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01.
medRxiv (Medicine) 2026-06-23

Sex-Specific Hemostatic Responses and Diagnostic Potential of Platelet Distribution Width (PDW) and D-Dimer in Mild COVID-19, Malaria, and Co-Infection in a Tropical Setting: A Case-Control Study in Port Harcourt, Nigeria

Background: In malaria-endemic tropical regions, the overlapping coagulopathy in COVID-19 and malaria poses diagnostic and prognostic challenges, particularly with potential sex differences. This study evaluated sex-specific variations in platelet indices and fibrinolytic markers and assessed the utility of Platelet Distribution Width (PDW) and D-dimer in mild/asymptomatic cases. Methods: A case-control study was conducted with 220 participants (55 each in healthy controls, malaria-positive, COVID-19-positive, and COVID-19+malaria co-infected groups), aged 20-65 years, in Port Harcourt, Nigeria. Platelet indices were analysed using Sysmex XP-300 haematology analyser, while D-dimer and fibrinogen were measured by ELISA. Data were analysed using SAS 9.4 with ANOVA, Tukey's HSD, Pearson correlation, and sex-stratified comparisons. Results: PDW was significantly elevated in all infected groups compared to controls (malaria: 15.21 +/- 0.22 fL; COVID-19: 15.21 +/- 0.22 fL; co-infection: 15.61 +/- 0.21 fL vs. control: 13.26 +/- 0.17 fL; F=25.850, p < 0.001). D-dimer levels were highest in the co-infected group (553.42 +/- 59.74 ng/ml, F=2.816, p = 0.040). No significant changes were observed in other platelet indices or fibrinogen across groups. No significant correlation existed between platelet indices and the fibrinolytic markers. Males exhibited significantly higher D-dimer levels across all infected groups (p < 0.05) and higher fibrinogen in COVID-19 subjects (p = 0.036). Sex exerted a stronger influence on parameters than age. Conclusion: Males show heightened fibrinolytic activation in COVID-19 and malaria co-infection. PDW and D-dimer are promising, cost-effective biomarkers for screening mild infections in resource-limited tropical settings.

02.
arXiv (CS.AI) 2026-06-11

Using Explainability as a Training-Time Reliability Signal for Efficient ECG Classification

arXiv:2606.12252v1 Announce Type: cross Abstract: Training deep neural networks for clinical time-series analysis is computationally demanding, yet many healthcare settings lack the resources required for repeated model development and deployment. This challenge is particularly evident in electrocardiogram classification, where large datasets and long training schedules make efficiency practically important. Progressive Data Dropout reduces training cost by excluding samples from gradient updates once they are learned, but it relies on model confidence and may retain samples that are difficult due to noise or ambiguity rather than useful signal. In this work, we introduce ERTS, an explainability-based reliability training signal for efficient ECG classification. ERTS uses explanation quality during training to distinguish between informative and unreliable uncertainty. Building on progressive data selection, we compute Grad-CAM attention maps for candidate samples and derive a focus score that measures whether model predictions are supported by coherent and localised patterns. Samples with low focus are filtered out, while those with meaningful attention are prioritised for gradient updates. We evaluate ERTS across three ECG datasets and multiple backbone architectures, showing consistent improvements in macro-F1 alongside reduced effective training cost. These results suggest that explanation quality can serve as a practical signal for improving both efficiency and reliability in clinical time-series learning. Code will be released.

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

TimeRouter: Efficient and Adaptive Routing of Time-Series Foundation Models

arXiv:2606.11625v1 Announce Type: new Abstract: Time-series foundation models (TSFMs) are increasingly explored as predictive experts within emerging agentic time-series systems. However, TSFMs exhibit heterogeneous inductive biases, and no single model consistently dominates across forecasting regimes, making expert selection a critical challenge. Existing systems often delegate this decision to LLM-based controllers, incurring substantial inference overhead. We present TimeRouter, an efficient routing framework that leverages empirical complementarity across a pool of pretrained TSFMs through lightweight discriminative routing, selective gating, and ensemble fallback. Concretely, TimeRouter combines a learned routing head, a selective gate, and an ensemble fallback, enabling adaptive expert selection without invoking an LLM at inference time. TimeRouter achieves state-of-the-art performance on the GIFT-EVAL leaderboard, with an LB MASE of 0.6765. Beyond benchmark performance, our ablation studies provide empirical insights into TSFM routing design, highlighting the importance of pool composition and selective gating. Taken together, these results position TimeRouter as a modular and lightweight routing layer for future agentic time-series systems built upon foundation-model pools. Our code is available at https://github.com/UConn-DSIS/TimeRouter.

