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01.
arXiv (quant-ph) 2026-06-16

Information Is Not Physical: Possibility Spaces, Erasure, and the Structure of Unrealized Alternatives

arXiv:2606.15120v1 Announce Type: cross Abstract: The slogan ``information is physical,'' introduced by Rolf Landauer and developed through quantum information theory and black-hole thermodynamics, has achieved near-axiomatic status in modern physics. Yet the ontological status of information remains surprisingly underexamined: most discussions either reduce information to a form of energy or treat it as a purely mathematical object. This paper proposes a third position. I argue that information is neither a physical substance nor a free-floating abstraction, but rather the structure of physically realizable alternatives – a counterfactual structure that a physical system instantiates in virtue of the possibility space available to it. Building on Shannon's combinatorial definition, the Landauer principle, the no-cloning theorem, and the black-hole information paradox, I show that the informational content of any physical event is constituted by the set of outcomes that could have occurred but did not. This counterfactual reading dissolves several persistent confusions: it explains why erasing information dissipates heat without making information ``material,'' why quantum superposition is informationally richer than any classical mixture, and why information loss in black holes is physically significant beyond mere bookkeeping. The proposal sits within a structural-realist framework but departs from standard structural realism by locating the relevant structure in modal, not merely actual, relations. I conclude by sketching implications for the foundations of quantum mechanics, quantum gravity, and scientific ontology more broadly.

02.
arXiv (CS.CV) 2026-06-16

Structure-aware Knowledge-guided Heterogeneous Mamba for Zygomaticomaxillary Suture Assessment

The Zygomaticomaxillary Suture is a key circummaxillary structure that connects the zygomatic bone and the maxilla, which serves as a primary site of resistance during maxillary advancement, and its maturation status directly influences the timing and efficacy of orthopedic interventions. However, accurate staging of ZMS maturation remains challenging due to subtle high-frequency transitions in suture lines and the global semantic ambiguity between adjacent stages. To address this, we present the first public ZMS dataset, comprising 3,790 ZMS images covering the entire age range from 4 to 24 years. Based on this dataset, we propose SKMamba, a Structure-aware and Knowledge-guided Mamba-based multi-modal framework for automated ZMS maturation assessment. SKMamba adopts a decoupled dual-path architecture that mimics the hierarchical diagnostic process used by experienced orthodontists. We first introduce an Implicit Edge Extractor (IEE), which leverages structural pre-training to reduce trabecular noise and accentuate sutural boundaries. Complementarily, a Cross-Modal Semantic Alignment (CSA) module is designed to incorporate anatomical descriptions from a large language model (LLM). This module helps align local morphological cues with global semantic descriptions while ensuring that objective morphological evidence remains the primary basis for decisions. Extensive experiments on our ZMS dataset demonstrate that SKMamba achieves state-of-the-art performance compared to existing methods. Code is available at https://github.com/galaxygxq1116/SKMamba.

03.
arXiv (CS.CV) 2026-06-16

A Comprehensive Survey of Knowledge-Based Vision Question Answering Systems: The Lifecycle of Knowledge in Visual Reasoning Task

Knowledge-based Vision Question Answering (KB-VQA) extends general Vision Question Answering (VQA) by not only requiring the understanding of visual and textual inputs but also extensive range of knowledge, enabling significant advancements across various real-world applications. KB-VQA introduces unique challenges, including the alignment of heterogeneous information from diverse modalities and sources, the retrieval of relevant knowledge from noisy or large-scale repositories, and the execution of complex reasoning to infer answers from the combined context. With the advancement of Large Language Models (LLMs), KB-VQA systems have also undergone a notable transformation, where LLMs serve as powerful knowledge repositories, retrieval-augmented generators and strong reasoners. Despite substantial progress, no comprehensive survey currently exists that systematically organizes and reviews the existing KB-VQA methods. This survey aims to fill this gap by establishing a structured taxonomy of KB-VQA approaches, and categorizing the systems into main stages: knowledge representation, knowledge retrieval, and knowledge reasoning. By exploring various knowledge integration techniques and identifying persistent challenges, this work also outlines promising future research directions, providing a foundation for advancing KB-VQA models and their applications.

