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01.
arXiv (CS.CV) 2026-06-11

BiWM: Advancing Open-Source Interactive Video World Models with Bidirectional Autoregression

Transitioning bidirectional video diffusion models into an autoregressive paradigm improves the interactivity of video world models, but existing causal pipelines need many stages (control fine-tuning, autoregressive training, causal initialization, few-step distillation) and still trail bidirectional models in quality due to error accumulation. Recent world models such as Yume-1.5 and Matrix-Game-3.0 instead adopt a bidirectional autoregressive approach, gaining fidelity and stable long-horizon rollout from self-correcting error propagation, yet open-source frameworks (e.g., minWM) support only causal models. We present BiWM, the first full-stack framework for interactive video world models under the bidirectional autoregressive paradigm, jointly optimizing generation quality and inference speed. From a pretrained video backbone, BiWM injects camera control by fine-tuning, then runs a few-step Distribution Matching Distillation (DMD) stage that turns the backbone into an action/camera-controllable world model: just two training stages instead of four in minWM, converging in a few hundred steps on 8xH200 GPUs. A single recipe spans Wan2.1-1.3B, Wan2.2-5B, HunyuanVideo-1.5-8B, and LTX-2.3-22B, and also supports secondary fine-tuning of existing bidirectional models. BiWM enables real-world camera control where minWM loses controllability, integrates pluggable history compression (FramePack-style and PackForcing-style) for long rollouts, and offers an optional NVFP4 4-bit training/inference pipeline. To counter DMD's mode-seeking degradation, we add GAN and mass-covering forward-KL objectives that preserve scene dynamics. We open-source BiWM for resource-constrained research and high-fidelity environment simulation.

02.
PLOS Medicine 2026-05-08

Climate change and non-communicable diseases: An invisible syndemic

by Gokul Parameswaran, Sadeer Al-Kindi, Sanjay Rajagopalan Climate change accelerates non-communicable diseases (NCDs) through cascading environmental disruptions and is attributed to driving increased NCD-related mortality. Yet this syndemic remains invisible and underfunded. We detail why addressing the climate-NCD intersection is critical for improving health. In this Perspective, Sanjay Rajagopalan and colleagues discusses how climate change accelerates non-communicable diseases (NCDs) and exacerbates NCD-related mortality, and calls for greater visibility and funding to address this syndemic and improve human health.

03.
arXiv (CS.CV) 2026-06-11

i1: A Simple and Fully Open Recipe for Strong Text-to-Image Models

Diffusion models have consistently driven progress in text-to-image generation. However, it is challenging to attribute recent progress to specific modeling and data choices: state-of-the-art open-weight models provide limited ablations, and do not disclose their training data and full training details. The research community needs fully open (weights, data, and code) models as a foundation for further research; yet existing fully open models still fall significantly short of leading models in performance. In this project, we conduct a systematic investigation of the modeling and data design choices in text-to-image diffusion training and inference with 300+ controlled experiments totaling 700K+ TPU v6e hours. Our experiments highlight several empirical findings (e.g., equal weighting is a strong default for mixing curated datasets) and simple design decisions (e.g., larger text encoder adapters improve performance with minimal added parameters) for training strong models. Guided by these insights, we train i1, a 3B-parameter text-to-image diffusion model using only publicly available datasets. i1 is competitive with leading models on five representative benchmarks (GenEval, DPG, PRISM, CVTG-2K, and LongText), and outperforms the best existing fully open model by 29.5 absolute percentage points on average. We provide the i1 checkpoints, training and inference code, and the data processing pipeline. Together, our findings and the i1 recipe establish a practical foundation for future open research in text-to-image diffusion models. Our code is available at https://github.com/zlab-princeton/i1.

