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01.
arXiv (CS.LG) 2026-06-18

MetaboNet-Bench: A Multi-modal Benchmark for Glucose Forecasting in Type 1 Diabetes

arXiv:2606.18640v1 Announce Type: new Abstract: Glucose forecasting algorithms are an important aspect of glycemic control management in type 1 diabetes. So far, the research community has developed numerous algorithms and models for forecasting. However, it is well-recognized that the lack of standardized model performance evaluation benchmarks makes fair comparison difficult and hinders further innovation, and thus benchmark standardization is in urgent need. Furthermore, many published glucose forecasting algorithms are limited to CGM data alone, ignoring other multimodal signals such as insulin dosing and carbohydrate intake. Here, we introduce MetaboNet-Bench, a benchmark for multimodal glucose forecasting for patients with type 1 diabetes that provides an extensible open-source evaluation framework for comparison of glucose forecasting algorithms that leverage glucose, insulin, and carbohydrate data. We then demonstrate its utility by benchmarking several recently published glucose forecasting models and a custom multimodal time-series model, representing different model architectures. The results show that the benefit of adding data modalities is conditioned on the complexity of the model and that incorporating more clinical metrics helps identify meaningful gaps to fill for future research.

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

Variable-Rate Deep Image Compression based on Low-Rank Adaptation by Progressive Learning

In the digital age, image compression is crucial for numerous applications, including web media, streaming services, high-resolution medical imaging, and connected vehicle networks, enabling efficient data storage and transmission. With the increasing demand for high-quality image communication, the need for advanced compression techniques becomes increasingly critical. Numerous Deep Image Compression (DIC) techniques have recently been introduced, showing impressive performance compared to traditional standards. However, variable-rate image compression remains an unresolved issue. Specific DIC methods deploy multiple networks to attain different compression rates, whereas others use a single model, which often results in higher computational complexity and reduced performance. This work proposes a progressive learning approach for variable-rate image compression based on the parameter-efficient fine-tuning method, the Low-Rank Adaptation (LoRA). We introduce an additional LoRA Rate-Adaptive Module (LoRAM) in DIC methods. Due to the re-parameterized merging of LoRA, our proposed method does not introduce additional computational complexity during inference. Compared to methods utilizing multiple models, comprehensive experiments demonstrate that our approach achieves competitive performance, saving 99\% in parameter storage, 90% in datasets, and 97% in training steps.

03.
medRxiv (Medicine) 2026-06-17

A multistate model of frailty progression after severe infections in adults >=65 years in England: a matched-cohort study

Background Evidence on frailty progression following severe infections is limited. We compared rates of transition to greater frailty or death between adults with and without severe infection in England. Methods We conducted a matched-cohort study among adults aged [≥]65 years (1,452,117: median age 76 years, 45% male) in Clinical Practice Research Datalink Aurum (2006-2019). Adults with severe infection (hospitalised primarily due to infection) were matched on calendar time to individuals without severe infection on age, sex, and primary care practice. The admission date was used as index date and same was assigned to matched unexposed adults. We measured frailty using Electronic Frailty Index, a proportion of 36 health deficits in validated categories (Fit 0-0.12, Mild >0.12-0.24, Moderate >0.24-0.36, Severe >0.36). In a time-varying Markov multistate model, we focused on forward transitions from baseline or intermediate frailty states to higher states or death. For each transition, we used Cox regression to estimate cause-specific transition hazard ratios (HR) with 95% confidence intervals (CIs), comparing adults with and without severe infection. We adjusted for baseline frailty score, age, sex, deprivation, harmful alcohol use, smoking, and primary care infection history 5 years before index date. We estimated state occupancy probabilities, and expected length of stay (ELOS) in each state at year five among adults with and without severe infection. We explored effect modification by infection type. Results Across all transitions, severe infection was associated with higher adjusted hazards of transitioning to worsening frailty or death, HR, 95% CI: (fit to: mild[1.56, 1.54-1.58], moderate[2.51, 1.79-3.51], death[4.57, 4.50-4.65]; mild to: moderate[1.52, 1.50-1.53], severe[1.90, 1.43-2.52], death[2.67, 2.64-2.70]; moderate to: severe[1.40, 1.38-1.42], death[1.87, 1.85-1.90]; severe to death[1.48, 1.46-1.50]). Transition hazard ratios were strongest for lower respiratory tract infections, followed by sepsis, urinary tract infections, meningitis/encephalitis, gastroenteritis, and skin and soft tissue infections. At five years, adults with severe infection had higher probabilities of transitioning to greater frailty or death across all transitions and lower ELOS in each frailty state than those without severe infection. Interpretation Severe infections may accelerate frailty deterioration in older age. Prevention through vaccination, early detection, and prompt management may help mitigate this decline.

