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01.
arXiv (CS.CL) 2026-06-16

MedSynth: Realistic, Synthetic Medical Dialogue-Note Pairs

Authors:
Ahmad Rezaie Mianroodi↗Amirali Rezaie↗Niko Grisel Todorov↗Nadine A. Friedrich↗Maria P Mogollon↗Alexander Hernandez-Tirado↗Guillermo Lopez Garcia↗Cyril Rakovski↗Frank Rudzicz↗

Physicians spend significant time documenting clinical encounters, a burden that contributes to professional burnout. To address this, robust automation tools for medical documentation are crucial. We introduce MedSynth – a novel dataset of synthetic medical dialogues and notes designed to advance the Dialogue-to-Note (Dial-2-Note) and Note-to-Dialogue (Note-2-Dial) tasks. Informed by an extensive analysis of disease distributions, this dataset includes over 10,000 dialogue-note pairs covering over 2000 ICD-10 codes. We demonstrate that our dataset markedly enhances the performance of models in generating medical notes from dialogues, and dialogues from medical notes. The dataset provides a valuable resource in a field where open-access, privacy-compliant, and diverse training data are scarce. Code is available at https://github.com/ahmadrezarm/MedSynth/tree/main and the dataset is available at https://huggingface.co/datasets/Ahmad0067/MedSynth.

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02.
arXiv (CS.CL) 2026-06-19

Granularity-Regulated Adaptive Computational Efficiency for Optimal Verification in Test-Time Scaling

Authors:
Ardit Krasniqi↗Luan Vejsiu↗Elira Dervishi↗

Test-time scaling (TTS) has emerged as a powerful paradigm for improving the reasoning performance of large language models (LLMs) by investing additional compute at inference time. A central component of TTS is the verifier, which selects or scores candidate solutions to guide the search process. While prior work has explored the benefit of verification, a fundamental question remains underexplored: what is the optimal granularity of verification under a given compute budget? Coarse-grained outcome reward models (ORMs) and fine-grained process reward models (PRMs) represent two extremes, yet neither alone achieves compute-optimality across all regimes. In this paper, we establish a unified theoretical framework, called GRACE (\underline{G}ranularity-\underline{R}egulated \underline{A}daptive \underline{C}omputational \underline{E}fficiency), that characterizes the optimal verification granularity as an explicit function of problem difficulty, verifier accuracy, and compute budget. We prove that there exists a phase transition: fine-grained verification dominates when either the compute budget is large or the problem is hard, whereas coarse-grained verification is preferred in the low-budget, easy-problem regime. Our theory unifies Best-of-$N$, beam search, and step-level MCTS within a single Pareto-optimality framework, and motivates an adaptive granularity strategy that provably achieves the compute-performance Pareto frontier. Empirical results on MATH-500, GSM8K, and AIME benchmarks corroborate all four theoretical claims, with our adaptive strategy outperforming fixed-granularity baselines by up to 3.1\% accuracy at matched compute.

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03.
arXiv (CS.LG) 2026-06-15

MOSIC: Model-Agnostic Optimal Subgroup Identification with Multi-Constraint for Improved Reliability

Authors:
Wenxin Chen↗Weishen Pan↗Kyra Gan↗Fei Wang↗

arXiv:2504.20908v3 Announce Type: replace Abstract: Current subgroup identification methods typically follow a two-step approach: first estimate conditional average treatment effects and then apply thresholding or rule-based procedures to define subgroups. While intuitive, this decoupled approach fails to incorporate key constraints essential for real-world clinical decision-making, such as subgroup size and propensity overlap. These constraints operate on fundamentally different axes than CATE estimation and are not naturally accommodated within existing frameworks, thereby limiting the practical applicability of these methods. We propose a unified optimization framework that directly solves the primal constrained optimization problem to identify optimal subgroups. Our key innovation is a reformulation of the constrained primal problem as an unconstrained differentiable min-max objective, solved via a gradient descent-ascent algorithm. We theoretically establish that our solution converges to a feasible and locally optimal solution. Unlike threshold-based CATE methods that apply constraints as post-hoc filters, our approach enforces them directly during optimization. The framework is model-agnostic, compatible with a wide range of CATE estimators, and extensible to additional constraints like cost limits or fairness criteria. Extensive experiments on synthetic and real-world datasets demonstrate its effectiveness in identifying high-benefit subgroups while maintaining better satisfaction of constraints.

