stateful agent operates within a fixed-size conversation window at $O(1)$ cost. This paper describes the architecture in sufficient detail for practitioners to implement a stateful autoresearch agent for their own workflows.

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

HorusEye: Language as Dynamic Attention for Emergency Visual Analysis

作者:

We introduce HorusEye, Language as Dynamic Attention for Emergency Visual Analysis. Our investigation followed five stages. The first one is benchmarking RefCOCO-Degraded, a dataset of 15,244 images (3,811 base images x 4 conditions: Clean, Fog, Smoke and Thermal) with systematic visual degradation. Through four research questions, we evaluate multiple VLMs (Gemini, Qwen2-VL, BLIP-2, LLaVA, Kosmos-2) across visual grounding the second stage, language feedback recovery the third one, health VQA tasks the fourth, and hallucination analysis the final stage. Our key finding is that language feedback effectiveness is model-dependent: Gemini achieves +47.3% improvement in thermal conditions through iterative language feedback, while Qwen2-VL shows -5.1% degradation under the same protocol. We also identify the 'Thermal Paradox' where cropping strategies that improve RGB performance catastrophically fail in thermal imagery. Furthermore, BLIP-2 uniquely hallucinates more under degradation, making it unsuitable for emergency deployment

10.
arXiv (CS.CL) 2026-06-16

WavSLM: Single-Stream Speech Language Modeling via WavLM Distillation

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

11.
arXiv (CS.CL) 2026-06-19

Generative Engine Optimization at Scale: Measuring Brand Visibility Across AI Search Engines

People increasingly get answers straight from AI search engines like ChatGPT, Claude, Perplexity, and Gemini rather than scrolling search results. Brands that once focused on search engine optimization (SEO) must now optimize for how these engines represent, cite, and recommend them – a shift variously called Generative Engine Optimization (GEO), Answer Engine Optimization (AEO), and AI Search Visibility. We treat AEO and AI Visibility as part of GEO, and study how to measure brand visibility across AI engines: what they value when they cite a brand, which sources they rely on, and what content large language models surface. The hard case is everyone outside the already-authoritative top brands – SMEs, D2C brands, creators, and early-stage startups. We analyze 100K+ prompt responses across 100+ brands tracked on Ranqo between March and May 2026. First visibility runs form a clear three-tier brand-stature ladder: global household names (e.g., Stripe, Nike) appear in 73% of relevant AI answers on their first run; established mid-market and regional brands (e.g., Olipop, Klaviyo) in 44%; niche and small brands in just 11% – about 30 percentage points per step. When engines cite sources, about 78% go to corporate websites; among non-corporate sources YouTube leads, ahead of Reddit, editorial media, and Wikipedia. The highest-leverage page is the ranked "best-of" listicle, the most-cited content format at about 21% of all citations. Sentiment is the unstable signal: whether a brand is framed positively or negatively flips about 6.7 times more often than whether it is mentioned at all. These findings provide a first large-scale baseline for measuring GEO: AI brand visibility can be measured, differs by platform, and varies strongly by brand maturity. We close by proposing seven v1.1 protocols to test whether specific recommendations can causally improve AI visibility.

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

ProtoX-AD: Self-Explainable Time Series Anomaly Detection and Characterization

arXiv:2606.13277v1 Announce Type: cross Abstract: Recent advances in time series anomaly detection (TSAD) have highlighted the effectiveness of self-supervised classification-based approaches. These methods apply transformations to normal training samples, training a classifier to recognize transformation-specific patterns that help identify anomalies through increased classification errors. Despite their strong performance, a significant challenge is their lack of explainability, as they provide limited insight into the characteristics of flagged anomalies. To address this limitation, we propose ProtoX-AD, a prototype-based self-explainable framework for self-supervised TSAD. ProtoX-AD learns transformation-aware latent representations alongside interpretable prototypes, enabling both accurate anomaly detection and the identification of distinct anomalous profiles through prototype-based explanations. Additionally, it allows for systematic analysis of how transformation design impacts detection performance and explainability. Experimental results on synthetic and real-world datasets demonstrate that ProtoX-AD achieves detection performance comparable to its black-box counterparts while offering more consistent and semantically meaningful explanations than existing explainable baselines. Our code is publicly available at https://github.com/Aitorzan3/ProtoX-AD.