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

Retrieve, Don't Retrain: Extending Vision Language Action Models to New Tasks at Test Time

arXiv:2606.15631v1 Announce Type: cross Abstract: Extending a vision-language-action (VLA) policy to a new task typically requires task-specific teleoperated demonstrations and per-task fine-tuning, making adaptation costly in both data collection and compute. In this paper, we show that this target-side per-task adaptation cost can be replaced by retrieval. Our retrieval-augmented policy is trained once on paired demonstrations from the target embodiment (query) and a cheaper embodiment (pool, e.g., human-hand video), then frozen. New tasks are added at deployment by appending pool-side demonstrations to a retrieval pool. The frozen policy conditions on retrieved trajectories at every control step, so new tasks are absorbed by indexing data rather than updating parameters. Fine-tuning is needed only to take on a new, unseen embodiment, not for each new task. We show that retrieval improves policies beyond a specific backbone, including standard VLA policies, but its effect is especially pronounced in Cosmos Policy, a video-generation-based world-action model (WAM). In this setting, retrieval supplies coarse task progression, while the WAM's future-image objective provides an additional visual consistency signal that strengthens the retrieval-conditioned actions. On PushT, we study how retrieval provides a reusable high-level motion prior for cross-embodiment generalization to unseen goal angles, while on RoboTwin 2.0 our method outperforms cross-embodiment baselines on unseen tasks, and we additionally demonstrate the method on a real robot.

05.
medRxiv (Medicine) 2026-06-12

A Machine Learning Pipeline for Scalable Annotation of Patient-Ventilator Dyssynchrony from Bedside Ventilator Data

Objective: Patient-ventilator dyssynchrony (PVD) is a common and clinically consequential problem in critically ill patients receiving invasive mechanical ventilation. Yet automated identification of PVD subtypes at scale remains an unmet clinical need, owing to the lack of large annotated bedside waveform datasets. Methods: We developed and validated a semi-supervised algorithm for automated annotation of PVD. In two medical ICUs at a tertiary academic center, bedside devices continuously collected airway flow and pressure waveforms from the ventilators. We developed a software interface with an information retrieval system that grouped similar breaths for expert human review, yielding 1,542,296 labeled breaths across eight categories: 2 labels for breath delivery mode, 5 labels for PVD subtypes, and 1 label denoting a normal breath. Two pulmonary physicians with expertise in ventilator training and education provided the expert reference labels. We trained an initial classification model on a model-derivation set of 771,148 breaths (divided into training and validation) and evaluated it on a hold-out test set of 771,149 breaths A semi-supervised approach was utilized to extend labeling to an additional 12,965,000 unlabeled breaths. Results: The supervised model performed well across all labels, with Macro-F1 scores between 0.96 and 1.00. Semi-supervised learning across 12 rounds expanded the training set from 771,148 to 8,563,995 breaths without significant performance degradation. Conclusion: We developed a practical and scalable system for automated PVD annotation that performed well across all subtypes. This work provides a reproducible foundation for automated PVD labeling to support the development of machine-learning-based clinical decision support systems for identifying patient-level asynchrony.

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

Token-Operations-Oriented Inference Optimization Techniques for Large Models

Large model inference optimization serves as a key foundation for supporting the scalable, low-cost, and highly stable operation of large model services. Centered on token-oriented inference optimization technology, this paper proposes for the first time a four-layer technical architecture consisting of Multi-model Fusion, Model Optimization, Compute-Model Fusion, and Compute-Network-Model Fusion. It systematically reviews the key technologies and current industry status across these four levels and analyzes the application value of related technologies in real-world business scenarios. This paper provides a practical technical path for reducing token production costs, improving token service efficiency, ensuring the stability of token supply, and driving the transition of large model services from being merely callable to being operable.

