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01.
arXiv (CS.CL) 2026-06-18

Freeing the Law with LOCUS: A Local Ordinance Corpus for the United States

Progress in legal AI increasingly depends on access to authoritative legal text at scale. Yet one of the most consequential layers of American law remains largely absent from existing machine-readable corpora: local ordinances. Local codes govern zoning, housing, business licensing, public health, noise, animal control, and many other domains of everyday regulation, but they are fragmented across vendor platforms designed for human browsing rather than bulk research access. We introduce LOCUS - the Local Ordinance Corpus for the United States - a comprehensive corpus and county-harmonized access layer for U.S. municipal and county ordinance codes. The raw corpus, available for release to researchers, represents nearly all publicly available municipal and county ordinance codes. The resulting raw corpus contains codes from 9,239 cities and counties. A smaller county-harmonized LOCUS access layer provides coverage for the largest 2,309 of 3,144 U.S. counties, accounting for a majority of the population. We use OCR to handle the myriad of document formats that have kept the law from being a public resource. We release the corpus with coverage metadata to support reproducibility, downstream legal AI research, and the incremental expansion of machine-readable access to local law. We train a collection of ModernBERT-based classifiers and scorers to facilitate analyzing U.S. local law among several dimensions, such as opacity and paternalism, that have not previously been studied at this scale. LOCUS-v1 and its derivative models are available at: https://huggingface.co/datasets/LocalLaws/LOCUS-v1

02.
arXiv (CS.CL) 2026-06-12

Beyond the Commitment Boundary: Probing Epiphenomenal Chain-of-Thought in Large Reasoning Models

Chain-of-thought (CoT) reasoning is the dominant paradigm for inference-time scaling in language models, yet the causal influence of individual steps on the final answer poorly understood. We estimate each step's causal importance via early exit and use this measure to study how answers form across the reasoning traces of several model families. Across diverse tasks, we find that reasoning typically crosses a commitment boundary – a sharp transition from transient intermediate guesses to a stable, high-confidence answer. This transition often happens in a single step, well before the model's reasoning block ends, and is followed by epiphenomenal CoT steps that leave the final answer probability unaltered. Using attention probes, we show that answer-formation stages can be linearly decoded from intermediate reasoning steps with high accuracy and generalize robustly to unseen reasoning tasks. We exploit this signal to early-exit reasoning blocks at the commitment boundary, reducing the length of CoTs up to 55\% on average with negligible impact on model performance.

03.
arXiv (CS.CV) 2026-06-16

HSQ-VLM: A Novel Spatially-Constrained Quadrant Segmentation VLM Model for Explainability in Diabetic Retinopathy

Diabetic Retinopathy (DR) is an aggressive retinal disease and a leading cause of global blindness, yet its clinical management is currently hindered by the black-box nature of diagnostic AI. While deep learning models achieve high classification accuracy, there is a critical lack of explainability methods capable of detailing the exact anatomical landmarks and lesion distributions that lead to a clinical decision for DR. Therefore, we propose HSQ-VLM, a novel quadrant segmentation pipeline on fundus images that utilizes a Landmark-Anchored Cartesian Cross-Attention mechanism to unify visual feature extraction with structured clinical reasoning. Unlike traditional methods that rely on arbitrary image partitioning, our pipeline implements 4-quadrant Topological Latent Partitioning (TLP) to dynamically align retinal features with a fovea-centered coordinate system. This allows the Vision-Language Model to generate natural language reports that quantify pathology with anatomical precision. On a dataset of 3,500 high-resolution fundus images, this innovative methodology achieved a lesion detection sensitivity of 99.6% for hemorrhages and 96.4% for microaneurysms, while demonstrating a significant reduction in boundary-ambiguity errors compared to standard segmentation baselines.

04.
arXiv (CS.LG) 2026-06-12

Understanding Truncated Positional Encodings for Graph Neural Networks

arXiv:2606.13671v1 Announce Type: new Abstract: Positional encodings (PEs) enhance the power of graph neural networks (GNNs), both theoretically and empirically. Two of the most popular families of PEs - spectral (e.g., Laplacian eigenspaces, effective resistance) and walk-based (polynomials of the adjacency matrix) - are theoretically equivalent in expressive power, with expressivity between the 1-WL and 3-WL tests. However, this equivalence assumes the GNN uses the "complete" version of these PEs, which requires $O(n^3)$ time and space complexity. Instead, practitioners commonly use truncated variants of these encodings, such as the first $k$ eigenspaces or powers of the adjacency matrix. However, the theoretical properties of these truncated PEs are unknown. In this work, we initiate the study of these truncated PEs. Theoretically, we show that, under truncation, several families of PEs are fundamentally different in expressive power. As a corollary, we show that truncated spectral PEs are no longer stronger than the 1-WL test. We also study a family of spectral PEs, the $k$-harmonic distances, to highlight the differences in expressive power of even closely related truncated PEs. Finally, we experimentally show that a mix of truncated PEs is preferable to any single family on real-world datasets.

