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01.
medRxiv (Medicine) 2026-06-11

Hantavirus Disease in Uruguay: Trends and Mortality Before and During the COVID-19 Pandemic.

Introduction: Hantavirus disease is an emerging and potentially severe zoonosis of global distribution. In Uruguay, it is transmitted by rodents inhabiting peridomestic, suburban, and rural areas. Global incidence is estimated at 150,000 to 200,000 cases per year, with up to 300 annual cases in the Americas. Since 1997, Uruguay's Ministry of Public Health (MPH) has monitored Hantavirus cardiopulmonary syndrome (HCPS), the most common clinical presentation in the region. By 2019, a total of 271 cases had been identified in the country, with an estimated mortality rate of nearly 50%. Objectives: To describe the clinical, epidemiological, and occupational characteristics of patients with Hantavirus disease in Uruguay during the pre-pandemic (2018-2019) and pandemic (2020-2021) periods. Methods: A descriptive, cross-sectional, observational study was conducted, including all serologically confirmed cases of Hantavirus infection reported to the MPH between 2018 and 2021. Clinical and demographic data were extracted from the mandatory reporting form for zoonotic diseases. Incidence and case fatality rates were calculated, and factors associated with fatal outcomes were analyzed. Results: A total of 58 confirmed cases were identified between 2018 and 2021. Most patients were male (62%), with a mean age of 36.5 years (SD 16). A decline in incidence was observed during 2020-2021, with no significant change in case fatality. Direct rodent exposure was the most frequently associated risk factor. Montevideo and Canelones were the most affected departments. Renal and pulmonary involvement were significantly associated with mortality. Conclusion: Hantavirus remains a relevant public health concern in Uruguay. Although a decrease in incidence was observed during the COVID-19 pandemic years, case fatality rates remained high. The findings underscore the need for sustained surveillance and early recognition, particularly in urbanizing regions.

02.
arXiv (CS.AI) 2026-06-15

Generative AI for Managerial Decision-Making under Ambiguity and Sycophancy

arXiv:2603.03970v2 Announce Type: replace Abstract: Generative artificial intelligence (GenAI) is increasingly being integrated into complex business workflows, fundamentally shifting the boundaries of managerial decision-making. However, the reliability of its strategic advice in ambiguous business contexts remains a critical knowledge gap. To address this gap, this study compares multiple GenAI models in their ability to detect ambiguity, examines whether a systematic ambiguity-resolution process improves response quality, and investigates their susceptibility to sycophantic behavior when confronted with flawed managerial directives. Using a novel four-dimensional business ambiguity taxonomy, we conducted a human-in-the-loop experiment across strategic, tactical, and operational scenarios. The resulting decisions were assessed through a human-validated automated evaluation framework based on agreement, actionability, justification quality, and constraint adherence. The results show that our approach not only distinguishes different types of ambiguity, but also reveals how ambiguity resolution systematically changes model behavior. In particular, resolving ambiguities improved decision quality across all managerial levels, with the strongest gains observed in constraint adherence. The analysis further showed that sycophantic behavior is not uniform across models: some models challenged flawed assumptions, whereas others tended to comply with them. This study contributes to the bounded rationality literature by positioning GenAI as a cognitive scaffold that can detect and resolve ambiguities managers might overlook, while demonstrating that its artificial limitations require human oversight to ensure its reliability as a strategic partner.

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

DiffCold: A Diffusion-based Generative Model for Cold-Start Item Recommendation

arXiv:2606.12245v1 Announce Type: cross Abstract: Cold-start item recommendation remains a persistent challenge in real-world systems due to the absence of interaction histories. While prior models attempt to bridge this gap using item content features, they universally suffer from the seesaw dilemma: enhancing performance for cold items inevitably degrades performance for warm items, and vice versa. We identify that this dilemma stems from a fundamental distributional disparity: warm item embeddings occupy a complex ``behavioral manifold" shaped by rich interaction signals, whereas cold item embeddings are constrained to a ``semantic manifold" derived solely from auxiliary content. Existing methods often force a rigid mapping between these inconsistent spaces, causing the model to sacrifice the precision of warm representations to accommodate cold ones. To address this, we propose DiffCold, a diffusion-based generative model that unifies warm and cold representations. Unlike GANs or VAEs, DiffCold leverages conditional diffusion to reconstruct warm item embeddings from content, preserving the underlying manifold structure without degradation. We further tailor this paradigm with two specific designs: a Retrieval-enhanced Aggregator that initializes generation using semantically similar warm items to bypass inefficient noise, and a Simulation-based Representation Alignment module that enforces distribution consistency between generated and real embeddings via contrastive learning. Experiments on three benchmarks confirm that DiffCold resolves the seesaw dilemma, consistently outperforming state-of-the-art methods across all metrics.