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

Pointwise is Pointless? A Multimodal Ablation Study for Precipitation Nowcasting with Graph Neural Networks

arXiv:2606.18436v1 Announce Type: cross Abstract: Sparse point observations are increasingly available for precipitation nowcasting, but it is unclear how much they improve dense radar-field forecasts. We partially address this question with a multimodal graph neural network nowcasting system over the Nordic radar domain. The model predicts rain rate every five minutes up to two hours ahead and is trained with different combinations of radar history, MEPS numerical weather prediction, Netatmo surface observations, MSG satellite channels, stochastic noise, and CRPS-based ensemble losses. The study is designed as an ablation of operationally relevant information sources and training objectives. We compare radar-only, NWP-informed, station-informed, satellite-informed, noise-augmented, and CRPS-based configurations using complementary diagnostics on the radar grid, at station locations, for rain onset, and through oracle, displacement, and amplitude scores. The results show that each source improves a different part of the forecast problem. MEPS stabilises radar-only extrapolation, Netatmo observations improve local station and onset diagnostics, and satellite predictors reduce some station-level biases but may activate rain too early when used deterministically. CRPS-based configurations provide the most consistent radar-grid gains, while the combined satellite and CRPS setup gives the best overall oracle/DAS score. These results do not support the conclusion that point observations are uninformative for nowcasting, but they show that local observational skill and spatially coherent radar-field skill are distinct targets. The practical implication is that sparse observations can provide useful local constraints, but their benefit for radar-like fields depends on the training loss, uncertainty representation, and how observation support is encoded in the model.

08.
arXiv (CS.AI) 2026-06-17

Dimensionality Controls When Modularity Helps in Continual Learning

arXiv:2606.17889v1 Announce Type: cross Abstract: Compositional learning systems must balance plasticity, the ability to acquire new knowledge, with stability, the preservation of previously learned components, especially when tasks share structure and risk interference. We study how modular architecture, task similarity, and representational dimensionality jointly shape compositional continual learning in a sequential A-B-A paradigm, comparing a task-partitioned recurrent network to a single-network baseline while inducing high- and low-dimensional regimes via weight-scale manipulations. In a high-dimensional "lazy" regime, both architectures achieve similar performance and internal geometry, suggesting that explicit modular structure has little impact when representations are weakly constrained. In a lower-dimensional "rich" regime, modularity becomes decisive: the modular network develops graded task-specific subspaces that overlap for similar tasks, partially align for moderately dissimilar tasks, and separate for dissimilar tasks, yielding a more compositional and interpretable organization than the single network. These findings identify the representational regime induced by initialization scale, which co-varies with representational dimensionality, as a key factor governing when compositional, modular structure is functionally beneficial in continual learning, and support viewing safety and robustness as problems of adaptive allocation of representational subspaces rather than fixed separation versus sharing.

09.
arXiv (CS.AI) 2026-06-19

The Hidden Evolution of Disguised Visual Context inside the VLM

arXiv:2606.20077v1 Announce Type: cross Abstract: Visual tokens enter Large Language Models (LLMs) as raw, foreign signals. How they are transformed into meaningful representations and interact with the language space depends entirely on the integration architecture. Whether by treating visual tokens as in-context prompts within the input sequence or injecting them directly into the LLM's intermediate layers. A controlled comparison and understanding of how these architectural choices affect visual information and its internal transformation to integrate with the LLM remains underexplored. We provide a fair comparison by evaluating in-context and layer-wise injection VLM integration paradigms under identical training conditions across single image, multi-image, and video benchmarks. In doing so, we uncover a hidden evolution where visual tokens enter the LLM as disguised visual context, raw representations lacking linguistic structure, but are progressively reshaped depending on the integration paradigm, each capturing fundamentally different frequency characteristics of the visual signal. We show that this evolution inside the LLM determines what visual features the VLM can utilize effectively, how visual representations align with the language space, and ultimately how each paradigm performs across different tasks. We further demonstrate that attention allocation alone is insufficient, and that performance is driven by the quality of visual representations at each layer.