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

Discrete optimal transport is a strong audio adversarial attack

arXiv:2509.14959v3 Announce Type: replace-cross Abstract: In this paper, we investigate discrete optimal transport (DOT) as a black-box attack against modern automatic speaker verification (ASV) and anti-spoofing countermeasure (CM) systems. Our attack operates as a post-processing distribution-alignment step. Frame-level WavLM embeddings of generated speech (or another person speech) are aligned to an unpaired bona fide speech pool using entropic optimal transport and a top-k barycentric projection, followed by neural vocoding. Unlike gradient-based attacks, the proposed method requires no access to model parameters, gradients, or training data. Experiments on ASVspoof2019 and ASVspoof5 demonstrate that DOT attack substantially increases CM EER and substantially degrades ASV performance across multiple spoofing attacks. The attack transfers across datasets and remains effective after CM fine-tuning. Analysis using speaker similarity, Fréchet Audio Distance, and visualization of embedding distributions suggests that DOT succeeds by shifting source speech toward bona fide regions of the representation space rather than by maximizing speaker similarity. These results indicate that optimal-transport-based distribution alignment represents a previously underexplored attack vector for contemporary ASV and anti-spoofing systems.

14.
arXiv (CS.AI) 2026-06-11

Robust Privacy: Inference-Stage Privacy through Certified Robustness

arXiv:2601.17360v2 Announce Type: replace-cross Abstract: An adversary observing a model's released prediction can infer sensitive attributes of the queried input, or even reconstruct representatives of the model's training data. The inference interface thus acts as a side channel for privacy leakage. We introduce Robust Privacy (RP), an inference-stage privacy notion inspired by certified robustness: if a model's prediction is provably invariant within a radius-R neighborhood around an input x with confidence at least $1-\alpha$, then x enjoys $(R,\alpha)$-Robust Privacy, under which we prove that any adversary observing the released prediction has at most $\alpha/2$ advantage in distinguishing x from any input within distance R of x. Building on RP, we formalize Robust Attribute Privacy (RAP), an attribute-level privacy notion that characterizes the set of sensitive-attribute values that remain compatible with a released prediction. On a classification task, RP increases the median length of the RAP-compatible inference interval from 23.50 to 29.96, reducing attribute-inference precision. Model inversion attacks, often treated as a training-stage threat, in fact rely on fine-grained signals leaked through the inference interface; RP masks these signals at the inference stage, reducing attack success rate (ASR) from 73% to 4% on a black-box inversion attack. This direct targeting of the leakage channel enables RP to dominate DP-SGD and randomized response in the privacy-utility tradeoff space: RP retains 98.4% accuracy at 21% ASR, whereas DP-SGD must drop accuracy to 61.7% to reach a comparable ASR. Across both experiments, increasing the smoothing sample size N strengthens privacy and improves utility together. Finally, we examine model distillation as a scope boundary and show that RP mitigates attribute-level and instance-level inference-stage privacy leakage, but not function-level extraction through model distillation.

15.
arXiv (quant-ph) 2026-06-16

Against probability: A quantum state is more than a list of probability distributions

arXiv:2601.18872v2 Announce Type: replace Abstract: The state of a quantum system can be represented by listing the outcome probabilities for a tomographically complete set of measurements. Such representations appear throughout physics, for example, in quantum field theory via correlation functions and in quantum foundations within generalized probabilistic frameworks. In this paper, we show a no-go result: To enable useful statements, the probability representation must be topologically robust$\unicode{x2014}$preserving the notion of closeness between states. Yet, a topologically robust probability representation cannot simultaneously retain other essential structure, such as the subsystem structure.

16.
arXiv (CS.CL) 2026-06-12

RogueAI: A Reverse Turing Test for Detecting Licensed AI Deception in Dialogue

The original Turing Test asks a human judge to distinguish a machine from a person through dialogue. Three quarters of a century later, conversational systems pass this test in casual settings; the interesting epistemological question has shifted. We argue that the relevant modern variant asks not whether a dialogue partner is artificial, but whether it can be trusted. We present RogueAI, an interactive webapp that operationalizes this revisited test as a one-on-two interrogation game: a human player questions two indistinguishable Large Language Model agents, knowing that exactly one of them has been licensed to deceive within a shared fictional scenario. The player's task is to identify the deceptive agent and "shut it off" before a turn budget is exhausted. We further introduce AutoRogueAI, a procedural extension in which players co-design a custom scenario with a narrator agent that secretly chooses its own deception strategy. We describe the framing, sketch the abstract architecture and gameplay loop, and situate the artifact within recent work on LLM deception, social-deduction benchmarks, and scalable oversight via debate. A three-day pilot deployment (467 initiated sessions, 415 completed, 1876 interaction turns in Italian) provides early feasibility evidence and surfaces a concrete tension: the deceptive agent carries a reliable, locally-present linguistic signature - differential helpfulness, brevity, hedging - that a simple heuristic exploits at 75.6% accuracy, yet human players achieved only 56.6%, consistent with ignoring the most diagnostic signal entirely. We discuss what this gap implies for the artifact's use as a data-collection vehicle, a teaching tool, and an evaluation harness for honesty-trained models.

