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01.
medRxiv (Medicine) 2026-06-12

Microbial etiology, antibiotic susceptibility profiles, and multidrug resistance of urinary tract infections at a secondary healthcare facility in Ghana

作者:
Agyapong↗J. K↗Damalie↗Dombawel↗Noah↗Balo↗Acheampong↗Kudzordzi↗P.-C↗Nyarko↗Ofori↗D. K↗…

Background: Rising antibiotic resistance challenges empirical therapies for urinary tract infections (UTIs). This study evaluated the microbial etiology, susceptibility profiles, and multidrug resistance (MDR) patterns of uropathogens among outpatients at the Berekum Holy Family Hospital, Ghana. Methods: This cross-sectional study (February to August 2021) screened 263 symptomatic outpatients. Mid-stream urine samples underwent quantitative culture, biochemical identification, and antimicrobial susceptibility testing via the Kirby-Bauer disc diffusion method following the 2021 CLSI guidelines. Results: Significant bacteriuria prevalence was 22.8% (60/263). UTIs predominated in females (78.3%, 47/60; p = 0.1501) and individuals [≥]45 years (33.3%, 20/60). Gram-negative rods accounted for 90.0% of isolates, primarily Escherichia coli (26.7%), Citrobacter spp. (25.0%), and Enterobacter spp. (21.7%); Staphylococcus aureus (10.0%) was the only Gram-positive pathogen. Extreme phenotypic resistance was observed against piperacillin/tazobactam (98.3%), cefotaxime (93.3%), tetracycline (88.3%), and cefoperazone (85.0%). Conversely, highest therapeutic susceptibilities were retained by amikacin (78.3%), levofloxacin (61.7%), and gentamicin (58.3%). Conclusion: The high prevalence of MDR uropathogens against advanced beta-lactamase inhibitor combinations and cephalosporins necessitates an immediate re-evaluation of regional empirical protocols. Amikacin, levofloxacin, and gentamicin remain viable options prior to culture confirmation. These findings establish a crucial phenotypic baseline to guide localized prescribing policies and regional antimicrobial resistance tracking strategies.

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02.
arXiv (CS.CV) 2026-06-18

Moving Beyond Diversity: Visual Token Pruning as Subspace Reconstruction for Efficient VLMs

作者:
Jaeyeon Lee↗Shunjie Wen↗Dong-Wan Choi↗

Despite their remarkable performance, Vision Language Models (VLMs) incur substantial computational overhead due to the large number of visual tokens. While diversity maximization has become a dominant strategy for token reduction, existing methods rely on cosine-based normalized similarity that discards magnitude information, failing to faithfully approximate the original feature representation and leading to suboptimal performance, particularly on compositional multi-skill reasoning tasks. In this paper, we introduce SPARE, a subspace reconstruction method that reformulates token pruning as a column subset selection problem and explicitly minimizes reconstruction error. By iteratively selecting tokens with large projection residuals, SPARE performs reconstruction-driven pruning beyond angular diversity. Moreover, we reveal a counterintuitive anti-relevance phenomenon: tokens with lower image-text relevance score can better preserve contextual information. Based on this finding, we incorporate anti-relevance into SPARE as an additional selection criterion to promote context-aware token selection. Extensive experiments across multiple VLMs and benchmarks demonstrate that SPARE consistently achieves state-of-the-art performance, with strong gains on compositional tasks. When applied to LLaVA, SPARE removes up to 94% of visual tokens while retaining 95% of the baseline performance, all in a fully training-free manner.

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03.
arXiv (CS.AI) 2026-06-16

NeuronFabric: A Software Reference Architecture for On-Chip Transformer Training with Local Adam