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

CARE: Controlling LLM-Generated Policies through Auditable Review of Evidence in Scientific Experimentation

arXiv:2606.14581v1 Announce Type: cross Abstract: Granting LLMs direct control over costly, irreversible scientific experiments leads to unsafe exploration and unstable performance, but discarding LLM creativity entirely sacrifices significant optimization potential. We introduce CARE (Controlling LLM-Generated Policies through Auditable Review of Evidence in Scientific Experimentation), an auditable controller for high-throughput experimentation (HTE) optimization that keeps a non-LLM incumbent optimizer as the default action path while using LLMs to revise challenger ranking policies. Before each outcome is revealed, a public-evidence intervention gate compares the challenger with the incumbent. It authorizes the challenger's selection only when the evidence available before selection supports the change, with the decision recorded in the audit log. CARE outperforms all other evaluated methods on Minerva/Olympus and ChemLex benchmarks, with final-best improving from 80.0 to 88.5 on Minerva/Olympus and from 83.9 to 92.1 on ChemLex, relative to the public incumbent. Our experiments indicate that LLM self-evolution is more reliable when it expands the proposal space under an auditable controller, rather than directly choosing experiments.

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

MortarBench: Evaluating Mortgage Loan Origination Agents

arXiv:2606.19416v1 Announce Type: new Abstract: Loan origination is the process by which a lender creates a new loan, from application and underwriting through approval and funding. This process serves a critical role in evaluating the eligibility and level of risk posed by an applicant. Recently, firms have begun using mortgage loan agents to augment human loan officers, despite a lack of any public benchmark. To fill this gap, we present MortarBench, a loan origination agent benchmark. MortarBench uses a financial data synthesis and mutation pipeline to generate examples with broad edge case coverage that match real-world distributions and questions. We find that state-of-the-art large language models (LLMs) perform poorly, with closed-source models achieving at most 77.1\% exact match accuracy. We also discover systematic biases in LLM perception of foreignness related to non-English names. Noting these weaknesses, we introduce CRIT, a confidence calibration framework. Our method increases accuracy to 80.5\% while improving risk management steering and reducing bias.

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

G-Long: Graph-Enhanced Memory Management for Efficient Long-Term Dialogue Agents

While Large Language Models (LLMs) have advanced open-domain dialogue systems, maintaining long-term consistency remains a challenge due to inherent limitations in long-context reasoning and the inefficiency of processing extensive raw text. Existing approaches typically rely on either unstructured memory storage, which is prone to information loss, or computationally expensive LLMs that incur high latency. To address these limitations, we propose G-Long, a graph-enhanced framework that utilizes a fine-tuned small Language Model (sLM) for structured triplet extraction and associative retrieval, significantly reducing operational costs. Furthermore, we introduce the novel attention-aware importance scoring mechanism that leverages the intrinsic cross-attention signals of a T5 summarizer to identify salient memories. Extensive experiments across diverse benchmarks demonstrate that G-Long achieves state-of-the-art performance in both response generation and memory retrieval, yielding performance gains of up to 9.8% in response quality on MSC and 40.8% in retrieval recall on LME, while significantly minimizing computational overhead.

13.
medRxiv (Medicine) 2026-06-10

Estimating COVID-19 Cumulative Incidence from Seroprevalence Surveys accounting for Time-Varying Seroreversion: A Fully Bayesian Methodology

Seroprevalence surveys reveal the extent of humoral immunity against pathogens such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and under some circumstances represent cumulative incidence of prior infection. However, antibody waning - or seroreversion - biases these estimates by reducing assay sensitivity in a time-varying manner. Because assay sensitivity decays over time, naively using serosurveys can substantially bias estimates of SARS-CoV-2 cumulative incidence and fatality rates. The Bayesian assay-specific, time-varying sensitivity adjustment developed in this paper can reliably correct for this bias and account for the delay between infection and serosurvey. In seroprevalence studies conducted in the United States in 2020, adjusting for time-varying sensitivity increased cumulative incidence by up to 1.4-fold, with an adjustment of 1.08 for a national study. Our estimates contrast with a previously published 2-fold adjustment that did not account for assay design. This suggests that previous analyses overestimated cumulative incidence by applying seroreversion corrections that did not account for assay-specific effects, or underestimated cumulative incidence by not applying seroreversion corrections. These biases imply fatality rate underestimation and overestimation, respectively. Our model provides a framework for design-specific time-varying sensitivity corrections in seroprevalence surveys for other pathogens.

