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01.
arXiv (CS.AI) 2026-06-24

Topological Neural Dynamics: A Neuron-wise Framework for Sequence Modeling

arXiv:2606.21295v2 Announce Type: replace-cross Abstract: Existing sequence models, including RNNs, LSTMs, continuous-time networks, and Transformers, share a common structural principle: layer-wise dynamics, where all neurons in the same layer co-evolve through a shared parameterized operator, leaving individual neurons no freedom to evolve independently. Yet in many complex dynamical systems, rich global behavior emerges precisely from locally evolving units interacting through structured connectivity. Inspired by this principle, we introduce Topological Neural Dynamics (TND), a sequence modeling framework that shifts computation from layer-wise to neuron-wise dynamics. TND represents a neural system as a directed neuron graph, an interaction operator, and a local dynamics function, where each neuron evolves independently and collective computation emerges from interactions through the explicit graph topology. We instantiate TND as a discrete-time graph-coupled dynamical system and evaluate it as a case study on a behavior cloning task in single-player Pong. Compared with Vanilla RNN, Sparse RNN, LSTM, Closed-form continuous-time neural network (CfC), and Transformer baselines, TND achieves the best catch rate and a mean of 17.47 consecutive catches per round, more than three times that of the strongest baseline. These results suggest that shifting from layer-wise to neuron-wise dynamics provides an effective inductive bias for sequence modeling.

04.
arXiv (CS.CL) 2026-06-16

ESBMC-PLC: Formal Verification of IEC 61131-3 Ladder Diagram Programs Using SMT-Based Model Checking

PLCs execute safety-critical programs across industrial sectors. The dominant PLC notation, ladder diagram (LD) per IEC 61131-3, remains absent from formal verification: SMT-based model checkers cannot process LD's rung-and-coil graphics. This paper presents ESBMC-PLC, the first open-source formal verifier with native LD support (PLCopen XML format), implemented as a new ESBMC frontend. ESBMC-PLC translates LD rungs to GOTO IR, models the PLC scan cycle as a while(true) loop with nondeterministic inputs, and checks safety properties via SMT-based bounded model checking or k-induction. A five-property YAML language (mutual_exclusion, invariant, absence, response, reachability) avoids temporal logic. A survey of 22 studies (2020-2026) identifies four research gaps; ESBMC-PLC closes two of them. Evaluation on 13 benchmarks (6 domains, 3 sources - including deployed CONTROLLINO PLCs and MathWorks Simulink PLC Coder) shows correct classification across 61 properties: all 9 author-constructed programs (Categories A/B) as expected, all 4 vendor programs (Category C) correctly unlabeled, with 8 bugs found (actionable counterexamples), 7 unbounded k-induction proofs, all runs under 60ms on Apple Silicon. Feature comparison with PLCverif shows that ESBMC-PLC is the only open-source tool that combines native LD, k-induction, and SMT bit-vector semantics.

05.
arXiv (CS.CV) 2026-06-24

TrOCR for Medieval HTR: A Systematic Ablation Study with Cross-Dataset Validation

Fine-tuning transformer-based handwritten text recognition (HTR) models on medieval manuscripts is challenging because these models are pre-trained on modern text and must adapt to a very different visual domain. This paper studies how three controllable fine-tuning choices (contrast normalization, data augmentation, and layer freezing) affect recognition accuracy when adapting TrOCR to small historical datasets. We run controlled experiments on a 13th-century Italian manuscript (I-CT 91 "Cortonese") and replicate the same experimental grid on the public READ-16 benchmark as robustness evidence. On Cortonese, our best configuration achieves 8.03% character error rate (CER). Statistical comparisons across 13 configurations show that freezing up to three encoder layers or six decoder layers does not significantly harm accuracy, while deeper freezing becomes progressively detrimental. Removing contrast normalization (CLAHE) yields 7.84% CER, comparable to a domain-specialized baseline, suggesting strong optimization can reduce reliance on image preprocessing. Cross-dataset validation on READ-16 shows that decoder freezing thresholds transfer more robustly than encoder thresholds, and combined freezing strategies require dataset-specific re-validation. Finally, we use Grad-CAM gradient attributions and decoder cross-attention maps to diagnose error patterns and failure modes revealed by the ablations. Source code is available at https://github.com/LaudareProject/TrOCR-analysis

