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01.
medRxiv (Medicine) 2026-06-15

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

Authors:

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.

02.
bioRxiv (Bioinfo) 2026-06-15

VrySure: A Multi-Task AI Scientific Fraud Detection Platform for Identifying Manipulated and AI-Generated Biomedical Research Images

Integrity of scientific data is critical in biomedical research, where images often serve as primary evidence for experimental observations and conclusions. Advances in image-editing technologies and generative artificial intelligence (AI) have increased the accessibility and realism of visual manipulation, making detection through manual review increasingly challenging. To empower our laboratory researchers to continuously monitor and uphold scientific rigor and data integrity, and serve the global scientific community, we developed VrySure, an easy-to-deploy, AI-driven multi-task platform for automated image-integrity screening in biomedical research. VrySure integrates four detection modules: cross-image transformation detection, within-image copy-move detection, splicing detection in blot and gel images, and AI-generated image detection. The system identifies potentially manipulated images and, when possible, localizes suspicious regions using bounding-box outputs to support downstream verification. To support development and evaluation, we constructed task-specific datasets by combining public biomedical image resources, curated manipulated examples, and synthetic images generated by multiple generative AI systems. We evaluated VrySure using region-level F1 score, recall, precision, false negative rate (FNR), and false discovery rate (FDR) across multiple manipulation categories and compared its performance with two commonly used commercial image-integrity screening platforms under a predefined benchmark protocol. Under the tested conditions, VrySure achieved a higher F1 score and recall, lower FNR, and maintained a low FDR for within-image copy-move detection, splicing detection, and AI-generated image detection, while showing comparable performance in transformation detection. Beyond automated screening, VrySure is designed to support source-data comparison and evidence-based assessment in scientific integrity investigations. By integrating multiple detection capabilities into a unified and scalable workflow, VrySure provides a practical framework to improve the efficiency and consistency of image-integrity screening in biomedical research.

03.
arXiv (CS.AI) 2026-06-19

Implicit Semantic-Aware Communication Based on Hypergraph Reasoning

arXiv:2606.20162v1 Announce Type: new Abstract: Semantic-aware communication has emerged as a transformative paradigm for next-generation communication systems, shifting the fundamental goal from transmitting bit-level symbols to reliably recovering and understanding the semantic meaning of information. Previous studies have demonstrated that representing the semantic content of source messages as graph-based structures can significantly improve communication efficiency and the accuracy of semantic inference at the receiver. However, existing solutions typically employ graphs that capture only pairwise relationships, thereby neglecting higher-order implicit correlations commonly observed in real-world scenarios, such as group interactions, multi-entity associations, and complex relational contexts. This limitation reduces semantic expressiveness and makes semantic inference susceptible to ambiguity and performance degradation, particularly under noisy or corrupted channel conditions. To address these issues, this paper proposes a novel hypergraph-based implicit semantic reasoning framework, HISR, which leverages hypergraphs to represent complex multi-entity relationships among semantic knowledge entities. In HISR, entities and their associated higher-order relations are mapped into dedicated semantic subspaces tailored to distinct relational contexts. This design not only disentangles diverse semantic interactions to mitigate the over-smoothing effects commonly found in traditional graph embedding methods but also enables robust semantic inference even when partial information loss occurs during transmission. Numerical results show that the proposed HISR achieves up to a 36.6% improvement in implicit semantic interpretation accuracy over the state-of-the-art benchmarks.