14.
arXiv (quant-ph) 2026-06-12

Quantum-Driven Neuromorphic Computing for Million-Qubit-Scale Workloads

arXiv:2606.12968v1 Announce Type: new Abstract: We introduce Apollo, a 10000 node p-qubit neuromorphic processor fabricated in 16 nm mixed signal CMOS and operating fully at room temperature with a typical analog core power envelope of about 0.5 W. Its fundamental element, the p-qubit, is a bistable stochastic unit whose continuous time state fluctuations are driven by integrated quantum entropy units that inject true quantum derived randomness. This enables ultrafast stochastic transitions at low energy while preserving a classical state representation. Apollo combines these p-qubits with a high degree Hyperion 256 interconnect topology, allowing efficient embedding of dense Ising and QUBO problems with substantially reduced minor embedding overhead compared with sparse annealing platforms. We show that, through the Suzuki Trotter correspondence, the equilibrium statistics and annealing dynamics of the p-qubit network reproduce key properties of transverse field quantum annealing without cryogenic cooling, long lived coherence, or microwave control. Beyond device level validation, Apollo is evaluated on a three dimensional spin glass benchmark previously used to study quantum advantage in superconducting annealers. Across 300 disorder realizations, Apollo reaches substantially lower ground state energies than reported cryogenic quantum annealing hardware, while remaining distinct from classical simulated annealing and simulated quantum annealing. A 350 nm release candidate device experimentally validates the core p-qubit dynamics, thermodynamic sampling correctness, and continuous time annealing behavior. These results establish Apollo as a room temperature, industrially scalable platform for quantum driven energy based optimization, probabilistic inference, generative modeling, and hybrid classical quantum workflows.

15.
arXiv (CS.AI) 2026-06-18

CAPRA: Scaling Feedback on Software Architecture Deliverables with a Multi-Agent LLM System

arXiv:2606.18976v1 Announce Type: cross Abstract: Automated assessment in software engineering education has advanced significantly for code grading and essay scoring. However, reviewing software architecture deliverables, which requires analyzing structural completeness and requirements traceability, has not yet been fully automated. Applying Large Language Models (LLMs) to this task requires robust architectures to ensure technical feedback is accurate and reliable for students. This paper presents CAPRA (Configurable Architecture Proficiency Report Assessment), a multi-agent LLM system that analyzes software architecture deliverables to generate personalized, template-compliant LaTeX feedback. As a core design choice, CAPRA coordinates multiple specialized agents and employs a Python-based microservice for multi-modal document extraction, utilizing PyMuPDF and vision-enabled LLMs (specifically gpt-4o) to parse text and UML diagrams. To ensure educational reliability and mitigate hallucinations, CAPRA introduces a deterministic Evidence Anchoring step using fuzzy matching via normalized Levenshtein distance, along with a ConsistencyManager agent that cross-verifies, deduplicates, and merges findings. System performance is assessed using a structured eight-criterion binary evaluation taxonomy covering: (i) extraction completeness, (ii) feature validation, (iii) issue grounding and severity detection, (iv) recommendation specificity and traceability, and (v) template and tone compliance. A preliminary empirical evaluation on 10 student reports shows that CAPRA satisfied 88.8% of the evaluated criteria under a strict two-rater aggregation rule, achieved moderate inter-rater agreement with human evaluators (kappa = 0.582), and processed each report in slightly over 4 minutes. While these results support the viability of LLM-supported architectural feedback, human oversight remains essential for subjective assessment dimensions.