04.
arXiv (quant-ph) 2026-06-16

Exactly Solvable Quantum Model with Spin-Dependent Coulomb Interaction

arXiv:2501.05103v5 Announce Type: replace Abstract: In this work, we report an exactly solvable quantum model featuring a spin-dependent Coulomb interaction, described by the spin vector potential \(\vec{\mathcal{A}} = k (\vec{r} \times \vec{S}) / r^2\) together with a Coulomb-type scalar potential \(\varphi = \kappa / r\) . The model is governed by the Schrödinger-type Hamiltonian \(\mathcal{H}_S = \vec{\Pi}^2 / (2M) + q \varphi\) in nonrelativistic quantum mechanics and by the Dirac-type Hamiltonian \(\mathcal{H}_D = c \vec{\alpha} \cdot \vec{\Pi} + \beta M c^2 + q \varphi\) in relativistic quantum mechanics, where \(\vec{\Pi} = \vec{p} - (q/c)\vec{\mathcal{A}}\) is the canonical momentum. We demonstrate two main results: (i) Just as the Coulomb-type scalar potential \(\mathcal{S}_Maxwell = \{\vec{\mathcal{A}} = 0,\ \varphi = \kappa / r\}\) is a local exact solution of Maxwell's equations on $r\neq0$, the gauge potential \(\mathcal{S}_YM = \{\vec{\mathcal{A}} = k (\vec{r} \times \vec{S}) / r^2,\ \varphi = \kappa / r\}\) constitutes a local exact solution of the Yang–Mills equations on the punctured region $r\neq0$. (ii) Both Hamiltonians \(\mathcal{H}_S\) and \(\mathcal{H}_D\) can be solved exactly in the presence of this spin-dependent Coulomb interaction. The resulting energy spectra are derived, and they naturally reduce to those of the ordinary hydrogen atom when the spin-dependent terms are neglected. Finally, we clarify the quantization conditions and the fixed-background interpretation of the model.

05.
bioRxiv (Bioinfo) 2026-06-22

HTS-Oracle X: AI-Guided Prospective Discovery of Small Molecule Immune Checkpoint Binders

Targeting immune checkpoint protein-protein interactions (PPIs) using small molecules remains limited by the shallow, featureless binding surfaces of co-stimulatory and co-inhibitory receptors and the characteristically low hit rates of conventional high-throughput screening against these interfaces. Here we report HTS-Oracle X, a multimodal deep learning platform that integrates bidirectional cross-attention fusion of ChemBERTa SMILES embeddings with extended RDKit descriptors, trains on continuous biophysical binding signals rather than binary labels, and employs Monte Carlo Dropout uncertainty quantification for uncertainty-adjusted compound selection. Trained on 45,760 Dianthus TRIC-screened compounds per target under scaffold-aware cross-validation, HTS-Oracle X was applied prospectively to a 100,160-compound Enamine library against CD28, TIM-3, and VISTA. From 150 model-selected compounds, 45 dose-response confirmed binders were identified (30.0% overall hit rate), yielding enrichment factors of 234-408x over experimentally established random prospective baselines and 16 sub-micromolar hits. The top hits, HX-CD28-1 (KD = 233 nM), HX-TIM3-1 (KD = 249 nM), and HX-VISTA-1 (KD = 345 nM), demonstrated on-target functional activity in immune cell and tumor co-culture assays. HTS-Oracle X represents a scalable AI-guided framework for small molecule discovery against non-enzymatic immune checkpoint targets.

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

Efficient Multinomial Logistic Bandit via Frequent Directions

arXiv:2606.11968v1 Announce Type: new Abstract: This paper studies efficient online algorithms for multinomial logistic bandits (MLogB), where the feedback distribution over $K+1$ outcomes follows a multinomial logistic model of $d$-dimensional action vectors. A representative UCB-type algorithm, OFUL-MLogB, achieves a regret bound of $\tilde{\mathcal{O}}(Kd\sqrt{T})$, but still requires $\mathcal{O}(K^3d^3)$ time and $\mathcal{O}(K^2d^2)$ space per round due to parameter estimation and optimistic reward construction, which is prohibitive in high-dimensional settings. To address this limitation, we propose EOFD-MLogB, which integrates frequent directions matrix sketching into OFUL-MLogB. By maintaining a low-rank SVD sketch of the accumulated Hessian, constrained online Newton updates in parameter estimation and $Kd \times K$ spectral-norm computations in the reward bonus are reduced to one-dimensional root-finding tasks and $K \times K$ eigenvalue computations, respectively. This yields dominant per-round time complexity $\mathcal{O}(Kd(m+K)^2)$ and space complexity $\mathcal{O}(Kd(m+K))$, where $m \ll d$ is the sketch size. We further prove a regret bound of $\tilde{\mathcal{O}}(\Delta_T(Kd\ln\Delta_T+m)\sqrt{T})$, where the sketching error factor $\Delta_T$ is controlled by the $m$-truncated spectral tail of the Hessian. Thus, when the Hessian is approximately low-rank, the regret is close to that of OFUL-MLogB. Experiments validate the computational efficiency and competitive performance.