04.
bioRxiv (Bioinfo) 2026-06-11

A quantitative coordinate system for developmental dynamics

Quantitative comparison of morphogenesis across individuals remains a fundamental challenge, as developing embryos vary in shape, orientation and developmental tempo. Moreover, real-time three-dimensional imaging generates large, heterogeneous four-dimensional datasets that are difficult to directly align. As a result, developmental variability is typically described qualitatively rather than measured. Here we introduce STERN, a quantitative framework that learns continuous spatiotemporal representations of morphogenesis directly from in vivo 4D imaging data. By embedding embryos into a shared spatiotemporal space, STERN defines a quantitative developmental coordinate system that enables direct comparison of developmental trajectories across individuals without requiring explicit registration or staging. Applied to mouse embryogenesis, STERN reveals that embryos follow conserved developmental trajectories while progressing at distinct temporal rates, providing a quantitative measure of developmental heterochrony. Extending this framework to zebrafish neural crest light-sheet timelapse imaging, we further show that developmental order is preserved across distinct imaging views even with altered anatomical coverage, supporting the generality of the learned representation across vertebrate imaging contexts. Finally, in developing mouse hearts, where morphogenesis proceeds through subtle and continuously evolving structural changes, STERN resolves fine-scale developmental dynamics at minute-scale temporal resolution that are difficult to localize reproducibly using human experts or general-purpose multimodal AI. Together, these results establish a shared quantitative coordinate system for morphogenesis, in which developmental trajectories become directly comparable across individuals and developmental variability becomes a measurable property.

05.
medRxiv (Medicine) 2026-06-16

The biological clock of multimorbidity: temporal dynamics of disease co-occurrence in primary care

Multimorbidity is the dominant clinical reality of primary care, yet the temporal dynamics governing when and how persistent comorbidity associations emerge remain poorly characterised. Most large-scale comorbidity studies adopt a single observation window after an index diagnosis, implicitly assuming that associations detectable at one year are equally detectable at five. Using 11 years of electronic health records from 5,821,197 individuals in Catalan primary care, we applied a matched cohort design across nine complementary follow-up windows, five cumulative (0-1 to 0-5 years) and four conditional (1-2 to 4-5 years), to 1,315 index diseases, identifying 144,030 significant directed comorbidity associations in the five-year network. We found that 60.1% of these associations required at least three years of follow-up and were undetectable in shorter-window analyses, demonstrating that observation window length is a primary determinant of which comorbidities can be observed. To organise this temporal heterogeneity, we introduce the biological clock of multimorbidity: a two-dimensional framework that positions ICD-10 disease categories according to their rates of cumulative signal attenuation and the persistence of conditional risk. This framework identifies four reproducible temporal patterns (episodic, chronic stable, chronic progressive, and transient-persistent) that are robust under bootstrap resampling, leave-one-disease-out sensitivity analysis, and alternative clustering approaches. The biological clock is systematically modulated by sex, with Blood/Immune and Musculoskeletal disorders showing the largest sex differences in temporal dynamics. Network analysis identified 19 disease "initiators" that generate broad downstream comorbidity burdens and 21 "sinks" representing convergent endpoints of multiple disease trajectories. Comparison with hospital-based Danish data from 6,909,676 individuals showed that shared associations were 2.7-fold enriched over chance expectation (hypergeometric test, p

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

Online Realizable Regression and Applications for ReLU Networks

arXiv:2602.19172v2 Announce Type: replace Abstract: Realizable online regression can behave very differently from online classification. Even without any margin or stochastic assumptions, realizability may enforce horizon-free (finite) cumulative loss under metric-like losses, even when the analogous classification problem has an infinite mistake bound. We study realizable online regression in the adversarial model under losses that satisfy an approximate triangle inequality (approximate pseudo-metrics). Recent work of Attias et al. shows that the minimax realizable cumulative loss is characterized by the scaled Littlestone/online dimension $\mathbb{D}_{\mathrm{onl}}$, but this quantity can be difficult to analyze. Our main technical contribution is a generic potential method that upper bounds $\mathbb{D}_{\mathrm{onl}}$ by a concrete Dudley-type entropy integral that depends only on covering numbers of the hypothesis class under the induced sup pseudo-metric. We define an entropy potential $\Phi(\mathcal{H})=\int_{0}^{diam(\mathcal{H})} \log N(\mathcal{H},\varepsilon)\,d\varepsilon$, where $N(\mathcal{H},\varepsilon)$ is the $\varepsilon$-covering number of $\mathcal{H}$, and show that for every $c$-approximate pseudo-metric loss, $\mathbb{D}_{\mathrm{onl}}(\mathcal{H})\le O(c)\,\Phi(\mathcal{H})$. In particular, polynomial metric entropy implies $\Phi(\mathcal{H})d$, otherwise infinite), and for bounded-norm $k$-ReLU networks separate regression (finite loss, even $\widetilde O(k^2)$, and $O(1)$ for one ReLU) from classification (impossible already for $k=2,d=1$).

