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01.
medRxiv (Medicine) 2026-06-24

Development and Validation of Machine Learning Models for Predicting Initiation of Emergency Dialysis in Advanced Chronic Kidney Disease

Background: Initiation of emergency dialysis, often requiring temporary catheter owing to unprepared definitive vascular access, is associated with infectious and vascular complications and suggests advanced chronic kidney disease (CKD) care gaps. Previous studies focused on kidney failure or dialysis timing. This study aimed to predict initiation of emergency dialysis using machine learning and baseline data. Methods: This retrospective cohort study used the Japan Medical Data Center claims data (2014-2022). Adults with an estimated glomerular filtration rate (eGFR)

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

VigilFormer: Deformable Attention for Video Anomaly Detection with Causal Risk Inference

Authors:

Video anomaly detection in surveillance settings must balance detection accuracy against real-time throughput, a tension that existing methods address either through stronger feature extractors or more efficient architectures, but rarely both. We present VigilFormer, a unified framework that combines deformable spatio-temporal attention with causal temporal modeling to detect anomalies in untrimmed surveillance video. The proposed Deformable Spatio-Temporal Encoder (DSTE) attends to a sparse set of informative locations across frames, avoiding the quadratic cost of dense attention while retaining the ability to capture irregular motion patterns. A Causal Anomaly Classifier (CAC) applies dilated causal convolutions over snippet-level features and optimizes a contrastive multiple-instance learning objective that separates anomalous and normal representations without frame-level labels. To meet deployment constraints, an Adaptive Confidence Scheduler (ACS) dynamically skips low-information frames at inference time, reducing redundant computation in static scenes. Evaluated on UCF-Crime, ShanghaiTech, and CUHK Avenue, VigilFormer achieves AUC scores of 87.83%, 97.21%, and 89.74% respectively, at 41.5 FPS on a single GPU, outperforming recent weakly-supervised methods in both accuracy and speed.

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

The Answer Lies Within: Self-Derived Rewards Enable Explainable Relation Extraction

Despite the remarkable reasoning capabilities of large language models, they still struggle with one-shot relation extraction without predefined relation labels. We identify two pitfalls: models are often misled by irrelevant tokens instead of relation-conveying semantics, and they often fail to align with the abstraction level human annotators expect. We introduce a novel framework that closes this gap with two components: (1) COGRE, a cognitively-inspired reasoning framework that structures RE into a series of processes mimicking human text-processing; and (2) HIT@DICT, a reinforcement learning intermediate reward strategy that encourages reasoning to align with relational labels by rewarding relation-relevant phrases in reasoning. The reward is derived on a credit dictionary automatically extracted from correct predictions. Our experiments show that our framework improves both accuracy and explanation quality by addressing these two pitfalls. For example, COGRE with Qwen2.5-14B-Instruct on One-shot NYT29 achieves 24.65% F1, surpassing prior reasoning-based designs. Optimizing this approach with RL using HIT@DICT further improves performance by +23.46% points. Finally, human evaluation shows that our best model generates relational phrases closely aligned with gold labels, increasing human explanation quality ratings by 54% (relative).