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

CaVe-VLM-CoT: An Interpretable Vision-Language Model Framework

arXiv:2606.18385v1 Announce Type: new Abstract: Vision-Language Models (VLMs) remain prone to hallucinations, producing fluent but visually unfaithful outputs. Existing chain-of-thought and retrieval-augmented methods only partially address this, as they neither enforce step-level citation grounding nor route verification failures back to retrieval for correction. We present CaVe-VLM-CoT, a modular reflection-based agentic-RAG framework that enforces evidence-grounded reasoning through a five-stage closed-loop pipeline: Extractor, Retriever, Solver, Citation Injector, and Verifier, in which detected ungrounded claims trigger structured feedback to the Extractor for targeted re-retrieval. Since no existing framework jointly measures retrieval quality, step-wise citation faithfulness, and cross-modal grounding, we propose a suite of 23 component-wise metrics across all stages, anchored by CaVeScore, a composite metric weighting accuracy, citation precision and recall, attribution, and evidence grounding. Without any architectural or prompt modifications, CaVe-VLM-CoT achieves 87.1\% accuracy and 56.6\% CaVeScore on ScienceQA , and 55.2\% accuracy and 35.7\% CaVeScore on MMMU (30 subjects).

05.
bioRxiv (Bioinfo) 2026-06-11

TifBERT: a self-supervised foundation model for normalization-robust bulk RNA-seq representation learning

Bulk RNA sequencing remains central to translational genomics, yet foundation-model development has largely focused on single-cell data. Existing transformer approaches for bulk RNA-seq often rely on expression discretization, numerical reconstruction, external gene embeddings, or restricted gene sets, limiting robustness across normalization schemes and cohorts. Here, we introduce TifBERT, a self-supervised framework for full-transcriptome bulk RNA-seq representation learning. TifBERT converts each unordered expression profile into a sample-specific gene sequence using term frequency-inverse document frequency (TF-IDF) ordering, prioritizing genes that are both highly expressed within a sample and selectively expressed across the cohort. It is then pretrained using masked gene modeling, predicting gene identities from transcriptomic context rather than reconstructing expression values. Pretrained on harmonized TCGA Pan-Cancer data spanning five RNA-seq normalization schemes, TifBERT learns contextual representations across approximately 10,000 genes without expression binning, landmark-gene restriction, or external biological embeddings. Across 33 TCGA cancer types, TifBERT achieved 90.83% accuracy, 0.996 macro AUC-ROC, and 0.903 MCC. It also captured pathway-level biology, achieving mean sample-wise and pathway-wise Pearson correlations of 0.754 and 0.762 across 1,387 PARADIGM pathway activities. Independent evaluation on GTEx healthy tissues showed preservation of tissue-level transcriptomic structure without retraining. In comparison with existing models, TifBERT achieves competitive subtype discrimination with substantially greater stability and produces markedly richer embedding geometry (effective rank 95.6 versus 6.3), without requiring expression discretization or in-distribution pretraining exposure. Together, TifBERT provides a scalable, normalization-independent foundation model for reusable bulk transcriptomic representation learning

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

A Survey on Long-Term Memory Security in LLM Agents: Attacks, Defenses, and Governance Across the Memory Lifecycle

The emergence of writable, cross-session persistent memory in LLM agents introduces a qualitatively different threat landscape from conventional input-centric security concerns, characterized by three properties: persistence, statefulness, and propagation. To systematically characterize this landscape, we propose a Memory Lifecycle Framework that organizes attacks, defenses, and their cross-phase dependencies along two axes: six lifecycle phases (Write, Store, Retrieve, Execute, Share & Propagate, Forget & Rollback) and four security objectives (Integrity, Confidentiality, Availability, Governance). This analysis in turn exposes the need for formal security guarantees at the system level, motivating Verifiable Memory Governance(VMG), a framework of five architectural primitives that specifies what verifiable mechanisms a long-term-memory system must provide to maintain auditable, recoverable control over its memory state. Our analysis indicates that robust Long-Term Memory (LTM) security cannot be retrofitted at retrieval or execution time alone, but must be anchored in storage-time provenance, versioning, and policy-aware retention from the outset.

