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01.
arXiv (CS.CV) 2026-06-17

LiveStarPro: Proactive Streaming Video Understanding with Hierarchical Memory for Long-Horizon Streams

Despite the remarkable progress of Video Large Language Models (Video-LLMs), current online architectures still struggle to simultaneously process continuous video streams, decide autonomously when to respond, and preserve long-horizon contextual memory. These obstacles undermine real-time responsiveness and cause severe forgetting throughout prolonged interactions. In this work, we introduce LiveStarPro, a live streaming assistant that is designed for proactive video understanding over long-horizon streams. The design of LiveStarPro rests on three complementary components. The first component is Streaming Verification Decoding (SVeD), an inference framework that identifies the appropriate response timing through single-pass perplexity verification, thereby eliminating the dependency on explicit silence tokens. The second component is Streaming Causal Attention Masks (SCAM), a training strategy that enforces incremental video-language alignment over variable-length streams. The third component is Tree-Structured Hierarchical Memory (TSHM), a recursive memory architecture that organizes evicted historical information into event chains and consequently enables efficient retrieval from effectively unbounded video streams. To facilitate a comprehensive evaluation under realistic online conditions, we further present OmniStarPro, a large-scale benchmark that spans 15 diverse real-world scenarios and that extends to hour-scale streams for the assessment of long-term recall. Extensive experiments demonstrate that LiveStarPro consistently surpasses existing methods, attaining a 28.9% improvement in semantic correctness and an 18.2% reduction in timing error, while its streaming key-value cache further yields a 1.58x inference speedup over the same model without caching. The model and the code are publicly available at https://github.com/sotayang/LiveStarPro.

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

BRDFusion: Physics Meets Generation for Urban Scene Inverse Rendering

Inverse rendering of urban scenes from captured videos enables numerous applications, including content creation and autonomous driving simulation. Physically-based rendering methods follow and control lighting physics, but suffer from reconstruction and rendering artifacts. While generative models produce realistic videos, they offer limited consistency and controllability. We present BRDFusion, a unified framework that combines two complementary models for inverse and forward rendering. Specifically, BRDFusion recovers explicit, consistent scene properties with physical modeling and alleviates optimization ambiguity with generative priors. During forward rendering, the physical model provides controllable rendering from the scene configuration, and the generative model denoises and fixes artifacts. Therefore, our method produces high-quality videos while allowing precise control, outperforming baselines in real and synthetic scenes. Moreover, BRDFusion supports novel-view relighting, night simulation, and dynamic object insertion/editing. Project page: https://shigon255.github.io/brdfusion-page/

03.
arXiv (CS.CV) 2026-06-17

TaFD: Threat-Aware Frequency Decoupling for Adversarial Robustness against Heterogeneous Attacks

Multi-threat robustness remains a fundamental challenge in deep learning. Although joint adversarial training (JAT) is widely adopted, it suffers from negative transfer under heterogeneous threats, particularly between $\ell_p$-bounded and semantic attacks. Through first-order gradient analysis, we formalize this as gradient incompatibility and theoretically establish the necessity of decoupled optimization. We further reveal that these conflicting threats exhibit separable spectral characteristics in the frequency domain. Motivated by this observation, we propose Threat-aware Frequency Decoupling (TaFD), a two-stage defense framework that reformulates JAT as a frequency-domain divide-and-conquer paradigm. TaFD first discovers latent threat domains via unsupervised clustering of attack spectral prototypes and trains a lightweight classifier for inference-time threat domain identification. Conditioned on the prediction, TaFD employs a Frequency-Conditional Convolution that learns threat-domain-specific spectral masks and routes each sample to the corresponding expert, enforcing structural parameter separation and alleviating optimization conflicts. We validate TaFD on three representative image-classification benchmarks (CIFAR-10, CIFAR-100, and Tiny-ImageNet) and on two representative architectures (the convolutional ResNet and the hybrid-transformer MobileViT). Extensive results demonstrate that TaFD achieves more balanced robustness against heterogeneous attacks than existing JAT and frequency-domain baselines, improving average robust accuracy by approximately 11\% over the strongest baseline while maintaining leading clean accuracy.

