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01.
arXiv (CS.CL) 2026-06-16

Hidden Ghost Hand: Unveiling Backdoor Vulnerabilities in MLLM-Powered Mobile GUI Agents

Graphical user interface (GUI) agents powered by multimodal large language models (MLLMs) have shown greater promise for human-interaction. However, due to the high fine-tuning cost, users often rely on open-source GUI agents or APIs offered by AI providers, which introduces a critical but underexplored supply chain threat: backdoor attacks. In this work, we first unveil that MLLM-powered GUI agents naturally expose multiple interaction-level triggers, such as historical steps, environment states, and task progress. Based on this observation, we introduce AgentGhost, an effective and stealthy framework for red-teaming backdoor attacks. Specifically, we first construct composite triggers by combining goal and interaction levels, allowing GUI agents to unintentionally activate backdoors while ensuring task utility. Then, we formulate backdoor injection as a Min-Max optimization problem that uses supervised contrastive learning to maximize the feature difference across sample classes at the representation space, improving flexibility of the backdoor. Meanwhile, it adopts supervised fine-tuning to minimize the discrepancy between backdoor and clean behavior generation, enhancing effectiveness and utility. Extensive evaluations of various agent models in two established mobile benchmarks show that AgentGhost is effective and generic, with attack accuracy that reaches 99.7\% on three attack objectives, and shows stealthiness with only 1\% utility degradation. Furthermore, we tailor a defense method against AgentGhost that reduces the attack accuracy to 22.1\%. Our code is available at \texttt{anonymous}.

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

A Self Consistency Based Reranking for Narrative Question Answering

Narrative question answering (NQA) is a challenging task in natural language processing that requires models to understand long textual contexts, capture relationships across events, and generate coherent responses. Despite recent advances in pretrained language models, most existing approaches rely on a single decoding output during inference, making them sensitive to generation variability and often resulting in incomplete or inconsistent answers .To address this limitation, we propose a self-ensemble Self-Consistency-Based reranking framework for narrative question answering. The proposed method generates multiple candidate answers for each story-question pair and selects the final answer based on semantic agreement among the generated responses. This allows the model to explore diverse answer formulations while improving robustness through consensus-based selection without requiring modifications to the underlying architecture .The framework combines pretrained and fine-tuned language generation with multi-answer inference and similarity-based reranking. We evaluate the proposed approach on the NarrativeQA dataset using multiple models, including FLAN-T5 (Base and Small) and Pegasus-Large, under both baseline and fine-tuned settings .Experimental results demonstrate that the proposed method consistently improves performance across all models. In particular, FLAN-T5-Base achieves the best overall performance, improving from 82.32% to 86.66% (+4.34%) when combined with self-ensemble inference. Additionally, the largest improvement is observed with Pegasus-Large, which increases from 72.50% to 87.07% (+14.57%), highlighting the effectiveness of the proposed strategy.

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

Ultrafast On-chip Online Learning via Spline Locality in Kolmogorov-Arnold Networks

arXiv:2602.02056v3 Announce Type: replace-cross Abstract: Ultrafast online learning is essential for high-frequency systems, such as controls for quantum computing and nuclear fusion, where adaptation must occur on sub-microsecond timescales. Meeting these requirements demands low-latency, fixed-precision computation under strict memory constraints, a regime in which conventional Multi-Layer Perceptrons (MLPs) are both inefficient and numerically unstable. We identify key properties of Kolmogorov-Arnold Networks (KANs) that align with these constraints. Specifically, we show that: (i) KAN updates exploiting B-spline locality are sparse, enabling superior on-chip resource scaling, and (ii) KANs are inherently robust to fixed-point quantization. By implementing fixed-point online training on Field-Programmable Gate Arrays (FPGAs), a representative platform for on-chip computation, we demonstrate that KAN-based online learners are significantly more efficient and expressive than MLPs across a range of low-latency and resource-constrained tasks. To our knowledge, this work is the first to demonstrate model-free online learning at sub-microsecond latencies.