作者:
Evgeny Ukladchikov↗

arXiv:2606.16440v1 Announce Type: cross Abstract: Publicly documented accelerator architectures generally separate training computation from optimizer-state updates or rely on external memory and host orchestration. This paper presents NeuronFabric, a software reference architecture intended for future FPGA and ASIC implementations of transformer training with local Adam updates. A complete C# prototype implements forward pass, backpropagation, and Adam optimization without external machine-learning frameworks. The goal is to validate numerical correctness and memory requirements before hardware implementation. The evaluated model is a 334K-parameter autoregressive transformer (d=88, H=4, f=264, L=4, vocab=256) trained on the Shakespeare corpus. The BF16W configuration achieves evaluation loss 1.5426 after 80K samples, compared with 1.5224 for an FP32 GPU reference, while producing coherent character-level text. The paper introduces BF16W, which stores weights in BF16 while retaining Adam optimizer moments in FP32. This reduces memory requirements for on-chip training. A 334K-parameter FP32 model with Adam moments requires approximately 4.0 MB, matching the BRAM capacity of a Xilinx ZCU102 device. The BF16W variant requires approximately 3.34 MB, leaving memory available for activation storage. We describe the vocabulary-budget constraint observed during earlier experiments, quantify BF16W memory savings, and outline FPGA training as the next stage of development. No FPGA measurements are included in this paper. This publication serves as a public architectural disclosure and software reference implementation for future FPGA and ASIC exploration of the NeuronFabric architecture.

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04.
arXiv (math.PR) 2026-06-17

How long does it take to train an Elephant Random Walk

作者:
Zheng Fang↗

arXiv:2509.15049v2 Announce Type: replace Abstract: We study how conditioning on the first $k$ steps, which we think of as training, affects the long-term behavior of the Elephant Random Walk. When the elephant is conditioned to be at position $k$ at time $k$, the first return time to the origin scales as $k^{(4-4p)/(3-4p)}$ in the diffusive regime, and grows exponentially in the critical regime. We loosely interpret this as a measurement of the rate at which the elephant forgets its training.

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05.
medRxiv (Medicine) 2026-06-22

Genetic modifiers of psychiatric, motor, and cognitive symptoms in Huntington's disease

作者:
Li↗Q. S↗Regeneron Genetic Center↗Kwak↗Sampaio↗Vogt↗T. F↗Rosinski↗

The Enroll HD natural history platform provides rich longitudinal phenotypes enabling genome wide analyses across diverse clinical domains. Psychiatric symptoms are a major source of morbidity in Huntington's disease (HD), yet the genetic architecture underlying their onset is poorly understood. We analyzed ~18,000 people with HD (PwHD) to define genetic determinants of ages at psychiatric, motor, and cognitive symptom onset, and HD diagnosis. GWAS meta analysis recapitulated 11 established modifiers of motor onset and identified a novel locus spanning RAB3B/ZFYVE9 associated with age at violent/aggressive behavior onset. Exome wide analyses in Enroll HD participants implicated rare variants in FAN1, PMS1, POLD1, and HTT. Several HD modifiers of motor and cognitive symptom onset (MSH3, FAN1, HTT) also influenced psychiatric symptom onset, whereas PMS1 and POLD1 showed significant association with motor symptom onset. Psychiatric polygenic scores predicted psychiatric symptom onset, revealing a hybrid architecture combining psychiatric liability in general population with HD- or repeat expansion disease (RED) specific pathways.

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

Divide-and-Denoise: A Game-Theoretic Method for Fairly Composing Diffusion Models

作者:
Abhi Gupta↗Polina Barabanshchikova↗Vikas Garg↗Samuel Kaski↗Tommi Jaakkola↗

The abundance of pre-trained diffusion models provides an opportunity for composition. Combining several models, however, runs the risk of one model dominating or models disagreeing with each other. Here, we propose Divide-and-Denoise, a method for coordinating multiple pre-trained diffusion models during sampling. Much like managing a specialized workforce, our method creates a fair but efficient division of labor across models. Central to our method is the notion of an allocation which defines the responsibility of each model to every region of the noisy sample. At every timestep, we then denoise by (i) updating the allocation by solving a fair division game, where we divide the sample into regions that maximize total utility under fairness constraints, and (ii) aligning the models with this allocation, where we guide each model to denoise within its assigned region. This leads to a new composite denoising process that evolves in tandem with a division process. We evaluate Divide-and-Denoise on conditional image generation. Across several quality metrics, including the GenEval benchmark, our method outperforms baselines and resolves common failures including missing objects and mismatched attributes. Experiments show that Divide-and-Denoise utilizes each model's expertise without neglecting any other model.