04.
arXiv (CS.AI) 2026-06-16

RollArt: Disaggregated Multi-Task Agentic RL Training at Scale

arXiv:2512.22560v2 Announce Type: replace-cross Abstract: Agentic Reinforcement Learning (RL) trains LLMs through multi-turn interactions with environments, producing workloads that mix compute-bound prefill, bandwidth-bound decoding, CPU-heavy environment execution, and bursty reward evaluation. Existing systems either colocate all stages on a single GPU cluster or decouple them only at a coarse granularity, overlooking hardware heterogeneity and incurring substantial synchronization overhead across stages. We present ROLLART, a system for multi-task agentic RL on disaggregated infrastructure. ROLLART maps each pipeline stage to best-fit hardware, routing prefill-heavy tasks to compute-optimized GPUs, decode-heavy tasks to bandwidth-optimized GPUs, and environments to CPU clusters. It decouples rollout at the trajectory level, allowing generation, environment interaction, and reward scoring to proceed independently, so that slow or failed environments never block the others. ROLLART offloads stateless reward computation to serverless infrastructure and overlaps rollout with training via staleness-bounded asynchronous weight synchronization. Our results demonstrate that ROLLART effectively improves training throughput and achieves 1.31–2.05 \(\times\) training time reduction compared to various RL systems. We also evaluated ROLLART by training a hundreds-of-billions-parameter MoE model for Qoder product on an Alibaba cluster with above 3,000 GPUs, demonstrating its stability and scalability.

05.
arXiv (math.PR) 2026-06-16

An Algebraic Matrix Spencer Theorem

arXiv:2606.16005v1 Announce Type: new Abstract: We develop an algebraic approach to matrix discrepancy based on the representation theory of finite-dimensional C$^*$-algebras. As an application, we resolve a substantial structured special case of the Matrix Spencer conjecture. In particular, we show that for every family of contractions $A_1,\ldots,A_n$ that are contained in a finite-dimensional $C^*$-algebra $\mathcal A$ with $dim_{\mathbb C} (\mathcal A) \lesssim n$, there exists signs $x\in\{\pm1\}^n$ such that $\|\sum_{i=1}^n x_i A_i\| \le O(\sqrt n)$. As a noteworthy special case, our main result also resolves the Group Spencer conjecture of (Bandeira'24). We furthermore prove that Matrix Spencer continues to hold for low-rank perturbations of matrix families coming from an $C^*$-algebra of small dimension.

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

Weakly Supervised Segmentation as Semantic-Based Regularization

Weakly supervised semantic segmentation (WSSS) trains dense pixel-level segmentation models from partial or coarse annotations such as bounding boxes, scribbles, or image-level tags. While recent work leverages foundation models such as the Segment Anything Model (SAM) to generate pseudo-labels, these approaches typically depend on heuristic prompt choices and offer limited ways to incorporate prior knowledge or heterogeneous labels. We address this gap by taking a neurosymbolic perspective: integrating differentiable fuzzy logic with deep segmentation models. Weak annotations and domain-specific priors are unified as continuous logical constraints that fine-tune SAM under weak supervision. The refined foundation model then produces improved pseudo-labels, from which we train a second-stage prompt-free segmentation model. Experiments on Pascal VOC 2012 and the REFUGE2 optic disc/cup segmentation dataset show that our logic-guided fine-tuning yields higher-quality pseudo-labels, leading to state-of-the-art segmentation accuracy that often exceeds densely supervised baselines.

