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01.
arXiv (CS.LG) 2026-06-19

Execution-State Capsules: Graph-Bound Execution-State Checkpoint and Restore for Low-Latency, Small-Batch, On-Device Physical-AI Serving

Authors:

arXiv:2606.20537v1 Announce Type: new Abstract: Mainstream LLM serving systems reuse prefix work mainly through paged or radix key-value (KV) caches. This is highly effective for high-throughput, high-concurrency serving, but it manages only one positional fragment of execution state: the KV cache. We study the opposite regime: low-latency, small-batch, on-device physical-AI serving, where interactive LLM agents, speech systems, and robot policies repeatedly branch, reset, interrupt, and re-enter under tight responsiveness budgets. We introduce execution-state capsules, a graph-bound checkpoint and restore mechanism for the complete restorable state at a committed boundary. FlashRT is a white-box, backend-facing kernel runtime whose evaluated NVIDIA CUDA backend runs captured graph plans over contiguous static buffers with no block-table indirection. Because the live state is a closed set of named buffers, a capsule can snapshot, restore, fork, or roll back the whole execution boundary, including KV, recurrent state, convolution state, MTP state, and metadata. This moves reuse from token-addressed KV fragments to graph-bound execution-state boundaries. On an RTX 5090, capsule restore is byte-exact at the stored-state level and token-identical under greedy decode. A KV-only ablation diverges, showing that recurrent state is load-bearing. GPU-resident snapshot and restore are sub-millisecond, and TTFT speedup over cold prefill grows from 3.9x at 2k tokens to 27x at 16k tokens. On Jetson AGX Thor and DGX Spark, the same correctness and structural properties hold. Capsules are not a replacement for high-throughput KV-cache serving; they define a complementary latency-first serving point for explicit execution-state reuse.

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

Toward Vibe Medicine: A Self-Evolving Multi-Agent Framework for Clinical Decision Support

arXiv:2606.15504v1 Announce Type: new Abstract: In recent years, the advances of large language models and autonomous agents have revolutionized the healthcare field, facilitating diagnosis and improving treatment results. However, most existing AI systems rely on pre-trained knowledge and predefined pipelines, which struggle to learn dynamically from the interactive chat session history that contains patient outcomes and past failures. To address this limitation, we propose VIBEMed, a multi-agent framework with a built-in self-evolution mechanism and architecture-level safety sandbox for robust clinical decision support. The system integrates three specialized agents, including a Clinical Diagnostic Agent (CDA) for hypothesis generation, a Therapeutic Execution Agent (TEA) for treatment planning, and a Clinical Evolution Manager Agent (CEMA) that distills longitudinal clinical feedback into reusable knowledge, transforming multimodal patient information into personalized medical decisions. Through self-evolution mechanism, the framework enables iterative updates across memory, model behavior, and decision strategies, allowing the system to improve over time. Experimental results show that VIBEMed demonstrates superior performance through its evolving mechanism in complex clinical cases, particularly in tasks that require integrated decision-making and longitudinal planning. The framework also supports reliable end-to-end decisions in challenging scenarios such as oncology treatment planning, highlighting its feasibility in real-world clinical contexts. Overall, VIBEMed provides a practical path beyond static AI systems toward adaptive, experience-driven clinical decision support, demonstrating the value of combining multi-agent collaboration with continuous evolution for advancing precision medicine.

03.
medRxiv (Medicine) 2026-06-15

Quantitative Gait Categorization in Parkinson's Disease with and without Freezing of Gait

Background: Freezing of gait (FOG) is a disabling and often underrecognized feature of Parkinsons disease (PD). Objective gait analysis may improve characterization of this motor symptom. Objective: To compare quantitative 3D gait parameters in PD with FOG (PDF) and PD without FOG (PDNF) in a routine clinical cohort. Methods: We retrospectively analyzed a sequential sample of 180 patients with PD referred for motion analysis between 2020 and 2024. All patients underwent 3D motion capture in the off-medication state. Eighteen gait outcomes spanning pace, rhythm, postural control, variability, and asymmetry domains were derived from steady-state walking tasks. FOG status was determined using physician documentation and Movement Disorder Society Unified Parkinsons Disease Rating Scale (MDS-UPDRS) items. Group differences between PDF (n=99) and PDNF (n=81) were evaluated using independent samples t-tests, with outcomes adjusted for disease duration and corrected for multiple comparisons. A secondary analysis among PDF compared those in Hoehn and Yahr (H&Y) stage [≥]III to those in H&Y [≤]II. Results: PDF had longer disease duration, higher OFF MDS-UPDRS III scores, and higher Hoehn and Yahr stage than PDNF but were similar in age and sex. After adjusting for disease duration and multiplicity, PDF demonstrated reduced step length, stride length, and forward velocity, and greater cadence variability, while most postural control, and asymmetry measures were comparable between groups. Among PDF, advanced H&Y stage was associated with impaired pace and rhythm, similar to previous reports among PD in general. Conclusion: In this large, sequential, clinically referred cohort, FOG was associated with more advanced PD and specific impairments in pace and gait variability. These findings support comprehensive 3D gait analysis as an objective tool to better delineate FOG-related gait abnormalities and identify features that may predict FOG, informing targeted interventions.