04.
bioRxiv (Bioinfo) 2026-06-23

VCBench: A Multi-Dimensional Benchmark for Single-Cell Foundation Models

Single-cell foundation models are increasingly positioned as virtual cells, yet their capabilities are assessed by fragmented, largely single-task benchmarks that obscure where these models improve on simple baselines. VCBench addresses this by synthesizing four independent virtual-cell frameworks into seven capability dimensions: perturbation response prediction, cross-species universality, gene regulatory network (GRN) inference, modality integration, temporal dynamics, multi-scale integration, and in silico experimentation. Each dimension is assessed for operational testability under current architectures and datasets: five admit direct or proxy evaluation, while multi-scale integration and in silico experimentation are structurally untestable as end-to-end tasks. We evaluate five foundation models (Geneformer, scGPT, UCE, TranscriptFormer, Arc State) against pre-registered linear and nearest-neighbor baselines across the five testable dimensions, and report three findings. First, the baselines match or exceed every foundation model on four of the five scored dimensions, replicating the reported competitiveness of linear baselines on perturbation prediction and extending it to cross-species transfer, GRN inference, and temporal ordering. Second, TranscriptFormer alone exceeds the strongest baseline on cross-modal RNA-to-protein prediction (53% Pearson improvement, with a documented contamination caveat) and is the only model to reach Level 2 in the pre-registered Virtual Cell (VC) Level rubric; the architectural choice behind this advantage simultaneously causes a spectral collapse that destroys its temporal-ordering performance, a tradeoff invisible to single-task benchmarks. Third, no foundation model publishes a complete cell-level training manifest, leaving data contamination undetectable to users. Alongside the benchmark, VCBench releases a Contamination Reporting Schema and contributes two further methodological tools: a common-label-set protocol that controls for class-count confounds in cross-species transfer, and a spread-error correlation probe for epistemic calibration.

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

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

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

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

PhysDrift: Bridging the Embodiment Gap in Humanoid Co-Speech Motion Generation

arXiv:2606.19935v1 Announce Type: new Abstract: Humanoid robots require co-speech motions that are not only expressive and speech-aligned, but also physically executable under embodiment constraints. Existing co-speech generation pipelines are predominantly human-centric: motions are first generated in human-body representations such as SMPL-X and subsequently retargeted to humanoid robots. In this work, we identify a fundamental embodiment gap in this paradigm, where the mismatch between human motion manifolds and humanoid embodiment constraints disrupts embodiment consistency during motion transfer and physical execution. Through extensive analysis, we show that although retargeting can preserve coarse motion semantics, it significantly compresses motion diversity and weakens prosody-motion synchronization, limiting expressive humanoid behaviors. To address this problem, we first propose IK-EER, a prosody-preserving humanoid motion curation framework that jointly optimizes kinematic feasibility and speech-motion temporal alignment during retargeting. Building upon the curated robot-native motion dataset, we further introduce PhysDrift, an embodiment-aware co-speech motion generation framework that directly predicts executable humanoid joint trajectories from speech without relying on intermediate human-body representations. Unlike conventional human-centric pipelines, PhysDrift maintains embodiment consistency throughout both training and inference while incorporating physical regularization to stabilize robot motion dynamics. Extensive experiments and real-world humanoid deployment demonstrate that embodiment-aware robot-native generation substantially improves speech-motion alignment, physical plausibility, motion smoothness, inference efficiency, and real-time interaction capability.

07.
arXiv (quant-ph) 2026-06-19

Optimal Shadow Estimation with Minimal Measurement Settings

arXiv:2606.20003v1 Announce Type: new Abstract: Shadow estimation is a powerful framework for predicting quantum properties from randomized measurements. While $3$-design protocols achieve optimal worst-case performance, the minimal number of measurement bases required for such optimality has remained open. Here we prove that $\Theta(d^2)$ measurement bases are both necessary and sufficient for worst-case optimal shadow estimation and construct an explicit basis family. In stark contrast, any state $2$-design already suffices for average-case optimality: the mean squared shadow norm of normalized observables is bounded by a universal constant, and we prove strong concentration for Haar-random states, yielding constant sample complexity for generic pure-state fidelity estimation. Easily implementable $2$-designs – from mutually unbiased bases, cyclic measurements, or shallow $\mathcal{O}(\log n)$-depth circuits – enable optimal average-case protocols with remarkably simple measurement strategies. Our results establish a fundamental complexity separation: worst-case estimation requires $\Theta(d^2)$ bases, whereas average-case performance requires only $\Theta(d)$ bases, with broad implications for quantum information theory and near-term experiments.

