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01.
arXiv (CS.LG) 2026-06-16

TreeGRNG: Binary Tree Gaussian Random Number Generator for Efficient Probabilistic AI Hardware

arXiv:2606.16599v1 Announce Type: cross Abstract: Bayesian Neural Networks (BNNs) offer opportunities for greatly enhancing the trustworthiness of conventional neural networks by monitoring the uncertainties in decision-making. A significant drawback for BNN inference at the extreme edge, however, is the imperative need to incorporate Gaussian Random Number Generators (GRNG) within each neuron. State-of-the-art GRNG algorithms heavily depend on multiple arithmetic operations and the use of extensive look-up tables, posing significant implementation challenges for ultra-low power hardware implementations. To overcome this, this paper presents an innovative binary tree random number generator (TreeGRNG) allowing the use of ultra-low-cost constant comparators instead of arithmetic units. We further enhance the TreeGRNG proposal with a set of hardware-aware optimizations exploiting the Gaussian properties. The optimized TreeGRNG surpasses the State-of-the-Art (SoTA) in terms of distribution accuracy while achieving a 3.7$\times$ reduction in energy per sample and boosting the throughput per unit area by 5.8$\times$. Moreover, our TreeGRNG proposal possesses a distinct advantage over the current SoTA in terms of flexibility, as it easily enables designers to adjust the shape of the sampled probability distribution, extending beyond the capabilities of traditional GRNGs, opening the horizon towards future probabilistic AI designs. The TreeGRNG design is available open-source in the link

02.
arXiv (quant-ph) 2026-06-15

Dose-efficient Quantum Phase Estimation in Lossy Optical Interferometry

arXiv:2606.14254v1 Announce Type: new Abstract: Optical interferometry is a cornerstone technique for precise phase measurements across various fields. In many applications, for example, biological imaging, it often necessitates stringent limits on light intensity to prevent adverse effects on light-sensitive samples, a condition known as dose-limited regimes. Maximizing the precision per dose is therefore crucial. In quantum metrology, quantum correlations enable high precision in phase estimation while adhering to dose constraints. Nevertheless, photon loss, including absorption by a sample, substantially diminishes the benefits of quantum enhancement in interferometry. In this work, we experimentally investigate a dose-efficient approach to quantum phase estimation using sequential strategies in the presence of loss. Performance of sequential strategies with and without control is evaluated through quantum Fisher information (QFI) per dose. Experimental results show that both sequential strategies exceed the classical limit and outperform the parallel strategy using unbalanced N00N states. Notably, the control-enhanced sequential strategy attains superior QFI per dose, approaching the quantum limit. These results highlight the promise of sequential strategy for imaging and sensing in resource-constrained scenarios, marking a significant step toward practical and efficient quantum metrology in lossy environments.

03.
medRxiv (Medicine) 2026-06-16

Upper airway disease in primary ciliary dyskinesia: Clinical management and factors influencing decision-making, a multicentre analysis

Background Upper airway disease is common in primary ciliary dyskinesia (PCD), but management evidence is limited. We aimed to describe management practices and identify factors influencing management decisions. Methods Using data from the Ear-Nose-Throat (ENT) Prospective International Cohort of patients with PCD (EPIC-PCD) and an ENT-specialist survey across participating centres, we described management practices recorded at routine follow-up. We assessed clinical factors associated with practices via mixed-effects logistic regression models. In a subgroup of patients, we assessed factors associated with initiation or discontinuation of practices. Results We included 579 patients: median age 15 years, 46% female. Nasal rinsing (54%) and nasal corticosteroids (22%) were most frequently prescribed. Among 466 patients with available data, 47 had grommets (10%) and 42 hearing aids (9%). Nasal corticosteroids and rinsing were more frequently prescribed in patients with polyps (odds ratio [OR] 3.74, 95% confidence interval [CI] 1.80-7.76; OR 3.39, 95% CI 1.37-8.37) or turbinate hypertrophy (OR 1.89, 95% CI 1.03-3.47; OR 2.89, 95% CI 1.55-5.38), and upper airway nebulisation in patients with frequent nasal symptoms (OR 2.86, 95% CI 1.11-7.39). Management practices differed between centres, as seen also by the specialists survey responses. In 177 patients with multiple visits, initiation of nasal rinsing was associated with frequent nasal symptoms (OR 3.18, 95% CI 1.24-8.18) and turbinate hypertrophy (OR 3.21, 95% CI 1.20-8.59). Conclusion Upper airway disease management in PCD varies and is partly guided by symptom burden and clinical findings. This variation across centres highlights the need for care standardisation and PCD-specific management guidelines.