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

Predicting the Neutrino Mass Ordering Using Neural Networks

arXiv:2606.03745v1 Announce Type: cross Abstract: Determining the neutrino mass ordering remains a central open problem in particle physics. While next-generation long-baseline experiments are expected to resolve this question, current data provide limited sensitivity because the spectral differences between normal and inverted ordering are subtle and entangled with parameter degeneracies. We investigate a machine-learning strategy for mass-ordering determination using a feed-forward neural-network classifier trained on synthetic long-baseline datasets generated with three-flavour oscillation probabilities, matter effects, and statistical fluctuations. We evaluate the classifier against standard $\chi^2$ and $\log\mathcal{L}$ approaches using common discrimination metrics, including receiver-operating-characteristic curves, to quantify sensitivity and to illustrate how operating points can be selected to prioritise purity or efficiency. We find that the neural network achieves performance comparable to conventional fits for the scenarios studied, providing a flexible, independent cross-check of established analyses. The framework can be extended to incorporate systematic uncertainties and to explore joint inference of oscillation parameters, and it may also serve as a pedagogical tool for introducing machine-learning methods in neutrino physics.

08.
bioRxiv (Bioinfo) 2026-06-19

Evaluation of analysis modes for RNA coexpression in single-cell and bulk tissue

Coexpression of transcripts presents the most common means of computational inference of transcription factor regulation, and is often combined with other data types to infer regulatory networks. With the growing popularity of single-cell approaches, there are questions about how best to extract coexpression information from the data. Recently we reported a simulation study that explored the differences among coexpression performed at different levels: across single cells (xCell, per cell type), across subjects from pseudobulked single-cell data (xSubject, per cell type), or across subjects using bulk tissue samples (xBulk). Here we test predictions made by those models using real data. We consider both preservation (consistency of coexpression findings across different levels of analysis of the same data) and replicability across independent studies, as well as biological interpretability. We find that preservation across levels is limited, indicating the choice of analysis level will affect outcomes. We show that xCell coexpression is more replicable across studies compared to xSubject. xBulk coexpression is dominated by patterns driven by variability in cellular composition and fails to capture much coexpression that is reliably detected at finer resolutions. While all modes of analysis exhibit some enrichment for known regulatory relationships, it was highest with the xCell mode. Finally, we present a case study of the effect of analysis modes on a schizophrenia-associated pattern, reinforcing the importance of analytic choices in the interpretation and replicability of coexpression analyses. Together with our modeling study, this work emphasizes the importance of understanding sources of expression covariation as they relate to the goals of the analysis, and recommend single-cell-based data with biological replicates should be the focus of attempts to infer dynamic regulatory interactions that are more likely to be replicable by others.

09.
arXiv (CS.LG) 2026-06-11

Energy-Conserved Neural Pipelines: Attenuating Error Propagation in Modular Neural Networks via Physical Conservation Constraints

arXiv:2606.11341v1 Announce Type: new Abstract: Modular neural network pipelines suffer from error compounding: noise at any module boundary propagates and potentially amplifies through subsequent modules. We introduce energy conservation as a hard physical constraint on inter-module information flow. Activation energy (the squared L2 norm of feature vectors) is enforced to be exactly preserved at every module boundary. Unlike soft energy penalties, conservation is an inviolable law: the network may redistribute energy across neurons but cannot create or destroy it. Four experiments on CIFAR-10 demonstrate: (1) conservation retains 77.4% of clean accuracy at noise sigma=0.2, versus 35.1% for baselines and 30.9% for energy-penalized models (p