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

RedAct: Redacting Agent Capability Traces for Procedural Skill Protection

Users rely on execution traces to observe agent behavior, diagnose failures, and ensure accountability. These traces contain rich procedural detail, including tool invocations, intermediate decisions, and error-recovery logic. Yet this detail can expose private procedural skills, allowing downstream methods to recover key formulas, thresholds, and strategies without access to model weights or skill files. To quantify this risk and evaluate protection, we construct \textsc{CapTraceBench}, a benchmark of 75 specialized long-horizon tasks and 154 curated skills across seven domains. We also introduce \textsc{RedAct} https://github.com/XuShuwenn/RedAct, a protected trace release framework that localizes protected key information, rewrites traces while preserving verifier-critical evidence, and embeds behavioral watermarks for downstream provenance analysis. Across representative trace reuse methods, \textsc{RedAct} reduces normalized skill transfer (NST) from 44.7–67.1\% on raw traces to below the no-skill baseline, while preserving audit evidence. Its standalone behavioral watermarks reach 93.6–100.0\% true detection with a false alarm rate of at most 1.9\%. These results frame public agent traces as security interfaces and show that selective redaction can reduce procedural capability leakage without removing audit evidence.

08.
arXiv (CS.CL) 2026-06-16

REFLEX: Reflective Evolution from LLM Experience

Authors:

Large multimodal language models (LLMs) have emerged as powerful tools for guiding evolutionary search toward interpretable programmatic policies. However, existing frameworks rely on a monolithic model call to simultaneously interpret visual behavioral evidence and synthesize corrective code. This diagnosis-repair entanglement creates an opaque feedback loop, obscuring the rationale behind mutations and preventing the retention of algorithmic insights across independent runs. To achieve auditable and efficient policy search, we argue that visual diagnosis must be structurally decoupled from code generation. We present REFLEX, a train-free evolutionary framework that operationalizes this decoupling. In REFLEX, a vision-enabled Critic first distills task-specific behavioral evidence into structured, auditable diagnoses. Subsequently, a text-optimized Actor synthesizes child policies using these diagnoses alongside a persistent, self-evolving Skill Memory of reusable code snippets. This architecture not only provides transparent mutation traces but also enables cross-run programmatic knowledge transfer. Extensive evaluations across control benchmarks (Lunar Lander, Acrobot, Pendulum) and a 36-dimensional antenna array synthesis task demonstrate exceptional sample efficiency. Notably, REFLEX solves Acrobot and Pendulum in under 10 LLM calls and reaches a best Normalized Weighted Score of 1.092 on Lunar Lander, achieving highly competitive final performance while significantly accelerating the early-stage discovery of transparent policies.

09.
arXiv (CS.AI) 2026-06-16

From Tokens to Regions: CUDA-Sensitive Instruction Tuning for GPU Kernel Generation

arXiv:2606.16231v1 Announce Type: cross Abstract: High-performance CUDA kernels are essential for scalable AI systems, while Large Language Models (LLMs) still struggle to generate correct kernels due to strict and implicit execution constraints. Existing LLM-based approaches either rely on costly agentic or reinforcement-learning (RL) pipelines, or adopt supervised fine-tuning (SFT) objectives that fail to explicitly model CUDA sensitivity, namely code tokens or regions tightly coupled with execution constraints. In this work, we investigate CUDA sensitivity from the perspective of token confidence patterns, showing that CUDA sensitivity appears at both token and region levels, where most CUDA-sensitive tokens are predicted with high confidence, while a smaller low-confidence subset forms regions corresponding to execution-critical structures. These findings suggest that effective CUDA kernel generation should both leverage high-confidence CUDA-sensitive tokens and preserve low-confidence CUDA-sensitive regions. Building on these insights, we propose \underline{CUDA-\underline{Se}nsitive Instruction \underline{T}uning (CuSeT)}, a low-cost post-training method within a simple SFT framework. CuSeT follows the principle of ``from tokens to regions'' by combining adaptive token-level masking with region-aware sample reweighting. Experiments show that CuSeT consistently improves functional correctness across multiple model families and scales, outperforming standard SFT and advanced SFT variants, while achieving competitive performance against frontier CUDA kernel generation models with substantially lower inference cost.