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

Teaching Values to Machines: Simulating Human-Like Behavior in LLMs

Large Language Models (LLMs) demonstrate a remarkable capacity to adopt different personas and roles; however, it remains unclear whether they can manifest behavior that adheres to a coherent, human-like value structure. In this work, we draw on established psychological value theory to induce human-like values in LLMs and assess their alignment with patterns observed in human studies. Using validated psychological questionnaires, we conduct large-scale experiments – over 5 million questions – to evaluate value structures and value-behavior relationships in leading LLMs and compare them to humans. Our findings reveal strong agreement between value-prompted LLMs and humans across both dimensions. Moreover, incorporating human value distributions enhances population-level simulations with value-induced LLMs. These findings highlight the potential of value-induced LLMs as effective, psychologically grounded tools for simulating human behavior.

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

Functional Gradient Descent with Adaptive Representations

arXiv:2606.16926v1 Announce Type: cross Abstract: Functional optimization problems are typically solved by optimizing the parameters of a fixed representation, such as a neural network, resulting in highly nonconvex losses that complicate both training and theoretical analysis. An interesting alternative is functional gradient descent (FGD), that is, gradient descent directly in function space, which benefits from strong convergence results and admits a clean theory. However, FGD is difficult to implement in practice because functional gradients are infinite-dimensional, and thus cannot be fully computed nor stored in memory. Existing implementations therefore rely on fixed approximations, which introduce approximation error. We propose a new, theoretically-grounded FGD algorithm that adapts the representation of the functional gradients over the course of optimization. By explicitly incorporating this approximation into the analysis, we establish convergence to a stationary point (for smooth losses) and to a global minimizer (under smoothness + a Polyak-Lojasiewicz-type condition) regardless of our approximations. To the best of our knowledge, this is the first implementable FGD method with such guarantees in a general setting. We demonstrate the effectiveness of our method on regression, numerical solution of PDEs, and modern computer vision. Across settings, our method consistently outperforms both FGD with fixed approximations and neural network baselines in efficiency and accuracy.

10.
arXiv (CS.LG) 2026-06-24

Natural Identifiers for Privacy and Data Audits in Large Language Models

arXiv:2606.24408v1 Announce Type: new Abstract: Assessing the privacy of large language models (LLMs) presents significant challenges. In particular, most existing methods for auditing differential privacy require the insertion of specially crafted canary data during training, making them impractical for auditing already-trained models without costly retraining. Additionally, dataset inference, which audits whether a suspect dataset was used to train a model, is infeasible without access to a private non-member held-out dataset. Yet, such held-out datasets are often unavailable or difficult to construct for real-world cases since they have to be from the same distribution (IID) as the suspect data. These limitations severely hinder the ability to conduct scalable, post-hoc audits. To enable such audits, this work introduces natural identifiers (NIDs) as a novel solution to the above-mentioned challenges. NIDs are structured random strings, such as cryptographic hashes and shortened URLs, naturally occurring in common LLM training datasets. Their format enables the generation of unlimited additional random strings from the same distribution, which can act as alternative canaries for audits and as same-distribution held-out data for dataset inference. Our evaluation highlights that indeed, using NIDs, we can facilitate post-hoc differential privacy auditing without any retraining and enable dataset inference for any suspect dataset containing NIDs without the need for a private non-member held-out dataset.

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

FrozenDrive: Zero-Shot Text-Guided Driving Scene Generation and Data Augmentation with Parameter-Free Frozen Diffusion Model