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

EpiBench: Verifiable Evaluation of AI Agents on Epigenomics Analysis

arXiv:2606.13602v1 Announce Type: new Abstract: We introduce EpiBench, a verifiable benchmark for short-horizon epigenomics analysis. EpiBench evaluates whether agents can make well-defined analysis decisions from realistic workflow states and return deterministically gradable answers. The benchmark includes 106 evaluations across CUT\&Tag/CUT\&RUN, ATAC-seq, ChIP-seq, and DNA methylation workflows. Across 5,088 valid trajectories from 16 model-harness pairs, no system passed a majority of attempts: GPT-5.5 / Pi led at 45.0\% (143/318 attempts; 95\% confidence interval (CI), 36.3–53.7), followed by GPT-5.5 / OpenAI Codex at 39.9\% (127/318 attempts; 95\% CI, 31.6–48.3). Claude Opus 4.8 Max / Pi and GPT-5.4 / Pi each passed 39.0\% (124/318 attempts; 95\% CI, 30.2–47.8 and 31.0–47.0, respectively). Performance varies across assay types, and many failed runs still contain parts of the correct answer. Agents often found the right files and computed useful intermediate results, but failed when the task required deeper, assay-specific scientific judgment.

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

Prediction-Powered Causal Inference by Automatic Debiased Machine Learning and Semi-Supervised Riesz Regression

arXiv:2606.12892v1 Announce Type: cross Abstract: This study investigates semiparametric efficient estimation of causal and structural parameters in a semi-supervised setting. In our setting, unlabeled auxiliary regressors are available in addition to labeled observations consisting of outcomes and regressors. Our goal is to construct estimators of causal and structural parameters whose asymptotic variances are smaller than those of estimators constructed using only labeled data. We refer to this framework as prediction-powered causal inference (PPCI). We first derive the efficient influence function and the efficiency bound, which imply that the use of auxiliary regressors can attain a smaller asymptotic variance than the efficiency bound attainable from labeled observations alone. Then, by combining the efficient influence function with the debiased machine learning (DML) framework, we propose methods that we call DML-PPCI. If we construct an estimating-equation estimator, we refer to the method as EE-DML-PPCI; if we construct a targeted-learning estimator, we refer to the method as TMLE-DML-PPCI. The asymptotic variances of both estimators match our derived efficiency bound. In the construction of the estimators, estimation of the efficient influence function plays an important role. In our study, the efficient influence function is also a Neyman orthogonal score, which depends on the Riesz representer and the regression function. For Riesz representer estimation, we develop semi-supervised generalized Riesz regression with convergence rate guarantees.

07.
arXiv (CS.AI) 2026-06-19

ZeSTA: Zero-Shot TTS Augmentation with Domain-Conditioned Training for Data-Efficient Personalized Speech Synthesis

arXiv:2603.04219v2 Announce Type: replace-cross Abstract: We investigate the use of zero-shot text-to-speech (ZS-TTS) as a data augmentation source for low-resource personalized speech synthesis. While synthetic augmentation can provide linguistically rich and phonetically diverse speech, naively mixing large amounts of synthetic speech with limited real recordings often leads to speaker similarity degradation during fine-tuning. To address this issue, we propose ZeSTA, a simple domain-conditioned training framework that distinguishes real and synthetic speech via a lightweight domain embedding, combined with real-data oversampling to stabilize adaptation under extremely limited target data, without modifying the base architecture. Experiments on LibriTTS and an in-house dataset with two ZS-TTS sources demonstrate that our approach improves speaker similarity over naive synthetic augmentation while preserving intelligibility and perceptual quality. Audio samples are available on our web page.