04.
medRxiv (Medicine) 2026-06-10

Longitudinal brain structural changes during clozapine treatment: associations with neuroreceptor architecture and clinical response

In treatment-resistant schizophrenia, clozapine treatment has been associated with longitudinal reductions in subcortical volumes, ventricular enlargement, and widespread cortical thinning. However, it is unknown how these structural changes relate to clozapines pharmacological profile and clinical efficacy. We combined five longitudinal datasets with MRI acquired before and on average 5 months after clozapine initiation in 143 individuals to quantify brain structural changes and their association with normative maps relating to neuroreceptor architecture and physiological systems, and improvement in symptom severity. Clozapine treatment was associated with grey matter volume reductions across multiple subcortical regions (including the amygdala, hippocampus, thalamus, caudate, putamen and nucleus accumbens), increases in pallidal volume, ventricular enlargement, and widespread cortical thinning. Cortical regions showing the greatest magnitude of thinning corresponded to areas with higher normative densities of serotonergic 5-HT1A, 5-HT2A and 5-HT4 receptors. Changes in subcortical volume or cortical thickness during clozapine treatment were not associated with changes in total or positive symptom severity. In addition, baseline subcortical volume, cortical thickness, or gyrification prior to starting clozapine did not predict subsequent symptom improvement. Cortical thinning may partly reflect clozapines activity at serotonergic receptors, which have been implicated in cortical network stabilisation and neuroplasticity, however structural remodelling during clozapine treatment may reflect a process independent from its clinical efficacy in improving core symptoms of psychosis.

05.
arXiv (CS.AI) 2026-06-18

A Hybrid LSTM–Vision Transformer Architecture for Predicting HRRR Forecast Errors

arXiv:2606.19026v1 Announce Type: cross Abstract: Forecast errors in high-resolution numerical weather prediction (NWP) systems are often linked to unresolved planetary boundary layer (PBL) processes, convection, terrain-induced circulations, and other vertically structured atmospheric phenomena. Previous work demonstrated that Long Short-Term Memory (LSTM) networks can successfully predict forecast errors in the High-Resolution Rapid Refresh (HRRR) model using mesonet observations, but we believe performance degradation is linked to periods of complex vertical atmospheric evolution. To address this limitation, we develop a hybrid LSTM-Vision Transformer (LSTM-ViT) framework that combines temporal sequence learning from surface observations with atmospheric profiles from the New York State Mesonet profiler network. The LSTM-ViT framework is trained to predict HRRR hourly precipitation, 10 m wind speed, and 2 m temperature forecast errors at individual mesonet stations. Across all three predictors, incorporation of profiler-derived atmospheric structure improves forecast error prediction skill relative to the baseline LSTM architecture, with the largest gains occurring at shorter forecast lead times and during periods of enhanced PBL activity. Improvements are particularly pronounced for precipitation forecast error, where the LSTM-ViT framework achieves approximately a twofold increase in predictive skill relative to the baseline LSTM while better capturing convectively driven error evolution and reducing degradation associated with PBL processes. These results demonstrate that combining temporal sequence learning with vertically informed attention mechanisms provides a physically meaningful pathway for improving forecast error prediction in operational NWP systems. Our research offers forecasters enhanced guidance regarding model bias and forecast confidence.