04.
arXiv (quant-ph) 2026-06-17

Impact of Network Constraints on Fault-Tolerant Distributed Quantum Computing

arXiv:2606.17495v1 Announce Type: new Abstract: As we move towards scalable and modular quantum computing, quantum data centres become imperative. Existing analyses typically treat network constraints in isolation or through simplified models, leaving the interplay between error correction operations and communication resources underexplored. In this work, we present an end-to-end simulation framework that jointly models surface-code operations, internal QPU connectivity, and realistic network constraints including finite entanglement generation rates, limited communication qubits, and bandwidth contention, producing execution latency, from which logical error rate estimates are obtained. The framework is modular by design, allowing individual components such as routing heuristics, scheduling policies, and network topologies to be independently replaced. Numerical evaluation reveals distinct operating regimes in which the optimal resource allocation and code distance selection shift depending on the network characteristics. These results point to tradeoffs in the design of distributed quantum computing architectures that are not visible when computation and communication are modeled separately.

05.
arXiv (CS.CV) 2026-06-16

MixTeX: Data-Efficient LaTeX OCR via Synthetic Pretraining and Limited Fine-Tuning

LaTeX OCR converts scientific document images into editable LaTeX code. Existing systems rely on large paired datasets, which are costly to collect and limited for low-resource languages. This paper presents MIXTEX, a data-efficient system using synthetic pretraining without real LaTeX sources. Unlike Nougat that depends on arXiv datasets, we generate training data by randomly pairing grammatical Wikipedia text with LaTeX formulas, requiring only syntactic correctness. This eliminates dependency on real document collections, enables scalable data generation (120M tokens), and supports low-resource languages. Following synthetic pretraining, adaptation requires only 400 real samples. Evaluation on a 977-sample benchmark with printed and handwritten English and Chinese shows that this two-stage strategy outperforms methods trained on large real datasets while requiring less human effort and computation. Data, code, and models are publicly available.

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

Uncertainty Decomposition for Clarification Seeking in LLM Agents

Recent position papers argue that the classical aleatoric/epistemic uncertainty framework is insufficient for interactive large language model (LLM) agents and call for underspecification-aware, decomposed, and communicable uncertainty representations that can unlock new agent capabilities such as proactive clarification seeking and shared mental-model building. Practical deployment constraints – black-box APIs, interactive latency budgets, and the absence of labeled trajectories – rule out logprob-based, multi-sampling, and training-based methods, leaving prompt-based estimation as the most viable family for surfacing such signals at deployment time. We answer this call with a simple prompt-based decomposition that separates action confidence from request uncertainty (u), enabling the agent to ask for clarification when the task specification is ambiguous. To evaluate it, we introduce two clarification-augmented benchmarks (WebShop-Clarification and ALFWorld-Clarification) in which 50% of tasks are deliberately underspecified, and systematically compare the proposed decomposition against ReAct+UE and Uncertainty-Aware Memory (UAM) across five LLM backbones (GPT-5.1, DeepSeek-v3.2-exp, GLM-4.7, Qwen3.5-35B, GPT-OSS-120B) on these variants together with the standard WebShop, ALFWorld, and REAL benchmarks for fault detection. Averaged across the five backbones, the proposed decomposition improves clarification F1 on ALFWorld-Clarification by 73% over ReAct+UE and by 36% over UAM, and leads clarification F1 on every backbone on WebShop-Clarification and on four of five backbones on ALFWorld-Clarification, indicating that the gains generalize beyond a single LLM.

07.
arXiv (math.PR) 2026-06-11

Matrix Discrepancy for Representations of Finite Groups

arXiv:2606.12181v1 Announce Type: new Abstract: Given a finite group $G$, we prove that there exist signs $\varepsilon\in\{\pm1\}^G$ such that $$\left\| \sum_{g\in G} \varepsilon_g\rho(g) \right\|\leq C\, \sqrt{|G|},$$ where $\rho$ is the left regular representation of $G$, and $C$ is a universal constant. This special case of the Matrix Spencer conjecture was posed in [BKMZ24], where it was established for simple groups.