04.
arXiv (CS.CL) 2026-06-15

CORA: Analyzing and bridging thinking-answer gap in Multimodal RLVR via Consistency-Oriented Reasoning Alignment

Reinforcement learning with verifiable rewards (RLVR) has successfully elicited the reasoning capabilities of large language models, motivating its extension to multimodal scenarios. Existing methods primarily focus on improving the visual coverage of reasoning traces and mitigating visual hallucinations, but underestimate the semantic inconsistency between the reasoning process and the final answer. In this paper, we delve into thinking-answer inconsistency in RLVR for large vision-language models (LVLMs), showing thorough analyses of rollouts collected throughout Group Relative Policy Optimization (GRPO) training process and post-RLVR evaluation outputs that this issue persists during training and remains present during inference. Motivated by the analysis, we propose Consistency-Oriented Reasoning Alignment (CORA), which introduces thinking-answer semantic consistency into RLVR through a lightweight plug-and-play consistency reward model, and further incorporates Hybrid Reward Advantage Splitting (HRAS) to stably coordinate task and consistency optimization. Extensive experiments across representative multimodal reasoning benchmarks and mainstream LVLMs show that CORA improves task performance while effectively mitigating thinking-answer inconsistency, leading to more faithful reasoning traces.

05.
arXiv (CS.CL) 2026-06-16

SHARD: Safe and Helpful Alignment via Self-Reframing Distillation

Large language models often struggle with sensitive prompts. They may refuse outright, provide generic safety boilerplate, or fail to address the user's legitimate informational needs that can be answered safely. We introduce SHARD, a self-reframing distillation method to improve safe-helpfulness. It first rewrites sensitive prompts to surface benign intent using philosophical guidelines, then reframes its original responses into safe, more helpful ones, and finally fine-tunes the model on its self-reframed responses. Across DNA and the English subset of LINGUASAFE, SHARD improves helpfulness for most model families while preserving safety. It also remains competitive with distillation from a larger teacher model, suggesting that models can internalize safe and helpful behavior elicited from their own. Warning: This paper contains content that may be offensive or harmful.

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

OpenAnt: LLM-Powered Vulnerability Discovery Through Code Decomposition, Adversarial Verification, and Dynamic Testing

arXiv:2606.19149v1 Announce Type: cross Abstract: Automated vulnerability discovery in large codebases remains challenging: traditional static analysis produces high false-positive rates, while dynamic approaches such as fuzzing require substantial infrastructure and often target narrow classes of bugs. Recent advances in large language models (LLMs) enable semantic reasoning about program behavior, but applying LLMs to repository-scale security analysis introduces challenges related to context management, cost, and verification. We present OpenAnt, an open-source vulnerability discovery system that integrates static program analysis with LLM-based reasoning in a multi-stage pipeline. OpenAnt introduces three key techniques. First, codebases are decomposed into self-contained analysis units filtered by reachability from external entry points, reducing the analysis surface by up to 97% while preserving attack-relevant code. Second, candidate vulnerabilities undergo adversarial verification through constrained attacker simulation, where the model evaluates exploitability under realistic attacker capabilities. Third, findings are validated through dynamic verification, in which exploit environments are generated automatically, executed in sandboxed containers, and discarded after use. Evaluation on widely used open-source projects including OpenSSL, WordPress, and Flowise shows that this architecture can identify previously unknown vulnerabilities while maintaining manageable analysis cost and substantially reducing false positives. Our results suggest that closed-loop vulnerability discovery pipelines, combining semantic reasoning with exploit validation, provide a practical path toward scalable automated security analysis. OpenAnt is released as open source under the Apache 2.0 license at https://github.com/knostic/OpenAnt.

