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The Effects of Digital Health Interventions on Motor Symptoms, Nonmotor Symptoms, and Quality of Life in Patients With Parkinson Disease: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: Parkinson disease (PD) is a progressive neurodegenerative disorder with increasing global prevalence, necessitating innovative management. Digital health interventions (DHIs) offer potential advantages for PD care; yet, a comprehensive systematic review and synthesis across all DHI types and core outcomes is still lacking. Objective: This review aimed to assess the effectiveness of DHIs for improving motor symptoms, nonmotor symptoms, and quality of life in patients with PD and to summarize the reach, uptake, and feasibility. Methods: We searched PubMed, Ovid Embase, Web of Science, CINAHL, Cochrane Central Register of Controlled Trials, and APA PsycINFO up to November 2025. Pooled standardized mean differences (SMDs) were calculated using random-effects models. We calculated 95% prediction intervals (PIs) to estimate the true effects. The revised Cochrane Risk of Bias 2 tool was used to assess risk of bias. Heterogeneity was assessed using I2, Ο„2, and 95% PI. Subgroup analyses, meta-regression, and sensitivity analyses were conducted to address heterogeneity and potential bias. The quality of evidence was assessed using GRADE (Grading of Recommendations Assessment, Development, and Evaluation). Results: The review included 112 randomized controlled trials involving 5594 participants. Significant postintervention improvements were identified in motor symptoms (SMD=–0.39, 95% CI –0.60 to –0.18, 95% PI –1.75 to 0.99; I2=80.3%) and overall nonmotor symptoms (SMD=–0.26, 95% CI –0.49 to –0.03, 95% PI –0.56 to 0.03; I2=13.8%), including cognitive function (SMD=0.47, 95% CI 0.22 to 0.72, 95% PI –0.41 to 1.35; I2=63.5%) and psychiatric symptoms (SMD=–0.42, 95% CI –0.74 to –0.09, 95% PI –1.82 to –0.99; I2=85.4%); however, there was no significant enhancement in quality of life (SMD=–0.19, 95% CI –0.47 to 0.09, 95% PI –1.50 to 1.12; I2=81.2%). The certainty of evidence was very low for quality of life, motor, and psychiatric symptoms and low for cognitive function and overall nonmotor symptoms. Improvements in motor symptoms and cognitive function remained stable at follow-up. Meta-regression analysis indicated that age, percentage of female participants, and supervision mode were possible sources of heterogeneity. Overall, 94 studies reported reach (median 37.5%), 38 reported fidelity (95.7%), and 105 reported dropout rates (9.1%). Conclusions: In contrast to previous reviews focused on single technologies or outcomes, this review provided the first comprehensive synthesis across all DHI types on multiple outcomes and indicated their potential as nonpharmacological interventions for PD management. However, current evidence is of low to very low certainty, and wide 95% PIs, together with high risk of bias and substantial heterogeneity, indicate considerable uncertainty regarding the true effect in future implementations. Therefore, findings should be interpreted with caution. These findings provide integrated evidence to guide the design and prioritization of future research. The results have important real-world implications, supporting cautious implementation while underscoring the need for more robust trials, particularly in resource-limited settings. Trial Registration: PROSPERO CRD42023492123; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023492123

Automated Reinforcement Learning: An Overview

arXiv:2201.05000v2 Announce Type: replace-cross Abstract: Reinforcement Learning and, recently, Deep Reinforcement Learning are popular methods for solving sequential decision-making problems modeled as Markov Decision Processes. RL modeling of a problem and selecting algorithms and hyper-parameters require careful consideration, as different configurations may entail completely different performances. These considerations are mainly the task of RL experts; however, RL is progressively becoming popular in other fields, such as combinatorial optimization, where researchers and system designers are not necessarily RL experts. Besides, many modeling decisions are typically made manually, such as defining state and action space, size of batches, batch update frequency, and time steps. For these reasons, automating different components of RL is of great importance, and it has attracted much attention in recent years. Automated RL provides a framework in which different components of RL, including MDP modeling, algorithm selection, and hyper-parameter optimization, are modeled and defined automatically. In this article, we present the literature on automated RL (AutoRL), including the recent large language model (LLM) based techniques. We also discuss the recent work on techniques that are not presently tailored for automated RL but hold promise for future integration into AutoRL. Furthermore, we discuss the challenges, open questions, and research directions in AutoRL.

