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

On the Oracle Complexity of Interpolation-Based Gradient Descent

作者:
Dongmin Lee↗William Lu↗Anuran Makur↗

arXiv:2606.19878v1 Announce Type: new Abstract: Recent work on first-order optimizers for empirical risk minimization (ERM) has suggested that smoothness of ERM loss functions in the training data, rather than in the optimization parameters, can be leveraged to improve the oracle complexity of gradient descent (GD) methods. In this paper, we propose an inexact gradient method, piecewise polynomial interpolation-based gradient descent (PPI-GD), which approximates the full gradient in each iteration by querying the first-order oracle at equidistant points in the data domain to construct polynomial interpolants of the resulting gradient samples over appropriately sized patches of the data domain. We analyze the oracle complexity of PPI-GD for strongly convex and non-convex loss functions when the data space dimension is bounded by a polylogarithmic function of the number of training samples, and find it to outperform several GD variants in key regimes when the loss function is sufficiently smooth. Furthermore, our analysis extends several techniques from the error analysis of bicubic spline interpolants to the setting of $d$-variate tensor product polynomial interpolants which may be of independent interest in interpolation analysis.

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

Minimalist Genetic Programming

作者:
Leonardo Trujillo↗

arXiv:2606.10237v2 Announce Type: replace Abstract: Genetic programming (GP) is based on two important insights. First, that any learning task can fundamentally be posed as a program induction problem, where the goal is to construct a symbolic hierarchical model that is expressed as a syntax tree. Second, to pose this task as a search problem, and use evolution to locate the desired model. Since it was proposed, GP has produced notable results in a wide range of tasks and problem domains. This work presents an alternative view by modifying the second core insight of GP, posing the problem as a syntactic derivation task instead. In particular, this paper presents Minimalist Genetic Programming (MGP), an algorithm that like GP is biologically inspired, but instead of evolution it takes inspiration from the Minimalist Program to human language, in which syntax is understood as an optimal solution to the problem of linking two other mental systems. In minimalism, the core computational process is a binary set formation operator called $MERGE$, than can be used to incrementally construct complex syntactic structures using a simple Markovian process. MGP is able to discover the core building blocks of the symbolic expressions, and to incrementally combined them using $MERGE$. The proposed system is benchmarked on symbolic regression tasks that are known to be difficult to solve with standard GP systems because of the propensity for bloat. Results show that when a proper lexicon of atomic syntactic objects are chosen, MGP is able to consistently produce the exact ground truth model on a set of symbolic regression tasks where standard GP struggles to do the same. The insights provided by minimalism are shown to be relevant to the problem of program induction, and should be explored further based on the potential exhibited by MGP in this work.

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03.
arXiv (CS.AI) 2026-06-18

Analysing drivers and interdependencies in European electricity markets using XAI

作者:
Antoine Pesenti↗Aidan O'Sullivan↗

arXiv:2606.19118v1 Announce Type: new Abstract: Electricity markets are inherently complex systems characterised by strong nonlinearities, high-dimensional interactions, and increasing interdependence across regions. While deep neural networks (DNNs) have demonstrated strong predictive capabilities for electricity prices, their lack of interpretability limits their usefulness for understanding the underlying drivers of price formation. This paper addresses this gap by combining DNN models with explainable artificial intelligence (XAI) techniques to analyse the determinants of electricity prices across 39 European bidding zones. We employ SHAP (SHapley Additive exPlanations) to quantify feature contributions and apply and extend SSHAP, an aggregation framework to improve interpretability in high-dimensional settings. The analysis identifies that renewable energy sources, particularly solar, play a disproportionately important role in price formation despite their lower share in total power generation. Gas prices remain a dominant and consistent driver across electricity markets, while interconnections significantly shape price dynamics, highlighting the strong interdependence of European electricity systems. In addition, a synthetic EU-wide electricity market is constructed to explore the counterfactual scenario of a fully integrated market with a single price.