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

MLUBench: A Benchmark for Lifelong Unlearning Evaluation in MLLMs

arXiv:2606.12809v1 Announce Type: new Abstract: Multimodal large language models (MLLMs) are trained on massive multimodal data, making data unlearning increasingly important as data owners may request the removal of specific content. In practice, these requests often arrive sequentially over time, giving rise to the challenging problem of MLLM Lifelong Unlearning. However, most existing benchmarks are limited in scale and scope, failing to capture the complexities of MLLM lifelong unlearning. To fill this gap, we introduce the MLUBench, a large-scale and comprehensive benchmark featuring 127 entities across 9 classes under lifelong unlearning requests. We perform extensive experiments using MLUBench and reveal that existing unlearning methods suffer from severe, cumulative degradation. More critically, we further identify the unique challenge of this problem: unlike in unimodal models, MLLM lifelong unlearning is constrained by the need to preserve multimodal alignment. Continually unlearning from one modality could degrade the entire model. To alleviate this challenge, we propose LUMoE, an effective method. Experiments demonstrate that LUMoE significantly mitigates the degradation problem faced by baselines. The source code and the MLUBench dataset are open-sourced in https://github.com/lihe-maxsize/Lifelong_Unlearning_main.

05.
arXiv (quant-ph) 2026-06-19

All-valid-state HOBO encoding for constrained combinatorial optimization on NISQ devices

arXiv:2606.20017v1 Announce Type: new Abstract: Continued advancements in quantum computing have stimulated growing interest in translating quantum technologies into real-world applications. Consequently, the investigation of practically motivated NP-hard problems is of significant value. This study investigates the performance of a variational quantum eigensolver (VQE) in addressing the traveling salesperson problem (TSP) through noiseless simulations representative of noisy intermediate-scale quantum (NISQ) devices using higher-order binary optimization (HOBO) encodings. We construct a HOBO Hamiltonian with an efficient binary representation and propose an all-valid-state HOBO (AVS-HOBO) scheme based on cyclic mapping that eliminates one penalty term and reuses states that would otherwise be invalid. Using TSP instances of up to 20 cities, we compare the original HOBO and AVS-HOBO encodings from multiple perspectives, including the energy convergence behavior and the approximation, tour-length, and feasibility ratios. In addition to simulations, we perform computations on real quantum hardware with different device architectures, where we not only compare the performances of different chips but also investigate the effects of different error-mitigation methods on actual quantum machines. The results indicate that AVS-HOBO encoding enhances the practical reliability of VQE on NISQ devices and improves scalability for larger TSP instances, with broader applicability to constrained quantum optimization problems.

06.
medRxiv (Medicine) 2026-06-15

Longitudinal monitoring exposes correlated temporal protein variations in the female plasma proteome

The plasma proteome is a valuable resource for assessment of the physiological state of the donor. Containing hundreds of different proteins of variable concentrations, it displays substantial inter-donor differences in individual protein levels, making each plasma proteome highly donor-specific. Less is known about intra-donor variability in the plasma proteome over time, although such variations may even be more indicative of a changing physiological state. Here we assessed data obtained from the TIMES cohort, comprising 51 apparently healthy participants monitored monthly over 12 months, focusing especially on temporal variations in blood protein levels. Most strikingly, we observed that several women in this cohort revealed strongly correlated temporal variations in their plasma proteome, including most notably PZP, SHBG, FETUB, AGT, SERPINA6, SERPINA7, CP, APOL1 and KNG1, with levels sometimes fluctuating by more than 20-fold. In contrast, such variations were absent in men. Some of the fluctuating proteins have been known to be hormone-regulated (e.g., PZP, SHBG), but for others this was not yet fully clear. Through the tight co-variation observed for these proteins in the plasma proteome of women, we can conclude that all these proteins are similarly hormone regulated. The findings reported here not only corroborate previous studies showing estrogen-dependent regulation of several plasma proteins, but also extend this category to include also CP, APOL1, and KNG1. As these latter have been often proposed as candidate biomarkers, they should be validated in sex-balanced cohorts and interpreted with caution, especially in large-scale plasma proteomics studies wherein often only one or a few sampling time points are measured per donor.