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

Do we have the knowledge we need? Rethinking human-AI decision-making in corporations

arXiv:2606.15575v1 Announce Type: new Abstract: Organizational knowledge is fragmented across a variety of software systems, tacit expertise, and manual documents that have traditionally been designed for human consumption. As AI systems are increasingly deployed and granted decision-making roles, they require access to this knowledge. This raises two questions: how should organizations store and maintain knowledge so that it remains accessible to both humans and future AI systems, and how should agency be allocated between humans and AI across tasks with different risks and levels of uncertainty? In this position paper, we describe how organizational knowledge evolves and contribute a framework that maps task attributes and knowledge availability to recommended agency allocations and control mechanisms. We illustrate the applicability of the framework on two different manufacturing tasks: a routine operation (visual quality inspection) and a one-off strategic decision (factory location), and conclude with opportunities for future research.

08.
arXiv (CS.CV) 2026-06-16

RGFVR: Reference-Guided Face Video Restoration with Flow Matching

Face video restoration from degraded observations is challenging, as it requires simultaneously recovering visual fidelity, temporal consistency, and subject identity. Existing approaches are often either reference-free, which can lead to identity loss when person-specific facial details are lost, or subject-specific, which limits generalization to unseen identities. We propose a subject-agnostic, reference-guided framework for identity-preserving face video restoration. Our method introduces bimodal perceptual-descriptive identity conditioning into a pretrained flow-based text-to-video generator and employs a two-stage training strategy to strengthen identity guidance during restoration. Experiments show that our approach improves restoration fidelity, temporal consistency, and identity preservation, achieving superior performance under challenging video degradations, including downsampling, blur, noise, and compression artifacts. The code is available under: https://github.com/batuhanntosun/RG-FVR.

09.
medRxiv (Medicine) 2026-06-18

From Paper Letters to an Integrated Digital Workflow: Improving Efficiency, Reliability, and Engagement in Health Guidance

Background: Post-checkup health guidance in Japan has traditionally relied on paper-based communication and manual administrative processes. These workflows are time-consuming, prone to transcription errors, and can delay timely engagement with health guidance recipients. Objective: To assess whether replacing a paper-based workflow with an integrated digital system using Microsoft Access, robotic process automation (RPA), and web-based responses could improve administrative efficiency, operational reliability, and engagement among health guidance recipients. Methods: This single-site quality improvement initiative redesigned the existing letter-based workflow. Access served as a central interface for managing recipients and generating guidance letters. RPA (EzRobot) automated repetitive clerical and billing-related tasks. A web form accessed via a QR code enabled recipients to respond digitally. Outcomes included manual administrative handling time per case, occurrence of transcription-related errors, health guidance completion rate, and guidance duration distribution. Results: Following implementation, staff active handling time per case decreased from approximately 10 minutes to less than 1 minute (approximately 30 seconds), while automated RPA execution typically required about 4-5 minutes per case without staff input. No transcription-related errors were detected during the post-implementation observation period. Health guidance completion rates improved from 28.3% to 39.2% (chi-square test, P=200 days decreased from 30.5% to 20.9% and cases with >=240 days decreased from 13.6% to 8.9% (R4 n=59, R5 n=158). Conclusion: An integrated Access-RPA-Web workflow was associated with improvements in administrative efficiency and operational reliability in post-checkup health guidance while retaining human verification and exception handling. This pragmatic, non-AI-dependent approach may offer a useful model for process-level improvement in preventive care settings.

10.
arXiv (CS.CV) 2026-06-19

Composed Object Retrieval: Object-level Retrieval via Composed Expressions

Retrieving fine-grained visual content based on user intent remains a challenge in multimodal systems. Although current Composed Image Retrieval (CIR) methods combine reference images with retrieval texts, they are constrained to image-level matching and cannot localize specific objects. To this end, we propose Composed Object Retrieval (COR), a new object-level retrieval task that retrieves target object(s) from candidate objects in a target image and grounds the retrieved result with pixel-level masks. Given a reference object, its mask, a target image, and a retrieval text describing the desired modification, COR requires models to perform composed visual-textual reasoning rather than relying on explicit category names. This setting introduces several challenges, including fine-grained compositional matching, negative-object filtering under visually similar distractors, and flexible single- or multi-object retrieval. We construct COR125K, the first large-scale COR benchmark, containing 125,541 retrieval triplets across 408 categories with base/novel splits for evaluating category-level generalization. We also present CORE, a unified end-to-end model that integrates reference region encoding, adaptive vision-text interaction, and region-level contrastive learning to align composed representations with target objects while suppressing background and distractors. Extensive experiments demonstrate that CORE significantly outperforms existing CIR-based pipelines and strong baselines in both base and novel categories, establishing a simple and effective foundation for fine-grained object-level multimodal retrieval. Code will be released publicly at https://github.com/wangtong627/COR.