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

Conformal Candidate Certification for Offline Model-Based Optimization

作者:
Seungjin Choi↗

arXiv:2606.15217v1 Announce Type: cross Abstract: Offline model-based optimization (MBO) proposes candidates by optimizing a surrogate trained on a fixed historical dataset. Because candidates are deliberately out-of-distribution, surrogate rankings are least reliable exactly where the optimizer is most aggressive, yet existing methods provide no per-candidate statistical certificate that a design meets a target threshold. We propose Conformal Candidate Certification (CCC), a post-hoc wrapper that attaches a calibrated one-sided lower bound to each candidate and advances only those whose bound exceeds the target. We show that entropy-regularized surrogate maximization induces a Gibbs-tilted proposal, so the same surrogate supplies importance weights for weighted conformal prediction without a separate density-ratio estimation step. In a controlled synthetic study, CCC certifies $16.7\%$ of an aggressive proposal pool with empirical coverage 0.990 at nominal 0.90, while standard conformal prediction ignoring the covariate shift collapses to 0.416 coverage.

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

DeceptionX: Explainable Deception Detection with Multimodal Large Language Models

作者:
Jiayu Zhang↗Shuo Ye↗Jiajian Huang↗Yawen Cui↗Taorui Wang↗Wei Xia↗Zeheng Wang↗Haowen Tang↗Hui Ma↗Zitong Yu↗

Deception detection is a critical and highly challenging task within affective computing and behavioral analysis. Existing deep learning methods typically treat this task as a straightforward classification problem; however, this black-box approach lacks interpretability and fails to capture the complex logical deduction processes utilized by human experts when identifying lies. While Multimodal Large Language Models (MLLMs) have shown potential, applying them effectively requires a bridge between low-level audiovisual cues and high-level logical reasoning. In this paper, we propose DeceptionX, a novel MLLM framework that shifts the paradigm of deception detection from black-box classification to an interpretable Observe-Think-Summarize reasoning process. To address the scarcity of high-quality reasoning data, we first constructed DeceptChain, a high-quality dataset developed through a human-in-the-loop process. This dataset synthesizes fine-grained visual and auditory evidence (such as micro-expressions and vocal tremors) into structured chain-of-thought reasoning data. Furthermore, we propose a three-stage training pipeline and a Discrepancy-Aware Redundancy Elimination~(DARE) strategy for DeceptionX to further enhance the model's generalization capabilities. Extensive experiments demonstrate that DeceptionX not only outperforms existing MLLM baselines and state-of-the-art methods on standard real-world benchmarks but also provides transparent, expert-level reasoning paths, bridging the critical gap between accuracy and interpretability in multimodal deception detection.

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

A Deep Reinforcement Learning (DRL)-Based Transformer Method for Solving the Open Shop Scheduling Problem

作者:
Faezeh Ardali↗Mwembezi A. Nyelele↗Gerald M. Knapp↗

arXiv:2606.13682v1 Announce Type: new Abstract: The open shop scheduling problem (OSSP) arises in many industrial and service settings but remains computationally challenging as the number of jobs and machines increases. While exact methods quickly become intractable, classical dispatching rules and metaheuristics may require substantial tuning to maintain solution quality at large scales. This study develops a Transformer-based scheduling policy for OSSP using an encoder-decoder architecture with multi-head attention. The model is trained on Taillard benchmark instances (4x4, 5x5, 7x7, and 10x10) using only the processing-time matrix as input and produces feasible schedules with makespans typically within 15-30% of best-known values. To evaluate scalability, the trained policy is applied without retraining to randomly generated instances from 40x40 to 100x100 and compared against classical dispatching heuristics, including SPT, LPT, MWKR, and EST. Across these large instances, the Transformer achieved average gaps of 12.89-15.12% relative to a standard lower bound. Compared with EST, the Transformer remained competitive, typically within a modest margin, while substantially outperforming SPT and LPT. These results indicate that a Transformer policy trained on small OSSP instances can generalize to substantially larger problems and provide a feature-light, learning-based alternative to classical dispatching rules.

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

Are LLMs Bad at Moral Reasoning?

作者:
Menghang Zhu↗Seth Lazar↗

arXiv:2606.11635v1 Announce Type: cross Abstract: For highly capable AI systems to operate safely in dynamic, open-ended environments, they must be able to identify, understand, and respond to moral reasons for action, and constrain their behaviour accordingly. A growing body of research aims to evaluate this capacity – moral competence – in today's most capable AI systems, recently reaching broadly pessimistic conclusions. One of the most ambitious such papers collects gold-standard human-authored rubrics for evaluating moral reasoning in 1,000 cases, and benchmarks frontier AI models against those rubrics, with underwhelming results. In this paper, we argue that the MoReBench dataset can be redeployed to give a much more optimistic picture of LLMs' moral reasoning (an essential part of moral competence). We show that if, instead of scoring LLMs' responses to these cases against these rubrics, we instead give the LLMs the same task given to humans – to generate scoring rubrics for the moral analysis of particular cases – the rubrics they generate are both better calibrated to the human rubrics than their open-ended responses, and, where they differ, plausibly reflect nothing more than the vast dimensionality of most moral problems, as well as highlighting some human departures from the "rubric for creating rubrics". Taking these points into consideration, the MoReBench dataset suggests that LLMs are significantly more capable at moral reasoning than was previously believed.

