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Authors: Amir M. Rahmani ×
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01.
arXiv (CS.AI) 2026-06-16

AP-GRPO: Anchor-Gated Phonetic Alignment with Policy Optimization for Pathological Speech Reconstruction

Authors:
Pengfei Zhang↗Hoang H Nguyen↗Yutong Song↗Wenjun Huang↗Tahmid Imtiaz Imu↗Henry Peng Zou↗Jiang Wu↗Honghui Xu↗Amir M. Rahmani↗

arXiv:2606.15540v1 Announce Type: cross Abstract: Pathological speech from patients with neurodegenerative and neuromotor disorders is often acoustically distorted and linguistically fragmented, making pathological speech reconstruction necessary to recover intended textual content from distorted and incomplete speech recordings. Crucially, such recordings are rarely uniformly degraded: some words or short phrases remain reliable and can serve as audible anchors for reconstructing the corrupted surrounding content. We introduce Anchor-gated Phonetic Group Relative Policy Optimization (AP-GRPO), a GRPO framework with phonetic reward that aligns speech language models (SLMs) through audible-anchor preservation and inter-anchor phonetic compatibility to the original speech signal. AP-GRPO consists of: (i) an anchor-gated reward that matches reliable audible anchors in clear regions; and (ii) an inter-anchor phonetic alignment reward that evaluates whether recovered contents are phonetically supported by the corresponding corrupted inter-anchor speech span. Across four disease conditions, AP-GRPO improves faithful speech reconstruction, and the learned anchor constraint automatically adapts to each condition and thus reveals interpretable disease-specific profiles: conditions with severe articulatory degradation require stronger anchor enforcement, whereas milder impairment or linguistically impaired conditions rely more on phonetic alignment for inter-anchor recovery.

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02.
arXiv (CS.AI) 2026-06-25

From Sounds to Scenes: A Benchmark for Evaluating Context-Aware Auditory Scene Understanding in Large Audio Language Models

Authors:
Pengfei Zhang↗Hoang H Nguyen↗Kazi Shaharair Sharif↗Yutong Song↗Wenjun Huang↗Henry Peng Zou↗Pinxin Liu↗Honghui Xu↗Amir M. Rahmani↗

arXiv:2606.25391v1 Announce Type: cross Abstract: Recent Large Audio Language Models (LALMs) have achieved remarkable progress in audio perceptual tasks across individual acoustic layers, including speech, sound, and music. However, existing benchmarks predominantly evaluate these layers in isolation, overlooking the complex contextual relationships that arise when multiple acoustic sources co-occur in real-world auditory scenes. Real-world auditory interpretation requires Context-Aware Auditory Scene Understanding (CASU): the ability to comprehend the holistic scene by integrating sound layers. To evaluate this capability, we introduce the CASU benchmark, which assesses whether Audio LLMs can interpret auditory scenes composed of speech, acoustic events (e.g., announcements), and background environments (e.g., traffic), and reason about the logical relationships between these layers. We propose a scalable pipeline for constructing time-accurate, semi-synthetic audio streams by composing real-world scene sounds with synthetic speech. Building on this data, we design four tasks that probe scene understanding: contextual question answering, entity extraction from the scene, speaker role inference, and counterfactual reasoning where scene is manipulated. Experiments across multiple LALMs demonstrate that effective auditory scene understanding requires integration over all auditory layers, rather than reliance on speech or sound alone, underscoring the necessity of CASU for advancing complex audio understanding in LALMs.

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03.
arXiv (CS.AI) 2026-06-24

Event-Aligned Analysis of Multi-Rater Pain Assessments Using Continuous Wearable Physiology

Authors:
Saba A. Farahani↗Elahe Khatibi↗Thomas D. Hughes↗Ariana M. Nelson↗Hung Cao↗Amir M. Rahmani↗

arXiv:2606.23705v1 Announce Type: cross Abstract: Pain is assessed differently by patients, nurses, and clinicians, yet most computational approaches assume a single ground-truth label - effectively ignoring who is doing the rating. We introduce a rater-aware, event-aligned framework that converts sparse, rater-specific pain ratings into discrete pain-change events and aligns continuous wearable physiological signals to these events, preserving rater identity throughout. Applied to multimodal wearable data collected during spine-related pain procedures, the framework identifies substantial disagreement across rater groups and provides preliminary, exploratory evidence of rater-dependent physiological differences preceding reported pain increases. These findings suggest that pain-physiology relationships may not be rater-invariant, and that aggregating assessments across raters may mask meaningful physiological patterns. A rater-aware, event-aligned perspective is therefore a promising direction for interpreting wearable data in real-world clinical pain assessment.

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04.
arXiv (CS.LG) 2026-06-18

Beyond AHI: An Interpretable Causal-Discovery-Guided Framework for Sleep Recovery in Connected Health

Authors:
Saba A. Farahani↗Elahe Khatibi↗Manoj Vishwanath↗Amir M. Rahmani↗Hung Cao↗

arXiv:2606.18506v1 Announce Type: new Abstract: Objective sleep assessment relies on polysomnography (PSG), yet clinical impact is often better reflected in patient-reported outcomes (PROs) such as sleepiness and fatigue. Existing summary indices, including the Apnea-Hypopnea Index (AHI), provide limited insight into the multidomain physiology underlying functional recovery. We propose an interpretable, causal-discovery–guided framework for deriving a hierarchical Sleep Recovery Score (SRS) from multimodal PSG. Using two large population cohorts (MESA: n=1540; MrOS: n=825), we apply directed acyclic graph (DAG) learning to identify candidate physiological drivers spanning respiratory burden, hypoxic burden, sleep fragmentation, sleep architecture, and autonomic regulation. Although derived from clinical PSG, these domains map naturally to sensing streams increasingly available in connected health technologies, including wearable ECG, oximetry, and sleep-stage estimation devices. To preserve mechanistic plausibility, we introduce a two-stage screening process that combines physiology-based constraints with constrained LLM-assisted auditing to identify and remove structural confounders and construct-overlapping variables. Across cohorts, these five domains emerge as recurrent physiological domains associated with recovery, and the resulting SRS shows up to 2.5$\times$ stronger alignment with perceived recovery than AHI. By linking multimodal sleep physiology to patient-centered outcomes through an interpretable, bias-aware, and domain structured framework, this work provides a practical foundation for recovery modeling across both clinical sleep studies and emerging smart and connected health settings.