04.
arXiv (CS.AI) 2026-06-11

The Power of Test-Time Training for Approximate Sampling

arXiv:2606.11437v1 Announce Type: cross Abstract: Efficiently sampling from a complex probability distribution is a fundamental problem which has become increasingly pertinent in recent years with the rise of generative AI, as sophisticated sampling procedures from LLMs have been proposed to solve challenging reasoning problems. The efficacy of such sampling algorithms is limited, however, by the relationship between the LLM and the particular sampling task at hand, which has motivated the framework of test-time training (TTT). TTT works by updating a model's weights in response to partial generations and reward feedback received at inference time, thus adapting to the particular problem. In this work, we propose a formalization for TTT as the problem of producing a sample from a given probability measure $\mu^\star$ belonging to a known class ${F}$ of distributions, given an oracle $\hat \mu$ which yields approximate density estimates for $\mu^\star$. This is closely related to the problem of reducing sampling to approximate counting studied in seminal works of Jerrum, Valiant & Vazirani (1986) and Jerrum & Sinclair (1989): namely, when ${F}$ is the class of all distributions, it coincides exactly with the aforementioned counting-to-sampling reduction. In this paper, we first show a quadratic lower bound on the query complexity of sampling from $\mu^\star$ given query access to $\hat \mu$ (for sufficiently large classes ${F}$), thus showing that the random walk approach proposed by Jerrum & Sinclair (1989) and refined by Hayes & Sinclair (2010), is optimal. This answers an open question posed by Hayes & Sinclair. We then show that this lower bound can be circumvented if the size of ${F}$ is bounded appropriately. As we discuss, this latter result can be viewed as an abstraction of TTT, and thus represents a starting point for the development of a principled theoretical framework for TTT.

05.
arXiv (CS.LG) 2026-06-12

To GAN or Not To GAN: Segmentation Analysis on Mars DEM

arXiv:2606.13252v1 Announce Type: new Abstract: To better understand Martian Surface, which is needed to enable Rovers navigate Mars with ease, it is necessary to be able to determine the location of mounds. Detecting and studying these morphologies can also help us find evidence of extraterrestrial life, in this case, more specifically, water or signs of life conducive environments. Detection of mounds was done by manually mapping morphological parameters onto Digital Elevation Models. This paper solves the problem by automatically detecting and or predicting mounds on Mars using Neural Network based Semantic Segmentation methodologies. This is done by using supervised semantic segmentation model and generative adversarial approach. A comparison of the approaches shows that adding extra artificially generated data did not improve the result.

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

Integrating Reasoning and Generalization in Text-to-SQL via Self-Enhanced Fine-Tuning

arXiv:2606.15598v1 Announce Type: new Abstract: Text-to-SQL aims to translate natural language questions into executable SQL queries over structured databases, enabling non-expert users to access data intuitively. While recent advances in large language models (LLMs) have shown promise in this task, existing LLM-based approaches often struggle to strike a balance between strong reasoning capabilities and robust generalization. To address these limitations, we propose CoTE-SQL to enhance the LLM-based text-to-SQL generation with three key innovations: (i) self-enhanced reasoning traces distilled from LLMs without human annotation, (ii) structured chain-of-thought (CoT) prompting with modular decomposition and examples retrieval, and (iii) error-aware revision based on SQL execution feedback. Extensive experiments on the Spider and Bird benchmarks demonstrate that CoTE-SQL achieves new state-of-the-art performance among methods built on open-source LLMs with comparable model sizes on Bird (53.39% EX / 59.02 VES) and strong results on Spider (79.60% EX / 77.19 VES), with especially significant gains on complex queries. Results highlight the effectiveness of combining self-enhancement, structured reasoning, and execution-time feedback within an LLM-based framework for text-to-SQL design.