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04.
arXiv (CS.AI) 2026-06-17

Reversal Q-Learning

Authors:
Aditya Oberai↗Seohong Park↗Sergey Levine↗

arXiv:2606.17551v1 Announce Type: cross Abstract: Iterative generative modeling techniques, such as flow matching, provide powerful tools to model complex behaviors for effective offline reinforcement learning (RL). In this work, we propose a new off-policy RL algorithm that trains a flow policy based on prior data. Our idea starts from the "expanded" Markov decision process (MDP) framework, which treats individual flow refinement steps as separate actions in an MDP. To enable off-policy RL within this framework, we apply two techniques: we generate virtual on-policy trajectories (by "reversing" flows) to make this framework compatible with prior data, and we apply a bias-and-variance reduction technique to mitigate the curse of horizon in off-policy RL. We call the resulting algorithm Reversal Q-learning (RQL). RQL has several advantages over previous flow-based RL methods: it does not suffer from backpropagation through time, makes better use of the learned value function, and directly trains the full, expressive flow policy. Through our experiments on 50 challenging simulated robotic tasks, we show that RQL leads to the best average offline RL performance compared to state-of-the-art flow-based offline RL algorithms.

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05.
Nature (Science) 2026-06-10

A first-in-class pulsatile FXR agonist for bile-acid-related liver diseases

Authors:
Yi Zang↗

Nuclear receptors are central regulators of metabolism1, yet therapeutic strategies that enforce continuous receptor activation frequently lead to reduced efficacy and unacceptable toxicity. Here we report a first-principles drug design strategy that aligns pharmacokinetics with physiological signalling cycles. We developed linafexor, a potent non-bile-acid agonist of the farnesoid X receptor (FXR)2; it is engineered for rapid systemic clearance, which enables pulsatile receptor activation that mirrors endogenous bile acid dynamics3–5. Linafexor has robust efficacy across multiple preclinical models of metabolic dysfunction-associated steatohepatitis6, liver fibrosis7, primary biliary cholangitis and primary sclerosing cholangitis8,9. Transcriptomic analyses reveal that, unlike long-acting FXR agonists10,11, linafexor preserves cyclic FXR signalling, avoids receptor downregulation and prevents broad transcriptional dysregulation. Direct manipulation of delivery patterns demonstrates that sustained FXR activation—independent of compound identity—induces severe toxicity, establishing activation duration as a determinant of therapeutic index. In phase 1 clinical studies (ClinicalTrials.gov; NCT05082779), linafexor administered once daily produces transient FXR pathway engagement, marked by (1) induction of FGF1912–14, a key endocrine mediator of bile acid feedback regulation; and (2) suppression of C415, an intermediate reflecting hepatic bile acid synthesis, with no treatment-related adverse events. Together, these findings identify pulsatile FXR activation as a mechanistically grounded and clinically translatable strategy, and establish linafexor as a first-in-class therapeutic for bile acid–related liver diseases. Linafexor is a rapidly cleared FXR agonist designed to mimic natural bile acid signalling, achieving transient receptor activation with strong efficacy and reduced toxicity in preclinical and early clinical studies.

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

Do Time Series Foundation Model Benchmarks Hide Regime-Dependent Failures? Evidence from Traffic Speed Forecasting

Authors:
Yingshuo Wang↗Xian Sun↗Lingdong Kong↗Wei Gao↗Yanhang Li↗Zhichao Fan↗Zexin Zhuang↗

arXiv:2606.18367v1 Announce Type: new Abstract: Standard benchmarks evaluate time series foundation models (TSFMs) using aggregate metrics, but these can mask severe failures in critical operating regimes. We introduce regime-stratified evaluation and apply it to three TSFMs on two standard traffic speed benchmarks. Traffic exhibits abrupt regime switching between free-flow and congested states, producing bimodal speed distributions during transitions. When we stratify by traffic regime, both accuracy and prediction-interval coverage degrade sharply during transitions: transition-regime MAE reaches 11 mph (versus 3 mph overall), and empirical coverage of 90% prediction intervals drops as low as 55%. These failures are invisible in aggregate metrics because free-flow observations dominate the sample. A simple historical conditional baseline (sampling from per-sensor training distributions) achieves better transition coverage than any TSFM, but has far worse overall accuracy. We propose bimodal mixture augmentation (BMA), a post-hoc method that combines TSFM forecasts with historical distributional knowledge, approaching the historical baseline's transition coverage while preserving the TSFM's accuracy. Our results suggest that TSFM benchmarks should incorporate regime-aware evaluation to surface failures that aggregate metrics hide.