07.
arXiv (CS.CL) 2026-06-15

Harsher on Male? Evaluating LLMs on Gender-Asymmetric Moral Framing Across Diverse Conflict Scenarios

Existing studies on gender bias in LLMs have largely focused on stereotypes, occupational associations, or explicit harmful outputs. In this work, we ask whether LLMs apply consistent response standards to the same negative behavior under matched male-actor and female-actor conditions. We introduce GAMA-Bench, a gender-mirrored benchmark of 1,298 scenarios covering intimate relationship and public social conflicts. It constructs gender-neutral misconduct templates through controlled grids and cross-model review, then compiles them into paired first-person prompts with matched actor-gender and role-reference variations. We further design a structured response-framing protocol to measure how models allocate punishment, empathy, escalation, instruction, and blame. Experiments on 10 representative LLMs reveal a consistent male-disadvantaging asymmetry: male actors receive more punitive, escalatory, and blame-centered framing, whereas female actors receive more therapeutic and empathy-oriented framing for the same misconduct. Further analyses show that this pattern persists across model families, scenario tracks, model scale, and explicit thinking-style reasoning. The official code is available at https://github.com/xufeiqiong/GAMA-Bench.

08.
arXiv (CS.CL) 2026-06-15

Same-Origin Policy for Agentic Browsers

Agentic browsers integrate autonomous AI agents into web browsers, enabling users to accomplish web tasks through natural-language instructions. The same-origin policy (SOP) is a fundamental browser security mechanism that prevents unauthorized automated cross-origin data flows induced by scripts. However, whether SOP remains effective in agentic browsers is an open question that has not been systematically studied. In this work, we bridge this gap. We first observe that an agentic browser can itself serve as an automated channel for cross-origin data flows, potentially leading to SOP violations. To investigate this phenomenon, we construct SOPBench, a benchmark for evaluating SOP violations in agentic browsers. Our evaluation shows that existing agentic browsers frequently violate SOP, both in benign settings and under attacks. To address this problem, we propose SOPGuard, an SOP enforcement mechanism tailored to agentic browsers. We implement SOPGuard in BrowserOS, an open-source agentic browser. Extensive evaluations demonstrate that SOPGuard effectively enforces SOP while preserving utility and incurring only a small runtime overhead. Our code and data are available at https://github.com/wxl-lxw/BrowserOS-SOPGuard.

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

EQPO: Equitable Group Relative Policy Optimization for Clinical Reasoning

arXiv:2510.19893v2 Announce Type: replace Abstract: Medical AI systems demonstrated impressive diagnostic performance, yet they routinely show uneven accuracy across demographic groups, disadvantaging underrepresented populations. Although multimodal reasoning foundation models have pushed clinical diagnosis forward, reinforcement learning-based post-training tends to absorb and magnify the biases present in majority-dominated training corpora. We propose Equitable Group Relative Policy Optimization (EQPO), a hierarchical reinforcement learning method that encourages balanced learning across heterogeneous clinical populations by adaptively reweighting samples according to subgroup representation, task difficulty, and data source. As demographic annotations are frequently missing in real-world clinical data, EQPO additionally applies unsupervised clustering to recover latent subpopulations when they are unavailable. On 7 diagnostic benchmarks covering 5 modalities (X-ray, CT, dermoscopy, mammography, ultrasound), EQPO reduces F1 standard deviation by 43.9% and the maximum cross-group F1 gap by 42.7% on QoQ-Med3-8B over vanilla GRPO, and narrows predictive parity gaps by 27.2% on MedGemma-4B over bias-mitigated RL baselines while raising F1 by 12.5% even without any demographic labels. Examining the training trajectory shows that EQPO steadily improves fairness over the course of optimization, in contrast to baseline methods whose fairness degrades as training proceeds, and the discovered implicit groups remain stable and align with masked demographic attributes. We further release EquiMedGemma-4B and EquiQoQ-Med3-8B, equitability-aware clinical VLLMs that attain state-of-the-art accuracy with markedly smaller demographic gaps.

