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01.
medRxiv (Medicine) 2026-06-22

Spatial Analysis and Multilevel Determinants of Hypertension in Zambia: Analysis of the 2017 WHO STEPS Survey

Background: Hypertension is the leading modifiable cardiovascular risk factor globally, with the fastest-growing burden in low- and middle-income countries. This study aimed to estimate national hypertension prevalence, map provincial patterns, assess spatial clustering, and identify individual and community-level determinants among Zambian adults using the 2017 WHO STEPS survey. Methods: This cross-sectional study used data from the 2017 WHO STEPS survey, a nationally representative sample of 4,301 adults aged 18-69 years. Hypertension was defined as systolic BP [&ge;]140 mmHg, diastolic BP [&ge;]90 mmHg, or current antihypertensive use. Spatial autocorrelation was assessed via Moran's I and LISA. Four nested generalised linear mixed models with PSU-level random intercepts identified individual and community-level determinants. Results: Overall weighted hypertension prevalence was 24.0%. Lusaka recorded the highest prevalence (30.2%), followed by Southern (29.9%) and Muchinga (28.3%) provinces; Western Province had the lowest (12.4%). Spatial clustering was statistically significant but modest (Moran's I = 0.0247, p < 0.001). Between-cluster variation reduced from ICC = 5.9% to 1.8% in the full model, indicating geographic differences were largely explained by individual characteristics. Age was the strongest predictor; adults aged 60-69 had nearly sevenfold higher odds than those aged 18-29 (AOR 6.92, 95% CI: 4.95-9.66). Women had lower odds than men (AOR 0.64, 95% CI: 0.52-0.79). Obesity (AOR 2.34), overweight (AOR 1.65), high cholesterol (AOR 1.40), diabetes (AOR 1.35), and single marital status (AOR 1.34) were independently significant. Western Province showed consistently lower odds than Central Province (AOR 0.48). Conclusion: Hypertension affects one in four Zambian adults, driven primarily by age, sex, obesity, dyslipidaemia, and diabetes. Geographically prioritised interventions, including community health worker-led screening programmes in Lusaka and Southern Province, would maximise population-level impact. Population-level salt reduction and alcohol policies represent cost-effective complementary strategies. Longitudinal studies with finer spatial resolution are needed to clarify causal pathways underlying observed geographic clustering and inform SDG Target 3.4 progress.

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

RotRNN: Modelling Long Sequences with Rotations

arXiv:2407.07239v3 Announce Type: replace Abstract: Linear recurrent neural networks, such as State Space Models (SSMs) and Linear Recurrent Units (LRUs), have recently shown state-of-the-art performance on long sequence modelling benchmarks. Despite their success, their empirical performance is not well understood and they come with a number of drawbacks, most notably their complex initialisation and normalisation schemes. In this work, we address some of these issues by proposing RotRNN – a linear recurrent model which utilises the convenient properties of rotation matrices. We show that RotRNN provides a simple and efficient model with a robust normalisation procedure, and a practical implementation that remains faithful to its theoretical derivation. RotRNN also achieves competitive performance to state-of-the-art linear recurrent models on several long sequence modelling datasets.

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

SEAL: Searching Expandable Architectures for Incremental Learning

arXiv:2505.10457v3 Announce Type: replace-cross Abstract: Incremental learning is a machine learning paradigm where a model learns from a sequential stream of tasks. This setting poses a key challenge: balancing plasticity (learning new tasks) and stability (preserving past knowledge). Neural Architecture Search (NAS), a branch of AutoML, automates the design of the architecture of Deep Neural Networks and has shown success in static settings. However, existing NAS-based approaches to incremental learning often rely on expanding the model at every task, making them impractical in resource-constrained environments. In this work, we introduce SEAL, a NAS-based framework tailored for data-incremental learning, a scenario where disjoint data samples arrive sequentially and are not stored for future access. SEAL adapts the model structure dynamically by expanding it only when necessary, based on a capacity estimation metric. Stability is preserved through cross-distillation training after each expansion step. The NAS component jointly searches for both the architecture and the optimal expansion policy. Experiments across multiple benchmarks demonstrate that SEAL effectively reduces forgetting and enhances accuracy while allocating additional capacity only when required. These results highlight the promise of combining NAS and selective expansion for efficient, adaptive learning in incremental scenarios.