08.
arXiv (CS.CL) 2026-06-11

BioDivergence: A Benchmark and Evaluation Framework for Hidden Contextual Contradictions in Biomedical Abstracts

Biomedical findings often seem to conflict across studies, but many of these differences are context-dependent rather than true contradictions. Variations in cohort, geography, assay protocol, disease subtype, and clinical setting can make both claims locally valid. Existing NLI and scientific claim-verification benchmarks reduce such cases to entailment, contradiction, or neutral, failing to capture the contextual structure behind divergence. To address this, we introduce BioDivergence, an evaluation framework with a six-class conflict taxonomy, a 13-axis divergence ontology, and four structured outputs per claim pair: conflict type, divergence axes, dominant confounder, and reconciliation explanation. We release BioDivergence-Silver-v1.0, an article-disjoint silver benchmark of 11,865 claim pairs across five biomedical domains, alongside a legacy deduplicated variant for comparison. Results show notable ranking differences between the two variants, with the fine-tuned reference model dropping about 12 points under the article-disjoint setting, while Mistral-7B-Instruct-v0.3 achieves 0.5523 accuracy and 0.3894 contextual-F1 on the 842-example primary test set. BioDivergence offers a more faithful way to distinguish contextual divergence from direct contradiction and to separate article-level memorization from genuine task learning.

09.
arXiv (CS.AI) 2026-06-17

Learning Red Agent Policy from Observations for Neurosymbolic Autonomous Cyber Agents

arXiv:2606.18223v1 Announce Type: cross Abstract: With sophisticated cyber-attacks becoming increasingly prevalent, modern networks require intelligent autonomous cyber-defense agents trained via Reinforcement Learning (RL). These agents employ neurosymbolic approaches such as behavior trees with learning-enabled components (LECs) to learn, reason, adapt, and implement security rules while maintaining critical operations. However, these autonomous networks are partially observable systems, i.e., the cyber-attacker's (red agent's) actions are not observable, making it difficult for the defender to predict red actions, learn red policies, or assess the attacker's intrusion levels. To address this, we propose a Policy Learning Technique using imitation learning to learn policies for partially observable RL agents with discrete states and discrete actions. We apply this technique in an autonomous cyber environment to predict red agent's actions from network observations and defender actions. Integrated with a neurosymbolic cyber-defense agent, our method effectively handles different red policies and achieves high prediction accuracy across diverse simulated scenarios.

10.
arXiv (CS.CL) 2026-06-11

ClawEnvKit: Automatic Environment Generation for Claw-Like Agents

Constructing environments for training and evaluating claw-like agents remains a manual, human-intensive process that does not scale. We argue that what is needed is not just a dataset, but an automated pipeline capable of generating diverse, verified environments on demand. To this end, we introduce ClawEnvKit, an autonomous generation pipeline that instantiates this formalism from natural language descriptions. The pipeline comprises three modules: (1) a parser that extracts structured generation parameters from natural language input; (2) a generator that produces the task specification, tool interface, and scoring configuration; and (3) a validator that enforces feasibility, diversity, structural validity, and internal consistency across the generated environments. Using ClawEnvKit, we construct Auto-ClawEval, the first large-scale benchmark for claw-like agents, comprising 1,040 environments across 24 categories. Empirically, Auto-ClawEval matches or exceeds human-curated environments on coherence and clarity at 13,800x lower cost. Evaluated across 4 model families and 8 agent harness frameworks, we find that harness engineering boosts performance by up to 15.7 percentage points over a bare ReAct baseline, completion remains the primary axis of variation with no model saturating the benchmark, and automated generation enables evaluation at a scale previously infeasible. Beyond static benchmarking, ClawEnvKit enables live evaluation: users describe a desired capability in natural language and obtain a verified environment on demand, turning evaluation into a continuous, user-driven process. The same mechanism serves as an on-demand training environment generator, producing task distributions that adapt to an agent's current weaknesses rather than being bounded by existing user logs.

