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01.
arXiv (CS.CV) 2026-06-15

What Drives Test-Time Adaptation for CLIP? A Controlled Empirical Study from an Update Perspective

Vision-Language Models (VLMs) such as CLIP have become a standard backbone for open-vocabulary recognition, yet their zero-shot predictions remain vulnerable to distribution shifts encountered at deployment. Test-Time Adaptation (TTA) has recently been extended to CLIP as a lightweight solution, leading to a rapidly growing body of TTA4CLIP methods. However, empirical progress in this area has largely outpaced our understanding of what truly drives adaptation, where their gains originate, and under which shifts they remain reliable. In this paper, we take a step back from the pursuit of state-of-the-art accuracy and conduct a systematic controlled study of TTA4CLIP. We first organize existing methods into three unified paradigms according to what is updated at test time. We then introduce TTABC, an open-source TTA Benchmark for CLIP, which standardizes evaluation protocols and integrates more than 20 representative methods. Our controlled empirical analysis focuses on three key areas. First, we determine the driving factors in parameter-based methods, revealing that adaptation gains are primarily driven by test-time evidence and reliable proxies rather than heavy optimization. Second, we explore evidence utilization beyond heavy parameter tuning, showing that competitive and efficient performance can be achieved through cross- or current-sample evidence and lightweight prototype updates. Finally, we demonstrate that there is no silver bullet for TTA: no single adaptation paradigm is universally optimal, and the preferred paradigm depends on the nature of shift. We hope our benchmark and study provide a clearer understanding of the current TTA4CLIP landscape and establish a foundation for further research.

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

When the Past Matters: FlashBack Memory for Precipitation Nowcasting

Accurate precipitation nowcasting is crucial for disaster mitigation and socio-economic planning, yet existing methods often struggle with false alarms, missed events, and long range dependency modeling at high spatiotemporal resolution. To address these challenges, we propose FlashBack Memory (FB), a module that dynamically retrieves key historical states and integrates them via an adaptive fusion gate, enhancing the spatiotemporal representation capability of recurrent-based models. We incorporate FB into PredRNN, PredRNNpp, MIM, MotionRNN, and PredRNN-V2, and evaluate on CIKM2017, Shanghai2020, and SEVIR datasets. Experimental results demonstrate that FB significantly improves MSE, MAE, SSIM, and CSI metrics, particularly for high-intensity rainfall and long-sequence predictions, while reducing false alarms and missed events and enhancing temporal consistency and spatial localization. The proposed method provides a general and efficient memory enhancement mechanism, improving the overall performance of recurrent-based precipitation nowcasting models.

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

Agentic Reinforcement Learning for Search Misaligns Instruction-Tuning

Agentic reinforcement learning (RL) trains large language models to use tools, but its impact on alignment is poorly understood. We study how agentic RL for search affects the alignment of instruction-tuned (IT) models. We find that RL-trained models inherit refusal reasoning by deflecting harmful requests into benign search queries, but this breaks down under a simple diagnostic trigger that elicits a search call before refusal can occur. Under this condition, RL models produce multi-step unsafe search actions and reasoning, reducing search query safety by up to 68.6% in Qwen and Llama models relative to their IT counterparts. The effect generalises across model families, scales, and RL algorithms. To understand why, we identify linear directions in the residual stream that control search query safety, and show that RL training progressively shifts search behaviour toward the harmful end of this direction. We thus propose representation-guided RL training, which adds a reward penalty based on projection toward the harmful search direction. Training on benign data alone, it restores IT-level alignment without reducing task accuracy and requires no additional training data. Together, our work provides the first framework for diagnosing, mechanistically analysing, and mitigating alignment degradation in agentic RL for search.