10.
arXiv (CS.CV) 2026-06-12

YOLO-AMC: An Improved YOLO Architecture with Attention Mechanisms for Building Crack Detection

Crack detection plays an important role in infrastructure inspection and Structural Health Monitoring (SHM). However, cracks typically appear as thin, low-contrast structures and are easily affected by background noise, posing challenges for existing object detection models. This study proposes an improved YOLO-based architecture with integrated attention mechanisms, termed YOLO-AMC (YOLO with Attention Mechanisms for Crack Detection), to enhance automated crack detection performance. Based on YOLOv11, the original C2PSA module is removed, and multiple attention mechanisms, including Global Attention Mechanism (GAM), Residual Convolutional Block Attention Module (Res-CBAM), and Shuffle Attention (SA), are introduced into the multi-scale feature fusion layers of the Neck to strengthen cross-scale feature integration. Experimental results demonstrate that YOLO-AMC consistently outperforms baseline models YOLOv11n and YOLOv8n across multiple evaluation metrics. Among the evaluated attention modules, GAM achieves the best detection performance, obtaining mAP@0.5 = 0.9917 and mAP@0.5:0.95 = 0.9506 on the test dataset, which are higher than those of YOLOv11 (0.9833 / 0.9112) and YOLOv8 (0.9707 / 0.8921). Furthermore, while maintaining a computational complexity of 7.6 GFLOPs, the proposed model achieves 110.95 FPS on an NVIDIA RTX 4090 platform and approximately 5 FPS on a Raspberry Pi 5 edge device, demonstrating a favorable trade-off between accuracy and deployment efficiency. The implementation code for this study is available on GitHub at https://github.com/CY-Tsai24/YOLO-AMC.

11.
medRxiv (Medicine) 2026-06-22

Virtual Responsive Neurostimulation Implantation: From Intracranial Connectivity to Optimized Lead Placement

Responsive neurostimulation (RNS) is an implanted device that delivers direct brain stimulation for drug-resistant focal epilepsy. Individual responses are highly variable, and no validated framework exists to predict outcome or guide lead placement before implantation. We hypothesized that this variability is partly explained by lead placement in relation to patterns of functional connectivity in brain networks. Fourty-nine patients with drug-resistant focal epilepsy who underwent pre-implantation intracranial EEG (iEEG) and RNS implantation across three independent epilepsy centers were retrospectively studied. We developed a composite functional connectivity score, based on simple Spearman correlation, combining the standard deviation and kurtosis of interictal iEEG connectivity distributions to predict the response outcome in a training cohort (HUP, n=18) and validated in two independent cohorts (NYU, n=17; UCSF, n=14). We accounted for a spatial mismatch between iEEG and RNS electrodes with a distance-based correction. The score was extended to generate patient-specific 3D maps of predicted RNS efficacy across 200 simulated, or virtual RNS, lead configurations. Accuracy of the score in predicting clinical outcome was 72% at the group level, 61% at the individual patient level, and, after distance-based optimization, 100% in patients with RNS electrodes placed close to location of iEEG electrodes. Applied to the validation cohort, the same score reached 68% accuracy (71% balanced accuracy, 55% sensitivity, 88% specificity). The spatial combination of the scores at different SEEG contacts localization gives a spatial score for each patient. Responders showed significantly higher spatial scores than non-responders, supporting that actual RNS lead placement in responders was located in map-identified favorable regions. Interictal iEEG functional connectivity predicts individual RNS response across independent epilepsy centers, and patient-specific 3D maps derived from this biomarker could prospectively guide lead implantation toward favorable network regions, opening a promising avenue toward network-informed RNS surgical planning.