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

LoRA-Muon: Spectral Steepest Descent on the Low-Rank Manifold

arXiv:2606.12921v1 Announce Type: cross Abstract: Low-Rank Adaptation (LoRA) significantly reduces compute and memory costs for finetuning Deep Learning models but is often harder to tune than dense training: when using factor-wise optimizers such as AdamW, it is sensitive to initialization choices, its optimal learning rates transfer poorly across ranks, and it often fails to beat dense baselines. We derive LoRA-Muon by applying the Muon optimizer's spectral steepest-descent rule to the low-rank setting. Along with our split weight-decay rule, our main claim is that LoRA-Muon is a good low-rank proxy for full-rank Muon and Shampoo-family optimizers. Its optimal learning rates transfer across rank, width, depth, and factor-rescaling. In our compute-matched TinyShakespeare study, a rank-$2$ proxy recovers the dense best tested learning rate, and a rank-$32$ LoRA-Muon run attains lower mean validation loss than the dense baseline in the seed-averaged sweep. We further show that the Spectron optimizer depends on arbitrary factor scaling, so it would likely be a poor fit when finetuning starts from badly imbalanced factors, and that LoRA-RITE's simplified QR-coordinate core implements the same spectral update. LoRA-Muon computes that update without QR-decomposition and avoids storing second moments, making it more accelerator-friendly and memory-efficient.

07.
arXiv (CS.AI) 2026-06-19

UltraQuant: 4-bit KV Caching for Context-Heavy Agents

arXiv:2606.20474v1 Announce Type: cross Abstract: Context-heavy agents place unusual pressure on the key-value (KV) cache: long prefixes are reused across many short turns, while concurrency determines whether the serving system can keep GPUs utilized. We study 4-bit KV-cache compression for this setting, using TurboQuant-style rotation and codebook quantization as a quality anchor and vLLM FP8 KV caching as the deployment anchor. We report three contributions. First, we frame 4-bit KV caching around multi-round agent workloads where task quality, cache residency, and serving throughput must be measured jointly. Second, we describe the practical design choices needed to make the 4-bit path robust, including asymmetric K/V treatment, Walsh-Hadamard rotation, QJL removal, and block-scale variants. Third, we present serving optimizations on AMD GPUs, including optimized decode-attention kernels and UltraQuant, an FP4 approximation path that uses FP8 queries, FP4 KV tensors, UE8M0 group scales, and native scaled-MFMA support on CDNA4. On a long-context, multi-turn agentic workload, UltraQuant cuts P50 time-to-first-token by 3.47x in the cache-pressured late rounds (2.3x across all rounds) and raises output throughput by 1.63x over the FP8 KV baseline.

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

Stable and Steerable Sparse Autoencoders with Weight Regularization

arXiv:2603.04198v2 Announce Type: replace-cross Abstract: Sparse autoencoders (SAEs) are widely used to extract human-interpretable features from neural network activations, but their learned features can vary substantially across random seeds and training choices. To improve stability, we studied weight regularization by adding L1 or L2 penalties on encoder and decoder weights, and evaluate how regularization interacts with common SAE training defaults. On MNIST, we observe that L2 weight regularization produces a core of highly aligned features and, when combined with tied initialization and unit-norm decoder constraints, it dramatically increases cross-seed feature consistency. For TopK SAEs trained on language model activations (Pythia-70M-deduped), adding a small L2 weight penalty increased the fraction of features shared across three random seeds and roughly doubles steering success rates, while leaving the mean of automated interpretability scores essentially unchanged. Finally, in the regularized setting, activation steering success becomes better predicted by auto-interpretability scores, suggesting that regularization can align text-based feature explanations with functional controllability.

09.
arXiv (CS.LG) 2026-06-11

Kalman Linear Attention: Parallel Bayesian Filtering For Efficient Language Modelling and State Tracking

arXiv:2602.10743v2 Announce Type: replace Abstract: State-space language models such as Mamba and gated linear attention (GLA) offer linear-complexity, parallelisable alternatives to transformers, but their linear state updates limit expressivity and robust state tracking. We close this gap from a probabilistic angle, casting sequence mixing as exact Bayesian filtering with the Kalman filter as the core primitive. Classical Kalman filters give principled state and uncertainty estimates but are viewed as inherently sequential; we show that reparameterising them in information form turns their updates into an associative scan - so the per-token recurrent update is non-linear (a Möbius/precision recursion) yet remains temporally parallel. The resulting Kalman Linear Attention (KLA) layer is a drop-in sequence mixer that performs time-parallel probabilistic inference, carries an explicit belief-state uncertainty, and is strictly more expressive than GLA-style linear updates at the same computational cost. This expressivity translates directly into stronger state tracking: KLA solves permutation-composition ($A_5$) tasks that linear SSMs and attention cannot, while staying scan-parallel. As a drop-in primitive it also matches or improves on modern SSMs and GLAs across synthetic token-manipulation and zero-shot commonsense benchmarks, and is among the first stacked Bayesian-filtering primitives trained at the billion-token scale.

