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02.
arXiv (CS.CV) 2026-06-15

Catching magnetic resonance imaging outliers in artificial intelligence-supported radiotherapy workflows: unsupervised detection and localization of image anomalies using deep learning

Artificial intelligence is increasingly integrated into radiotherapy workflows, yet such pipelines remain vulnerable to out-of-distribution image data that may introduce unexpected behavior in clinical tasks. Deep learning-based anomaly detection for pelvic magnetic resonance imaging (MRI) remains largely unexplored, and transparent evaluation of its feasibility for full automation is limited. We developed and evaluated a fully automated, unsupervised anomaly-detection framework for pelvic and brain MRI. A two-stage framework was trained on reference images from public datasets: LUND-PROBE for pelvic MRI, and IXI, fastMRI, and fastMRI+ for brain MRI. In the first stage, MRI slices were compressed into discrete tokens; in the second, the distribution of normal tokens was modeled. Anomaly evidence was estimated by combining perceptual image differences with token-surprisal scores based on negative log-likelihood. Automated detection was evaluated on pelvic MRI with synthetic global and real clinical anomalies, and on brain MRI with clinically annotated fastMRI+ abnormalities. Sensitivity, specificity, area under the receiver operating characteristic curve (AUC), and false-positive behavior in held-out normal cases were assessed. The framework achieved robust detection across hidden evaluation cohorts, with AUCs of 0.97 (95% CI, 0.95-0.98) and 0.81 (95% CI, 0.74-0.87) for pelvic and brain MRI, respectively. Heatmap analysis showed strong spatial agreement between detected anomalies and ground-truth locations, supporting localization accuracy and interpretability. These results support the potential of unsupervised anomaly detection as an automated MRI quality-control layer for radiotherapy workflows, with transparent visualization of image regions likely to compromise downstream AI-based tasks.

03.
arXiv (CS.LG) 2026-06-15

AcceRL: A Distributed Asynchronous Reinforcement Learning and World Model Framework for Vision-Language-Action Models

arXiv:2603.18464v3 Announce Type: replace Abstract: Reinforcement learning (RL) for large-scale Vision-Language-Action (VLA) models is severely bottlenecked by synchronization barriers and the high cost of environment data acquisition. To overcome these challenges, we propose AcceRL, a distributed asynchronous RL framework that physically isolates environment rollouts, model inference, and gradient updates. By eliminating the cascading long-tail idle bubbles inherent in synchronous systems, AcceRL maximizes hardware utilization and ensures scalable throughput. Furthermore, AcceRL features a modular design that supports the integration of diverse, plug-and-play world models into its distributed pipeline. Extensive experiments demonstrate that the base framework achieves highly competitive performance across all four LIBERO[liu2023libero] task suites. Systematically, the asynchronous architecture delivers a $2.4\times$ throughput speedup over leading synchronous baselines. Algorithmically, by leveraging a world model pre-trained on 1,000 offline trajectories, AcceRL achieves up to a $200\times$ improvement in online sample efficiency on LIBERO-Spatial, establishing a robust framework that is both sample-efficient and time-efficient for embodied AI. Code is included in the supplementary material. Code is available at https://github.com/distanceLu/AcceRL.

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

Graph Instance Landscapes: When Structural Similarity Does (Not) Reflect Shortest-Path Performance

arXiv:2606.18267v1 Announce Type: cross Abstract: Benchmarking shortest-path algorithms is commonly based on aggregate performance over heterogeneous graph sets, which limits insight into how different search paradigms react to instance structure. We adopt an instance-landscape view of graph benchmarking by embedding graphs into a low-cost structural feature space and clustering them into regions of similar structure. Three benchmark suites are studied: weighted Erdős–Rényi graphs, random geometric (wireless) graphs, and real-world road networks. We evaluate four representative shortest-path solvers spanning uninformed exact search (Dijkstra), bidirectional exact search (bidirectional Dijkstra), heuristic-guided exact search (A$^{*}$), and deque-based strategies (DEQ). Clustering robustness is analyzed under multiple feature-selection schemes, and runtime distributions are compared across landscape regions using non-parametric tests. While generator parameters induce stable structural regions, we find that feature-space similarity does not necessarily imply performance similarity: significant runtime shifts are frequently observed even within the same landscape region. A merged-suite analysis further shows that different benchmark families occupy largely disjoint regions. These results highlight both the potential and the limits of structural landscapes for the structure-aware benchmarking of shortest-path algorithms.