10.
PLOS Computational Biology 2026-06-04

CIPHER: An end-to-end framework for designing optimized aggregated spatial transcriptomics experiments

by Zachary Hemminger, Haley De Ocampo, Fangming Xie, Zhiqian Zhai, Jingyi Jessica Li, Roy Wollman Motivation Most imaging-based spatial transcriptomics methods measure individual genes, which limits scalability and typically requires integration with scRNA-seq to recover full cellular states. Recent approaches such as CISI, FISHnCHIPs, and ATLAS address this limitation by measuring aggregate transcriptional signatures, where multiple genes are pooled into each channel to increase throughput. While aggregate measurements improve scalability, they shift the problem from gene selection to feature design. For effective integration with scRNA-seq, these signatures must be not only discriminative in transcriptional space but also straightforward to measure, with balanced signal, sufficient dynamic range, and robustness to experimental noise. By optimizing decoding accuracy in isolation, existing methods leave substantial performance on the table. Results We present CIPHER (Cell Identity Projection using Hybridization Encoding Rules), a neural-network framework that jointly optimizes the experimental encoding matrix, i.e., the way that genes are aggregated to signatures, and the downstream cell embedding. CIPHER integrates the physical limits of imaging assays directly into its loss function, shaping the latent space to maximize discriminability while maintaining robustness to measurement noise and signal constraints. Using a large-scale mouse brain scRNA-seq reference, we show that CIPHER-designed encodings yield latent spaces with improved cell-type separability, uniform signal utilization, and greater resilience to hybridization variability, resulting in higher decoding accuracy from both simulated and experimental data. Conclusion CIPHER formulates aggregate signature design as a joint optimization problem over decoding accuracy and experimental measurability. This enables systematic, scRNA-seq-aligned feature design for scalable spatial transcriptomics based on aggregate measurements. Availability Code and documentation are available at https://github.com/wollmanlab/Design/.

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

M4FC: a Multimodal, Multilingual, Multicultural, Multitask Real-World Fact-Checking Dataset

Existing real-world datasets for multimodal fact-checking have multiple limitations: they contain few instances, cover on only one or two languages, focus only on one task, or rely on external news article sets for sourcing true claims. To address these shortcomings, we introduce M4FC, a new real-world dataset comprising 4,982 images paired with 6,980 claims. The images, verified by professional fact-checkers from 22 organizations, represent a diverse range of cultural and geographic contexts. Each claim is available in one or two out of ten languages. M4FC spans six multimodal fact-checking tasks: visual claim extraction, claimant intent prediction, fake image detection, image contextualization, location verification, and verdict prediction. We provide baseline results for all tasks and analyze how combining intermediate tasks affects verdict prediction performance. We make our dataset and code publicly available.

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

No Hidden Prompts Needed! You Can Game AI Peer Review with Presentation-Only Revisions

As AI-generated reviews move from experimental tools into peer-review infrastructure, most robustness concerns have focused on explicit attacks such as hidden instructions and prompt injection. We study a harder and more policy-relevant failure mode: no hidden text, no prompt injection, and no changes to methods, experiments, figures, equations, proofs, or numerical results. The attacker modifies only presentation-level content, such as the abstract, contribution framing, related work, discussion, and narrative structure. We introduce adversarial repackaging: a closed-loop attack that uses AI-reviewer feedback to search for presentation-level revisions while keeping the scientific evidence fixed. Across three mainstream AI reviewers, adversarial repackaging achieves a 75.1% attack success rate and a mean score gain of +1.21/10. The effect is not explained by ordinary prose polishing. We also reveal that strategies that change how the reviewer interprets the paper, such as related-work repositioning and analytical discussion expansion, substantially outperform surface edits such as local polishing, table formatting, and algorithm boxes. Our analysis reveals two deeper structural failure modes. First, AI reviewers are easier to impress than to convince: highlighting strengths reliably increases perceived merit, while attempts to dissolve weaknesses frequently backfire. Second, AI reviewers can confuse the appearance of addressing a limitation with actually resolving it, allowing unchanged evidence to be reinterpreted as stronger scientific contribution. These results show that the deployment risk is not only malicious hidden instructions, but the emergence of paper presentation itself as an optimization surface. We release a contamination-free rolling benchmark and attack framework for testing whether AI reviewers remain anchored to scientific content under presentation-only edits.