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

Enhancing Multilingual Reasoning via Steerable Model Merging

Model merging is an effective technique for composing the capabilities of a multilingual model and a reasoning model. It has achieved promising generalization in multilingual reasoning tasks by aligning feature spaces of different models. However, the merged single model often fails to address the conflicts between source models, leading to suboptimal performance. In other words, the one-size-fits-all merging strategy may not align with the characteristics of different inputs which may require prioritizing certain models over others. To this end, we propose a Steerable Model Merging (ST-Merge) framework to modulate the contribution of each source model. To realize this idea, we introduce a gated cross-attention mechanism to weight or filter the two attended source models in an adaptive manner. Extensive experiments demonstrate that ST-Merge consistently outperforms multiple strong baselines on four multilingual reasoning benchmarks across 21 different languages.

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

Cascade Classification of Dermoscopic Images of Skin Neoplasms with Controllable Sensitivity and External Clinical Validation

Purpose. To compare deep learning architectures and classification schemes for dermoscopic images of skin neoplasms and assess their generalization on transfer from open international datasets to independent clinical datasets of Russian practice. Methods. Four architectures (ViT-B/16, Swin-S, ConvNeXt-S, EfficientNetV2-S) were compared in three schemes: binary (malignant/benign), single-stage four-class (benign, MEL, SCC, BCC), and a two-stage cascade (binary triage, then three-class differentiation MEL/SCC/BCC). All models used ImageNet-pretrained weights and a single augmentation protocol on aggregated open ISIC Archive data, and were evaluated on an internal held-out sample and two clinical datasets (Melanoscope AI mobile system; Sechenov University). Results. Internally the binary stage attains ROC-AUC 0.952-0.966; on Sechenov University it drops to 0.797-0.893, sensitivity to 0.53-0.67, and ECE rises from 0.02 to 0.27-0.39 with underestimation of malignancy, quantifying a generalization gap in ranking and calibration. Paired tests confirm one inter-architecture result on clinical data: the deficit of ViT-B/16 at the binary stage (p

18.
medRxiv (Medicine) 2026-06-15

Supporting people to access social security payments through the Special Rules for End of Life: a qualitative study of the perspectives of patients, carers and health care professionals

Background: People living with terminal illness face a double financial burden from additional costs and loss of earning for themselves and their carers. Social security benefits are intended to help alleviate some of this financial pressure, and in the UK and other countries people are eligible for fast-tracked access to financial support via the Special Rules for End of Life. One in 3 people who are eligible miss out on this support, yet there is limited evidence on the reasons for this take-up deficit. Objectives: The aim of this study is to understand the barriers and facilitators to claiming benefits for terminally ill people from the perspectives of patients, carers, and health care professionals. Methods: This is a qualitative study combining i) focus groups with healthcare professionals recruited via professional networks and social media, and ii) interviews with patients and carers recruited in hospital and hospice settings. We analysed the data using Practical Thematic Analysis Results: Fifty-five multidisciplinary healthcare professionals participated in 11 focus groups, and we interviewed 10 patients and carers. We constructed five descriptive themes to summarise the data: Navigating priorities and uncertainty; positive impacts alongside a sense of shame and stigma; talking about money, difficulties and dividends; everybodys, yet nobodys, responsibility; and sticking points in the system. Conclusion: The themes reveal several challenges that may contribute to people not taking up this financial support. However, discussions about access to benefits were also seen as a core part of holistic care, a positive way to offer support and a gateway to other discussions about end-of-life care preferences and decisions. Recommendations for policy and practice include evaluating the adoption of a diagnostic rather than a prognostic eligibility criteria, integrating discussions about benefits into existing processes such as advance care planning, and improving education and support for clinicians.

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

The embrace of open science: An analysis of a decade of AI research and 56 800 conference papers

arXiv:2606.16974v1 Announce Type: new Abstract: The reproducibility crisis has directed the AI research community toward improving documentation practices. Several studies have identified methodological issues, and in response, the most impactful venues in the field have introduced reproducibility checklists. We seek to understand whether documentation practices have changed over time by assessing all published papers at five leading AI conferences over the past decade. Seven reproducibility variables were identified, quality-assured and used to analyse 56 800 publications. Our analysis reveals that in the period 2014 to 2024, documentation practices have improved; papers sharing both code and data increased nearly sixfold, from 11% to 64% Building on empirical reproducibility rates from a prior study, we estimate - inferred from documentation practices, not direct testing - that reproducibility increased from 28% in 2014 to 64% in 2024. Improvements in documentation practices predate the introduction of reproducibility checklists, suggesting these changes reflect a broader movement toward open science rather than a direct response to formal requirements.