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

From Bounding Boxes to Visual Reasoning: An On-Policy Data Annotation Tool for Vision-Language Models

Vision-language models (VLMs) are rapidly advancing toward sophisticated grounded structured visual reasoning. Training models for such advanced capabilities demands a new genre of data that seamlessly unifies spatial coordinates, open-vocabulary descriptions, structured attributes, and topological relationships into a singular representation. However, existing data annotation tools fundamentally fail to meet these intricate demands, suffering from three systematic bottlenecks: limited expressiveness, severe annotation-training decoupling, and poor data reusability. To bridge this infrastructure gap, we introduce an open-source annotation tool, ScreenAnnotator. First, we define a unified annotation atom schema that binds spatial, semantic, and structural primitives into a single unit. Second, we implement an on-policy annotation loop embedded with a Bayesian Annotation Verifier (BAV). Finally, we design a template-driven multi-task data synthesis process dynamically transforms static atoms into diverse multi-dimensional reasoning tasks, eliminating redundant re-annotation. The on-policy loop drives the annotation accept rate to nearly 100% on flowcharts and 77% on GUI screenshots, while steadily reducing per-image annotation time as labeled data accumulate. In the flowchart scenario, fine-tuning a VLM yields 76.1% average accuracy, which is a 35.1% point absolute gain. Our code is available at: https://github.com/WnQinm/Annotator.

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

Planning with the Views via Scene Self-Exploration

Can VLMs predict how each camera move changes the view, and plan many such moves ahead? We call this capability view planning, requiring (1)understanding how a single action transforms the view, and (2)composing many such transformations across multi-turn plans to identify a target view. We probe both abilities in our proposed ViewSuite, a 3D point-cloud environment on real ScanNet scenes. Across 13 frontier VLMs, a critical planning gap emerges: they possess basic view-action knowledge but fail to compose it across multi-turn plans, with the gap widening as viewpoint distance grows. To close this gap, we propose an iterative framework that alternates self-exploration with view graph distillation. The key insight is that all exploration trajectories, regardless of their outcome, collectively form a view graph that compactly captures how viewpoints connect across a scene. Distilling this graph into diverse supervised tasks reshapes the policy distribution and overcomes the sparse rewards that stall pure RL. This improves Qwen2.5-VL-7B from 2.5% to 47.8% on interactive view planning, surpassing GPT-5.4 Pro (18.5%) and Gemini 3.1 Pro (21.4%). Self-exploration emerges as a promising path toward VLMs that can actively reason and plan in 3D space. Code and Data are at https://viewsuite.github.io.

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

ArtBoost: Synthetic Articulatory Data Augmentation for Acoustic-to-Articulatory Inversion

arXiv:2606.16327v1 Announce Type: cross Abstract: Recent acoustic-to-articulatory inversion (AAI) models rely on electromagnetic articulography (EMA) data, which are costly and limited in scale. To address this limitation, we propose ArtBoost, a novel data augmentation strategy that leverages large-scale speech–mesh datasets originally developed for speech-driven 3D facial animation to improve AAI under limited EMA supervision. ArtBoost extracts pseudo articulatory trajectories from visible facial anchors and uses them for pre-training before fine-tuning on real EMA data. Experiments show consistent improvements in PCC and RMSE. Trajectory analyses confirm that the pseudo articulatory signals reflect physically meaningful visible articulatory dynamics. Additional evaluations across different AAI architectures demonstrate stable performance gains, indicating that ArtBoost can be integrated into diverse AAI models. These results suggest that speech–mesh data provide an effective and scalable source of articulatory supervision for AAI. Project page: https://cau-irislab.github.io/Interspeech26-ArtBoost/

08.
arXiv (quant-ph) 2026-06-15

Bandstructure of a coupled BEC-cavity system: effects of dissipation and geometry

arXiv:2504.17730v2 Announce Type: replace-cross Abstract: We present a theoretical model for a transversally driven Bose-Einstein condensate coupled to an optical cavity. We focus on the interplay between different coherent couplings, which can trigger a structural phase transition, known as the superradiant phase transition. Our approach, based on band structure theory and a mean-field description, enables a comprehensive analysis of the nature of the system's excited modes, precursing the phase transitions. By incorporating dissipative couplings, intrinsic to these systems, we find non-Hermitian phenomena such as the coalescence of crossing precursor modes and the emergence of exceptional points (EPs). The general formulation of our model allows us to explain the role of an angle between transverse pump and the cavity deviating from $90^\circ$. This offers us a unified perspective on the plethora of different implementations of such systems.