13.
arXiv (CS.AI) 2026-06-16

AI Pluralism and the Worlds It Misses

arXiv:2606.16167v1 Announce Type: new Abstract: AI pluralism is often framed as a problem of representing diverse values, preferences, users, or outputs. This paper argues that this framing is incomplete because AI systems also impose ontologies: they define what counts as an entity, relation, feature, harm, benefit, and valid form of evidence. We define ontological flattening as the conversion of situated, contested, and historically specific meanings into a restricted technical category, proxy, aggregation rule, or benchmark target that is treated as neutral and difficult to contest. The paper develops a bounded conceptual and qualitative synthesis across value pluralism, pluralistic alignment, participatory and democratic AI, procedural justice, science and technology studies, accountability research, aggregate themes from 11 expert interviews, and three urban AI companion cases. The cases illustrate how pluralistic methods can improve or structure model behavior while still compressing categories, proxies, aggregation rules, and revision rights before affected actors have procedural standing. We introduce Pluralistic Lifecycle Governance (PLG) as a preliminary qualitative audit scaffold for documenting ontological openness, epistemic inclusion, procedural authority, evaluation pluralism, and lifecycle accountability. PLG is not presented as a validated scoring instrument; it is a framework for making the evidence and governance conditions of pluralistic AI explicit.

14.
arXiv (CS.AI) 2026-06-11

APPO: Agentic Procedural Policy Optimization

arXiv:2606.12384v1 Announce Type: cross Abstract: Recent advances in agentic Reinforcement Learning (RL) have substantially improved the multi-turn tool-use capabilities of large language model agents. However, most existing methods assign credit over coarse heuristic units, such as tool-call boundaries or fixed workflows, making it difficult to identify which intermediate decisions influence downstream outcomes. In this work, we study agentic RL from two perspectives: where to branch and how to assign credit after branching. Our pilot analysis shows that influential decision points are broadly distributed throughout the generated sequence rather than concentrated at tool calls, while token entropy alone does not reliably reflect their impact on final outcomes. Motivated by these observations, we propose Agentic Procedural Policy Optimization (APPO), which shifts branching and credit assignment from coarse interaction units to fine-grained decision points in the sequence. APPO selects branching locations using a Branching Score that combines token uncertainty with policy-induced likelihood gains of subsequent continuations, enabling more targeted exploration while filtering out spurious high-entropy positions. It further introduces procedure-level advantage scaling to better distribute credit across branched rollouts. Experiments on 13 benchmarks show that APPO consistently improves strong agentic RL baselines by nearly 4 points, while keeping efficient tool-calls and maintaining behavior interpretability.

15.
arXiv (CS.LG) 2026-06-17

Performance-Driven Environment Abstraction with Multi-Timescale Learning

arXiv:2606.17377v1 Announce Type: new Abstract: We study performance-driven environment abstraction for decision-making in large Markov decision processes. Rather than preserving geometric or topological structure, we seek abstractions that directly optimize decision quality. We model abstraction as a controlled approximation obtained by aggregating the state space and enforcing a shared action distribution within each aggregated state. For a fixed partition, we establish a performance guarantee that separates value-function approximation error from the loss introduced by action sharing. Guided by this analysis, we develop a multi-timescale reinforcement learning framework that jointly adapts the policy and a tree-structured environment abstraction. The resulting algorithm refines and coarsens regions of the state space based on Q-value discrepancies, balancing performance against abstraction size and complexity. Empirical results demonstrate substantial state compression, improved sample efficiency, and faster replanning compared to actor-critic baselines.

16.
arXiv (CS.CV) 2026-06-17

NTIRE 2024 Challenge on Image Super-Resolution (x4): Methods and Results

This paper reviews the NTIRE 2024 challenge on image super-resolution ($\times$4), highlighting the solutions proposed and the outcomes obtained. The challenge involves generating corresponding high-resolution (HR) images, magnified by a factor of four, from low-resolution (LR) inputs using prior information. The LR images originate from bicubic downsampling degradation. The aim of the challenge is to obtain designs/solutions with the most advanced SR performance, with no constraints on computational resources (e.g., model size and FLOPs) or training data. The track of this challenge assesses performance with the PSNR metric on the DIV2K testing dataset. The competition attracted 199 registrants, with 20 teams submitting valid entries. This collective endeavour not only pushes the boundaries of performance in single-image SR but also offers a comprehensive overview of current trends in this field.