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

Temporally Consistent and Controllable Video Generation of 2D Cine CMR via Latent Space Motion Modeling

Cine cardiac magnetic resonance is the gold standard for assessing cardiac function, but the scarcity of public datasets limits the development of advanced data-driven models. To address this limitation, we propose a generative method for synthesizing temporally coherent and anatomically consistent cardiac sequences. Our text-to-video framework decouples cardiac spatial structure from temporal motion. First, a fine-tuned diffusion model synthesizes an initial frame from a clinical text prompt, controlling anatomical features. Then, a latent flow model conditioned on a cardiac phase embedding generates the complete cardiac motion, ensuring spatial consistency and temporal control. Our model generates anatomically and pathologically diverse sequences with high temporal coherence and strong fidelity to input prompts, achieving a FID of 31.68 for image realism and a CLIP score of 31.04 for text-image alignment. These experimental results highlight its potential to produce high-fidelity, on-demand medical data, offering a scalable solution to data scarcity.

08.
PLOS Computational Biology 2026-06-05

Heuristic multi-site optimization for protein sequence design using Masked Protein Language Models

Authors:

by Lijuan Wang, Yuze Wang, Chen Qiu, Liwei Xiao, Xianliang Liu, Junjie Chen Protein sequence design for tailored functional properties is a fundamental task in protein engineering, with critical applications in drug discovery and therapeutic development. Efficient navigation of the combinatorial vastness of protein sequence space to identify functional variants remains a formidable challenge. Conventional approaches, which predominantly rely on template-based local search or single-residue mutagenesis, are constrained by their susceptibility to local optima and their potential risk of destabilizing native structural stability. In this study, we introduce ProtHMSO, a heuristic multi-site optimization framework leveraging masked protein language models (ProtLMs) for context-aware sequence exploration. ProtHMSO mimics natural evolutionary mechanisms by employing ProtLM-derived substitution probabilities to guide heuristic searches for synergistic mutations, thereby constraining combinatorial search spaces through evolutionary and biophysical priors. ProtHMSO is further applied to replace the exploration strategies in genetic algorithms (GAs) and Monte Carlo tree search (MCTS) for improving their convergence efficiency. Benchmark experiments demonstrate that protein sequences generated by ProtHMSO exhibit superior functional performance and closer alignment with natural sequence distribution, compared with state-of-the-art methods. These advancements highlight that ProtHMSO has strong potential and compatibility to accelerate functional protein discovery, offering a robust framework for efficient and context-aware exploration of protein sequence space.

09.
arXiv (CS.LG) 2026-06-12

Net-Ev$^2$: A Generative Simulator for Network Event Evolution

arXiv:2606.12494v1 Announce Type: new Abstract: Reducing real-world trial and error has long been a central goal of decision making, and generative simulators advance this goal by modeling the evolution of future states. An even more challenging yet meaningful task is simulating how disturbance events (e.g., accidents) propagate their impacts across real-world networks. The existing approaches fall short of modeling both structured attributes and unstructured semantics of events, and capturing topological structures in simulating network event evolution. Therefore, we are motivated to propose Net-Ev$^2$ ($\underline{Net}$work $\underline{Ev}$ent $\underline{Ev}$olution), a novel generative simulator that jointly leverages event cues while preserving network topology in simulations. Specifically, the framework consists of two stages, namely structure-guided masked pre-training and topology-aware diffusion process, which is achieved by U-Net-like graph downsampling and upsampling during denoising. At inference time, Net-Ev$^2$ can generate simulations using natural-language event input only, with greater flexibility for practical usage. Furthermore, we introduce Net-Ev$^2$-6.5M, a multimodal benchmark of aligned event and network traffic data across four large-scale road networks, as well as a new topology-aware metric, namely JL-MMD, to evaluate topological fidelity in generated network dynamics. Extensive experiments demonstrate the state-of-the-art performance and strong generalization ability of Net-Ev$^2$. Code is made available at https://github.com/Guangyu4/Net-Ev-2.

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

Making Models Unmergeable via Scaling-Sensitive Loss Landscape

arXiv:2601.21898v2 Announce Type: replace Abstract: The rise of model hubs has made it easier to access reusable model components, making model merging a practical tool for combining capabilities. Yet, this modularity also creates a governance gap: downstream users can recompose released weights into unauthorized mixtures that bypass safety alignment or licensing terms. Because existing defenses are largely post-hoc and architecture-specific, they provide inconsistent protection across diverse architectures and release formats in practice. To close this gap, we propose Trap$^2$, an architecture-agnostic protection framework that encodes protection into updates during fine-tuning, regardless of whether they are released as adapters or full models. Instead of relying on architecture-dependent approaches, Trap$^2$ uses weight re-scaling as a simple proxy for the merging process. It keeps released weights effective in standalone use, but degrades them under re-scaling that often arises in merging, undermining unauthorized recomposition.