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07.
arXiv (CS.AI) 2026-06-24

Legal Reasoning Is Not Lawyering: Rethinking Legal Benchmarks for Pro Se Access to Justice

作者:
Andrew Lou↗David Shin↗

arXiv:2606.23716v1 Announce Type: cross Abstract: Legal AI benchmark research frequently invokes the assumption that large language models can improve access to justice, including for people who cannot access lawyers in order to understand and exercise their legal rights. We argue that current benchmarks are not equipped to support this assumption because they evaluate legal reasoning over inputs that have already been preprocessed by legal experts, which measures the upper bound of model performance. Access to justice depends on a lower bound: how models perform when inputs come from pro se litigants, whose prompts may contain noisy narratives, buried facts, omissions, folk-legal assumptions, and surface-level errors. These degradations are comparable to conditions under which LLMs are known to degrade in the general machine learning literature, including long-context sensitivity, underspecification, hallucination, and typographical perturbations. We connect evidence from pro se literature with this body of machine learning research and present a small perturbation experiment on LEXam, a legal benchmark, to illustrate the gap between these two bounds. If model development continues to focus on benchmarks that measure only the upper bound, this gap may remain hidden or even widen. We conclude by calling for legal benchmarks that directly measure robustness under pro se-like inputs so that access-to-justice claims about legal AI can become empirically testable.

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08.
medRxiv (Medicine) 2026-06-15

An epidemiological scenario for Mass Events During the World Cup

作者:
Velasco-Hernandez↗J. X↗

This brief work discusses potential superspreading events that may occur during the World Cup in Mexico. The study is particularly focused on the city of Guadalajara due to a large recent outbreak in January and February and insufficient vaccine coverage prior to 2026. Keywords: Superspreading; measles outbreak; branching process; individual reproduction number; World Cup

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09.
arXiv (math.PR) 2026-06-16

Uniform integrability of the distance to the nearest leaf in random trees

作者:
V\'ictor J. Maci\'a↗Benedikt Stufler↗

arXiv:2606.15339v1 Announce Type: new Abstract: We study the distance from the root to the nearest leaf, the analogous quantity for a uniformly chosen vertex, and its protection number, in size-conditioned simply generated trees. We prove a uniform exponential tail bound for each of these quantities, valid for arbitrary offspring distributions. As a consequence, these random variables are uniformly integrable of every order. This yields convergence of all moments to those of the corresponding local limit. The argument is probabilistic and unified across the three quantities.

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

Cross-Silo De-Anonymization Under Local Differential Privacy: Threat Model, Phase Transition, and Coordination Necessity

作者:
Ziniu Liu↗Aiping Li↗

arXiv:2606.16763v1 Announce Type: cross Abstract: When a person's records appear in k independent data silos, each protected by (epsilon, delta)-differential privacy, standard composition yields a valid (k*epsilon, k*delta)-DP guarantee for the joint output. This worst-case bound, however, does not answer the concrete inference question: at what k can an adversary actually identify a target person? This paper develops the information-theoretic framework needed to answer that question. We introduce cross-silo person-level DP (XSP-DP), a Pufferfish-style privacy notion whose adjacency relation captures all records of a single person across all silos simultaneously, and verify that the standard basic composition bound carries over to this adjacency model. Within this framework we prove that de-anonymization undergoes a phase transition at k* = Theta(log n / epsilon^2) (population size n, per-silo RR parameter epsilon): a Fano lower bound shows any estimator fails for k > k*. An explicit XOR + randomized-response construction demonstrates information synergy: each silo's output is individually uninformative about the target, yet the joint mutual information is strictly positive. For non-coordinated binary randomized-response mechanisms, we prove that de-anonymization is inevitable once k exceeds the threshold, establishing that cross-silo coordination is necessary. These results provide a baseline threat model and Theta-level threshold for cross-silo inference attacks under local DP.

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

Relational Retrieval: Leveraging Known-Novel Interactions for Generalized Category Discovery

作者:
Yulin Xu↗Chunqi Guo↗Yuanzhen Shuai↗Jianyuan Ni↗

In this study, we tackle Generalized Category Discovery (GCD) via a Relational Retrieval perspective, explicitly coupling labeled and unlabeled data through bidirectional knowledge transfer. While existing methods treat these sources separately, missing valuable interaction opportunities, we propose Relational Pattern Consistency (RPC) that enables mutual enhancement. RPC employs One-vs-All classifiers for soft ID/OOD decomposition, then introduces two mechanisms: (i) for known-class preservation, we transfer semantic behavioral alignment; (ii) for category discovery, we leverage the insight that samples from the same category maintain invariant relationships with known-class prototypes, transforming unreliable pseudo-labeling into well-defined relational pattern matching. This bidirectional design allows labeled data to guide unlabeled learning while discovering novel categories through their collective relational signatures. Extensive experiments demonstrate RPC achieves state-of-the-art performance on both generic and fine-grained benchmarks.

