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01.
arXiv (math.PR) 2026-06-11

Unbiased Derivative Estimation for Stationary Mean of Parameterized Markov chains

arXiv:2606.11487v1 Announce Type: cross Abstract: We propose a new approach to unbiased estimation of the gradients of the stationary means associated with parametrized families of Markov chains. Our estimators are particularly efficient when the Markov chains have slow mixing rate. Our approach does not require a specific parametrization except for an oracle to evaluate the transition density and its gradient at a given data point without any additional knowledge about the density function itself. It makes our estimator suitable for parametrizations associated with neural networks. The estimator can potentially achieve large improvement in terms of efficiency. Numerical experiments confirm the good performance predicted by the theory.

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

Adaptive Multi-Resolution Procedural Knowledge Compression for Large Language Models

Large language models (LLMs) are widely used to tackle complex tasks with autonomous workflows. Recently, reusable natural language skills have emerged as a popular paradigm to inject procedural knowledge into LLM applications. Since popular skills are often invoked repeatedly, placing their full text in every context significantly increases prefill cost and latency. While text compression techniques have the potential to solve this problem, most existing methods are designed to compress factual knowledge in documents instead of procedural knowledge, making them insufficient for skill compression. In this paper, we argue that an effective skill compression method should: 1) preserve logical dependencies among workflows and tool protocols, 2) enable lightweight, offline compression for frequently updated community skills, and 3) be adaptable to varying complexities across skills. To address this, we present SKIM (SKIll coMpression), an adaptive multi-resolution soft token compression framework for procedural skills. Depending on the complexity of each skill, SKIM creates different numbers of soft tokens that not only improve the efficiency of LLM inference, but also preserve the effectiveness of skill usage. Experiments indicate that SKIM compresses skills to 30 to 60 percent of their original token length while preserving task performance better than existing compression methods.We have released our code at https://github.com/bebr2/SKIM .

03.
medRxiv (Medicine) 2026-06-10

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

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

04.
arXiv (CS.LG) 2026-06-19

UltraEP: Unleash MoE Training and Inference on Rack-Scale Nodes with Near-Optimal Load Balancing

arXiv:2606.04101v3 Announce Type: replace-cross Abstract: Large-scale expert parallelism (EP) is becoming pivotal for training and serving frontier MoE models, but it also amplifies device-level expert load imbalance into compute stragglers, token all-to-all bottlenecks, and activation-memory spikes. Existing balancers redistribute experts periodically based on historical load, which becomes unreliable for production deployments with non-stationary load patterns. We present UltraEP, the first exact-load, real-time balancer for large-EP MoE training and serving prefill on rack-scale nodes (RSNs). Leveraging the extended scale-up connectivity among dozens of GPUs within RSNs, UltraEP rebalances every microbatch and layer on critical paths, which requires nontrivial co-design of plan solving and expert replication communication to minimize exposed overhead. To this end, UltraEP eagerly reacts to post-gating load with an efficient quota-driven planner, and executes the resulting irregular expert-state transfers with RSN-native persistent tile streaming and relay-based fan-out mitigation. We evaluate UltraEP in a multi-RSN deployment of up to 256 GPUs, using cutting-edge MoE models from 106B to 671B parameters. Averaged across training and serving, UltraEP achieves 94.3% of the force-balanced ideal throughput, delivering 1.49$\times$ improvement over no-balancing, while reducing the final inter-rank imbalance from 1.30$-$4.01 to 1.01$-$1.04.

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

Question-Aware Evidence Ledgers for Video Relational Reasoning

The VRR-QA challenge evaluates visual relational reasoning in videos, where answers often depend on implicit spatial relations, event boundaries, target identity, and dialogue context rather than a single salient frame. We present a test-time reasoning pipeline built around a strong GPT-5.5 video QA solver and a set of question-aware evidence ledgers. The initial solver answers each question from a uniform video representation, while routed ledgers are prompted to make the required targets, count units, reference frames, and temporal or spatial scope explicit for counting, spatial, endpoint, viewpoint, and dialogue reasoning. External tools such as open-vocabulary detection, depth cues, pair crops, ASR, and scene-graph ledgers are used only as evidence sources. A conservative gate keeps the current answer unless independent evidence uniquely supports a different option. The final evidence-gated pipeline achieves 92.95% overall accuracy and 93.79% macro accuracy on the challenge test split.