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

Attention-Based Prototype Calibration for Multi-Rater Few-Shot Medical Image Segmentation

Few-shot medical image segmentation methods typically assume a single ground-truth annotation, overlooking systematic variability across expert raters commonly observed in clinical datasets. We propose an attention-based prototype calibration framework for few-shot multi-rater segmentation that models rater-specific deviations from a consensus representation in prototype space. A lightweight yet principled attention operator directly refines rater prototypes without modifying the backbone feature extractor, making the approach fully compatible with existing prototype-based few-shot segmentation methods. This design preserves semantic consistency while enabling personalized segmentation outputs with minimal computational overhead. Experiments on multi-rater medical imaging datasets demonstrate consistent improvements over baseline prototype approaches, highlighting the effectiveness of structured prototype calibration for modeling annotation variability. Our code is available at https://github.com/truong2710-cyber/JAPC.

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

Progressive Alignment Objectives for Aligner-Encoder based ASR

Aligner-Encoders are recently proposed seq2seq end-to-end ASR models that replace decoder attention by predicting the uth token directly from the u-th encoder position, so the encoder must learn the alignment internally without cross-attention or a transducer lattice. In practice, this alignment often forms abruptly in the upper layers, making training sensitive and brittle on long utterances. We propose InterAligner, which adds an intermediate Aligner objective so alignment can form progressively across depth, together with an intermediate CTC loss (InterCTC) to stabilize optimization. On LibriSpeech with a 17-layer Conformer, a final-only Aligner reaches 5.0/7.8 WER (test-clean/other). InterCTC improves to 3.4/6.0, and InterAligner further reduces WER to 3.1/5.6 with the largest gains on long utterances.

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

Inference-time Policy Steering via Vision and Touch

arXiv:2606.14981v1 Announce Type: cross Abstract: Inference-time steering adapts pre-trained generative robot policies during deployment by verifying candidate actions before execution. While prior methods typically perform this verification only with visual observations, vision alone is often insufficient for contact-rich manipulation, where success depends on both global task progress and subtle local interactions such as contact force. We introduce ViTaL, a visuo-tactile inference-time steering framework that formulates multimodal guidance as a bi-level optimization problem. At the high level, visual sampling-and-verification performs long-horizon mode selection, deciding what behavior the robot should execute. At the low level, tactile-guided diffusion editing refines the selected action sequence over a shorter horizon to satisfy local contact requirements. To support outcome-based steering, ViTaL learns a visuo-tactile latent world model and employs semantically aligned visual and tactile verifiers, including a novel text-conditioned tactile reward that scores predicted tactile futures directly in latent space. Across three real-world contact-rich manipulation tasks, ViTaL improves overall success by 51% over the base policy, outperforms unimodal steering by at least 33%, and exceeds naive multimodal fusion by at least 20%. Website: https://yilin-wu98.github.io/vital_website.

08.
arXiv (CS.CL) 2026-06-17

Translating the Untranslatable: An Operationalizable Ontology for Untranslatability

Untranslatability, cases where meaning cannot be directly preserved across languages, is well-studied in linguistics but underexplored in NLP. As machine translation (MT) systems improve on standard benchmarks, their limitations increasingly concentrate in such cases, where translation cannot be reduced to one-to-one equivalence. We introduce a structured ontology of untranslatability along with a taxonomy of compensation strategies, which are specific techniques to convey meaning under these untranslatable circumstances. We operationalize this framework into a multilingual dataset of untranslatable sentences paired with strategy-based translations, enabling controlled analysis of translation behavior. Initial human preference studies suggest that translation quality depends on the strategy used, with consistent preferences for outputs that include explanatory context, known as the Annotation compensation strategy. Our framework and dataset provide a foundation for studying and modeling strategy-informed machine translation.

