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01.
medRxiv (Medicine) 2026-06-22

Leishmaniasis on YouTube: a critical appraisal of the quality, reliability, and transparency of educational content

Background: Leishmaniasis is a neglected tropical disease of significant global public health importance, for which accurate information is essential to support prevention and early care-seeking, particularly in endemic, resource-limited settings. YouTube is a widely used source of health information, but the quality and reliability of leishmaniasis-related content have not been evaluated. We aimed to assess the quality, reliability, and transparency of English-language YouTube videos on leishmaniasis. Methods: We conducted a cross-sectional analysis of YouTube videos retrieved via the YouTube Data API on 15 June 2026 using the terms "leishmaniasis," "cutaneous leishmaniasis," and "visceral leishmaniasis." After applying eligibility criteria and screening the 150 most-viewed eligible videos, 48 videos were included. Two reviewers independently assessed each video using the modified DISCERN (mDISCERN) tool, the Global Quality Score (GQS), and the JAMA benchmark criteria, with disagreements resolved by consensus. Inter-rater agreement was assessed using the intraclass correlation coefficient (ICC), and associations were examined using Spearman's rank correlation. Results: Of 402 videos retrieved, 48 met the inclusion criteria. The median GQS was 3.00 (IQR 2.00-4.00) and median mDISCERN was 3.00 (IQR 2.38-4.50), indicating moderate quality and reliability, while the median JAMA score was 2.00 (IQR 1.00-2.00), reflecting limited transparency; no video met all four JAMA criteria. The overwhelming majority of videos (47/48, 97.9%) were of professional or institutional origin. Inter-rater agreement was good to excellent (ICC 0.883 for GQS, 0.896 for mDISCERN, 1.000 for JAMA). The instruments were strongly inter-correlated (mDISCERN-GQS rho = 0.841, p < 0.001). Quality scores did not correlate positively with views, likes, or video duration; comments correlated weakly and negatively with mDISCERN (rho = -0.337, p = 0.031) and JAMA (rho = -0.381, p = 0.014). Conclusions: YouTube videos on leishmaniasis are of moderate quality and reliability but limited transparency, and are produced almost exclusively by professional sources. Video popularity, length, and age were not indicators of quality. There is a need for experts and institutions to produce clearly authored, well-sourced, and transparent educational content on this neglected tropical disease.

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

Metric Match: A Subset Selection Approach to Evaluating LLM Judge Reliability

arXiv:2606.15029v1 Announce Type: new Abstract: LLM judges are used to reduce the need for costly human labor in evaluating open-ended text generation. However, the reliability of these judges depends critically on their alignment with human raters – a property that itself depends on costly human annotations. In this work, we develop a method (Metric Match) for estimating correlation-based reliability metrics of LLM judges from limited annotations. Metric Match selects a subset of samples for human annotation such that the subset matches the population reliability metric with respect to acquired synthetic labels. We empirically show that Metric Match achieves a win-rate of 0.838 against random subset selection across four different correlation metrics and 15 datasets, with an 18.7% decrease in average estimation error and reduces annotation needs by 32.5%. We provide a cost model and highlight a medical case study where our method saves $1,041.67 compared to random selection for expert annotation. Further, we shift our task from reliability estimation to reliability classification of whether a given judge is above a deployment threshold, outperforming random selection with Metric Match. All project code is publicly available, and we additionally provide an installable package for ease of use.

03.
arXiv (math.PR) 2026-06-18

Law of the Iterated Logarithm for $p$-Walks on $\mathbb{Z}$

Authors:

arXiv:2606.19131v1 Announce Type: new Abstract: The $p$-rotor walk on $\mathbb{Z}$ is a self-interacting walk that interpolates between the simple random walk and the deterministic rotor walk. While the weak convergence of this model to a perturbed Brownian motion is known, its almost sure asymptotic boundaries have not been characterized. In this paper, we establish the exact Law of the Iterated Logarithm (LIL) for the $p$-rotor walk. Utilizing the decomposition of the walk into a martingale perturbed by its running extrema, we obtain first a functional Law of the Iterated Logarithm for the linearly interpolated paths of the $p$-walk. We then obtain the classical LIL constants by solving a calculus of variations problem over the perturbed Strassen set.