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

Detecting Hate and Inflammatory Content in Bengali Memes: A New Multimodal Dataset and Co-Attention Framework

作者:
Rakib Ullah↗Mominul islam↗Md Sanjid Hossain↗Md Ismail Hossain↗

Internet memes have become a dominant form of expression on social media, including within the Bengali speaking community. While often humorous, memes can also be exploited to spread offensive, harmful, and inflammatory content targeting individuals and groups. Detecting this type of content is exceptionally challenging due to its satirical, subtle, and culturally specific nature. This problem is magnified for low-resource languages like Bengali, as existing research predominantly focuses on high-resource languages. To address this critical research gap, we introduce Bn-HIB (Bangla Hate Inflammatory Benign), a novel dataset containing 3,247 manually annotated Bengali memes categorized as Benign, Hate, or Inflammatory. Significantly, Bn- HIB is the first dataset to distinguish inflammatory content from direct hate speech in Bengali memes. Furthermore, we propose the MCFM (Multi-Modal Co-Attention Fusion Model), a simple yet effective architecture that mutually analyses both the visual and textual elements of a meme. MCFM employs a co-attention mechanism to identify and fuse the most critical features from each modality, leading to a more accurate classification. Our experiments show that MCFM significantly outperforms several state-of-the-art models on the Bn-HIB dataset, demonstrating its effectiveness in this nuanced task. To facilitate reproducibility and future research, the Bn-HIB dataset has been made publicly available through Mendeley Data. Warning: This work contains material that may be disturbing to some audience members. Viewer discretion is advised

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09.
arXiv (CS.AI) 2026-06-17

Online LLM Selection via Constrained Bandits with Time-Varying Demand

作者:
Yin Huang↗Qingsong Liu↗Jie Xu↗

arXiv:2606.17489v1 Announce Type: cross Abstract: Large Language Models (LLMs) are increasingly deployed in edge-cloud inference systems to handle diverse user tasks with heterogeneous accuracy, latency, and cost profiles. Selecting the appropriate LLM for each incoming task is critical for ensuring service quality and efficient resource utilization. However, model heterogeneity, stochastic and unknown performance characteristics, and time-varying task demands make static selection strategies inadequate. Real-world deployments often impose hard resource budgets such as monetary expenditure limits, along with soft service-level requirements such as latency guarantees. These constraints introduce additional challenges for online decision-making. We formulate this problem as a constrained stochastic bandit learning task, where the learner sequentially selects models under both packing-type (hard) and covering-type (soft) constraints, while adapting to time-varying task demand. The learner operates without access to the underlying reward, cost, or latency distributions and must rely on partial feedback. We develop a novel online learning algorithm that leverages confidence-bound estimates and demand predictions to balance reward maximization with long-term constraint satisfaction. We provide theoretical guarantees showing sublinear regret and sublinear covering constraint violations compared to an offline benchmark with full information. Experimental results on synthetic workloads demonstrate the effectiveness and robustness of our approach in dynamic, resource-constrained environments.

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10.
medRxiv (Medicine) 2026-06-17

Multi-strain Probiotics Alter Gut Microbiota and Estrobolome Pathways in Primary Dysmenorrhea

作者:
Kiraman↗S. K↗Zakaria↗I. A↗Loh↗S. Y. E↗Norfuad↗F. A↗Abdul Ghani↗N. A↗Ahmad↗H. F↗…