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

Can Editing 1 Neuron Fix Repetition Loops in LLMs?

arXiv:2606.13705v1 Announce Type: cross Abstract: Yes. Can it cure doom loops? Probably not. The Gemma 4 instruction-tuned models share a reproducible failure: on long factual enumeration prompts, such as listing every episode of a TV series, the 88 IAU constellations, or the 151 original Pokemon, they collapse into repetition, either a tight verbatim loop or a list whose entries decay onto a single answer. These loops occur at rates as high as 95% and survive prompt rewording, inference-engine changes, and most sampling adjustments. In this paper we explore whether this behavior is localized enough to remove by weight edits. To localize the cause, we use per-layer ablation and per-neuron attribution, then confirm the strongest candidates with full-generation sweeps. The loops trace to a small set of MLP neurons (or, in the 26B-A4B Mixture-of-Experts model, a few routed experts) which we suppress with static weight edits. These "surgeries" can be as small as a single sign-inverted neuron (in the E2B model). The size of the effective edits grows with model scale, but in all cases, the loop patterns can be addressed at normal generation budgets while preserving general-purpose benchmark scores. However, the edits do not solve everything: we also study longer thinking budgets, where the two larger models most visibly enter doom looping, i.e. a non-convergent regime in which the model self-corrects in circles over a fact it cannot recall, exhausting the budget without committing to a final answer. We show this residual failure is reduced but not eliminated by the same edits, and argue it is fundamentally a knowledge-precision problem rather than a removable circuit; weight surgery can delete a loop, but it cannot supply a missing fact. Our results are both a feasibility demonstration, that is, evidence that a concrete generation pathology can be localized to a few parameters and edited out, and a delineation of where that approach stops.

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

Context-Aware Markov VAE for CSI Compression in Wireless Systems

arXiv:2606.16607v1 Announce Type: cross Abstract: This paper considers neural channel state information (CSI) compression for time-varying massive multiple-input multiple-output (MIMO) channels in frequency division duplex (FDD) systems with limited feedback resources. The main challenge lies in obtaining a compact and efficient representation of the CSI given that it exhibits strong temporal correlation across successive snapshots. Existing memoryless compression models do not exploit this property, while simple temporal extensions often incorporate multiple observations without explicitly modeling the latent dynamics. We propose a context-aware compression framework based on a k-memory Markov variational autoencoder (k-MMVAE), which uses a finite temporal window to capture the evolution of CSI in the latent space. The model introduces Markov-structured latent dynamics with finite memory, enabling efficient use of temporal dependencies for compression. Simulation results show that the proposed approach improves target CSI reconstruction performance compared to memoryless and weakly sequential baselines, particularly at low and moderate compression rates. These results suggest that explicit latent temporal modeling can provide an effective mechanism for CSI compression under limited feedback constraints.

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

TerraMARS: A Domain-Adapted Small-Language-Model Pipeline for Mars Terraforming Literature

Researchers are interested in learning about Mars so that it may eventually become habitable for humans. To achieve this, there is a need for comprehensive knowledge of the planet's atmosphere, hydrology, surface chemistry, radiation environment, and spatial features through the scientific literature. These contain valuable information and meaningful quantitative constraints that can be used in other models and studies, such as habitability assessment and future terraforming studies. We present TerraMARS, an end-to-end information extraction pipeline that combines a domain-adapted Small Language Model to answer Mars terraforming-related questions and convert unstructured Mars science text into machine-readable structured outputs in JavaScript Object Notation (JSON) format. A corpus of open-access papers is collected and processed using a multistage retrieval and chunking framework. Google Gemma 3 1B was adapted to the domain using Quantized Low-Rank Adaptation (QLoRA) fine-tuning on Mars-specific question-answering and information extraction datasets. The resulting pipeline generates both types of output and provides a foundation for integrating knowledge from scientific literature into downstream applications like digital twins and habitability modeling for Mars. The output from this pipeline looks promising, but further improvements are needed to increase extraction accuracy and factual consistency.