11.
arXiv (CS.CV) 2026-06-19

Scaling Self-Play for End-to-End Driving

End-to-end autonomous driving models are typically trained on offline human-demonstration datasets that provide limited state coverage and often no closed-loop feedback, making them prone to compounding errors when deployed in closed-loop and brittle to long-tail agent interactions. To overcome these limitations, we propose an alternative strategy for training end-to-end driving models: large-scale self-play directly from pixels in simulation. While prior self-play approaches have shown promising transfer to real-world driving, they typically assume vectorized Bird's-Eye-View (BEV) observations that are incompatible with end-to-end policies operating directly on sensor observations. To this end, we introduce Gigapixel, a high-throughput batched driving simulator with perspective rendering, enabling scalable self-play directly from pixel observations. Rather than targeting compute-costly photorealistic sensor simulation, Gigapixel renders a simplified bounding-box world that preserves essential scene structure while achieving throughput at 50k agent steps per second. Since direct pixel-space self-play RL is prohibitively sample-inefficient at end-to-end model scale, we propose self-play DAgger training: we train pixel-based policies in self-play via on-policy distillation from a privileged RL teacher. To bridge the sim-to-real gap, we subsequently transfer the self-play trained policies to real-world sensor data through lightweight perception adaptation. Policies trained in Gigapixel and adapted to real-world sensor data achieve competitive performance on the HUGSIM and NAVSIM-v2 benchmarks without human trajectory supervision. Moreover, scaling self-play training yields proportional gains in policy performance, establishing self-play as a practical and scalable strategy for training end-to-end models.

12.
bioRxiv (Bioinfo) 2026-06-11

A multi-agent system for spine MRI report generation from multi-sequence imaging

Spinal pathology is a leading cause of pain and disability worldwide. Spine magnetic resonance imaging (MRI) is central to clinical evaluation, yet its interpretation remains complex and time-consuming, requiring integration of information across multiple imaging sequences and anatomical regions. Despite recent advances in automated MRI analysis, effectively combining multi-sequence data while preserving sequence-specific diagnostic information remains an open challenge. Here we present SpineAgent, a multi-agent framework for spine MRI report generation built upon a multi-sequence foundation model trained on routine clinical data from 32,047 patients and 453,683 MRI series, comprising a total of 13,441,191 MRI slices. To accommodate diverse modalities of sequences, we first pre-train two DINOv3-based encoders separately on T1- and T2-weighted sequences. We then introduce a continual training strategy that learns a synthesizer to embed images of other sequences using the T1 and T2 encoders, producing patient-level embedding that integrates various signals across MRI sequences. Using these embeddings, SpineAgent achieves state-of-the-art performance, with mean 10.8% AUROC improvement across 17 spinal condition-prediction tasks compared to the best competing method, and demonstrates strong generalizability under cross-manufacturer and cross-cohort evaluation. Beyond classification, SpineAgent enables pathology localization by identifying findings-relevant slices and segmenting pathological regions. It also supports multimodal image-report retrieval, providing a solid foundation for scalable and explainable MRI report generation. We further integrate these validated capabilities of SpineAgent into 37 specialized agents for condition diagnosis, pathological-region localization, and clinically-similar-cases retrieval. Finally, we incorporate their outputs as structured tokens within a Medical Report Agent trained end-to-end for report generation. Through both automated metrics and expert evaluation by five radiologists, SpineAgent achieves leading performance in spine MRI report generation. Together, SpineAgent introduces a continual training approach for multi-sequence spine MRI understanding. By decomposing report generation into clinically grounded subtasks addressed by specialized agents, the SpineAgent framework enables accurate, interpretable and generalizable spine MRI reporting across diverse imaging sequences and anatomical regions.