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07.
arXiv (CS.CV) 2026-06-16

SAMTok: Representing Any Mask with Two Words

Authors:
Yikang Zhou↗Tao Zhang↗Dengxian Gong↗Yuanzheng Wu↗Ye Tian↗Haochen Wang↗Haobo Yuan↗Jiacong Wang↗Lu Qi↗Hao Fei↗Anran Wang↗Zhuochen Wang↗…

Pixel-wise capabilities are essential for building interactive intelligent systems. However, pixel-wise multi-modal LLMs (MLLMs) remain difficult to scale due to complex region-level encoders, specialized segmentation decoders, and incompatible training objectives. To address these challenges, we present SAMTok, a discrete mask tokenizer that converts any region mask into two special tokens and reconstructs the mask using these tokens with high fidelity. By treating masks as new language tokens, SAMTok enables base MLLMs (such as the QwenVL series) to learn pixel-wise capabilities through standard next-token prediction and simple reinforcement learning, without architectural modifications and specialized loss design. SAMTok builds on SAM2 and is trained on 209M diverse masks using a mask encoder and residual vector quantizer to produce discrete, compact, and information-rich tokens. With 5M SAMTok-formatted mask understanding and generation data samples, QwenVL-SAMTok attains state-of-the-art or comparable results on region captioning, region VQA, grounded conversation, referring segmentation, scene graph parsing, and multi-round interactive segmentation. We further introduce a textual answer-matching reward that enables efficient reinforcement learning for mask generation, delivering substantial improvements on GRES and GCG benchmarks. Our results demonstrate a scalable and straightforward paradigm for equipping MLLMs with strong pixel-wise capabilities. Our code and models are available.

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

See First, Answer Later: Visual Evidence Pre-Alignment via Sufficiency-Driven RL

Authors:
Yilian Liu↗Sicong Leng↗Guoshun Nan↗Junyi Zhu↗Jiayu Huang↗Minghao Sun↗Xuancheng Zhu↗Yisong Chen↗Zexian Wei↗Xiaofeng Tao↗

Multimodal large language models (MLLMs) integrate strong text reasoning with visual inputs, yet their responses can be inconsistent with the underlying images, indicating ineffective utilization of visual evidence during inference. The prevailing training paradigm relies on large-scale caption-based pretraining for general alignment, followed by supervised fine-tuning and reinforcement learning to enable instruction following and complex reasoning. However, such pretraining provides only weak visual grounding: short, coarse captions bias models toward salient objects while neglecting fine-grained visual evidence. In this paper, we introduce Visual Evidence Pre-Alignment (VEPA), an intermediate stage between pretraining and post-training that explores a novel sufficiency-driven objective with Group Relative Policy Optimization (GRPO) to optimize question-conditioned visual evidence descriptions. Extensive experiments across diverse benchmarks show that our VEPA consistently enhances performance on visually demanding evaluations and complements standard supervised post-training. Further analyses show that the income stems from strengthened, transferable visual grounding, rather than from additional task-specific training.

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

Can In-Context Learning Support Intrinsic Curiosity?

Authors:
Eric Elmoznino↗Sangnie Bhardwaj↗Johannes von Oswald↗Rajai Nasser↗Blaise Ag\"uera y Arcas↗Jo\~ao Sacramento↗Rif A. Saurous↗Guillaume Lajoie↗

arXiv:2606.19476v1 Announce Type: cross Abstract: Effective machine learning depends not only on how we model data, but also on what data we choose to collect. While large sequence models have revolutionized data modeling, the problem of automated data selection, or "intrinsic curiosity", remains a significant challenge. Classic approaches incentivize exploration by rewarding an agent based on its "learning progress", which measures how much a newly acquired observation improves a world model's predictive ability. However, evaluating these rewards traditionally requires expensive inner loops of gradient descent updates within each trajectory, rendering them computationally impractical at scale. In this work, we investigate whether the emergent in-context learning (ICL) capabilities of sequence models can eliminate this bottleneck by serving as immediate, update-free world models. Specifically, we evaluate whether an exploration policy can be trained to maximize learning progress, using solely the prediction errors and counterfactual context manipulations of an in-context learner. We first prove that in general Markov decision processes, this is in fact impossible in an unbiased way: the resulting intrinsic rewards either suffer from nuisance terms that bias their estimation of true learning progress, or they cannot be implemented using an in-context learner's prediction errors. Conversely, we prove a positive result for a broad subclass of non-temporal settings, encompassing active learning and Bayesian Experimental Design: here, ICL-derived rewards successfully bound and asymptotically converge to the true learning progress. We corroborate our theory with controlled experiments across continuous and symbolic environments, demonstrating that our ICL-driven framework successfully trains curious data-collection policies that explore optimally.