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

FasterPy: An LLM-based Code Execution Efficiency Optimization Framework

arXiv:2512.22827v2 Announce Type: replace-cross Abstract: Code often suffers from performance bugs. These bugs necessitate the research and practice of code optimization. Traditional rule-based methods rely on manually designing and maintaining rules for specific performance bugs (e.g., redundant loops, repeated computations), making them labor-intensive and limited in applicability. In recent years, machine learning and deep learning-based methods have emerged as promising alternatives by learning optimization heuristics from annotated code corpora and performance measurements. However, these approaches usually depend on specific program representations and meticulously crafted training datasets, making them costly to develop and difficult to scale. With the booming of Large Language Models (LLMs), their remarkable capabilities in code generation have opened new avenues for automated code optimization. In this work, we proposed FasterPy, a low-cost and efficient framework that adapts LLMs to optimize the execution efficiency of Python code. FasterPy combines Retrieval-Augmented Generation (RAG), supported by a knowledge base constructed from existing performance-improving code pairs and corresponding performance measurements, with Low-Rank Adaptation (LoRA) to enhance code optimization performance. Our experimental results on the Performance Improving Code Edits (PIE) benchmark demonstrate that our method outperforms existing models on multiple metrics. The FasterPy tool and the experimental results are available at https://github.com/WuYue22/fasterpy.

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

FALCON: Transforming Cyber Threat Intelligence into Deployable IDS Rules with Self-Reflection

Signature-based Intrusion Detection Systems (IDS) detect malicious activity by matching network or host events against predefined rules. Security analysts manually develop these rules from Cyber Threat Intelligence (CTI). As threats evolve, this manual pipeline faces two bottlenecks. Before authoring a new rule, an analyst must reconcile the incoming CTI with the existing rule base and determine whether to create, update, or retire one. This process is challenging due to the representational differences between the CTI and Rule formats. This gap limits the effectiveness of keyword- and embedding-based search, making rule reconciliation cognitively demanding and, in turn, contributing to "rule bloat". Second, automated verification of a new rule is inherently difficult as zero-day threats lack ground truth from simulated testing. Hence, standard metrics cannot prove that a rule semantically adheres to the CTI, and the use of LLMs leads to non-deterministic behavior. To address these challenges, we introduce FALCON, an agentic framework for CTI-grounded rule retrieval, generation, and validation. At its core, a novel CTI-Rule semantic scorer, quantifies the functional alignment between a CTI and a rule; the same signal drives a retriever that surfaces relevant deployed rules and a ground-truth-free validator that scores generated ones. Around it, a generation pipeline produces deployable rules from CTI in real time and refines them through self-reflective syntactic, semantic, and performance validators. Across network (Snort) and host-based (YARA) platforms on a purpose-built CTI-Rule dataset, FALCON attains a mean relevance of 0.72 (approx), with 84% inter-rater agreement among cybersecurity analysts, underscoring the promise of real-time security automation.

13.
medRxiv (Medicine) 2026-06-18

Artificial Intelligence-informed mobile behavioural interventions to support adolescents mental health in schools: protocol for a randomised controlled trial using the MindCraft app

Background: Children and young people (CYP) are particularly affected by mental health problems. Mobile apps provide a scalable and accessible approach to adolescent mental health support, and schools are well-positioned to address multiple risk factors and deliver large-scale interventions. By combining active (self-reported) and passive (sensor-derived) data, mobile apps can model mental states and deliver context-aware support. Artificial Intelligence (AI) enables adaptive, context-aware recommendations tailored to each user. However, there is limited research on AI-based mental health interventions in community CYP. MindCraft is a mobile app designed to monitor adolescents mental health using active and passive data and provide AI-informed recommendations ("nudges"). This study aims to investigate the effectiveness of personalised AI nudges delivered through MindCraft on improving mental health outcomes among adolescents in schools in the United Kingdom. Methods: The study is a three-arm RCT using a prospective cohort of secondary school students aged 14-19. Following informed consent, participants complete a baseline online assessment at school and download MindCraft. The primary outcome is the Strengths and Difficulties Questionnaire global and subscale scores. Secondary outcomes include the Eating Disorders Diagnostic Scale, the Sleep Condition Indicator Questionnaire, the Self-Injurious Thoughts and Behaviours Interview, the Self-Efficacy Questionnaire for Children and the World Health Organisation-Five Well-Being Index. Participants are randomised to: (1) an AI-informed intervention group receiving personalised nudges, (2) an active control receiving non-personalised nudges, or (3) a control group with self-monitoring only. Participants use the app for four weeks, with follow-up at one month. Repeated-measures analyses will assess changes across time points. Discussion: We hypothesise that AI nudges will have a greater positive effect on mental health outcomes at one month than general nudges and self-monitoring. Our findings will provide key evidence on the effectiveness of personalised mobile AI recommendations for adolescents mental health and inform school-based mental health prevention and early intervention. This study will contribute evidence on the ethical, acceptable, and scalable integration of AI-enabled digital mental health tools within public health and educational systems, with implications for the design of future digital public health interventions and policies supporting their safe integration in schools.