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

Foundations of Practical Quantum Advantage in Quantum-Informed Machine Learning for Predicting Chaos

arXiv:2606.13422v1 Announce Type: cross Abstract: We develop theoretical foundations for a practical quantum-advantage mechanism in quantum-informed machine learning for chaotic dynamical systems. A family of k-indexed higher-order quantum statistical priors (Q-Priors) hosts the k-point marginal of the invariant measure on n_q = kq qubits, extending the single-site construction of prior work. We prove a two-stage advantage. In the representation stage, superposition and entanglement compactly store non-factorisable spatial correlations of the invariant measure on n_q qubits. In the extraction stage, joint Bell measurements on two copies estimate any post hoc Pauli functional with a copy-pair count independent of n_q, whereas any adaptive single-copy protocol for the corresponding full-Pauli read-out requires Omega(2^(n_q)) copies; this is a provable quantum-classical separation in copy-measurement complexity. The two-copy read-out is realised in simulation and on IQM superconducting processors. Two case studies instantiate the mechanism in workflows of independent scientific value: a turbulent channel-flow study in which the two-copy read-out yields a named non-diagonal correlator of the invariant measure (the velocity-direction coherence), and a medium-range weather forecasting workflow on the European Centre for Medium-Range Weather Forecasts ERA5 reanalysis in which the diagonal k

07.
arXiv (CS.LG) 2026-06-11

Energy Use of AI Inference, Efficiency Pathways, and Test-Time Scaling

arXiv:2509.20241v2 Announce Type: replace Abstract: As AI inference scales to billions of queries, estimates of per-query energy use are increasingly important for capacity planning, efficiency interventions, and policy. Yet many public estimates assume non-production settings, leading to systematic overestimation. We introduce a bottom-up framework estimating inference energy from token throughput, node power, and overhead under large-scale deployment assumptions. For frontier-scale models (>200B parameters) on H100 nodes, we estimate a median energy of 0.31 Wh/query (IQR 0.16-0.60), indicating widely cited estimates are overstated by 4-20x. In test-time scaling scenarios 15x longer than typical queries, the median energy rises 13x to 3.91 Wh (IQR 2.15-7.05). Across models, serving systems, and hardware, we estimate 8-20x line-of-sight energy reductions. At datacenter scale, serving 1 billion queries/day requires 0.7 GWh; if 10% are long queries, demand rises to 1.7 GWh/day. With efficiency interventions, it falls to 0.8 GWh/day, mitigating the energy impact of test-time scaling.

08.
arXiv (math.PR) 2026-06-11

On the $d$-rigidity phase transition in random graphs

作者:

arXiv:2605.25711v2 Announce Type: replace-cross Abstract: We study generic $d$-dimensional rigidity in sparse random graphs. Our main result is that for every $d\ge 2$, the Erdős–Rényi random graph $G\sim G(n,c/n)$ undergoes a $d$-rigidity phase transition at the known, explicit, $d$-orientability threshold $c_d$: If $cc_d$, then $G$ is a.a.s. not independent in the generic $d$-rigidity matroid, and we give a sharp asymptotic estimate for its rank. In addition, the $d$-rigidity closure of $G$ has a giant clique of linear size, which contains all but at most $o(n)$ vertices of the $((d+1)+d)$-core of the graph. More generally, we compute, up to a $1+o(1)$ factor, the generic $d$-rigidity rank of random graphs with a given degree distribution. For example, we show that the uniform $n$-vertex $k$-regular graph a.a.s. has rank $\min(k/2,d)n+o(n).$ Our approach is to estimate the rigidity rank of a random graph from its Galton–Watson local weak limit, using a parameter that we call local flexibility.