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10.
arXiv (CS.CV) 2026-06-18

Performance Gap Analysis between Latin and Arabic Scripts HTR

Authors:
Sana Al-azzawi↗Elisa Barney↗Marcus Liwicki↗

Recent studies have shown that handwritten text recognition (HTR) systems perform worse on Arabic-script datasets than on Latin-script data. However, the reasons for this gap are still not well understood due to the lack of controlled comparisons. In this work, we present a comprehensive study of Arabic and Latin scripts HTR using a unified CRNN model for line-level HTR across nine datasets (including KHATT (Arabic), Muharaf (Arabic), NUST-UHWR (Urdu), PHTD (Persian), IAM (English), READ-2016 (German), and others) and di ferent training sizes (K in {100, 500, 1000, 2000, ..., Kfull}). Our results show the performance gap remains: it is large in low-resource settings, decreases with more data, but remains even at full scale, with a consistent difference of 5-7 CER points. We show that annotation quality matters, as many datasets contain labeling errors. Cleaning reduces error rates and narrows the gap, but does not eliminate it. In addition, we find that a fixed number of training samples provides less effective coverage in Arabic due to higher visual variability, requiring more data to learn similar representations. We compare recognition across datasets in terms of the number of text lines and the number of characters, showing an equivalence trade-off. We compare character frequency distributions across scripts and show that Arabic is significantly more heavy-tailed than Latin. Our error analysis reveals that around 30 percent of substitution errors in Arabic datasets (e.g., KHATT) are caused by confusion between visually similar characters, compared to about 15 percent in Latin-script datasets such as IAM.

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

Beyond Classification: A Cough Regression Benchmark for Respiratory Acoustic Foundation Models

Authors:
Mayur Sanap↗Prasanna Desikan↗Edgar Lobaton↗

arXiv:2606.15436v1 Announce Type: cross Abstract: Respiratory acoustic foundation models (FMs) excel at cough classification, yet their ability to predict continuous health quantities from cough audio remains largely unexplored, despite the clinical value of passive age, BMI, and disease probability estimation in settings where physical measurements are unavailable. We introduce the multi-model, multi-target cough regression benchmark evaluating five FMs (OPERA-CT, OPERA-CE, OPERA-GT, HeAR, M2D+Resp) across six targets on three datasets under subject-disjoint protocols, comparing linear, MLP-small, and full MLP regression heads. MLP-small beats the mean-predictor baseline on all tasks and linear probing in 23 of 30 model x task cases, with full MLP overfitting on small clinical data but recovering on larger sets, revealing a dataset size x head-capacity trade-off. HeAR leads within-dataset age regression on Coswara (9.12 yr MAE); its CIDRZ result is excluded from headline claims owing to possible HeAR-CIDRZ pretraining overlap. OPERA-GT is favored over OPERA-CT on age in all three datasets, with the CIDRZ margin within seed variance, extending a generative-pretraining advantage from breath to cough. HeAR and M2D+Resp reach near-full performance at N = 50 samples while OPERA models require N = 400. Cross-dataset transfer is strongly asymmetric as large diverse data generalises to small clinical populations (CoughVID to CIDRZ: -0.17 yr) but not vice versa (CIDRZ to Coswara: +2.43 yr, +26.6%).

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12.
arXiv (quant-ph) 2026-06-16

The Distribution Postulate in Algorithmic Bohmian Mechanics

Authors:
Jeffrey A. Barrett↗Eddy Keming Chen↗Josiah Lopez-Wild↗

arXiv:2606.16165v1 Announce Type: new Abstract: In order to make the right empirical predictions Bohmian mechanics requires a special statistical boundary condition – the distribution postulate – but it is unclear how best to understand this condition. We show how one might use the theory of algorithmic randomness to formulate the distribution postulate as an objective constraining law. The framework requires us to say something about admissible quantum-mechanical states and measurements. In return, algorithmic Bohmian mechanics (aBM) guarantees the standard Born statistics for a collection of canonical quantum experiments in the limit, not just with high probability. The algorithmic distribution postulate provides a sharp typicality condition, clarifies the status of quantum probabilities in the deterministic theory, and provides a concrete example of how notions provided by the theory of algorithmic randomness can aid in specifying the content of a physical law.