07.
arXiv (CS.LG) 2026-06-18

Starter-Iterator Neural Operator: A Unified Architecture for High-Fidelity Forward and Inverse PDE Problems

arXiv:2606.18305v1 Announce Type: cross Abstract: Operator learning is an emerging interdisciplinary field that integrates machine learning with scientific computing. By mapping infinite-dimensional function spaces, this approach provides an efficient surrogate modeling framework for high-dimensional partial differential equations (PDEs). Compared to traditional numerical solvers, it achieves a superior trade-off between computational complexity and approximation accuracy, demonstrating significant advantages in many-query tasks such as real-time prediction and parameter sweeps. Given the stringent accuracy requirements of both forward simulation and inverse inference, as well as the precision bottlenecks of existing operator learning methods in handling complex boundaries or long-term evolution, we propose the Starter-Iterator Neural Operator (SINO). Our framework reinterprets the initialization strategies and iterative formats of traditional iterative methods through neural networks, establishing an efficient approach for spectral-spatiotemporal collaborative modeling. Specifically, the frequency-domain initialization module captures globally stable low-frequency features, while the time-domain learning module focuses on optimizing local solution residuals, thereby effectively overcoming the inherent limitations of conventional single-domain modeling approaches. Extensive experiments on typical dynamical systems such as the Navier-Stokes equations and acoustic wave equations, as well as practical applications including super-resolution imaging and weather forecasting, demonstrate that SINO achieves outstanding performance in numerical accuracy, generalization capability, and robustness.

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

Bounded Context Management for Tabular Foundation Models on Stream Learning

arXiv:2606.18677v1 Announce Type: cross Abstract: Tabular stream learning requires predictions on sequentially arriving examples under distribution shift. While standard methods adapt by updating model states, tabular foundation models (TFMs) make predictions conditioned on a labeled context in an in-context manner, making them a natural alternative for stream learning. This shifts the challenge from how to update the model to how to manage the context. We propose a future information view that yields three practical requirements for context management: preserve recent examples, retain uncertain examples, and remove redundant examples. We instantiate these requirements as CURE (Context management via Uncertainty-aware admission and Redundancy aware Eviction), a context-managing policy with entropy-gated admission and redundancy-aware eviction. Across seven streams, CURE shows up to 27.0% relative improvement over classical stream learners, remains robust across multiple TFM backbones, and ranks first among other policy variants. Code and datasets are available at https://github.com/morcellinus/CURE-ICML-FMSD.

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

VLADriveBench: Evaluating CoT-Action Relationship in VLA for Autonomous Driving

Vision-language-action (VLA) models generate chain-of-thought (CoT) reasoning alongside driving trajectories, but existing benchmarks evaluate only trajectory quality and do not assess whether the CoT is relevant, consistent, or causally connected to the driving action. We introduce VLADriveBench, a framework that combines observational metrics (mentioning, hallucination, contradiction, action alignment) with a CoT intervention protocol to provide complementary views of the CoT-action relationship. Applying VLADriveBench to three models across two architectures, we find that the two analyses can diverge sharply: ORION scores highest on observational alignment yet its CoT is epiphenomenal, while Alpamayo v1.5 scores lower yet its CoT is strongly causal, with visual salience gating the extent of CoT influence.

10.
arXiv (CS.CL) 2026-06-15

MET-Bench: Multimodal Entity Tracking for Evaluating the Limitations of Vision-Language and Reasoning Models

Entity state tracking is a necessary component of world modeling that requires maintaining coherent representations of entities over time. Previous work has benchmarked entity tracking performance in purely text-based tasks. We introduce MET-Bench, a multimodal entity tracking benchmark designed to evaluate the ability of vision-language models to track entity states across modalities. Using three domains, we assess how effectively current models integrate textual and image-based state updates. Our findings reveal a significant performance gap between text-based and image-based entity tracking. We empirically show this discrepancy primarily stems from deficits in visual reasoning rather than perception. We further show that explicit text-based reasoning strategies improve performance, yet limitations remain, especially in long-horizon multimodal tasks. We apply reinforcement learning to improve entity tracking in open-source VLMs. This yields substantial in-modality gains, but does not transfer robustly across input modalities. Our results highlight the need for improved multimodal representations and reasoning techniques to bridge the gap between textual and visual entity tracking.