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

LLMs Struggle to Measure What Distinguishes Students of Different Proficiency Levels: A Study of Item Discrimination in Reading Comprehension Assessment

Item discrimination is a fundamental psychometric property of educational assessment, which measures whether an item meaningfully distinguishes students with higher proficiency from students with lower proficiency. While various existing works have explored whether large language models (LLMs) can estimate item difficulty, it remains unclear whether they can capture item discrimination. In this work, we evaluate 42 proprietary and open-weight LLMs in zero-shot settings using two complementary approaches: direct discrimination prediction, where models explicitly estimate an item's discrimination value from its content, and response-based Classical Test Theory (CTT) calibration, where LLM answers are treated as synthetic student responses to compute discrimination scores. Our results show that direct prediction yields weak alignment with human-calibrated discrimination: the best-performing model reaches only a Spearman correlation of 0.152. Response-based CTT calibration provides a stronger but still limited signal, with the all-persona synthetic respondent pool reaching a Spearman correlation of 0.241. These findings highlight item discrimination as an open challenge for LLM-based psychometric evaluation: current LLMs contain non-random discrimination-relevant signal, but they do not yet reliably capture how assessment items distinguish human students.

08.
medRxiv (Medicine) 2026-06-15

Socioeconomic inequalities in smoking prevalence and intensity in Germany: A repeated cross-sectional analysis from 1998 to 2024

Background: Smoking inequalities by socioeconomic status have widened consistently in Germany, but sex-specific trends after 2013 and inequalities in daily cigarette consumption among smokers (intensity) are unknown. We analyzed trends in absolute and relative socioeconomic inequalities in smoking prevalence and intensity among German adults across three decades. Methods: We used 14 waves (1998-2024) of population-representative cross-sectional data from the German Socio-Economic Panel to estimate sex-specific trends in smoking prevalence and intensity in adults aged 25-64. Inequalities were quantified across strata of education, occupation, and equivalized household income using the absolute and relative concentration index with 95% bootstrap confidence intervals. Results: Overall smoking prevalence declined from 35.05% (CI: [33.90%, 36.20%] in 1998 to 22.19% (CI: [21.15%, 23.24%]) in 2024, and mean intensity from 17.49 (CI: [17.09,17.90]) to 13.33 (CI: [12.88, 13.79]) cigarettes/day. Over this period sex-differences in both outcomes narrowed almost completely. Absolute and relative inequalities in smoking prevalence widened across all SES dimensions, particularly for education and occupation. By 2024, inequalities were larger among women than men driven by a stagnating or rising smoking prevalence among low-SES women at least until 2018 alongside continued declines in higher-SES women and for men. Inequalities in smoking intensity, particularly related to income, were generally smaller than those in prevalence. Conclusion: Socioeconomic smoking inequalities in Germany widened from 1998 to 2024 primarily driven by reductions among higher-SES groups and increases in low-SES women. However, recent reductions in low-SES women may indicate a new phase in the smoking epidemic. Health equity considerations should be integrated into a targeted German tobacco control strategy.

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

Automated Standardization of Legacy Biomedical Metadata Using an Ontology-Constrained LLM Agent

arXiv:2604.08552v2 Announce Type: replace-cross Abstract: Scientific metadata are often incomplete and noncompliant with community standards, limiting dataset findability, interoperability, and reuse. Even when standard metadata reporting guidelines exist, they typically lack machine-actionable representations. Producing FAIR datasets requires encoding metadata standards as machine-actionable templates with rich field specifications and precise value constraints. Recent work has shown that LLMs guided by field names and ontology constraints can improve metadata standardization, but these approaches treat constraints as static text prompts, relying on the model's training knowledge alone. We present an LLM-based metadata standardization system that queries standard reporting guidelines and authoritative biomedical terminology services in real time to retrieve canonically correct standards on demand. We evaluate this approach on 839 legacy metadata records from the Human BioMolecular Atlas Program (HuBMAP) using an expert-curated gold standard for exact-match assessment. Our evaluation shows that augmenting the LLM with real-time tool access consistently improves prediction accuracy over the LLM alone across both ontology-constrained and non-ontology-constrained fields, demonstrating a practical approach to automated standardization of biomedical metadata.