06.
medRxiv (Medicine) 2026-06-22

Histologically validated diffusion MRI signatures of neuroinflammation and neurodegeneration in Alzheimer disease

Noninvasive neuroinflammation measurement remains a major barrier for Alzheimer disease (AD) therapeutics. We present generalized diffusion basis spectrum imaging (g-DBSI), a diffusion MRI framework that decomposes the tissue signal into biologically interpretable microstructural compartments. In postmortem Knight ADRC brains, g-DBSI-derived restricted isotropic fraction (RIF) and restricted anisotropic fraction (RAF) mapped cellularity and neurofilament density, while their ratio (RIF/RAF) tracked inflammatory cell density and peri-plaque amyloid-beta with higher specificity and regional consistency than RIF alone. In 112 living Knight ADRC participants stratified by PET amyloid, g-DBSI metrics showed amyloid-dependent trajectories: in low-amyloid individuals, RIF and RAF rose together with amyloid, consistent with early neuropil expansion and glial elaboration, whereas in high-amyloid individuals, RIF/RAF increased, and RAF declined, indicating established neuroinflammatory remodeling and neurofilament loss. CSF proteomics linked RIF/RAF to glia-enriched immune and vascular pathways, supporting g-DBSI as a clinically compatible MRI biomarker of neuroinflammation and neurodegeneration in AD.

07.
medRxiv (Medicine) 2026-06-24

INCREASED REMOVAL SIGNALS ON ERYTHROCYTES OF ANEMIC CANCER PATIENTS

BACKGROUND: Anemia is a negative factor in cancer, influencing the prognosis, quality of life and financial situation of cancer patients. Recent studies have shown that anemia in cancer is provoked by augmented erythrocyte removal. OBJECTIVE: In this study we sought to investigate the molecular bases for erythrocyte removal in cancer patients with anemia. In particular, we explored the levels of erythrocyte CD47, lactadherin, calreticulin and MCP1. METHODS: Thirty five anemic cancer patients (25 women, aged 66.4 +/-11.35 years old) and twelve healthy non-anemic controls (8 men, aged 61.1+/-9.98 years old) participated in our study. Red blood cells were isolated throug multiple centrifugations, and were lysed with the use of Triton-X 100. The levels of CD47, lactadherin, calreticulin and monocyte chemoattrractant protein 1 were determined by ELISA. RESULTS: Erythrocytes of anemic cancer patients display reduced CD47 (p

08.
arXiv (CS.AI) 2026-06-24

Context-Aware Prediction of Student Quiz Performance with Multimodal Textbook Features

Authors:

arXiv:2606.24770v1 Announce Type: cross Abstract: Educational platforms often predict student performance from prior interactions, but the assessment content itself also varies in linguistic and visual complexity. This paper studies whether lightweight content features extracted from CourseKata chapter-review questions improve prediction of end-of-chapter quiz scores beyond a student's average prior exercise performance. The study combines 2023 CourseKata student response data with chapter-level text features from review-question wording and image features from textbook visuals. Across 4,742 student-chapter observations from 562 class-student IDs, adding content features improves student-grouped five-fold quiz prediction performance by 9.1% relative to a prior-performance baseline. In leave-chapter-out validation, text features reduce prediction error relative to the baseline, while image-containing models have higher error. This paper suggests that a context-aware model adds useful signal about the text and visual features of questions to better predict student quiz performance compared with using past student performance alone.