10.
medRxiv (Medicine) 2026-06-16

Reliability and construct validity of the Technology Device Interference Scale in a sample of children and parents

There is increasing interest in parent-child technoference: the interference with personal interactions caused by technology devices. This study examined the reliability and construct validity of the Technology Device Interference Scale (TDIS) to measure technoference in a sample of Canadian parents and children. Parents (n=883) and children (n=376) were recruited from clinical and community settings and completed the TDIS for their own and family member technoference over three timepoints (T1=2023, T2=2024, T3=2025). TDIS internal consistency, test-retest reliability, and construct validity were assessed using Cronbachs alpha, intraclass correlation coefficient, and confirmatory factor analysis, respectively. The TDIS showed good internal consistency and adequate to good construct validity when used by children to report on their own technoference (all >.70; CFI>.95, TLI>.95, RMSEA.70; CFI>.95, TLI>.90, RMSEA[≤].11). The TDIS had low to acceptable internal consistency and poor model fit for parent report of their own technoference ( range: .63 - .66; CFI

11.
medRxiv (Medicine) 2026-06-22

MinderCare: protocol for a mixed-methods evaluation of a digitally enabled dementia care service.

Introduction and aims Dementia is a growing public health challenge affecting millions of people worldwide. It is a progressive condition that increases the risk of infections, falls, hospital admissions, dependence in activities of daily living, safety issues such as wandering, care home transfers, and death. New ways of supporting people living with dementia (PLWD) at home are urgently needed. We describe the MinderCare study which evaluates a digitally enabled care model that integrates low-burden sensor-based remote monitoring within a nurse-led clinical service. Methods and analysis In this mixed-methods study, we will recruit 100 people with confirmed or suspected dementia living at home and deploy the Minder remote monitoring system for at least 12 months. A detailed characterisation of the cohort will be obtained, including cognition, frailty, participant and carer wellbeing, functioning, and quality of life. The feasibility, acceptability, sustainability, and resource requirements of the service will also be assessed. Low-cost sensors provide information about behaviour, environment and physiology from the home. Machine-learning algorithms have been used to develop digital biomarkers of infection, sleep, night-time behaviours, daily activities and routines, and the effects of clinical events and treatment. These will be assessed through clinical reports of sensor-derived data that include anomaly alerts provided to the clinical teams. Algorithms will be assessed for their clinical utility and acceptability. The comparative-effectiveness component will be designed as a target trial emulation using linked electronic health-record data to construct a time-indexed external usual-care control cohort. The primary comparative outcome will be Days Alive and Out of Hospital (DAOH) over 12 months from the activation-index date, with healthcare utilisation, costs, institutionalisation and mortality assessed as secondary outcomes. DAOH and estimated MinderCare effects will also be examined across prespecified strata of baseline inpatient utilisation. Ethics and dissemination Ethical approval has been granted by the North East Newcastle and North Tyneside 2 Research Ethics Committee, and the study has received confirmation of capacity and capability by the Imperial College Healthcare NHS Trust. Study findings will be disseminated to patients, health and social care professionals, and policymakers through peer-reviewed publications and conference presentations. Study registration number: ISRCTN14997677 and NIHR portfolio CPMSID 63023.

12.
arXiv (CS.CL) 2026-06-17

Evaluating Large Language Models Abilities for Addressee, Turn-change, and Next Speaker Prediction in Meetings

We investigate turn-taking in multimodal multi-party conversations using large language models (LLMs). We construct an evaluation framework for three tasks: addressee detection, turn-change prediction, and next speaker prediction. We compare supervised models trained for these tasks, text-based LLMs, multimodal LLMs (MM-LLMs), and human subjects. Experiments on the AMI corpus showed that LLMs outperformed supervised models and humans in next speaker prediction, despite not being trained on the target domain and without access to audio or visual information. An MM-LLM performed better than text-based LLMs on addressee detection and turn-change prediction but remained below human performance, indicating difficulty leveraging raw audio-visual signals. Ablation analyses revealed that conversational context was critical, particularly for next speaker prediction. We observed that human and LLM prediction patterns were similar, and intervals with frequent turn changes were difficult for both.