04.
arXiv (CS.CL) 2026-06-18

Dual Dimensionality for Local and Global Attention

Decoder-only Transformers compute attention over the KV cache of preceding tokens. Keys (and Values) are typically represented with the same dimensionality, regardless of its distance from the prediction target. In natural language, however, the next word is most strongly influenced by the immediately preceding tokens. We hypothesize that local and distant tokens impose asymmetric demands on representational capacity: local tokens are more critical for predicting immediate outputs and thus require richer representations, whereas distant tokens primarily serve as long-range memory, for which lower-dimensional representations may suffice. We formalize this idea as Distance-Adaptive Representation (DAR), implemented in a controlled setting that preserves full-dimensional representations within a local context window while assigning reduced-dimensional representations (e.g. 1/4 of the original dimensionality) to tokens beyond that window. Across multiple pretraining scales (70M to 410M parameters), as well as continued supervised fine-tuning on a 1B-scale model, this approach closely matches the performance of full-dimensional baselines. In contrast, uniformly reducing dimensionality across all token positions leads to worse performance. These results challenge the common assumption that key and value dimensionality should be uniform across token positions. Our findings suggest a new direction for designing attention architectures that adaptively allocate representational capacity across sequences, enabling further reductions in KV cache during inference.

05.
arXiv (CS.CV) 2026-06-24

VistaRef: Boosting Visual Spatial Orientation Awareness for Pointing-to-Object Detection

Grounding deictic gestures in natural images is fundamental to AR and human-robot collaboration, providing a basis for seamless spatial interaction. While Transformer-based visual models have achieved significant progress in general object detection, their global attention mechanisms often neglect micro-geometric relationships, degrading orientation accuracy. In pointing tasks, this deficiency manifests as an inability to accurately capture the pointing ray implied by finger poses, which results in pointing drift and localization ambiguity when dealing with distant or densely packed objects. To address this, we propose VistaRef, a framework designed to explicitly enhance spatial orientation awareness. First, we develop the Local Hand Entity Modeling (LHEM) module, which incorporates hand-pose embeddings to strengthen the model's capability to capture subtle finger deviations. Second, drawing inspiration from multi-view geometry, we construct the Geometric Ray Modeling (GRM) module to transform implicit orientation information into explicit spatial geometric features, guiding feature aggregation and deep fusion via attention mechanisms. Furthermore, we introduce a novel Orientation-Consistent Alignment Loss (OCAL) to synergistically supervise hand presence and pointing consistency, ensuring that all architectural improvements collectively serve the core objective of spatial localization. Experimental results demonstrate that VistaRef significantly outperforms the baseline, achieving a 14-point absolute gain in grounding accuracy. Qualitative analysis further confirms that VistaRef effectively models the geometric correlation from hand to target, bridging the spatial perception gap inherent in traditional Transformers for complex scenarios. Code: https://github.com/lingli1724/VistaRef.

06.
Nature Biotechnology 2026-06-05

Multiplexed, precise genome engineering in monocots with twin prime editing systems

Authors:

Simultaneously introducing diverse genomic edits remains a challenge in crop genome engineering. Here we describe a twin prime editing-based knockout (TKO) system that installs stop codon clusters (SCCs) for precise translational termination with minimal in-frame mutations. TKO achieves knockout efficiencies of up to 70.5%, 58.6% and 75.1% in rice, maize and wheat protoplasts, respectively, and produces heritable knockout alleles in 96.8% of regenerated rice plants. In hexaploid wheat, TKO outperforms Cas9 4.2-fold in generating triple-homolog knockouts, largely by reducing in-frame mutations. Orthogonal TKO editors with sequence-divergent SCCs enable simultaneous knockout of up to ten genes without cross-interference. Integration of TKO with conventional prime editing establishes TRIM1 (TKO editor-enabled gene rupture and development of integrated multitype genome modification system) for simultaneous knockout and precise editing, achieving a 22.8% coediting of four genes in rice. TRIM2 extends this capacity to kilobase-scale modifications through a prime editor–recombinase system, enabling a 4.9-kb insertion (1.2% efficiency) and gene knockout (up to 79.8%) in protoplasts. Plant genome editing is multiplexed with twin prime editing.