17.
arXiv (CS.LG) 2026-06-19

Improved Stochastic Optimization of LogSumExp

arXiv:2509.24894v4 Announce Type: replace-cross Abstract: The LogSumExp function, dual to the Kullback-Leibler (KL) divergence, plays a central role in many important optimization problems, including entropy-regularized optimal transport (OT) and distributionally robust optimization (DRO). In practice, when the number of exponential terms inside the logarithm is large or infinite, optimization becomes challenging since computing the gradient requires differentiating every term. We propose a novel convexity- and smoothness-preserving approximation to LogSumExp that can be efficiently optimized using stochastic gradient methods. This approximation is rooted in a sound modification of the KL divergence in the dual, resulting in a new $f$-divergence called the Safe KL divergence. Our experiments and theoretical analysis of the LogSumExp-based stochastic optimization, arising in DRO and continuous OT, demonstrate the advantages of our approach over existing baselines.

18.
arXiv (CS.LG) 2026-06-19

Probe-and-Refine Tuning of Repository Guidance for Coding Agents

arXiv:2606.20512v1 Announce Type: cross Abstract: LLM-based coding agents need higher-level operational knowledge about a repository (which files house which subsystems, how to run the test suite, which workflows have historically led to wrong fixes) that does not exist in the code itself. Engineers typically maintain \texttt{AGENTS.md} files to supply this context as instructions for coding agents, but whether they help is contested: recent studies disagree on whether LLM-generated guidance improves or harms agent performance. In this paper we show that how the guidance is produced is the decisive variable, and introduce probe-and-refine tuning: a procedure that uses synthetic bug-fix probes to iteratively diagnose and patch a repository's guidance file through single-shot LLM calls, with no agent loop or tool use during tuning. On SWE-bench Verified across four independent trials with Qwen3.5-35B-A3B at 200 steps, probe-and-refine achieves 33.0\,\% mean resolve rate vs.\ 28.3\,\% for the static knowledge base used to initialize it and 25.5\,\% for an unguided baseline ($p < 0.001$ for both probe-and-refine contrasts). The improvement comes from coverage rather than precision: refined guidance produces evaluable patches for 14.5 percentage points (pp) more instances while per-patch precision remains statistically constant ($\sim$59\,\%, $p = 0.119$), showing that improved guidance helps agents reach the correct file rather than improving the quality of the changes they make. Further, a step-budget experiment shows that guidance is what lets the agent use a larger step budget productively, and a cross-model experiment with NVIDIA-Nemotron-3-Nano-30B-A3B finds that the tuning loop degrades when the model cannot generate sufficiently diagnostic output, though per-patch precision remains constant even then.

19.
arXiv (CS.AI) 2026-06-11

What Limits Does Quantization Place on Dense Top-$k$ Retrieval? A Theoretical Study

arXiv:2606.11780v1 Announce Type: cross Abstract: We establish conditions for embedding a corpus of $N$ documents as $d$-dimensional vectors such that every $k$-subset $S \subseteq [N]$ is realizable as a result of top-$k$ retrieval by some query vector. Recent work shows that $d = O(k)$ suffices for such embeddings to exist in $\mathbb{R}^d$, independently of $N$. We theoretically prove that this corpus-independent bound is specific to infinite precision. With $B$ bits per coordinate, perfect top-$k$ retrieval requires $Bd = \Omega(k \ln N)$; thus, at any fixed precision, the dimension must grow at least logarithmically with $N$. Specializing to a $\ell_2$-normalized $B$-bit uniform scalar quantization model, we also identify a threshold on the precision $B^{*} = O(\ln \ln N)$ below which no dimension suffices, together with two further regimes that bound the feasible $(B, d)$ pairs. Our result implies that in practical vector databases and dense retrieval systems where quantization is standard, the embedding dimension and possibly the precision must grow with the corpus size.