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

MVOFormer: Flow-Semantic Transformer for Robust Monocular Visual Odometry

Monocular visual odometry (MVO) is foundational to autonomous navigation and robotic localization. However, existing learning-based MVO approaches often struggle with either a lack of interpretable, complementary features or overly complex multi-stage architectures. These limitations inherently restrict their robustness and cross-domain generalization. In this work, we propose MVOFormer, a novel transformer framework for robust monocular visual odometry. Our architecture features a Flow-Semantic Dual Branch Encoder that synergizes dense geometric motion cues with object-centric semantic priors, explicitly distinguishing static structures from dynamic distractors. These representations are then fused by an Iterative Multimodal Decoder, enabling coarse-to-fine pose refinement while dynamically suppressing attention on unreliable regions. Extensive evaluations demonstrate that, without any target-domain fine-tuning, MVOFormer achieves superior zero-shot generalization and robustness, significantly outperforming prior learning-based frame-to-frame methods across diverse benchmarks including TartanAir, KITTI, TUM-RGBD, and ETH3D-SLAM.

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

InstantForget: Update-Free Backdoor Unlearning with Inference-Time Feature Reset

作者:

arXiv:2606.15730v1 Announce Type: cross Abstract: Backdoor unlearning aims to remove a malicious trigger behavior from a deployed model while preserving clean utility. We study the update-free inference-time setting, where model parameters remain frozen. First, we audit a common projection assumption under oracle paired clean and triggered features. Projection succeeds mainly on BadNets and leaves WaNet, Blended, and SIG at 0.683, 0.888, and 0.941 ASR on CIFAR-10 ResNet-18. This failure is not explained by spectral compactness, spatial locality, or subspace misalignment. It is predicted by a logit-triplet gap involving the target margin, target-logit drop, and non-target logit rise. We then introduce InstantForget, a clean-calibrated gated reset that flags anomalous features with a Mahalanobis score and moves only flagged features toward a neutral non-target representation. With one fixed operating point selected on held-out triggered validation, InstantForget reduces average ASR to 0.071 across four non-adaptive CIFAR-10 triggers without triggered samples or parameter updates at deployment. It also reaches 0.981 detection AUROC and transfers to six of eight tested backbones. Reported failures under WaNet, ModelNet10 point blend, two backbone geometries, and adaptive feature-compactness attacks define the method's scope.

13.
arXiv (CS.CV) 2026-06-18

DreamReg: Belief-Driven World Model for 2D-3D Ultrasound Registration

Ultrasound (US) is widely used for surgical navigation, yet real-time registration between intraoperative 2D slices and preoperative 3D volumes remains challenging due to partial observability, speckle noise, and the action-dependent US acquisition. Existing methods are one-shot or short-horizon, making it hard for them to gather evidence over time or capture how surgeons adjust probe motion based on on-screen feedback. We propose DreamReg, a belief-driven world-model framework that formulates 2D-3D registration as belief updating over rigid transformations. DreamReg maintains a latent belief state that summarizes past observations and poses information, and continuously refines the transformation through learned dynamics as new slices arrive. During training, DreamReg is exposed to probe-motion trajectories that mimic clinical scanning behavior and learns to update its belief by conditioning pose refinement on the current US observation. During inference, DreamReg refines registration via internal imagination: it rolls out the learned world model to simulate candidate probe motions and their predicted observations, and integrates these imagined outcomes to converge to an accurate rigid transformation. Experiments on CAMUS and u-RegPro datasets demonstrate improved robustness and competitive registration accuracy for real-time guidance compared with state-of-the-art methods.