17.
arXiv (CS.CV) 2026-06-11

Findings of the MAGMaR 2026 Shared Task

This overview paper presents the results of the shared task for the second workshop on Multimodal Augmented Generation via Multimodal Retrieval (MAGMaR). In this shared task participants submitted systems focused on either (i) video retrieval or (ii) grounded generation of articles given retrieved videos. Teams could submit to either task. For the retrieval task, we had 2 participating teams that submitted a total of 17 systems – all of which beat a baseline derived from the winner of last year's shared task. On the generation side, we had 4 teams submit 16 systems. All teams had at least one generated report that was labeled the best by a human annotator.

18.
bioRxiv (Bioinfo) 2026-06-19

Tox21mer, A transformer foundation model for Tox21 high-throughput concentration-response curves data

The U.S. Tox21 collaboration has generated a large reference library of high-throughput concentration-response assays. Here we present Tox21mer, a 43.5-million-parameter transformer that encodes each Tox21 concentration-response curve together with assay metadata into a 768-dimensional representation. Tox21mer was pretrained on ~2.5 million curves from 102 assay protocols and 6,727 compounds using masked-response reconstruction as the primary objective, with low-weight auxiliary supervision on assay outcome and AC50. To evaluate the learned representation, we trained lightweight probes on frozen embeddings from concentration-response curves of held-out compounds. The representation supported a macro-F1 of 0.985 for three-class outcome prediction (agonist, antagonist, inactive), a binary F1 of 0.994 for active/inactive prediction, and an R2 of 0.87 for log10(AC50). The learned embeddings formed coherent groupings by curve-class category. A masked-only pretraining variant retained near-baseline probe performance, indicating that the representation is learned largely from the self-supervised objective rather than from auxiliary labels. Ablation analyses further showed that predictive performance depends mainly on curve-level response-value distributions conditioned on assay context, with limited reliance on detailed within-curve ordering. Tox21mer thus provides a reusable foundation representation for Tox21 concentration-response data that can support extrapolation to untested compounds through integration with chemical features or distillation into chemistry-only student models for large-scale external screening.

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

Position: Stop Anthropomorphizing Intermediate Tokens as Reasoning/Thinking Traces!

arXiv:2504.09762v4 Announce Type: replace Abstract: Intermediate token generation (ITG), where a model produces output before the solution, has become a standard method to improve the performance of language models on reasoning tasks. These intermediate tokens have been called \say{reasoning traces} or even \say{thinking traces} – implicitly anthropomorphizing the traces, and implying that these traces resemble steps a human might take when solving a challenging problem, and as such can provide an interpretable window into the operation of the model's thinking process to the end user. In this position paper, we present evidence that this anthropomorphization isn't a harmless metaphor, and instead is quite dangerous – it confuses the nature of these models and how to use them effectively, and leads to questionable research. We call on the community to avoid such anthropomorphization of intermediate tokens.

20.
arXiv (CS.LG) 2026-06-12

Realistic noise synthesis reduces bias and improves tissue microstructure estimation with supervised machine learning

arXiv:2606.02044v2 Announce Type: replace Abstract: Diffusion MRI enables non-invasive probing of tissue microstructure, but accurate parameter estimation is challenged by noise-related effects. In supervised machine learning frameworks trained on simulated data, discrepancies between the noise characteristics of simulated and acquired signals introduce a form of covariate shift, whereby the input signal distribution differs between training and inference. We investigated the impact of this mismatch on microstructure parameter estimation and propose a realistic noise synthesis (RNS) framework to mitigate it. RNS incorporates both the Rician expectation and the effective post-processing noise variance into simulated training signals. The Rician expectation was modelled using a noise standard deviation estimated with MPPCA, while the effective standard deviation was derived from spherical harmonic residuals of preprocessed data. The method was evaluated using the cylinder-zeppelin and the SANDI models on simulated datasets across multiple SNR levels and on in vivo diffusion data with repeated acquisitions. Sensitivity to noise misestimation was also assessed. Ignoring magnitude-induced noise effects during training produced systematic, SNR-dependent parameter bias, particularly at low SNR. Incorporating the Rician expectation substantially reduced bias to the level of noise-aware nonlinear least-squares fitting. Modelling the effective standard deviation further improved precision. Performance was largely independent of regression architecture but sensitive to accurate noise estimation. These findings demonstrate that realistic noise modelling in simulated training data mitigates signal-domain covariate shift and is essential for unbiased supervised microstructure estimation, particularly in low-SNR regimes associated with high b-values or high spatial resolution.