11.
arXiv (math.PR) 2026-06-16

The Backward Stochastic Partial Differential Integral Equations: Solvability and Comparison Principle

arXiv:2606.16237v1 Announce Type: new Abstract: The paper is concerned with the well-posedness of backward stochastic partial differential equations with jumps, also called backward stochastic partial differential integral equations. We start from the proof for the existence and uniqueness of solution to backward stochastic evolution equation with jump in the Gelfand triple framework. Then the well-posedness of both weak solution and strong solution to backward stochastic partial differential integral equation is obtained with the Gelfand triple replaced by specific Sobolev spaces. Finally, the comparison principle for backward stochastic partial differential integral equation is proved, which has potential applications in financial mathematics.

12.
arXiv (CS.AI) 2026-06-19

Techniques for Peak Memory Reduction for LoRA Fine-tuning of LLMs on Edge Devices

arXiv:2606.19528v1 Announce Type: cross Abstract: Fine-tuning of Large Language Models (LLMs) using Low-Rank Adaptation (LoRA) on an end-user's data offers personalized experiences while keeping data private, but faces severe memory constraints on consumer hardware. Peak memory during fine-tuning often exceeds device limits, especially for models with billions of parameters and long-context training data. This paper introduces a suite of complementary techniques to reduce memory footprint without sacrificing model quality: (1) base model quantization with on-the-fly dequantization, (2) memory-efficient checkpointing combining selective activation caching and disk offloading, (3) softmax approximation using semantically relevant token subsets, and (4) logits masking. Experiments on Llama-3.2 3B and Qwen-2.5 3B demonstrate up to $26\times$ and $28\times$ reduction in peak memory, enabling fine-tuning on resource-constrained devices.

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

EvoTrainer: Co-Evolving LLM Policies and Training Harnesses for Autonomous Agentic Reinforcement Learning

arXiv:2606.03108v2 Announce Type: replace Abstract: Autonomous LLM training is often framed as recipe search, which leaves the training harness largely static. This limitation sharpens in agentic RL, where shifting bottlenecks and scalar rewards mask diverse failure modes. We introduce EvoTrainer, an autonomous training framework that co-evolves LLM policies and training-side harnesses through empirical feedback: it diagnoses rollout-level evidence, revises diagnostics, backtests interventions, and accumulates reusable skills. Evaluated on mathematical reasoning, competitive-programming code generation, and repository-level software engineering, EvoTrainer matches or exceeds the human-engineered RL references under the same data, codebase, and evaluation protocol, with the largest gain on long-horizon agentic SWE. Trajectory analyses show that retained strategies diverge across domains, evolving diagnostics prevent invalid high-scoring branches from being promoted, and reusable skills shape later search. Autonomous LLM RL should move beyond recipe search toward joint evolution of policies and the training harnesses that interpret them.

14.
arXiv (CS.CV) 2026-06-15

Instruct-Particulate: Scaling Feed-Forward 3D Object Articulation with Kinematic Control

Reconstructing articulated 3D objects is important for animation, gaming, and robotic simulations. Recent neural networks can estimate the articulated structure of 3D objects, but their generalization remains limited by the scarcity of annotated data for this task. To address this gap, we introduce Instruct-Particulate, a model that takes a 3D mesh together with a target kinematic specification, including part descriptions, connectivity, joint types, and optional point prompts, and predicts the corresponding kinematic part segmentation and joint motion parameters. The kinematic specification disambiguates the task and allows the model to target annotations of different granularity, thereby making it possible to use more abundant heterogeneous training data. At test time, the kinematic specification can be obtained automatically from large-scale vision-language models, so the model can be applied to any input mesh. To train our model at scale, we construct a heterogeneous dataset of more than 150,000 articulated 3D objects, extending existing publicly available collections with data obtained by partially labelling other 3D models (monolithic or already decomposed into parts) with kinematic labels by means of vision-language models. Experiments show that our model generalizes better across categories and to AI-generated meshes, enabling articulated asset reconstruction from real-world images via image-to-3D models.