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

HAMON: Passive Optical Sequence Mixing for Long-Horizon Forecasting

Authors:
Alper Y{\i}ld{\i}r{\i}m↗

arXiv:2606.17028v1 Announce Type: cross Abstract: Simple linear and frequency-domain models remain surprisingly competitive in long-horizon time-series forecasting, and recent mechanistic evidence suggests that standard forecasting benchmarks may not require the dense superposed representations that make transformers powerful in other domains. This raises a substrate-level question: if the core forecasting operator is often low-complexity and approximately linear, does it need to be implemented as learned digital temporal mixing? We introduce HAMON, a passive diffractive optical forecasting core in which historical values are encoded onto an optical aperture, future positions are left dark, and cascaded trainable phase masks with free-space diffraction shape the forecast directly in the output field. At inference, prediction is performed by a single passive optical propagation pass with no trainable digital sequence-mixing layer. Across standard benchmarks, HAMON outperforms the strongest digital baselines considered on ETTm2 at all horizons and on ETTh2 at all but the longest horizon, improving MSE by up to 14\% and doing so consistently across horizons rather than at isolated points. It is competitive on Weather and trails the strongest baselines on the remaining ETT settings and on the high-channel-count Traffic and Electricity datasets. Phase encoding, intensity-compatible readout, and phase-scrambling ablations, together with a TorchOptics cross-simulator check, indicate that the forecasts arise from the data-bearing optical field rather than from a digital forecasting head. Because the passive core uses standard Fourier optics, HAMON defines a concrete target for optical hardware and for passive physical sequence mixing.

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14.
medRxiv (Medicine) 2026-06-15

Dysplasia-Stratified Management of Barrett's Esophagus: An Incidence-Based U.S. Cost-Effectiveness Analysis

Authors:
Kowada↗

Background and Aims Barrett's esophagus (BE) is the principal precursor of esophageal adenocarcinoma (EAC), whose incidence has risen sharply in Western countries since the 1960s. Effective, dysplasia stratified surveillance strategies are needed to prevent progression. This study evaluated the cost effectiveness of dysplasia stratified surveillance intervals and endoscopic eradication therapy (EET) across the BE spectrum. Methods We developed an incidence-based Markov state transition model of BE progression calibrated to U.S. epidemiologic data from a healthcare sector perspective over a lifetime horizon. Four hypothetical cohorts of 50-year-old individuals with short segment BE (SSBE), nondysplastic BE (NDBE), low grade dysplasia (LGD), or high-grade dysplasia (HGD) were evaluated. Strategies included no surveillance; surveillance at 1-, 2-, 3-, 4-, 5-, or 10-year intervals; standard or AI assisted endoscopy; non endoscopic screening (sponge, breath, miRNA tests); and EET for LGD and HGD. Outcomes included costs, quality adjusted life years (QALYs), incremental cost effectiveness ratios (ICERs), net monetary benefits (NMBs), EAC cases, and EAC-related deaths. Sensitivity analyses used a willingness to pay threshold of US$100,000 per QALY. Results No surveillance was the most cost-effective strategy for SSBE and NDBE. For LGD, upfront EET was more cost effective than all surveillance strategies, with results sensitive to EAC incidence and recurrence. For HGD, EET was cost saving and yielded the greatest QALYs, with findings robust in 99.9% of simulations. EET prevented 12,614 and 44,295 EAC related deaths per 100,000 individuals with LGD and HGD, respectively. Conclusion Dysplasia-stratified management is essential for optimizing surveillance and treatment strategies in BE. Any degree of dysplasia should receive EET followed by targeted post-treatment monitoring, establishing EET as the central therapeutic pathway for dysplastic BE.

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

APEX: Adaptive Principle EXtraction A Three-Layer Self-Evolution Framework for Production AI Agents

Authors:
Ya-Chuan Chen↗Tien-Jen Lai↗Hsiang-Wei Hu↗

arXiv:2606.15363v1 Announce Type: new Abstract: Self-improvement in AI agents has emerged as a key research frontier: systems that modify their own prompts, workflows, and decision rules based on accumulated operational experience. The state-of-the-art Self-Harness framework [1] achieves 14–21% improvement on Terminal-Bench-2.0 by mining failure clusters and patching the agent harness. However, Self-Harness optimises only one dimension – the prompt harness – leaving behavioural principles and workflow topology unchanged. We propose APEX (Adaptive Principle EXtraction), a three-layer co-evolution framework that simultaneously evolves: (L1) the harness via failure-mode patching, (L2) behavioural principles via success-trace distillation [2], and (L3) the agent workflow topology via structural fitness-based selection [6]. We implement APEX on Joe [13], a production-grade super AI Agent built on NVIDIA Nemotron and designed as an Edge AI Agent Factory for the NVIDIA Agent Challenge 2026, managing a 15-node compute fleet using 114 real task traces collected over 18 days. APEX achieves an APEX Health Score of 0.570 (+90% vs. baseline 0.300) in a single evolutionary run, distilling 6 novel reusable principles and selecting a research-first workflow topology scoring 0.900 (+20%). Our results demonstrate that multi-dimensional co-evolution substantially outperforms single-axis harness optimisation, at a cost of only 4 LLM calls (~270 s) on a local qwen2.5-coder:32b instance.