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

SemanticXR: Low Power and Real-time Queryable Semantic Mapping with an Object-Level Device-Cloud Architecture

Semantic mapping is a core service that enables grounded interactions in emerging Extended Reality (XR) applications such as AI assistants and spatial object search. Deploying this capability on mobile XR devices requires a system that is open-vocabulary, real-time, and low-power. Existing approaches are compute-intensive and assume server-class resources. Cloud offloading offers a practical path, but no existing system splits semantic mapping across the device-cloud boundary or manages its communication, execution, and memory footprint. We present SemanticXR, the first device-cloud system for real-time, open-vocabulary semantic mapping and querying under XR power, bandwidth, and memory constraints. Our key insight is to elevate semantically identifiable objects to first-class units of communication, execution, and memory across the device and server. On the server, object-level parallelism and geometry downsampling improve mapping latency, while object-level depth-mapping co-design reduces upstream bandwidth. On the device, an object-level sparse local map with incremental updates and update prioritization enables network-robust querying with bounded memory and downstream bandwidth. Object-level configurable resource usage vs. quality trade-offs let applications and the system adapt mapping to application requirements and operating conditions, respectively. Against a device-cloud baseline with the same perception models, object-level organization improves server-side mapping latency by 2.2X at equal semantic quality. Depth-mapping co-design maintains upstream bandwidth under 2.5 Mbps. On the device, SemanticXR sustains sub-100 ms query latency for up to 10,000 objects even under network drops, supports tens of thousands of objects within 500 MB, and scales downstream bandwidth with map changes, not total scene size. The system adds only 2% device power during normal operation.

13.
arXiv (CS.AI) 2026-06-18

A Knowledge Theory of Capital:The Value of Natural and Artificial Intelligence

arXiv:2606.18288v1 Announce Type: cross Abstract: This volume develops a knowledge theory of capital for economies in which productive capacity increasingly resides in software, data, models, routines, expertise, platforms, organizations, commons, and public epistemic infrastructure. Beginning from Adam Smith's theory of labour, stock, specialization, and market extent, it asks what changes when knowledge becomes stock-like, mobile across forms, scalable, governable, recombinable, and imperfectly visible in accounting. The book introduces knowledge-bearing stock as the central object and analyses how it is generated, converted into governable form, deployed, improved through feedback, enclosed or shared, measured, impaired, and used as input to future production. It distinguishes embodied, disembodied, institutionalized, commons, and public knowledge forms and develops concepts such as first conversion, cognitive enclosure, feedback capture, dark capital, and expected knowledge loss. The argument is conditional and testable: modern wealth depends not only on capital accumulation, but on how productive knowledge is governed.

14.
arXiv (CS.LG) 2026-06-17

A Generalized Sinkhorn Algorithm for Mean-Field Schrödinger Bridge

arXiv:2604.06531v3 Announce Type: replace-cross Abstract: The mean-field Schrödinger bridge (MFSB) problem concerns designing a minimum-effort controller that guides a diffusion process with nonlocal interaction to reach a given distribution from another by a fixed deadline. Unlike the standard Schrödinger bridge, the dynamical constraint for MFSB is the mean-field limit of a population of interacting agents with controls. It serves as a natural model for large-scale multi-agent systems. The MFSB is computationally challenging because the nonlocal interaction makes the problem nonconvex. We propose a generalization of the Hopf-Cole transform for MFSB and, building on it, design a Sinkhorn-type recursive algorithm to solve the associated system of integro-PDEs. Under mild assumptions on the interaction potential, we discuss convergence guarantees for the proposed algorithm. We present numerical examples with repulsive and attractive interactions to illustrate the theoretical contributions.

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

Locally Acting Grover Mixers for Constraint-Preserving QAOA

arXiv:2606.11530v1 Announce Type: new Abstract: The Grover mixer quantum alternating operator ansatz (GM-QAOA) employs the Grover mixer to confine the quantum evolution to the feasible subspace defined by the problem. Its mixing unitary, however, requires a global multi-controlled phase-shift gate acting on all qubits, resulting in substantial circuit overhead on near-term quantum devices. In this work, we propose locally acting Grover mixers tailored to initial states that admit a product structure over disjoint qubit subsystems, which may be obtained by encoding only a subset of problem constraints into the initial state preparation. The proposed method preserves the search space defined by the initial state while significantly lowering implementation cost, as the global multi-controlled phase-shift gate is replaced with local operations on disjoint subsystems. Numerical simulations on the exact-cover problem and the traveling salesman problem (TSP) demonstrate that the proposed method achieves convergence behavior comparable to that of the original GM-QAOA, while using shallower circuits with fewer gates. We further compare two constraint encoding strategies for the TSP, encoding only a subset of constraints versus all constraints into the initial state preparation, and show that the former combined with the proposed mixer yields markedly more compact circuits at the point where comparable solution quality is achieved.