08.
arXiv (CS.CV) 2026-06-18

VidCRAFT3: Camera, Object, and Lighting Control for Image-to-Video Generation

Controllable image-to-video (I2V) generation transforms a reference image into a coherent video guided by user-specified control signals. While precise control over camera motion, object motion, and lighting is essential for high-fidelity creation, existing methods often treat these factors independently. This overlooks the physical coupling among viewpoint, geometry, and illumination in dynamic scenes, leading to visual inconsistencies such as mismatched shadows and perspective drift under simultaneous changes. We present VidCRAFT3, a unified and flexible I2V framework that explicitly models cross-factor interactions among geometry, motion, and illumination, enabling both independent and joint control over camera motion, object motion, and lighting direction. Image2Cloud provides explicit 3D geometric priors for accurate camera motion control. ObjMotionNet encodes sparse object trajectories into multi-scale motion features to guide realistic object motion. A Spatial Triple-Attention Transformer integrates lighting direction through lighting cross-attention for consistent relighting. To address the scarcity of jointly annotated data, we construct the VideoLightingDirection (VLD) dataset with accurate per-frame lighting direction annotations, and introduce a three-stage progressive training strategy that enables robust learning without fully joint annotations. Extensive experiments demonstrate that VidCRAFT3 achieves state-of-the-art performance in control precision and visual coherence across diverse scenarios.

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

MMD-SLAM: Structure-Enhanced Multi-Meta Gaussian Distribution-Guided Visual SLAM

3D Gaussian Splatting (3DGS) has significantly boosted novel view synthesis and high-fidelity scene reconstruction, expanding the potential of 3DGS-based Visual Simultaneous Localization and Mapping (SLAM) methods. However, most existing systems fail to fully exploit the underlying structural information, which limits rendering quality and often leads to inconsistent maps. To address these limitations, we propose MMD-SLAM, a structure-enhanced Visual SLAM framework that leverages the Atlanta World (AW) assumption to guide a Multi-Meta Gaussian representation for photorealistic mapping. First, we introduce a point-line fusion strategy for pose optimization, where 3D line segments are incorporated to improve tracking robustness and provide additional constraints for mapping. Second, we design a Multi-Meta Gaussian representation with dominant directions, explicitly encoding structural priors from the AW hypothesis. Finally, we propose a Gaussian evolution strategy that adapts to scene geometry and incorporates structural cues into global optimization. Extensive experiments demonstrate that these innovations enable MMD-SLAM to achieve state-of-the-art performance in both tracking accuracy and mapping quality. e.g., our method achieves a 48.56% reduction in ATE RMSE on ScanNet and a 5.71% improvement in PSNR on Replica, compared with MonoGS.

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

4DP-QA: Scalable QA for 4D Perception in Vision Language Models

Despite recent advances, Vision Language Models (VLMs) still struggle to grasp the dynamics of the world. We note that the ability to reason about a 4D scene, challenging in itself, is further complicated by two factors. First, VLMs observe motion indirectly via its projection onto 2D images. Second, existing datasets fail to disentangle object and camera motion. To address these challenges, we present a QA generation pipeline that focuses on motion-related scene understanding. We take particular care of the entanglement of camera and object motion by casting tracking in both the traditional way and in a novel, fixed reference system, dubbed True-Motion Tracking, which provides an intuitive description of motion. From this pipeline, we generate a large-scale training dataset of 400K samples, 4DP-QA (4D Perception QA), and a 2.2K-sample benchmark, 4DP-QA-Bench. Training existing models on our dataset yields performance improvements on an external benchmark, validating the effectiveness of our method.

11.
medRxiv (Medicine) 2026-06-15

Beyond the Apnea-Hypopnea Index: Physiological and Demographic Predictors of Excessive Daytime Sleepiness in Obstructive Sleep Apnea

Excessive daytime sleepiness (EDS) is a common but inconsistently predicted symptom of obstructive sleep apnea (OSA). OSA is typically diagnosed with polysomnography (PSG), and the current standard for severity assessment is the apnea-hypopnea index (AHI). AHI has many limitations, including its inability to explain physiological mechanisms or reflect variability in patient symptoms, such as EDS. This retrospective study aims to find physiological and demographic parameters that better predict EDS in patients with OSA and to evaluate whether these parameters outperform AHI using PSG data from the Mount Sinai Integrative Sleep Center. Clinical variables used to predict EDS included arousal index (AI), average oxygen desaturation during sleep, average heart rate during sleep, and AHI, along with demographic variables including age, sex, and BMI. Hypothesis tests, logistic regression models, and decision tree classifier models were performed on the data to discriminate sleepy from nonsleepy patients as determined by an Epworth Sleepiness Scale (ESS) score [≥] 10. AI and oxygen desaturation were found to be the most predictive physiological variables, and sex and BMI were found to be the most predictive demographic variables. The final decision tree model with these four variables outperformed the AHI in predicting EDS. These findings suggest that daytime sleepiness in OSA can be better explained by measures of apnea burden, oxygenation impairment, and patient demographics than by AHI alone, although these remain only modestly predictive. Future studies should focus on investigating more comprehensive physiological markers, multi-night sleep data, and more objective assessments of sleepiness.