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

Pseudo-Feature Padding: A Lightweight Defense Against False Data Injection in Power Grids

arXiv:2606.20415v1 Announce Type: new Abstract: Deep Neural Networks DNNs have achieved remarkable accuracy in various tasks including their application in CyberPhysical Systems CPS for detecting False Data Injection Attacks FDIA during critical operations However the unique infrastructure of CPS makes DNNs vulnerable to exploitation by attackers aiming to evade detection Additionally the distinct nature of CPS presents challenges for conventional defense mechanisms against FDIA This paper proposes an innovative defense framework that strengthens DNNs against such attacks by introducing an additional input layer that performs padding in the input samples using pseudofeature values derived from the inputs statistical distribution This padding increases the input dimensionality in a randomized and dataaware manner making adversarial attacks computationally infeasible due to the nontransferable nature of crafted perturbations and the unpredictability of the padded structure Our method is lightweight modelagnostic and requires no modifications to the core architecture making it highly deployable in realworld CPS settings We evaluated our framework on critical power grid applications such as state estimation using the IEEE 14bus 30bus 118bus and 300bus systems Experiments under adversarial settings demonstrate that our padding strategy significantly improves model robustness with negligible impact on performance and effectively mitigates attacks that would otherwise bypass conventional defenses

10.
arXiv (math.PR) 2026-06-19

The central heat trace on large compact classical groups

arXiv:2511.08288v2 Announce Type: replace-cross Abstract: We study the large-$N$ asymptotics of the central trace of the heat kernel on compact classical groups. For every classical family $G_N\subset \mathrm{GL}_N(\C)$, we prove a full large-$N$ asymptotic expansion, using a highest weights/partitions correspondence adapted to the large-rank regime, under which the eigenvalues of the Laplace–Beltrami operator stabilize as observables in the algebra of shifted symmetric functions. Then, we prove a random surface representation of the trace in terms of ramified coverings of the torus. We provide two independent applications: an explicit large-rank counting law for the Casimir spectrum, with exponential Hardy–Ramanujan-type growth in contrast with the polynomial behavior of Weyl's law at fixed rank, and a rigorous probabilistic formulation of the Yang–Mills/Hurwitz duality on a two-dimensional torus initiated by Gross and Taylor, completing a previous work of the authors. We also extend this duality to a Yang–Mills/Gromov–Witten duality by expressing the coefficients of the central heat trace as explicit functionals of the generating function of Gromov–Witten invariants.

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

PI-Hunter: Automated Red-Teaming for Exposing and Localizing Prompt Injections

arXiv:2606.12737v1 Announce Type: cross Abstract: Large Language Models (LLMs) are rapidly evolving into agentic systems that interact with external tools and environments, introducing new security risks such as indirect prompt injection attacks through untrusted external sources. Existing defenses mainly focus on blocking malicious content at inference time, and current red-teaming methods primarily optimize attack success. As a result, developers have limited visibility into how latent prompt injections emerge and propagate through agents. We propose PI-Hunter, an automated agentic auditing framework for proactive vulnerability exposure in LLM agents. PI-Hunter constructs realistic source-aware test cases and iteratively evolves them through feedback-driven exploration to induce agents to retrieve and reveal latent malicious instructions embedded within external environments. Extensive experiments across multiple benchmarks, agent architectures, attacks, and defenses demonstrate that PI-Hunter substantially improves vulnerability exposure and attack-surface coverage over strong automated red-teaming baselines, while remaining effective under existing prompt injection defenses.

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

Spatial-Aware Reduction Framework: Towards Efficient and Faithful Visual State Space Models

arXiv:2606.19932v1 Announce Type: cross Abstract: Mamba demonstrates strong efficiency in modeling long visual sequences. However, when token reduction is applied to structurally enhanced Mamba variants, these models exhibit a severe performance collapse. We attribute this degradation to the spatially agnostic nature of existing reduction methods, which violate the two-dimensional structural premise required by the selective scanning mechanism. In this work, we propose STORM, a spatial-aware token reduction framework designed to maintain structural integrity throughout the compression process. STORM reformulates reduction into a structured operation on spatial units, enforcing localized constraints to maintain both grid topology and neighborhood coherence. As a plug-and-play module, STORM equips existing reduction pipelines with explicit spatial awareness without any training. Empirical results demonstrate that STORM achieves state-of-the-art pruning accuracy across diverse vision Mamba backbones under training-free settings. Notably, STORM delivers a substantial accuracy recovery on VMamba, outperforming prior methods by up to 63.3\% in top-1 accuracy. Meanwhile, STORM incurs only a 1.0\% accuracy drop on PlainMamba, achieving performance comparable to ViT.