07.
medRxiv (Medicine) 2026-06-22

AFFORDABILITY OF INTOXICATION FROM CHEAP ETHANOL: EVIDENCE FROM RETAIL ALCOHOL MARKETS IN UGANDA

Background: Alcohol affordability is a determinant of consumption and alcohol-related harm. In many low- and middle-income countries (LMICs), informal production, variable alcohol strength, and non-standard packaging complicate conventional affordability measures, limiting evidence on the economic accessibility of alcohol and the cost of intoxication. Objective: To assess the affordability of intoxication in Uganda by estimating the cost of obtaining ethanol to reach intoxication across alcohol products, packaging types, and retail contexts. Methods: Data were collected on 824 alcoholic beverages from urban, rural, and urban-slum retail markets. Ethanol-standardized pricing (price per gram of alcohol) was calculated, and the cost of consuming 60 g of ethanol was estimated. Multivariate regression identified determinants of ethanol affordability. Results: Affordability varied by product type and packaging. Opaque beers and illicit spirits provided the cheapest pathways to intoxication, with median costs of UGX 1,200-1,500 per 60 g of ethanol. Plastic packaging was associated with lower ethanol costs than glass packaging. Ethanol prices differed across formal and informal markets (p < 0.01), while rural areas and urban informal settlements had 20-25% lower costs than urban areas. Regulatory status alone did not predict affordability. Conclusions: In Ugandas diverse alcohol market, affordability is driven by access to ethanol rather than beverage price alone. Low-cost, high-strength alcohol sold through informal channels enables intoxication at minimal expense, among disadvantaged populations. Implications: Alcohol policies should target ethanol content through minimum unit pricing, alcohol-content-based taxation, and regulation of informal markets and packaging practices to reduce harmful consumption and inequities.

08.
medRxiv (Medicine) 2026-06-22

Substantia Nigra and Subthalamic Nucleus Deep Brain Stimulation Exert Opposing Effects on Novelty Recognition in Parkinson's Disease

Episodic memory plays a critical role in supporting adaptive behavior; however, whether it can be causally regulated in humans via deep subcortical stimulation remains unclear. In the present study, we investigated the differential effects of substantia nigra (SN) and subthalamic nucleus (STN) stimulation on episodic memory, as well as the underlying mechanisms of its associated brain networks, using a recognition memory task combined with concurrent functional magnetic resonance imaging in patients with Parkinson's disease. SN-DBS increased recognition sensitivity and reduced false alarms at both frequencies, whereas 10 Hz STN-DBS reduced sensitivity and increased false alarms. Functional connectivity analyses in the absence of DBS stimulation identified a false recognition-related network linking nigral, pallidal, subthalamic, medial temporal, frontal, and occipital regions. SN-DBS-related false alarm reduction tracked modulation of this circuit and was marked by its baseline vulnerability state. These behavioral effects mapped onto target-dependent parieto-occipital and SN-visual retrieval pathways, supporting a model in which DBS bidirectionally regulates recognition memory through target- and frequency-dependent subcortical-cortical circuits.

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

From Affect Prediction to Affect Forecasting: Evidence for Distinct Information Sources in Longitudinal Text

Modeling dimensional affect in longitudinal text requires distinguishing current affect estimation from future affective change forecasting. Existing approaches often treat each text as an independent observation and apply similar assumptions to both tasks, without testing whether they rely on different information sources. This paper investigates that distinction using longitudinal self-reported ecological essays and feeling-word entries. We propose the Trait–State Affective Prediction (TSAP) framework and its temporal extension E-TSAP for per-text valence and arousal prediction, evaluated on a held-out prediction test set of 1,737 entries from 91 users. We further propose the Affective Change Forecaster Hybrid (ACF-Hybrid) for next-step affective change forecasting, evaluated on a held-out forecasting test set of 46 users. For prediction, E-TSAP achieves composite Pearson correlations of 0.670 for valence and 0.449 for arousal. For forecasting, textual representations perform worse than compact numeric trajectory baselines: the text-inclusive model achieves only r=0.316 for valence and r=0.284 for arousal, whereas a simple prior-state baseline reaches r=0.615 and r=0.670, respectively. ACF-Hybrid, using dimension-specific numeric trajectory features, achieves r=0.659 for valence and $r=0.658$ for arousal. These results show that textual semantics support current affect prediction, whereas future affective change is better captured through prior numeric trajectory dynamics.