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

The Hidden Cost of Approximation in Online Mirror Descent

arXiv:2511.22283v2 Announce Type: replace Abstract: Online mirror descent (OMD) is a fundamental algorithmic paradigm that underlies many algorithms in optimization, machine learning and sequential decision-making. The OMD iterates are defined as solutions to optimization subproblems which, oftentimes, can be solved only approximately, leading to an inexact version of the algorithm. Nonetheless, existing OMD analyses typically assume an idealized error free setting, thereby limiting our understanding of performance guarantees that should be expected in practice. In this work we initiate a systematic study into inexact OMD, and uncover an intricate relation between regularizer smoothness and robustness to approximation errors. When the regularizer is uniformly smooth, we establish a tight bound on the excess regret due to errors. Then, for barrier regularizers over the simplex and its subsets, we identify a sharp separation: negative entropy requires exponentially small errors to avoid linear regret, whereas log-barrier and Tsallis regularizers remain robust even when the errors are only polynomial. Finally, we show that when the losses are stochastic and the domain is the simplex, negative entropy regains robustness-but this property does not extend to all subsets, where exponentially small errors are again necessary to avoid suboptimal regret.

17.
medRxiv (Medicine) 2026-06-15

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

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

18.
medRxiv (Medicine) 2026-06-12

Crimean-Congo haemorrhagic fever virus transmission: exploring perceptions of human-animal-tick interactions across six districts in Uganda

Crimean-Congo haemorrhagic fever virus (CCHFV) causes a viral zoonotic disease transmitted through tick bites and direct contact with infected blood or tissue of infected animals. Socio-ecological and behavioural risk factors for CCHFV exposure in Uganda remain poorly understood, which can lead to the omission of key risk factors in quantitative survey design and limit our wider understanding. In this study, we explored human-animal-tick interaction transmission risks in Uganda. We conducted 24 focus group discussions (FGDs) and 31 key-informant interviews (KIIs) across six environmentally and socio-ecologically diverse districts, between October 2023 and March 2024. Study sites were selected using K-prototype analysis, which combined environmental and socio-ecological variables to identify distinct clusters within Uganda. FGDs were conducted separately with groups of community leaders, men, women and teenagers with stratified purposive sampling. Medical doctors, veterinarians, traditional healers, district surveillance officers, and herdsmen were individually interviewed as key informants and purposively sampled. Data were transcribed and translated into English, and analysed thematically using iterative categorisation in NVivo 14. Most participants reported tick bites, some as frequently as every day. Close contact with animals was common, including sleeping next to them in the same building, largely due to concerns about animal theft. Less frequent but notable practices included slaughtering animals for consumption or sacrifice and interactions with wild animals during hunting. Slaughtering and butchering an animal which was sick or had died was reportedly performed by participants in most districts. Plucking and roasting engorged ticks was a practice described in the Kaabong and Arua districts of Northern Uganda. These practices and behaviours highlight potential key risks of CCHFV transmission and underscore the need for future studies to address specific behaviours, to quantify if, and to what extent, they present an exposure risk. Further work should include underlying reasons for the behaviours, which would help ensure that culturally appropriate interventions are targeted.