14.
arXiv (CS.AI) 2026-06-16

Towards End-to-End Automation of AI Research

arXiv:2606.15497v1 Announce Type: new Abstract: The automation of science is a long-standing ambition in the field of AI. While the community has made significant progress in automating individual components of the scientific process, a system that autonomously navigates the entire research lifecycle – from conception to publication – has remained out of reach. Here, we present the strongest demonstration to date toward automating the entire process end-to-end. We present The AI Scientist, which creates research ideas, writes code, runs experiments, plots and analyzes data, writes the entire scientific manuscript and performs its own peer review. Its ideas, execution, and presentation are of sufficient quality to produce a manuscript generated by an AI system that passes the first round of peer review at a major machine learning conference workshop. The workshop has an acceptance rate of 70 percent. Our system leverages modern foundation models within a complex agentic system. We evaluate The AI Scientist in two settings: a focused mode using human-provided code templates as an initial scaffold to conduct research on a specific topic, and a template-free, open-ended mode that leverages agentic search for wider scientific exploration. Both settings produce diverse ideas and automatically test, report on, and evaluate them. This achievement demonstrates AI's growing capacity for scientific contribution and signifies a potential paradigm shift in how research is conducted. As with any impactful new technology, there could be significant risks, including taxing overwhelmed review systems and adding noise to scientific literature. However, if developed responsibly, such autonomous systems could greatly accelerate scientific discovery.

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

Limited Marginal Benefit of Reasoning-Heavy LLM Deployment in ESG Narrative Scoring: A 4-Model Consensus Study on Japanese Listed Firms

arXiv:2606.13693v1 Announce Type: cross Abstract: Automated scoring of ESG narrative disclosures with large language models (LLMs) is gaining traction, yet whether reasoning-heavy frontier models add value commensurate with their cost remains empirically unsettled. We evaluate this question on a corpus of ten Japanese listed firms across three rubric axes – quantitative targets, progress-tracking infrastructure, and external-standard alignment – using a four-model consensus design that combines a reasoning-on frontier model with three reasoning-off contemporaries. Across 120 firm x axis x model scores, the pooled mean absolute deviation between the reasoning-on model and each reasoning-off counterpart is 0.38 on a 5-point scale; only 2% of pairwise comparisons reach a two-point deviation, and none exceeds two points. Per-firm cost accounting shows the reasoning-on arm alone costs roughly 5.6x as much as the three-provider reasoning-off ensemble, for outcomes that differ only within small margins. We conclude that in span-based ESG narrative scoring, reasoning-heavy deployment does not materially improve outcomes relative to reasoning-off consensus, while substantially increasing operational cost. We discuss implications for cost-effective ESG auto-scoring pipelines and LLM deployment governance in applied accountability settings. An earlier version of this work is available on SSRN (Abstract ID 6683303).

16.
arXiv (CS.AI) 2026-06-19

The Algorithmic-Human Manager: AI, Apps, and Workers in the Indian Gig Economy

arXiv:2606.19975v1 Announce Type: cross Abstract: This paper examines the impact of artificial intelligence and digital technologies on the blue-collar gig economy in India, focusing on algorithmic management. This paper examines the impact of artificial intelligence and digital technologies on the blue collar gig economy in India, focusing on algorithmic management he use of automated systems to allocate, monitor, and evaluate work in location-based services such as ride sharing and delivery. Using a social justice framework and a mixed-methods approach comprising interviews with 16 gig workers and 21 key stakeholders, the study uncovers a dual reality: while AI-powered systems expand access to work and generate operational efficiencies, they simultaneously introduce significant challenges related to fairness, transparency, and worker dignity. Key findings reveal that algorithmic systems are opaque by design, produce inequitable outcomes, and are not structured to reward additional labour with proportionate pay. The study advocates for a pragmatic hybrid governance model an Algorithmic Human Manager framework in which technological efficiency and human accountability operate together rather than in opposition. The findings carry implications for policymakers, platform companies, and civil society organizations working to design equitable AI governance frameworks for the gig economy in India and across the Global South.