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

K-Prism: A Knowledge-Guided and Prompt Integrated Universal Medical Image Segmentation Model

Medical image segmentation is fundamental to clinical decision-making, yet existing models remain fragmented. They are usually trained on single knowledge sources and specific to individual tasks, modalities, or organs. This fragmentation contrasts sharply with clinical practice, where experts seamlessly integrate diverse knowledge: anatomical priors from training, exemplar-based reasoning from reference cases, and iterative refinement through real-time interaction. We present $K-Prism$, a unified segmentation framework that mirrors this clinical flexibility by systematically integrating three knowledge paradigms: (i) $semantic priors$ learned from annotated datasets, (ii) $in-context knowledge$ from few-shot reference examples, and (iii) $interactive feedback$ from user inputs like clicks or scribbles. Our key insight is that these heterogeneous knowledge sources can be encoded into a dual-prompt representation: 1-D sparse prompts defining $what$ to segment and 2-D dense prompts indicating $where$ to attend, which are then dynamically routed through a Mixture-of-Experts (MoE) decoder. This design enables flexible switching between paradigms and joint training across diverse tasks without architectural modifications. Comprehensive experiments on 18 public datasets spanning diverse modalities (CT, MRI, X-ray, pathology, ultrasound, etc.) demonstrate that K-Prism achieves state-of-the-art performance across semantic, in-context, and interactive segmentation settings.

10.
arXiv (CS.AI) 2026-06-12

Democracy in the Era of Artificial Intelligence

arXiv:2606.13026v1 Announce Type: cross Abstract: Interfacing Artificial Intelligence (AI) with democracy is one of the most profound challenges of our times. On the one hand, AI comes with opportunities to overcome long-standing challenges in democracy, such as low participation in deliberative and voting processes with poor representation of people. On the other hand, new risks arise from AI algorithms that are privacy-intrusive, biased, manipulative, spread misinformation and influence election results. Moving beyond the over-simplistic question of whether AI is good or bad for democracy, the Handbook on Democracy in the Era of Artificial Intelligence asks instead: how to upgrade democracies and the principles they are built on, using AI? How to engage with AI and on what terms? Which new values and design principles are required to build democratic resilience? In 34 chapters by 59 authors across the world from different disciplines, we explore how AI can empower collective intelligence for democracy (Part 1) and what is the future of deliberative democracy using large language models and social media (Part 2). We also illustrate the role of AI for building resilient self-governance systems (Part 3) and the challenges of transforming democracy in the age of AI (Part 4). We conclude with broader perspectives (Part 5) that re-imagine the interplay of democracy and AI.

11.
arXiv (math.PR) 2026-06-17

Killed resolvents and measure-valued stopping gains for reflected optimal stopping with max-type rewards

arXiv:2606.17517v1 Announce Type: new Abstract: We study an infinite-horizon optimal stopping problem for a normally reflected two-dimensional diffusion in the positive quadrant with nonsmooth max-type reward \(G(x_1,x_2)=x_1\vee \alpha x_2\). The paper develops a conditional measure-theoretic framework for the associated reflected obstacle problem. The main innovation is to show that the stopping gain \(\Gamma=c+rG-\mathcal LG\) is a signed measure, not a function: the kink of \(G\) generates an explicit negative surface measure on \(\Delta=\{x_1=\alpha x_2\}\). We then prove that the correct potential representation uses the resolvent of the reflected diffusion killed on first entry into the stopping set, rather than the unrestricted reflected resolvent. Under explicit monotonicity, regularity, and measure-superharmonicity assumptions, we derive an epigraph representation, a continuation-side boundary-trace condition, and a candidate verification theorem. The framework clarifies hidden regularity and uniqueness assumptions in multidimensional nonsmooth optimal stopping.

12.
arXiv (CS.LG) 2026-06-16

Prediction of Runtime Parameters of Parallel Chemistry Applications via Active and Generative Learning

arXiv:2606.16226v1 Announce Type: new Abstract: In this work, we develop two main Machine Learning based approaches to predict the runtime parameters of highly scalable parallel chemistry computations.These approaches employ active and generative learning together with the empirically determined gradient boosted regression tree models chosen among a rich suite of machine learning models. When evaluated on Coupled-Cluster with Singles and Doubles computations, our models achieve a mean absolute error percentage (MAPE) as low as 0.023 and a coefficient of determination as high as 99.9%. Furthermore, when combined with active learning to mitigate the lack of large amounts of training data, our models score a MAPE about 0.2 with 20-25% of the original dataset.