11.
arXiv (math.PR) 2026-06-16

Large Deviations for the Nonlinear Schrödinger Equation with Randomized Quasi-Periodic Initial Data in Higher Dimensions: Subcritical Case

arXiv:2604.17253v2 Announce Type: replace Abstract: We study the cubic weakly nonlinear Schrödinger equation with randomized spatially quasi-periodic initial data in higher dimensions. Under a polynomial decay assumption in Fourier space, we establish a Large Deviations Principle for rogue waves in the so-called subcritical time regime. The proof proceeds in two main steps. We first characterize the distribution of the linear solution and establish the corresponding linear large deviations principle. The lower bound is obtained via pointwise estimates, while the upper bound follows from a combination of truncation and probabilistic arguments. {The method used in this step appears to be new; compare with [GGKS23].} We then perform a detailed combinatorial analysis of the Picard iteration, deriving an effective bound for the Duhamel term and thereby establishing the nonlinear large deviations principle.

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

The Benchmark Illusion: Pruned LLMs Can Pass Multiple Choice but Fail to Answer

Compressing large language models reduces memory use and inference cost, but it can also create failures that standard benchmarks miss. A pruned model may still perform well on multiple-choice evaluations, yet fail to answer the same question in open generation. We ask what pruning changes: does it erase the correct answer, or does it make the answer harder to produce as the top output? We study this question with multilingual question answering, tracking the same questions before and after pruning. We find a benchmark illusion. Under high-sparsity pruning, especially Wanda, models often fail in greedy open generation while still selecting the correct answer under multiple-choice scoring. In these recognition-only errors, the answer is usually not gone, but demoted: it often reappears with beam search, sampling, or one in-context example. Overall, multiple-choice benchmarks can overstate the usability of compressed LLMs, creating an evaluation blind spot. Compressed models should be tested on what they can produce, not only on what they can recognize.

13.
PLOS Computational Biology 2026-06-12

Ten simple rules for executing an inherited research plan in computational biology

by Sahar Javaheri Tehrani, Toni Ingolf Gossmann Trainees in computational biology frequently inherit research plans whose aims, datasets, analytical strategies, and technical constraints were defined before their arrival. These plans often emerge from grants, collaborations, legacy codebases, shared high-performance computing environments, or partially completed analyses. While such plans provide a useful scaffold, they rarely specify all implementation details, prior assumptions, evaluation criteria, or dependencies needed for reliable execution. The transition from inheriting a partially articulated plan to producing reproducible results therefore creates an execution gap: a phase in which trainees must reconstruct what the project is, which elements are fixed, which remain negotiable, and which technical or organizational assumptions need to be tested before full-scale analysis begins. In this Ten Simple Rules article, we provide a practice-oriented framework for stabilizing inherited computational biology projects before workflows, benchmarks, and decision paths become entrenched. We do not claim that the individual practices described here are novel in isolation. Rather, our contribution is to organize familiar practices into a sequenced framework for a recurrent but under-articulated phase of computational research: inherited-plan execution. Computational biology makes this phase especially important because projects often combine heterogeneous datasets, fragile software environments, undocumented preprocessing choices, benchmarking assumptions, distributed collaborators, and asymmetrical access to contextual knowledge. By making this transition visible and operational, the rules aim to help trainees, supervisors, and collaborators reduce ambiguity, test feasibility, document decisions, and support reproducible and equitable project execution under real-world constraints.

14.
arXiv (CS.CL) 2026-06-18

ActMem: Bridging the Gap Between Memory Retrieval and Reasoning in LLM Agents

Memory management is essential for LLM agents in long-term interactions. Current memory frameworks typically treat agents as passive ``recorders'' and retrieve information without understanding its deeper implications. They may fail in scenarios requiring reasoning and complex decision-making. To bridge this critical gap, we propose a novel actionable memory framework called ActMem that integrates memory retrieval with active causal reasoning. ActMem transforms unstructured dialogue history into a structured causal and semantic graph. By leveraging counterfactual reasoning and commonsense completion, it enables agents to deduce implicit constraints and resolve potential conflicts between past states and current intentions. Furthermore, we introduce a comprehensive dataset ActMemEval to evaluate agent reasoning capabilities in logic-driven scenarios, moving beyond the fact-retrieval focus of existing memory benchmarks. Experiments demonstrate that ActMem significantly outperforms baselines in handling complex, memory-dependent tasks, paving the way for more consistent and reliable intelligent assistants.