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12.
arXiv (CS.LG) 2026-06-17

Amortizing Maximum Inner Product Search with Learned Support Functions

作者:
Theo X. Olausson↗Jo\~ao Monteiro↗Michal Klein↗Marco Cuturi↗

arXiv:2603.08001v2 Announce Type: replace Abstract: Maximum inner product search (MIPS) is a crucial subroutine in machine learning, requiring the identification of a vector taken within a database (the keys) that best aligns with a given query. We propose amortized MIPS: a regression-based approach that trains neural networks to directly predict MIPS solutions, amortizing the cost of repeatedly solving MIPS for queries drawn from a known distribution over a fixed key database. Our key insight is that the MIPS value function is the support function of the set of keys, a well-studied convex function whose gradient yields the optimal key. This motivates two complementary amortized models: SupportNet, an input-convex neural network trained to regress the support function, and KeyNet, a vector-valued network that directly regresses the optimal key. SupportNet can serve as a cluster router, steering queries toward relevant database partitions, while KeyNet can be used as a drop-in replacement for the original query, fed directly to off-the-shelf indexing pipelines. Our experiments on the BEIR benchmark show that, for document embeddings, learned \SupportNet{}s and \KeyNet{}s significantly improve IVF match rates when accounting for compute effort, whether measured in FLOPs, number of probes, or wall-clock time. Our code is available at: https://github.com/apple/ml-amips.

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

Towards Global AI-Driven Cervical Cancer Screening

作者:
Thuy Nuong Tran↗\"Omer S\"umer↗Evangelia Christodoulou↗Lennart Nausch\"utte↗Simon Kalteis↗Martin Paulikat↗Esmira Pashayeva↗Klara Steinheuer↗Isabella Borges↗Piotr Kalinowski↗Hermann Bussmann↗Sieng Sokmney↗…

The global elimination of cervical cancer is a key public health goal set by the World Health Organization (WHO), with screening programs reducing mortality by up to 80%. However, access to experts and biopsy services is limited in low- to middle-income countries (LMICs). Deep learning (DL)-based algorithms offer promising support for screening, but most existing approaches have been developed and validated on private datasets from single countries. We present the first DL-based approach to cervical cancer screening validated on data from multiple countries. Technically, we phrase the problem of detecting and classifying lesions in colposcopy images as a multi-task learning problem, in which we simultaneously perform image-level classification and lesion segmentation. Our model was trained on a private data set of acid stain colposcopy images with manually generated lesion segmentation masks and corresponding histopathological results, employing extensive data augmentation to address image variability. In an in-distribution validation with pathology results serving as ground truth, our algorithm outperformed medical experts (Balanced Accuracy: 0.68 vs 0.64) in CIN1- (Cervical intraepithelial neoplasia grade 1 or lower) versus CIN2+ (grade 2 or higher) classification. External validation on four colposcopy data sets from four countries featuring radical differences in prevalence and patient characteristics yielded superior performance of our method compared to baseline methods. Performance variability across countries was high with AUC values ranging from 0.54 - 0.80. Overall, algorithm performance varied with age, transformation zone (cervical area most prone to lesion development), presence of comorbidities and pathognomonic signs, with comorbidities having by far the largest negative effect. Future work should focus on improving model robustness and generalizability.