10.
arXiv (CS.CV) 2026-06-19

Abstraction in Style: Beyond Texture and Color

Artistic styles often embed abstraction beyond surface appearance, involving deliberate reinterpretation of structure rather than mere changes in texture or color. Conventional style transfer methods typically preserve the input geometry and therefore struggle to capture this deeper abstraction behavior, especially for illustrative and nonphotorealistic styles. In this work, we introduce Abstraction in Style (AiS), a generative framework that separates structural abstraction from visual stylization. Given a target image and a small set of style exemplars, AiS first derives an intermediate abstraction proxy that reinterprets the target's structure in accordance with the abstraction logic exhibited by the style. The proxy captures semantic structure while relaxing geometric fidelity, enabling subsequent stylization to operate on an abstracted representation rather than the original image. In a second stage, the abstraction proxy is rendered to produce the final stylized output, preserving visual coherence with the reference style. Both stages are implemented using a shared image space analogy, enabling transformations to be learned from visual exemplars without explicit geometric supervision. By decoupling abstraction from appearance and treating abstraction as an explicit, transferable process, AiS supports a wider range of stylistic transformations, improves controllability, and enables more expressive stylization.

11.
medRxiv (Medicine) 2026-06-11

Conversational Speech for Respiratory Triage in Primary Care: A Pilot Study

Authors:

Background. Respiratory complaints account for a substantial share of adult ambulatory care visits, and triaging them accurately has direct consequences for antibiotic stewardship and pathogen-specific therapy. Prior work has investigated voice as a triage signal, but that literature is dominated by single-condition detection from scripted speech in crowdsourced or controlled clinical settings and has not been evaluated at primary care scale on conversational ambient audio. Methods. A dataset of 514,377 ambient-recorded primary care visits from 379,225 adult patients at a US clinic network was used, with per-visit clinically assigned ICD-10 diagnosis codes and de-identified demographic and geographic metadata. Patient audio was extracted from each doctor-patient conversation, and spectral, voice quality, and prosodic features were computed. Eleven binary classification tasks were defined, aligned with a respiratory triage cascade (e.g., acute respiratory versus acute non-respiratory illness, and lower versus upper respiratory tract infection). An acoustic model (feed-forward network) was trained independently for each task using patient-stratified five-fold cross-validation and evaluated on a held-out test set. Each task's model was also compared against six non-acoustic baselines using a single demographic, geographic, or temporal variable. The 11 trained classifiers were composed into a hierarchical cascade and illustrated as case studies on selected patients. Results. Test-set AUC across the 11 tasks ranged from 0.602 (95% CI: 0.588-0.614) to 0.745 (95% CI: 0.742-0.748), with a mean expected calibration error of 0.018. Six of eleven binaries outperformed all confounder baselines. Four binaries showed median within-stratum AUC of 0.62-0.70 when the confounder was held fixed, indicating acoustic discrimination beyond what the confounder alone explains. The exception was the pneumonia versus non-pneumonia lower respiratory tract infection binary, which failed against the patient-city confounder baseline, plausibly reflecting a clinic-level difference in ICD-10 coding. Conclusion. Conversational primary care audio carries acoustic signal that discriminates clinically meaningful respiratory contrasts. Absolute performance is moderate, but the conditions are stricter than prior work: conversational speech and differential-diagnosis contrasts among sick patients. This pilot study is a baseline for voice-based clinical AI moving beyond sick-versus-healthy detection toward differential-diagnosis panels and a proof-of-concept for hierarchical reasoning.