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

DemoDiffusion: One-Shot Human Imitation using pre-trained Diffusion Policy

arXiv:2506.20668v3 Announce Type: replace-cross Abstract: We propose DemoDiffusion, a simple method for enabling robots to perform manipulation tasks by imitating a single human demonstration, without requiring task-specific training or paired human-robot data. Our approach is based on two insights. First, the hand motion in a human demonstration provides a useful prior for the robot's end-effector trajectory, which we can convert into a rough open-loop robot motion trajectory via kinematic retargeting. Second, while this retargeted motion captures the overall structure of the task, it may not align well with plausible robot actions in-context. To address this, we leverage a pre-trained generalist diffusion policy to modify the trajectory, ensuring it both follows the human motion and remains within the distribution of plausible robot actions. Unlike approaches based on online reinforcement learning or paired human-robot data, our method enables robust adaptation to new tasks and scenes with minimal effort. In real-world experiments across 8 diverse manipulation tasks, DemoDiffusion achieves 83.8\% average success rate, compared to 13.8\% for the pre-trained policy and 52.5\% for kinematic retargeting, succeeding even on tasks where the pre-trained generalist policy fails entirely. Project page: https://demodiffusion.github.io/

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

The Truth Stays in the Family: Enhancing Contextual Grounding via Inherited Truthful Heads in Model Lineages

Recent advances in large language models (LLMs) have produced many specialized multimodal LLMs (MLLMs) that share common foundational LLMs, forming distinct model lineages. It remains unclear whether a fundamental behavioral link exists between the foundational LLMs and downstream variants. We investigate this question by quantifying head-level context-truthfulness scores. Across diverse LLM and MLLM lineages, including Vicuna-, Qwen2.5-, LLaMA2-, and Mistral-based models, we find that Truth Scores are strongly preserved within model families, even after instruction tuning or multimodal adaptation. We further show that this inheritance is consistent with attention-head weight preservation, and that context-truthful heads attend to query-relevant evidence. Building on this finding, we propose TruthProbe, a soft-gating strategy that amplifies context-truthful heads while preserving other head contributions. TruthProbe improves contextual truthfulness on HaluEval and reduces multimodal hallucination on POPE and CHAIR, with base-LLM Truth Scores transferring effectively to their fine-tuned LLM and MLLM descendants. Code is available at https://github.com/miso-choi/TruthProbe.

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

Physics-Guided Spatiotemporal Learning for Coastal Wave Peak Period Estimation from Video

arXiv:2606.13302v1 Announce Type: new Abstract: Wave parameters in the nearshore are crucial for coastal engineering, shoreline protection, marine hazard assessment, and coastal management for climate resilience. Traditional monitoring systems like buoys and radar platforms offer accurate monitoring but can have high installation and maintenance expenses and limited spatial coverage. Passive ocean monitoring using video has been achieved by leveraging deep learning, however, many methods are not physically interpretable, feasible, and validated for oceanography. In thiswork, a Physics-Guided Deep Spatiotemporal Learning Framework for direct estimation of nearshore wave peak periods from passive coastal video stream is proposed. The framework combines automated temporal-variance based region-of-interest detection, multi-stage Sim-to-Real transfer learning, and physics-informed regularization to enhance the predictive accuracy and physical consistency. A variety of spatiotemporal architectures were assessed, such as transformer-based and recurrent-convolutional ones, alongside synthetic pretraining,silver-label adaptation, and expert fine-tuning. The results show that transformer-based architectures outperformed in terms of the accuracy of the instantaneous prediction, while lightweight recurrent-convolutional architectures achieved higher temporal stability and operational oceanographic skill. Ablation studies also demonstrated the benefits of physics-guided regularization in terms of trend-following consistency, and physically implausible predictions. Explainability auditing also helped to focus attention in hydrodynamically active surf-zone regions and showed good agreement with the physically derived wave propagation behavior. In general, the proposed framework shows the promise of physics-guided video-based deep learning systems for long-term coastal wave monitoring that are cost-efficient and operationally feasible.

18.
PLOS Medicine 2026-06-01

Prenatal exposure to asthma medications and risk of neurodevelopmental disorders and educational difficulties: A systematic review and meta-analysis