20.
medRxiv (Medicine) 2026-06-12

Estimating the effectiveness of syndromic screening at airports for Bundibugyo ebolavirus disease

Authors:

We used a stochastic simulation model to estimate the effectiveness of combined exit and entry airport screening for Bundibugyo ebolavirus disease (BVD), using natural-history parameters from a Bayesian re-analysis of the 2012 Isiro outbreak. For a 12-hour international flight from DRC or Uganda at 86% screening sensitivity, we estimate 65% of infected travellers would arrive undetected (95% CrI: 38 - 76%). The main driver of this outcome is the relative duration of the the incubation period (approximately 7.7 days) and the onset-to-severe-disease interval (approximately 4 days): most infected travellers board before symptom onset and are undetectable by any syndromic screen, whilst those who are symptomatic progress rapidly to illness severe enough to preclude travel. This is compounded during active epidemic growth, when recently exposed (and therefore pre-symptomatic) cases are overrepresented among travellers. Syndromic airport screening offers limited protection against BVD spread via air travel, and should be complemented by outbreak control at source and strengthened clinical surveillance in receiving countries with high travel connectivity to affected areas.

21.
arXiv (CS.LG) 2026-06-15

AcceRL: A Distributed Asynchronous Reinforcement Learning and World Model Framework for Vision-Language-Action Models

arXiv:2603.18464v3 Announce Type: replace Abstract: Reinforcement learning (RL) for large-scale Vision-Language-Action (VLA) models is severely bottlenecked by synchronization barriers and the high cost of environment data acquisition. To overcome these challenges, we propose AcceRL, a distributed asynchronous RL framework that physically isolates environment rollouts, model inference, and gradient updates. By eliminating the cascading long-tail idle bubbles inherent in synchronous systems, AcceRL maximizes hardware utilization and ensures scalable throughput. Furthermore, AcceRL features a modular design that supports the integration of diverse, plug-and-play world models into its distributed pipeline. Extensive experiments demonstrate that the base framework achieves highly competitive performance across all four LIBERO[liu2023libero] task suites. Systematically, the asynchronous architecture delivers a $2.4\times$ throughput speedup over leading synchronous baselines. Algorithmically, by leveraging a world model pre-trained on 1,000 offline trajectories, AcceRL achieves up to a $200\times$ improvement in online sample efficiency on LIBERO-Spatial, establishing a robust framework that is both sample-efficient and time-efficient for embodied AI. Code is included in the supplementary material. Code is available at https://github.com/distanceLu/AcceRL.

22.
arXiv (CS.CV) 2026-06-16

Lesion-DDPM: Lesion-Enhanced 3D Diffusion for MS MRI Synthesis

3D FLAIR MRI is widely recommended as one of the standard MRI sequences for brain imaging in multiple sclerosis (MS), but publicly available MS datasets remain relatively small and vary across scanners, acquisition protocols, and lesion patterns. This scarcity and variability hinder the development of robust neuroimaging machine learning models and are particularly challenging for generative models that aim to synthesize images while preserving small, sparse lesions. We propose Lesion-DDPM, a 3D conditional diffusion framework for lesion-aware FLAIR synthesis that incorporates multi-level anatomical mask injection together with a lesion-weighted reconstruction loss to emphasize lesion voxels while maintaining global brain structure. Using a curated subset of the MSLesSeg dataset, we compare Lesion-DDPM with representative state-of-the-art GAN- and diffusion-based models, assessing both image-generation metrics and downstream 3D U-Net segmentation. In our experiments, Lesion-DDPM achieved the lowest lesion-region reconstruction error among all methods. In a downstream 3D U-Net lesion segmentation task, a model trained only on Lesion-DDPM-generated scans and evaluated on real MRIs reached a Dice score of 0.616 compared with 0.569 for the best competing synthetic dataset. When Lesion-DDPM images were added to the real training set, the Dice score further increased to 0.685.