09.
arXiv (CS.LG) 2026-06-15

Nonlinear Two-Time-Scale Stochastic Approximation: A Sharp Phase Transition and How to Beat It

arXiv:2606.14488v1 Announce Type: cross Abstract: Recent finite-time analyses of nonlinear two-time-scale stochastic approximation show that under contractive assumptions the slow iterate $Y_k$ with stepsizes $\beta_k=\Theta(k^{-1})$ and $\alpha_k=\Theta(k^{-a})$, $a\in(1/2,1)$, generally satisfies a mean-square rate of order $k^{-a}$; decoupled $k^{-1}$ rates require strong local linearity. We identify a sharp regularity-dependent boundary. In a rate-determining normal form where the slow drift contains a locally linear leakage and a nonlinear remainder of order $1+\rho$ ($\rho\in[0,1]$), the uncorrected recursion satisfies \[ \mathbb{E}\|Y_k\|^2 \le C\bigl(k^{-1}+k^{-a(1+\rho)}\bigr), \] and a matching scalar Gaussian lower bound shows that the slower term is unavoidable without modifying the update. Thus the decoupled $k^{-1}$ rate is guaranteed for the uncorrected recursion exactly when $a(1+\rho)\ge 1$. This lower bound concerns only the naive update; it is not an information-theoretic obstruction. We demonstrate this by equipping the normal-form recursion with an auxiliary online bias estimator \[ M_{k+1}=M_k+\gamma_k(R(X_k)-M_k),\qquad \beta_k\ll\gamma_k\ll\alpha_k, \] and subtracting $M_k$ from the slow update. Under the same stability, moment, and remainder assumptions, the corrected recursion achieves $\mathbb{E}\|\widetilde Y_k\|^2=O(k^{-1})$ for every $\rho\in[0,1]$, including regimes where the uncorrected update provably suffers the slower rate. Finally, we prove localized transfer theorems that extend the phase-transition mechanism to general nonlinear TTSA in fast-manifold coordinates. The proofs are non-asymptotic and rely on two Abel-transform cancellations: one for the locally linear fast-error leakage, and one for the tracked nonlinear bias.

10.
arXiv (CS.AI) 2026-06-16

Boosting Knowledge Graph Foundation Models via Enhanced Negative Sampling

arXiv:2605.27023v2 Announce Type: replace Abstract: Knowledge graphs (KGs) have become the core backbone of numerous downstream tasks such as question answering and recommender systems. However, despite all this, KGs are often very incomplete. To perform zero-shot knowledge graph completion in unseen KGs, which have different relational vocabularies from those used for pre-training, KG foundation models (KGFMs) receive a wide range of attention. Existing KGFMs often perform training using random negative triples, which are constructed by replacing the head or tail entity of a positive triple with a random entity. However, these negative triples are often constructed with limited quality, providing weak supervision for KGFM training. In this paper, we propose a simple yet effective adaptive negative sampling approach, KMAS, to enhance existing KGFMs. KMAS constructs hard negative triples through the updated relation embeddings generated from the existing KGFM's relation encoder. To further adaptively align with the evolving capability of the KGFM during the training process, KMAS adjusts the ratio of hard negative triples dynamically throughout the whole training process: after a warmup phrase, it increases the ratio linearly and then decreases linearly. Extensive experiments are conducted over 44 data sets. Experimental results demonstrate that our proposed negative sampling method can enhance many SOTA KGFMs without requiring excessive additional time or memory consumption.

11.
arXiv (CS.LG) 2026-06-16

Temporal Validation Changes the Apparent Public-Health Utility of Under-Five Mortality Prediction in Bangladesh: A Four-Round DHS Machine-Learning Study