12.
medRxiv (Medicine) 2026-06-19

Rumination as a cognitive vulnerability factor in perinatal bereavement: evidence from the CARING study

Purpose. Perinatal loss is associated with a high risk of persistent psychological distress, including prolonged grief, depression, anxiety, and post-traumatic stress symptoms. Cognitive processes such as rumination may play a crucial role in maintaining and amplifying distress following loss, yet their specific contribution in perinatal bereavement remains underexplored. Methods. The CARING (Cognitive Analysis and Rumination INvestigation in perinatal Grief) study employed a cross-sectional design involving 298 parents who experienced perinatal loss within the previous five years. Participants completed an anonymous online survey including measures of depressive rumination (Ruminative Response Scale, RRS), angry rumination (Anger Rumination Scale, ARS), perinatal grief (Perinatal Grief Scale, PGS), general psychopathology (SCL-90), and post-traumatic stress symptoms (NSESSS). Non-parametric analyses were conducted to examine associations between rumination patterns and psychological outcomes. Results. Higher levels of rumination were significantly associated with greater perinatal grief, depressive and anxiety symptoms, and post-traumatic stress. Depressive rumination showed consistently stronger associations with all outcomes compared to angry rumination. Participants presenting both depressive and angry rumination exhibited the highest levels of grief intensity, psychological distress, and PTSD symptoms, suggesting a graded relationship between rumination patterns and severity of distress. Rumination levels were not significantly associated with gestational age at loss or with having received psychological support. Conclusions. Rumination, particularly in its depressive form, appears to function as a transdiagnostic cognitive vulnerability factor in perinatal bereavement. These findings highlight rumination as a potential target for early screening and tailored psychological interventions aimed at reducing long-term distress following perinatal loss.

13.
medRxiv (Medicine) 2026-06-22

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

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

14.
arXiv (CS.LG) 2026-06-16

GPT-Based Fast Simulation of CLAS12 Detector Hits via Conditional Autoregressive Generation

arXiv:2606.16035v1 Announce Type: cross Abstract: Modern particles physics experiments have demonstrated an increasing need for fast, high-fidelity detector simulation as detector components have improved and subsequent computational requirements approach the limits of available resources. Recently, deep generative models have emerged as a promising alternative to traditional Monte-Carlo methods, with recent works drawing inspiration from large language models (LLMs) and self-supervised next-token prediction methods. In this work, we present an application of a GPT-style autoregressive transformer as a fast surrogate model for the calorimeter inside the CLAS12 experiment at the Thomas Jefferson National Accelerator Facility. The model is conditioned on incident momentum and generates realistic detector hits autoregressively across all nine calorimeter layers as sequences of strip, ADC, and TDC tokens. We demonstrate that the model faithfully reproduces hit multiplicity, spatial distributions, energy deposits, and the energy-momentum response of the electromagnetic calorimeter. The generator achieves inference rates exceeding 700 events per second on a single GPU, providing a substantial speedup over traditional Geant4-based simulations while maintaining physics fidelity essential for high-luminosity experimental programs.

15.
arXiv (CS.CL) 2026-06-11

ISE: An Execution-Grounded Recipe for Multi-Turn OS-Agent Trajectories

Training capable OS agents requires data that simultaneously captures structured user intents, multi-turn task delegation, and grounded tool execution–properties absent from existing datasets. We propose ISE (Intent -> Simulate -> Execute), a three-stage synthesis paradigm that addresses these gaps jointly. Stage 1 constructs roughly 50000 structured intents via a 4D framework (Persona x Domain x Task x Complexity); after deduplication the pool contains 43956 unique intents and attains a Vendi Score of 61.57 over the entire pool on mpnet-base-v2 embeddings (cosine kernel, q=1). Stage 2 drives multi-turn user-agent interaction through a role-locked user simulator that grounds each user turn in actual execution outcomes, producing 23132 complete trajectories averaging 8.12 user turns and 68.24 total dialogue turns. Stage 3 runs every tool call inside a live, isolated OS workspace, generating authentic failure-recovery dynamics instead of simulated responses. Fine-tuning on ISETrace improves ClawEval pass@1 from 19.3 to 37.7 using Qwen3-8B on agent tool-use tasks with a standard protocol. This result outperforms zero-shot GPT-4o and the larger Qwen3-32B base model which is four times bigger. An ablation on Stage 2 proves multi-turn simulation brings a large portion of the performance gain. We release all source code and dataset at https://github.com/Valiere01/ISE-Trace.