13.
arXiv (CS.LG) 2026-06-19

Predicting gestational age at birth in the context of preterm birth from multi-modal fetal MRI

arXiv:2606.20172v1 Announce Type: new Abstract: Preterm birth is associated with significant mortality and a risk for lifelong morbidity. The complex multifactorial aetiology hampers accurate prediction and thus optimal care. A pipeline consisting of bespoke machine learning methods for data imputation, feature selection, and regression models to predict gestational age (GA) at birth was developed and evaluated from comprehensive multi-modal morphological and functional fetal MRI data from 333 control cases and 93 preterm birth cases. The GA at birth predictions were classified into term and preterm categories and their accuracy, sensitivity, and specificity were reported. An ablation study was performed to further validate the design of the pipeline. Performance was evaluated using stratified 10-fold cross-validation. The pipeline achieves an R2 score of 0.13 and a mean absolute error of 2.74 weeks. It also achieves a 0.77 accuracy, 0.59 sensitivity, and 0.82 specificity across folds. The predominant features selected by the pipeline include cervical length and statistics derived from placental T2* values. The confluence of fast, motion-robust and multi-modal fetal MRI techniques and machine learning prediction allowed the prediction of the gestation at birth. This information is essential for any pregnancy. To the best of our knowledge, preterm birth had only been addressed as a classification problem in the literature. Therefore, this work provides a proof of concept. Future work will increase the cohort size to allow for finer stratification within the preterm birth cohort. Our code is available at https://github.com/dfajardorojas/ml-for-preterm-birth-.

14.
arXiv (CS.LG) 2026-06-19

Variational Consensus Monte Carlo for Bayesian Mixture

arXiv:2606.19643v1 Announce Type: cross Abstract: Motivated by the privacy, sensitivity and sharing limitations of health data, we present a comprehensive pipeline for inference of Bayesian mixture models within a federated learning setting, i.e. when data cannot be fully shared or pooled across compute nodes. We adopt a Consensus Monte Carlo (CMC) approach, in which an MCMC algorithm is run independently within each data silo to estimate local posterior distributions, which are then aggregated to approximate the posterior over the full data. The variational CMC approach of Rabinovich, Angelino and Jordan (2015) [1] frames the aggregation step as a variational inference problem, but their application to mixtures assumes the number of clusters and key mixture parameters to be known. Our main methodological contributions are: (i) an extension of variational CMC to over-fitted Bayesian mixture models that infer the number of clusters and all model parameters, without requiring conjugacy; (ii) novel cluster-matching algorithms suitable for cross-silo settings in which not every cluster appears in each local dataset; (iii) a number of inference strategies for the aggregation step, matched to different federated learning constraints; and (iv) guidelines for choosing among these in practice. A comprehensive simulation study validates the framework and allows us to compare to state-of-the-art federated learning alternatives. Notably, we show that when the composition of local datasets reflects the underlying clustering structure in the data, our approach can recover small clusters with greater accuracy than standard MCMC applied to the pooled data. We illustrate the framework on large-scale electronic health record data, identifying multi-morbidity patterns in a British geriatric population.

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

Large Language Models for Agentic NetOps and AIOps: Architectures, Evaluation, and Safety

arXiv:2605.12729v2 Announce Type: replace-cross Abstract: Large language models are increasingly being used to support network operations (NetOps) and artificial intelligence for IT operations (AIOps), including incident investigation, root-cause analysis, configuration synthesis, and limited self-healing. In both NetOps and AIOps, this shift is changing how tasks are managed. Agent-based operations work as workflows, from gathering evidence to taking action, following permissions, policies, and checks, and providing rollback options when necessary. This is crucial because operational decisions can have instant impacts. To make the argument concrete, we organise the relevant literature around the hierarchy of autonomy, tool scope, evidence traces, and assurance contracts. These contracts define what an agent may observe, propose, and execute. They also define the checks that must pass before any action is allowed. A consistent pattern appears across work on telemetry query recommendation, diagnosis, root-cause analysis, configuration synthesis, change planning, and limited self-healing. Operational reliability does not come chiefly from the model itself. It depends on the machinery around the model. We also argue that evaluation should go beyond static question answering. Agentic NetOps and AIOps systems require workflow-centred evaluation, including trace quality, bounded tool use, safe proposal generation, replay in sandboxed environments, and canary trials with rollback-aware scoring. Without these measures, a system may appear robust yet remain too fragile. Finally, we examine security, privacy, and governance risks that become acute when agents sit close to operational control surfaces. Taken together, the survey concludes that progress in intelligent NetOps and AIOps will depend on treating autonomy as a constrained operational control problem, whose outputs must be reliable, auditable, and securely deployable.