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

MPK: A Compiler and Runtime for Mega-Kernelizing Tensor Programs

arXiv:2512.22219v2 Announce Type: replace-cross Abstract: We introduce Mirage Persistent Kernel (MPK), the first compiler and runtime system that automatically transforms multi-GPU model inference into a single high-performance mega-kernel. MPK introduces an SM-level graph representation that captures data dependencies at the granularity of individual streaming multiprocessors (SMs), enabling cross-operator software pipelining, \rev{fine-grained overlap of computation and communication, and other optimizations that are infeasible under the conventional kernel-per-operator execution model}. The MPK compiler lowers tensor programs into optimized SM-level task graphs and generates fast CUDA implementations for each task, while the MPK in-kernel parallel runtime executes these tasks within a single persistent mega-kernel using decentralized scheduling across SMs. Together, these components provide end-to-end kernel fusion with minimal developer effort, while preserving the flexibility of existing programming models. Our evaluation shows that MPK significantly outperforms existing kernel-per-operator LLM serving systems, achieving up to 1.7$\times$ lower end-to-end inference latency and pushing LLM inference performance close to the limits of the underlying hardware. MPK is publicly available at https://github.com/mirage-project/mirage.

13.
arXiv (CS.AI) 2026-06-19

Beyond Static Leaderboards: Predictive Validity for the Evaluation of LLM Agents

arXiv:2606.19704v1 Announce Type: new Abstract: Agent benchmarks are growing fast, but no single benchmark touches more than four or five of the dimensions that deployment exposes. This paper aggregates the largest coordinated deep-dive of one MCP-based industrial-agent benchmark to date: fourteen parallel implementation studies covering new asset classes (including a multi-modal visual extension), alternative orchestrations, retrieval strategies, reasoning modes, infrastructure optimizations, and evaluation-methodology probes. Consolidating those studies with seven prior agent benchmarks, we argue that aggregate-score leaderboards systematically underspecify deployed-agent evaluation. Rankings derived from aggregate scores do not transfer to out-of-distribution settings; recent public-to-hidden competition retrospectives provide direct empirical evidence of this rank instability. We propose ranking configurations by predictive validity, the correlation between in-sample and out-of-sample rank, rather than in-sample mean, and report a twelve-tier measurement apparatus that exposes the deployment-relevant dimensions HELM and its agent-era successors collapse. The position is operationalized through three falsifiable out-of-distribution criteria with explicit thresholds; existing evidence partly supports it but is too thin to confirm. We close with a pre-registered pilot design and a field-level vision for what the next generation of agentic benchmarks should report.

14.
arXiv (CS.AI) 2026-06-19

Controlled Comparison of Machine Learning Models for Fault Classification and Localization in Power System Protection

arXiv:2510.00831v2 Announce Type: replace Abstract: The increasing complexity of modern power systems, driven by the integration of inverter-based and distributed energy resources, challenges the reliability of conventional protection schemes and motivates the use of machine learning for protection tasks. However, published results are often difficult to compare because datasets, sensing assumptions, and decision horizons vary across studies. This paper presents a controlled comparison of machine learning models for fault classification (FC) and fault localization (FL) under identical sensing, timing, and validation conditions on a common electromagnetic transient dataset, using decision windows of 10-50 ms to reflect protection-relevant time scales. For FC, the best-performing nonlinear models achieve F1 scores above 0.98 already at 10 ms, while lower-capacity models degrade at shorter horizons but improve with longer windows, indicating that relevant fault-type information is already present in the earliest transient. For FL, the top-performing models reach a stable localization error of about 10 % of normalized line length across all evaluated horizons, while weaker models form a clearly separated second performance tier. Line-resolved analysis shows that localization accuracy varies across grid segments, indicating topology-dependent difficulty rather than insufficient temporal context alone. These findings provide a controlled reference for comparing machine learning models across two protection tasks with fundamentally different information requirements.