10.
arXiv (CS.AI) 2026-06-19

OnDeFog: Online Decision Transformer under Frame Dropping

arXiv:2606.19721v1 Announce Type: cross Abstract: In challenging real-world reinforcement learning applications, communication delays or sensor failures often cause frame dropping, in which the agent cannot receive the dropped states and associated rewards. To address the performance degradation caused by frame dropping, the Decision Transformer under Random Frame Dropping (DeFog) was developed by incorporating additional mechanisms into the decision transformer to tackle frame dropping. Although DeFog can mitigate performance degradation in frame-dropping environments, since DeFog is an offline learning method, it struggles to effectively generalize to novel states not adequately represented in the training dataset. In this study, we propose OnDeFog, which integrates the mechanisms in DeFog with the online decision transformer (ODT), an online reinforcement learning method that learns policies through direct environmental interaction. Comprehensive experimental evaluation demonstrates that our proposed OnDeFog achieves superior performance compared to ODT in environments characterized by high dropping frame rate and outperforms DeFog on datasets containing a large amount of low-reward data.

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

Manifold-Orthogonal Dual-spectrum Extrapolation for Parameterized Physics-Informed Neural Networks

arXiv:2603.13751v2 Announce Type: replace Abstract: Physics-informed neural networks (PINNs) have achieved notable success in modeling dynamical systems governed by partial differential equations (PDEs). To avoid computationally expensive retraining under new physical conditions, parameterized PINNs (P$^2$INNs) commonly adapt pre-trained operators using singular value decomposition (SVD) for out-of-distribution (OOD) regimes. However, SVD-based fine-tuning often suffers from rigid subspace locking and truncation of important high-frequency spectral modes, limiting its ability to capture complex physical transitions. While parameter-efficient fine-tuning (PEFT) methods appear to be promising alternatives, applying conventional adapters such as LoRA to P$^2$INNs introduces a severe Pareto trade-off, as additive updates increase parameter overhead and disrupt the structured physical manifolds inherent in operator representations. To address these limitations, we propose Manifold-Orthogonal Dual-spectrum Extrapolation (MODE), a lightweight micro-architecture designed for physics operator adaptation. MODE decomposes physical evolution into complementary mechanisms including principal-spectrum dense mixing that enables cross-modal energy transfer within frozen orthogonal bases, residual-spectrum awakening that activates high-frequency spectral components through a single trainable scalar, and affine Galilean unlocking that explicitly isolates spatial translation dynamics. Experiments on challenging PDE benchmarks including the 1D Convection–Diffusion–Reaction equation and the 2D Helmholtz equation demonstrate that MODE achieves strong out-of-distribution generalization while preserving the minimal parameter complexity of native SVD and outperforming existing PEFT-based baselines.

12.
arXiv (CS.CL) 2026-06-11

Steering the Noise: Turning Random Perturbations into Effective Descent for Memory-Efficient LLM Fine-Tuning

Fine-tuning large language models (LLMs) achieves strong performance but is often limited by the memory overhead of backpropagation. Zeroth-order (ZO) optimization avoids this overhead by estimating gradients through forward passes alone, yet it typically converges slowly because random Gaussian perturbations yield high-variance gradient estimates in high-dimensional parameter spaces. In this paper, we propose a plug-and-play framework that turns random perturbations into more effective descent directions. The key idea is to draw a small pool of candidate perturbations, evaluate their loss values, and then select or combine those that are best aligned with the optimization objective. We develop two instantiations of this idea: MeZO-GV, which forms a guiding vector from the contrast between low-loss and high-loss perturbation groups, and MeZO-Greedy, which keeps the single best perturbation within a fixed evaluation budget. We theoretically show that both strategies yield a larger per-step reduction in the objective than standard ZO estimation, leading to improved convergence rates. Experiments on LLMs of different scales and architectures confirm that the proposed methods integrate naturally with existing ZO optimizers and consistently improve convergence speed and task accuracy. On OPT-13B, our approach outperforms all ZO baselines across 11 benchmarks and exceeds gradient-based methods on 9 of them, while retaining the memory efficiency of forward-only optimization.