Synthetic data for autonomous driving is surging, powered by diffusion models that promise scalable scene generation. Yet key obstacles remain, as enforcing multi-view and temporal consistency often relies on backbone fine-tuning or added layers, which erodes pre-trained knowledge and weakens text alignment. Models also stay close to the training distribution, struggling under adverse weather and unseen configurations, and fidelity favors frequent over rare classes. We address these gaps with FrozenDrive, a controllable generative framework that preserves a pretrained diffusion models knowledge while achieving strong consistency. FrozenDrive conditions on rich driving-stack signals and text prompts, and introduces knowledge-preserving spatio-temporal attention to impose cross-view alignment and temporal coherence in a single pass within a parameter-free frozen diffusion backbone. An additional object-focused constraint improves per-object fidelity for rare categories. Without any weather- or scene-specific fine-tuning, our model synthesizes globally coherent multi-view driving scenes from text, particularly under adverse and rare conditions, and surpasses prior baselines. On nuScenes, FrozenDrive augmented data significantly improves AD models performance, especially at night and in rain, demonstrating stronger robustness when trained with our scenario-targeted data.

12.
arXiv (CS.AI) 2026-06-11

Automating Geometry-Intensive Compliance Checking in BIM: Graph-Based Semantic Reasoning Framework

arXiv:2606.12065v1 Announce Type: new Abstract: Automating compliance check for geometry-intensive regulations remains a significant technical bottleneck in Building Information Modeling (BIM), primarily due to the semantic disparity between high-level regulatory logic and structured IFC data. Existing methods, often reliant on static rule templates, struggle to traverse multi-hop reasoning chains or resolve latent spatial dependencies across multiple building entities. To address these challenges, a Spatial-Geometric Reasoning System for Building Information Modeling (SGR-BIM) is proposed as an integrative graph-driven reasoning framework. SGR-BIM dynamically constructs a cross-modal knowledge graph that aligns user intent, regulatory semantics, and BIM geometry, enabling interpretable reasoning without rigid hard-coding. Validated on 679 expert-verified queries from fire safety codes, the framework achieves 84.3% accuracy, representing an 8.6% improvement over enhanced-tool single-agent baselines. This research provides a graph-based semantic reasoning paradigm, enhancing the transparency and flexibility of automated geometric compliance check workflows in the Architecture, Engineering, and Construction (AEC) industry.

13.
bioRxiv (Bioinfo) 2026-06-11

ANCHOR: haplotype-aware allelic and isoform inference from single-cell long-read RNA sequencing with de novo variant calling

Long-read RNA sequencing enables haplotype- and isoform-resolved allelic analysis of transcriptomes, yet extending this capability to single cells and distinct cell types remains computationally challenging due to sparse coverage, sequencing errors, incomplete variant information, and reference-biased transcript assignment. Here we present ANCHOR, a haplotype-aware framework for single-cell long-read RNA sequencing that performs de novo expressed-variant discovery, molecule-level haplotype assignment and isoform-resolved allelic quantification. ANCHOR combines a signed-graph variant caller, pair hidden Markov modelling and beta-binomial UMI aggregation to infer parental allele counts for genes and splice-resolved isoforms, without requiring a pre-existing phased genotype or deep learning. In human single-cell long-read RNA benchmarks, ANCHOR improved variant-calling performance over tested long-read RNA callers at single-cell and low-to-moderate coverage, and its beta-binomial model reduced depth-driven false positives in allele-specific expression testing. Applied to newly generated single-cell long-read RNA-seq data from reciprocal mouse crosses during gastrulation, ANCHOR resolved cell-type- and isoform-specific parent-of-origin imprinting and identified an antagonistic maternally biased Sgce isoform. ANCHOR provides a general framework for allele- and isoform-resolved analysis of diploid single-cell long-read transcriptomes.

