Reinforcement learning with verifiable rewards (RLVR) is a powerful recipe for improving language-model reasoning, but it is expensive to repeat on every new strong model because the target model must generate many rollouts during training. As models scale, post-training itself becomes a bottleneck. We study a weak-to-strong alternative: run RL on a smaller model where rollouts are cheaper, then reuse what that RL run learned to improve a stronger target model. Directly distilling the post-RL weak teacher is not enough, because the teacher's final policy mixes useful RL gains with the limitations of the smaller model. We propose Direct On-Policy Distillation (Direct-OPD), which transfers the teacher's RL-induced policy shift instead. Direct-OPD compares the post-RL teacher with its own pre-RL reference and treats their log-ratio as a dense implicit reward for the student. In plain terms, the checkpoint pair tells us which actions RL made the weak model more or less likely to take, and Direct-OPD applies that signal on the stronger student's own on-policy states. This directly reuses the weak model's RL supervision signal without running sparse-reward RL on the target model. Empiric
Object insertion aims to seamlessly composite a reference object into a specified region of a background image. Recent diffusion-based methods achieve high visual quality but formulate insertion as a simple 2D inpainting task, providing no explicit control over the object's 3D pose and limiting their practical applicability. We propose DIRECT (Decomposed Injection for Reference Composition and Target-integration), a novel framework that integrates interactive pose manipulation with high-fidelity 2D image synthesis to enable pose-controllable object insertion. Our method decomposes the insertion conditions into three complementary components: appearance guidance capturing visual details from the reference object, geometry guidance derived from the user-adjusted 3D proxy, and context guidance from the target background. By injecting them through separate pathways, DIRECT avoids feature entanglement and simultaneously preserves reference appearance, follows the user-specified pose, and adapts the object to the target scene. We also introduce an automated data construction pipeline to improve the diversity and quality of training data. Experiments show that DIRECT outperforms previous
The study of disparities in the liver transplantation process may focus on quantifying causal effects, particularly the average, direct, or indirect effects of various social determinants of health on being listed as a candidate for transplant. Selection bias arises when the data sample does not represent the target population, defined here as all individuals referred to the transplant clinic. Listing decisions are made for the subset of patients who complete the evaluation process, who may differ systematically from the referred population. There is evidence that selection is associated with patient characteristics that also impact outcomes. Using data only from the selected population may yield biased causal effect estimates. However, incorporating data from the referred population allows for analytic correction. This correction leverages hypothesized causal relationships among selection, the outcome (getting listed), exposures, and mediators. Using directed acyclic graphs (DAGs), we establish graphical conditions under which a reweighted mediation formula identifies effect of interest - direct, indirect, and path-specific effects - in the presence of sample selection. In a clini
This study presents an Initial Data Analysis (IDA) of the German Transplantation Registry (TxReg) data for a better data understanding and to inform future data analyses. The IDA is focusing on data on first-time kidney-only transplantations in adult recipients from deceased donors between 2006 and 2016 and refers to data from 14,954 recipients and 9,964 donors across 25 tables. Investigated aspects include missing data patterns and structure, data consistency, and availability of event time data. Results show that missing data proportions vary widely, with some tables nearly complete while others have over 50% missing values. Missing data patterns are identified using a decision tree approach. An influx and outflux analysis demonstrates that some variables have high potential for imputing missing data, while others were less suitable for imputation. We identified 168 multi-sourced variables that are reported by multiple data providers in parallel leading to discrepancies for some variables but also providing opportunities for missing data imputation. Our findings on event time data demonstrate the importance of carefully selecting the variables used for event time analyses as resu
Interactive large language model agents have advanced rapidly, but most remain specialized to a single environment and fail to adapt robustly to other environments. Model merging offers a training-free alternative by integrating multiple experts into a single model. In this paper, we propose Agent-Role Merging (ARM), an activation-guided, role-conditioned neuron transplantation method for model merging in LLM agents. ARM improves existing merging methods from static natural language tasks to multi-turn agent scenarios, and over the generalization ability across various interactive environments. This is achieved with a well designed 3-step framework: 1) constructing merged backbones, 2) selection based on its role-conditioned activation analysis, and 3) neuron transplantation for fine-grained refinements. Without gradient-based optimization, ARM improves cross-benchmark generalization while enjoying efficiency. Across diverse domains, the model obtained via ARM merging outperforms prior model merging methods and domain-specific expert models, while demonstrating strong out-of-domain generalization.