13.
arXiv (CS.AI) 2026-06-15

From Shield to Target: Denial-of-Service Attacks on LLM-Based Agent Guardrails

arXiv:2606.14517v1 Announce Type: cross Abstract: LLM-based guardrails have emerged as a highly effective defense against prompt injection and jailbreak attacks in autonomous agents. However, we reveal that the very reasoning and task-following capabilities enabling this protection introduce a novel vulnerability: attackers can inject crafted data to trap the guardrail in extended reasoning loops, effectuating a systematic denial-of-service (DoS) attack. To systematically expose this threat, we design a beam-search optimization framework that crafts natural-language payloads to maximize guardrail reasoning length, utilizing an LLM proposer guided by a strategy bank. Based on the observation of guardrail's schema-following nature, we also provide another attack framework driven by mechanism-aware structural mutations with less computational load. The attack efficacy is systematically evaluated in two parts. First, in standalone evaluations, the attack generalizes across diverse guardrail architectures, safety templates, and agent benchmarks. Payloads optimized on a single open-source surrogate successfully transfer to eight leading model backbones (e.g., Claude, GPT, Gemini, DeepSeek, and Qwen), achieving a 13–63$\times$ token amplification. Second, in end-to-end real-world agent deployments (web, desktop, code, and multi-agent systems), the attack reveals up to a 148$\times$ latency amplification. We show that a single poisoned document can saturate shared guardrail infrastructures, effectively starving co-located agents and paralyzing the entire system. By uncovering this availability flaw, our work underscores the urgent need to develop cost-bounded, reasoning-robust guardrails.

14.
arXiv (CS.CV) 2026-06-15

MirrorCheck: Efficient Adversarial Defense for Vision-Language Models

Vision-Language Models (VLMs) are increasingly susceptible to sophisticated adversarial attacks, including adaptive strategies specifically designed to bypass existing defenses. To address this vulnerability, we propose MirrorCheck, a robust and model-agnostic detection framework that operates effectively in both unimodal and multimodal settings. MirrorCheck leverages Text-to-Image (T2I) models to regenerate visual content from captions produced by the target model and assesses semantic consistency by comparing feature-space embeddings between the original and synthesized images. To enhance robustness against adaptive attacks, MirrorCheck introduces a stochastic defense strategy that randomly selects T2I generators and image encoders from a diverse model zoo. Additionally, we incorporate a novel One-Time-Use (OTU) perturbation applied to the selected encoder embeddings, regulated by a scaling factor, which decreases the effectiveness of adaptive attacks. Extensive experiments across multiple threat scenarios demonstrate that MirrorCheck consistently outperforms baseline methods, and maintains its utility even under strong adaptive adversarial conditions.

15.
arXiv (CS.CV) 2026-06-19

HEad and neCK TumOR (HECKTOR) 2025: Benchmark of Segmentation, Diagnosis, and Prognosis in Multimodal PET/CT

Head and neck cancers (HNC) represent a significant global health burden, with accurate tumor delineation being essential for effective radiotherapy planning. The complexity of the oropharyngeal anatomy, combined with the heterogeneous appearance of tumors on imaging, makes manual segmentation time-intensive and subject to inter-observer variability. Beyond segmentation, predicting long-term clinical outcomes, such as recurrence-free survival (RFS), and determining human papillomavirus (HPV) status from noninvasive imaging, remain challenging yet clinically valuable goals. The HECKTOR 2025 challenge addresses these needs by establishing a comprehensive benchmark for automated HNC analysis using multimodal PET/CT imaging and electronic health records. Building on previous editions (2020-2022), this challenge features an expanded multi-institutional dataset comprising over 1,100 patients from 10 centers worldwide. Participants were tasked with three complementary objectives: (1) segmenting primary gross tumor volumes (GTVp) and metastatic lymph nodes (GTVn), (2) predicting recurrence-free survival, and (3) classifying HPV status. The challenge attracted 35 registered teams, with 15 final submissions evaluated on a held-out test set. Top-performing algorithms achieved a mean Dice similarity coefficient of 0.75 for segmentation, a concordance index of 0.66 for survival prediction, and a balanced accuracy of 0.56 for HPV classification. This paper presents a comprehensive analysis of the submitted methodologies, evaluates their performance across different lesion characteristics, and discusses their implications for clinical translation in automated oncology workflows and decision support systems.

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

Clinically Aware Synthetic Image Generation for Concept Coverage in Chest X-ray Models

Deep learning models for chest X-ray diagnosis are constrained by limited coverage of clinically meaningful concept combinations in publicly available training datasets. While synthetic image generation has been explored to increase data diversity, existing methods rarely enforce clinical or anatomical constraints, limiting utility for improving model reliability. We propose CARPA, a clinically aware and anatomically grounded framework for synthetic chest X-ray generation that applies targeted perturbations to clinical concept vectors while preserving anatomical structure. By producing anatomically faithful synthetic images with controlled concept insertions and deletions, CARPA expands clinically relevant concept coverage. We evaluate CARPA across seven backbone architectures by fine-tuning models on synthetic subsets and testing on a held-out MIMIC-CXR benchmark. Compared to prior concept perturbation approaches, fine-tuning on CARPA-generated images consistently improves precision-recall performance, reduces predictive uncertainty, and improves model calibration. Structural and semantic analyses demonstrate high anatomical fidelity, strong concept alignment, and low semantic uncertainty. Evaluation by two expert radiologists further confirms realism and clinical agreement. Together, these results show that anatomically grounded concept perturbations enable more effective use of synthetic data, improving both performance and reliability of chest X-ray classification models and supporting safer clinical deployment.