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

Thinking with Visual Grounding

arXiv:2606.16122v1 Announce Type: new Abstract: Visual thinking should not only sound right; it should show its evidence. While recent vision-language models (VLMs) can produce natural-language reasoning traces, these traces often leave the supporting image regions implicit, making them hard to verify and difficult to supervise. We introduce visually grounded thinking, a reasoning process in which models interleave natural-language thoughts with explicit point or box groundings of the visual evidence used at each step. This lets the model express intermediate reasoning in language while grounding key objects in the image regions they refer to. To train this behavior, we construct a scalable synthesis pipeline that distills correct visual reasoning traces, extracts the visual objects required by the traces, grounds them with a SAM3-based agent, and derives aligned point and box supervision from the resulting masks. We further propose grounding-aware reinforcement learning, which combines answer correctness rewards with dense grounding rewards that score whether generated object references match the correct image evidence. Across two counting benchmarks and four spatial reasoning benchmarks, adding visually grounded thinking to Gemma3-4B-IT consistently improves performance over the original model and the non-grounded thinking baseline. On spatial reasoning, the visually grounded thinking 4B models match, and in some cases surpass, Gemma3-27B-IT from the same model family. Our analysis shows that point grounding is well suited to counting, while box grounding benefits most from explicit grounding rewards on spatial tasks. Overall, our results show that VLMs think better when their intermediate thoughts are tied to the image regions that make them true.

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

Calibrated Triage, Not Autonomy: Confidence Estimation for Medical Vision-Language Models

A vision-language model can answer a question about a medical image fluently and confidently while barely using the image, leaning instead on language priors. In medicine this is the failure that matters most, because the answer looks trustworthy and is not, and the only protection is a confidence score reliable enough to tell the system when to abstain. We ask a deployment question rather than an accuracy one: how much imaging work a model can safely handle alone, and which confidence signal makes that possible. We evaluate seven confidence estimators across five open-weight LVLMs and three medical visual-question-answering datasets spanning broad clinical imaging, radiology, and pathology, with every probe trained only on natural images and applied without adaptation. Recast as bounded selective prediction (automate a case only when confidence clears a threshold, defer the rest), the comparison is cautionary. The standard metrics are poor guides: discrimination barely separates the methods, and the weak calibration of a cheap self-report is cheaply removed by off-domain temperature scaling without changing deployable yield. What distinguishes a usable estimator is the high-confidence region a clinician acts on: the weakest baselines are confidently wrong on 41 to 45 percent of their errors against 1 to 4 percent for the best probe, and no estimator is reliably best across domains or models. Safe handoff is governed at two levels: base-model competence sets a ceiling, so a well-calibrated score recovers roughly a third of radiology cases at a 20 percent error tolerance but almost none of pathology; the confidence layer then decides how much of that ceiling is reachable. The usable role today is calibrated triage, not autonomy: automate the cases a calibrated score marks safe, route the rest to a clinician. We release all outputs, correctness judgments, and confidence scores, with code.

19.
arXiv (CS.LG) 2026-06-15

Arbitrary control over multimode wave propagation for machine learning

arXiv:2402.17750v2 Announce Type: replace-cross Abstract: Controlled multimode wave propagation can enable more space-efficient photonic processors than architectures based on discrete components connected by single-mode waveguides. Instead of defining discrete elements, one can sculpt the continuous substrate of a photonic processor to perform computations through multimode interference in two dimensions. Here we designed and demonstrated a device with a refractive index that can be rapidly reprogrammed across space, allowing arbitrary control of wave propagation. The device, a two-dimensional programmable waveguide, uses parallel electro-optic modulation of the refractive index of a slab waveguide with about $10^4$ programmable spatial degrees of freedom. We implemented neural network inference on benchmark tasks with up to $49$-dimensional vectors in a single pass, without digital pre-processing or post-processing. Theoretical and numerical analyses further indicated that two-dimensional programmable waveguides may offer not only a constant-factor reduction in device area but also a scaling benefit, with the area required growing as $N^{1.5}$ rather than $N^2$.