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

LLM-Powered Multi-Agent System for Automated Crypto Portfolio Management

Authors:
Yichen Luo↗Yebo Feng↗Jiahua Xu↗Paolo Tasca↗Yang Liu↗

arXiv:2501.00826v3 Announce Type: replace-cross Abstract: Cryptocurrency portfolio management requires the fusion of heterogeneous multi-modal signals, including structured price and on-chain time series, unstructured news text, and technical indicators, under high-volatility and real-time constraints. While deep learning approaches show predictive capability, their opacity limits practical adoption, and single large language model (LLM) agents struggle to process the breadth of modality-specific inputs needed for robust decision-making. We propose a multi-agent system (MAS) framework in which three modality-specialised agents, a Crypto Agent for market dynamics, a News Agent for weekly news sentiment, and a Trading Agent for signal fusion and portfolio execution, decompose the task across three communication architectures: hierarchical, collaborative, and debate. We evaluate four capability configurations: zero-shot, chain-of-thought (CoT), retrieval-augmented generation (RAG), and skill-augmented. In a 52-week backtest over calendar year 2025 across the top 15 L1 blockchain native cryptocurrencies by market capitalisation as of January 2025, the best configuration, Hierarchical (Skill), achieves a cumulative return of 133.52% and a Sharpe ratio of 1.502, outperforming single-agent variants, passive benchmarks, and deep learning baselines. An ablation study identifies the Crypto Agent as the most critical component, with its removal reducing cumulative return by 42.57 percentage points. A cross-model comparison further shows that MAS outperforms the single-agent baseline under GPT-4o, GPT-5, and Claude Sonnet 4.5, suggesting that the benefit of multi-agent coordination is model-agnostic. Unlike black-box deep learning models, every portfolio decision is traceable to explicit agent reasoning, offering an interpretable and effective approach to multi-modal cryptocurrency portfolio management.

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17.
medRxiv (Medicine) 2026-06-12

Order-Based Bayesian Network Modeling of Early Detection and Post-Diagnosis Control for Cardiovascular Disease Risk in Type 2 Diabetes

Authors:
Kathuria↗Miller↗Selden↗E. B↗Gallagher↗W. J↗Capan↗

Patients diagnosed with type 2 diabetes (T2D) are at increased risk of developing cardiovascular disease (CVD), the leading cause of morbidity and mortality in this population. Early detection and glycemic control within the first year after diagnosis reduce CVD risk. However, gaps remain in how to operationalize early detection of T2D using Electronic Health Record (EHR) data and quantify its relationship with subsequent CVD risk using longitudinal observations. We developed a probabilistic graph model to analyze the interdependencies between early detection of T2D, post-diagnosis glycemic control, and CVD occurrence. Using a temporally structured Bayesian Network (BN) learned from EHR data of 9,450 primary care patients between 2017 and 2023, we quantified probabilistic dependencies between demographics, diagnostic delay surrogates, glycemic control, and post-diagnosis CVD occurrence. Percentile based thresholds defined risk groups, where individuals with predicted probabilities in the bottom decile ([≤] 10th percentile) were classified as low risk, and those in the top decile ([≥] 90th percentile) as high risk. Results demonstrated heterogeneity in predicted risks across glycemic and cardiovascular outcomes. Predicted probability of developing CVD within the first year after T2D diagnosis ranged from a mean of 5.2% in the low-risk group to 28.9% in the high-risk group, while predicted probabilities of mean Hemoglobin A1c (HbA1c) [≥] 8% during the first year post-diagnosis ranged from 1.6% in low-risk to 55.1% in high-risk group. Patients with HbA1c at diagnosis [≥] 8% had higher predicted probabilities of first-year post-diagnosis mean HbA1c [≥] 8% (53.3% vs. 1.9%) and high HbA1c coefficient of variation (18.7% vs. 3.1%) compared with those with HbA1c [≤] 6.5%. Incorporating early clinical outcomes refined later risk predictions, with long-term CVD risk reaching 33.5% among high-risk individuals. The proposed model achieved predictive performance comparable to conventional machine learning approaches while providing interpretable relationships for risk stratification in primary care populations.