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

Massive Open-Vocabulary Keyword Spotting

Automatic speech recognition systems have been shown to under-perform when it comes to transcribing words rarely seen in the training data, namely specialized terminology. Open-vocabulary keyword spotting, combined with contextual biasing, has been shown to mitigate this issue. However, existing systems can only handle glossaries of a few hundred terms without becoming an infeasible bottleneck. We propose a system that stores features with a memory footprint up to 128 times smaller than a comparable baseline and allows users to process massive databases while remaining open-vocabulary. Without fine-tuning the speech recognition model, our system achieves a comparable entity recall as uncompressed solutions, even in languages not seen during training.

17.
arXiv (CS.CL) 2026-06-18

RedactionBench

Large Language Models are increasingly applied to sensitive domains that require redaction of personally identifiable information (PII). While redacting PII is a data cleaning prerequisite, existing benchmarks conflate extraction mechanics with privacy semantics. A public phone number is not equivalent to a phone number in a medical record. Whether information constitutes a violation depends heavily on who holds it, why, and in what context, fundamentally differentiating redaction from simple entity recognition. Grounded in contextual integrity, we introduce RedactionBench, a manually annotated benchmark comprising 200 diverse documents across 11 domains, mostly seeded from real-world sources. We also introduce R-Score, a novel character-level metric that treats semantically similar redactions equally and nullifies shallow formatting choices, such as varying masking styles for phone numbers. Evaluations across Named Entity Recognition models, entity extraction Small Language Models, and frontier models equipped with agentic tools demonstrate that contextual redaction remains an unsolved problem. A human evaluation with over 80 users on RedactionBench reveals a stark dichotomy in privacy perceptions. Annotators show consensus with target labels for mandatory redactions (89.4 percent) and safe text preservations (94.1 percent), but fail to agree on contextual redactions (47.7 percent). This variance demonstrates the subjective nature of contextual privacy and motivates R-Score, which decouples contextual ambiguity from strict precision. We compare 35 models across families and report their performance in redacting PII. Finally, we release RedactionBench to establish a baseline for future privacy-preserving systems, hoping to inspire efficient model design and standardized evaluations.

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

Posterior Twins: Distributional Behavioral Simulation for Enterprise Decisions

Authors:

arXiv:2606.16415v1 Announce Type: new Abstract: Enterprise behavioral simulation requires more than producing a plausible response. Many decisions depend on the shape of a population under a proposed action: which segments accept, defect, hesitate, or move into risk-sensitive states. This paper introduces Posterior Twins, a memory-grounded digital-twin approach that represents likely behavior as an updated distribution under a specific decision context. We evaluate a family of Twinning Labs behavioral-model operating points on a 226-example held-out behavioral-response benchmark and report both modal accuracy and Wasserstein-1 distance. The results show that modal accuracy and distributional fidelity identify different operating regimes. TL-Twin Alpha achieves the lowest observed Wasserstein-1 distance in the reported result set ($W_1 = 1.16$), while TL-Twin Delta and TL-Twin Gamma provide balanced operating points near the modal-accuracy frontier. The paper frames these results as a systems result: governed memory, behavioral model routing, scenario orchestration, distributional aggregation, and auditability are necessary for turning simulated behavior into reusable enterprise decision evidence.

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

Understanding helpfulness and harmless tension in reward models

Reward models are a key component of reinforcement learning from human feedback (RLHF), aligning language models toward both helpful and harmless behaviour. However, the internal mechanisms underlying these objectives and their conflicts remain poorly understood. We study alignment tension in reward models trained under helpfulness-only, harmlessness-only, and mixed-objective settings. We find that mixed-objective models often underperform single-objective models, indicating interference between objectives. Using activation-based methods, we identify neurons associated with each objective and study their functional roles via targeted ablations. We find that these neurons causally support their corresponding objectives while often negatively affecting the opposing one. We find that a substantial proportion of neurons are shared between helpfulness and harmlessness, and that these shared neurons exert a disproportionate influence on model behaviour, contributing to alignment tension. Additionally, our results provide insights and mechanistic interpretation into how alignment objectives are represented in reward models and why multi-objective alignment remains challenging, motivating future work on disentangled and controllable alignment methods.