17.
PLOS Medicine 2026-06-09

Prediction of hospitalisation in young children with pneumonia in Malawi: A machine learning-based approach

by Patrick Staunton, Mohammad Adib Makrooni, Master Chisale, Billy Nyambolo, Joseph Wu, Damien McCarthy, Mark Ledwidge, Yasir Bin Nisar, Chris Watson, Balwani Mbakaya, Cathal Seoighe, Joe Gallagher Background Globally, pneumonia remains the single biggest cause of mortality in children under 5 years of age. This study sought to train and test a prediction model for hospitalisation within 7 days after initial presentation in 2- to 59-month-old Malawian children with WHO-defined pneumonia in primary care and compare its performance to existing risk prediction models. Methods and findings BIOTOPE is a cohort study of children with pneumonia in a primary healthcare setting in Malawi. The training cohort involved nine primary care centres and the testing cohort involved two primary care centres in Northern Malawi. The training cohort was recruited between December 2022 and April 2023 while the testing cohort was recruited in 2016. Participants were consecutive children aged 2–59 months presenting with cough and/or difficulty breathing and who were diagnosed as WHO-defined pneumonia in primary care of any severity. The training cohort was used to train and validate a machine learning model with a prespecified primary outcome defined as hospitalisation and/or death within 7 days as the outcome. This model was then further evaluated in the testing cohort.Median age was 15 months (interquartile range 8−27) in the training and 17 months (interquartile range 9−29) in the external testing cohort (52.1% and 54.4% male, respectively). Hospitalisation occurred in 14.3% (294) of the training cohort and 12.1% (55) of the testing cohort. There was one death in the training cohort only. WHO danger signs were present in 17.6% (360) and 15.9% (70) of children in the training and testing cohorts, respectively. The optimal machine learning model achieved an area under the receiver operating characteristic and precision recall curves of 0.87 and 0.57, respectively, in the testing cohort outperforming existing risk prediction models; furthermore, this model produced an expected calibration error of 0.16 (a logistic regression model using severity status as the response variable and the log odds of the machine learning model’s calibrated probabilities produced an intercept estimate of −0.32 and a slope estimate of 1.13). Key limitations include the use of hospitalisation and/or death as a severity outcome, which may reflect health system factors rather than true disease severity, that mortality-based comparisons were not possible due to low mortality in these primary care cohorts, and that comparator tools were developed for hospital populations rather than primary care populations. Conclusion This machine learning score outperformed traditional pneumonia risk scores in predicting hospitalisation within 7 days in Malawian children presenting to primary care. Traditional pneumonia risk scores diminish in performance when externally applied to new datasets suggesting they may not generalise well beyond their original derivation settings. Mortality-related findings are not applicable as there was only one death in this cohort. Overall these findings support the potential of machine learning to meaningfully improve early identification of children at risk of severe pneumonia in low-resource primary care settings. Further external validation and clinical impact studies are needed to confirm these results.

18.
arXiv (quant-ph) 2026-06-17

Intrinsic Pointer Basis and Irreversible Classicality from Coherence Contraction

Authors:

arXiv:2604.23304v4 Announce Type: replace Abstract: This work analyzes an operational route to classical behavior for reduced quantum states using the intrinsic reference basis (IRB). Relative to a fixed physical conjugation, the IRB separates intrinsic populations from a real antisymmetric cohesion sector. A globally bounded cohesion index is defined and its exponential contraction is proved for phase-free dephasing dynamics aligned with the IRB; for general aligned dephasing, the corresponding modulus-based coherence functional contracts at the same computable rates. The results provide distance bounds to the IRB-diagonal description and a logarithmic upper bound on the time required to reach a prescribed experimental tolerance. The IRB projectors constitute state-derived candidate pointer sectors, and they become dynamically stable pointer sectors when the effective dephasing generator is aligned with them and damps the relevant inter-sector coherences. Degenerate population sectors lead naturally to block-classicality and protected intra-block coherence. In a two-level active sector, the cohesion index equals fringe visibility, giving a direct interferometric test of the contraction law. The construction is independent of any spacetime- or unification-emergence hypothesis and is intended as a channel-level complement to environment-induced einselection.