13.
arXiv (CS.CL) 2026-06-12

Two Wrongs, No Right: Auditing Social-Desirability Bias in LLM Annotators for Computational Social Science

作者:

LLM annotators are increasingly used in computational social science (CSS), but it is unclear whether their alignment-shaped errors preserve the empirical conclusions a researcher would report. We audit three open-source 7B instruction-tuned models (Zephyr, Mistral-Instruct, Qwen2.5-Instruct) across six TweetEval tasks under four prompt conditions (72 cells) and find that social-desirability failures do not run in a single direction. Zephyr exhibits leniency bias, systematically under-applying harmful labels (offensive language: false benign rate 0.729, false alarm rate 0.031). Mistral and Qwen exhibit overcorrection, over-applying the same labels (Mistral hate-speech FAR = 0.604). All three models exhibit neutrality bias on abortion stance, underestimating opposition prevalence by 24 to 40 percentage points and inflating the neutral label. None of the four prompting interventions we test (neutral, safety framing, depersonalized, chain-of-thought) corrects these failures across models; safety framing can worsen stance distortion. Strikingly, Zephyr's hate-speech prevalence estimate matches the gold rate exactly while its class-conditional errors are large in both directions, an accidental cancellation that misleads aggregate validation. We translate these patterns into a three-part taxonomy with diagnostic FBR/FAR signatures and a lightweight gold-sample validation protocol. The headline for trustworthy CSS: a model that looks calibrated on aggregate metrics can still flip the substantive empirical conclusion a researcher would report.

14.
medRxiv (Medicine) 2026-06-19

Fine-Tuning SAM2 for Coronary Artery Segmentation in X-Ray Fluoroscopy

作者:

SAM2 (Meta, 2024) provides a strong starting point for segmentation, but given the unique challenges in medical imaging (noise from patient movement, the projection-based nature of X-ray fluoroscopy, and low contrast between vessels and background), direct application is difficult. We fine-tune MedSAM2 on annotated coronary angiograms and apply it to video data for point-of-care use. On the ARCADE validation set (200 images), the fine-tuned model achieves Dice 0.767 compared to 0.033 zero-shot. On 10 fluoroscopic video studies from CoronaryDominance, it tracks vessels coherently and avoids falsely segmenting ribs, stents, and bypass grafts in 9 of 10 studies. Code is available at https://github.com/elakiyasivakumar/SAM2-Coronary-Angiography-VA and the fine-tuned checkpoint at https://huggingface.co/Elakiya17/CA-SAM2.

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

SPOT-E: Test-Time Entropy Shaping with Visual Spotlights for Frozen VLMs

arXiv:2606.20244v1 Announce Type: cross Abstract: Vision-language models (VLMs) often underperform on evidence intensive tasks because decisive visual evidence are small, localized, and easy to overlook, leading to failures in evidence readout even when high-level reasoning is intact. Prior inference-time visual interventions can improve grounding without retraining, but they are largely open-loop and lack a mechanism to verify whether highlighted evidence is actually used. We study answer-span prediction entropy as a model-internal feedback signal and show that naive entropy minimization is ambiguous, since low entropy may arise from evidence-grounded confidence or shortcut collapse. To resolve this ambiguity, we introduce low-entropy anchors and an entropy-shaping objective that reduces answer uncertainty while preserving baseline high-confidence tokens. We instantiate this principle in SPOT-E, a plug-and-play test-time method that produces question-conditioned spotlights, optimized per instance via light-weight tuning based on Group Relative Policy Optimization (GRPO). Across all benchmarks and different VLM families, SPOT-E yields consistent gains and improved robustness under visual corruptions. Code is publicly available at: \url{https://github.com/YinBo0927/SPOT-E}

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

ReFree: Towards Realistic Co-Speech Video Generation via Reward-Free RL and Multilevel Speech Guidance

Speech-driven talking character animation seeks to generate life-like portrait videos that convey natural conversation behavior, aligning facial motion with spoken audio. Although recent advances in video generation have substantially improved realism in video-based animation, achieving both accurate lip articulation and expressive behavior remains challenging. Existing approaches typically trade off precise phoneme-to-lip synchronization against dynamic facial expressions and head motion, yielding animations that are either accurate yet rigid, or expressive but poorly synchronized. We address this challenge by proposing ReFree-S2V, a flow-matching speech-to-portrait animation framework that builds upon a pretrained video generation model to achieve fine-grained speech articulation and high-level expressive cues in speech-driven portrait animation. This model introduces a multi-level speech representation capturing phonetic and prosodic information at both local and global granularities. These representations are selectively injected into transformer blocks via learnable level selectors, enabling both accurate lip synchronization and natural expressive motion. To achieve natural head movements, we further introduce a novel reward-free reinforcement learning scheme into flow-matching training to discourage perceptually implausible motion without relying on handcrafted synchronization metrics or reward models, or the high cost of human preference annotation. Extensive experiments demonstrate that ReFree-S2V achieves state-of-the-art performance, significantly outperforming existing methods in both quantitative lip-sync accuracy and qualitative human evaluations of naturalness and expressivity.