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

From Persistence to Survival: Hypothesis Testing, Effect Sizes and Vectorisation for Topological Features

arXiv:2606.11911v1 Announce Type: cross Abstract: Persistence diagrams are common representations in topological data analysis, but they do not naturally live in a vector space, and the statistical tools developed for comparing them have largely evolved separately from those used for downstream prediction. We introduce STRAND (Survival Topological Representation ANalysis of Diagrams), which treats (collections of) PDs as survival data: each topological feature with persistence value $p = d - b$ is a fully observed time-to-event, and the persistence survival function $S(t) = \mathbb{P}(p > t)$ is the central object for comparing diagrams. From this single representation we derive (i) a non-parametric two-sample test with calibrated Type I error and high power from a small number of diagrams; (ii) interpretable effect sizes; and (iii) a 1-Wasserstein-stable feature vector for downstream machine learning. We validate calibration and power on synthetic manifolds with controlled topology, demonstrate competitive vectorisation across 14 graph and 3D point cloud benchmarks, and apply the method to study functional brain connectivity in fMRI/neuroscience data. To our knowledge, STRAND is the first method to provide hypothesis testing and vectorisation for persistence diagrams from a single coherent and interpretable representation.

14.
arXiv (quant-ph) 2026-06-12

Beyond-Third-Order Quantum Coherence in Two-Dimensional Spectroscopy via Order-Selective Isolation

arXiv:2606.12794v1 Announce Type: new Abstract: A central challenge in nonlinear spectroscopy is the order-selective readout of weak higher-order responses that spectrally overlap with dominant lower-order signals. This bottleneck is particularly severe in two-dimensional (2D) spectroscopy, where extending conventional phase-cycling schemes to higher orders rapidly increases measurement and analysis complexity. Here we introduce a computation-assisted strategy that combines rotating-frame acquisition with a frame-shift tracking algorithm to separate signals by their frame-dependent spectral shifts. In a rubidium vapor experiment, we use this approach to isolate a 7th-order nonlinear contribution from coexisting 3rd-order components, enabling direct access to higher-order quantum-coherence dynamics without sacrificing operation at comparatively high pulse intensities. The method is broadly compatible with multidimensional spectroscopy platforms and provides a practical route to probing many-body and collective ultrafast dynamics beyond third order.

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

RGB-S: Image-Aligned Tactile Saliency for Robust Dexterous Manipulation

Effective visuo-tactile integration is critical for robotic dexterous manipulation, especially when visual observations are unreliable or occluded. However, robustly aligning sparse, heterogeneous tactile measurements with dense visual representations remains a fundamental challenge. Most existing approaches require policies to learn cross-modal correspondences implicitly from limited demonstrations, without leveraging geometric priors. As a result, they are often data-inefficient and generalize poorly when visual observations are degraded. To address this limitation, we propose a framework that explicitly grounds physical contacts in the image domain. Using robot forward kinematics and camera calibration, we project tactile sensor locations directly onto the RGB image plane. We then render force-modulated Gaussian saliency maps to model spatial uncertainty arising from kinematic and calibration errors. By integrating these 2D spatial anchors through a zero-initialized conditioning architecture, our method injects physical contact priors into standard visual backbones while preserving pre-trained visual representations. We evaluate our method on six dexterous manipulation tasks in both simulation and the real world under severe visual occlusions. Real-world experiments show that explicit RGB-S grounding in the image domain improves real-world occluded manipulation success rates by $26.7$ percentage points over the strongest implicit visuo-tactile baseline, suggesting its improved spatial reasoning and robustness to occlusion. Project page: touch-as-saliency.github.io