07.
arXiv (CS.CL) 2026-06-11

Where Do Backdoors Live? A Component-Level Analysis of Backdoor Propagation in Speech Language Models

Speech language models (SLMs) are systems of systems: independent components that unite to achieve a common goal. Despite their heterogeneous nature, SLMs are often studied end-to-end; how information flows through the pipeline remains obscure. We investigate this question through the lens of backdoor attacks. We first establish that backdoors can propagate through the SLM, leaving all tasks highly vulnerable. From this, we design a component analysis to discover the role each component takes in backdoor learning. We find that backdoor persistence or erasure is highly dependent on the targeted component. Beyond propagation, we examine how backdoors are encoded in shared multitask embeddings, showing that poisoned samples are not directly separable from benign ones, challenging a common separability assumption used in filtering defenses. Our findings emphasize the need to treat multimodal pipelines as intricate systems with unique vulnerabilities, not solely extensions of unimodal ones.

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

Learned Image Compression for Vision-Language-Action Models

Vision-language-action (VLA) models increasingly rely on high-frequency multi-camera observations, making visual communication a major bottleneck for real-time robotic control in bandwidth-constrained or distributed deployment settings. Existing image and video codecs, however, are designed to preserve generic visual fidelity rather than the control performance of downstream VLA policies. In this work, we introduce SPARC (SPatially Adaptive Rate Control), a learned image compression framework tailored for VLA-driven robots. Our key observation is that the importance of visual information varies substantially across both camera views and spatial regions within an image. Based on this observation, SPARC employs a lightweight temporal mask selector that adaptively allocates bitrate over latent representations according to task relevance while leveraging temporal context. We further introduce a tilted rate loss that stabilizes training by reducing the tendency of entropy-based objectives to over-suppress rare yet task-critical visual patterns. Experiments on diverse robotic benchmarks, including RoboCasa365, VLABench, and LIBERO, show that SPARC consistently achieves stronger control performance than conventional image/video codecs and recent learned compression methods under the same bitrate budget. We additionally demonstrate real-world deployment benefits in remote-control settings, where our method substantially improves the bitrate-success tradeoff.

09.
arXiv (CS.CV) 2026-06-16

MVOFormer: Flow-Semantic Transformer for Robust Monocular Visual Odometry

Monocular visual odometry (MVO) is foundational to autonomous navigation and robotic localization. However, existing learning-based MVO approaches often struggle with either a lack of interpretable, complementary features or overly complex multi-stage architectures. These limitations inherently restrict their robustness and cross-domain generalization. In this work, we propose MVOFormer, a novel transformer framework for robust monocular visual odometry. Our architecture features a Flow-Semantic Dual Branch Encoder that synergizes dense geometric motion cues with object-centric semantic priors, explicitly distinguishing static structures from dynamic distractors. These representations are then fused by an Iterative Multimodal Decoder, enabling coarse-to-fine pose refinement while dynamically suppressing attention on unreliable regions. Extensive evaluations demonstrate that, without any target-domain fine-tuning, MVOFormer achieves superior zero-shot generalization and robustness, significantly outperforming prior learning-based frame-to-frame methods across diverse benchmarks including TartanAir, KITTI, TUM-RGBD, and ETH3D-SLAM.

10.
arXiv (CS.AI) 2026-06-15

From Prompts to Responses: Dual-Sided Data Leakage and Defense in Split Large Language Models

arXiv:2606.14210v1 Announce Type: cross Abstract: Large language models (LLMs) are increasingly deployed in privacy-sensitive domains, where users must balance the risk of data exposure through external APIs against the high computational cost of local deployment. Split learning has therefore emerged as a promising paradigm for LLM fine-tuning and inference under limited local resources. However, it introduces new privacy risks. Prior work primarily studies leakage of private input prompts, typically via inversion attacks on intermediate representations, while the potential for sensitive information leakage through generative response outputs remains largely unexplored. In this work, we unveil novel vulnerabilities of Split-LLM by presenting Patched Model Inversion with Dual-Sided Initialization (PIDI), a two-stage attack that simultaneously targets both private input prompts and output responses in Split-LLM settings. It combines dual-sided initialization with a patched inversion strategy to tackle long sequences, substantially outperforming prior inversion methods. To counter threats from both sides, we further propose the Adapter-based DualGuard with Mutual Information Defense (ADMI), which integrates an adapter-based local warmup strategy and mutual information regularization to provide a strong empirical privacy protection with minimal impact on task performance. Extensive experiments across diverse tasks and models demonstrate that ADMI effectively defends against PIDI and other state-of-the-art inversion attacks. Our code is publicly available at https://github.com/FLAIR-THU/VFLAIR-LLM.