10.
arXiv (CS.CL) 2026-06-17

PseudoBench: Measuring How Agentic Auto-Research Fuels Pseudoscience

As Large Language Model based agents enter autonomous scientific research, their ability to resist pseudoscience becomes increasingly important. Otherwise, such systems may rapidly generate plausible yet misleading studies that contaminate academic literature and erode trust in science. We present PseudoBench, an adversarial benchmark for evaluating whether agentic auto-research systems can identify and resist pseudoscientific narratives. PseudoBench contains 200 curated pseudoscientific claim-evidence pairs across five domains and evaluates agents through an end-to-end research pipeline from experiments to writing. Testing seven state-of-the-art agents, we find that current systems readily produce persuasive reports that align with pseudoscientific premises with near-zero refusal rates and the highest resistance of only 27.4%. Stronger agents risk packaging pseudoscience in more sophisticated scientific language, increasing its apparent credibility. These findings reveal an alarming capacity to fuel pseudoscience, calling for scientific alignment before widespread deployment.

12.
arXiv (math.PR) 2026-06-11

Delta-Epsilon-Common Knowledge and Quantitative Agreement Theorems

arXiv:2606.11902v1 Announce Type: cross Abstract: Aumann defined common knowledge mathematically and established his now famous Agreement Theorem. We present a novel approach to quantifying how close individuals are to commonly knowing events, $(\delta,\epsilon)$-common knowledge, which is defined for any (and not just countable) probability spaces, and provide quantitative versions of the key results in this field. Specifically, we do this for Aumann's Agreement Theorem and Nielsen's extension thereof to random variables, as well as for the setting in which posteriors are communicated back and forth between individuals. Our results apply in particular to noisy communication settings.

13.
arXiv (CS.CV) 2026-06-16

MNet++: Extended 2D/3D Networks for Anisotropic Medical Image Segmentation

This work demonstrates a full reproduction and extension of MNet, a hybrid 2D/3D convolutional network designed for anisotropic medical image segmentation. The original architecture was re-implemented within the nnU-Net framework to verify its reported performance and robustness to variable voxel spacing, known as anisotropy. Experiments were conducted on PROMISE prostate MRI and a controlled subset of LiTS liver CT under matched preprocessing and compute constraints. The reproduced MNet achieved a Dice similarity coefficient (DSC) of 89.0 +/- 0.9% on PROMISE, within 0.8% of the published result, and 94.3 +/- 1.9% / 54.6 +/- 3.1% for liver and tumor segmentation on LiTS, respectively. Two lightweight extensions were further introduced: (1) a learned Fusion Gating mechanism enabling adaptive 2D-3D feature blending, and (2) a VMamba state-space module for efficient long-range depth modelling. The Spatial Gating variant improved DSC by +0.8% with less than 3% inference overhead, while VMamba improved performance consistency, reducing PROMISE Dice variation to +/- 0.7% and achieving the strongest LiTS liver performance at 95.8% Dice. Both extensions preserved MNet robustness to anisotropy, with delta Dice = 1.5% across 1-4 mm voxel spacing. Overall, the study confirms MNet reproducibility and demonstrates that adaptive fusion and state-space modelling have the potential to further strengthen segmentation reliability under anisotropic conditions. However, further tests are required to provide definitive conclusions.

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

A First-Principles Derivation of LLM Policy Optimization: From Expected Reward to GRPO and Its Structural Extensions

arXiv:2606.16733v1 Announce Type: new Abstract: Policy gradient algorithms for language models optimize the same objective $J(\theta) = \mathbb{E}*{\tau \sim p*\theta(\tau)}[R(\tau)]$, which has exactly two factors: the trajectory probability $p_\theta(\tau)$ and the reward $R(\tau)$. Every method from REINFORCE to PPO to GRPO and their descendants modifies one or both factors to address a specific failure in the preceding formulation. Existing surveys organize these methods by domain or chronology, which obscures the rationale behind each design choice and the precise location of its intervention within the gradient estimator. This survey revisits the landscape of LLM policy optimization from $J(\theta)$ on first principles and uses the trajectory side, induced by $p_\theta(\tau)$, and the reward side, induced by $R(\tau)$, as the two axes along which methods are located. It covers the path from REINFORCE and PPO to GRPO, as well as post-GRPO variants, Agentic RL, and GRPO-OPD. The resulting framework is unified, diagnostic, and extensible: it analyzes methods from a shared objective, identifies which side each method modifies and why, and applies the same trajectory and reward axes across these settings. Across these settings, the framework also exposes compound failures that no single-side fix resolves and that therefore require joint design of the trajectory side and the reward side. The boundary cases and coupled failures identified by this map mark where existing solutions run out and provide a principled starting point for designing the next generation of LLM policy optimization algorithms.