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

A Quantitative Experimental Repeated Measures Study of Training Dynamics in a Small Llama Style Language Model Under a Compute-Aware Token Budget

Authors:

arXiv:2606.13370v1 Announce Type: new Abstract: This study examines training dynamics in a small Llama-style language model trained under a fixed, compute-constrained token budget. Rather than evaluating efficiency solely through endpoint performance, the study uses a quantitative experimental repeated measures design to analyze how validation loss, validation perplexity, rolling volatility, backslide behavior, spike behavior, and between-seed variability change across token-based training intervals. Six independent training runs were conducted on a 4.26-million-parameter model using the TinyStories corpus, CPU-based full-precision training, and a target budget of approximately 20 million cumulative training tokens. Metrics were collected across 21 intervals, producing 126 seed-by-interval observations. Repeated measures ANOVA showed statistically significant interval effects for validation loss, validation perplexity, and rolling volatility. Descriptive trajectories revealed rapid early improvement followed by non-monotonic degradation during later training intervals. Mean validation loss decreased from 8.3552 at initialization to 2.7996 near 4 million tokens, but increased to 3.9010 by the final checkpoint. Validation perplexity followed the same pattern, falling sharply early in training before rising later. Derived telemetry further showed recurrent validation-loss backslides and no interval-summary evidence of a stable phase under the predefined criteria. These findings suggest that compute-aware language model evaluation should examine training trajectories rather than endpoint metrics alone. In constrained compute settings, additional token exposure may increase computational cost without producing proportional generalization gains, and interval-level telemetry can reveal instability, regression, and diminishing returns that final metrics may obscure.

20.
arXiv (CS.LG) 2026-06-17

X-REFINE: XAI-based RElevance input-Filtering and archItecture fiNe-tuning for channel Estimation

arXiv:2602.22277v2 Announce Type: replace Abstract: AI-native architectures are vital for 6G wireless communications. The black-box nature and high complexity of deep learning models employed in critical applications, such as channel estimation, limit their practical deployment. While perturbation-based eXplainable Artificial Intelligence (XAI) solutions offer input filtering, they often neglect internal structural optimization. We propose X-REFINE, an XAI-based framework for joint input-filtering and architecture fine-tuning. By utilizing a decomposition-based, sign-stabilized LRP epsilon rule, X-REFINE backpropagates predictions to derive high-resolution relevance scores for both subcarriers and hidden neurons. This enables a reliable optimization that identifies the most reliable model components. Simulation results demonstrate that X-REFINE achieves a superior performance-complexity-interpretability trade-off compared to the external perturbation-based XAI frameworks, significantly reducing computational complexity while maintaining robust bit error rate (BER) performance.

21.
arXiv (CS.CV) 2026-06-18

Hallucination Detection and Correction in Medical VLMs via Counter-Evidence Verification

Vision-Language models (VLMs) reliability in medical diagnosis is challenged by trust-undermining hallucinations. Existing hallucination detection approaches mainly focus on identifying factual inconsistencies between generated text and reference data. While some studies analyze where models attend in images, they seldom verify whether such attention truly reflects the visual evidence supporting the generated text. To address this gap, we propose Co}unter-Evidence Verification (CoEV), a training-free plug-and-play framework that detects and corrects hallucinations through evidence-based factual consistency verification. CoEV performs bidirectional verification between textual assertions and visual evidence, testing whether each statement is supported by its corresponding evidence region, and assigns each statement into a four-quadrant diagnostic map capturing combinations of text factuality and visual grounding. CoEV detects hallucinated content and serves as a post hoc refinement tool, correcting hallucinations without retraining. Extensive experiments on four medical datasets show that CoEV combats hallucinations in VLMs.For hallucination detection, CoEV consistently outperforms existing methods, improving average PR-AUC and ROC-AUC by 3.0% and 3.9% absolute points respectively, with notable gains of up to 18.5% in specific VQA scenarios. For hallucination correction, it improves Micro-F1 by up to 12.5%, reduces hallucination rates by over 11.9% on medical report generation, and also boosts medical VQA accuracy. These results show that CoEV enables reliable detection and correction of hallucinations, providing clinicians with dependable, evidence-based cues for diagnosis. Code will be released upon acceptance.