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

HoloRec: Holistic Encoding and Interleaved Reasoning for Generative Recommendation

arXiv:2606.15331v1 Announce Type: cross Abstract: Generative recommendation models that formulate the task as sequence generation overcome the objective fragmentation problem of traditional cascade architectures, yet existing approaches still suffer from flat semantic representations lacking hierarchical structure for multi-step reasoning and an externally constructed chain-of-thought (CoT) that requires expensive annotations and remains disconnected from the generation objective. We propose HoloRec, an endogenous chain-of-thought recommendation mechanism that unifies representation, reasoning, and generation by constructing a hierarchical semantic encoding matrix via multi-granularity nested residual quantization optimized by a holistic reconstruction loss. HoloRec supports two inference modes: a non-thinking mode that uses lightweight multi-granularity supervised alignment for fast prediction, and a thinking mode that employs an interleaved reasoning scheme to generate CoT steps on the fly, directly embedding reasoning into the generation process without external data. Experiments on multiple public recommendation datasets demonstrate that HoloRec consistently outperforms baselines, with especially significant gains in sparse scenarios, and the thinking mode achieves better accuracy than the non-thinking mode with only modest inference overhead.

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

CREDENCE: Claim Reduction for Decomposition & Enhanced Credibility – Semantic Metrics and Convergence Analysis

Decomposing compound sentences into atomic, verifiable claims is a prerequisite for reliable automated fact-checking. Prior work has relied on token-overlap (Jaccard) metrics that systematically underestimate decomposition quality for paraphrastic claims, and has lacked formal termination analysis for the repair loop. We present Credence, a revised claim decomposition and evaluation framework addressing both shortcomings. Our contributions are: (1) Semantic-F1: we use BGE-large cosine similarity fidelity metric that resolves Jaccard's penalisation and improves downstream fact-checking accuracy; (2) Convergence theorems: we formally characterise four properties of the repair pipeline, establishing that rule-based repair is monotone and finitely terminating under an oracle parser assumption; LLM-based self-repair is provably non-monotone and requires an early-exit guard; (3) Three evaluation benchmarks spanning social-media, encyclopaedic, and news domains for cross-domain generalisation measurement; (4) Multi-model benchmarking across four decomposer models (3.8B-12B) and a closed API model. Experiments on SocialClaimSplit, WikiSplitBench, and ClaimDecompBench show that Semantic-F1 outperforms Jaccard-F1 by +15-32pp. EPR ranges from 0.94 to 1.00 on SocialClaimSplit and WikiSplitBench, while ClaimDecompBench includes lower base EPR cases (down to 0.824) due to harder news-domain constructions, and rule-repair reduces the Atomicity Violation Rate (AVR) by 47-100% relative to the base model without degrading fidelity.

13.
arXiv (CS.CL) 2026-06-11

Pre-AF 13: An Interpretable Atrial Fibrillation Risk Score Mined from Discharge Reports

Background. Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia and a major determinant of prognosis. Established AF risk scores rely on factors (older age, hypertension) nearly ubiquitous among patients with cardiovascular disease (CVD), offering limited stratification in this high-risk group. Most target long-term (5-10 year) rather than medium-term prediction. We developed interpretable ML models predicting AF risk over a 24-month and entire follow-up horizon in CVD patients using routinely collected hospital data. Methods. Single-center retrospective study of electronic health records from the National Research Cardiology Center (Russia) for patients aged >=18 with CVD but without pre-existing AF, hospitalized more than once between January 2012 and May 2019. A custom NLP pipeline transformed unstructured discharge reports into 73 structured features, combining a rule-based parser with transformer-based NER. Using LightAutoML we built a full model (73 features), a simple model (reduced subset), and a linear model for a bedside risk score. Performance was assessed by ROC AUC, compared with CHARGE-AF, C2HEST, MHS, and HAVOC, and interpreted via SHAP. Results. Of 80,576 records from 45,000 patients, 17,562 met inclusion criteria; 1,438 (8.19%) developed AF. The full model reached ROC AUC 0.735 (24-month) and 0.696 (entire follow-up); the simple model was nearly identical (0.725, 0.696). All non-linear models outperformed the four clinical risk scores (ROC AUC 0.53-0.64). The simple model uses 13 features and is named Pre-AF 13. SHAP identified age and left atrial volume as dominant predictors. A linear risk score (Pre-AF 9) stratified observed 24-month AF incidence from ~7% to 36%. Conclusion. Interpretable ML models built from routinely collected EHR data identify high-AF-risk CVD patients, outperforming established clinical risk scores.