15.
medRxiv (Medicine) 2026-06-15

Sociodemographic Disparities in Tafamidis Initiation and Clinical Outcomes in ATTR-CM Across the United States

BACKGROUND Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive, life-threatening disease. Sociodemographic factors may influence time to treatment initiation and resulting clinical outcomes, yet these relationships are poorly characterized. OBJECTIVE Assess the effects of sex and race on tafamidis initiation and subsequent outcomes and their interaction with factors such as ATTR-CM type and social deprivation measures. METHODS A retrospective cohort analysis was conducted using the US Komodo Healthcare Map (01/2016-06/2024) among patients with amyloidosis, identified by ICD-10-CM diagnosis codes. Cumulative incidence of treatment initiation and survival probabilities for cardiovascular-related hospitalization (CVH) or death were estimated by Kaplan-Meier, stratified by sex and race. Cox proportional hazards models were fitted for both endpoints to estimate hazard ratios, adjusting for demographics and clinical characteristics. RESULTS Of 11,311 patients identified, White and Black patients (n=9,223) were included in subsequent analyses. Within 12 months of diagnosis, White women had the lowest cumulative incidence of tafamidis initiation (11.4%), followed by Black women (22.0%), Black men (26.7%), and White men (31.0%). Event-free survival at 12 months was lowest in Black women (42.9%), followed by Black men (46.8%), White women (48.6%), and White men (54.4%). Median (95% CI) time to CVH or death was shortest for Black women (8.0 months [6.8-10.0]) followed by Black men (9.9 months [8.8-12.0]), White women (11.0 months [9.6-13.0]), and White men (15.0 months [14.0-16.0]). CONCLUSIONS In this large, real-world cohort of US patients with ATTR-CM, sex and race contributed to disparities in tafamidis initiation and survival, underscoring compounded disparities in both access and outcomes.

16.
PLOS Computational Biology 2026-06-17

Deciphering cell type-specific causal genetic effects on brain imaging-derived phenotypes and disorders with single-cell Mendelian randomization

作者:

by Anyi Yang, Xingzhong Zhao, Xing-Ming Zhao, Yucheng T. Yang Reconstructing causality routes from genetic effects to complex phenotypes in particular cell types is crucial for understanding biological mechanisms underlying the brain-associated phenotypes including imaging-derived phenotypes (IDPs), and brain disorders and behaviors (DBs). Here, we develop a single-cell Mendelian randomization framework to infer cell type-specific causal relationships between gene expression and diverse brain-associated complex phenotypes by integrating single-cell expression quantitative trait loci (cis-eQTLs) and genome-wide association study findings. We identifiy a set of 254 and 217 cis-eQTL target genes (eGenes) that may have causal effects on 112 IDPs and 26 DBs in eight cell types, respectively. These causal eGenes exhibit strong cell type specificity and varied pleiotropy among different types of brain-associated phenotypes. Further integrative analysis reveals putative causality routes among cell type-specific causal eGenes and brain-associated complex phenotypes. Finally, we characterize the spatiotemporal expression patterns of these causal eGenes, and highlight the coordinated associations of the brain-associated phenotypes based on the expression of their causal eGenes. Overall, our study presents a large-scale analysis of the genetic effects of brain structures, disorders and behaviors, providing a catalog of cell type-specific causal eGenes.