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

The Scaffold Effect: How Prompt Framing Drives Apparent Multimodal Gains in Clinical VLM Evaluation

arXiv:2603.28387v2 Announce Type: replace Abstract: Trustworthy clinical AI requires that performance gains reflect genuine evidence integration rather than surface-level artifacts. We evaluate 12 open-weight vision-language models (VLMs) on binary classification across two clinical neuroimaging cohorts, \textsc{FOR2107} (affective disorders) and \textsc{OASIS-3} (cognitive decline). Both datasets come with structural MRI data that carries no reliable individual-level diagnostic signal. Under these conditions, smaller VLMs exhibit gains of up to 58\% F1 upon introduction of neuroimaging context, with distilled models becoming competitive with counterparts an order of magnitude larger. A contrastive confidence analysis reveals that merely mentioning MRI availability in the task prompt accounts for 70-80\% of this shift, independent of whether imaging data is present, a domain-specific instance of modality collapse we term the scaffold effect. Expert evaluation reveals fabrication of neuroimaging-grounded justifications across all conditions, and preference alignment, while eliminating MRI-referencing behavior, collapses both conditions toward random baseline. Our findings demonstrate that surface evaluations are inadequate indicators of multimodal reasoning, with direct implications for the deployment of VLMs in clinical settings.

20.
arXiv (CS.CL) 2026-06-16

MosaicQuant: Inlier-Outlier Disaggregation for Unified 4-Bit LLM Quantization

4-bit quantization significantly reduces the memory footprint and accelerates the inference of large language models (LLMs). However, its limited bit-width representation struggles to faithfully capture both dense common values (inliers) and rare large-magnitude values (outliers), causing substantial accuracy degradation. Existing mixed-precision methods mitigate this by retaining outliers in high precision, but at the cost of breaking the uniformity of low-bit execution, introducing precision conversion and extra data movement that undermine practical speedup. We propose MosaicQuant, a unified 4-bit LLM quantization paradigm built on a novel principle of inlier–outlier disaggregation. Rather than elevating outlier precision, MosaicQuant quantizes the full weight matrix into a dense 4-bit base component, where inliers are captured faithfully while outlier are inevitably quantized. A sparse 4-bit residual component is then introduced to compensate for these quantization errors, selectively targeting the most error-critical weight blocks where output distortion is shown to be concentrated. However, a unified representation alone is insufficient, as naïvely executing the sparse residual as a separate kernel still breaks the unified low-bit inference pipeline. To bridge this gap, we introduce ZipperEngine, which fuses sparse block computation into the dense 4-bit GEMM kernel via an overlapped pipeline, unifying not only the representation but also the execution into a single coherent low-bit inference pipeline. Extensive experiments on LLaMA3 and Qwen3 demonstrate that MosaicQuant preserves near-FP16 accuracy while achieving up to $1.24\times$ speedup over the W16A16 baseline.

21.
arXiv (CS.AI) 2026-06-12

When Does Delegation Beat Majority? A Delegation-Based Aggregator for Multi-Sample LLM Inference

arXiv:2606.08098v2 Announce Type: replace Abstract: Majority voting over sampled answers is the dominant unsupervised aggregator for multi-sample LLM inference. In this paper, we show a delegation-based aggregator (Propagational Proxy Voting, PPV; Sakai et al., 2025) yields an unsupervised consensus rule that beats majority on MMLU-Pro by +1.5 pp overall and +2.24 pp on the non-trivial subset (paired McNemar p ~ 1.0e-14, n = 8,099). Majority discards two signals that every sample carries: within-group letter entropy and between-group reasoning geometry. PPV exposes per-voter levers that consume exactly these two signals: When (how much weight a voter keeps on its own pick) and Whom (how it splits the remainder across peers). We drive When with letter entropy and Whom with per-question-centered embedding cosine. Our method needs no gold labels and no auxiliary training: per-question, we partition 128 sampled generations into 16 groups, compute each group's letter-level semantic entropy and reasoning embedding centroid, and feed both into a stochastic delegation matrix whose stationary distribution selects the consensus answer. We walk through an example in which PPV overturns a clear 10-6 majority for the wrong letter: the 10-voter majority cluster is geometrically incoherent (mean within-cluster cosine -0.02) while the 6-voter minority is tight (+0.26), so propagated delegation mass concentrates on the minority's answer even though entropy alone would keep the majority ahead. We further report delegation strategies with negative results that constrain the design space for unsupervised LLM aggregation. No within-question ensemble of confidence modes closes the oracle gap.