Background: Exact cause of primary dysmenorrhoea is unknown but recent evidence uncovers a potential link between gut dysbiosis and benign gynaecological disorder via disruption of estrobolome. Methods: A randomized controlled trial to investigate the effects of multi-strain oral probiotics on primary dysmenorrhoea has been conducted. This is a secondary analysis comparing the stool microbiome in women with primary dysmenorrhoea and those without (control), and the effects of treatment with probiotics versus placebo. Results: Although microbial richness and evenness were comparable between groups (alpha diversity, p > 0.05), gut microbial community composition differed significantly (Bray Curtis PERMANOVA, p = 0.015), characterised by reduced Bifidobacterium adolescentis and Blautia and enrichment of Faecalibacterium in dysmenorrhoea, alongside condition-specific core taxa. Post-intervention analysis revealed significant shifts in microbial community structure between pre- and post-treatment groups (PERMANOVA, F = 2.11, p = 0.005), with probiotic supplementation inducing more consistent and directed microbiome changes than placebo, without altering alpha diversity (p > 0.05). Functional prediction showed no significant difference in overall beta glucuronidase pathway abundance (p > 0.05); however, dysmenorrhoea was associated with higher abundance of beta glucuronidase producing taxa (MaAsLin2, q < 0.05) that were differentially modulated by probiotic treatment. Conclusion: This discovery provides evidence on the microbial disruption in primary dysmenorrhoea as well as the benefit of probiotics to modulate the intestinal microbiota to improve the condition.

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

GePBench: Evaluating Fundamental Geometric Perception for Multimodal Large Language Models

作者:
Shangyu Xing↗Changhao Xiang↗Yuteng Han↗Yifan Yue↗Zhen Wu↗Xinyu Liu↗Zhangtai Wu↗Fei Zhao↗Xinyu Dai↗

Geometric shapes play important roles in both physical world and human cognition. While multimodal large language models (MLLMs) have made significant advancements in visual understanding, their abilities to recognize geometric shapes and their spatial relationships, which we term geometric perception, are not explicitly and systematically explored. To address this gap, we introduce GePBench, a novel benchmark specifically designed to assess the geometric perception capabilities of MLLMs. Our extensive evaluations reveal that even the current state-of-the-art MLLMs exhibit significant deficiencies in geometric perception tasks. Furthermore, we show that models trained with GePBench data demonstrate considerable improvements on a wide range of downstream tasks, highlighting the critical role of geometric perception in enabling advanced multimodal applications. Our code and datasets are available at \href{https://github.com/Changhao-Xiang/GePBench}{https://github.com/Changhao-Xiang/GePBench}.

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13.
arXiv (CS.LG) 2026-06-19

Insulin4RL: Real-Time Insulin Management in the Intensive Care Unit for Offline Reinforcement Learning

作者:
Thomas Frost↗Steve Harris↗

arXiv:2606.19481v1 Announce Type: new Abstract: Offline reinforcement learning (ORL) offers the potential to improve the quality of clinical decision-making using historical electronic health record (EHR) data. Current training and evaluative practices in this field rely heavily on EHR datasets that have been temporally discretised into fixed, regular time intervals. Discretisation creates fictional representations of complex clinical scenarios and compromises the generalisability of retrospective model evaluations. In this paper, we introduce Insulin4RL, a healthcare ORL dataset featuring naturally irregular inputs and actions from real clinical trajectories. Derived from MIMIC-IV, Insulin4RL comprises over 375,000 labelled decisions across 12,209 patients requiring insulin infusion titration in the Intensive Care Unit. The dataset can thus be used for research into ORL model performance under realistic clinical sampling assumptions. We provide a description of the dataset's structure and characteristics, baseline performance metrics using model-free offline reinforcement learning, and a standardised evaluation protocol using fitted Q-evaluation. We conclude with suggested areas for future research that could be addressed using this resource.

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14.
arXiv (CS.LG) 2026-06-18

Does VLA Even Know the Basics? Measuring Commonsense and World Knowledge Retention in Vision-Language-Action Models

作者:
Nikita Kachaev↗Andrey Moskalenko↗Matvey Skripkin↗Nikita Kurlaev↗Daria Pugacheva↗Albina Burlova↗Mikhail Kolosov↗Denis Shepelev↗Andrey Kuznetsov↗Elena Tutubalina↗Aleksandr I. Panov↗Alexey K. Kovalev↗…