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

Agentic AI-based Framework for Mitigating Premature Diagnostic Handoff and Silent Hallucination in Healthcare Applications

arXiv:2606.18068v1 Announce Type: new Abstract: Recent advances in Large Language Models (LLMs) and multi-agent systems have driven the rise of Agentic AI, showing promise for medical reasoning. However, open-ended conversational agents remain prone to two critical failure modes: premature diagnostic handoff and silent clinical hallucinations that may go undetected before reaching the patient. In this work, we propose a multi-agent framework that addresses both issues by replacing ``LLM-as-a-judge'' routing with deterministic orchestration constraints. The framework incorporates two safety mechanisms. First, a neuro-symbolic state-tracking gate enforces completeness of the OLDCARTS clinical protocol (Onset, Location, Duration, Character, Aggravating/Alleviating factors, Radiation, Timing, and Severity) by blocking diagnostic transitions until all required dimensions are collected. Second, an epistemic uncertainty quantification (UQ) gate computes semantic entropy (H) across K=5 independent diagnostic samples to identify and intercept divergent outputs before delivery. We evaluate the system using simulated patient agents powered by the llama-3.1-70b-instruct model on 150 test cases. The full architecture achieves 49.3% diagnostic precision, representing an absolute improvement of 11.3 percentage points over an unconstrained baseline. Additionally, we observe a statistically significant negative correlation (r = -0.181, p < 0.05) between OLDCARTS completeness (\sigma) and semantic entropy (H), suggesting that structured information gathering is associated with reduced diagnostic uncertainty.

15.
arXiv (quant-ph) 2026-06-17

Optimal Calibration of Quantum Network Links

arXiv:2606.18167v1 Announce Type: new Abstract: The reliable distribution of entanglement is essential for the effective operation of quantum networks. Due to fundamental differences between quantum and classical communication systems, it is necessary to develop specialised algorithms and protocols that also account for quantum-specific constraints. In this work, we focus on the issue of recalibration. As suggested by recent experimental studies, the process of local entanglement generation in a quantum link degrades over time due to environmental changes that have to be estimated and compensated via a calibration operation, during which the link is not available. Therefore, in such a quantum network, every link alternates between an activation period, during which it operates normally, and a calibration period, during which it cannot participate in the end-to-end entanglement distribution, thereby creating a trade-off between link quality (the fidelity of generated pairs, which decays during activation) and availability (the fraction of time the link is usable, which calibration reduces). We develop analytically a protocol for optimally assigning activation periods to each link in linear quantum repeater chains, subject to any general end-to-end fidelity requirements and local initial fidelity thresholds. Building on this foundation, we extend to general quantum networks, where multiple paths may cross at common links, proposing a heuristic approach evaluated in simulations and compared with a benchmark, numerical approach, and theoretical bounds.