16.
arXiv (CS.AI) 2026-06-18

Sparsity Curse: Understanding RLVR Model Parameter Space from Model Merging

arXiv:2606.18521v1 Announce Type: cross Abstract: Reinforcement Learning with Verifiable Reward (RLVR) has emerged as a powerful post-training paradigm that surpasses Supervised Fine-Tuning (SFT) in eliciting reasoning intelligence and resisting catastrophic forgetting. Recent studies further reveal that RLVR induces highly sparse and off-principal parameter updates compared to SFT. This naturally raises the question: does such sparsity make RLVR models more amenable to model merging? If so, model merging would offer a scalable, training-free path to aggregate diverse reasoning capabilities from independently trained RLVR models. Surprisingly, we find the opposite, uncovering a sparsity curse: the sparse RLVR updates are spread farther apart in parameter space, forming near-orthogonal shortcuts that make aggregation inherently fragile. This is likely rooted in the stochasticity of RL optimization and the diversity of emergent reasoning patterns. Unlike SFT models that converge to shared, flat basins and merge naturally, RLVR models suffer severe degradation under standard merging methods. Through systematic empirical analysis of the update geometry, we characterize the mechanisms behind this failure and propose Sensitivity-aware Resolving Merging (SAR-Merging), a merging recipe tailored for the unique structure of RLVR parameter spaces. SAR-Merging resolves conflicts in overlapping update regions via Fisher Information-based sensitivity arbitration, followed by magnitude-aware sparsification and rescaling to preserve fragile reasoning pathways. Experiments on mathematical and coding benchmarks demonstrate that SAR-Merging substantially outperforms existing merging methods on RLVR models, enabling both single-task enhancement and multi-capability fusion.

17.
arXiv (quant-ph) 2026-06-19

Robust Generation of Topological Biphoton Mode via Adiabatic Passage

arXiv:2606.19786v1 Announce Type: new Abstract: Topological waveguide arrays support robust mode propagation in the presence of fabrication imperfections, providing a significant advantage for on-chip quantum information processing. However, this robustness does not fully extend to nonlinear biphoton generation. Structural disorder can enhance the excitation of non-topological biphoton modes during nonlinear interactions, which degrades the quantum properties of the generated state. To overcome this limitation, we propose an adiabatic passage that connects an isolated site to a topological defect array. By initiating the nonlinear process in a strongly isolated regime, nonlinear coupling to unwanted modes is effectively suppressed, thereby preserving the Schmidt number of the generated state. The subsequent adiabatic connection facilitates the high fidelity transfer of the generated biphoton into the topological biphoton mode. Our numerical simulations demonstrate that, unlike conventional topological structures, the adiabatic scheme maintains both high biphoton fidelity and a unit Schmidt number in the presence of waveguide gap disorder. Furthermore, we show that this robustness extends to path entangled NOON states, achieving a near-unity quantum interference visibility. Our approach provides a practical design strategy for disorder-tolerant integrated quantum photonic devices.

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

Finetuning Vision-Language-Action Models Requires Fewer Layers Than You Think

arXiv:2606.20246v1 Announce Type: cross Abstract: Vision-Language-Action (VLA) models pre-trained on massive video-robot datasets have revolutionized robotic manipulation, yet their multi-billion parameter architectures impose prohibitive computational burdens during downstream fine-tuning and real-time inference. In this work, we reveal a highly non-trivial architectural characteristic of these continuous control foundation policies (e.g., pi_0, GR00T-N1.5): despite being trained on diverse physical trajectories, they exhibit severe layer-wise representational redundancy. To exploit this, we introduce a structural compression pipeline that is entirely training-free, bypassing the need of existing methods to load full-scale models to learn optimized token reductions or dynamic layer selectors. Instead, using only a single forward pass via Centered Kernel Alignment to identify redundant layer features, we remove twin layers to permanently compress the model depth by up to 50% across both the VLM backbone and the continuous control policy head. Downstream fine-tuning of this streamlined architecture yields a dual acceleration benefit: a 40-50% reduction in training time and up to 30% faster real-time inference, while matching or exceeding full-scale base model performance. We comprehensively validate our method across three simulation benchmarks (LIBERO, RoboCasa, SimplerEnv) and 10 diverse real-world manipulation tasks across 4 unique robotic embodiments. These results prove that advanced VLAs require significantly fewer layers than previously assumed, offering a highly compute-efficient paradigm for scalable robot learning.