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

Federated Causal Inference from Multi-Site Observational Data via Propensity Score Aggregation

arXiv:2505.17961v4 Announce Type: replace-cross Abstract: Causal inference typically assumes centralized access to individual-level data. Yet, in practice, data are often decentralized across multiple sites, making centralization infeasible due to privacy, logistical, or legal constraints. We address this problem by estimating the Average Treatment Effect (ATE) from decentralized observational data via a Federated Learning (FL) approach, allowing inference through the exchange of aggregate statistics rather than individual-level data. We propose a novel method to estimate propensity scores via a federated weighted average of local scores using Membership Weights (MW), defined as probabilities of site membership conditional on covariates. MW can be flexibly estimated with parametric or non-parametric classification models using standard FL algorithms. The resulting propensity scores are used to construct Federated Inverse Propensity Weighting (Fed-IPW) and Augmented IPW (Fed-AIPW) estimators. In contrast to meta-analysis methods, which fail when any site violates positivity, our approach exploits heterogeneity in treatment assignment across sites to improve overlap. We show that Fed-IPW and Fed-AIPW perform well under site-level heterogeneity in sample sizes, treatment mechanisms, and covariate distributions. Theoretical analysis and experiments on simulated and real-world data demonstrate clear advantages over meta-analysis and related approaches.

18.
arXiv (CS.CL) 2026-06-17

Continuous Language Diffusion as a Decoder-Interface Problem

Gaussian-corrupted sentence embeddings have no direct linguistic interpretation, yet continuous diffusion language models can generate fluent text from them. We study this puzzle through Embedded Language Flows (ELF) and identify a decoder-basin mechanism: our evidence suggests that denoising becomes reliable when trajectories reach regions where the native decoder can read stable tokens. We introduce a diagnostic protocol for denoisability, semantic recoverability, order sensitivity, decoder compatibility, and trajectory reliability. It exposes failures hidden by scalar metrics: low mean-squared error can discard linguistic content, low perplexity can reflect low-entropy collapse, and clean latent reconstruction can coexist with a narrow decoder basin. A decoder-margin bound explains why token recovery depends on margin and local decoder sensitivity, not latent error alone. Auditing public ELF checkpoints reveals an interface phase diagram: early predictions are weakly readable, mid-trajectory disagreement marks a competition region, and late predictions enter a high-margin decoder basin. Once inside, token realization is surprisingly simple on generated ELF states: frozen T5 (Text-to-Text Transfer Transformer) token-embedding lookup recovers $93$–$96\%$ of native decoder decisions, and a single linear readout reaches $97.9\%$ agreement at 32k samples, leaving an $\approx1.1$–$1.2$ perplexity gap in a structured residual tail. Under conservative held-out gates, a margin rule exits roughly $17$–$28\%$ earlier in denoising steps under an explicit diagnostic monitor. Boundary checks on LangFlow, BitstreamDiffusion, and the Continuous Latent Diffusion Language Model (Cola-DLM) show that the same interface questions remain meaningful when the state object and decoder change. Continuous and latent diffusion language models should therefore be evaluated as representation-decoder systems.

19.
arXiv (CS.LG) 2026-06-12

Design Criteria for SGD Preconditioners: Local Conditioning, Noise Floors, and Basin Stability

arXiv:2511.19716v2 Announce Type: replace-cross Abstract: Stochastic Gradient Descent (SGD) often slows in the late stage of training due to anisotropic curvature and gradient noise. We analyze preconditioned SGD in the geometry induced by a symmetric positive definite matrix $\mathbf{M}$, deriving bounds in which both the convergence rate and the stochastic noise floor are governed by $\mathbf{M}$-dependent quantities: the rate through an effective condition number in the $\mathbf{M}$-metric, and the floor through the product of that condition number and the preconditioned noise level. For nonconvex objectives, we establish a preconditioner-dependent basin-stability guarantee: when smoothness and basin size are measured in the $\mathbf{M}$-norm, the probability that the iterates remain in a well-behaved local region admits an explicit lower bound. This perspective is particularly relevant in Scientific Machine Learning (SciML), where achieving small training loss under stochastic updates is closely tied to physical fidelity, numerical stability, and constraint satisfaction. The framework applies to both diagonal/adaptive and curvature-aware preconditioners and yields a simple design principle: choose $\mathbf{M}$ to improve local conditioning while attenuating noise. Experiments on a quadratic diagnostic and three SciML benchmarks validate the predicted rate-floor behavior.