21.
medRxiv (Medicine) 2026-06-15

Repurposing cardiovascular disease risk models to predict incident and co-occurring cardiovascular, cardiometabolic and neurocognitive outcomes.

Background: Cardiovascular disease (CVD), cardiometabolic and neurocognitive conditions share risk factors and frequently co-occur. We evaluated whether four established CVD risk prediction models (QRISK3, PCE, SCORE2, SCORE2-OP) can be repurposed to predict 10-year risk of these conditions and their co-occurrence with CVD. Methods: The models were recalibrated using 20% of the UK Biobank (UKB) and evaluated in the remaining 80%. We performed external validation using data from Clinical Practice Research Datalink (CPRD) Aurum, assessing model discrimination (c-statistics) and calibration (intercept and slope). We used permuted feature importance to determine the influence of each individual predictor in the models. Results: Depending on the model, the c-statistics for incident CVD ranged from 0.71 to 0.74 in the UKB test set (16,137 events). Discrimination was equal to or higher than CVD when evaluated against non-traditional CVD outcomes: 0.74 to 0.77 for heart failure (3,471 events), 0.72 to 0.73 for atrial fibrillation (9,213 events), 0.73 to 0.75 for peripheral arterial disease (1,927 events) and 0.80 to 0.82 for abdominal aortic aneurysm (595 events). For the multimorbidity endpoints, model discrimination ranged from 0.74 for the composite of CVD and T2DM (SCORE2-OP) to 0.83 for the composite of CVD and dementia or Parkinson's disease (QRISK3). When considering the onset of any cardiovascular, cardiometabolic, or neurocognitive outcome discrimination ranged from 0.71 to 0.72. The repurposed models slightly underestimated the predicted risk in the CPRD compared to the UKB: average difference in calibration intercept was at most -0.64. After age and sex, smoking status and systolic blood pressure contributed most to model predictions. Conclusions: Repurposed CVD models can be used to identify 10-year risk of many CVD-related conditions and their multimorbidity. These may be used to support risk-based approaches to prevention and screening. The repurposed models have been made available at: https://repurposed-cvd-risk-models.shinyapps.io/cvd_cmd_dementia_app/ Keywords: Risk prediction; cardiovascular disease; cardiometabolic disease; dementia; disease prevention.

22.
arXiv (CS.CL) 2026-06-11

Language Shapes Mental Health Evaluations in Large Language Models

Multilingual large language models (LLMs) are increasingly used in socially sensitive mental health contexts, including support chatbots, screening, and content moderation. This raises a reliability question: do semantically equivalent mental health inputs elicit comparable evaluations across languages, or systematic shifts consistent with language-associated social and cultural contexts? We examine this question in an English-Chinese setting with GPT-4o and Qwen3-32B using a two-level framework: construct-level evaluative orientation, measured by psychometric stigma instruments, and decision-level behavior, measured by binary stigma detection and four-class depression severity classification. Across instruments and models, Chinese prompts elicit higher stigma-related scores than English prompts. At the decision level, Chinese prompts reduce sensitivity to stigmatizing content and produce more conservative depression severity judgments, leading to more under-estimation errors. These findings show that prompt language can shift both evaluative orientation and downstream behavior in LLM-based mental health evaluation. They highlight the need to evaluate multilingual LLMs not only for aggregate performance, but also for whether they apply comparable evaluative standards across languages in socially sensitive domains.