arXiv:2606.19297v1 Announce Type: new Abstract: Embodied Vision-Language-Action (VLA) models are typically obtained by fine-tuning powerful pretrained VLMs on robotics data, yet it is unclear how much commonsense and factual knowledge they retain after adaptation. Failures on knowledge-sensitive tasks are ambiguous, conflating missing knowledge with poor generalization of low-level control. We introduce Act2Answer, a lightweight protocol that adapts VLM knowledge benchmarks to VLA evaluation by requiring agents to answer through action. Each question becomes a short tabletop episode where the agent performs a single object-placement action to select among candidate answers, yielding an action-grounded success rate with reduced control confounds. We curate a test suite of such environments across diverse commonsense and world-knowledge categories and introduce layerwise intent probing to localize answer-relevant information across the VLM backbone and action head. In a large-scale study of 7 VLA models and 9 VLM baselines, we systematically rank models across categories, finding that VLAs show solid performance on simple concepts while exhibiting larger gaps on richer semantic categories relative to their source VLMs, that VQA co-training is associated with better knowledge retention, and that answer-relevant signals peak in middle VLA layers but attenuate in upper layers. Act2Answer is available at https://tttonyalpha.github.io/act2answer/.

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15.
arXiv (CS.AI) 2026-06-11

AI Researchers Must Help Lead Arms Control to Mitigate Military AI Risks

作者:
Ted Fujimoto↗Jacob Benz↗

arXiv:2606.11533v1 Announce Type: cross Abstract: The advancement of AI capabilities compels researchers and the public to be more aware of its potential worldwide impact. A pressing near-term concern is the regulation of military AI applications. Armament manufacturers and defense contractors are increasingly investing in AI capabilities and forging partnerships with AI companies, creating a burgeoning coalition that demands military leaders, arms control diplomacy experts, and AI researchers collaborate to ensure a safer future. While AI researchers often focus on the long-term implications of superintelligent AI, this approach may not adequately address the immediate challenges posed by AI in military applications. Success requires acknowledging and mitigating the emerging risks of frontier AI models that plan to be integrated into defense applications, like military AI systems. Arms control has reduced past catastrophic risks, so lessons learned from nuclear deterrence can guide AI safety and security research towards innovations in verification and diplomacy. AI researchers, however, must assist in leading the technical research that clearly defines and alleviates instability in military settings. Given these new responsibilities and the lack of sufficiently reliable solutions, we argue that AI researchers must take a leading role in advancing arms control research to minimize risk in military AI applications.

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

Reaffirming a Challenge to Bohmian Mechanics

作者:
Jan Klaers↗Violetta Sharoglazova↗Marius Puplauskis↗

arXiv:2509.06584v4 Announce Type: replace Abstract: In our recent work, we reported the first measurement of the speed of tunnelling particles using a coupled waveguide system. The measured speed is operationally defined through a comparison of two orthogonal motions in a coupled waveguide system, is compatible with the standard definition of dwell time and with the Büttiker-Landauer tunnelling time, and does not presuppose a trajectory picture. Here we respond to objections raised in comments, referee reports, preprints, and articles. We distinguish two questions that are often conflated: whether Bohmian mechanics reproduces the measured density, and whether the standard guiding equation assigns the correct state of motion to the particles. The first point follows under the usual quantum equilibrium assumptions. The second is a separate physical assumption, since the standard guiding equation does not follow from the Schrödinger equation alone. We argue that, in the evanescent regime, the state of motion assigned by the standard guiding equation is in disagreement with the measured speed. To make the distinction explicit, we also present a bidirectional Bohmian model that reproduces the same stationary density while assigning finite speeds compatible with the speed inferred in the evanescent regime.

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

Cross-Dataset Bloom Question Classification: Supervised Models and Prompted LLMs

作者:
Abdolali Faraji↗Mohammadreza Molavi↗Zohreh Rasoulkhani↗Mohammadreza Tavakoli↗G\'abor Kismih\'ok↗

Automatic Bloom's taxonomy classification of assessment questions can substantially reduce instructor workload, but labeling is subjective and teacher-dependent. Prior machine learning (ML) and deep learning (DL) approaches reported strong within-dataset results, yet were rarely evaluated in cross-dataset settings, leaving real-world generalizability unclear; meanwhile, LLM effectiveness for Bloom question classification has not been systematically studied. We evaluated the cross-dataset generalization of existing ML/DL methods and assessed LLMs with multiple prompting strategies on five datasets; the best prompting strategy combined in-context examples with course-specific action verbs. Supervised ML/DL models degraded substantially on unseen datasets, whereas LLMs were more stable, suggesting a robust alternative across diverse educational contexts. Based on the best prompting strategy, we also presented a lightweight UI that supports instructors in automatically classifying large question banks; a usability study indicated low workload and high usability.