13.
arXiv (CS.AI) 2026-06-11

KAN-MLP-Mixer: A comprehensive investigation of the usage of Kolmogorov-Arnold Networks (KANs) for improving IMU-based Human Activity Recognition

arXiv:2605.19031v2 Announce Type: replace Abstract: Kolmogorov-Arnold Networks (KANs) have demonstrated an exceptional ability to learn complex functions on clean, low-dimensional data but struggle to maintain performance on noisy and imperfect real-world datasets. In contrast, conventional multi-layer perceptrons (MLPs) are far more tolerant to noise and computationally efficient. Replacing all MLP components with KANs in HAR models often degrades accuracy and computation efficiency, highlighting an open challenge: how to combine KANs' precision with MLPs' noise robustness and efficiency. To address this, we systematically explore various placements of KAN modules within deep HAR networks and propose a hybrid architecture that strategically synergizes the strengths of both paradigms, which uses a KAN-based input embedding layer, retains MLP layers for intermediate feature mixing, and introduces a specialized LarctanKAN module for final activity classification. Across eight public HAR datasets, the hybrid KAN-MLP model achieves an average macro F1 score relative improvement of 5.33\% compared pure-MLP model, significantly outperforming standalone KAN and MLP baselines. Furthermore, integrating this hybrid strategy into other state-of-the-art HAR architectures consistently boosts their performance. Our findings demonstrate that a carefully orchestrated combination of KAN, MLP, or other conventional neural components yields more robust and accurate HAR models for real-world wearable sensing environments.

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

Schrödinger Symmetry in Spherically-symmetric Static Mini-superspaces with Matter Fields

arXiv:2512.13651v3 Announce Type: replace-cross Abstract: Schr\"{o}dinger symmetry has been shown to emerge in a ``fluid limit" from the full superspace to several mini-superspace models. To investigate one aspect of the robustness of this emergent symmetry, we consider two spherically-symmetric static mini-superspace models with matter fields at the classical level: (i) a Maxwell field with a cosmological constant and (ii) $n$ massless scalar fields. By developing a method based on canonical transformations, we demonstrate that for model (i), 3D Schrödinger symmetry emerges, and the solution is the (anti-)de Sitter Reissner-Nordström spacetime, and for model (ii), $(2+n)$D Schrödinger symmetry appears, and the solution is a generalized Janis-Newman-Winicour spacetime and its ``interior", a Kantowski-Sachs type closed universe. Furthermore, for the vacuum model, we find that 2D Schrödinger symmetry holds with different lapse functions and mini-superspace coordinates, suggesting the potential, yet unconfirmed, covariance of the symmetry. Finally, we propose a physical interpretation of the symmetry under the Hamiltonian constraint $H$: symmetry generators commuting with $H$ map a solution to another one, while those non-commuting with $H$ generate a new theory with the Schrödinger symmetry and the transformed configuration is a solution to the new theory. These results reinforce the robustness of the emergent Schrödinger symmetry and open new frontiers for exploring dynamics of matter and gravity.