15.
arXiv (CS.CV) 2026-06-12

RepWAM: World Action Modeling with Representation Visual-Action Tokenizers

This work presents RepWAM, a representation-centric world action model (WAM) built on representation visual-action tokenizers. Existing WAMs typically inherit reconstruction-oriented video tokenizers from pretrained video generation models. Although these tokenizers preserve visual fidelity, pixel reconstruction alone provides limited guidance for learning instruction-following dynamics that connect future prediction with robot control. To address this, we explore a semantic visual-action latent space for representation-centric world action modeling. Specifically, we train a representation visual-action tokenizer that maps visual inputs into aligned visual and latent action tokens. We then pretrain our WAM to jointly model future visual states and the latent actions that connect them under language instructions, followed by adaptation to real robot trajectories for closed-loop manipulation. Experiments on real-world manipulation tasks and simulation benchmarks show that RepWAM delivers strong performance across diverse manipulation settings, while ablations highlight the value of semantic visual-action tokenization over reconstruction-oriented alternatives. These results establish representation visual-action tokenization as a promising foundation for world action models and a step toward generalist robot policies. Code and weights will be available at https://github.com/wdrink/RepWAM.

16.
arXiv (quant-ph) 2026-06-19

Benchmark of quantum algorithms for ground state preparation in the presence of noise

arXiv:2606.20551v1 Announce Type: new Abstract: We compare the performance of representative cooling, adiabatic, and optimization algorithms for ground-state preparation in the presence of noise. Using an exactly solvable family of quadratic fermionic Hamiltonians subject to depolarizing noise, we derive the scaling of the achievable relative energy as a function of the noise rate and support these results with numerical simulations. The Hamiltonian exhibits two phases, separated by a quantum phase transition. As expected, the performance of the different algorithms depends on the phase: adiabatic evolution is favorable in the trivial phase, while a multi-frequency cooling algorithm, as proposed in [1], becomes competitive or superior in the topological phase, where gap-closing limits adiabatic protocols. We further present numerical results for the quantum approximate optimization algorithm [2], showing that it performs competitively with cooling in the trivial phase but is typically outperformed in the topological regime. Finally, we show that for this model the cooling protocol exhibits enhanced robustness to parameter imperfections, highlighting its potential advantage for realistic implementations of noisy quantum state preparation. The analytical approach developed here, in conjunction with numerical validation, establishes an extendable approach to benchmarking ground-state preparation algorithms.

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

HistoRAG: Embedding Historical Methodology in Retrieval-Augmented Generation Through Critical Technical Practice

Retrieval-Augmented Generation (RAG) is the prevailing architecture for grounding language model outputs in external evidence, yet its dominant evaluation paradigms and default configurations remain oriented toward factual question-answering. For interpretive disciplines such as historical studies, RAG embeds assumptions that conflict with scholarly practice. We introduce HistoRAG, a framework that translates historiographical principles into concrete architectural interventions. Separated retrieval and generation decouples source discovery from interpretation, temporal windowing enforces balanced source representation across the research period as a methodological requirement of historical inquiry, and LLM-as-judge evaluation makes relevance judgments transparent and contestable. We evaluate these interventions using SPIEGELragged, applied to 102,189 articles from Der Spiegel (1950-1979). Each intervention addresses a measurable deficiency in standard RAG: era-specific vocabulary retrieves zero chunks from the 1950s when using 1970s terminology, evidence of the temporal skew that motivates windowing; vector similarity and LLM-assessed relevance correlate only weakly (Spearman rho = 0.275), motivating post-retrieval evaluation; and keyword-based and semantic retrieval surface largely disjoint source pools, motivating an architecture in which both operate as complementary retrieval layers under a shared LLM evaluation filter. We also introduce the concept of Zwischentexte (intermediate texts that function as interpretive proposals rather than findings) as a framework for responsible integration of LLM-generated text into scholarly practice. The architecture offers a model for how domain-specific epistemological commitments can be translated into RAG design decisions, and may transfer to other interpretive disciplines working with large corpora.