20.
arXiv (CS.LG) 2026-06-16

A Gradient Perspective on RLVR Stability and Winner Advantage Policy Optimization

arXiv:2606.16154v1 Announce Type: new Abstract: Reinforcement learning with verifiable rewards (RLVR) improves language-model reasoning, but GRPO-style optimization remains prone to collapse. We analyse this instability through token-level gradient dynamics, deriving a taxonomy that predicts how updates affect next-token probabilities and entropy. The taxonomy shows that stability depends jointly on the advantage sign and token distribution under the current policy. Motivated by this finding, we propose Winner Advantage Policy Optimization (WAPO), a simple online clipped policy-gradient objective that updates only on positive-advantage completions. Across mathematical reasoning and multi-hop QA benchmarks, WAPO improves training stability and matches or outperforms baselines across multiple model families. Full code can be found at https://github.com/layer6ai-labs/wapo.

21.
medRxiv (Medicine) 2026-06-17

Treatment of Multi-Drug-Resistant Tuberculosis with Second-Line All-Oral Drugs in Ghana: Incidence of Adverse Events.

Introduction: The treatment of multidrug-resistant tuberculosis (MDR-TB) remains challenging due to the toxicity of second-line medications and suboptimal treatment outcomes. This study aimed to determine the incidence of adverse events and identify factors associated with these events in patients undergoing treatment for MDR-TB with second-line all-oral drugs in Ghana. Methods: This retrospective cohort study reviewed the medical records of 384 MDR-TB patients treated with second-line all-oral drugs at selected health facilities in Ghana, including the Greater Accra Regional Hospital, Eastern Regional Hospital, and Kumasi South Hospital. Data were extracted using the Kobo Collect tool, capturing patient demographics, baseline clinical and laboratory characteristics, treatment regimens, and adverse events. The study period spanned from 2020 to August 2024. Results: The study included a total of 384 MDR-TB patients, with a mean age of 45 years (SD = 15). The majority of patients were male (65.78%), and most were within the 45-64 years age group (33.85%), followed by those aged 25-44 years (31.25%). Regionally, the highest number of cases were reported from the Greater Accra Region (39.06%), followed by the Eastern Region (31.25%) and Kumasi South Hospital (29.69%). Approximately one in four patients (25%) presented with comorbidities, with HIV being the most common (19.5%). The most frequently reported adverse events were diarrhea (14%), dizziness (13.7%), and vomiting (12.3%). Most of these were mild to moderate in severity and tended to decrease as treatment progressed. Severe adverse events, such as leukopenia and acute kidney injury, were rare, occurring in less than 5% of patients. Over the course of treatment, gastrointestinal adverse events such as vomiting and nausea showed a significant decline, indicating possible patient adaptation or improved clinical management. Results from the multivariate Poisson regression analysis revealed that age and comorbidities were significant predictors of adverse events. Patients aged 65 years and above had a 56% lower risk of developing adverse events compared to younger patients (Adjusted Risk Ratio [aRR] = 0.44, 95% CI: 0.25-0.79, p = 0.005). Conversely, patients with comorbid conditions such as diabetes or hypertension were approximately 2.6 times more likely to experience adverse events compared to those without comorbidities (aRR = 2.65, 95% CI: 1.58-4.43, p < 0.001). The effect of sex was not statistically significant after adjustment (aRR = 1.03, 95% CI: 0.70-1.50, p = 0.86). At the end of the treatment period, 74.9% of patients achieved successful outcomes, including both those who were cured and those who completed treatment without being classified as cured. However, 25.1% had unsuccessful outcomes, which included treatment failure, relapse, or death. Conclusion: In conclusion, adverse events are common in the treatment of MDR-TB with second-line All-Oral drugs, with gastrointestinal adverse events being the most prevalent. These findings highlight the importance of monitoring and managing adverse events to optimize treatment outcomes for MDR-TB patients in Ghana.

22.
arXiv (CS.AI) 2026-06-18

From Memorization to Creation: Evaluating the Cognitive Depth of LLM-Generated Educational Questions

arXiv:2606.18257v1 Announce Type: cross Abstract: While LLMs show promise in automating educational content creation, their ability to generate questions that stimulate higher-order thinking remains understudied. This work evaluates six widely-used LLMs through a Bloom's Taxonomy lens, focusing on their capacity to transcend rote memorization and achieve cognitive leaps. Using a hybrid human–AI evaluation protocol, we generate and analyze 20{,}700 questions across computer science, K–12 math, and social-science domains. Key contributions include: (1) a fine-grained prompting strategy that reduces question repetitiveness by 24.45\% for Qwen2.5-7B-Instruct, and increases the proportion of higher-order cognitive level outputs by 11.53\% for InternLM3-8B-Instruct; (2) quantitative metrics for cognitive shift intensity (CogShift) and category drift, revealing InternLM3's superior performance in multi-level transitions; (3) an interpretability analysis revealing metric-level correlations that enhance the transparency of Chain-of-Thought prompting. Our findings highlight the importance of cognitive-aware prompt design and provide benchmarks for deploying LLMs in personalized learning systems.