23.
medRxiv (Medicine) 2026-06-13

Projected population level impact and cost-effectiveness of clinic and community-based tuberculosis screening approaches

The South Africa National Department of Health have set ambitious targets to scale up TB testing, focusing primarily on clinic attendees. In the context of declining funding for TB care and prevention, the most cost-effective approaches for targeting testing should be identified. We developed a mathematical model of TB in South Africa, explicitly incorporating clinic attendance by sex and HIV/ART status. We simulated six screening approaches over 2026-2035 (individually and in combination): three clinic-based (symptom screening, intensified targeted universal TB testing [TUTT, symptom-agnostic sputum testing of clinic attendees in key risk groups], and intensified TUTT allowing saliva samples) and three targeted community-based (community radiographic screening, symptom screening, and universal Xpert Ultra testing), each implemented at a range of coverage levels. Model outputs were combined with a mechanistic cost function to estimate potential impact and cost-effectiveness from a societal perspective. The most cost-effective standalone approach was community radiographic screening at 10% annual population coverage, with an incremental cost-effectiveness ratio (ICER) of $421 per disability-adjusted life year (DALY) averted. 10/11 scenarios along the expansion path included community radiographic screening at progressively higher coverage, combined with a clinic-based approach. Combining complementary approaches to reach both groups at increased risk of TB (e.g. clinic-based screening) and groups with lower screening coverage (e.g. community-based screening) may increase cost-effectiveness of TB screening, compared to standalone approaches. When designing TB screening strategies, both population risk and existing screening coverage should be considered.

24.
arXiv (CS.LG) 2026-06-19

PU-UNet: Stable Multiplicative Interactions for Medical Image Segmentation

arXiv:2606.20035v1 Announce Type: cross Abstract: Many dense prediction networks rely on additive feature transformations and model higher-order feature interactions only implicitly. Product units provide an explicit mechanism for multiplicative feature modeling, but their logarithmic–exponential formulation can cause numerical instability, which has limited their use in deep dense prediction networks. In this work, we propose Product-Unit U-Net (PU-UNet), a residual U-Net that integrates stable product-unit residual blocks into rich low-resolution stages for medical image segmentation. The proposed formulation combines smooth positivity mapping with log-domain clipping, enabling stable multiplicative feature learning with negligible computational overhead. On ISIC 2018, Kvasir-SEG, and BUSI, PU-UNet achieves Dice scores of 0.942, 0.959, and up to 0.925, respectively. Compared with a matched Residual U-Net baseline, PU-UNet consistently improves Dice and IoU while keeping parameters, FLOPs, and inference latency nearly unchanged, and reduces the image-level false-positive rate on normal BUSI cases from 0.077 to zero. Ablation studies suggest that the gains are associated with product-unit interactions, are strongest under low-resolution placement, and benefit from the proposed stabilization design. These results suggest that stable product-unit residual learning can be an effective way to enhance U-Net-style segmentation networks with explicit multiplicative interactions.

25.
medRxiv (Medicine) 2026-06-17

High burden of subclinical TB in Africa revealed from a postmortem cohort.

Tuberculosis (TB) is increasingly recognised as a spectrum of infection and disease, yet the prevalence of viable, asymptomatic Mycobacterium tuberculosis (M.tb) infection remains uncertain. Subclinical Tuberculosis (scTB), defined as microbiologically confirmed M.tb infection in the absence of recognised symptoms, is under detected by symptom, sputum and imaging-based approaches. We conducted postmortem examinations of 94 adults who died from non-infectious causes, none of whom were clinically suspected of TB or reported TB related symptoms prior to death. Lung and extrapulmonary tissues were cultured for M.tb. Viable M.tb was confirmed in six individuals, corresponding to a prevalence of 6.4% (95% CI: 2.4 to 13.4%). These findings provide direct tissue-based evidence that viable, asymptomatic M.tb infection can persist beyond the reach of conventional clinical detection. Our data suggest that a biologically active reservoir of infection may exist undetected within high-burden settings, with implications for surveillance strategies aimed at TB elimination.