We introduce Neural Organ Transplantation (NOT), a modular adaptation framework that enables trained transformer layers to function as reusable transferable checkpoints for domain adaptation. Unlike conventional fine-tuning approaches that tightly couple trained parameters to specific model instances and training data, NOT extracts contiguous layer subsets ("donor organs") from pre-trained models, trains them independently on domain-specific data, and saves them as standalone checkpoint files that can be transplanted into compatible recipient models without access to the original training data. Through experiments on three decoder-only transformer architectures spanning 124M to 20B parameters (GPT-2, TinyLlama, and GPT-OSS), we demonstrate that donor transplantation substantially outperforms existing adaptation methods, achieving an order-of-magnitude improvement in perplexity over LoRA while training significantly faster. The method exhibits position dependence, with early insertion positions yielding optimal results. Cross-domain transfer at billion-parameter scale reveals unexpected regularization benefits. These findings demonstrate that transformer middle layers can support ef
We consider a stopping problem and its application to the decision-making process regarding the optimal timing of organ transplantation for individual patients. At each decision period, the patient state is inspected and a decision is made whether to transplant. If the organ is transplanted, the process terminates; otherwise, the process continues until a transplant happens or the patient dies. Under suitable conditions, we show that there exists a control limit optimal policy. We propose a smoothed perturbation analysis (SPA) estimator for the gradient of the total expected discounted reward with respect to the control limit. Moreover, we show that the SPA estimator is asymptotically unbiased.
Ensemble learning is a widespread technique to improve the prediction performance of neural networks. However, it comes at the price of increased memory and inference time. In this work we propose a novel model fusion technique called \emph{Neuron Transplantation (NT)} in which we fuse an ensemble of models by transplanting important neurons from all ensemble members into the vacant space obtained by pruning insignificant neurons. An initial loss in performance post-transplantation can be quickly recovered via fine-tuning, consistently outperforming individual ensemble members of the same model capacity and architecture. Furthermore, NT enables all the ensemble members to be jointly pruned and jointly trained in a combined model. Comparing it to alignment-based averaging (like Optimal-Transport-fusion), it requires less fine-tuning than the corresponding OT-fused model, the fusion itself is faster and requires less memory, while the resulting model performance is comparable or better. The code is available under the following link: https://github.com/masterbaer/neuron-transplantation.
Each year, thousands of patients in need of heart transplants face life-threatening wait times due to organ scarcity. While allocation policies aim to maximize population-level outcomes, current approaches often fail to account for the dynamic arrival of organs and the composition of waitlisted candidates, thereby hampering efficiency. The United States is transitioning from rigid, rule-based allocation to more flexible data-driven models. In this paper, we propose a novel framework for non-myopic policy optimization in general online matching relying on potentials, a concept originally introduced for kidney exchange. We develop scalable and accurate ways of learning potentials that are higher-dimensional and more expressive than prior approaches. Our approach is a form of self-supervised imitation learning: the potentials are trained to mimic an omniscient algorithm that has perfect foresight. We focus on the application of heart transplant allocation and demonstrate, using real historical data, that our policies significantly outperform prior approaches -- including the current US status quo policy and the proposed continuous distribution framework -- in optimizing for population
Graft-versus-host disease (GVHD) is a rare but often fatal complication in liver transplantation, with a very high mortality rate. By harnessing multi-modal deep learning methods to integrate heterogeneous and imbalanced electronic health records (EHR), we aim to advance early prediction of GVHD, paving the way for timely intervention and improved patient outcomes. In this study, we analyzed pre-transplant electronic health records (EHR) spanning the period before surgery for 2,100 liver transplantation patients, including 42 cases of graft-versus-host disease (GVHD), from a cohort treated at Mayo Clinic between 1992 and 2025. The dataset comprised four major modalities: patient demographics, laboratory tests, diagnoses, and medications. We developed a multi-modal deep learning framework that dynamically fuses these modalities, handles irregular records with missing values, and addresses extreme class imbalance through AUC-based optimization. The developed framework outperforms all single-modal and multi-modal machine learning baselines, achieving an AUC of 0.836, an AUPRC of 0.157, a recall of 0.768, and a specificity of 0.803. It also demonstrates the effectiveness of our approac
In this paper we present uniform weighted inequalities for the Hankel transform transplantation operator. A weighted vector-valued inequality is also obtained. As a consequence we deduce an extension of a transference theorem due to Rubio de Francia.