15.
arXiv (CS.LG) 2026-06-18

Unsupervised Diffusion Solver for Combinatorial Optimization via Combinatorial Adjoint Matching

arXiv:2605.30920v2 Announce Type: replace Abstract: Diffusion-based neural solvers have shown strong promise for combinatorial optimization (CO), but existing methods typically rely on supervised training with large collections of near-optimal solutions. In this work, we extend adjoint-based trajectory optimization methods to discrete combinatorial domains. We formulate diffusion-based CO as a stochastic control problem over Continuous-Time Markov Chains and introduce discrete adjoint dynamics for propagating optimization signals through discrete generative trajectories. Building on this formulation, we propose Combinatorial Adjoint Matching (CAM), an unsupervised training framework for discrete diffusion solvers with structured and low-variance trajectory-level optimization signals. Empirically, CAM consistently outperforms existing unsupervised diffusion baselines and achieves performance competitive with strong supervised diffusion solvers and even traditional solvers across diverse combinatorial optimization problems. Our code is available at https://github.com/Shengyu-Feng/CAM.

16.
arXiv (CS.LG) 2026-06-18

QUIVER: Cost-Aware Adaptive Preference Querying in Surrogate-Assisted Evolutionary Multi-Objective Optimization

arXiv:2605.04267v2 Announce Type: replace Abstract: Interactive multi-objective optimization systems face a budget allocation dilemma: one can spend resources on expensive objective evaluations or on eliciting decision-maker preferences that identify the relevant region of the Pareto set. Moreover, preference elicitation itself spans modalities with different information content and cognitive burden, ranging from cheap, noisy pairwise preference statements (PS) to richer but costlier indifference adjustments (IA). We study cost-aware optimization under an unknown scalarization and introduce QUIVER (Query-Informed Value Estimation for Regret), a surrogate-assisted evolutionary multi-objective optimizer that adaptively chooses between objective evaluations and heterogeneous preference queries. At each step, QUIVER selects the next action by maximizing the expected decision-quality improvement per unit total cost. Across DTLZ and WFG benchmarks under synthetic decision-maker models, QUIVER achieves the lowest final utility regret on challenging WFG problems (utility regret of 2.14 on WFG4, 2.82 on WFG9: a 25% improvement over baselines), outperforming all single-modality baselines. We analyze how the optimal mix of PS and IA adapts to problem difficulty: on easy problems (DTLZ2), QUIVER selects 80\% PS queries; on hard problems (WFG9), it shifts to 35% IA queries. This adaptive modality selection demonstrates cost-aware preference learning in action.

17.
medRxiv (Medicine) 2026-06-10

Towards the Virtual Amyotrophic Lateral Sclerosis Patient: Inferring Cortical Excitability through Whole-Brain Dynamical Modeling

Amyotrophic lateral sclerosis (ALS) is increasingly recognized as a multisystem neurodegenerative disorder in which motor-neuron degeneration is accompanied by widespread alterations in cortical dynamics. Among its most reproducible neurophysiological signatures is cortical hyperexcitability, yet how this local excitability imbalance shapes distributed whole-brain activity remains poorly understood. Here, we combined source-reconstructed resting-state MEG data, tractography-informed whole-brain modeling, and simulation-based inference to investigate whether ALS-related alterations in large-scale brain dynamics can be mechanistically explained by changes in cortical excitability. First, we characterized empirical brain dynamics using complementary features spanning regional activity amplitude and variability, functional connectivity, and avalanche-based metrics. These analyses revealed significant alterations in ALS patients relative to healthy controls, as well as associations with clinical impairment and disease staging. To mechanistically interpret these changes, we employed a reduced Wong-Wang whole-brain model in which local recurrent excitation modulates emergent large-scale neural dynamics. Simulations showed that increasing excitability systematically reproduced the empirical dynamical signatures observed in ALS. We then applied a simulation-based inference framework to estimate latent excitability parameters directly from empirical observations. Whole-brain model inversion revealed increased excitability in ALS patients compared with controls. The recovered excitability parameter was associated with disease staging, supporting its clinical relevance as a model-derived descriptor of ALS progression. Finally, by extending the model to estimate frontal and non-frontal excitability separately, we found that ALS-related alterations were predominantly associated with increased frontal excitability, whereas non-frontal regions appeared comparatively less affected. The recovered parameters related to disease staging. Together, these findings provide a mechanistic framework linking altered large-scale brain dynamics in ALS to selective cortical hyperexcitability, explaining how local excitability changes can give rise to global network reorganization. More broadly, they show how computational model inversion can recover latent multiscale pathophysiological processes from empirical neural recordings, offering a non-perturbative alternative to complex experimental paradigms typically required to causally probe local-to-global mechanisms.