arXiv:2602.03957v2 Announce Type: replace Abstract: Background: Under-five mortality in Bangladesh remains uneven despite national progress. DHS-based prediction models may guide targeted follow-up, but only if validation reflects future use. We examined how validation design changes apparent prediction performance. Methods: Four BDHS rounds (2011-2022; 33,962 children; 1,290 deaths) were analysed with a 26-feature pipeline and three model classes under four validation regimes, including cross-survey temporal validation (train 2011+2014, calibrate 2017, test 2022). A 32-unit ELU multilayer perceptron was selected via genetic-algorithm neural architecture search. AUROC used 2,000 bootstrap resamples; screening utility used sensitivity, PPV, and number needed to screen (NNS) at fixed capacity. Results: Validation regime altered public-health interpretation more than model class. NAS MLP AUROC ranged from 0.669 (2022-only random) to 0.775 (pooled random), with temporal AUROC 0.730. At the top-10% temporal threshold, NAS identified 152/355 deaths in 2022 (sensitivity 42.8%, PPV 13.2%, NNS 7.6). NNS across designs ranged from 5.6 to 11.0. Conclusions: Validation-regime choice changed screening workload and apparent policy value more than architecture. Temporal validation supports defensible estimates of follow-up and referral demand; DHS child-mortality studies should report sensitivity, PPV, and NNS before programmatic use.

12.
medRxiv (Medicine) 2026-06-11

A global cross-sectional survey of health professionals' interest-confidence gaps in value-based health care implementation: a learning needs assessment

Abstract Objectives Value-Based Health Care (VBHC) increasingly guides health system redesign internationally. Despite the increasing availability of VBHC education, gaps remain between health professionals' conceptual understanding of VBHC and their confidence to implement it in practice. This study assessed perceived learning needs and preferences of healthcare professionals across foundational topics essential to VBHC implementation. Design Cross-sectional online survey study Setting and participants The survey was distributed to the global VBHC community and yielded 518 responses. Most respondents were based in the UK and Ireland (51%) and 65% had more than 10 years of experience in the health sector. Participants represented a variety of professional backgrounds, including clinicians (34%), operational or executive managers and leaders (22%), and life sciences or procurement professionals (13%). Primary and secondary outcome measures Primary outcome measures included self-reported interest and confidence across 15 VBHC domains and the magnitude of the gap between them. Secondary outcomes included perceived implementation challenges and preferred VBHC learning approaches, including prior engagement with VBHC-related learning. Results Respondents identified substantial VBHC implementation challenges, including implementing outcome measurement (62.4%), conflicting priorities (57.7%), and resistance to change (56.8%). Interest in all VBHC domains was high (median >= 80/10), while confidence to implement remained substantially lower across most domains (median

13.
arXiv (CS.AI) 2026-06-15

An interpretable unsupervised representation learning for high precision measurement in particle physics

arXiv:2511.22246v2 Announce Type: replace-cross Abstract: Unsupervised learning has been widely applied to various tasks in particle physics. However, existing models lack precise control over their learned representations, limiting physical interpretability and hindering their use for accurate measurements. We propose the Histogram AutoEncoder (HistoAE), an unsupervised representation learning network featuring a custom histogram-based loss that enforces a physically structured latent space. Applied to silicon microstrip detectors, HistoAE learns an interpretable two-dimensional latent space corresponding to the particle's charge and impact position. After simple post-processing, it achieves a charge resolution of $0.25\,e$ and a position resolution of $3\,\mu\mathrm{m}$ on beam-test data, comparable to the conventional approach. These results demonstrate that unsupervised deep learning models can enable physically meaningful and quantitatively precise measurements. Moreover, the generative capacity of HistoAE enables straightforward extensions to fast detector simulations.

14.
arXiv (CS.AI) 2026-06-16

Mind-Studio: Executable World Models with Lookahead Evaluation for Partially Observable Games

arXiv:2606.16070v1 Announce Type: new Abstract: World-model synthesis aims to turn interaction experience into an internal model of environment dynamics. Existing symbolic approaches often fit observed transitions or mixtures of local rules, but they do not produce a complete executable program that can run independently of the real environment. We present Mind-Studio, a framework that synthesizes executable pygame-style world models from state-action-next-state trajectories using large language models. Mind-Studio combines entropy-selected traces with a lightweight game skill file containing object, action, and static scene information extracted from screenshots. We evaluate synthesis quality with a K-step lookahead fidelity protocol that compares generated world-model rollouts against Real-ALE rollouts from the same state. On Montezuma's Revenge, Mind-Studio improves chosen-action next-state prediction from 0.3% for PoE-World to 48.7% while verifying 5 of 8 subgoals; across Alien, Assault, and Skiing, it achieves stronger branch-level fidelity than prior learned lookahead sources.