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

Did You Forget What I Asked? Prospective Memory Failures in Large Language Models

作者:

Large language models often fail to satisfy formatting instructions when they must simultaneously perform demanding tasks. We study this behaviour through a prospective memory inspired lens from cognitive psychology, using a controlled paradigm that combines verifiable formatting constraints with benchmark tasks of increasing complexity. Across three model families and over 8,000 prompts, compliance drops by 2-21% under concurrent task load. Vulnerability is highly type-dependent: terminal constraints (requiring action at the response boundary) degrade most, with drops up to 50%, while avoidance constraints remain comparatively robust. A salience-enhanced format (explicit instruction framing plus a trailing reminder) recovers much of the lost compliance, restoring performance to 90-100% in many settings. Interference is bidirectional: formatting constraints can also reduce task accuracy, with one model's GSM8K accuracy dropping from 93% to 27%. In additional stacking experiments, joint compliance declines sharply as constraints accumulate. All results use deterministic programmatic checkers without an LLM-as-judge component on publicly available datasets.

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

TAB-PO: Preference Optimization with a Token-Level Adaptive Barrier for Token-Critical Structured Generation

Direct Preference Optimization (DPO) is an effective and widely adopted approach for offline alignment but is poorly matched to ontology-driven structured prediction, where preferred and rejected JSON objects often differ in only a few schema-defining tokens. In this low-edit-distance regime, sequence-level DPO spreads gradient mass across non-critical serialization tokens (gradient dilution) and can reduce likelihood on rare, under-confident preferred schema tokens (token erosion). To address these limitations, we first develop a confusion-aware preference-construction strategy that augments expert-curated ambiguity patterns with empirical structured-error modes estimated from validation-set SFT predictions, synthesizing minimally perturbed, schema-valid negatives that focus preference learning on realistic ontology-level decision errors. We then introduce Token-Adaptive Barrier Preference Optimization (TAB-PO), a post-SFT objective for token-critical structured generation. TAB-PO adds a confidence-gated token-level barrier that applies supervised anchoring to under-confident schema tokens. On the public SciERC scientific information extraction task, evaluated with Llama/Qwen models from 1.5B to 70B, TAB-PO improves ontology-critical semantic-label and relational-linking metrics over SFT by 11.59% on average, wins 100% of comparisons against the strongest token-level and sequence-level DPO variants on these metrics, and surpasses leading frontier models by 14.71%, while delivering strong gains in textual grounding.

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

Experimental Analysis of Neural Network-Based Image Classification on the CIFAR-10 Dataset

An experimental investigation of neural image classification on the CIFAR-10 benchmark is presented through fully connected and convolutional network formulations. The analysis emphasizes the complete learning pipeline: image vectorization, normalization, one-hot class encoding, supervised loss minimization, learning-rate selection, mini-batch training, convolutional feature extraction, max-pooling, and validation-based generalization assessment. A convolutional architecture with six convolutional layers and three max-pooling stages is evaluated for ten training epochs using a batch size of 128 and an Adam optimizer with a learning rate of 0.001. The validation accuracy reaches approximately 74.77%, while the validation loss begins to increase after the middle of training despite continued reduction in training loss. The resulting behavior illustrates the practical difference between representation learning and memorization, and it provides a compact experimental baseline for future studies on regularization, data augmentation, deeper architectures, and reproducible image-classification education.