14.
arXiv (CS.AI) 2026-06-25

Variable Bound Tightening for Nash Equilibrium Computation in Multiplayer Imperfect-Information Games

Authors:

arXiv:2606.25997v1 Announce Type: cross Abstract: There has been significant recent progress in algorithms for approximation of Nash equilibrium in large two-player zero-sum imperfect-information games and exact computation of Nash equilibrium in multiplayer strategic-form games. While counterfactual regret minimization and fictitious play are scalable to large games and have convergence guarantees in two-player zero-sum games, they do not guarantee convergence to Nash equilibrium in multiplayer games. Recently, an approach has been presented for exact computation of Nash equilibrium in multiplayer imperfect-information games that solves a quadratically constrained program based on a nonlinear complementarity problem formulation derived from the sequence-form game representation. This formulation was solved using Gurobi's nonconvex quadratic solver, which employs spatial branch-and-bound to iteratively refine variable bounds by solving convex relaxations of bilinear terms via McCormick envelopes. During presolve, Gurobi introduces auxiliary variables and, in some cases, binary variables, leading to an internal MIQCP reformulation. This approach was demonstrated to outperform prior algorithms from the Gambit software suite and quickly solve three-player Kuhn poker after removal of dominated actions; however, the algorithm was not able to solve the full version of the game within 24 hours. In this paper, we derive finite bounds on slack and multiplier variables in the nonlinear complementarity formulation. These bounds strengthen the convex relaxations used within spatial branch-and-bound and lead to substantial computational improvements. We demonstrate the impact of the proposed bounds on exact Nash equilibrium computation in three-player Kuhn poker.

15.
medRxiv (Medicine) 2026-06-16

Development and reliability and validity test of the Questionnaire on Knowledge, Attitude and Practice of ICU Nurses on Blood Oxygen Saturation Management in Mechanically Ventilated Patients

Objective: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in patients with mechanical ventilation was compiled, and its reliability and validity were tested. Method: Drawing upon the knowledge-attitude-practice theory, the initial questionnaire draft was developed through literature review and consultation with Delphi experts. Employing convenience sampling, 32 nurses from the General ICU of Wuxi Second People's Hospital were surveyed between 1 August 2025 and 27 September 2025, enabling item screening and assessment of reliability and validity.The full version of the developed questionnaire is provided as Supporting Information (S1 File). All items are published under a CC BY 4.0 license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Result: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in mechanically ventilated patients was finalised, comprising 26 items: 11 in the knowledge dimension, 6 in the attitude dimension and 9 in the behaviour dimension. The overall Cronbach's coefficient for the questionnaire was 0.88, with dimension-specific coefficients of 0.787, 0.722, and 0.781 respectively. The Spearman-Brown coefficient for the entire questionnaire was 0.967, while dimension-specific coefficients were 0.796, 0.666, and 0.728 respectively. The content validity index at the questionnaire level (S-CVI) was 0.886, and the item-level content validity index (I-CVI) ranged from 0.913 to 0.967. 0.728. The questionnaire's level content validity index (S-CVI) was 0.886, and the item level content validity index (I-CVI) ranged from 0.913 to 1.00. Conclusion: The questionnaire on knowledge, attitude and practice of blood oxygen saturation management in mechanically ventilated patients demonstrates good reliability and validity. It may serve as an assessment tool for intensive care unit nurses regarding their knowledge, attitude, and practices concerning blood oxygen saturation management in mechanically ventilated patients, thereby establishing a foundation for developing targeted intervention strategies in future practice.