by Lama A. Shakhshir, Alexia Karain, Jill P. Pell, Claire E. Hastie, Scott M. Nelson, Michael Fleming Background Since asthma exacerbations during pregnancy risk maternal and fetal health, continued medication is important. However, some studies have reported adverse neurodevelopmental outcomes following prenatal exposure to asthma medication. Therefore, this systematic review aimed to collate the existing evidence on the associations between prenatal exposure to asthma medication and neurodevelopmental and educational outcomes. Methods and findings A systematic review was conducted in accordance with PRISMA guidelines and the PECO framework. PubMed, Medline and Embase databases were searched for studies investigating prenatal exposure to one or more asthma medication and neurodevelopmental or educational outcomes published, in English, between January 2003 and September 2024, and updated in November 2025. Studies of asthma medication used for other indications were excluded. Study quality was assessed using the Newcastle-Ottawa scale. Random-effects meta-analyses were conducted where appropriate and heterogeneity was evaluated using Cochran’s Q and I2 tests.Of 16,824 studies identified by the initial search, seven were eligible for inclusion. All investigated beta-2-adrenergic agonists (B2AA), with one including B2AA as mono- and polytherapy—and one study also investigated inhaled corticosteroids (ICS) exposure. Two reported associations with autism spectrum disorder (ASD) and one with attention-deficit hyperactivity disorder (ADHD). An updated search identified one additional eligible study, which examined both ADHD and ASD, as well as other neurodevelopmental disorders. The included eight studies (n = 3,867,170 participants) comprised cohort (n = 5) and case-control (n = 3) designs and reported inconsistent results. Meta-analysis of three studies (n = 1,380,871) indicated significant associations with ASD for exposure to B2AA both preconception (aOR 1.34, 95% CI [1.19,1.52]) and during pregnancy (aOR 1.29, 95% CI [1.16,1.42]). Heterogeneity was low, with no evidence of significant publication bias. Limitations of the included studies comprised residual confounding and exposure misclassification. Additionally, studies included in the meta-analysis were few in number and did not adequately distinguish between medication effects and underlying maternal asthma. Conclusion Meta-analysis suggested an association between prenatal exposure to B2AA and ASD. An association with ADHD, reported in a single study, requires corroboration. To date, based on our search strategy, no association has been reported with communication skills, motor skills, problem-solving and personal-social skills, or cerebral palsy.

19.
arXiv (CS.CV) 2026-06-17

Theoretical Grounding of Out-Of-Distribution Detection With Reinforcement Learning Optimizer

Out-of-distribution (OOD) detection in dynamic open-world environments requires a model to continually adapt to evolving data distributions while generalizing to covariate-shifted inputs and rejecting semantic-shifted OOD examples. Most existing OOD detection methods optimize only the current-step objective and do not explicitly account for how post-deployment environment changes affect future OOD behavior. In this paper, we establish a theoretical grounding for dynamic OOD detection using a reinforcement learning (RL)-guided optimizer that explicitly favors updates that reduce the semantic OOD false positive rate over time. We develop a novel augmented optimizer that uses an RL-guided correction term on top of standard gradient descent (GD) and show its improvement over both future-domain generalization and semantic-OOD rejection. We analyze temporal error decomposition in terms of model-change and environment-change generalization errors and develop a new theoretical framework for comparing the generalization errors under both GD and RL-guided optimizers.

20.
medRxiv (Medicine) 2026-06-12

Heterogeneity of Treatment Effect of Aspirin and Clinically Significant Bleeding in Older Adults

Aim: The global population of older adults is growing, and older age is linked to higher bleeding risk. Although guidelines discourage aspirin for primary prevention in healthy older adults due to bleeding harms outweighing benefits, many continue taking it without a clear indication. It remains unclear whether all older adults face uniform aspirin-related bleeding risk or if certain subgroups are more vulnerable. Methods: We analyzed data from 19,114 ASPREE trial participants to develop machine learning models using 116 baseline variables. Random forest (RF) and random survival forest (RSF) models predicted 5-year bleeding risk, and participants were stratified into low, intermediate, and high-risk groups based on the 20th and 80th percentiles of predicted risk. We assessed heterogeneity of treatment effect (HTE) by testing treatment-by-risk group interactions on the relative scale using Fine-Gray models, and on the absolute scale using observed 5-year cumulative incidence rates. Results: Over a median follow-up of 4.7 years, 626 major bleeding events occurred. The RF model had moderate discrimination (AUC = 0.65, 95% CI: 0.63-0.67) and good calibration (Brier = 0.032, 95% CI: 0.029-0.034). Statistically significant HTE was observed on the relative scale, with the greatest relative increase in bleeding risk seen in the low-risk group (subdistribution hazard ratio = 2.26, 95% CI: 1.27-4.01). On the absolute scale, low-risk participants experienced higher bleeding with aspirin (absolute risk difference (ARD) = 1.17%, 95% CI: 0.37-1.95), but heterogeneity in ARDs was not statistically significant (Cochran's Q p > 0.45). Similar findings were observed when using the RSF model. Conclusion: Participants at lowest baseline bleeding risk experienced the greatest relative increase in bleeding risk with aspirin therapy. We found statistically significant heterogeneity in treatment effects on the relative but not absolute scale. These findings support an individualized, risk-based approach to aspirin therapy decision-making in older adults.