16.
medRxiv (Medicine) 2026-06-19

Extraction of Glaucoma Diagnosis, Type, and Severity from Clinical Notes using Secure Cloud-based Large Language Models

Purpose: To evaluate the performance of secure cloud-based large language models (LLMs) in extracting glaucoma diagnosis, type, and severity from free-text clinical notes in the electronic health record (EHR). Design: Retrospective chart review analysis. Participants: 1,250 subjects from the Bascom Palmer Ophthalmic Repository. Methods: Clinical notes of glaucoma-related encounters between 2014 and 2024 were extracted from the Bascom Palmer Ophthalmic Repository. Two fellowship-trained glaucoma specialists annotated clinical notes for glaucoma presence, type, and severity at the eye level. The dataset was split into development (10%), validation (10%), and test (80%) sets. Development and validation sets were used for prompt engineering and refinement, and the held-out test set was used for evaluation. Five LLMs (Claude Opus 4.6, DeepSeek-V3.2, GPT-5.2, Grok 4.1, and Qwen3.6-35B-A3B) were accessed via Azure AI Foundry within HIPAA-compliant containers. Model performance was assessed using standard metrics. Clinician-entered ICD-10 codes were also compared with adjudicated labels. Main Outcome Measures: Gwet AC1, accuracy, sensitivity, specificity, and F1-score. Results: Inter-grader agreement was high for glaucoma detection (Gwet AC1= 0.930 (95% CI: 0.917-0.945), type classification (Gwet AC1= 0.917 (95% CI: 0.904-0.930), and severity staging (Gwet AC1= 0.901 (95% CI: 0.884-0.916). For glaucoma diagnosis, LLMs demonstrated high overall accuracy, with Claude achieving 97.5%, DeepSeek 96.0%, GPT 96.2%, Grok 94.4%, and Qwen 95.5%. F1 scores for glaucoma detection ranged from 95.4% to 98.9% across models. For glaucoma type classification, accuracies were 97.1%, 94.2%, 94.2%, 94.0%, and 94.4% for Claude, DeepSeek, GPT, Grok, and Qwen, respectively. F1 scores for the most prevalent type (POAG) ranged from 96.3% to 98.9%. For severity staging, accuracies were 95.0%, 94.8%, 94.5%, 94.0%, and 95.2%, respectively, with F1 scores ranging from 89.7% to 96.3% across severity categories and models. ICD-10 codes demonstrated substantially lower performance for type and severity staging, with overall accuracies of 89.2% and 58.5%, respectively. Conclusions: Secure cloud-based LLMs accurately extracted glaucoma diagnosis, type, and severity information from free-text ophthalmology notes, achieving performance approaching expert clinician adjudication while substantially outperforming ICD-based phenotyping approaches, particularly for disease severity classification. These findings demonstrate the potential of LLMs to transform unstructured clinical documentation into scalable, research-ready phenotypic data for large-scale glaucoma cohort development and EHR-based ophthalmic research.

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

Dual-Granularity Orthogonal Disentanglement for Generalizable Audio Deepfake Detection

arXiv:2606.16532v1 Announce Type: cross Abstract: Audio deepfake detectors often fail to generalize across speakers, as they learn speaker-identity features rather than synthesis artifacts, known as implicit identity leakage. Existing methods address this but incur architectural complexity or training instability. This paper proposes a dual-granularity orthogonal disentanglement framework enforcing feature independence at two levels: sample-level cosine orthogonality captures directional decorrelation, while batch-level cross-covariance regularization eliminates linear correlations across embedding dimensions. A curriculum disentanglement schedule progressively strengthens the orthogonality constraint without auxiliary networks or adversarial dynamics. Experiments on ASVspoof 2019 LA, ASVspoof 2021 DF, and In-the-Wild datasets demonstrate that the proposed method achieves 1.35%, 7.88%, and 21.58% equal error rates (EER), respectively, surpassing gradient reversal disentanglement by 2.60% absolute on cross-dataset transfer.