16.
medRxiv (Medicine) 2026-06-18

Consistency of sleep timing and duration are associated with more physical activity and favorable heart rate metrics in a naturalistic cohort

Background: Regularity of sleep patterns over time has increasingly gained traction as an important axis of sleep health. Since sleep habits are under some degree of behavioral control, understanding such patterns in naturalistic settings is particularly important. We quantified sleep variability and tested the hypothesis that regularity correlates with physical activity, resting heart rate (rHR), and heart rate variability (HRV). Methods: We analyzed real-world digital health data from over 81,000 participants (over 18 million nights) who provided informed consent to participate in the Apple Heart and Movement Study and elected to contribute sleep, activity, and heart rate data to the study. Variability was quantified using the standard deviation (SD) computed from total sleep time (TST), sleep start time (S-start), end time (S-end), and midpoint time (MP), as well as the Sleep Regularity Index (SRI). Results: The SD-based variability metrics correlated with one another (R values 0.74-0.92), and with the SRI metric (R values 0.62-0.64). More consistent sleep, by any metric, was associated with more activity and better rHR and HRV. The most consistent tertile for TST variability had higher median TST (6.9 vs 5.9 hours), more daily exercise (32.8 vs 20.4 minutes), lower rHR (62.4 vs 65.6 beats per minute), and higher HRV (40.6 vs 37.3), all p

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

DVD: Discrete Voxel Diffusion for 3D Generation and Editing

We introduce Discrete Voxel Diffusion (DVD), a discrete diffusion framework to generate, assess, and edit sparse voxels for SLat (Structured LATent) based 3D generative pipelines. Although discrete diffusion has not generally displaced continuous diffusion in image-like generation, we show that it can be an effective first-stage prior for sparse voxel scaffolds. By treating voxel occupancy as a native discrete variable, DVD avoids continuous-to-discrete thresholding and provides a simple framework for voxel generation, uncertainty estimation, and editing. Beyond quality gains, DVD provides more interpretable generation dynamics through explicit categorical modeling. Furthermore, we leverage the predictive entropy as a robust uncertainty metric to identify ambiguous voxel regions and complicated samples, facilitating tasks such as data filtering and quality assessment. Finally, we propose a lightweight fine-tuning strategy using block-structured perturbation patterns. This approach empowers the model to inpaint and edit voxels within a single sampling round, requiring negligible auxiliary computation and no additional model evaluations. Code is available at https://github.com/TeCai/DVD.

18.
arXiv (CS.CV) 2026-06-24

From Open Waters to Enclosed Cabins: ProteusVPR for Cross-Scene Visual Place Recognition in Maritime Perception and Cabin Inspection

Autonomous robotic inspection in maritime environments presents unique challenges for Visual Place Recognition (VPR) due to cross-scene perceptual shifts. Robots navigating ship-borne environments must transition between visually distinct domains: open decks with sparse textures and severe illumination changes, and enclosed cabins with repetitive structures and high visual ambiguity. Existing VPR methods, designed primarily for urban or indoor scenes, fail to generalize reliably across these starkly different scenarios. To address this, we propose ProteusVPR, a two-stage retrieval-refinement framework. The first stage employs any standard VPR model for initial image retrieval. The second stage introduces a geometric-visual estimation network that fuses the retrieved image with two temporally preceding frames, incorporating geometric descriptors, a local affine coordinate system, and camera azimuth encoding to achieve precise localization. To support this task, we introduce the XHZ dataset, an 8K-panoramic ship-borne dataset collected from an operational vessel, featuring multi-floor cabin structures, deck transition zones, and strict query-database separation for rigorous evaluation. Extensive experiments on the XHZ dataset demonstrate that ProteusVPR consistently improves the localization accuracy across multiple VPR backbones, reducing mean localization error by over 60\% on average and that ProteusVPR offers an effective and robust solution for precise visual localization in challenging, cross-scene maritime environments.