19.
medRxiv (Medicine) 2026-06-19

Fine-Tuning SAM2 for Coronary Artery Segmentation in X-Ray Fluoroscopy

Authors:

SAM2 (Meta, 2024) provides a strong starting point for segmentation, but given the unique challenges in medical imaging (noise from patient movement, the projection-based nature of X-ray fluoroscopy, and low contrast between vessels and background), direct application is difficult. We fine-tune MedSAM2 on annotated coronary angiograms and apply it to video data for point-of-care use. On the ARCADE validation set (200 images), the fine-tuned model achieves Dice 0.767 compared to 0.033 zero-shot. On 10 fluoroscopic video studies from CoronaryDominance, it tracks vessels coherently and avoids falsely segmenting ribs, stents, and bypass grafts in 9 of 10 studies. Code is available at https://github.com/elakiyasivakumar/SAM2-Coronary-Angiography-VA and the fine-tuned checkpoint at https://huggingface.co/Elakiya17/CA-SAM2.

20.
arXiv (CS.CV) 2026-06-11

Higher order PCA-like rotation-invariant features for detailed shape descriptors modulo rotation

Authors:

PCA can be used for rotation invariant features, describing a shape with its $p_{ab}=E[(x_i-E[x_a])(x_b-E[x_b])]$ covariance matrix approximating shape by ellipsoid, allowing for rotation invariants like its traces of powers. However, real shapes are usually much more complicated, hence there is proposed its extension to e.g. $p_{abc}=E[(x_a-E[x_a])(x_b-E[x_b])(x_c-E[x_c])]$ order-3 or higher tensors describing central moments, or polynomial times Gaussian allowing decodable shape descriptors of arbitrarily high accuracy, and their analogous rotation invariants. Its practical applications could be rotation-invariant features to include shape modulo rotation e.g. for molecular shape descriptors, or for up to rotation object recognition in 2D images/3D scans maybe also for 3D scene understanding, or shape similarity metric allowing inexpensive comparison of objects modulo rotation avoiding costly optimization over rotations.

21.
bioRxiv (Bioinfo) 2026-06-17

DesignMaster: A Multi-Conditional Diffusion Framework for Rational PROTAC Design

Motivation: Proteolysis-targeting chimeras (PROTACs) enable targeted protein degradation through ternary complex formation with E3 ubiquitin ligase. However, the rational design of PROTACs remains highly challenging due to limited structure-activity relationship data and the vast conformational diversity of linkers. Existing computational approaches can be broadly divided into structure-based ternary modelling methods and fragment-based linker generation models. Although these approaches have advanced PROTAC design, they typically neglect key physicochemical constraints and linker-length control during the generation process, causing the generated PROTACs to lack balanced structural properties required for effective ternary complex formation with drug-like characteristics. Results: To address these limitations, we propose DesignMaster, a diffusion-based generative framework that explicitly incorporates linker length and physicochemical properties as controllable conditioning signals. DesignMaster employs an E(3)-equivariant graph Transformer with a gated multi-condition fusion module to inject linker length and physicochemical constraints throughout the diffusion process, enabling fine-grained and constraint-aware molecular generation. Experiments on PROTAC-DB 2.0 and 3.0 demonstrate that DesignMaster outperforms state-of-the-art baselines, with a 3.2% improvement in validity and a 34.4% improvement in recovery. The Case study shows DesignMaster achieves a 51.78% reduction in RMSD when predicting the linker of PROTAC BCPyr targeting 6W7O, highlighting its potential for practical structure-guided PROTAC design. Availability: The source code and datasets are available at https://github.com/ABILiLab/DesignMaster.