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

S4oP: Operator-level Pruning of Structured State Space Models for Resource-Constrained Devices

作者:
Marco Deano↗Filippo Ziche↗Nicola Bombieri↗

arXiv:2606.18096v1 Announce Type: cross Abstract: Structured State Space Models (SSMs), including the S4 and S4D architectures, have recently emerged as powerful alternatives to attention-based models for capturing long-range dependencies in sequential data. Despite their strong empirical performance, deploying these models in time- and resource-constrained settings remains challenging due to their computational and memory demands. In this paper, we propose a novel incremental, operator-level pruning approach for S4- and S4D-based models that significantly reduces inference cost while preserving predictive performance. To the best of our knowledge, this is the first work to systematically investigate structured operator pruning for SSMs. Our method progressively prunes model operators by interleaving structured masking with fine-tuning, while jointly monitoring accuracy and inference latency. We implement this approach within a unified training and evaluation framework that enables systematic exploration of efficiency-accuracy trade-offs. Experiments across multiple benchmark datasets show that pruning up to 70% of the model operators preserves the performance of the original models in most cases, while substantially reducing inference latency. These results demonstrate that structured operator pruning is an effective and previously unexplored strategy for improving the efficiency of SSMs and facilitate their deployment in practical, resource-constrained scenarios.

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

Scaling Adaptive Depth with Norm-Agnostic Residual Networks

作者:
Tom\'as Figliolia↗Beren Millidge↗

arXiv:2606.16112v1 Announce Type: cross Abstract: Residual architectures are ubiquitous in deep learning, but they suffer from a subtle structural limitation: the norm of the residual stream can grow rapidly with depth. As a result, updates from later layers become small relative to the accumulated residual state. This reduces their impact on the representation and limits the benefits of scaling models in depth. To address this, we introduce NAG, a norm-agnostic residual architecture that separates magnitude from directional information in the residual stream, preserving meaningful layer contributions throughout depth and preventing later updates from being systematically suppressed by residual-norm growth. Importantly, NAG introduces only a negligible number of additional parameters and relies on simple operations that are easily kernel-fusible, preserving training efficiency in practice. We show that this architecture outperforms baseline Transformers, with gains that increase substantially as depth grows, enabling effective training of much deeper models. The norm-agnostic formulation also leads to an interpretable Mixture-of-Depths (MoD) mechanism that adaptively skips both attention and MLP layers. Beyond serving as a post-training accuracy-compute tradeoff, this mechanism can be used as a pretraining-time scaling strategy: under iso-FLOP training, compute saved by reducing per-token forward-pass cost can be reinvested into training on more tokens while keeping the total parameter count and KV-cache budget fixed. In our experiments, moderate Mixture-of-Depths rates of approximately 20%-25% match full-depth baseline performance under equal training compute while substantially reducing the number of executed layer parameters and forward-pass FLOPs. These results identify sparsity in depth as a new scaling axis for fixed-compute training, enabling very deep yet FLOP-efficient models.

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

Effective and Low-cost Lane-based Map Localization for Vehicle-Centric Route Generation

作者:
Hong-Shiang Lin↗Jung-Hsin Chen↗Yu-Luen Tzeng↗Wei-Hao Chen↗Yi-Chen Lee↗Li-Jhe Chen↗Peng-Yuan Chen↗

Driver-centric route representation plays a vital role in intuitive driving guidance systems. This paper presents OLRA, a low-cost, map-localization-based framework that derives driver-view-aligned routes by matching map-based navigation routes with camera-detected lane markings. This alignment process mutually enhances vehicle localization accuracy and visual route consistency. To bridge the evaluation gap across different paradigms, we introduce practical route evaluation metrics and benchmark OLRA against OpenPilot, a representative direct-generation approach. Experimental results on the nuScenes dataset demonstrate that OLRA outperforms OpenPilot in complex road segments and in route estimation at distance beyond 20 meters, achieving lower overall Euclidean error. This study is expected to promote future research in low-cost, maplocalization-based route generation methods.

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18.
PLOS Medicine 2026-05-13

Contribution of nosocomial transmission to <i>Klebsiella pneumoniae</i> neonatal sepsis in Africa and South Asia: An observational study of infection clusters inferred from pathogen genomics and temporal data