14.
arXiv (CS.CV) 2026-06-24

Predicting brain tumour enhancement from non-contrast MR imaging with artificial intelligence: a multi-cohort retrospective diagnostic accuracy study

Brain tumour MRI typically requires both pre- and post-contrast imaging, but gadolinium is not always desirable (frequent follow-up, renal impairment, allergy, paediatric patients). We developed and validated a deep learning model to predict tumour contrast enhancement from non-contrast MRI alone. We assembled 11,089 brain MRI studies (2006-2024) from 10 datasets across four countries and three continents, spanning adult and paediatric populations with glioma, meningioma, metastases, and post-resection appearances. Three architectures were trained to detect and segment enhancing tumour from T1w, T2w and FLAIR alone. Performance was assessed in a 1,109-study held-out test set (primary endpoint: patient-level enhancement detection; secondary: voxel-level Dice). Eleven expert radiologists attempted the same task on a 564-case subset (100 cases each), blinded to history, prior imaging, and referral. The best model, nnU-Net, achieved 83.0% balanced accuracy (95% CI 79.1-87.2; sensitivity 91.5%, specificity 74.4%) for detection, with R2 = 0.859 for enhancement volume. Of enhancing cases, 76.8% reached Dice >= 0.3, 67.5% >= 0.5, and 50.2% >= 0.7. Under blinded conditions, radiologists' majority vote was lower (71.7% balanced accuracy; sensitivity 77.6%, specificity 65.8%). The proportion reaching Dice >= 0.3 varied by pathology (meningioma 93%, presurgical glioma 76%, metastases 74%, postoperative glioma 74%) and was lowest for paediatric cases (45%). Deep learning can identify contrast-enhancing brain tumours from non-contrast MRI. These models show promise as a triage or decision-support adjunct, such as in flagging studies likely to enhance so that contrast can be added to a non-contrast protocol, and may reduce gadolinium dependence in neuro-oncology imaging. Future work should optimise these models with radiologists.

15.
arXiv (CS.CV) 2026-06-24

DivRL: Disentangled Self-Similarity Rewards for Diverse Subject-Driven Generation

Subject-driven image generation faces an "Identity-Diversity Paradox", where strong identity preservation often leads to rigid and low-diversity outputs. We propose a post-training framework called DivRL that jointly optimizes identity consistency and structural diversity simultaneously by leveraging disentangled visual features from a robust similarity model. Specifically, we introduce a Negative Self-Similarity Measure (nSSM) to quantify structural diversity, and Visual Semantic Matching (VSM) to evaluate identity consistency. We propose an "Explore-and-Suppress" strategy that treats VSM as a gated constraint: the model freely explores structurally diverse configurations, and only samples that violate the identity threshold are penalized via a quadratic hinge loss. This converts identity preservation from a competing objective into a feasibility constraint, allowing nSSM and VSM to improve jointly. Experiments demonstrate that our method effectively pushes the model to generate both consistent and diverse images and improves structural diversity while maintaining comparable identity consistency through a gated optimization formulation.

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

Watching a Superconducting Coplanar Waveguide Heat Up with a Single Color Center

arXiv:2606.15398v1 Announce Type: new Abstract: Single color centers in diamond offer a local probe of their cryogenic environment, providing a direct way to quantify heating in spin-control hardware. Here, we establish a single spectrally stable tin-vacancy (SnV) center as an on-chip thermometer for a diamond membrane and use it to characterize microwave- and radio-frequency-induced heating in a superconducting coplanar waveguide patterned on the same chip. We first calibrate the temperature dependence of the optical C-transition frequency and linewidth from $20\,\mathrm{K}$ down to the few-kelvin regime. At lower temperatures, where the optical response becomes weakly temperature dependent, we use the spin-lattice relaxation time $T_1$ as a complementary thermometer and tune its sensitivity with the transverse magnetic-field component. Applying this local thermometer to a niobium coplanar waveguide, we observe magnetic-field-dependent superconducting breakdown under GHz drive, accompanied by abrupt heating of the diamond. In contrast, at $20\,\mathrm{MHz}$ and $400\,\mathrm{mT}$, relevant for nuclear-spin control, we detect no measurable heating up to the breakdown threshold of $9.4\,\mathrm{dBm}$, corresponding to $B_\mathrm{ac}\sim1.2\,\mathrm{mT}$. These results define a safe operating window for superconducting microwave and RF control structures in diamond-based quantum nodes.