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

HK-LegiCoST: Leveraging Non-Verbatim Transcripts for Speech Translation

We introduce HK-LegiCoST, a new three-way parallel corpus of Cantonese-English translations, containing 600+ hours of Cantonese audio, its standard traditional Chinese transcript, and English translation, segmented and aligned at the sentence level. We describe the notable challenges in corpus preparation: segmentation, alignment of long audio recordings, and sentence-level alignment with non-verbatim transcripts. Such transcripts make the corpus suitable for speech translation research when there are significant differences between the spoken and written forms of the source language. Due to its large size, we are able to demonstrate competitive speech translation baselines on HK-LegiCoST and extend them to promising cross-corpus results on the FLEURS Cantonese subset. These results deliver insights into speech recognition and translation research in languages for which non-verbatim or ``noisy'' transcription is common due to various factors, including vernacular and dialectal speech.

24.
medRxiv (Medicine) 2026-06-22

Accounting for uncertainty in the expected treatment effect substantially increases the sample size required for randomised trials: implications for the feasibility of clinical trials in anaesthesia and critical care

Background Multicentre trials in anaesthesia and critical care report low rates of statistically significant differences. This finding may partly reflect conventional sample size methods, which assume a fixed treatment effect. Assurance methods use a design prior to represent uncertainty in the expected treatment effect, which may provide a more realistic way of estimating sample sizes. Methods We calculated power curves across a range of effect sizes, design priors, and sample sizes using frequentist and Bayesian assurance methods and compared the sample sizes required to achieve 80% and 90% power to the conventional method. We standardised the design priors across effect sizes using the coefficient of variation. We derived a theoretical limit for achievable power. We validated a normal approximation to the Bayesian posterior distribution. Results Frequentist and Bayesian assurance methods produced similar power curves across all scenarios. At a coefficient of variation of 0.5 - reflecting realistic prior uncertainty in the expected effect size - both methods required sample sizes that were approximately 1.5 to 3.5 times larger than the conventional method. The theoretical power limit depends only on the coefficient of variation of the design prior and holds true across all effect sizes. The normal approximation to the Bayesian posterior distribution matched the results obtained from Markov chain Monte Carlo sampling. Conclusions Incorporating clinical uncertainty in the expected effect size substantially increases the sample size required to achieve adequate power, which has important implications for the feasibility of randomised trials in anaesthesia and critical care.

25.
medRxiv (Medicine) 2026-06-19

Cardiometabolic multimorbidity and care experiences in primary healthcare among Brazilian adults aged 50 and over (ELSI-Brazil)

Background: Population aging and the rising burden of non-communicable diseases have increased the prevalence of cardiometabolic multimorbidity (CM-MM) among older adults. Patient-reported experience measures (PREMs) are recognized as essential components of healthcare quality assessment, yet evidence on primary care experiences among individuals with CM-MM remains scarce. Objective: To analyze primary care experiences according to the presence of cardiometabolic multimorbidity among Brazilians aged 50 years and older. Methods: Cross-sectional study using data from the second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021; n = 9,949). CM-MM was defined as the self-reported coexistence of two or more of the following conditions: hypertension, diabetes mellitus, dyslipidemia, acute myocardial infarction, and stroke. Primary care experiences were assessed using a validated 12-item instrument organized into four domains: first-contact access, longitudinality, communication, and care coordination. Associations were estimated using Poisson regression adjusted for sociodemographic, health conditions, and healthcare utilization variables, with stratified analysis by Family Health Strategy (FHS) coverage. Results: CM-MM prevalence was 25.5%, with a progressive increase by age and an inverse gradient by education. Individuals with CM-MM reported significantly more positive experiences in longitudinality (mean index 2.53 vs. 2.34; adjusted PR = 1.22; 95%CI 1.12-1.33; p < 0.001) and, to a lesser extent, in communication (mean index 2.68 vs. 2.58; adjusted PR = 1.10; 95%CI 1.00-1.20; p = 0.041). No statistically significant differences were found in first-contact access or care coordination. After stratified by FHS coverage, the observed differences in longitudinality and communication were no longer statistically significant. Conclusions: CM-MM was associated with more positive primary care experiences in longitudinality and communication. The absence of differentiated experiences in first-contact access and coordination highlights structural gaps in primary care responsiveness to individuals with greater clinical complexity. Keywords: Multimorbidity; Cardiometabolic diseases; Primary Care; Patient-reported experience measures; Older adults; ELSI-Brazil.