作者:
Erkison Ewomazino Odih↗

by Erkison Ewomazino Odih, Jabir A. Abdulahi, Anne V. Amulele, Matthew Bates, Eva Heinz, Weiming Hu, Kajal Jain, Rindidzani Magobo, Courtney P. Olwagen, John M. Tembo, Tolbert Sonda, Jonathan Strysko, Caroline C. Tigoi, Kyle Bittinger, Jennifer Cornick, Ebenezer Foster-Nyarko, Wilson Gumbi, Steven M. Jones, Chileshe L. Musyani, Carolyn M. McGann, Ahmed M. Moustafa, Patrick Musicha, James C. L. Mwansa, Moreka L. Ndumba, Thomas D. Stanton, Donwilliams O. Omuoyo, Oliver Pearse, Laura T. Phillips, Paul J. Planet, Charlene M. C. Rodrigues, Fatou Secka, Kirsty Sands, Erin Theiller, Allan M. Zuza, Sulagna Basu, Grace J. Chan, Kenneth C. Iregbu, Jean-Baptiste Mazarati, Semaria Solomon Alemayehu, Timothy R. Walsh, Rabaab Zahra, Angela Dramowski, Sombo Fwoloshi, Appiah-Korang Labi, Lola Madrid, Noah Obeng-Nkrumah, David Ojok, Boaz D. Wadugu, Andrew C. Whitelaw, Anudita Bhargava, Atul Jindal, Ramesh K. Agarwal, Alexander M. Aiken, James A. Berkley, Susan E. Coffin, Nicholas A. Feasey, Nelesh P. Govender, Davidson H. Hamer, Shabir A. Madhi, Mari Jeeva Sankar, Kelly L. Wyres, Kathryn E. Holt Background Klebsiella pneumoniae is the leading cause of sepsis among neonates in low- and middle-income countries (LMICs) in Africa and Asia, contributing substantially to the overall burden of antimicrobial-resistant infections and mortality among neonates globally. Pathogen sequencing has been used to investigate case clusters and confirm nosocomial transmission in a small number of neonatal units. Here we utilise pathogen sequence data to estimate the fraction of K. pneumoniae neonatal sepsis attributable to nosocomial transmission in African and South Asian countries. Methods and findings We estimated the proportion of invasive K. pneumoniae disease involved in nosocomial transmission clusters in a given neonatal unit, using single-linkage clustering based on pairwise temporal and genetic distances estimated from bacterial whole-genome sequences aggregated from 10 contributing studies. Analysing 1,523 K. pneumoniae isolates from 27 units in 13 countries in Africa and South Asia between 2013 and 2023, we inferred 156 nosocomial transmission clusters, ranging from 2 to 188 neonates each (83 of the clusters comprised ≥3 cases). Overall, we estimated that 1,035 neonatal infections (68.0%) were part of nosocomial transmission clusters. Excluding the first infection in each cluster as a potential index case, we estimate at least 879 (57.7%) infections were acquired via nosocomial transmission. Sensitivity analyses showed that results were robust to the choice of genetic distance estimation methods and thresholds used to define clusters, and cluster estimates were stable over temporal distance thresholds ranging from 2 to 8 weeks. Isolates were mostly extended-spectrum beta-lactamase (ESBL) producers (90.9%) and included 172 multi-locus sequence types (STs). Fourteen STs, including several globally recognised multidrug-resistant lineages, were associated with transmission clusters at multiple units, and these were collectively responsible for two-thirds of all infections. Carriage of carbapenemase genes (adjusted odds ratio, aOR = 2.08 [95% confidence interval, CI: 1.04, 4.14]; p = 0.04) and ESBL genes (aOR = 2.48 [95% CI: 1.26, 4.90]; p = 0.006) were significantly positively associated with transmission in a logistic regression model with site as a covariate. Limitations of this study include the lack of sufficient clinical data to allow high-resolution investigation of transmission dynamics and lack of facility-level data to investigate contributors to the observed differences in transmission burden across sites. Conclusions Nosocomial transmission contributes to a substantial proportion of K. pneumoniae sepsis in neonatal care units in Africa and South Asia. Reducing transmission within these settings through improved infection prevention and control and other measures could substantially reduce the neonatal sepsis burden. A high burden of transmission clusters is associated with the same drug-resistant lineages that are recognised as high-risk clones associated with hospital outbreaks in high-income countries, indicating global connectivity of the antimicrobial-resistant pathogen population.