20.
arXiv (quant-ph) 2026-06-17

Experimental Characterization and Modeling of Measurement-Induced State-Transitions in a Fluxonium Superconducting Qubit

arXiv:2606.17866v1 Announce Type: new Abstract: Superconducting qubits are most often measured using dispersive readout, which, ideally, implements a projective quantum non-demolition (QND) measurement. While a larger readout drive can increase the signal and, thus, reduce discrimination errors in the readout, strong microwave drives may also cause non-QND errors by driving the qubit to a state outside the computational subspace. In this work, we experimentally characterize measurement-induced state transitions (MIST) in a fluxonium qubit over its full external flux range. We further numerically calculate the MIST errors, and find that the theory accurately predicts eleven experimentally identified regions with increased MIST. In addition to transitions to higher fluxonium levels, we also find that, at certain flux points, MIST errors are dominated by transitions that include the transmission-line-like array modes of the fluxonium's superinductor. The excellent match between theory and experiment validates that the models accurately predict the occurrence of MIST in these systems, and further highlights the influence of array modes in fluxonium readout.

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

AIPatient Arena: EHR-grounded evaluation of large language models in end-to-end clinical consultation workflows

Large language models (LLMs) are increasingly considered for use in clinical consultation tasks, yet most medical evaluations remain static, single-turn, or narrowly outcome-based, limiting their ability to reflect the sequential, uncertain, and interactive nature of real-world care. Here, we propose AIPatient Arena, an EHRs-grounded evaluation framework for assessing the clinical utility of LLMs across eight dimensions of clinical competence. The framework integrates EHR data into patient-specific knowledge graphs, enabling multi-turn physician-patient interactions. We applied AIPatient Arena on a primary cohort of 437 patients and two out-of-distribution validation cohorts of 119 and 67 patients. We observe that LLMs performed well in medical interview questioning skills (QS; mean scores, 4.43-4.99/5), ethical and professional conduct (ET; 4.38-4.93/5), and clarity and transparency of clinical explanations (EX; 3.80-4.72/5). Performance was moderate in information integration (II; 3.19-4.21/5) and medication safety and justification (MS; 3.13-3.78/5), but persistent weaknesses were observed in handling of ambiguous patient responses (HR; 2.57-3.32/5), information coverage (IC; 2.08-3.02/5), and diagnostic accuracy and reasoning (Dx; 2.63-3.55/5). Process-based evaluation revealed recurrent interaction failures, including repetitive questioning, omission of past medical history, and inadequate handling of uncertainty. Richer conversational context improved diagnostic reasoning but yielded limited gains in treatment planning. These findings indicate that final-answer accuracy alone is insufficient for evaluating clinical readiness and highlight the importance of assessing how models gather, interpret, and communicate information throughout a consultation. AIPatient Arena provides an EHR-grounded framework for workflow-oriented pre-deployment evaluation of medical LLMs.

22.
arXiv (CS.AI) 2026-06-12

Select and Improve: Understanding the Mechanics of Post-Training for Reasoning

arXiv:2606.13125v1 Announce Type: cross Abstract: Reinforcement learning has rapidly emerged as a key component in the training of reasoning and coding models, yet it remains poorly understood from a mechanistic perspective. We study how and through what underlying processes capabilities are acquired or enhanced via reinforcement learning post-training. Our analysis, based on controlled math reasoning experiments with Qwen-2.5-1.5B, reveals two core mechanisms: strategy selection and strategy improvement. Our results highlight the role of SFT data and reinforcement learning data in activating these mechanisms, in particular showing how supervising the model on diverse reasoning strategies can enable strategy selection and how increasing difficulty in reinforcement learning data can enable strategy improvement. Taken together, our results provide mechanistic insight into RL training and suggest practical interventions to continue scaling reasoning capabilities.