18.
arXiv (CS.CL) 2026-06-24

Aspect-Based Sentiment Evolution and its Correlation with Review Rounds in Multi-Round Peer Reviews: A Deep Learning Approach

Mining sentiment information from the textual content of peer review comments offers valuable insights into the scientific evaluation process. However, previous studies are often constrained by coarse-grained analysis and the lack of differentiation across review rounds. Notably, the dynamic shifts in reviewers' focus and sentiment tendencies throughout multiple review stages remain underexplored. To address this gap, the present study investigates the distribution and evolution of aspect-level sentiments and examines their correlation with the number of review rounds. We begin by segmenting the multi-round review comments of 11,063 accepted papers from Nature Communications and identifying fine-grained review aspect clusters. A manually annotated corpus of approximately 5,000 review sentences is then constructed. Using this dataset, we train a series of deep learning-based aspect sentiment classification models. Among them, the LCF-BERT-CDM model achieves the best performance, with a Macro-F1 score of 82.65%. Subsequent statistical analysis reveals a consistent trend: as the number of review rounds increases, the proportion of positive sentiments rises, while negative sentiments decline. Correlation analysis further indicates that aspect sentiment scores are negatively associated with the total number of review rounds. Key aspects exhibiting stronger correlations include "experiments", "research significance" and "result analysis".

19.
medRxiv (Medicine) 2026-06-23

Estimating vaccine-prevented disease outcomes when vaccination has only direct effects

Vaccination can be a useful intervention for reducing infectious disease burden. Estimating numbers of vaccine-prevented health outcomes is one approach to quantifying the benefits of vaccination. Here we improve a method described by Foppa et al. (1) that assumes vaccination has only direct effects, that is, it cannot prevent infection or onward transmission of the disease. We rederive this method and derive an improved method that increases estimation accuracy with minimal additional analytical complexity. To evaluate the improved method, we simulated disease outbreaks and compared the accuracy of the two methods for estimating prevented disease outcomes. In 84% of simulations performed over a wide parameter space, the improved method had an equal or smaller estimation error compared to the original Foppa method, with 7.9-fold smaller mean error and 44-fold smaller standard deviation of errors. Our study improves a method for estimating prevented burden when assuming vaccination has only direct effects.

20.
arXiv (CS.CV) 2026-06-19

Rethinking Robust Adversarial Concept Erasure in Diffusion Models

Concept erasure aims to selectively unlearning undesirable content in diffusion models (DMs) to reduce the risk of sensitive content generation. As a novel paradigm in concept erasure, most existing methods employ adversarial training to identify and suppress target concepts, thus reducing the likelihood of sensitive outputs. However, these methods often neglect the specificity of adversarial training in DMs, resulting in only partial mitigation. In this work, we investigate and quantify this specificity from the perspective of concept space, i.e., can adversarial samples truly fit the target concept space? We observe that existing methods neglect the role of conceptual semantics when generating adversarial samples, resulting in ineffective fitting of concept spaces. This oversight leads to the following issues: 1) when there are few adversarial samples, they fail to comprehensively cover the object concept; 2) conversely, they will disrupt other target concept spaces. Motivated by the analysis of these findings, we introduce S-GRACE (Semantics-Guided Robust Adversarial Concept Erasure), which grace leveraging semantic guidance within the concept space to generate adversarial samples and perform erasure training. Experiments conducted with seven state-of-the-art methods and three adversarial prompt generation strategies across various DM unlearning scenarios demonstrate that S-GRACE significantly improves erasure performance 26%, better preserves non-target concepts, and reduces training time by 90%. Our code is available at https://github.com/Qhong-522/S-GRACE.