Bee: A High-Quality Corpus and Full-Stack Suite to Unlock Advanced Fully Open MLLMs

arXiv:2510.13795v4 Announce Type: replace-cross Abstract: Fully open multimodal large language models (MLLMs) currently lag behind proprietary counterparts, primarily due to a significant gap in data quality for supervised fine-tuning (SFT). Existing open-source datasets are often plagued by widespread noise and a critical deficit in complex reasoning data, such as Chain-of-Thought (CoT), which hinders the development of advanced model capabilities. Addressing these challenges, our work makes three primary contributions. First, we introduce Honey-Data-15M, a new SFT dataset comprising approximately 15 million QA pairs, processed through multiple cleaning techniques and enhanced with a novel dual-level (short and long) CoT enrichment strategy. Second, we introduce HoneyPipe, the data curation pipeline, and its underlying framework DataStudio, providing the community with a transparent and adaptable methodology for data curation that moves beyond static dataset releases. Finally, to validate our dataset and pipeline, we train Bee-8B, an 8B model on Honey-Data-15M. Experiments show that Bee-8B establishes a new state-of-the-art (SOTA) for fully open MLLMs, achieving performance that is competitive with, and in some cases surpasses, recent semi-open models such as InternVL3.5-8B. Our work delivers to the community a suite of foundational resources, including: the Honey-Data-15M corpus; the full-stack suite comprising HoneyPipe and DataStudio; training recipes; an evaluation harness; and the model weights. This effort demonstrates that a principled focus on data quality is a key pathway to developing fully open MLLMs that are highly competitive with their semi-open counterparts.

Benchmarking MLLM-based Web Understanding: Reasoning, Robustness and Safety

arXiv:2509.21782v2 Announce Type: replace Abstract: Multimodal large language models (MLLMs) are increasingly deployed as the core reasoning engine for web-facing systems, powering GUI agents and front-end automation that must interpret page structure, select actionable widgets, and execute multi-step interactions reliably. However, existing benchmarks largely emphasize visual perception or UI code generation, showing insufficient evaluation on the reasoning, robustness and safety capability required for end-to-end web applications. To bridge the gap, we introduce a comprehensive web understanding benchmark, named WebRRSBench, that jointly evaluates Reasoning, Robustness, and Safety across eight tasks, such as position relationship reasoning, color robustness, and safety critical detection, etc. The benchmark is constructed from 729 websites and contains 3799 QA pairs that probe multi-step inference over page structure, text, widgets, and safety-critical interactions. To ensure reliable measurement, we adopt standardized prompts, a protocolized and deterministic evaluation pipeline, and multi-stage quality control combining automatic checks with targeted human verification. We evaluate 11 MLLMs on WebRRSBench. The results reveal significant gaps: models still struggle with compositional and cross-element reasoning over realistic layouts, show limited robustness when facing perturbations in user interfaces and content such as layout rearrangements or visual style shifts, and are rather conservative in recognizing and avoiding safety critical or irreversible actions. Our code and appendix are available at https: //github.com/annoy-worker/WebRSSBench.

High-order Knowledge Based Network Controllability Robustness Prediction: A Hypergraph Neural Network Approach

arXiv:2603.02265v1 Announce Type: cross Abstract: In order to evaluate the invulnerability of networks against various types of attacks and provide guidance for potential performance enhancement as well as controllability maintenance, network controllability robustness (NCR) has attracted increasing attention in recent years. Traditionally, controllability robustness is determined by attack simulations, which are computationally time-consuming and only applicable to small-scale networks. Although some machine learning-based methods for predicting network controllability robustness have been proposed, they mainly focus on pairwise interactions in complex networks, and the underlying relationships between high-order structural information and controllability robustness have not been explored. In this paper, a dual hypergraph attention neural network model based on high-order knowledge (NCR-HoK) is proposed to accomplish robustness learning and controllability robustness curve prediction. Through a node feature encoder, hypergraph construction with high-order relations, and a dedicated dual hypergraph attention module, the proposed method can effectively learn three types of network information simultaneously: explicit structural information in the original graph, high-order connection information in local neighborhoods, and hidden features in the embedding space. Notably, we explore for the first time the impact of high-order knowledge on network controllability robustness. Compared with state-of-the-art methods for network robustness learning, the proposed method achieves superior performance on both synthetic and real-world networks with low computational overhead.

Channel-Adaptive Edge AI: Maximizing Inference Throughput by Adapting Computational Complexity to Channel States

arXiv:2603.03146v1 Announce Type: cross Abstract: \emph{Integrated communication and computation} (IC$^2$) has emerged as a new paradigm for enabling efficient edge inference in sixth-generation (6G) networks. However, the design of IC$^2$ technologies is hindered by the lack of a tractable theoretical framework for characterizing \emph{end-to-end} (E2E) inference performance. The metric is highly complicated as it needs to account for both channel distortion and artificial intelligence (AI) model architecture and computational complexity. In this work, we address this challenge by developing a tractable analytical model for E2E inference accuracy and leveraging it to design a \emph{channel-adaptive AI} algorithm that maximizes inference throughput, referred to as the edge processing rate (EPR), under latency and accuracy constraints. Specifically, we consider an edge inference system in which a server deploys a backbone model with early exit, which enables flexible computational complexity, to perform inference on data features transmitted by a mobile device. The proposed accuracy model characterizes high-dimensional feature distributions in the angular domain using a Mixture of von Mises (MvM) distribution. This leads to a desired closed-form expression for inference accuracy as a function of quantization bit-width and model traversal depth, which represents channel distortion and computational complexity, respectively. Building upon this accuracy model, we formulate and solve the EPR maximization problem under joint latency and accuracy constraints, leading to a channel-adaptive AI algorithm that achieves full IC$^2$ integration. The proposed algorithm jointly adapts transmit-side feature compression and receive-side model complexity according to channel conditions to maximize overall efficiency and inference throughput. Experimental results demonstrate its superior performance as compared with fixed-complexity counterparts.