18.
arXiv (CS.CV) 2026-06-19

Smol-GS: Compact Representations for Abstract 3D Gaussian Splatting

We present Smol-GS, a novel method for learning compact representations for 3D Gaussian Splatting (3DGS). Our approach learns highly efficient splat-wise features to model 3D space, which capture abstracted cues, including color, opacity, transformation, and material properties. We propose octree-derived positional encoding, which explicitly models spatial locality and enhances representation efficiency. We further apply entropy-based compression to exploit feature redundancy and compress splat coordinates using a recursive voxel hierarchy. This design enables orders-of-magnitude reduction in storage while preserving representation flexibility. Smol-GS achieves state-of-the-art compression performance on standard benchmarks with high-level rendering quality.

19.
arXiv (quant-ph) 2026-06-12

Semi-Device-Independent Certification for Nonlocality without Entanglement

arXiv:2606.13667v1 Announce Type: new Abstract: In this work, we investigate maximum-confidence discrimination, which encompasses minimum-error and unambiguous discrimination, for ensembles of separable states by considering global and separable measurements. We demonstrate that global measurements outperform separable ones, thereby establishing nonlocality without entanglement (NLWE) in terms of confidence in a detection event, a fine-grained state-identification strategy that maximizes the probability of a correct guess given a measurement outcome. Conversely, verifying achievable confidence in measurement outcomes can certify global measurements, namely, semi-device-independent certification of NLWE. Our results make it feasible to experimentally demonstrate NLWE using present-day quantum measurement devices, even with non-unit detection efficiencies, since maximum-confidence measurements rely only on detected measurement outcomes.

20.
arXiv (CS.CL) 2026-06-15

Flood and Harvest: The Provable Necessity of Trivia for Generating Valuable Mathematics via the Lens of Language Generation in the Limit

AI systems coupled to proof assistants now generate formal mathematics at scale, and the gap between what a checker can verify and what a mathematician would value has become the binding constraint. We model the generation of valuable mathematics as nested language generation in the limit: a verifiable formal language $F$, accessed through a membership oracle (the proof checker), contains an unknown valuable language $H \in \mathcal{H}$ revealed only through an adversarial enumeration of a core $C \subseteq H$ of exact density $\alpha$ (the literature). Every output is valuable ($\in H$), trivial ($\in F \setminus H$), or a hallucination ($\notin F$). We settle four questions. First, the verifier is not taste: the collections admitting generation with breadth are exactly those of the oracle-free model, characterized fiber-wise by Angluin's condition. Second, the verifier does buy sound coverage, covering all unseen valuable statements while asserting only valid ones: possible with it, impossible without it; it relocates unavoidable errors from false to trivial. Third, and centrally, a sharp dichotomy on the tight family: generators emitting finitely many trivia achieve optimal coverage $\alpha/2$, while any infinite trivia allowance, even at vanishing rate, jumps the optimum to $1-\alpha/2$ (both tight, for cores presented as the candidate intersection), and one generator attains both ends. The transition is in trivia count, not rate; the gap $1-\alpha$ is the unrecorded mass. Fourth, both regimes instantiate in a compression model of mathematics. A perfect verifier cannot substitute for taste: the unbounded stream of correct-but-worthless statements is not an engineering accident but a provable necessity, since covering unrecorded valuable mathematics requires an infinite, but asymptotically negligible, stream of certified trivia.