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05.
arXiv (CS.CL) 2026-06-15

Personal Care Utility: Health as Everyday Infrastructure

Authors:
Mahyar Abbasian↗Elahe Khatibi↗Saba A. Farahani↗Nitish Nagesh↗Arshia Ilaty↗Hooman Sajjadi↗Amir Rahmani↗Ramesh Jain↗

Healthcare is essential, expert, and episodic by design - built around the roughly one hour per year a person spends with a clinician. The 8,759 hours outside clinical settings, where eating, sleeping, movement, medication, and stress actually shape long-term health, have no comparable infrastructure. The bottleneck for personalized health is not raw data or reasoning capability; it is the absence of that infrastructure layer. This paper introduces the Personal Care Utility (PCU): a layered, event-driven architecture proposed as the missing utility for everyday health, in the way that payments, networks, and power are utilities for their domains. PCU organizes continuous personal signals into semantically meaningful life events through a Personicle, estimates dynamic health state against personal baselines, reasons about cause and context, and routes guidance through an orchestrator that separates clinical decision logic, behavioral strategy selection, and natural-language expression. This separation lets large language models support reasoning and communication while keeping safety-critical clinical decisions grounded in validated evidence. We instantiate PCU for Type 2 Diabetes - turning CGM, meal, activity, medication, sleep, stress, and clinical data into glycemic events, individualized state estimates, causal explanations, and knowledge-grounded interventions. A day-in-the-life scenario shows the same infrastructure producing real-time nudges, weekly summaries, medication check-ins, silence, or deterministic safety alerts depending on context and risk. We close with how PCU generalizes to other chronic conditions and the governance questions any always-on personal health utility must address. The result is a blueprint that treats personalization not as a final messaging layer, but as an architectural property of everyday health guidance.

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06.
arXiv (CS.AI) 2026-06-18

PSyGenTAB: A Privacy-Preserving Framework for Synthetic Clinical Tabular Data Generation via Constrained Optimization

Authors:
Arshia Ilaty↗Hossein Shirazi↗Manasi Chitale↗Kedar Hegde↗Dhanalakshmi Ramesh↗Rashmi S. Manjunath↗Amir Rahmani↗Hajar Homayouni↗

arXiv:2606.18518v1 Announce Type: cross Abstract: The development of medical AI is constrained by limited access to high-quality clinical data due to institutional silos and strict privacy regulations such as HIPAA and GDPR. Synthetic data generation offers a potential solution, but existing methods lack principled mechanisms to explicitly manage the privacy-utility trade-off, often degrading clinically meaningful patterns or risking patient re-identification. We present PSyGenTAB, a privacy-preserving generative framework that formulates synthetic healthcare data generation as a constrained optimization problem solved using the Augmented Lagrangian Method. By embedding configurable privacy constraints directly into model training, PSyGenTAB enforces minimum privacy thresholds while maximizing clinical data utility. Across multiple clinically motivated benchmarks, PSyGenTAB preserves inter-feature clinical relationships and minority-class diagnostic patterns essential for reliable health AI. Downstream evaluation using Train-on-Synthetic, Test-on-Real and Train-on-Real, Test-on-Synthetic protocols shows that models trained on synthetic data achieve performance comparable to those trained on real patient records. Privacy auditing further demonstrates reduced exact record reproduction and strong resilience to membership inference attacks. These results establish PSyGenTAB as a principled framework for balancing privacy protection and clinical utility in synthetic healthcare data, supporting secure cross-institutional AI development.

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07.
arXiv (CS.AI) 2026-06-24

T2D-Bench: Evidence-Gated Evaluation of LLM Outputs for Type 2 Diabetes Using a Multi-Layer Clinical-Lifestyle Knowledge Graph

Authors:
Saba A. Farahani↗Hung Cao↗Ramesh Jain↗Amir M. Rahmani↗

arXiv:2606.24145v1 Announce Type: new Abstract: Large language models (LLMs) can produce clinically fluent recommendations for type 2 diabetes while failing to satisfy guideline constraints or explicitly justify lifestyle-related glycemic claims. We present T2D-Bench, a reproducible benchmark and evidence-gated evaluation framework for testing whether LLM outputs satisfy explicit, graph-checkable evidence requirements. T2D-Bench is built on a multi-layer clinical-lifestyle knowledge graph that combines a biomedical spine (UMLS, DrugBank, SIDER), computable ADA Standards of Care rules, and lifestyle knowledge connected through a mechanistic bridge to glycemic laboratory effects. Across 100 structured vignettes spanning diagnosis, medication safety, and adversarial lifestyle conflicts, baseline outputs failed benchmark-defined evidence-path checks in 35% of cases for GPT-4o-mini and 33% for GPT-4o. The evidence gate detects unsupported omissions and uses constrained revision to bring outputs into verifier-level compliance with benchmark-defined evidence requirements. These results show that computable evidence constraints can make unsupported clinical omissions explicit, measurable, and correctable in diabetes-focused LLM outputs.

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