20.
arXiv (CS.AI) 2026-06-11

From Architecture to Output: Structural Origins of Hallucination in Large Language Models and the Amplifying Role of Data

arXiv:2606.07537v1 Announce Type: cross Abstract: Large language models hallucinate–producing fluent, confident, factually wrong outputs–with a consistency that persists across generations and scales. Existing taxonomies classify hallucination by output type, distinguishing intrinsic from extrinsic failures and faithfulness from factuality divergence. These frameworks are descriptively rigorous but do not identify which internal mechanism produced a given instance. This paper analyses hallucination as a structural consequence of three architectural decisions that together form a compound failure system. Self-attention's co-occurrence learning substitutes statistical proximity for semantic meaning and produces entity confusion, fact misattribution, and semantic drift. The maximum likelihood estimation training objective optimises next-token probability without factual constraint, rewarding statistically plausible outputs regardless of their truth value. Autoregressive decoding's permanent left-to-right commitment under exposure bias ensures that a single wrong token cascades forward through the entire output sequence without revision. Dataset pathologies–long-tail deficiencies, training bias, and synthetic pollution–amplify these vulnerabilities but do not independently cause them. We make three contributions. First, we map each mechanism to a specific output category in the Alansari and Luqman taxonomy, locating intrinsic hallucination in self-attention, extrinsic hallucination in MLE, and logical inconsistency in autoregressive decoding. Second, we show that each commonly cited dataset pathology exploits one of these mechanisms rather than originating hallucination independently. Third, we identify the diagnostic limitation of output-type-only classification and contrast it with inference-layer mitigation approaches.

21.
Nature Medicine 2026-06-15

Adaptive deep brain stimulation for dynamic gait control in Parkinson’s disease: a randomized feasibility trial

A randomized crossover study of five patients with Parkinson’s disease (PD) demonstrates that gait-synchronized adaptive deep brain stimulation is feasible and safe, and reduces falls compared with continuous stimulation. Gait dysfunction in PD is a major source of disability and is often insufficiently treated by continuous deep brain stimulation (cDBS). Although adaptive DBS (aDBS) has shown efficacy for other motor symptoms using β-based, state-driven neural signals, gait is a dynamic, cyclical behavior that may require temporally precise modulation. Here we evaluated a behavior-contingent aDBS approach that synchronizes stimulation to gait phase. We reported a single-center, blinded, randomized, crossover study evaluating the feasibility of identifying patient-specific biomarkers to drive aDBS. The primary outcome was feasibility of successful identification of gait-phase biomarkers to implement aDBS. Five participants with PD undergoing pallidal DBS and subdural electrode paddle implantation were enrolled. We successfully identified personalized gait-phase biomarkers from cortical or pallidal field potentials in all five patients and embedded them into a bidirectional neurostimulator. During acute in-clinic testing, aDBS improved step variability and step symmetry versus cDBS. Three participants subsequently completed a double-blinded, multi-day crossover phase. In this setting, aDBS maintained general motor symptom control, reduced falls and yielded patient-specific gait improvements. No adverse events occurred and aDBS was well tolerated. These findings establish the feasibility of biomarker-driven, movement-synchronized neuromodulation and support the development of a larger randomized trial to determine clinical efficacy. ClinicalTrial.gov registration: NCT04675398 . A randomized crossover study shows that gait-phase-synchronized adaptive deep brain stimulation is feasible and safe, and reduces falls compared to continuous stimulation in Parkinson’s disease.

22.
medRxiv (Medicine) 2026-06-12

Opportunistic CKD Screening in Hospitalized Patients

Background. Chronic kidney disease (CKD) affects 10-13% of adults worldwide but remains largely undiagnosed until advanced stages. Hospitalization provides an opportunity for early detection through opportunistic urine albumin-to-creatinine ratio (UACR) measurement. Methods. We conducted a prospective three-arm study of opportunistic CKD screening in general internal medicine wards at Hadassah Mt. Scopus (MS), Hadassah Ein Kerem (EK), and Shaare Zedek Medical Center (SZMC) in Jerusalem (Protocol HMO-23-0300). Adult inpatients without known CKD or recent UACR were enrolled. Pathological UACR was defined as [≥]30 mg/g. Confirmed CKD required two pathological measurements [≥]90 days apart (KDIGO-compatible). eGFR was computed using the 2021 CKD-EPI race-free equation. Pooled proportions were estimated by fixed-effects logit meta-analysis; odds ratios by DerSimonian-Laird random-effects models. Results. A total of 158 patients were enrolled (MS n=50, EK n=57, SZMC n=51). Pathological first UACR was identified in 43/158 patients (27.2%; 95% CI 21.3-34.1%; I2=0% across centers). Of 24 patients with a second UACR available, 14 (58%) confirmed CKD, yielding a pooled confirmed-CKD rate of 8.9% of all screened patients. In-hospital mortality was significantly higher among patients with pathological UACR (9.3% vs ~2%; Fisher's exact p=0.012). In per-center multivariate logistic regression, three predictors reached pooled significance: BUN (OR 1.10 per mg/dL, 95% CI 1.04-1.17, p=0.002, I2=0%), heart failure (OR 3.21, 95% CI 1.34-7.70, p=0.009, I2=0%), and diabetes mellitus (OR 2.54, 95% CI 1.11-5.82, p=0.028, I2=17%). Cardiac/vascular admissions had the highest pathological UACR rate (~42%); GI/hepatic admissions had 0%. Conclusions. Opportunistic inpatient UACR screening identifies previously unrecognized CKD in approximately 9% of general internal medicine patients, with consistent results across three independent centers. BUN elevation, heart failure, and diabetes are the strongest independent predictors. Pathological UACR carries significant short-term mortality risk, supporting integration of routine screening into inpatient care pathways.