23.
medRxiv (Medicine) 2026-06-15

SPIRIT-CONSORT-ELM: Element-Level Assessment of Randomized Controlled Trial Reporting Using Large Language Models

Randomized controlled trials (RCTs) play a central role in assessing the benefits and harms of interventions. Incomplete reporting in RCT publications can compromise the verifiability and usefulness of RCTs. SPIRIT and CONSORT reporting guidelines aim to improve the completeness of RCT protocols and results publications, respectively. However, many RCTs are not reported completely. Checking manuscripts automatically could help authors improve the completeness of reports prior to publication. We previously annotated SPIRIT-CONSORT-TM, a corpus of 200 articles (comprising 100 protocol-results publication pairs) using 83 checklist items drawn from SPIRIT 2013 and CONSORT 2010. We also trained machine learning models to automatically assess reporting at the item level. Each checklist item can include multiple constituent elements (i.e., specific details required for that item), and an item might be considered fully reported when all of its elements are present. However, prior work does not explicitly capture or evaluate reporting at the element level. To address this gap, we extended SPIRIT-CONSORT-TM by incorporating element-level annotations and using them to assess reporting completeness (SPIRIT-CONSORT-ELM). We formulated element-level assessment as a machine reading comprehension task, operationalized through 119 questions, where each question targets a specific reporting element within a checklist item. Using the 200 articles included in SPIRIT-CONSORT-TM, two annotators independently answered 119 questions for 50 articles (25 protocol-results pairs) and resolved any discrepancies through discussion; the remaining 150 articles (75 protocol-results pairs) were assessed by a single annotator. We then developed an automated pipeline for element-level assessment using SPIRIT-CONSORT-ELM. The pipeline first applies a PubMedBERT-based model to identify sentences containing item-level reporting information, then it uses a generative large language model (LLM; GPT-5) with chain-of-thought reasoning to answer element-level questions based on the retrieved evidence. Agreement between the two annotators was high (Gwet's AC1: 0.782) and our pipeline achieved high accuracy in identifying element-level reporting evidence (F1: 0.822, Gwet's AC1: 0.796). Ablation studies indicate that chain-of-thought reasoning and the inclusion of illustrative in-context examples modestly improve LLM performance on the machine reading comprehension task. SPIRIT-CONSORT-ELM provides a benchmark for evaluating reporting guideline completeness at the element level, enabling assessment of RCT transparency beyond the simple presence or absence of checklist items and is publicly available at https://osf.io/kznx4/. The automated pipeline establishes a robust baseline for assessing RCT reporting and demonstrates potential as a practical aid for authors, reviewers, and editors to identify and address gaps in completeness and transparency of RCT reports.

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medRxiv (Medicine) 2026-06-15

Epileptogenicity alters intrahippocampal ripple propagation

Objective: Tracing the propagation of high-frequency oscillations (HFOs) aids in localizing epileptogenic regions and improving surgical outcomes. We examined how hippocampal epileptogenicity influences the propagation properties of the HFOs it generates. Methods: We analyzed non-REM sleep stereo-EEG from 49 patients (68 hemispheres) with verified hippocampal contacts. Hippocampi were stratified by excitability: 28 seizure onset zone (SOZ), 22 more-irritative non-SOZ (>6 interictal epileptiform discharges [IED]/min), and 18 less-irritative non-SOZ (

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medRxiv (Medicine) 2026-06-22

AI-Assisted Longitudinal Analyses of Environmental and Psychosocial Determinants of Subjective Cognitive Difficulties

Authors:

Short-term environmental exposures have been linked to cognitive and behavioral outcomes, although many reported associations may reflect broader geographic and contextual differences. Using longitudinal data from the All of Us Research Program (2018–2024), we linked daily weather and air-pollution exposures to repeated attention-related and subjective cognitive outcomes. Associations were evaluated using pooled, fixed-effects, lagged, and event-study analyses. Additional machine-learning analyses were conducted to explore potential heterogeneity and latent psychosocial structure. Replication analyses were performed using the 2024 Behavioral Risk Factor Surveillance System (BRFSS). Several environmental exposure measures showed small associations with cognitive outcomes in pooled analyses, but most attenuated substantially after accounting for within-location temporal variation. Mediation, sensitivity, and machine-learning analyses yielded similar conclusions. In contrast, mental-health burden, loneliness, and social functioning were consistently associated with subjective cognitive difficulty and exhibited substantially larger effect sizes than environmental exposures. Similar patterns were observed in BRFSS. Exploratory AI-assisted analyses yielded findings broadly consistent with the primary longitudinal analyses. These findings suggest that short-term environmental perturbations may have limited associations with cognitive outcomes after accounting for within-location variation, whereas psychosocial factors appear to be more consistently associated with subjective cognitive burden.