In clinical studies, the risk of the primary (terminal) event may be modified by intermediate events, resulting in semicompeting risks. To study the treatment effect on the terminal event mediated by the intermediate event, researchers wish to decompose the total effect into direct and indirect effects. In this article, we extend the randomized interventional approach to time-to-event outcomes, where both intermediate and terminal events are subject to right censoring. We envision a random draw for the intermediate event process from a reference distribution, either marginally over time-varying confounders or conditionally given the observed history. We present the identification formula for interventional effects. We also discuss some variants of the identification assumptions. We estimate the treatment effects using nonparametric maximum likelihood estimation and propose a sensitivity analysis that incorporates a latent frailty. As an illustration, we study the effect of matched unrelated donor versus haploidentical donor on death mediated by relapse in a hematopoietic cell transplantation study with graft-versus-host disease (GVHD) as the time-varying confounder. We find that ma
Patient life circumstances, including social determinants of health (SDOH), shape both health outcomes and care access, contributing to persistent disparities across gender, race, and socioeconomic status. Liver transplantation exemplifies these challenges, requiring complex eligibility and allocation decisions where SDOH directly influence patient evaluation. We developed an artificial intelligence (AI)-driven framework to analyze how broadly defined SDOH -- encompassing both traditional social determinants and transplantation-related psychosocial factors -- influence patient care trajectories. Using large language models, we extracted 23 SDOH factors related to patient eligibility for liver transplantation from psychosocial evaluation notes. These SDOH ``snapshots'' significantly improve prediction of patient progression through transplantation evaluation stages and help explain liver transplantation decisions including the recommendation based on psychosocial evaluation and the listing of a patient for a liver transplantation. Our analysis helps identify patterns of SDOH prevalence across demographics that help explain racial disparities in liver transplantation decisions. We hi
Ensuring large language models (LLM) behave consistently with human goals, values, and intentions is crucial for their safety but yet computationally expensive. To reduce the computational cost of alignment training of LLMs, especially for those with a huge number of parameters, and to reutilize learned value alignment, we propose ConTrans, a novel framework that enables weak-to-strong alignment transfer via concept transplantation. From the perspective of representation engineering, ConTrans refines concept vectors in value alignment from a source LLM (usually a weak yet aligned LLM). The refined concept vectors are then reformulated to adapt to the target LLM (usually a strong yet unaligned base LLM) via affine transformation. In the third step, ConTrans transplants the reformulated concept vectors into the residual stream of the target LLM. Experiments demonstrate the successful transplantation of a wide range of aligned concepts from 7B models to 13B and 70B models across multiple LLMs and LLM families. Remarkably, ConTrans even surpasses instruction-tuned models in terms of truthfulness. Experiment results validate the effectiveness of both inter-LLM-family and intra-LLM-famil
This paper presents a comprehensive review of the last two decades of research on Kidney Exchange Programs (KEPs), systematically categorizing and classifying key contributions to provide readers with a structured understanding of advancements in the field. The review highlights the evolution of KEP methodologies and lays the foundation for our contribution. We propose three mathematical models aimed at improving both the quantity and quality of kidney transplants. Model 1 maximizes the number of transplants by focusing on compatibility based on blood type and PRA, without additional constraints. Model 2 introduces a minimum Human Leukocyte Antigen (HLA) compatibility threshold to enhance transplant quality, though this leads to fewer matches. Model 3 extends the problem to a Multi-Agent Kidney Exchange Program (MKEP), pooling incompatible donor-recipient pairs across multiple agents, resulting in a higher number of successful transplants while ensuring fairness across agents. Sensitivity analyses demonstrate trade-offs between transplant quantity and quality, with Model 3 striking the optimal balance by leveraging multi-agent collaboration to improve both the number and quality of