21.
bioRxiv (Bioinfo) 2026-06-18

Population-associated molecular variation in histologically normal breast tissue is context-dependent and associated with distinct transcriptional states

Population-associated molecular variation in breast tissue may contribute to differences in tissue biology and disease susceptibility, yet the extent to which such variation is shaped by underlying tissue states remains unclear. Here, we performed RNA-seq and lipidomic profiling of histologically normal breast tissue samples from African American (AA) and Caucasian White (CW) individuals, followed by conceptual integration of the resulting transcriptomic and lipidomic patterns. Unsupervised analysis revealed two distinct baseline transcriptional states (G1 and G2) that defined the primary axis of molecular variation across the cohort and corresponded to epithelial-enriched (G1) and vascular-enriched (G2) tissue contexts as determined by cell-type deconvolution. Global comparisons between AA and CW samples showed minimal transcriptomic differences, with only a single gene reaching significance after multiple testing correction. However, when stratified by baseline tissue state, 191 genes were differentially expressed within G1, with coordinated upregulation of extracellular matrix organization and proliferative/cytoskeletal processes in AA samples. These patterns were consistently supported across multiple enrichment approaches. No comparable population-associated differences were observed within G2. Lipidomic analyses showed partial but non-significant trends consistent with transcriptomic structure, suggesting that lipid variation provides complementary but limited support for baseline molecular differences, likely reflecting constraints of bulk tissue composition. Together, these findings suggest that population-associated molecular differences in normal breast tissue are context-dependent and emerge within specific baseline transcriptional states, where distinct biological programs can coexist and be differentially modulated. These findings highlight the importance of tissue heterogeneity in shaping molecular variation and its potential relevance to disease-associated tissue states.

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

Entropy-Gated Latent Recursion

arXiv:2606.16620v1 Announce Type: cross Abstract: Inference-time scaling has become the dominant lever for improving language-model reasoning, but existing methods derive rollout diversity from a single source: stochastic token-level sampling. We argue that this single-axis sampling space is fundamentally limiting, and identify a second, fully deterministic and complementary axis: the layer span $L$ at which a frozen model's top decoder layers are recursively re-applied at high-uncertainty tokens. Different choices of $L$ produce distinct rollouts that solve different subsets of problems, with no stochasticity. We instantiate this axis through Entropy-Gated Latent Recursion (EGLR), a training-free decoding procedure that re-applies the top-$L$ layers for at most $K_{\max}$ iterations until the next-token distribution converges. Combined with $T$ temperature samples, EGLR turns a single-axis stochastic rollout pool into an $L\times T$ Cartesian sampling space at almost the same per-rollout cost. We characterize this space across $8$ instruction-tuned models and $6$ math reasoning benchmarks, and show that the $L$-axis is genuinely complementary to temperature: on MATH-500 with Qwen2.5-3B-Instruct, the joint $L\times T$ oracle reaches $91.6\%$, $+8.2$ percentage points beyond the temperature-only oracle ($83.4\%$) and $+10.4$ points beyond the layer-only oracle ($81.2\%$), confirming that the two axes capture genuinely complementary problems. The expanded rollout pool provides richer per-prompt candidates for any downstream procedure that consumes rollouts, including self-consistency, best-of-$N$ with verifiers, and group-relative RL training (GRPO), opening a new direction for inference-time scaling that does not rely on stochastic noise.

23.
medRxiv (Medicine) 2026-06-22

Cumulative Metabolic Exposure to Hyperglycemia and Risk of Cardiovascular and Limb Events in Peripheral Artery Disease