ScaleDoc: Scaling LLM-based Predicates over Large Document Collections

arXiv:2509.12610v2 Announce Type: replace-cross Abstract: Predicates are foundational components in data analysis systems. However, modern workloads increasingly involve unstructured documents, which demands semantic understanding, beyond traditional value-based predicates. Given enormous documents and ad-hoc queries, while Large Language Models (LLMs) demonstrate powerful zero-shot capabilities, their high inference cost leads to unacceptable overhead. Therefore, we introduce \textsc{ScaleDoc}, a novel system that addresses this by decoupling predicate execution into an offline representation phase and an optimized online filtering phase. In the offline phase, \textsc{ScaleDoc} leverages a LLM to generate semantic representations for each document. Online, for each query, it trains a lightweight proxy model on these representations to filter the majority of documents, forwarding only the ambiguous cases to the LLM for final decision. Furthermore, \textsc{ScaleDoc} proposes two core innovations to achieve significant efficiency: (1) a contrastive-learning-based framework that trains the proxy model to generate reliable predicating decision scores; (2) an adaptive cascade mechanism that determines the effective filtering policy while meeting specific accuracy targets. Our evaluations across three datasets demonstrate that \textsc{ScaleDoc} achieves over a 2$\times$ end-to-end speedup and reduces expensive LLM invocations by up to 85\%, making large-scale semantic analysis practical and efficient.

To Reason or Not to: Selective Chain-of-Thought in Medical Question Answering

24 February 2026 at 13:00
arXiv:2602.20130v1 Announce Type: cross Abstract: Objective: To improve the efficiency of medical question answering (MedQA) with large language models (LLMs) by avoiding unnecessary reasoning while maintaining accuracy. Methods: We propose Selective Chain-of-Thought (Selective CoT), an inference-time strategy that first predicts whether a question requires reasoning and generates a rationale only when needed. Two open-source LLMs (Llama-3.1-8B and Qwen-2.5-7B) were evaluated on four biomedical QA benchmarks-HeadQA, MedQA-USMLE, MedMCQA, and PubMedQA. Metrics included accuracy, total generated tokens, and inference time. Results: Selective CoT reduced inference time by 13-45% and token usage by 8-47% with minimal accuracy loss ($\leq$4\%). In some model-task pairs, it achieved both higher accuracy and greater efficiency than standard CoT. Compared with fixed-length CoT, Selective CoT reached similar or superior accuracy at substantially lower computational cost. Discussion: Selective CoT dynamically balances reasoning depth and efficiency by invoking explicit reasoning only when beneficial, reducing redundancy on recall-type questions while preserving interpretability. Conclusion: Selective CoT provides a simple, model-agnostic, and cost-effective approach for medical QA, aligning reasoning effort with question complexity to enhance real-world deployability of LLM-based clinical systems.

Batch Speculative Decoding Done Right

arXiv:2510.22876v3 Announce Type: replace-cross Abstract: Speculative decoding must produce outputs distribution identical to standard autoregressive generation-this output equivalence is not an optimization target but the defining criterion of valid speculative decoding. We demonstrate that all existing batch speculative decoding implementations violate this fundamental requirement, producing corrupted outputs ranging from repetitive tokens to gibberish. These failures stem from the ragged tensor problem: sequences in the same batch accept different numbers of draft tokens, desynchronizing position IDs, attention masks, and KV-cache state. We present the first authentic batch speculative decoding framework. We (1) formalize the synchronization invariants that valid batch speculative decoding must satisfy, (2) present EQSPEC, the first algorithm that guarantees output equivalence, and analyze its cost structure to show that alignment overhead grows superlinearly and consumes up to 40\% of computation, and (3) introduce EXSPEC, which reduces this overhead through cross-batch scheduling that dynamically groups same-length sequences. On SpecBench across Vicuna-7B/68M, Qwen3-8B/0.6B, and GLM-4-9B/0.6B pairs, our methods achieve up to 3x throughput improvement at batch size 8 while maintaining algorithmic correctness. Our methods achieve 95\% decoding-equivalence, with residual divergence attributable to floating-point non-determinism in GPU inference, not the synchronization failures that cause near-zero equivalence of prior methods. Our code is available at https://github.com/eBay/spec_dec.
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