15.
arXiv (CS.CL) 2026-06-19

Token-Operations-Oriented Inference Optimization Techniques for Large Models

Large model inference optimization serves as a key foundation for supporting the scalable, low-cost, and highly stable operation of large model services. Centered on token-oriented inference optimization technology, this paper proposes for the first time a four-layer technical architecture consisting of Multi-model Fusion, Model Optimization, Compute-Model Fusion, and Compute-Network-Model Fusion. It systematically reviews the key technologies and current industry status across these four levels and analyzes the application value of related technologies in real-world business scenarios. This paper provides a practical technical path for reducing token production costs, improving token service efficiency, ensuring the stability of token supply, and driving the transition of large model services from being merely callable to being operable.

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

CareTransition-Audit: A Benchmark to Audit Discharge Summaries for Efficient Care Transitions

arXiv:2604.05435v2 Announce Type: replace Abstract: Incomplete or inconsistent discharge documentation drives care fragmentation and avoidable readmissions. Despite its critical role in patient safety, auditing discharge summaries relies on manual review and does not scale. We propose an automated framework for auditing discharge summaries using large language models (LLMs). Our approach operationalizes the DISCHARGED framework into a checklist of 46 questions. Using 50 summaries from the MIMIC-IV database, with clinician ground-truth labels, we benchmark 11 LLMs. Model-assessed mean documentation completeness ranges from 54.9% to 74.2%, and the best-performing models achieve a Cohen's kappa values around 0.5 against clinician labels, indicating moderate agreement. All models struggle to identify ambiguous documentation (Unclear), highlighting a key gap in current automated auditing. This work provides a clinician-validated benchmark and zero-shot baselines for systematic quality improvement in clinical documentation.

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

From Sparse Features to Trustworthy Proxies: Certifying SAE-Based Interpretability

Sparse autoencoders (SAEs) are increasingly used to extract interpretable features from language models (LMs), yet a central question remains: when can an SAE-based explanation be treated as a faithful view of an underlying frozen LM We study this through a post-hoc generalization framework that certifies the LM via a sparse proxy, obtained by replacing a native hidden activation with its pretrained SAE reconstruction. Our framework derives an upper bound on the base model's expected risk using four measurable quantities: proxy risk, SAE reconstruction gap, concept-pool mismatch, and sparse complexity. We interpret this certificate as an operational criterion for explanatory faithfulness. In particular, a non-vacuous bound indicates that the extracted sparse features retain meaningful predictive information, while small reconstruction and mismatch errors indicate that the proxy remains behaviorally close to the original model. Empirically, we show that the bound becomes non-vacuous on GPT-2 Small, Gemma-2B, and Llama-3-8B at practical sample sizes. A detailed layerwise analysis of Llama-3-8B reveals a strong depth dependence, with later layers becoming much easier to certify, associated with both stronger local fidelity and weaker downstream error amplification. Finally, through feature-shuffling ablations, we show that the decomposition distinguishes genuine semantic alignment from mere statistical sparsity, providing a useful diagnostic for when SAE-based explanations become less reliable.

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

Priors Persist Through Suppression: A Stroop Paradigm for Lexical Override

Authors:

Glossaries, technical specifications, and system prompts routinely ask language models to use familiar words in unfamiliar ways. When this works, the local rule does not install the new meaning on top of the old one; the pretrained prior keeps operating underneath, and its strength still shows through. We test this with a Stroop-style paradigm: a remapping rule (doctor means forest) pitted against the query word's lexical-prior distractor (hospital), with matched neutral controls. Across 11 open-weight models spanning four families and 1B-9B parameters, lexical-prior strength predicts interference even after item-level controls for answer prior, frequency, tokenization, and prompt wording. Activation patching on five aligned models locates a source-position triplet (definition subject, definition target, query word) that nearly fully recovers the conflict effect (aggregate $R \in [0.92, 1.06]$); a definition-target swap shows the triplet performs binding rather than identity matching. Dissociation experiments isolate target preservation as the binding-specific signature: distractor suppression occurs under matched, swap, and item-mismatched conditions alike, whereas target logit collapse occurs only when the definition-target position is corrupted. Behavior and mechanism converge on the same channel: the prior's strength both predicts which overrides fail and marks where the causal repair lands.