Background: Although diabetes is a potent risk factor for the development of peripheral artery disease (PAD), the effect of cumulative metabolic exposure to hyperglycemia on risk of cardiovascular or limb events in patients with PAD remains unclear. Methods: The Peripheral Artery Disease: Long-term Survival (PEARLS) is a longitudinal registry of Veterans with newly diagnosed PAD identified using a natural language processing approach. Included patients had ankle brachial index [≤]0.9 or toe brachial index [≤]0.7, and no history of lower extremity revascularization or major amputation. Among patients with diabetes in this cohort, we assessed cumulative exposure to hyperglycema based on a 24-month rolling average of hemoglobin (Hgb) A1c values, categorized as [≤]7%, >7% to [≤]8%, and >8%. Multivariable Cox regression models evaluated the association between categories of HgbA1c, modeled as a time-varying exposure, and risk of cardiovascular (CV: myocardial infarction or stroke) and limb (chronic limb threatening ischemia [CLTI] or major amputation) events. Results: Among 45,109 patients with new diagnosis of PAD and pre-existing diabetes, the mean HgbA1c at baseline was 7.5%, with nearly one-third (30.4%) having HgbA1c >8%. The mean age was 70.4 years, 19.8% were Black and 4% were Hispanic. Patients with baseline HgbA1c >8% were younger and compared to those with HgbA1c [≤]7%, more likely to have coronary disease, kidney disease, and obesity. Over a median follow up of 4.2 years, 8,306 (18.4%) patients experienced a CV event, and 8,199 (18.2%) experienced a limb event. The adjusted association between HgbA1c and hazard of CV events was 12% higher in patients exposed to HgbA1c >7% to [≤]8% (HR 1.12; 95%CI: 1.05-1.18) and 38% higher in those exposed to HgbA1c >8% (HR 1.38; 95%CI: 1.30-1.46), compared to HgbA1c 7% to [≤]8% (HR 1.20; 95%CI: 1.13-1.28) and HgbA1c >8% (HR 1.60; 95%CI: 1.51-1.70), respectively when compared to HgbA1c [≤]7%. These findings were consistent in subgroups based on age and severity of PAD. Conclusions: Among diabetic patients with PAD, cumulatiave metabolic exposure to hyperglycemia is associated with a markedly increased risk of clinical events, especially limb events.

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

Decision-Aware Memory Cards: Counterfactual-Inspired Context Selection and Compression for Tool-Using LLM Agents

arXiv:2606.08151v2 Announce Type: replace Abstract: Modern large language model (LLM) agents do not simply need longer contexts; they need decision-relevant evidence at the moment of action. We study decision-aware context selection: ranking retrieved files, tests, traces, rules, and memories by their expected effect on an agent's next action rather than by semantic similarity alone. We present the Counterfactual-Inspired Context Layer (CICL), which builds an instance context graph, estimates decision-oriented utility for candidate units, and compresses selected evidence into typed memory cards. The same schema can be instantiated with hosted LLM judges, local surrogates, or lightweight rankers, making the selection protocol auditable across model choices. On 50 SWE-bench Verified file-retrieval instances, Qwen3.6-Plus reranking of BM25 top-50 candidates improves hit@1 from 0.58 to 0.78 and MRR@10 from 0.634 to 0.790, with all 2,500 judgments parseable. Controlled diagnostics show that CICL identifies action-critical evidence: removing the top-utility semantic unit reduces F1 from 0.245 to 0.000. In selected-then-compressed mode, memory cards save 44.93 tokens per query while preserving selected evidence. CICL provides a practical layer for measuring, ranking, and compressing decision-critical context for tool-using agents. Code is available at https://github.com/stephen-guan-researcher/CICL.

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arXiv (CS.CV) 2026-06-16

GraphBEV++: Multi-Modal Feature Alignment for Autonomous Driving

Feature misalignment in BEV perception is a critical yet often overlooked challenge in autonomous driving, especially under calibration uncertainties between LiDAR and camera sensors. To address this issue, we propose a robust multi-modal fusion framework, GraphBEV++, which systematically mitigates projection-induced misalignment. The framework consists of two key modules: LocalAlign-v2 and GlobalAlign-v2. LocalAlign-v2 introduces neighborhood-aware depth features via graph matching to correct local misalignment. It supports both LSS-based and query-based BEV representations, making it compatible with BEVFusion and BEVFormer architectures for consistent cross-paradigm alignment. GlobalAlign-v2 encompasses two variants: Deformable and Diffusion. The Deformable variant addresses global misalignment in LSS-based multi-modal BEV by explicitly learning cross-modal feature offsets. In contrast, the Diffusion variant targets implicit misalignment in query-based BEV by injecting noise to simulate misalignment and employing a denoising process to recover aligned features. Experimental results show that GraphBEV++ achieves state-of-the-art performance under misalignment noise on nuScenes and Waymo subset, improves long-range detection on Argoverse2, and generalizes effectively to the 3D occupancy prediction task, consistently improving occupancy estimation accuracy and robustness under both clean and noisy settings. Furthermore, GraphBEV++ effectively alleviates misalignment issues in end-to-end autonomous driving. Compared with five baselines (UniAD, VAD, FusionAD, MomAD, and WoTE), it demonstrates superior performance in both open-loop (nuScenes) and closed-loop (Bench2Drive and NAVSIM) evaluations across perception, prediction, and planning tasks.