20.
arXiv (CS.AI) 2026-06-15

VeriGeo: Controllable Geometry Question Generation with Numerical and Analytical Verification

arXiv:2606.14176v1 Announce Type: new Abstract: Geometry problem generation is useful for AI-assisted education and multimodal mathematical reasoning, but reliable synthesis remains difficult because the problem statement, diagram, constraints, and solution should be mutually consistent. Existing methods often trade off controllability and reliability: seed-based rewriting is flexible but weakly verifiable, whereas diagram-first construction improves validity but is less suited to arbitrary user-specified constraints. We introduce VeriGeo, a controllable geometry generation framework grounded in executable reasoning traces. Given user constraints such as target concepts and difficulty, an Author agent generates a problem and diagram, and a Solver agent produces a proof-aligned solution. Both agents use a shared action sequence that connects natural language, diagrams, geometric constraints, and proof steps into a verifiable representation. A three-stage pipeline checks numerical consistency, analytical realizability, and global consistency, using verification-guided reflection to repair recoverable failures and reject unrecoverable ones. Across five LLM backbones, raw generations frequently fail these checks, while VeriGeo repairs a substantial fraction of the invalid attempts. Supervised fine-tuning on 8.7k examples generated by VeriGeo achieves the best reported GeoQA performance among end-to-end multimodal LLM-based solvers, and obtains strong results on PGPS9K and MathVista-GPS, demonstrating the effectiveness of verified synthetic data for improving multimodal geometry reasoning.

21.
medRxiv (Medicine) 2026-06-17

Menopausal symptoms in peri- and postmenopausal women: systematic review and meta-analysis of prevalence, incidence, comorbidities, and clinical outcomes

Introduction: The global epidemiology of menopausal symptoms among middle-aged and elderly women remains unclear. Methods: Data on prevalence, comorbidities, incidence and outcomes of menopausal symptoms published up until March 1st 2019 were searched in PubMed, Embase and Cochrane databases. We used a random-effects model to compute point estimates of prevalence for 24 types of menopausal symptoms. We narratively summarized the patterns of the comorbidities, incidence and outcomes of menopausal symptoms due to limited data. Results: A total of 239 studies (n{approx}2.5 million middle-aged and elderly women) from 56 countries and regions were included in the analysis. The global pooled prevalence analysis revealed that hot flashes (48%) and night sweats (30%) were highly prevalent, alongside psychological symptoms like insomnia (47%), irritability (46%), anxiety (39%), and depression (30%). Physical symptoms including joint aches/pain (50%), backache (47%), and tiredness (61%) were also commonly reported. Heat intolerance showed the highest prevalence (76%), while symptoms like urinary incontinence (24%) and poor appetite (8%) were less frequent. These findings highlight the diverse and widespread impact of menopause on women globally, with significant variations across symptom types. Africa showed the highest pooled prevalence across a series of symptoms, compared with other continents. We observed high prevalence in developing countries, especially for psychological and physical symptoms; significant intra-Asian variation in vasomotor symptoms; hypertension and obesity as the most common comorbidities; joint pain, urinary incontinence, and vasomotor symptoms as the most incident complaints; and positive associations with cardiovascular disease in the psychological (depression and insomnia) and physical (joint pain) domains. Conclusion: This study highlights the global burden of menopausal symptoms, with significant differences across continents. The findings call for more inclusive research on underrepresented groups (particularly in Africa) and further investigation into drivers of this marked global heterogeneity in prevalence of menopausal symptoms and their comorbidities, incidence and outcomes.