16.
medRxiv (Medicine) 2026-06-17

Reverse engineering of motor unit discharge in multiple sclerosis reveals heterogeneity of voluntary motor commands

Central nervous system injury causes motor deficits through derangement of excitatory, inhibitory, and/or neuromodulatory inputs to motoneurons, the three fundamental components of motor commands. Typically, study of pathologic neural control in humans is restricted to only one of the three. Chardon et al. (2024) presented a fundamentally new approach to comprehensively study all components by reverse engineering motor unit firing patterns. We apply their framework to motor unit firing patterns from 89 people with multiple sclerosis (MS) and 34 controls to study excitatory, inhibitory, and neuromodulatory contributions to pathologic motor output. Disruptions to all components are plausible in MS, a disease hallmarked by heterogeneity in nearly all aspects. Accordingly, we found abnormalities in MS for all three components. Notably, neuromodulation included both high and low extremes. Our results suggest that pathophysiology of motor commands in MS varies among patients, a finding fundamentally different from other studied populations showing relative consistency.

17.
arXiv (CS.AI) 2026-06-18

EMORSION: Examining the Impact of Audio Parameters on Emotional Responses and Immersion in Film

arXiv:2606.18266v1 Announce Type: cross Abstract: EMORSION is an exploratory proof-of-concept study examining how film audio design shapes audience emotion and immersion in acinema setting. Four film scenes were selected across the horror (2) and drama (2) genres, balanced between mainstream and independent productions. For each scene, multiple alternative audio mixes were created by systematically manipulating three core aspects of audio design, frequency (pitch), dynamics (loudness), and directionality (spatial placement). Three audience groups viewed the scenes, with each group exposed to one manipulated mix alongside a control mix for each scene. Audience responses were assessed through a triangulated multimodal framework combining self-reported emotion and immersion via a questionnaire, physiological measures including heart rate monitoring, and video-based motion tracking. The protocol successfully captured measurable, interpretable differences across audio conditions, indicating that even subtle changes in audio design can shape emotional perception and immersion. Unconventional mixes tended to produce greater variability in audience interpretation, while conventional immersive mixes were associated with stronger cross-audience agreement. These findings establish the feasibility of the EMORSION protocol and motivate larger-scale studies to characterise the role of specific audio parameters in shaping audience experience.

18.
medRxiv (Medicine) 2026-06-17

Identifying anaphylaxis using weakly-supervised prediction models and natural language processing

Objectives Scalable computable phenotyping algorithms are critical for conducting high-throughput disease-outcome research in large, distributed-data electronic health record (EHR) and claims data settings. We developed and evaluated a claims- and EHR-based computable phenotyping algorithm for anaphylaxis, a rare acute condition that is challenging to accurately identify using claims data alone. Materials and Methods Potential anaphylaxis events came from two healthcare systems (Kaiser Permanente Washington [KPWA] and Vanderbilt University Medical Center [VUMC]). We engineered features from clinical text using automated natural language processing (NLP) methods. We then developed a phenotyping algorithm using four NLP- and diagnosis code-based silver labels (proxies for the gold-standard labels). Gold-standard abstracted outcomes were used to evaluate algorithm performance. Results The largest area under the receiver operating characteristic curve (AUC) was 0.931 for an NLP-based silver-label model at KPWA. Depending on the model and healthcare system site, positive predictive value (PPV) and sensitivity at the threshold of predicted probability that maximized F1 score ranged from 0.52 to 0.77 (PPV) and 0.78 to 1 (sensitivity). Discussion NLP-based silver-label models had large AUC at KPWA but not at VUMC. This may be because clinical text at KPWA is only available for outpatient encounters and secure messaging. High sensitivity for identifying anaphylaxis can be obtained using our best-performing models. Conclusion The best-performing models had better PPV and sensitivity tradeoffs than prior bespoke anaphylaxis models with costly, manually curated features. The simplicity of the approach compared to traditional phenotyping methods allows it to be deployed easily at multiple health care systems.