21.
arXiv (CS.LG) 2026-06-16

Communication-Efficient Distributed Training for Collaborative Flat Optima Recovery in Deep Learning

arXiv:2507.20424v3 Announce Type: replace Abstract: We study centralized distributed data parallel training of deep neural networks (DNNs), aiming to improve the trade-off between communication efficiency and model performance of the local gradient methods. To this end, we revisit the flat-minima hypothesis, which suggests that models with better generalization tend to lie in flatter regions of the loss landscape. We introduce a simple, yet effective, sharpness measure, Inverse Mean Valley, and demonstrate its strong correlation with the generalization gap of DNNs. We incorporate an efficient relaxation of this measure into the distributed training objective as a lightweight regularizer that encourages workers to collaboratively seek wide minima. The regularizer exerts a pushing force that counteracts the consensus step pulling the workers together, giving rise to the Distributed Pull-Push Force (DPPF) algorithm. Empirically, we show that DPPF outperforms other communication-efficient approaches and achieves better generalization performance than local gradient methods and synchronous gradient averaging, while maintaining communication efficiency. In addition, our loss landscape visualizations confirm the ability of DPPF to locate flatter minima. On the theoretical side, we show that DPPF guides workers to span flat valleys, with the final valley width governed by the interplay between push and pull strengths, and that its pull-push dynamics is self-stabilizing. We further provide generalization guarantees linked to the valley width and prove convergence in the non-convex setting.

22.
arXiv (CS.AI) 2026-06-12

M*: A Modular, Extensible, Serving System for Multimodal Models

arXiv:2606.12688v1 Announce Type: cross Abstract: We are entering a new era of composite model architectures that integrate diverse components such as vision encoders, language backbones, diffusion and flow heads, audio codecs, action generators, and world-model predictors. Such architectures underpin a broad class of multimodal models, including unified multimodal models, omni models, speech-language models, vision-language-action policies, and world models. However, existing model serving frameworks were built on narrow assumptions about model structure, making them ill-suited to accommodate this new architectural diversity. Here we present M*, a universal serving system for efficient serving of composite AI models. M* represents models as dataflow graphs, processing requests spanning diverse modalities and tasks as traversals over these graphs. The core insight is a modular abstraction that supports arbitrary composition of model components, flexible placement onto a physical cluster, and model-agnostic optimizations within a distributed runtime. We call this abstraction the Walk Graph and show how it can concisely capture composite models from a broad range of families. We instantiate M* on representative models and find that it achieves, on average, 20% lower end-to-end latency than vLLM-Omni for text-to-image workloads on BAGEL, while delivering up to 2.9x lower real-time factor and 2.7x higher throughput for text-to-speech workloads on Qwen3-Omni. M* also outperforms the V-JEPA 2-AC rollout baseline for robotic planning by up to 12.5x. Thus, our work paves the road towards more efficient serving of complex models with minimal developer effort.

23.
medRxiv (Medicine) 2026-06-18

Development and Initial Validation of the Quality of life Evaluation in NF2-related Schwannomatosis Trials (QUEST) Assessment

Individuals with NF2-related schwannomatosis (NF2-SWN) experience a complex constellation of physical, emotional, and social symptoms that substantially impact quality of life (QoL). Although disease-specific patient-reported outcome measures are increasingly important for evaluating treatment benefit in clinical trials, existing NF2-SWN QoL measures have limitations in content coverage and sensitivity to change. This study describes the development and initial validation a new disease-specific QoL assessment – the Quality of Life Evaluation in NF2-related Schwannomatosis Trials (QUEST). Using a three-phase, mixed-methods approach, items were generated through concept elicitation interviews with individuals with NF2-SWN and clinicians, prioritized via patient survey data, and refined through iterative cognitive debriefing procedures. The resulting 21-item QUEST assesses the extent to which NF2-SWN has negatively impacted a persons daily life over the past seven days. Initial psychometric evaluation was conducted in an international sample of 174 individuals with NF2-SWN aged 15 years and older (117 women (67%), 158 White individuals (89%)). Exploratory factor analysis supported a four-factor structure, and the total score demonstrated excellent internal consistency and strong test-retest reliability. Evidence of construct validity was demonstrated through hypothesized associations with disease-specific, generic, and domain-specific QoL measures, as well as known-groups validity based on self-reported disease severity and number of prior surgeries. Incremental validity analyses indicated that QUEST explained unique variance beyond existing measures. Together, findings support the QUEST as a reliable and valid disease-specific QoL measure with strong content validity and feasibility for use as a clinical trial endpoint in NF2-SWN.