18.
arXiv (CS.CL) 2026-06-16

Risk-Aware LLM Agents for Geospatial Data Retrieval: Design and Preliminary Adversarial Evaluation

We present an LLM-driven framework for retrieving remote sensing data from cloud-based geospatial catalogues using natural language queries. The system converts user intent into structured API calls, enabling efficient access to satellite imagery and environmental datasets. The architecture integrates three agents: Guardrail for safety and policy enforcement, General-QA for intent interpretation, and Recommender-Analyst for schema-aware API call generation. This coordinated design ensures reliable, semantically aligned interaction with external data services. The modular framework is portable across platforms through API schema substitution and supports applications in environmental monitoring, disaster response, and climate analysis. It establishes a scalable interface between user intent and geospatial infrastructure, enabling streamlined and automated Earth observation workflows. Preliminary experiments under adversarial multi-turn settings show that prompt-level safety instructions improve robustness, although rare high-impact failures persist in API manipulation scenarios and highlight the need for adaptive, system-level defenses that balance safety, usability, and cost efficiency, which motivates the use of our intercept-level Guardrail agent.

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

Hierarchical Advantage Weighting for Online RL Fine-Tuning of VLAs from Sparse Episode Outcomes

arXiv:2606.17043v1 Announce Type: cross Abstract: When pretrained VLA policies are fine-tuned through online RL, each rollout episode produces only a single binary outcome (success or failure), yet the actor update requires per-transition supervision. Existing approaches commonly reduce this sparse outcome to a single scalar reward or advantage signal, which conflates distinct forms of transition-level feedback and provides limited guidance once basic task success becomes achievable. First, a single scalar signal conflates the two objectives of viability and efficiency; once basic success is achieved, the binary label provides no gradient to distinguish efficient completions from slow ones. Second, real-world rollouts mix autonomous and intervention segments; naively assigning episode outcomes across these boundaries introduces incorrect credit assignment. To address these issues, we propose Hierarchical Advantage-Weighted Behavior Cloning (HABC), which trains separate critic heads for these two objectives on different data subsets and combines their outputs with a state-adaptive balance. A state-adaptive gate $g_t$ merges their one-step advantages, prioritizing viability when success is uncertain and shifting to efficiency only when viability is high, and converts the result into per-transition weights on the actor loss. Intervention-aware credit assignment further restricts outcome labels to segments executed by the current policy, preventing supervision from leaking across intervention boundaries. In real-robot experiments on three contact-rich bimanual tasks, HABC raises success from supervised fine-tuning (SFT) baselines of 36%, 44%, and 12% to 92%, 88%, and 38%.

20.
medRxiv (Medicine) 2026-06-15

GLLaucoMed: A Secure LLM-Powered Agentic Workflow for Automated Medication Extraction from Free-Text Glaucoma Clinical Notes

Purpose: To evaluate the efficacy of large language models (LLMs) in extracting medication-related information from glaucoma clinical notes in the electronic health record (EHR). Design: Cross-sectional. Subjects: 1,250 subjects in the Bascom Palmer Ophthalmic Repository. Methods: Extracted clinical notes from glaucoma-related encounters between 2014 and 2024 were labeled by two glaucoma specialists with a third serving as an adjudicator. Graders were asked to label current topical medications (CTM), proposed changes to topical medications ({Delta}TM), current oral medications (COM), and proposed changes to oral medications ({Delta}OM) in a structured fashion. The dataset was split into development (10%), validation (10%), and test (80%) sets stratified by clinician. Development and validation sets were used to engineer and refine prompts, and the held-out test set was used for model assessment. Five LLMs (Claude Opus 4.6, DeepSeek-V3.2, GPT 5.2, Grok 4.1, and Qwen3.6-35B-A3B) were accessed via Microsoft Azure AI Foundry within a HIPAA-compliant environment. Inter-grader agreement was assessed with Gwet AC1. LLM performance was initially assessed in a binary fashion with F1 scores, and the degree of text match among positive cases was evaluated using exact match accuracy and Jaccard Index (JI). Main Outcome Measures: F1 score, exact match accuracy, JI. Results: Gwet AC1 for intergrader agreement was 0.799, 0.888, 0.985, and 0.988 for CTM, {Delta}TM, COM, and {Delta}OM, respectively. F1 scores for CTM were 0.985, 0.971, 0.978, 0.968, and 0.970 for Claude, Deepseek, GPT, Grok, and Qwen, respectively; for {Delta}TM: 0.905, 0.826, 0.897, 0.842, 0.855, respectively; for COM: 0.923, 0.887, 0.899, 0.906, 0.894, respectively; for {Delta}OM: 0.958, 0.815, 0.937, 0.835, 0.940, respectively. Among positive cases, range of exact match accuracies for CTM (N=1354) was 0.730- 0.882 and range of JIs was 0.809-0.918. For {Delta}TM (N=404), exact match accuracy range was 0.619-0.780 and JI range was 0.668-0.827. For COM (N=47), exact match accuracy range was 0.766-0.872 and JI range was 0.765-0.870. For {Delta}OM (N=25), exact match accuracy range was 0.583-0.920 and JI range was 0.583-0.922. Conclusions: The GLLaucoMed pipeline demonstrated high performance in extracting and standardizing medication data from unstructured clinical notes, including both current medications and proposed changes. Claude and GPT exhibited the strongest performance.