20.
medRxiv (Medicine) 2026-06-19

Performance of family history-based colorectal cancer screening criteria by race and age at diagnosis in the Disparities and Cancer Epidemiology (DANCE) study

Importance: Family history (FH) and age are the primary criteria employed for early colorectal cancer (CRC) risk stratification. We evaluated how well these criteria identify individuals diagnosed with CRC across age and racial groups. Objective: To evaluate the performance of FH and age based screening criteria for identifying individuals with CRC, with attention to differences by race and age at diagnosis. Design, Setting, and Participants: This case control and case only analysis used data from the Disparities and Cancer Epidemiology (DANCE) cohort, a population based study of invasive CRC cases diagnosed from 2013 to 2022, recruited through the Metropolitan Detroit Cancer Surveillance System and the Louisiana Tumor Registry. Analyses included 1,158 non-Hispanic Black (NHB) and non-Hispanic White (NHW) CRC cases and 1,434 cancer-free controls from the Inflammation Health and Lung Epidemiology (INHALE) study, enrolled from the same Detroit catchment area. Data were analyzed in 2025. Exposures: Self reported cancer FH among first-degree (FD) relatives and grandparents, summarized into three FH-based screening criteria: at least one FD relative with CRC (colon early-screening criterion), any FH of Lynch syndrome related cancers, and meeting NCCN criteria for Lynch syndrome genetic testing. Main Outcomes and Measures: Proportion of cases meeting each FH based screening criterion stratified by race and age at diagnosis (

21.
arXiv (CS.AI) 2026-06-11

Architecture-Aware Reinforcement Learning Makes Sliding-Window Attention Competitive in Math Reasoning

arXiv:2606.11634v1 Announce Type: new Abstract: The rapid progress of reasoning and agentic large language models (LLMs) has increased the demand for long-context inference, but self-attention (SA) scales quadratically with context length. To address this, we study SWARR (Sliding-Window Attention with Reinforced Adaptation for Math Reasoning), a practical recipe for adapting SWA models to mathematical reasoning. SWARR has two stages: (1) efficient conversion from a pretrained SA model to SWA with supervised fine-tuning (SFT), which avoids pretraining a new base model, and (2) policy adaptation with reinforcement learning (RL). We find that SWA still underperforms SA after SFT, and we hypothesize that this gap is caused in part by a data-architecture mismatch: most SFT data are prepared for SA models and may contain long-range dependencies that are difficult for SWA to model. Because on-policy RL optimizes self-generated trajectories under the SWA constraint, it can adapt trajectories to better match SWA. Experiments on mathematical reasoning benchmarks show that this recipe substantially narrows the gap between SWA and SA, recovering much of the accuracy lost during SWA conversion while preserving the efficiency benefits of linear-complexity attention. Our central contribution is the empirical finding that RL changes the conclusion one would draw from conversion and SFT alone about SWA's viability for math reasoning.

22.
medRxiv (Medicine) 2026-06-15

Primary care practitioners preconception health literacy and information-seeking: A cross-sectional survey.

Background Parental health before pregnancy influences maternal and child outcomes. Primary care professionals, including general practitioners [GPs], midwives, and naturopaths, can provide preconception care, yet many report limited knowledge and difficulty accessing relevant information. This study described Australian GPs, midwives, and naturopaths preconception health literacy, including knowledge and ability to access information. Methods Between July and September 2022, Australian GPs, midwives, and naturopaths completed a 32-item online cross-sectional survey. Participants were recruited through professional associations, and data were analysed using descriptive and inferential statistics Results Participants (N=373) included naturopaths (40.7%), GPs (32.4%), and midwives (26.8%). Reported barriers to clinician health literacy including lack of preconception care resources (25.5%), and limited clinician knowledge (23.6%). The proportion identifying limited clinician knowledge differed significantly between professions (GP: 31.4%; midwives: 23.0%; naturopaths: 17.8%; p=0.030). The highest level of accurate knowledge regarding preconception exposures was for pre-pregnancy obesity (82.7%), while low birth weight was the most accurately identified preconception outcomes (83.7%). Incorrect responses were most common for maternal multivitamin use as an exposure (28.3%) and childhood leukaemia as an outcome (26.3%). Differences between professions were strongest for infant outcomes, with moderate associations observed for shoulder dystocia (V=.2355), precipitous labour (V=.2173), macrosomia (V=.2060), labour dystocia (V=.2018) and cryptorchidism (V=.2018). Discussion Preconception health literacy varies across primary care professions. Clinicians require greater access to targeted resources and education tailored to their differing scopes of practice and experience. Improving clinician preconception health literacy may strengthen consistent evidence-based care and support better maternal, child, and long-term family health outcomes.