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18.
arXiv (CS.CV) 2026-06-12

Possibilistic Predictive Uncertainty for Deep Learning

作者:
Yao Ni↗Jeremie Houssineau↗Yew-Soon Ong↗Piotr Koniusz↗

Deep neural networks achieve impressive results across diverse applications, yet their overconfidence on unseen inputs necessitates reliable epistemic uncertainty modeling. Existing methods for uncertainty modeling face a fundamental dilemma: Bayesian approaches provide principled estimates but remain computationally prohibitive, while efficient second-order predictors lack rigorous connections between their specific objectives and epistemic uncertainty quantification. To resolve this dilemma, we introduce Dirichlet-approximated possibilistic posterior predictions (DAPPr), a principled framework grounded in possibility theory. We define a possibilistic posterior over parameters, project it to the prediction space via supremum operators, and approximate the projected posterior using learnable Dirichlet possibility functions. This projection-and-approximation strategy yields a simple training objective with closed-form solutions. Despite its simplicity, extensive experiments across diverse benchmarks show that DAPPr achieves competitive or superior uncertainty quantification performance over state-of-the-art second-order predictors while maintaining both principled derivation and computational efficiency. Code is available at https://github.com/MaxwellYaoNi/DAPPr.

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19.
arXiv (quant-ph) 2026-06-17

Vorticity Induced by Non-frontal Collisions of Quantum Droplets

作者:
J. E. Alba-Arroyo↗Santiago F. Caballero-Benitez↗Rocio J\'auregu↗

arXiv:2606.17498v1 Announce Type: cross Abstract: The rotational dynamics induced by the non-frontal binary collisions of quantum droplets composed of ultracold alkali atoms are analyzed. A theoretical study is presented within the extended Gross-Pitaevskii equation framework, using experimentally feasible conditions. Numerical experiments elucidate a rich landscape of possible topological excitations in the system that are robust towards measurements. The collision of heteronuclear quantum droplets composed of $^{41}$K and $^{87}$Rb atoms in the incompressible regime, gives rise to dynamical instabilities that spontaneously generate topological defects: vortex rings, dislocation lines, and vortices in one species. Their presence depends on the Weber number and the impact parameter. An experimental proposal for vortex detection in both real and Fourier space using interaction ramps is described.

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20.
medRxiv (Medicine) 2026-06-22

Sex-specific multimorbidity clusters and all-cause mortality in relatively healthy older adults: findings from the ASPREE cohort

作者:
Du↗Vishwanath↗Wu↗Phyo↗A. Z. Z↗Orchard↗S. G↗Sheets↗Ernst↗M. E↗Ryan↗

Background: Multimorbidity is common in older adults, but sex differences in chronic condition clustering remain unclear. This study explored multimorbidity clusters and their associations with all-cause mortality among community-dwelling adults aged 70 years and over. Methods: This was a secondary analysis of data from 16,095 Australian ASPREE participants aged at least 70 years without prior dementia or cardiovascular disease. Fifteen baseline chronic conditions were grouped using latent class analysis (LCA). Observed-to-expected (O/E) ratios characterised conditions over-represented within clusters, and Cox proportional hazards models assessed associations with all-cause mortality. Results: Among 16,095 participants (mean age 74 years), 88.3% had multimorbidity at baseline; 4,217 deaths occurred over a median follow-up of 10.85 years. Five clusters were identified overall: hypertension and dyslipidemia (52.1%), gout and metabolic (14.4%), depressive symptoms, osteoporosis and frailty (10.0%), anaemia and kidney disease (10.2%), and hypotension, thyroid disorder and past cancer (13.3%). Sex-stratified analyses revealed three clusters in males and four in females. The frailty, depressive symptoms and osteoporosis cluster was associated with higher mortality in both sexes (aHR 1.56 [95% CI 1.40-1.73] in males; 1.68 [1.49-1.89] in females). Higher mortality was also observed for the metabolic, gout and kidney disease cluster in males (aHR 1.63 [1.47-1.81]) and the gout, anaemia and kidney disease cluster in females (aHR 1.96 [1.74-2.21]). Conclusions: Distinct multimorbidity clusters differed by sex and were associated with increased all-cause mortality. These findings may support risk stratification, targeted screening, and more person-centred management of older adults with multimorbidity.