19.
arXiv (CS.CL) 2026-06-16

Nemotron 3 Ultra: Open, Efficient Mixture-of-Experts Hybrid Mamba-Transformer Model for Agentic Reasoning

We introduce Nemotron 3 Ultra, a 550 billion total and 55 billion active parameter Mixture-of-Experts Hybrid Mamba-Attention language model. We pre-trained Nemotron 3 Ultra on 20 trillion text tokens, then extended the context length to 1M tokens, and post-trained using Supervised Fine Tuning (SFT), Reinforcement Learning (RL), and Multi-teacher On-Policy Distillation (MOPD). Nemotron 3 Ultra is our most capable model yet, employing multiple key technologies - LatentMoE, Multi Token Prediction (MTP), NVFP4 pre-training, multi-environment RLVR, MOPD, and reasoning budget control. Nemotron 3 Ultra achieves up to ~6x higher inference throughput as compared to state-of-the-art publicly available LLMs while attaining on-par accuracy. The state-of-the-art accuracy, high inference throughput, and 1M token context length make Nemotron 3 Ultra ideal for long-running autonomous agentic tasks. We open-source the base, post-trained, and quantized checkpoints, along with the training data and recipe on HuggingFace.

20.
arXiv (CS.CL) 2026-06-17

Non-Autoregressive Minimum Bayes' Risk Decoding for Fast Speech Recognition

Non-autoregressive (NAR) decoding generates output tokens in parallel, making speech recognition faster than autoregressive decoding, which generates them sequentially from left to right. However, the recognition performance is degraded because NAR decoding cannot resolve uncertainty by conditioning on previously generated tokens. To address this issue, we propose a novel NAR decoding framework based on minimum Bayes' risk (MBR) decoding, termed NAR-MBR decoding, that maximizes the expected utility calculated from samples drawn from the output probability of an NAR model rather than maximizing the output probability. Notably, by leveraging the nature of NAR models, multiple samples are obtained efficiently with a single forward computation. Our experiments across LibriSpeech, Switchboard, AMI, and web presentation corpus demonstrated that our NAR-MBR decoding outperformed previous NAR decoding and ran faster than AR decoding.

21.
medRxiv (Medicine) 2026-06-15

Pulmonary extracellular vesicles drive alveolar macrophage dysfunction via microRNA transfer in Acute Respiratory Distress Syndrome

Background: Alveolar macrophage (AM) dysfunction contributes to Acute Respiratory Distress Syndrome (ARDS) pathogenesis. We investigated the role of extracellular vesicles (EVs) in mediating this dysfunction. Methods: Pulmonary EVs were isolated from broncho-alveolar lavage and non-directed bronchial lavage samples of ventilated sepsis patients with and without ARDS, and post-operative control patients via ultracentrifugation. AMs were isolated from lung tissue resections of lobectomy patients. AMs were treated with pooled EVs for 24 hours prior to functional, metabolic and autophagy profiling. EV cargo was profiled via small RNA transcriptomics and proteomics. Mechanistic role of EV microRNAs was assessed via mimic / antagomir transfection. Results: Pulmonary EVs from sepsis patients with ARDS impaired AM efferocytosis, and control EVs had no effect. ARDS EV treatment enhanced AM mitochondrial-linked respiration, but not glycolysis. ARDS EV treatment impaired LC3B-II and LAMP1 expression, indicating dysregulated AM autophagy-lysosomal machinery. Proteomics revealed downregulation of innate immune pathways in ARDS EVs. Transcriptomics revealed enrichment of 24 microRNAs in ARDS EVs; miR-652-3p was the most enriched, validated by RT-qPCR. EV miR-652-3p was associated with 90-day mortality (9.20 vs 0.59 RQ, p=0.0295) and inversely correlated with oxygenation (PaO2/FiO2). AM transfection with miR-652-3p mimic induced similar dysregulation of function and autophagy as ARDS EVs. Transfection of ARDS EVs with antagomirs to miR-652-3p prior to AM treatment partially rescued efferocytosis and autophagy. Conclusions: Targeting EV miR-652-3p may restore alveolar macrophage function and reduce excessive inflammation, thus offering a novel therapeutic strategy for patients with ARDS.