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

Taming I2V models for Image HOI Editing: A Cognitive Benchmark and Agentic Self-Correcting Framework

Current image editing methods excel at static attributes but fail at complex Human-Object Interactions (HOI), a critical challenge unaddressed by existing benchmarks that conflate HOI with static attributes, relying on global metrics incapable of simultaneously assessing dynamic interaction validity and entangled human-object pair preservation. Thus, we first introduce HOI-Edit, a comprehensive benchmark with three progressive cognitive levels, which features an automated metric HOI-Eval that reliably evaluates instance-level interaction by letting VLM Q&A after thinking with images containing grounded Human-Object pairs. Considering the task's essence of remodeling dynamic relationships, we benchmark Image-to-Video (I2V) models, finding them inherently suited for dynamic editing due to their temporal generation capabilities. Crucially, beyond superior performance, this capability provides a "replay of the failure process," offering unique diagnosability into why errors occur. We thus propose SCPE (Self-Correcting Process Editing), a novel, agentic self-correcting framework that constrains the generation of I2V models through iteratively refined prompts, enabling the generated videos to more accurately present the target HOI. Extracted frames from these videos are the final editing results. On HOI-Edit, SCPE achieves performance competitive with state-of-the-art (SOTA) editing models like Nano Banana on interaction. Code is available at https://github.com/oceanflowlab/HOI-Edit.

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

EnvRL: Learn from Environment Dynamics in Agentic Reinforcement Learning

Reinforcement learning (RL) has emerged as a powerful paradigm for training Large Language Models (LLMs) as agents. However, conventional RL methods for long-horizon agentic tasks often struggle with sparse outcome rewards. Intuitively, this overlooks the rich environment dynamics information contained in rollout interaction trajectories. We argue that the interaction experience inherently serves as an implicit supervision signal, reveals the underlying transition mechanisms of the environment, and enables the agent to construct a more accurate internal model of the environment.. Therefore, in this work, we investigate how to leverage this additional signal to improve policy learning. Specifically, we propose EnvRL, a framework that incorporates environment dynamics learning into agentic RL via two auxiliary objectives: state prediction and inverse dynamics. By jointly optimizing with the primary RL objective, we encourage the agent to internalize environment dynamics from its own interaction experience. Extensive experiments on two long-horizon agentic benchmarks demonstrate that EnvRL achieves significant improvements on success-rates over RL-only baselines, e.g., when trained with GRPO, lifting Qwen-2.5-1.5B-Instruct from 72.8% to 77.4% on ALFWorld, and from 56.8% to 67.0% on WebShop.

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

Multi-task Learning is Not Enough: Representational Entanglement in Dual-output Second Language Speech Recognition

Second-language (L2) speech recognition often requires transcriptions of pronunciations and intended meanings. Multi-task learning (MTL) is a natural approach because it assumes that shared representations benefit both outputs. However, this paper shows that this assumption does not hold across Korean and English. MTL improves meaning but degrades surface transcription, especially in English, where the degradation scales with surface-meaning divergence measured by Levenshtein edit distance. Encoder analysis links these patterns to encoder-level entanglement, with Korean preserving distinct task representations while English produces nearly identical ones. Cross-task decoder analysis shows that the meaning dual-output decoder adapts with a unique representation, while the surface dual-output decoder remains constrained by the encoder. These findings motivate the design of MTL frameworks that mitigate encoder-level entanglement to reduce surface degradation in dual-output L2 automatic speech recognition.

25.
Nature (Science) 2026-06-10

Building user-driven climate adaptation products

Climate adaptation products have traditionally been developed using a supply-driven model reliant on available climate information, leading to usability gaps1–4. To better meet user needs, the climate services field has recognized a need to shift towards a demand-driven model emphasizing co-production, that is, user-driven, scientifically informed products created through shared knowledge practices1–5. However, co-production can be challenging, especially for researchers unfamiliar with the approach or for digital and software-based products with complex user needs2,5–8. User-centred design, from the human–computer interaction field, offers a process that could complement co-production approaches to product development, yet its potential remains underexplored2. Here we show how user-centred design can be integrated into, and strengthen, co-production approaches for building user-driven climate adaptation products. Through a systematic review of the co-production and user-centred design literature, we identify key processes, mechanisms and best practices for both approaches. Our findings offer practical guidance for researchers and propose an integrated approach for developing climate adaptation products that are useful, usable and used. A systematic review and analysis shows how user-centred design can be integrated into, and strengthen, co-production approaches for building user-driven climate adaptation products.