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

Resource-Efficient Variational Quantum Classifier

arXiv:2511.09204v3 Announce Type: replace-cross Abstract: We introduce the unambiguous quantum classifier based on Hamming distance measurements combined with classical post-processing. The proposed approach improves classification performance through a more effective use of ansatz expressivity, while requiring significantly fewer circuit evaluations. Moreover, the method demonstrates enhanced robustness to noise, which is crucial for near-term quantum devices. We evaluate the proposed method on a breast cancer classification dataset. The unambiguous classifier achieves an average accuracy of 90%, corresponding to an improvement of 6.9 percentage points over the baseline, while requiring eight times fewer circuit executions per prediction. In the presence of noise, the improvement is reduced to approximately 3.1 percentage points, with the same reduction in execution cost. We substantiate our experimental results with theoretical evidence supporting the practical performance of the approach.

18.
arXiv (CS.AI) 2026-06-12

The Safety-Aware Denoiser for Text Diffusion Models

arXiv:2605.08116v2 Announce Type: replace-cross Abstract: Recent work on text diffusion models offers a promising alternative to autoregressive generation, but controlling their safety remains underexplored. Existing safety approaches are geared toward autoregressive models and typically rely on post-hoc filtering or inference-time interventions. These are inadequate for effectively addressing safety risks in text diffusion models. We propose the Safety-Aware Denoiser (SAD), a safety-guidance framework in text diffusion models. The SAD modifies the iterative denoising process such that the text sample at the final denoising step is steered toward provably safe regions of the text space. This inference-time method can integrate safety constraints into the denoiser, avoiding computationally expensive retraining of the underlying diffusion model and enabling flexible, lightweight safety guidance. We evaluate the safety of the generated text using the SAD, with respect to hazard taxonomy, memorization, and jailbreak. Experimental results show that SAD substantially reduces unsafe generations while preserving generation quality, diversity, and fluency, outperforming existing methods. These results demonstrate that our safety guidance during denoising provides an effective and scalable mechanism for enforcing safety in text diffusion models.

19.
PLOS Computational Biology 2026-06-02

Data-driven model reveals increased stability of CAG-expanded <i>huntingtin</i> RNA due to MID1 binding

Authors:

by Yuhong Liu, Annika Reisbitzer, Domagoj Dorešić, Jan Hasenauer, Sybille Krauß, Tatjana Tchumatchenko RNA-binding proteins (RBP) are important regulators of RNA metabolism. In neurodegenerative disorders such as Huntington’s Disease (HD), disrupted RBP-RNA interactions contribute to neuronal dysfunction. One such RBP, Midline 1 (MID1), has been shown to aberrantly associate with mutant huntingtin (Htt) RNA, enhancing its translation, yet the mechanism driving this effect remains unknown. Here, we develop a computational model to understand the role of MID1. Based on previously published data, our model predicts that MID1 increases the stability of the Htt RNA. We experimentally validate this prediction, showing that overexpression of MID1 significantly prolongs the half-life of mutant Htt RNA. Furthermore, we evaluate model refinements, including clustering of MID1-bound RNA, which allow capturing all key observations in the data. Together, we provide a data-driven framework that underlines the importance of RBP-RNA interaction in post-transcriptional regulation. This framework also shows how individual molecular reactions jointly determine RNA stability and protein levels in HD.

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

Coverage Guarantees for Pseudo-Calibrated Conformal Prediction under Distribution Shift

arXiv:2602.14913v2 Announce Type: replace Abstract: Conformal prediction (CP) offers distribution-free marginal coverage guarantees under an exchangeability assumption, but these guarantees can fail if the data distribution shifts. We analyze the use of pseudo-calibration as a tool to counter this performance loss under a bounded label-conditional covariate shift model. Using tools from domain adaptation, we derive a lower bound on target coverage in terms of the source-domain loss of the classifier and a Wasserstein measure of the shift. Using this result, we provide a method to design pseudo-calibrated sets that inflate the conformal threshold by a slack parameter to keep target coverage above a prescribed level. Finally, we propose a source-tuned pseudo-calibration algorithm that interpolates between hard pseudo-labels and randomized labels as a function of classifier uncertainty. Numerical experiments show that our bounds qualitatively track pseudo-calibration behavior and that the source-tuned scheme mitigates coverage degradation under distribution shift while maintaining nontrivial prediction set sizes.