15.
arXiv (quant-ph) 2026-06-11

Super-Link Fragility in Asymmetric W-Class States under Quantum Noise

arXiv:2606.12307v1 Announce Type: new Abstract: The asymmetric three-qubit W-class state $|\overline{W_3^L}\rangle$ defines an isosceles entanglement-network geometry, (a) two vertex-base (VB) links form stronger bipartite connections, (b) while the base-base (BB) link is weaker. This suggests that concentrating entanglement into a super-link may be advantageous for quantum-network tasks. Here, we show that this intuition is incomplete. We analytically compare the bipartite concurrence dynamics of the symmetric |W> state and the asymmetric $|\overline{W_3^L}\rangle$ state, which differ both in entanglement-network geometry and excitation sector under standard noise models. In the absence of noise, the concurrence hierarchy is C_{VB} > C_W > C_{BB}$. Under phase damping, this hierarchy is preserved for all noise strengths and no entanglement sudden death occurs. Under amplitude damping, however, the hierarchy is reordered. The symmetric |W> state becomes the most robust, while the base-base concurrence of $|\overline{W_3^L}\rangle$ vanishes at the finite threshold of parameter $\gamma$. We term this reordering as the Super-Link Fragility Effect. The same structural asymmetry that produces a stronger vertex-base link also makes it more vulnerable to energy dissipation when coupled with multi-excitation amplitudes. Under depolarization, the asymmetry advantage is erased, with $C_W$ and $C_{VB}$ sharing the same sudden-death threshold for some value of the parameter p, while $C_{BB}$ disappears earlier at some other value of the parameter p. The generalized amplitude damping channel continuously connects the damping-dominated regime to the pure-excitation limit, where the initial hierarchy is restored. These results show that entanglement robustness in $W$-class resources is controlled not by initial concurrence alone, but by the joint structure of entanglement-network geometry, excitation sector, and noise symmetry.

17.
arXiv (math.PR) 2026-06-12

Voronoi Percolation: Topological Stability and Giant Cycles

arXiv:2601.00793v2 Announce Type: replace Abstract: We study the topological stability of Voronoi percolation in higher dimensions. We show that slightly increasing p allows a discretization that preserves increasing topological properties with high probability. This strengthens a theorem of Bollobás and Riordan and generalizes it to higher dimensions. As a consequence, we prove a sharp phase transition for the emergence of i-dimensional giant cycles in Voronoi percolation on the 2i-dimensional torus.

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

Recognizing and Reconstructing a Multi-Unit Floor Plan

Digital twins have a major potential to form a significant part of urban management in emergency planning, as they allow more efficient designing of the escape routes, better orientation in exceptional situations, and faster rescue intervention. Nevertheless, creating the twins still remains a largely manual effort, due to a lack of 3D-representations, which are available only in limited amounts for some new buildings. Thus, in this paper we aim to synthesize 3D information from commonly available 2D architectural floor plans. We propose two novel pixel-wise segmentation methods based on the MDA-Unet and MACU-Net architectures with improved skip connections, an attention mechanism, and a training objective together with a reconstruction part of the pipeline, which vectorizes the segmented plans to create a 3D model. The proposed methods are compared with two other state-of-the-art techniques and several benchmark datasets. On the commonly used CubiCasa benchmark dataset, our methods have achieved the mean F1 score of 0.86 over five examined classes, outperforming the other pixel-wise approaches tested. We have also made our code publicly available to support research in the field.

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

How Much Memory Do We Need? Adaptive Memory Gate for Neural Operators

arXiv:2606.13443v1 Announce Type: new Abstract: Neural operators have emerged as a powerful data-driven approach for solving time-dependent PDEs. Among recent advances, memory-augmented neural operators explicitly incorporate past states and have achieved remarkable performance under low-resolution observation settings. However, existing approaches apply a fixed memory weight regardless of observation conditions, such as resolution or physical parameters, limiting their adaptability. Our preliminary experiments reveal that optimal memory weight varies with resolution and viscosity, implying that a fixed memory weight cannot simultaneously optimize performance across diverse settings. We propose AMGFNO, which dynamically modulates memory weight through a learnable gate. On the Kuramoto-Sivashinsky and Burgers' equations, AMGFNO achieves 55-79% nRMSE reduction over at low resolution, with the learned gate value automatically decreasing from $\bar{g} \approx 0.7$ to near-zero as resolution increases.