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18.
Nature (Science) 2026-06-09

A unicellular relative links aggregative multicellularity to animal origins

Authors:
Ruibao Li↗

How animals evolved complex multicellularity from their unicellular ancestors remains unanswered. Unicellular relatives of animals exhibit simple multicellularity through clonal division, formation of multinucleate coenocytes, or aggregation. 1 Therefore, animal multicellularity may have evolved from one (or a combination) of these behaviours. Aggregation has classically been dismissed as a means to complex multicellularity. 2 However, aggregation occurs in many extant animal cells and has also been recently described in three close unicellular relatives of animals (the choanoflagellates Salpingoeca rosetta and Choanoeca flexa, and the filasterean Capsaspora owczarzaki). 3-5 It is unclear whether aggregation in these species is derived or ancestral, and its relevance for animal origins remains unknown. To fill this gap, we investigated whether an additional close unicellular relative of animals can undergo aggregation. We discovered that the marine free-living bacterivorous filasterean Ministeria vibrans 6 forms homogeneous aggregates with reproducible kinetics that have long-term stability, and that improved feeding and mating may be evolutionary drivers of this aggregation. Notably, we found that homologs of many animal multicellularity genes involved in cell adhesion, signalling, and transcriptional regulation were deployed during the aggregation process, indicating that they may have been used for aggregation in the unicellular ancestors of animals before being co-opted into animal multicellular development. Thus, our results imply that aggregative multicellularity was key to the development of the multicellular animal genetic toolkit.

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20.
medRxiv (Medicine) 2026-06-17

Low-Density Lipoprotein Cholesterol and Dementia Risk: Integrating Mendelian Randomization and Target Trial Emulation Within the Heart-Brain Axis

Authors:
Mukumbi↗Liu↗Shi↗Toyli↗Hung↗G.-U↗Chen↗Q.-H↗Sha↗Chiu↗P.-Y↗Zhou↗…

Background: The heart-brain axis links cardiovascular and neurodegenerative disease through shared vascular and inflammatory mechanisms. Although low-density lipoprotein cholesterol (LDL-C) is an established causal factor in atherosclerotic cardiovascular disease (ASCVD), its relationship with dementia remains uncertain, with midlife elevations associated with increased risk but late-life associations often appearing null or inverse. To address this cholesterol paradox, we integrated mendelian randomization (MR) with an active-comparator new-user target trial emulation. Methods: We applied a triangulated causal inference framework integrating two-sample MR with observational target trial emulation. Genetic variants associated with LDL-C were used as instrumental variables to evaluate Alzheimer disease (AD), dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and any dementia (AnyDem), with causal estimates derived using inverse-variance weighted models and sensitivity analyses for heterogeneity and pleiotropy. In parallel, an active-comparator new-user design compared statin versus ezetimibe initiation among adults aged 60 years or older using propensity score (PS) overlap weighting and Cox proportional hazards models to evaluate cardiovascular and dementia outcomes. Results: Genetically predicted LDL-C was associated with increased risk of DLB (OR 1.65, 95% CI 1.30-2.10; p

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21.
arXiv (CS.LG) 2026-06-16

Overcoming Rank Collapse in Feedback Alignment

Authors:
Gauthier Boeshertz↗Razvan Pascanu↗Claudia Clopath↗

arXiv:2606.11123v2 Announce Type: replace Abstract: Backpropagation (BP) is widely viewed as biologically implausible, in part because it requires feedback weights to be the transpose of forward weights for error propagation. Interestingly, when training a network with fixed random feedback weights to circumvent this issue, learning aligns the forward weights with the feedback weights, leading the backpropagated error signal to become an approximation of the standard gradient used by BP. This process, called Feedback Alignment (FA), occurs in MLPs and very shallow CNNs but does not scale well to deeper architectures. In this work, we first investigated differences between BP and FA models, trained on CIFAR10, specifically focusing on the effective rank of the signal. We found that the FA error has a considerably lower rank and hence is constrained to a lower-dimensional subspace compared to BP, limiting exploration of the parameter space. Motivated by this observation, we evaluated two mechanisms for increasing the effective dimensionality of FA: Muon, an optimiser that orthogonalises weight updates; and hidden activity normalisation, which promotes activation orthogonality. Across larger architectures and benchmarks, we find that these methods consistently improve over FA baselines, for example, on CIFAR100 with a Resnet-18, accuracy increases by 9 percentage points. Our results identify low-dimensional gradient dynamics as a key obstacle to scaling FA and suggest that inducing higher-dimensional update geometry is a promising route toward scaling alternatives to backpropagation.