22.
arXiv (CS.CV) 2026-06-16

Robust Spoofed Speech Detection via Temporal Pyramid Modeling

Spoofed speech detection is increasingly challenged by realistic synthesis, voice conversion, and replay attacks, with cross-dataset generalization remaining a major limitation. This work we propose a Temporal Pyramid Adapter that utilize parallel temporal convolutions with varying receptive fields to capture multi-scale spoofing cues, ranging from local artifacts to global prosodic irregularities. We also integrated self-supervised XLS-R representations combined with front-end adapters, including Mel, Sinc, and a Temporal Pyramid design for multi-scale temporal modeling. The proposed model is evaluated cross multiple benchmark including ASVspoof 2017, ASVspoof 2021 (DF/LA), PartialSpoof, DiffSSD, and multilingual HQ-MPSD datasets. Experimental results demonstrate that Temporal Pyramid model obtained AUC of 99.24% and a EER of 3.87% on the PartialSpoof database, which is significantly outperforming the base model and several SOTA baseline such as LCNN-BLSTM (9.87% EER) and TRACE (8.08% EER). Additionally, multilingual evaluations confirm that while spoofing artifact are independent from language. While self-supervised representations improve robustness, performance degrades under domain and language shifts, highlighting the need for better adaptation and calibration strategies.

23.
arXiv (CS.AI) 2026-06-25

Enhancing Clinician Decision-Making via Uncertainty-Aware Multi-Expert Fusion for Stroke Rehabilitation

arXiv:2606.24960v1 Announce Type: cross Abstract: Tailoring stroke rehabilitation requires assessing how movements are organized, not merely if they succeed. Currently, this assessment is a rate-limiting bottleneck. Instruments like the Action Research Arm Test (ARAT) compress rich behavioral observations into single ordinal endpoints, discarding the movement-quality details that distinguish recovery from compensation. Automated alternatives typically chase accuracy on noisy, single-observer labels to output opaque scores - a technology-centric approach that rarely reaches clinical practice. To address this, we present xAARA: an engine designed to augment rather than replace clinical judgment. From multi-view video, xAARA returns ARAT assessments with calibrated uncertainty and explanations across task, movement-phase, and movement-quality levels. Treating clinical scoring as an ill-posed inference problem, xAARA composes 692 calibrated multimodal models via a Dynamic Bayesian Network with entropy-based gating. It qualifies results against clinical validity rules and defers low-confidence cases. In 105 stroke survivors (788 exercises), xAARA achieved 94.2% task accuracy (Cohen's kappa=0.934) and 81.3% movement-phase accuracy (kappa=0.727), reducing predictive uncertainty by 96.1% compared to single-clinician scoring. For subjective cases, it matched at least one rater 100% of the time and never returned out-of-range scores. Four independent clinicians validated the assessments and indicated willingness to adopt the system. We argue that principled uncertainty quantification and clinician-aligned explainability are the critical bridges moving automated assessment from technical demonstration to a deployable clinical tool.

24.
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.

25.
arXiv (CS.AI) 2026-06-15

Design Methodology and Performance Trade-offs Management for Distributed and Compound AI Systems

arXiv:2606.14350v1 Announce Type: cross Abstract: Artificial Intelligence (AI) systems must typically satisfy service-level objectives including accuracy, latency, and cost. The prevailing model-centric approaches select a monolithic model at design time and apply identical computation regardless of input difficulty, cannot decompose tasks across specialized components, and have knowledge that is fixed at training time. During runtime, this can lead to performance degradation and increasing costs. Because the model is the main design variable, it determines the majority of system behavior, coupling operational objectives to a single design-time choice. Addressing these limitations requires shifting from model-centric to system-centric design. Compound AI systems realize this shift by orchestrating multiple models, algorithms, and tools as distributed AI systems through explicit control logic. The performance of such systems depends on their workflow topology, the models assigned to each task, and the parameters governing runtime behavior. We present a design methodology that organizes this space along two dimensions, workflow topology and configuration selection, and identifies eight design patterns, each consolidating techniques to address a specific limitation of monolithic deployment. We validate our methodology through three case studies. Across our case studies, Compound AI configurations approach accuracy of monolithic models within 2.5 to 4 percentage points while reducing latency by up to 60% and cost by up to 71%. We show that model selection and parameter configuration jointly determine system performance, but the resulting design space grows combinatorially, as workflows compose more patterns and components. Thus, we identify five open challenges that define a roadmap from manually configured prototypes towards systems that automatically discover and maintain SLO-compliance in Compound and Distributed AI systems.