21.
arXiv (CS.AI) 2026-06-16

Attention is Just Another Name for Coupling?: A Fast-Slow ODE Perspective on Hierarchical Pretraining

Authors:

arXiv:2606.16730v1 Announce Type: cross Abstract: Causal self-attention is a coupling mechanism: each token's hidden state is updated by a learned mixture of preceding tokens at the same timescale. This paper asks whether a second, temporally slower coupling-a slow sub-system operating on a temporally-downsampled view of the sequence and fed back into the fast path through a zero-initialised gate-complements it. The question is framed in the language of singularly perturbed ordinary differential equations (ODEs), where the fast variable $x$ evolves at the token rate, the slow variable $y$ evolves at one update per $P$ tokens, and the timescale ratio $\varepsilon = 1/P$ is enforced structurally by causal block-mean pooling. The paper instantiates the fast-slow ODE formalism as a concrete neural network: a fast path of standard causal attention over $T$ tokens, a slow path of full attention over $T/P$ pooled tokens ($P^2 \times$ cheaper per layer), and a zero-initialised additive gate. In addition, under a linear-generator assumption on the fast dynamics, we prove that the equilibrium manifold $x = \phi(y)$ is exactly the master-equation (ME) stationary distribution $p_{\mathrm{st}}(y)$; in that regime a learned MLP $\phi_\theta(y)$ is a variational approximation of it (the trained block is not a generator, so this identity is the structured limit, not a claim about the network as trained). Empirically, at $500$k tokens the coupling is neutral – the gate stays closed and the coupled and frozen ablations are within run-to-run noise – at a wall-clock cost comparable to a dense baseline. The contribution is the precise, gap-marked mapping itself, not a performance gain.

22.
medRxiv (Medicine) 2026-06-11

Corticospinal tract risk modifies motor recovery after minimally invasive surgery for intracerebral hemorrhage: a secondary analysis of MISTIE-III

Objective: Outcome after surgical hematoma evacuation for intracerebral hemorrhage (ICH) depends on hematoma location. As corticospinal tract (CST) integrity affects motor recovery after stroke, we hypothesized that CST integrity drives heterogeneity in surgical outcomes and investigated this in a secondary analysis of MISTIE-III participants. Methods: Risk of CST injury was categorized into four levels, based on the interaction between the CST, the hematoma, and perihematomal edema (PHE) on automatically segmented stability CT: no risk, PHE infiltration, hematoma infiltration, and complete interruption of the CST. Associations with outcome were tested using multivariable linear regression for motor National Institutes of Health Stroke Scale (NIHSS) at day 180 and ordinal regression for modified Rankin Scale (mRS) at day 365, introducing an interaction term between CST risk and treatment group. Results: Day 180 motor NIHSS was significantly lower for 'no risk' ({beta}:-3.77, [95% confidence interval [CI]: -5.8 to -1.70], p=0.0003) and 'PHE infiltration' ({beta}:-2.3, [95%CI: -3.5 to -1.1]; p=0.0002) vs. 'complete interruption'. Surgery was associated with lower Day 180 motor NIHSS in participants with hematoma infiltration ({beta}:-2.07, [95%CI: -3.8 to -0.4], p=0.016). Compared to complete interruption, 'no risk' (adjusted odds ratio [aOR]:0.27, [95%CI: 0.10 to 0.74], p=0.01) and 'PHE infiltration' (aOR:0.41, [95%CI: 0.23 to 0.74]; p=0.003) were associated with lower odds of unfavorable day 365 mRS. Surgery was associated with lower mRS in participants with no risk (aOR:0.23, [95%CI: 0.05 to 0.97, p=0.045). Interpretation: Increasing CST risk is associated with worse motor recovery (day 180) and disability (day 365). CST risk modifies the effect of the MISTIE-III procedure on motor recovery and disability.