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22.
arXiv (quant-ph) 2026-06-16

Bright Emission from Dark Sources in Hyperbolic Media

Authors:
Evgenii E. Narimanov↗

arXiv:2606.16071v1 Announce Type: cross Abstract: Hyperbolic media enable ultra-strong light-matter interactions through their extreme field localization and small mode volumes, but low-loss realizations are fundamentally limited to the mid-infrared, owing to the long lifetimes of optical phonons in high-quality crystals. Here we show that bright emitters operating at visible or near-infrared frequencies can be used to generate radiation in this regime by inducing mid-infrared population dynamics, thereby creating a source in the hyperbolic frequency band without a corresponding dipole transition. We demonstrate that even a source with vanishing dipole and higher multipole moments - strictly non-radiating in any isotropic medium - becomes radiatively active in a hyperbolic environment. This enables visible and near-infrared control of light-matter interactions in polaritonic hyperbolic materials, establishing a new low-loss solid-state quantum optics platform.

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23.
arXiv (CS.AI) 2026-06-17

A T-API-Compliant ReAct Agentic Loop for Optical Networks: Generic vs. Domain-Specific Tool Abstractions

Authors:
Seyed Morteza Ahmadian↗Paolo Monti↗Carlos Natalino↗

arXiv:2606.18000v1 Announce Type: cross Abstract: Optical networks need intent-driven, closed-loop agentic management, a key enabler for higher autonomy levels. We present the first T-API-compliant reasoning and act (ReAct) loop. We show that domain-specific composite tools achieve 90% oracle-validated correctness with threefold token savings compared to generic tools.

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

VL-DINO: Leveraging CLIP Vision-Language Knowledge for Open-Vocabulary Object Detectio

Authors:
Hao Zhang↗Qinran Lin↗Linqi Song↗Yong Li↗

Vision-language models like CLIP can provide rich semantic priors for open-vocabulary object detection. However, jointly integrating both textual and visual knowledge into detection architectures remains challenging. In this paper, we propose VL-DINO, an open-vocabulary detector that enhances DINO through more effective exploitation of CLIP's vision-language knowledge. Specifically, a Query-guided Positive Sample Construction (QPSC) module is first developed to construct additional high-quality positive samples, enabling the vanilla DINO framework to better accommodate mixed training across heterogeneous data sources while providing more vision-language alignment signals, thereby incorporating richer textual knowledge during training. A Visual Semantic Encoder (VSE) module is then introduced to distill CLIP visual knowledge into backbone-extracted features, producing fused features for subsequent encoder refinement. Based on the fused features, an Object-Region Semantic Alignment (ORSA) module extracts object-centric region features and aligns them with the corresponding textual embeddings, further incorporating textual cues. In the zero-shot setting, VL-DINO-T and VL-DINO-L achieve 36.3 and 38.1 AP on the LVIS benchmark, respectively, consistently outperforming prior advanced approaches. Extensive experiments demonstrate the effectiveness and competitive performance of the proposed design.

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25.
arXiv (CS.CV) 2026-06-11

MARIC: Multi-Agent Reasoning for Image Classification

Authors:
Wonduk Seo↗Minhyeong Yu↗Hyunjin An↗Seunghyun Lee↗

Image classification has traditionally relied on parameter-intensive model training, requiring large-scale annotated datasets and extensive fine tuning to achieve competitive performance. While recent vision language models (VLMs) alleviate some of these constraints, they remain limited by their reliance on single pass representations, often failing to capture complementary aspects of visual content. In this paper, we introduce Multi Agent based Reasoning for Image Classification (MARIC), a multi agent framework that reformulates image classification as a collaborative reasoning process. MARIC first utilizes an Outliner Agent to analyze the global theme of the image and generate targeted prompts. Based on these prompts, three Aspect Agents extract fine grained descriptions along distinct visual dimensions. Finally, a Reasoning Agent synthesizes these complementary outputs through integrated reflection step, producing a unified representation for classification. By explicitly decomposing the task into multiple perspectives and encouraging reflective synthesis, MARIC mitigates the shortcomings of both parameter-heavy training and monolithic VLM reasoning. Experiments on 4 diverse image classification benchmark datasets demonstrate that MARIC significantly outperforms baselines, highlighting the effectiveness of multi-agent visual reasoning for robust and interpretable image classification.

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