23.
bioRxiv (Bioinfo) 2026-06-12

PeptiDIA: A Machine Learning Framework for Enhanced Peptide Identification in Fast-Gradient Data-Independent Acquisition Proteomics

Data-independent acquisition (DIA) mass spectrometry has become increasingly prevalent in proteomics as advances in instrumentation, chromatography, and computational analysis have enabled robust proteome identification across complex biological samples. However, analytical depth achieved with fast chromatographic gradients remains lower than that obtained using long-gradients, reflecting a throughput-depth trade-off. Here, we present PeptiDIA, a machine learning framework that enhances peptide identification in fast-gradient DIA data by leveraging paired fast and long-gradient acquisitions from identical samples. PeptiDIA processes DIA-NN outputs generated at relaxed false discovery rate thresholds to obtain expanded candidate peptide pools and trains gradient-boosted decision tree models using long-gradient identifications as reference labels. The model integrates DIA-NN features with engineered peptide descriptors and applies isotonic regression to calibrate probabilities, enabling controlled peptide recovery relative to the long-gradient reference. Applied to human and murine datasets spanning six tissues acquired on an Orbitrap Exploris 480, PeptiDIA increased peptide identifications by 25-34% at 1% target reference-discordance rate (RDR) and increased the number of protein groups containing at least one rescued peptide by 15-17%. Overall, PeptiDIA improves the identification depth of fast-gradient DIA-NN workflows without altering acquisition strategies. The framework is available as a web application and command-line tool at https://github.com/Jordano700/PeptiDIA.

24.
arXiv (CS.CL) 2026-06-12

Reasoning Models Know What's Important, and Encode It in Their Activations

Language models often solve complex tasks by generating long reasoning chains, consisting of many steps with varying importance. While some steps are crucial for generating the final answer, others are removable. Determining which steps matter most, and why, remains an open question central to understanding how models process reasoning. We investigate if this question is best approached through model internals or through tokens of the reasoning chain itself. We find that model activations contain more information than tokens for identifying important reasoning steps. Crucially, by training probes on model activations to predict importance, we show that models encode an internal representation of step importance, even prior to the generation of subsequent steps. The internal representations of importance in different models yield high agreement on which steps are important. The representation is distributed across layers, and does not correlate with surface-level features, such as a step's relative position or its length. Our findings suggest that analyzing activations can reveal aspects of reasoning that surface-level approaches fundamentally miss, indicating that reasoning analyses should look into model internals.

25.
arXiv (CS.LG) 2026-06-12

Clustering Node Attributed Networks with Graph Neural Networks and Self Learning

arXiv:2606.13444v1 Announce Type: new Abstract: Graph clustering - partitioning the node set of a graph into disjoint subsets that reflect some latent information - is a fundamental problem as it finds applications in a myriad of different scenarios. While this classic problem has been tackled for decades by different communities, a recent variation of the problem driven by real data considers the scenario where nodes have attributes that are also informative. This has triggered novel methods that simultaneously leverage network information (edges) and node information (attributed) in the design of novel clustering algorithms. This work proposes a novel framework that builds on prior works that have applied graph neural networks (GNN) to graph clustering. The proposed framework operates in rounds of self learning in a fully unsupervised setting. In each round, a GNN generates representations for nodes that are used to cluster the nodes. This clustering influences the graph used to generate the node representation in the next round. Moreover, a context graph built in each round using the original graph is used to generate the node representations. Empirical results show that the proposed methodology extracts information from both network edges and node attributes in synthetic data, outperforming algorithms focused solely on the network or attributes when neither are very informative. Multiple rounds of learning also improve the performance and always outperforms a long single round of training (i.e., classic GNN graph clustering). When considering real datasets, empirical results indicate that the proposed methodology is competitive to state-of-the-art methods when cluster sizes are balanced.