19.
arXiv (CS.AI) 2026-06-11

Towards Deep Learning Surrogate for the Forward Problem in Electrocardiology: A Scalable Alternative to Physics-Based Models

arXiv:2512.13765v2 Announce Type: replace-cross Abstract: The forward problem in electrocardiology, computing body surface potentials from cardiac electrical activity, is traditionally solved using physics-based models such as the bidomain or monodomain equations. While accurate, these approaches are computationally expensive, limiting their use in real-time and large-scale clinical applications. We propose a proof-of-concept deep learning (DL) framework as an efficient surrogate for forward solvers. The model adopts a time-dependent, attention-based sequence-to-sequence architecture to predict electrocardiogram (ECG) signals from cardiac voltage propagation maps. A hybrid loss combining Huber loss with a spectral entropy term was introduced to preserve both temporal and frequency-domain fidelity. Using 2D tissue simulations incorporating healthy, fibrotic, and gap junction-remodelled conditions, the model achieved high accuracy (mean $R^2 = 0.99 \pm 0.01$). Ablation studies confirmed the contributions of convolutional encoders, time-aware attention, and spectral entropy loss. These findings highlight DL as a scalable, cost-effective alternative to physics-based solvers, with potential for clinical and digital twin applications.

20.
medRxiv (Medicine) 2026-06-16

AI-assisted continuous-time modelling of metastatic breast cancer reveals subtype-specific spatiotemporal organ interactions

Metastatic breast cancer is one of the leading causes of premature mortality among women worldwide. A major barrier to optimal care is the marked heterogeneity in both the temporal dynamics of metastatic spread and the organ-specific spatial distribution of metastases. Existing analyses do not adequately capture this complexity, as they either neglect temporal dependencies or assume independence between metastasic sites. As a result, it remains unclear how established metastases influence subsequent organ-specific dissemination. We address this question using patient-level longitudinal trajectories from a large multicentre real-world metastatic breast cancer registry, combined with an AI-assisted disease-progression modelling framework based on continuous-time Markov chains that represent combinations of metastatic sites and the non-uniform and practice-driven timing of radiologic response assessments, as encountered in routine clinical care. We present a stochastic model determined by progression rates, which are parameterised to capture baseline organ-specific transition risks, patient-level covariates, and pairwise inter-organ interaction effects. High-dimensional treatment information is incorporated using an large language model based encoding. We find that metastatic spread follows non-independent, subtype-specific spatiotemporal patterns, with subtype-specific inter-organ interaction patterns that shape progression. Visceral metastases, particularly lung and liver metastasis, are associated with an increased hazard of subsequent brain metastasis, with effects varying across hormone receptor-positive, HER2-positive, and triple-negative subtypes. Together, these findings define a clinically relevant spatiotemporal architecture of metastatic progression in breast cancer. This framework enables refined mechanism-informed risk stratification and provides a data-driven rationale for targeted and risk-adapted – rather than symptom-triggered – surveillance strategies.

21.
arXiv (CS.CL) 2026-06-18

Fair Cognitive Impairment Detection Through Unlearning

Mild Cognitive Impairment (MCI) is a medical condition characterized by a noticeable decline in memory, language, or thinking abilities. MCI detection from spontaneous speech is promising for scalable screening. However, learned models often exploit demographic cues correlated with labels, resulting in a large performance gap across subgroups. We present a multimodal framework that combines (i) cross-model fusion between modalities (speech, text, and image), and (ii) unlearning using gradient reversal that discourages the shared embedding from encoding task-irrelevant demographic attributes. Evaluated on the multilingual benchmarks TAUKADIAL and PREPARE, our method outperforms the state-of-the-art multilingual and multimodal baseline in MCI classification while substantially reducing the performance gap across patient subgroups (sex and language). We further analyze transfer across datasets, showing that demographic unlearning helps learn more robust representations for MCI detection.

22.
arXiv (CS.AI) 2026-06-19

Learner-based Concept Drift Detection: Analysis and Evaluation

arXiv:2606.20216v1 Announce Type: cross Abstract: Machine learning algorithms deployed for evolving streaming environments must handle the non-stationary data distributions, commonly referred to as concept drift. The presence of concept drift poses a major challenge for many real-world applications because it can severely degrade their predictive performance, hindering their ability to support robust decision-making. Consequently, the timely and efficient detection of drift events is critical for sustaining high accuracy over time. This study examines theoretically the concept drift characteristics and numerous drift detection algorithms across several categories. Furthermore, we evaluate their performance on both synthetic and real-world datasets exhibiting diverse streaming scenarios and drift characteristics, such as abrupt and gradual changes. This study aims to enhance understanding of the complex notion of concept drift characteristics and behavior of drift detectors, along with their applicability to diverse contexts.