21.
arXiv (CS.CL) 2026-06-17

AIPatient Arena: EHR-grounded evaluation of large language models in end-to-end clinical consultation workflows

Large language models (LLMs) are increasingly considered for use in clinical consultation tasks, yet most medical evaluations remain static, single-turn, or narrowly outcome-based, limiting their ability to reflect the sequential, uncertain, and interactive nature of real-world care. Here, we propose AIPatient Arena, an EHRs-grounded evaluation framework for assessing the clinical utility of LLMs across eight dimensions of clinical competence. The framework integrates EHR data into patient-specific knowledge graphs, enabling multi-turn physician-patient interactions. We applied AIPatient Arena on a primary cohort of 437 patients and two out-of-distribution validation cohorts of 119 and 67 patients. We observe that LLMs performed well in medical interview questioning skills (QS; mean scores, 4.43-4.99/5), ethical and professional conduct (ET; 4.38-4.93/5), and clarity and transparency of clinical explanations (EX; 3.80-4.72/5). Performance was moderate in information integration (II; 3.19-4.21/5) and medication safety and justification (MS; 3.13-3.78/5), but persistent weaknesses were observed in handling of ambiguous patient responses (HR; 2.57-3.32/5), information coverage (IC; 2.08-3.02/5), and diagnostic accuracy and reasoning (Dx; 2.63-3.55/5). Process-based evaluation revealed recurrent interaction failures, including repetitive questioning, omission of past medical history, and inadequate handling of uncertainty. Richer conversational context improved diagnostic reasoning but yielded limited gains in treatment planning. These findings indicate that final-answer accuracy alone is insufficient for evaluating clinical readiness and highlight the importance of assessing how models gather, interpret, and communicate information throughout a consultation. AIPatient Arena provides an EHR-grounded framework for workflow-oriented pre-deployment evaluation of medical LLMs.

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

PSCT-Net: Geometry-Aware Pediatric Skull CT Reconstruction via Differentiable Back-Projection and Attention-Guided Refinement

arXiv:2606.19867v1 Announce Type: cross Abstract: Computed Tomography (CT) is essential for diagnosing pediatric craniofacial abnormalities, yet poses radiation risks to developing anatomies. Reconstructing 3D CT from sparse bi-planar X-rays offers a low-dose alternative but is severely ill-posed. Existing methods employ geometry-agnostic feature lifting, naively projecting 2D features into 3D without explicit spatial modeling, causing depth ambiguity and degraded osseous boundaries. We present PSCT-Net, a geometry-aware framework with differentiable back-projection. Differentiable back-projection establishes a spatially faithful volumetric prior, alleviating depth ambiguity. An Attention-Guided Projection (AGP-3D) module then learns non-linear voxel-wise correspondences between 2D regions and 3D locations. A Bidirectional Mamba (BiM-3D) module captures long-range volumetric dependencies with linear complexity. We further curate a private institutional pediatric skull CT cohort, PedSkull-CT, comprising normal and pathological cases for internal evaluation, addressing the gap in adult-centric, trunk-focused datasets.

23.
arXiv (CS.LG) 2026-06-16

Sharp analysis of linear ensemble sampling

arXiv:2602.08026v2 Announce Type: replace Abstract: We analyse linear ensemble sampling (ES) with standard Gaussian perturbations in stochastic linear bandits. We show that for ensemble size $m=\Theta(d\log n)$, ES attains $\tilde O(d^{3/2}\sqrt n)$ high-probability regret, closing the gap to the Thompson sampling benchmark while keeping computation comparable. The proof brings a new perspective on randomized exploration in linear bandits by reducing the analysis to a time-uniform exceedance problem for $m$ independent Brownian motions. This continuous-time lens appears particularly natural here: it yields an exact representation of the relevant discrete-time processes, and we do not know another route to a sharp ES bound.