23.
medRxiv (Medicine) 2026-06-15

Evaluation of AI-Generated Synthetic Data for Clinical Research in Secondary Cardiovascular Prevention among Dyslipidemia Patients

Background: Access to high-quality clinical data is essential for advancing medical research and developing effective medical statistical and Artificial Intelligence models. However, privacy regulations and logistical barriers often hinder timely access to real-world data. Synthetic data offer a promising solution, preserving the statistical characteristics of original datasets while protecting patient privacy. Objectives: This study investigates the use of synthetic data for secondary cardiovascular prevention in patients with dyslipidemia, using two real-world datasets from Centro Cardiologico Monzino. Methods: Given the high dimensionality and limited sample size of the datasets, we employed a custom generative framework based on Large Language Models (LLMs). Pre-trained LLMs were fine-tuned on original clinical records to synthesize tabular data replicating source-data distributions. Fine-tuning was performed within the Centro Cardiologico Monzino's secure infrastructure to ensure data sovereignty. We evaluate clinical utility and privacy using fidelity and privacy metrics, identifying the optimal generative model and benchmarking against traditional anonymization methods. Results: Synthetic data achieved a superior trade-off than classically anonymized datasets. Real and synthetic datasets showed strong agreement, with significant distributional differences limited to few variables. Models trained on synthetic data replicated key associations from the original dataset, including therapy modification and creatine phosphokinase as predictors of SAMS, and pharmacological intensity as the main driver of LDL-C reduction. Conclusions: Results support the feasibility of using synthetic data as a proxy for real-world datasets in exploratory analyses and model development. Despite slight attenuation of some effect sizes, preserved clinical relationships reinforce the validity of synthetic data in medical research.

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

The Dynamics of Human and AI-Generated Language: How Semantics Fluctuates across Different Timescales

Spoken language, whether produced by humans or large language models (LLM), unfolds over time with varying semantic content. However, we still lack simple, interpretable time-series features that capture how generic versus specific content is distributed over time, and that can be used to compare human and AI-generated speech. We introduce a semantic-timescale analysis pipeline that turns word-level transcripts with timestamps into semantic time-series. For each spoken narrative, we compute (i) semantic specificity using WordNet-based word depth and (ii) contextual similarity using SBERT embeddings and quantify their temporal dependence using autocorrelation-window measures (ACW-0 and related metrics). We then compare original speech to multiple shuffled controls that selectively disrupt lexical identity, temporal order, and word duration. Across human-read autobiographical narratives, TTS readings, and LLM-generated texts rendered with TTS, we find that segments with longer ACW-0 in the semantic time-series tend to contain more generic vocabulary, whereas segments with shorter ACW-0 are enriched in more specific words. These associations are strongly attenuated or abolished when word order and timing are randomized, indicating that ACW-based measures capture non-trivial temporal organization of semantic content beyond static lexical distributions. Our results suggest that ACW-based semantic timescales are a useful family of features for analyzing and comparing the temporal structure of human and AI-generated speech.

25.
arXiv (CS.CV) 2026-06-16

HSQ-VLM: A Novel Spatially-Constrained Quadrant Segmentation VLM Model for Explainability in Diabetic Retinopathy

Authors:

Diabetic Retinopathy (DR) is an aggressive retinal disease and a leading cause of global blindness, yet its clinical management is currently hindered by the black-box nature of diagnostic AI. While deep learning models achieve high classification accuracy, there is a critical lack of explainability methods capable of detailing the exact anatomical landmarks and lesion distributions that lead to a clinical decision for DR. Therefore, we propose HSQ-VLM, a novel quadrant segmentation pipeline on fundus images that utilizes a Landmark-Anchored Cartesian Cross-Attention mechanism to unify visual feature extraction with structured clinical reasoning. Unlike traditional methods that rely on arbitrary image partitioning, our pipeline implements 4-quadrant Topological Latent Partitioning (TLP) to dynamically align retinal features with a fovea-centered coordinate system. This allows the Vision-Language Model to generate natural language reports that quantify pathology with anatomical precision. On a dataset of 3,500 high-resolution fundus images, this innovative methodology achieved a lesion detection sensitivity of 99.6% for hemorrhages and 96.4% for microaneurysms, while demonstrating a significant reduction in boundary-ambiguity errors compared to standard segmentation baselines.