21.
medRxiv (Medicine) 2026-06-22

Nutrient Composition of Foods Represented in the U.S. Food and Nutrient Database for Dietary Studies, 2013-2023

Background: The U.S. Food and Nutrient Database for Dietary Studies (FNDDS) is updated across NHANES dietary cycles and is central to U.S. nutrition surveillance. However, multi-cycle food-code-level changes in nutrient composition have not been comprehensively characterized across the full WWEIA nutrient panel. Objective: To characterize ten-year temporal patterns in nutrient composition across five FNDDS cycles, evaluate pandemic-period food-code compositional stability, and distinguish exploratory mean-level signals from distributional heterogeneity that may reflect reformulation, database coverage, or food-code definition changes. Methods: We analyzed five consecutive FNDDS biennial releases: 2013-14, 2015-16, 2017-18, 2019-20, and 2021-23. Nutrient values were extracted from the public FNDDS/FoodData Central release files and standardized to per-100-g food-code-level records. Cycle midpoints, 2013.5, 2015.5, 2017.5, 2019.5, and 2022.0, served as the independent variable in an exploratory ordinary least squares (OLS) regression. Mann-Kendall testing assessed monotonic rank trends, Welch's ANOVA assessed food-code-level distributional heterogeneity, and pairwise Welch comparisons with Cohen's d summarized pre-pandemic, pandemic-period, and post-pandemic differences. Equivalence testing using TOST with +/-10% bounds was restricted to the 2019-20 versus 2021-23 stability comparison. OLS sensitivity analyses were repeated after excluding the structurally atypical 2017-18 cycle. Results: Sixty-three nutrients were analyzed. Eight nutrients showed nominal OLS trends, p < 0.05, but none remained significant after Bonferroni correction. Mann-Kendall testing identified two nominal monotonic signals, and none after adjustment. Welch's ANOVA detected cycle-level distributional differences for 61 of 63 nutrients at nominal p < 0.05 and 57 of 63 after adjustment. Pairwise pandemic-period analyses showed many adjusted differences when the pre-pandemic baseline was compared with 2019-20 or 2021-23, but standardized effects were small, with all absolute Cohen's d values < 0.20. No nutrient differed after adjustment between 2019-20 and 2021-23, and 39 of 48 primary analytes met +/-10% TOST equivalence criteria for that comparison. Slope estimates were directionally stable after excluding 2017-18, but nominal significance status remained sensitive to the short time series. Conclusions: FNDDS food composition varied across cycles, but there was no clear decade-long linear trend for most nutrients. The main signal was a possible increase in total PUFA and linoleic acid, which may reflect changes in fat quality. The 2021-23 cycle was very similar to 2019-20, suggesting no major post-pandemic shift in the foods represented. These findings should be interpreted as food-database signals, not as direct estimates of what people consumed.

22.
arXiv (CS.AI) 2026-06-17

Beyond the Sampled Token: Preserving Candidate Support in RLVR

arXiv:2510.14807v3 Announce Type: replace Abstract: We revisit exploration collapse in reinforcement learning with verifiable rewards (RLVR), from the perspective of the candidate distribution for next-token prediction. We formally show that as probability concentrates on the top-$1$ candidate, the expected number of distinct responses collapses to one regardless of the sampling budget $K$. This theoretical implication is further verified by our empirical tracking of top-$N$ candidate probabilities during training, where the top-$1$ candidate progressively dominates while plausible alternatives are suppressed. These findings suggest a key desideratum for effective exploration: preserving non-negligible probability mass on the top-$N$ candidates. To this end, we propose Candidate-aware Support Preservation (CaSP), with two complementary designs. Specifically, CaSP redistributes positive gradients among top-$N$ candidates for correct responses, and applies a stronger penalty to the top-$1$ candidate for incorrect responses. Unlike many exploration-oriented methods that improve pass@$K$ at the cost of pass@1, CaSP improves pass@$K$ across the full $K$ spectrum. These gains generalize to 6 math, 2 logical-reasoning, and 2 coding benchmarks, and scales to 32B-parameter models and sampling budgets up to $K=1024$, positioning it as a principled, candidate-level approach for RLVR exploration.