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

Detect Before You Leap: Mirage Detection in Vision-Language Models

Vision-language models (VLMs) can produce confident visual answers even when the required visual evidence is missing, blank, or unrelated to the question. This failure mode, recently described as mirage (mirage2026), is especially concerning in medical and document VQA, where a plausible but visually ungrounded answer may be mistaken for image-based evidence. We study the complementary problem of pre-release mirage detection: given an image-question pair, determine whether the VLM should answer or abstain before generation. To that end, we propose a novel model-agnostic Text-Conditioned Layer-wise Internal Alignment (TC-LIA) method that probes patch-token representations across the layers of a CLIP ViT-H/14 vision encoder. The key idea is to project layer-wise image patch tokens into the final CLIP embedding space and measure their similarity with the question embedding, thereby tracking whether question-relevant visual evidence emerges across vision layers. TC-LIA summarizes this alignment trajectory using final image-text cosine similarity, late-layer top-k patch-text alignment, early-to-late gain, and layer-wise slope. These features are combined with pixel-statistic based blank/noise detection, zero-shot domain routing, and structured VLM self-assessment in an ensemble. Across five VQA domains with related, unrelated-real, and blank/noise inputs, and across twelve VLM backbones, Qwen2.5-VL-32B achieves the highest three-class detection accuracy of 94.7% with a 3.0% mirage rate, while Qwen2.5-VL-72B achieves 94.6% accuracy with a lower 2.8% mirage rate. Baseline mirage rates span 21.7-66.6%.

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

From Frames to Temporal Graphs: In-Context Egocentric Action Recognition with Vision-Language Models

Action reasoning in egocentric video requires capturing fine-grained transitions of hand-object interactions, a task where general-purpose Vision-Language Models (VLMs) often struggle when operating directly on raw pixels. We propose to decouple visual perception from symbolic reasoning by converting videos into Temporal Action Graphs. In a multi-stage prompting pipeline, we first generate dense natural language narratives over short temporal windows as a semantic bottleneck, then formalize them into structured, open-vocabulary graph representations. On the EGTEA and Epic-Kitchens-100 datasets, the symbolic representation unlocks efficient in-context learning: few-shot graph demonstrations yield substantial accuracy gains over zero-shot frame and graph-based inference alike. Even in the zero-shot setting, graph-based reasoning remains competitive with pixel-based inference despite potential pretraining contamination favoring the latter. Across 11 open-weight VLMs from 6 model families ranging from 2B to 235B parameters, our findings indicate that current VLMs are more effective as symbolic reasoners than as direct visual observers. By projecting video into the language domain, we provide a scalable, fine-tuning-free alternative to end-to-end approaches that better leverages these models' latent reasoning strengths. The code will be made public.

25.
medRxiv (Medicine) 2026-06-11

Allostatic Load in Endometrial Cancer Disparities

Background: Endometrial cancer incidence and mortality are increasing, particularly among Black women and for aggressive subtypes. Allostatic load (AL), a composite measure of physiologic dysregulation across metabolic, cardiovascular, and immune systems, varies by racial category and tumor subtype in other cancers. Endometrial cancer is strongly associated with obesity, and it is unknown whether AL scores maintain sufficient heterogeneity to evaluate differences across subgroups or with clinical outcomes. Objective: To describe the performance of AL scoring in endometrial cancer patients and examine associations with tumor characteristics (grade/histology) and survival outcomes. Methods: We evaluated AL among 398 participants newly diagnosed with endometrial cancer. AL score was calculated by assigning 1 point for each ''high-risk'' value (by clinical reference range or distribution-based) for 15 biologic variables for vital signs, anthropometrics, blood-based biomarkers, and medical comorbidities. Results: Distribution-based thresholds for variables were used to preserve heterogeneity in this obesity-dominant context. Overall, 68.7% of Black women had high AL compared to White (56.7%), Hispanic (56.7%), and other race (32.3%) women. Decision tree analyses revealed grade-dependent associations between AL and survival. For women with low-grade tumors, higher AL was associated with poorer overall survival. For high-grade tumors, intermediate AL ([≥]4,