24.
arXiv (CS.CV) 2026-06-17

Enhancing Pathological VLMs with Cross-scale Reasoning

Pathological images are inherently multi-scale, requiring pathologists to integrate evidence from global tissue architecture at low magnification to cellular morphology at higher magnification for accurate diagnosis. While existing pathological datasets for vision-language model (VLM) include various scales, they often lack an explicit cross-scale reasoning objective. This limitation prevents VLMs from capturing essential cross-scale representations and learning evidence-based reasoning. To bridge this gap, we introduce the first cross-scale training and evaluation paradigm that formulates pathology interpretation as multi-magnification reasoning. However, creating such a task reveals a critical challenge: multi-image visual question answering (VQA) is prone to text-only shortcuts, which allow models to guess answers using magnification-dependent artifacts rather than visual evidence. To address this, we propose a leakage-aware curation pipeline that combines adversarial text-only screening with constraint-guided question design. Using this pipeline, we construct Scale-VQA, a high-quality benchmark with 4,685 multiple-choice questions grounded in 2,537 pathology images across multiple magnification levels. Finally, we present ScaleReasoner-R1, a model trained via reinforcement learning to optimize performance on the cross-scale VQA task. ScaleReasoner-R1 achieves state-of-the-art performance on our cross-scale reasoning benchmark and generalizes to SOTA performance on established single-scale benchmarks. Findings suggest that even the limited cross-scale supervision can significantly improve pathological understanding. The code and demos will be open-sourced.

25.
medRxiv (Medicine) 2026-06-15

Two Blood-based Endotypes Reveal Divergent Clinical Outcomes of Fibrotic Hypersensitivity Pneumonitis

Rationale: Fibrotic hypersensitivity pneumonitis (fHP) is an antigen-driven, life-threatening interstitial lung disease characterized by heterogeneous radiologic features, clinical outcomes, and treatment responses. Objectives: To identify blood-based fHP endotypes that inform mechanism, prognosis and therapeutic response. Methods: We performed integrative analyses of multi-compartment transcriptomic data derived from whole blood, peripheral blood mononuclear cells, bronchoalveolar lavage, and surgical lung biopsies, alongside circulating plasma proteomics. Multiple clustering algorithms were cross-compared to ensure robustness and reproducibility of endotypes identification. Immune cell composition was inferred using bulk RNA-seq deconvolution and annotated with BAL single-cell RNA-seq. Pathway activities were characterized using Gene Set Enrichment Analysis. Transplant-free survival (TFS) was evaluated for endotype and corticosteroid exposure by Kaplan-Meier methods, with hazard ratios analyzed using multivariable Cox proportional hazards models. Results: Two molecular endotypes, lymphocytic-associated (L-fHP) and non-lymphocytic-associated (N-fHP), were identified and validated. L-fHP showed enrichment of adaptive immune signaling and lymphocyte predominance, whereas N-fHP demonstrated myeloid-cell activation with neutrophil and macrophage predominance. Corticosteroid exposure was associated with worse TFS in L-fHP but not in N-fHP after adjusting for age, sex, and baseline pulmonary function. Compared to L-fHP, N-fHP had poorer baseline pulmonary function, faster 12-month FVC decline, and shorter TFS. N-fHP also exhibited elevated neutrophil-associated markers, including matrix metalloproteinase-9, across paired transcriptomic and proteomic datasets, supporting a neutrophil-driven, cross-compartment disease process. Conclusion: Multi-omic, multi-compartment analysis identifies two reproducible fHP endotypes with distinct clinical outcomes and corticosteroid responses, supporting a precision medicine approach beyond current clinical and radiologic classification.