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

Mask Proposal Voting Based on Geodesic Framework for Robust Image Segmentation

Despite great advances, finding accurate segmentation remains a challenging task, especially in scenarios with cluttered backgrounds, complex intensity variations and topology appearance. Minimal path models have exhibited their strong ability in addressing image segmentation tasks. However, the performance of minimal paths-based segmentation approaches is heavily influenced by model initialization, hence limiting their application scope in practice. In this work, we propose a novel mask proposal voting framework that overcomes the major drawback of classical approaches, allowing robust segmentation even in complicated scenarios. Firstly, we introduce an efficient method for constructing adaptive domain cuts as a constraint for initializing the region-based min-cut evolution, by which diverse and reliable mask proposal candidates can be generated, substantially increasing the possibility of accurately covering the objective region by these proposals. Secondly, we propose a new mask voting scheme to build a voting score map encoding the final segmentation information. In contrast to classical path voting methods, our model allows incorporating priors to assign different importance to each individual mask. As a consequence, the proposed segmentation model is capable of accurately delineating object boundaries under complex scenarios, and is insensitive to initialization. Experiments demonstrate that our method consistently outperforms state-of-the-art minimal path-based approaches in both accuracy and robustness.

24.
arXiv (CS.AI) 2026-06-11

ConsistencyPlanner: Real-time Planning with Fast-Sampling Consistency Models

arXiv:2606.11569v1 Announce Type: cross Abstract: Closed-loop planning in complex, real-world driving scenarios presents a critical challenge for autonomous driving systems. While traditional rule-based methods are interpretable, their predefined heuristics lack the adaptability for dynamic traffic environments. Learning-based approaches have shown considerable promise. Conversely, learning-based approaches, despite their promise, struggle to balance the modeling diverse and multimodal driving behaviors and real-time planning, often leading to indecisive or unsafe actions. To address this limitation, we propose Consistency Planner, a real-time planning framework with fast-sampling consistency models. Our approach is built upon two key technical contributions. Efficient Multimodal Sampling: We employ fast-sampling consistency models to generate a diverse set of plausible future trajectories. This enables efficient, real-time exploration of multimodal actions, overcoming the computational bottlenecks of previous iterative generative methods. Heterogeneous Feature Fusion: We introduce an attention-enhanced decoder that dynamically integrates heterogeneous input features (including scene feature and action token) into a cohesive representation for robust planning. Extensive evaluation in the Waymax simulator demonstrates superior performance in safety metrics compared to existing methods, with particularly strong results in challenging dynamic scenarios.

25.
arXiv (quant-ph) 2026-06-15

Efimov Effect in Ultracold Microwave-Shielded Polar Molecules

arXiv:2602.21433v2 Announce Type: replace-cross Abstract: A quantum-mechanical description is presented for the three-body physics of shielded dipolar molecules, including a prediction of observable Efimov physics. Despite the anisotropic and long-range nature of the interaction, shielding enables a regime in which universality emerges already at the two-body level and extends to the three-body sector, where Efimov physics emerges. On the negative side of the scattering-length resonance, computed trimer binding energies display the characteristic scaling expected for Efimov resonances. Finally, the sudden approximation can be used to create trimer bound states, starting from positive energy trap states as a way to create or detect these molecular trimers. Moreover, the three-body parameter expressed in dipolar units is found to be universal.