20.
medRxiv (Medicine) 2026-06-10

Prediction of immunotherapy response using live tumor fragments from routine clinical biopsies

Functional ex vivo assays using live tumor tissues have demonstrated strong predictive accuracy for response to immune checkpoint inhibitors (ICIs) but are not scalable, requiring manual processing of large resections collected at academic centers. Here, an ex vivo live tumor fragment (LTF) platform was developed using standard-of-care biopsies from 228 patients with suspected malignancy collected across prospective, multicenter observational trials and biobanks. Hierarchical clustering of ICI-mediated changes in cytokine production identified two groups: responders and nonresponders. A binary classifier (elive index) using 8 cytokines achieved an AUC of 0.99 for cluster prediction. elive index correctly predicted clinical benefit in 93% (26/28) of patients (P = 3.2x10-5) and accurately identified 83% (10/12) of objective responders. Critically, elive responders were identified among biomarker-negative patients, highlighting the platform as a scalable approach that complements existing companion diagnostics and expands the population of patients identified to benefit from ICI therapy.

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

Can Post-Training Turn LLMs into Good Medical Coders? An Empirical Study of Generative ICD Coding

Automated International Classification of Diseases (ICD) coding is a core medical-coding task for billing, epidemiology, and clinical decision support. Generative large language models (LLMs) are often reported as weak medical coders, but this finding mainly comes from inference-time settings such as prompting, retrieval, reranking, or tool use, leaving the role of task-specific post-training underexplored. We present a controlled empirical study of post-training for generative ICD coding, comparing discriminative baselines with LLM coders across prompting, supervised fine-tuning, and reinforcement learning under a common protocol and metric set. To our knowledge, this is the first study to evaluate RL-based post-training for generative LLM coders in ICD coding. We further introduce PHI, a diagnostic curriculum that extends GRPO to refine missed-code cases. Our results show that prompting-only evaluation substantially underestimates the potential of LLMs for ICD coding. SFT provides the main capability jump, GRPO further improves code-set prediction beyond SFT, and PHI provides targeted gains on macro-level performance. These findings suggest that the main bottleneck is not the generative formulation alone, but how the model is adapted and optimized for full-taxonomy recall. We release our code, data splits, and checkpoints at https://github.com/AlexandreWANG915/LLM4ICD.

22.
medRxiv (Medicine) 2026-06-17

Differential Determinants of Past Behavior and Future Intention Regarding Voluntary Blood Donation: A Cross-Sectional Study of Knowledge, Attitudes, and Practices in Qingdao, China

Background A persistent gap between motivation and action threatens voluntary blood supply. This study examined the publics knowledge, attitudes, and practices (KAP) regarding blood donation, with a particular focus on identifying the different determinants of past blood donation behavior and future willingness to donate. Methods Convenience sampling was used to conduct a cross-sectional survey among 1,058 eligible people in Qingdao, China, between July and November 2025. Data were collected via a self-designed KAP questionnaire. To find independent characteristics linked to previous behavior and future intention, respectively, multivariable binary logistic regression was used. Results Overall, 37.0% of participants (n=391) had a lifetime donation history, while 39.2% (n=415) intended to donate in the next 12 months. Past behavior was positively associated with older age (36-45 years: OR=6.84; 95% CI: 3.21-14.58), higher education (OR=2.06; 95% CI: 1.33-3.17), and interpersonal interaction channels (OR=1.45; 95% CI: 1.01-2.09) but hindered by safety concerns (OR=0.23; 95% CI: 0.16-0.34). Conversely, future intention was positively correlated with male sex (OR=1.69; 95% CI: 1.24-2.29), prior donation history (OR=2.69; 95% CI: 1.87-3.86), having family members or friends in need of blood (OR=2.75; 95% CI: 1.96-3.85), and traditional media exposure (OR=3.33; 95% CI: 2.18-5.10). Higher education was adversely correlated with future intention (OR=0.55; 95% CI: 0.38-0.79). Conclusion There is a substantial disparity between donation motivation and action. The determinants of past behavior and future intention are asymmetric, suggesting that stage-specific interventions are required, using social mobilization for initiating first-time donations, while employing family reciprocity and authoritative communication to sustain long-term engagement.