19.
arXiv (CS.CV) 2026-06-15

HiLo-Token: Input-Adaptive High-Low Frequency Token Compression for Efficient Image Editing

Creative image editing tools, such as Photoshop's Remove or Generative Fill buttons, are central to everyday customer use and account for a major share of traffic in Photoshop and Lightroom. However, current generative AI models face significant latency challenges, which become even more pronounced when transitioning from convolution-based U-Nets to Diffusion Transformers (DiTs). In our evaluation on hundreds of representative image editing samples spanning a wide range of mask ratios, the DiT module alone accounts for an average of 73% of the total model latency, even after being distilled from 50 timesteps down to 8 timesteps. To tackle this challenge, we propose $HiLo-Token$, an input-adaptive token compression framework that allocates more token budget to high-frequency, rich-context regions while assigning fewer tokens to low-frequency areas. Specifically, for the editing region specified by the user mask, we retain all tokens within a dilated mask to preserve strong locality and contextual relevance. Outside the editing region, we introduce a simple yet effective high-frequency token selection strategy based on spatial frequency to capture important local details, while using tokens from a 16x downsampled image to represent low-frequency components and preserve the blurry but global structure. Extensive experiments on production-level evaluation data validate the effectiveness of the proposed method, achieving 3.13x, 2.59x, and 1.67x DiT speedups on A100-80GB for image editing tasks across small, medium, and large mask ratio categories with average ratios of 6.38%, 15.92%, and 35.36%, respectively, without any regression in generation quality.

20.
arXiv (CS.CL) 2026-06-16

Simplifying the Modeling of Arbitrary Conditionals in Natural Language

Causal Transformers model sequences through an autoregressive factorization of the joint distribution, which enables efficient left-to-right decoding and conditional likelihood computation. However, they cannot tractably sample from or evaluate arbitrary conditionals – e.g., a block of text conditioned on past and future tokens. Recent work aims to solve this problem through novel architectures, but they often lead to sub-optimal modeling of such conditionals and degraded generations. We propose Arbitrary Conditionals GPT (AC-GPT) which introduces a simple modification to standard causal Transformers to enable evaluating and sampling from arbitrary conditionals – including past, future, and mixed contexts – within a single forward pass. Unlike prior approaches, our method preserves the standard left-to-right ordering and next-token prediction objective essential for both strong performance and efficient training on natural language. Crucially, this compatibility allows existing LLMs to be fine-tuned for arbitrary conditioning. Our empirical results indicate that our method outperforms baselines on modeling arbitrary conditionals, without degrading standard left-to-right performance.

21.
arXiv (quant-ph) 2026-06-11

Scaling-optimal purification of noisy qubit unitary channels

arXiv:2606.12394v1 Announce Type: new Abstract: We consider the problem of purifying noisy qubit unitary channels. Given the ability to apply an unknown qubit unitary channel followed by depolarizing noise, we aim to construct a superchannel that purifies the noisy unitary back to the original unknown unitary. We first provide numerical evidence that sequential strategies can strictly outperform parallel strategies when the number of channel uses is finite, highlighting the fundamental distinction from state purification. We then provide a concrete $\mathrm{U}(2)$-covariant parallel protocol based on a novel entanglement-assisted quantum error-correcting code that suppresses the first-order noise strength as $O(1/n)$ with $n$ channel uses and show this scaling is asymptotically optimal in the low-noise regime, even when sequential strategies are allowed.

22.
medRxiv (Medicine) 2026-06-22

Rare loss-of-function variants in POLD1, PMS1 and FAN1 modify age at onset of motor symptoms in Huntington's disease

Huntington's disease is a rare neurodegenerative disease whose primary risk factors are inherited expansions of a CAG repeat tract in the HTT gene. Somatic expansion of these tracts leads to neuronal toxicity, neuronal death and clinical disease progression. To identify genetic factors with a major impact on disease onset and progression, we genome sequenced 18,825 individuals for the ENROLL-HD study. Our results show rare inactivating mutations in three genes, all involved in DNA damage repair, are major determinants of age of onset for motor symptoms (n=10,610) and other clinical manifestations. Heterozygote carriers of predicted loss-of-function (pLoF) variants in POLD1 and PMS1 developed motor symptoms an average 20 years (n=3; P=1x10-5) and 7 years (n=6; P=2x10-3) later than non-carriers, respectively. Conversely, heterozygote carriers of pLoF variants in FAN1 (n=30) developed symptoms 10 years earlier (P=2x10-10). Our findings highlight therapeutic strategies and help predict age of onset for at-risk individuals.