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

DynFS-MoE: Dynamic Functional-Structural Mixture-of-Experts for Post-Traumatic Epilepsy Diagnosis

Post-traumatic epilepsy (PTE) is a severe complication of traumatic brain injury (TBI), yet early identification remains challenging due to the complex structural and functional alterations it induces in the brain. To address this, we propose a dynamic multimodal Mixture-of-Experts (MoE) framework that integrates functional and structural MRI through time-aware functional-structural encoding and class-conditioned expert routing. Within this framework, modality-specific and cross-modal experts learn complementary representations, while a Modality-Class MoE (MCoE) module dynamically dispatches expert weights according to each classification objective. Experimental results across three binary classification tasks demonstrate that the framework consistently outperforms static fusion baselines, and high-interpretability analyses further reveal meaningful region-of-interest (ROI) interactions. This dynamic multimodal expert framework effectively captures class-dependent brain interaction patterns and provides an interpretable approach for PTE diagnosis and risk stratification.

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

Semi-Supervised Speech Confidence Detection using Pseudo-Labelling and Whisper Embeddings

arXiv:2606.16505v1 Announce Type: cross Abstract: Understanding speaker confidence is crucial in educational settings, as it can enhance personalised feedback and improve learning outcomes. This study introduces a novel framework for detecting speaker confidence by integrating human-engineered features with embeddings from the Whisper encoder. To address data limitations, a pseudo-labelling technique is employed to expand the labelled dataset, allowing the model to learn from both human-annotated and model-generated labels. The framework combines traditional speech features including pitch, volume, rate of speech, and the presence of disfluencies and stress, with Whisper embeddings, and uses a co-attention mechanism to fuse these representations and achieve an overall accuracy of 75%. This study contributes to advancing speech analysis, enabling applications that support personalised learning and speaking skill development.

25.
medRxiv (Medicine) 2026-06-22

Body composition subphenotypes, cardiometabolic risk and incident outcomes: validation in the population-based NAKO and UK Biobank imaging cohorts

Background Anthropometric measures do not adequately capture heterogeneity in body fat distribution and corresponding cardiometabolic risk, whereas magnetic resonance imaging (MRI) enables precise differentiation and quantification of adipose tissue compartments and ectopic fat. We aimed to validate previously derived MRI-based body composition subphenotypes and their cardiometabolic risk profiles in two independent European cohorts. Methods Using deep learning-based image analysis, we quantified bone marrow, visceral, subcutaneous, cardiac, renal sinus, hepatic, skeletal muscle, and pancreatic fat in the imaging substudies of two population-based cohorts: the German National Cohort (NAKO, N=29,314, age range 19-74 years) and the UK Biobank (N=36,109, age range 40-69 years). Body composition subphenotypes, previously identified by k-means clustering, were evaluated using a rigorous statistical cluster validation framework with method-based and results-based approaches. In NAKO, cross-sectional associations between subphenotypes and estimated cardiovascular disease risk scores were examined using linear regression. In UK Biobank, longitudinal associations between subphenotypes and incident cardiometabolic outcomes, ascertained through hospital record linkage, were analysed using Cox regression. Findings All five body composition subphenotypes were robustly validated across both cohorts, and showed distinct fat distribution patterns and cardiometabolic risk profiles: I "lean", II "average adiposity", III "bone and muscle adiposity", IV "hepato-abdominal adiposity", and V "general and pancreatic adiposity". Subphenotypes I-III showed progressive adipose tissue remodelling patterns likely reflecting ageing trajectories. The "hepato-abdominal adiposity" subphenotype showed highest risk of incident diabetes, whereas the "general and pancreatic adiposity" subphenotype showed highest overall cardiovascular disease burden and metabolic impairment. Interpretation MRI-derived body composition subphenotypes represent distinct fat distribution patterns that reflect ageing- and disease-related processes, which supports the potential of body composition phenotyping for improved cardiometabolic risk stratification and targeted prevention.