22.
arXiv (CS.AI) 2026-06-18

A Technical Taxonomy of LLM Agent Communication Protocols

arXiv:2606.19135v1 Announce Type: cross Abstract: As large language models (LLMs) advance and multi-agent systems aim to overcome the limits of standalone agents, robust communication protocols are becoming essential infrastructure for distributed agent networks. Nonetheless, the fragmented protocol landscape presents a significant interoperability challenge. This study develops a technical taxonomy to classify and analyze LLM agent communication protocols. Following an established iterative method, we defined the taxonomy's purpose, meta-characteristic, and ending conditions, then performed five iterations, three empirical-to-conceptual and two conceptual-to-empirical, on nine actively maintained open-source protocols with demonstrable adoption. The taxonomy comprises five dimensions: counterparty, payload, interaction state, discovery mechanism, and schema flexibility. Classification reveals recurring architectural patterns: all sampled agent-to-agent protocols combine hybrid payloads with session-state persistence; most protocols support multiple predefined schemas, and two negotiate schemas at runtime, indicating a trend toward schema flexibility; decentralized discovery remains rare. Analysis suggests short-term convergence pressure toward protocols unifying agent-to-agent and agent-to-context (tool and data) communication. Long-term, however, no single protocol is likely to maximize versatility, efficiency, and portability simultaneously. The field will more likely evolve toward a federated, layered protocol stack. The framework guides protocol selection and highlights open research gaps such as privacy and policy enforcement.}

23.
medRxiv (Medicine) 2026-06-23

Systemic and Mucosal Antibody Correlates of Protection Against Bordetella pertussis in a Controlled Human Infection Model

Abstract Background Despite high vaccination coverage, pertussis has resurged globally. Whole-cell (wP) and acellular (aP) pertussis vaccines induce distinct immune profiles, yet immune correlates of protection against infection and symptomatic disease remain incompletely defined. We leveraged a controlled human infection model (CHIM) to identify systemic and mucosal humoral signatures associated with resistance to Bordetella pertussis. Methods Adults with documented history of vaccination had previously been enrolled in a CHIM study and challenged intranasally with B. pertussis D420. For the present work, longitudinal serum and nasal wash samples were analyzed using systems serology to comprehensively profile antibody features. Multivariate modeling and network analyses were performed to define discriminatory immune features. Findings Baseline aP vaccine antigen-specific antibodies did not distinguish infection outcomes. In wP-primed individuals, protection from B. pertussis infection was associated with broad, high-magnitude, polyfunctional antibody responses targeting non-canonical antigens, including BrkA, TcfA, OmpP, OmlA, FauA, and Pal. Protective signatures associated with resistance to symptomatic disease in both vaccine groups were characterized by enhanced Fc-receptor-engaging antibody profiles with distinct antigenic patterns shaped by vaccine history. Importantly, while conventional aP vaccine antigens failed to reliably distinguish individuals susceptible to infection or symptom development, correlates generated by integrated serum and mucosal models based on select non-canonical antigens achieved near-perfect discrimination of infection and symptom outcomes, outperforming models restricted to aP-vaccine. antigens only. Interpretation Resistance to infection was largely restricted to wP-primed individuals and was associated with integrated systemic and mucosal antibody responses directed against antigens beyond those included in acellular vaccines. Protection from symptomatic disease in both vaccine groups was linked to distinct antibody response signatures, shaped by prior vaccination history. These findings indicate that immune mechanisms preventing infection differ from those limiting clinical disease and provide a framework for redesign of next-generation pertussis vaccines aimed at blocking infection and symptomatic disease.

24.
arXiv (CS.CL) 2026-06-12

GENIE: A Fine-Grained Measure for Novelty

Large Language Models have consistently demonstrated a lack of creativity and diversity across tasks. Prior work has focused on addressing whether models are capable of generating creative outputs. Here, we aim to consider novelty and investigate what makes model-generated content novel or not novel in a task-specific manner. We propose a fine-grained evaluation metric GENIE to measure the novelty of responses along task-specific features with respect to a population of responses. We show that unlike GENIE, holistic metrics struggle to capture the high-dimensionality of novelty and do not provide insight on which properties they target. Finally, we use GENIE to measure the effectiveness of mitigation methods that address creativity to better understand where these methods can improve novelty.

25.
arXiv (CS.LG) 2026-06-16

A Conservation Law for Equilibrium Propagation and Coupled Learning

arXiv:2606.15444v1 Announce Type: cross Abstract: In this paper we show that the physical learning methods known as coupled learning (CL) and equilibrium propagation (EP) conserve a mass-like quantity in the trainable parameters in the continuous-time, small-nudging limit. We prove that this conservation holds in a broad range of physically relevant settings. We then show that the conservation law constrains the training dynamics in a way that makes convergence reliable in important settings for linear circuits. We conclude by discussing some practical implications of this conservation law.