23.
medRxiv (Medicine) 2026-06-19

Within-host pathogen population diversity predicts treatment response in tuberculosis

Background: Tuberculosis (TB) treatment outcomes remain suboptimal, and standard clinical diagnostics cannot reliably identify patients at high risk of treatment failure or relapse at the time of diagnosis. While within-host Mycobacterium tuberculosis genetic diversity is hypothesized to reflect the viable bacterial burden and adaptive capacity of the infection, its clinical prognostic value remains unknown. Methods: We conducted a prospective cohort study of 364 patients with newly diagnosed, rifampicin-susceptible pulmonary TB in South Africa. Patients received standard 6-month therapy and were monitored for up to two years to ascertain composite unfavorable outcomes (treatment failure, death, or relapse). To accurately detect low-frequency (unfixed) genetic variants and eliminate reference bias artifacts, we mapped medium to high depth short-read sequences against matched, patient-specific long-read assemblies. The association between baseline pathogen genetic diversity and clinical outcomes was evaluated using multivariable Cox proportional-hazards models. Results: After bioinformatic filtering, true unfixed variants were relatively rare but significantly enriched in genes mediating pathogen adaptation and drug tolerance, including transporter proteins and two-component regulatory systems. Within-host bacterial genetic diversity (i.e., the total number of unfixed variants) ranged from 0-20, with a median of 1 per patient. In survival analysis adjusting for known clinical risk factors–including HIV status, prior TB, baseline smear positivity, and radiographic lung involvement–baseline within-host genetic diversity emerged as a strong, independent predictor of unfavorable treatment outcomes. For patients with greater than 3 unfixed variants at diagnosis, each increase of 5 unfixed variants was associated with more than double the risk of a composite unfavorable outcome (adjusted Hazard Ratio, 2.36; 95% CI, 1.27 to 4.39; p=0.007). Conclusions: Baseline within-host pathogen genetic diversity is an independent predictor of unfavorable TB treatment outcomes. As sequencing becomes increasingly integrated into routine diagnostics, quantifying unfixed variants is an accessible approach that promises to risk-stratify patients and guide the duration of individualized regimens.

24.
arXiv (CS.CL) 2026-06-11

FlowBank: Query-Adaptive Agentic Workflows Optimization through Precompute-and-Reuse

Large Language Model (LLM)-based multi-agent systems are increasingly powerful, but current agentic workflow optimization paradigms make an unsatisfying trade-off. Task-level methods spend substantial offline compute yet deploy only a single workflow, leaving complementary candidates unused, while query-level methods synthesize a new workflow per query at substantial inference cost. Our motivating analysis shows these paradigms are more complementary than competing: workflows discovered during offline search often solve different subsets of queries, and many queries handled by expensive query-level generation can already be solved by cheaper precomputed workflows. This suggests a different objective: rather than searching for one universally best workflow or regenerating one per instance, we should build a compact bank of reusable, complementary workflows and select among them adaptively at inference time. Doing so requires solving three coupled problems: generating complementary rather than redundant candidates, compressing them into a small deployable portfolio, and assigning each query to the right workflow under a performance-cost trade-off. To this end, we present FlowBank, a three-stage framework for portfolio-based agentic workflow optimization. Diversifying proposes DiverseFlow to steer search toward under-covered queries and produce a high-coverage candidate pool. Curating proposes CuraFlow to compress this pool into a compact portfolio with minimal redundancy. Matching casts deployment as edge-value prediction on a query-workflow bipartite graph and routes each incoming query to the portfolio member with the best predicted utility. Across five benchmarks, FlowBank achieves the highest average score among the evaluated methods while remaining cost-competitive, improving over the strongest automated and handcrafted baselines by 4.26% and 14.92% relative, respectively.

25.
arXiv (CS.CV) 2026-06-12

Comparing Commercial Depth Sensor Accuracy for Medical Applications

Depth estimation has numerous medical and surgical applications. We benchmark four depth sensors on a porcine bone specimen, a porcine belly specimen, and a silicone kidney phantom using stylus-sampled references. These objects contain several real-world challenges, including homogeneous surfaces, specular surfaces, and subsurface scattering. The comparison includes stereo, structured-light, and time-of-flight sensors at a distance of approximately 50 cm. Specifically, the Intel RealSense D405 (Intel RealSense, United States), PMD Flexx2 (pmdtechnologies, Germany), Stereolabs ZED 2i (Stereolabs, France), and Zivid 2M+ 60 (Zivid, Norway) are compared. The Zivid 2M+ 60 performed best across all objects and metrics considered in this work. The ZED ranked second for real tissue, but last on the phantom.