This study aimed to investigate the effects of genetic polymorphisms on tacrolimus blood levels and intra-individual variability in recipients of heart transplants during the early post-transplantation period. Demographic information, concomitant medications, daily tacrolimus dose, trough concentration, and physiological and biochemical information of 87 Chinese recipients of heart transplants were collected. Trough concentrations were determined using a chemiluminescent micro-particle immunoassay, and 17 selected single nucleic acid polymorphisms were genotyped by direct sequencing. We assessed intra-individual variability by calculating the coefficient of variation of tacrolimus trough concentration and analyzed factors associated with tacrolimus concentration and intra-individual variability. Our study found that low body weight and a high percentage of neutrophils significantly influenced the coefficient of variation of tacrolimus. CYP3A5*1D and CYP3A7 rs776744 haplotypes correlated significantly with an intra-individual coefficient of variation of tacrolimus trough concentration during the early postoperative period. Patients with the CYP3A5*1D rs15524 and CYP3A7 rs776744 TT h
End-Stage Liver Disease (ESLD), a complex condition, has high rates of co-occurring comorbidities affecting multiple organ systems. There is no clear evidence-based practice (EBP) guidelines addressing the progression of comorbidities in ESLD patients awaiting liver transplantation (LT) and their impact on survival, both pre- and post-transplant. This study aimed to identify and quantify the trajectory of the most common and deteriorating comorbidities in ESLD patients awaiting LT and to analyze their effect on patient outcomes. An initial exploratory phase to identify frequent comorbidities in ESLD patients. Relevant EBP-driven data for diagnosing and measuring the progression of these conditions were collected and organized into five research matrices. In the quantitative phase, a retrospective analysis was conducted using longitudinal de-identified data from electronic health records (EHR) for patients who underwent LT between 2011-2021. Data included demographics, labs, procedures, and medications. Descriptive statistics and survival analysis assessed the association of comorbidities with post-transplant survival. The five most frequent comorbidities identified were Diabetes Me
Direct imaging and spectroscopy is the likely means by which we will someday identify, confirm, and characterize an Earth-like planet around a nearby Sun-like star. This Chapter summarizes the current state of knowledge regarding discovering and characterizing exoplanets by direct imaging and spectroscopy. We detail instruments and software needed for direct imaging detections and summarize the current inventory of confirmed and candidate directly-imaged exoplanets. Direct imaging and spectroscopy in the past decade has provided key insights into jovian planet atmospheres, probed the demographics of the outskirts of planetary systems, and shed light on gas giant planet formation. We forecast the new tools and future facilities on the ground and in space that will enhance our capabilities for exoplanet imaging and will likely image habitable zone rocky planets around the nearest stars.
While kidney transplants are seen as the best treatment option for patients with end-stage renal disease and kidney failure, the organ's health depends on the dosage of immunosuppressant drugs post-transplantation. Due to the dosage variance based on each patient's unique physiology, nephrologists face numerous difficulties when determining the precise dosage needed for each patient. Therefore, in this research we aim to devise a machine learning algorithm to forecast the dosage of immunosuppressant drugs needed for different patients after kidney transplantation. Utilizing a random forest algorithm, the devised model is able to achieve accurate measurements for patient drug dosages.
Organ transplantation, which is the utilization of codes directly related to some specific functionalities to complete ones own program, provides more convenience for developers than traditional component reuse. However, recent techniques are challenged with the lack of organs for transplantation. Hence, we conduct an empirical study on extracting organs from GitHub repository to explore transplantation based on large-scale dataset. We analyze statistics from 12 representative GitHub projects and get the conclusion that 1) there are abundant practical organs existing in commits with add as a key word in the comments; 2) organs in this repository mainly possess four kinds of contents; 3) approximately 70% of the organs are easy-to-transplant. Implementing our transplantation strategy for different kinds of organs, we manually extract 30 organs in three different programming languages, namely Java, Python, and C, and make unit tests for them utilizing four testing tools (two for Java, one for Python, and one for C). At last, we transplant three Java organs into a specific platform for a performance check to verify whether they can work well in the new system. All the 30 organs extrac