23.
arXiv (CS.CL) 2026-06-18

Beyond Scalar Scores: Exploring LLM-based Metrics for Clinical Significance Evaluation in Radiology Reports

Reliable evaluation of generated radiology reports requires strict clinical accuracy, as omitted critical findings or mischaracterized radiographic observations can directly affect patient care. Existing metrics obscure this requirement by reducing report quality to a medically ungrounded scalar. Although Large Language Models (LLMs) possess rich medical knowledge, they likewise struggle to draw a reliable boundary between clinically significant errors and harmless variation. We study this boundary using ReEvalMed benchmark as testbed and evaluate metric-level clinical significance from detecting true clinical errors ("Discrimination") and tolerating insignificant variations ("Robustness"). Across 8 LLM evaluators under one-pass and two-pass settings, we identify a widespread discrimination bias: models effectively detect errors but also over-penalize harmless rephrasings. To mitigate this, we synthesize 4k report pairs and train lightweight interpretable metrics on Qwen3-8B and MedGemma-4B. Our trained metric sharpens the clinical significance boundary, surpassing 32B-scale medical LLMs and remaining competitive with proprietary models. Crucially, the more costly two-pass setting fails to consistently improve overall performance and mainly trades discrimination for robustness. These findings suggest one-pass trained metrics as the practical choice for cost-sensitive deployment, with two-pass inference reserved for settings where D-R balance is critical. We will release the dataset and metric.

24.
medRxiv (Medicine) 2026-06-18

Automated Airways Characterization and Assessment of Cystic Fibrosis from CT Imaging

Background Advancements in medical imaging have enabled non-invasive diagnosis and staging of cystic fibrosis (CF) using CT scans, revealing dilated airways, an increased number of visible airways, and airway generation splits in these patients. However, manual characterization of airways remains time-consuming and challenging due to the numerous structural changes, thereby limiting clinical feasibility. This study aims to develop an automated algorithm to characterize airways from segmented lung CT scans and apply this to a retrospective population. This approach reduces the time required to analyze images and obtain disease-staging results. Methods This framework consists of two stages. The first stage extracts and skeletonizes the airway tree from lung CTs, while the second stage measures lung features, including airway volumes, branch counts, generation splits, diameters, and cross-sectional areas. This permits comprehensive characterization for use in clinical assessment. Results The airways analysis was performed on 169 CT volumes ranging in age from 6 to 18 years of age, revealing substantial differences in detected airway branches, generation splits, and normalized airway volume between the control and CF groups. The framework also measures airway diameters and cross-sectional areas, revealing an increase in the number of small airways in cystic fibrosis patients, due to early bronchiectasis. These findings align with previous research and demonstrate the framework's ability to accurately quantify airway changes in patients with CF. Discussion The framework extracts entire airway trees, facilitating measurements of volume, branch count, diameters, and cross-sectional areas, which change with CF severity and/or treatment. However, partial lung atelectasis can limit the accuracy of airway detection in moderate-to-severe cases. Funding NIA U54 AG054345 and NIA R21 AG07857501

25.
Nature (Science) 2026-06-17

Structure of the pre-initiation complex explains CMGE biogenesis

When cells enter S phase, bidirectional DNA replication is initiated through the kinase-regulated recruitment of three activators (Cdc45, GINS and Pol ε) to a duplex-DNA-loaded double hexamer of minichromosome maintenance (MCM) ATPases. Together, these proteins form two CMGE helicases that establish divergent replication forks as they become separated1. Here, to gain an understanding of CMGE biogenesis, we reconstituted the pre-initiation complex with purified yeast proteins. The cryo-electron-microscopy structure shows a set of firing factors caught in the act of assembling two symmetrical CMGEs. We show how stepwise complex formation reshapes MCM in preparation for DNA opening, and we explain how ATP promotes firing-factor ejection and CMGE maturation. We find that although Sld2 facilitates the recruitment of GINS to MCM, as expected, it also aids the efficient separation of the CMGE dimer, and is essential for the ejection of the lagging strand from MCM. These findings have direct implications for our understanding of the metazoan Sld2 orthologue, RECQL4, and point to a replication-fork establishment mechanism that is conserved across eukaryotes. Cryo-electron microscopy and biochemical reconstitution experiments in yeast provide insight into the assembly of the CMGE complex, a helicase that establishes bidirectional DNA replication in eukaryotic cells, and elucidate the role of the firing factor Sld2.