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

Performance-Driven Environment Abstraction with Multi-Timescale Learning

作者:
Yue Guan↗Dipankar Maity↗Panagiotis Tsiotras↗

arXiv:2606.17377v1 Announce Type: new Abstract: We study performance-driven environment abstraction for decision-making in large Markov decision processes. Rather than preserving geometric or topological structure, we seek abstractions that directly optimize decision quality. We model abstraction as a controlled approximation obtained by aggregating the state space and enforcing a shared action distribution within each aggregated state. For a fixed partition, we establish a performance guarantee that separates value-function approximation error from the loss introduced by action sharing. Guided by this analysis, we develop a multi-timescale reinforcement learning framework that jointly adapts the policy and a tree-structured environment abstraction. The resulting algorithm refines and coarsens regions of the state space based on Q-value discrepancies, balancing performance against abstraction size and complexity. Empirical results demonstrate substantial state compression, improved sample efficiency, and faster replanning compared to actor-critic baselines.

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22.
medRxiv (Medicine) 2026-06-22

MinderCare: protocol for a mixed-methods evaluation of a digitally enabled dementia care service.

作者:
Jeyasingh-Jacob↗Tecilla↗Cro↗Lai↗Frigerio↗Joby↗Chavarro Novoa↗Fabusoro↗Rasulo↗James↗Amade Cassimo↗Hariss↗…

Introduction and aims Dementia is a growing public health challenge affecting millions of people worldwide. It is a progressive condition that increases the risk of infections, falls, hospital admissions, dependence in activities of daily living, safety issues such as wandering, care home transfers, and death. New ways of supporting people living with dementia (PLWD) at home are urgently needed. We describe the MinderCare study which evaluates a digitally enabled care model that integrates low-burden sensor-based remote monitoring within a nurse-led clinical service. Methods and analysis In this mixed-methods study, we will recruit 100 people with confirmed or suspected dementia living at home and deploy the Minder remote monitoring system for at least 12 months. A detailed characterisation of the cohort will be obtained, including cognition, frailty, participant and carer wellbeing, functioning, and quality of life. The feasibility, acceptability, sustainability, and resource requirements of the service will also be assessed. Low-cost sensors provide information about behaviour, environment and physiology from the home. Machine-learning algorithms have been used to develop digital biomarkers of infection, sleep, night-time behaviours, daily activities and routines, and the effects of clinical events and treatment. These will be assessed through clinical reports of sensor-derived data that include anomaly alerts provided to the clinical teams. Algorithms will be assessed for their clinical utility and acceptability. The comparative-effectiveness component will be designed as a target trial emulation using linked electronic health-record data to construct a time-indexed external usual-care control cohort. The primary comparative outcome will be Days Alive and Out of Hospital (DAOH) over 12 months from the activation-index date, with healthcare utilisation, costs, institutionalisation and mortality assessed as secondary outcomes. DAOH and estimated MinderCare effects will also be examined across prespecified strata of baseline inpatient utilisation. Ethics and dissemination Ethical approval has been granted by the North East Newcastle and North Tyneside 2 Research Ethics Committee, and the study has received confirmation of capacity and capability by the Imperial College Healthcare NHS Trust. Study findings will be disseminated to patients, health and social care professionals, and policymakers through peer-reviewed publications and conference presentations. Study registration number: ISRCTN14997677 and NIHR portfolio CPMSID 63023.

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23.
medRxiv (Medicine) 2026-06-19

A soluble bi-specific fusion protein for the improved expansion of human CD8+ CAR-T cells