24.
medRxiv (Medicine) 2026-06-24

Study protocol and statistical analysis plan for a randomized controlled trial evaluating the safety and feasibility of the recombinant human platelet-derived growth factor B (rhPDGF-BB)-enhanced collagen plug for complex perianal fistula healing

Background A drug-repurposing-specific phenome-wide association study (PheWAS) demonstrated that patients with a single nucleotide variant that decreases expression of platelet-derived growth factor receptor beta (PDGFR{beta}) have a higher prevalence of fistulas, suggesting that PDGFR{beta} signaling is important for tissue repair. Recombinant human platelet derived growth factor B (rhPDGF) is an FDA-approved protein-based therapeutic that signals through PDGFR{beta} to heal and regenerate cutaneous skin wounds, periodontal tissue, and orthopedic bone with a strong safety profile. We hypothesize that rhPDGF will benefit other conditions identified by PheWAS with a similar physiological mechanism as the existing indications, such as complex perianal fistulas that are ineligible for a fistulotomy. Methods and analysis This prospective, blinded, single-site study aims to enroll 12 participants, randomized at a ratio of 2:1, comparing implantation of rhPDGF-enhanced collagen to routine care procedures, and stratified by fistula etiology, idiopathic versus Crohns disease (CD)-related. The primary outcome of this study will evaluate the technical performance of the rhPDGF-enhanced collagen implant for treatment of complex perianal fistulas as measured by the proportion of participants with successful implantation of the intervention without any intervention-related serious adverse events. The secondary outcomes will assess the preliminary safety and efficacy of the intervention based on all intervention-related adverse events, total fistulas healed, rate of fistula recurrence, and change in patient-reported symptoms. Complex perianal fistulas, idiopathic or CD-related, remain a major clinical challenge in need of new multimodal treatments aimed at tissue repair and regeneration. Pharmaceutical rhPDGF stimulation of PDGFR{beta} signaling promotes healing of skin, bone, and soft tissue. PheWAS revealed fistulas as a novel indication for repurposing rhPDGF. This protocol aims to evaluate the technical performance, preliminary safety and efficacy, and feasibility of rhPDGF-enhanced collagen for healing and remission of complex perianal fistulas. Ethics and dissemination This trial was approved by the Vanderbilt University Medical Center institutional review board (IRB#240585). Results will be submitted for publication in a peer-reviewed journal.

25.
arXiv (CS.AI) 2026-06-11

DecompSR: A dataset for decomposed analyses of compositional multihop spatial reasoning

arXiv:2511.02627v3 Announce Type: replace Abstract: We introduce DecompSR, decomposed spatial reasoning, a large benchmark dataset (over 5m datapoints) and generation framework designed to analyse compositional spatial reasoning ability. The generation of DecompSR allows users to independently vary several aspects of compositionality, namely: productivity (reasoning depth), substitutivity (entity and linguistic variability), overgeneralisation (input order, distractors) and systematicity (novel linguistic elements). DecompSR is built procedurally in a manner which makes it is correct by construction, which is independently verified using a symbolic solver to guarantee the correctness of the dataset. DecompSR is comprehensively benchmarked across a host of Large Language Models (LLMs) where we show that LLMs struggle with productive and systematic generalisation in spatial reasoning tasks whereas they are more robust to linguistic variation. DecompSR provides a provably correct and rigorous benchmarking dataset with a novel ability to independently vary the degrees of several key aspects of compositionality, allowing for robust and fine-grained probing of the compositional reasoning abilities of LLMs.