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

Med-R2: Perception and Reflection-driven Complex Reasoning for Medical Report Generation

作者:
Hao Wang↗Shuchang Ye↗Jinghao Lin↗Usman Naseem↗Jinman Kim↗

Automated medical report generation (MRG) is increasingly used to reduce the burden of manual reporting and for decision support. Large vision-language models (LVLMs) hold great promise for automated MRG due to their fine-grained image-text alignment and advanced text-generation capabilities. Currently, state-of-the-art MRGs primarily focus on adapting pre-trained LVLMs with direct supervised fine-tuning (SFT), a fine-tuning strategy with medical image-report pairs. However, several factors limit the performance of these LVLMs. Firstly, direct SFT enables LVLMs to generate medical reports directly without an intermediate thinking process of pathological feature perception and diagnostic reasoning. This causes a potential failure to perceive pathological features and thus leads to misdiagnosis. Secondly, direct SFT lacks the incorporation of radiology-specific knowledge guidance, causing LVLMs to misinterpret perceived pathological features and make incorrect diagnoses. To address these gaps, we propose a novel fine-tuning strategy named Med-R2. We introduce a perception-driven long reasoning process that precedes report generation and incorporates radiology-specific knowledge as guidance. Additionally, to alleviate potential perceptual errors in complex reasoning, a reflection mechanism is introduced to refine the perception of pathological features and the generated report. Our experiments demonstrate that Med-R2 effectively enhances the capability of pathological features perception and diagnosis accuracy for MRG via fine-tuned LVLMs.

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20.
medRxiv (Medicine) 2026-06-16

Adherence to Red Reflex and Vision Screening Recommendations: A Deep Dive into Primary Care Implementation Gaps

作者:
Asare↗A. O↗Robles↗Hartmann↗E. E↗Stipelman↗Calder↗Omotowa↗Montgomery↗Baugh↗B. T↗Stagg↗…

Introduction: Early childhood vision screening is critical for detecting amblyopia and other vision-threatening conditions. Despite screening recommendations during well-child visits, rates remain low. Red reflex assessment is recommended to identify serious ocular pathology, yet its use in primary care is not well described. We examined rates and drivers of vision screening in pediatric primary care. Methods: We conducted a retrospective review of electronic health records for children 3 to 5 years attending well-child visits in 2022 in one of three representative primary care clinics within a university health system. Outcomes were documented red reflex and functional vision tests. We evaluated associations with patient demographics and clinic site using multivariable logistic regression Results: Among 1,003 visits, 21.1% (n=212) had a documented red reflex assessment, and 60.8% (n=610) a functional vision test. Younger children (ages 3 and 4 vs. 5 years) had higher odds of red reflex assessment [adjusted odds ratio (aOR) 9.00 and 8.64], and lower odds of a functional vision (aOR 0.47 and 0.59) test. Females had higher odds of red reflex assessment (aOR 1.53). Other/Multiracial children had lower odds of red reflex assessment than Non-Hispanic White children (aOR 0.48). Screening rates varied significantly by clinic site Conclusions: Visual function and red reflex assessment are inconsistently performed in pediatric primary care, with particularly low rates of red reflex documentation. Screening rates varied between clinics and were affected by age. These findings highlight missed opportunities for early detection of vision-threatening conditions and identify targets for improving adherence to pediatric vision screening recommendations

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21.
arXiv (quant-ph) 2026-06-19

QMCtwin: Master-Equation Simulation of Syndrome Statistics Beyond Pauli Noise

作者:
Tong Shen↗Huo Chen↗Benchen Huang↗Tyler Takeshita↗Arian Vezvaee↗Izhar Medalsy↗Daniel A. Lidar↗

arXiv:2606.19848v1 Announce Type: new Abstract: As quantum error correction moves toward large-scale experimental implementations, decoder performance increasingly depends on how faithfully hardware noise is translated into syndrome statistics. Standard stabilizer workflows achieve scalability by replacing device dynamics with stochastic Pauli or detector-error models, but this compression can discard coherent phase information, nonunital drift, continuous-time effects of always-on couplings, and correlations generated by simultaneous Hamiltonian and dissipative evolution. Here we present QMCtwin, a sign-problem-suppressed quantum Monte Carlo framework for master-equation simulation of QEC circuits, and apply it to a full syndrome-extraction round of a distance-$7$ rotated surface code with $97$ physical qubits. The open-system model includes realistic superconducting-device noise mechanisms such as relaxation, pure dephasing, coherent gate miscalibration, residual $ZZ$ crosstalk, and drive-qubit detuning. By directly estimating syndrome observables from the QMC-generated stochastic density matrix estimator, we compare the master-equation dynamics with their Pauli-twirled Clifford simulation counterparts. QMCtwin predicts syndrome-extraction biases and correlations between syndromes and proxies of logical-string-parity that are absent or strongly suppressed in the stochastic Pauli description. We introduce information-theoretic diagnostics that further quantify how information concerning syndromes versus string-parity proxies differs between the realistic master-equation simulation and the corresponding Pauli-twirled model. These results show that QMC-based master-equation digital twins can expose noise features hidden by conventional Pauli/Clifford noise models and provide a practical path toward more accurate decoder-facing syndrome models.