22.
bioRxiv (Bioinfo) 2026-06-11

A multi-agent system for spine MRI report generation from multi-sequence imaging

Spinal pathology is a leading cause of pain and disability worldwide. Spine magnetic resonance imaging (MRI) is central to clinical evaluation, yet its interpretation remains complex and time-consuming, requiring integration of information across multiple imaging sequences and anatomical regions. Despite recent advances in automated MRI analysis, effectively combining multi-sequence data while preserving sequence-specific diagnostic information remains an open challenge. Here we present SpineAgent, a multi-agent framework for spine MRI report generation built upon a multi-sequence foundation model trained on routine clinical data from 32,047 patients and 453,683 MRI series, comprising a total of 13,441,191 MRI slices. To accommodate diverse modalities of sequences, we first pre-train two DINOv3-based encoders separately on T1- and T2-weighted sequences. We then introduce a continual training strategy that learns a synthesizer to embed images of other sequences using the T1 and T2 encoders, producing patient-level embedding that integrates various signals across MRI sequences. Using these embeddings, SpineAgent achieves state-of-the-art performance, with mean 10.8% AUROC improvement across 17 spinal condition-prediction tasks compared to the best competing method, and demonstrates strong generalizability under cross-manufacturer and cross-cohort evaluation. Beyond classification, SpineAgent enables pathology localization by identifying findings-relevant slices and segmenting pathological regions. It also supports multimodal image-report retrieval, providing a solid foundation for scalable and explainable MRI report generation. We further integrate these validated capabilities of SpineAgent into 37 specialized agents for condition diagnosis, pathological-region localization, and clinically-similar-cases retrieval. Finally, we incorporate their outputs as structured tokens within a Medical Report Agent trained end-to-end for report generation. Through both automated metrics and expert evaluation by five radiologists, SpineAgent achieves leading performance in spine MRI report generation. Together, SpineAgent introduces a continual training approach for multi-sequence spine MRI understanding. By decomposing report generation into clinically grounded subtasks addressed by specialized agents, the SpineAgent framework enables accurate, interpretable and generalizable spine MRI reporting across diverse imaging sequences and anatomical regions.

23.
medRxiv (Medicine) 2026-06-22

A blinded, counterbalanced rater design for evaluating AI-assisted summarisation of tertiary clinical genomics reports: methodology of the QNOMX-VHIR-CPSP-001 Phase 1 study

Background. Tertiary clinical genomics reports condense layered molecular findings into documents that treating oncologists must read, translate, and act upon; manual summarisation of these reports is time-consuming and variable. Tools that assist summarisation and translation into local languages are emerging, yet the field lacks an agreed methodology for evaluating such tools before any downstream clinical use. The appropriate first endpoint is fidelity of the generated summary to its source report, assessed by qualified human raters under blinded scoring, not downstream variant classification. Methods. QNOMX-VHIR-CPSP-001 Phase 1 is a single-site, non-interventional clinical performance study conducted at Vall d'Hebron Institut de Recerca (VHIR) under ISO 20916:2019 as a Clinical Performance Study Protocol. De-identified tertiary cancer genomics reports from pediatric oncology cases are summarised by the AI-assisted summarisation system under evaluation and, in parallel, by the standard manual workflow. Qualified raters score both summary types against the source genomics report using the Quality Summary Index (QSI), a six-dimension, five-point rubric adapted from the Provider Documentation Summarization Quality Instrument, under a blinded, counterbalanced, two-period crossover with a minimum fourteen-day washout. Two co-primary composite endpoints, content and presentation, are analysed for non-inferiority under a Bayesian hierarchical model, with a frequentist linear mixed model as the convergence check. Inter-rater reliability is reported as Krippendorff's ; a Monte-Carlo power analysis of the fixed clustered design is pre-specified. Discussion. The design isolates summarisation quality from clinical decision-making by scoring both summary types against the same source report under blinding, counterbalancing, and a fourteen-day washout. Conclusion. The QSI rubric, the counterbalanced crossover, and the pre-specified Bayesian primary with frequentist convergence check define a replicable protocol for early-stage evaluation of AI-assisted summarisation in tertiary genomics reporting; observed variance components will inform sample-size determination for Phase 2.