23.
medRxiv (Medicine) 2026-06-17

Adverse Childhood Experiences Reorganise the Brain-Personality Network Across the Psychosis Spectrum

Exposure to adverse childhood experiences is a pervasive risk factor for psychosis, exhibiting a linear relationship across the psychosis spectrum from subclinical schizotypal traits to schizophrenia spectrum disorders. While this association is often conceptualised within the vulnerability-stress framework, the systemic mechanisms through which childhood trauma reconfigures the brain-personality interactome remain poorly understood. We examined clinical, neuropsychological, and neuroimaging data from a sample of low- and high-schizotypy individuals, and patients with a diagnosis of schizophrenia spectrum disorder (N=120). Our aim was to map how trauma reconfigures interactions between neurobiology and schizotypal phenomenology. We adopted a mixed graphical model approach to jointly estimate conditional dependencies between childhood trauma, regional brain morphometry, and schizotypal traits across the psychosis spectrum. Our results show that childhood trauma reconfigures the brain-personality network, shifting it from a state driven by cognitive processes to one anchored in emotional (limbic) reactivity. This transition is marked by the increased influence of impulsive traits and a significant strengthening of connections within the salience network. These changes converge with a reduced thickness of the frontal executive regions, the brain's control centres, identified in our models. Collectively, our results suggest a structural phenomenological decoupling, where trauma conditioned affective circuits may bypass weakened top-down regulatory controls. These findings highlight the necessity of using integrative frameworks to capture how trauma fundamentally reshapes the relationship between the brain and schizotypal personality.

24.
arXiv (CS.CL) 2026-06-19

LedgerAgent: Structured State for Policy-Adherent Tool-Calling Agents

Policy-adherent tool-calling agents in customer-service domains must maintain task states across turns while calling tools and obeying domain policies. Task states consist of relevant facts, identifiers, constraints, and conditions observed through user interaction and tool calls. In standard agents, task states are not represented separately. Observations, tool returns, and policy instructions are placed in the prompt, leaving agents to reconstruct the relevant states from the prompt each time they decide what to do next. This design makes state management implicit, creating two common failure modes. An agent may retrieve the right facts but later ground its decision in stale, missing, or incorrect information; and a syntactically valid tool call may still violate a domain policy that depends on the current task state. We introduce \textsc{LedgerAgent}, an inference-time method for tool-calling agents that maintains observed task states in a separate ledger and renders the states into the prompt. The ledger is also used to check state-dependent policy constraints before environment-changing tool calls are executed, blocking policy violations. Across four customer-service domains and a mixed panel of open- and closed-weight models, \textsc{LedgerAgent} improves average pass\textasciicircum{}k over a standard prompt-based tool-calling approach, with the largest gains under stricter multi-trial consistency metrics.

25.
medRxiv (Medicine) 2026-06-24

Developing and Evaluating an Online Educational Program for Falls Prevention Care in Community Optometric Primary Care Settings: A Pilot Study

Introduction Globally, falls are the leading cause of injury hospitalisation, with vision being a significant falls risk factor. Community optometrists, as primary eye care professionals, are well positioned to contribute to falls prevention care. However, scant studies have evaluated if education could enable optometrists to incorporate falls prevention care into practice. This two-phase pilot study aimed to design and develop an online education program for community optometrists to deliver primary falls prevention care and to evaluate optometrists reaction to, and learning from, the education. Methods In phase one, an education program was designed by optometrists and falls experts and published online. In phase two, community optometrists were recruited through convenience sampling to undertake the education. Guided by the New World Kirkpatrick model(R) of training evaluation, reaction and learning were evaluated using pre/post surveys. Quantitative data were analysed using Wilcoxon sign-rank tests and McNemar Exact Tests and qualitative responses using inductive content analysis. Results Participants (n=13) reported high levels of satisfaction and engagement with the online education and unanimously endorsed its relevance to clinical practice. Participants demonstrated significantly improved knowledge and awareness of falls prevention post-education, compared to pre-education and were significantly more confident to enact falls prevention care. Perceived enablers to providing falls prevention care included having access to practical resources and ongoing education. Time constraints during consultation and cost to patients for further care if subsequent referrals were made were identified as possible barriers to providing falls prevention care. Conclusion Online education improved community optometrists knowledge and confidence to provide falls prevention care. Further research that evaluates the effectiveness of continuing education for optometrists to enact falls prevention care into practice is required.