作者:
Law↗J. C↗Matus↗E. I↗Mina↗P. R↗Sparkes↗Asokumar↗Trottier↗Kim↗G. B↗Gariepy↗…

The success of Chimeric Antigen Receptor (CAR) T cell therapy is heavily dependent on the quality of the final cellular product. Current expansion protocols often rely on reagents that require removal from cell culture media, posing logistical challenges in manufacturing, and can also lead to terminal differentiation. Here, we evaluate the use of a soluble, bead-free T cell activator, T cell expansion protein (T-CEP), as a streamlined alternative for generating potent CAR-T cells. Human T cells were activated with T-CEP or known T cell activators (Dynabeads and TransAct) and transduced with either CD19 or interleukin-13 (IL-13) mutein (tetravariant-13; TV-13)-based CAR lentiviral vectors. Our results demonstrate that T-CEP supports robust CAR-T cell expansion and achieves transduction efficiencies comparable to commercial reagents for both types of CAR-T cells. Notably, T-CEP significantly favored the expansion of CD8+ T cells, yielding an enhanced CD27+ phenotype and a lower CD4:CD8 ratio compared to TransAct. Cytotoxicity assays confirmed that T-CEP-expanded CAR-T cells possess cytolytic function equivalent to commercial reagents for both CARs, while exhibiting lower levels of inflammatory cytokine secretion. In summary, T-CEP represents a competitive alternative to existing expansion agents, as it does not require its removal during CAR-T manufacturing and generates a CD8+ dominant, less-differentiated phenotype without compromising efficacy.

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24.
arXiv (CS.CV) 2026-06-17

Predicting Immune Biomarkers with MultiModal Mixture-of-Expert Pathology Foundation Models Empowers Precision Oncology

作者:
Tianyu Liu↗Ziqing Wang↗Zhaokang Liang↗Tong Ding↗Peter Humphrey↗Lorraine Col\'on-Cartagena↗Emily Ling-Lin Pai↗Kenneth Tou En Chang↗Mohamed Kahila↗Jonathan Chong Kai Liew↗Tinglin Huang↗Rex Ying↗…

Predicting immune biomarkers associated with the tumor immune microenvironment (TIME) is critical for advancing precision oncology, yet existing approaches are largely limited to single image modalities and suffer from insufficient resolution and incomplete utilization of complementary clinical and biological information. Here we introduce MixTIME, a multimodal foundation model that leverages a mixture-of-experts (MoE) architecture to integrate pathology foundation models trained across distinct modalities: image only (UNIv2), image text (CONCHv1.5), and image transcriptomic (STPath) representations for pixel-level and slide-level prediction of multiplex immunofluorescence (mIF) protein expression from hematoxylin and eosin (HE) whole-slide images. MixTIME employs a learnable router to dynamically weight expert contributions and is trained with a distribution- and tendency-aware loss function. Benchmarked on two datasets of different scales, MixTIME achieves state-of-the-art performance across 17 protein markers as measured by correlation metrics. The predicted mIF profiles substantially enhance downstream tasks, including spatial domain identification, survival prediction, and AI-assisted pathology report generation validated by expert pathologists from multiple institutes across the world. Furthermore, MixTIME enables longitudinal tracking of protein expression dynamics across clinical time points and reveals protein gene interaction patterns linked to drug resistance and immune suppression in tumor microenvironments. Collectively, MixTIME provides a scalable framework for multimodal biomarker discovery and clinical translation in computational pathology.

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25.
arXiv (CS.CL) 2026-06-19

MedRLM: Recursive Multimodal Health Intelligence for Long-Context Clinical Reasoning, Sensor-Guided Screening, Evidence-Grounded Decision Support, and Community-to-Tertiary Referral Optimization

作者:
Aueaphum Aueawatthanaphisut↗

Real-world clinical decision support requires reasoning over heterogeneous and longitudinal patient information rather than answering isolated medical questions. However, current medical large language models and retrieval-augmented generation systems often rely on single-step prompting or retrieval, which can be fragile when clinical evidence is distributed across long electronic health records, medical images, sensor streams, guidelines, and referral constraints. This paper proposes MedRLM, a Recursive Multimodal Health Intelligence framework for long-context clinical reasoning, sensor-guided screening, and community-to-tertiary referral support. Instead of compressing all patient information into one prompt, MedRLM treats the patient case as an external clinical environment that can be recursively inspected, decomposed, retrieved, verified, and synthesized. The framework coordinates specialized agents for clinical text, longitudinal EHR, medical imaging, physiological sensor signals, guideline retrieval, uncertainty auditing, and referral planning. It further introduces a Clinical Evidence Graph Memory to connect patient-specific observations with retrieved evidence, standardized definitions, sensor-derived biomarkers, and referral criteria. A sensor-guided recursive triggering mechanism activates deeper reasoning when abnormal physiological or behavioral patterns are detected, while uncertainty-gated refinement supports clinician review for high-risk or low-confidence cases. We also outline a real-data evaluation design using public and credentialed clinical datasets spanning EHR, radiology, ECG, ICU time series, and referral-proxy outcomes. MedRLM aims to move medical AI from static question answering toward auditable, multimodal, and workflow-aware clinical decision support.

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