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22.
arXiv (CS.LG) 2026-06-15

On the Geometry and Optimization of Polynomial Convolutional Networks

作者:
Vahid Shahverdi↗Giovanni Luca Marchetti↗Kathl\'en Kohn↗

arXiv:2410.00722v3 Announce Type: replace Abstract: We study convolutional neural networks with monomial activation functions. Specifically, we prove that their parameterization map is regular and is an isomorphism almost everywhere, up to rescaling the filters. By leveraging on tools from algebraic geometry, we explore the geometric properties of the image in function space of this map - typically referred to as neuromanifold. In particular, we compute the dimension and the degree of the neuromanifold, which measure the expressivity of the model, and describe its singularities. Moreover, for a generic large dataset, we derive an explicit formula that quantifies the number of critical points arising in the optimization of a regression loss.

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

CoffeeBench: Benchmarking Long-Horizon LLM Agents in Heterogeneous Multi-Agent Economies

作者:
Issa Sugiura↗Daichi Hattori↗Kazuo Araragi↗Keita Ogawa↗Shota Onose↗Taro Makino↗Teppei Usuki↗Takashi Ishida↗

arXiv:2606.16613v1 Announce Type: new Abstract: As LLM agents become capable of increasingly long-horizon tasks, evaluating their performance in economic systems is becoming increasingly important. Unlike existing benchmarks that primarily evaluate a single agent interacting with a passive environment, economic systems are inherently multi-agent, requiring autonomous agents to communicate, negotiate, and transact while pursuing their own objectives over extended periods. We introduce CoffeeBench, a benchmark for evaluating LLM agents in a long-horizon multi-agent economy composed of heterogeneous firms. In CoffeeBench, two farmers, two roasters, and two retailers autonomously operate their businesses over a 90-day simulation, each seeking to maximize cumulative net income through communication and transactions while managing cash, inventory, and pricing. The evaluated model controls one coffee roaster, while the remaining firms are controlled by fixed reference agents. Across several recent open-weight and proprietary LLMs, all models outperform a passive baseline that takes no actions, with most achieving positive net income. Analysis of agent behavior reveals substantial differences in long-horizon economic interaction: higher-performing models communicate more actively with other firms, whereas Claude~Haiku~4.5 exhibits an idle-drift failure mode, repeatedly choosing inaction despite producing coherent assessments and plans. We release our code and agent trajectories to support future research.

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25.
arXiv (CS.CL) 2026-06-12

MemRefine: LLM-Guided Compression for Long-Term Agent Memory

作者:
Minjae Kim↗Jinheon Baek↗Soyeong Jeong↗Sung Ju Hwang↗

Large language model (LLM) agents are increasingly expected to operate over long-term interactions, where information from past dialogues must be preserved and recalled to support future tasks. However, as interactions accumulate, the memory store grows without bound and fills with redundant entries that inflate storage cost and degrade retrieval by crowding out the most useful evidence. Furthermore, this is especially limiting on resource-constrained platforms with hard memory budgets, motivating us to formulate storage-budgeted memory management, the task of keeping an already constructed memory store within a fixed budget while preserving information useful for future interactions. To this end, we then propose MemRefine, an LLM-guided framework that, since surface similarity poorly reflects factual value, uses similarity only to propose candidate pairs and defers delete, merge, and preserve decisions to an LLM judge based on factual content, iterating until the budget is met. Across multiple memory frameworks and long-term conversation benchmarks, MemRefine consistently meets target budgets while preserving downstream performance and outperforming rule-based baselines under tight budgets.

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