23.
medRxiv (Medicine) 2026-06-15

Diabetes and the Life-Course: Evidence from Panel Data and Electronic Health Records

Incidence of type 2 diabetes is increasing at ages when education, work, family, and financial transitions are taking place, yet we lack robust evidence of whether earlier treatment changes life-course outcomes and over which time span this takes place. This paper uses the medical cutoff for diabetes diagnosis (HbA1c of 6.5 percent) as a natural experiment to study the effects of diabetes treatment using electronic health records (EHR) and panel data. This paper has three main findings. First, using EHR data, we find that there is a sharp increase in the probability of both diagnosis of diabetes and prescription when the HbA1c equals 6.5 percent. Second, we find that treating diabetes reduces HbA1c levels, weight, BMI, and blood pressure and increases the amount of care received, proxied by the number of HbA1c tests. Both the diagnosis and a prescription are independently able to produce positive changes in metabolic health, although a prescription is more effective in this regard. Third, we conclude that treating diabetes does not have a significant effect on life-course outcomes for a cohort of young Americans aged 24-32, although it does result in a reduction in HbA1c levels that are seen even eight years after the intervention. Taken together, these findings suggest that receiving a diagnosis and prescription are both effective treatments for diabetes, but they do not translate to significant alterations in the lives of young adults in the medium-term.

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medRxiv (Medicine) 2026-06-19

Specific epigenetic age acceleration measures are associated with oral health outcomes in U.S. adults

Objectives: Oral health conditions impact a significant proportion of the global population. Chronological age is a known risk factor; however, characterization of epigenetic age remains limited and is expected to provide additional insight into biological mechanisms. Materials and Methods: The National Health and Nutrition Examination Survey (NHANES) was used to analyze the effect of epigenetic age measures of DunedinPoAm, and epigenetic age acceleration (EAA) of Horvath, Hannum, Weidner, Lin, VidalBralo, PhenoAge, GrimAge, and GrimAge2, on various oral health outcomes from survey and examination results. Univariable and multivariable logistic regression were performed, adjusting for sex, race-ethnicity, education, poverty income ratio categories, and dental insurance coverage status. Results: DunedinPoAm was associated with the last dental appointment being for an existing issue (p=0.0093), poor general oral condition (p=0.0226), limiting food due to teeth problems (p=0.0031), and recommendation to see a dentist within the next two weeks (p=0.0171). EAAs for PhenoAge, GrimAge, and GrimAge2, were associated with a smaller number of oral health outcomes, whereas EAAs for Horvath, Hannum, Weidner, Lin, and Vidal-Bralo showed no associations. Conclusions: In a representative U.S. population, DunedinPoAm was most consistently positively associated with different adverse oral health outcomes compared with other epigenetic aging measures. Tracking specific epigenetic ages such as DunedinPoAm, EAA GrimAge, EAA GrimAge2, and PhenoAge, may aid in additional monitoring of oral health outcomes. Understanding specific aging-related CpGs associated with oral health may aid in elucidating underlying molecular mechanisms.

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medRxiv (Medicine) 2026-06-11

The impact of pre-stroke statin use on baseline corrected infarct volume and collateral perfusion

Stroke is a leading cause of disability and mortality worldwide, with ischaemic stroke the most prevalent type. Statins, used for cholesterol management, have demonstrated benefits in reducing stroke risk and improving outcomes in preclinical studies. However, the impact of pre-stroke statin use on stroke outcomes remain inconsistent. In this study, we aim to evaluate whether pre-stroke statin use is associated with greater volume of salvaged tissue and improved cerebral collateral perfusion. A retrospective analysis was conducted using data from 281 patients presenting with acute ischemic stroke to the John Hunter Hospital between May 2015 and May 2020. Patients were grouped based on pre-stroke statin use, and clinical variables, including infarct volume and collateral perfusion, were assessed. The primary outcome was salvage volume derived from baseline perfusion lesion volume minus infarct volume at follow-up. Collateral perfusion was measured by the hypoperfusion volume defined by delay time (DT)>6 seconds divided by the hypoperfusion volume defined by DT >2 seconds. Patients on statins at admission were significantly older and had more comorbidities. No significant association was found between pre-stroke statin use and salvage volume or collateral perfusion after adjusting for covariates. Larger initial infarct core was a significant predictor of salvage volume due to larger salvageable tissue volume at baseline. These findings indicate that pre-morbid statin use is not associated with larger salvage volume or improved cerebral collateral perfusion.