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01.
arXiv (CS.LG) 2026-06-19

Do Vision-Language Models Understand 3D Scenes or Just Catalogue Objects?

arXiv:2605.20448v2 Announce Type: replace-cross Abstract: Vision-language models reliably name objects in a scene, but do they represent the 3D layout those objects inhabit? We introduce a 3,034-sample human-curated benchmark targeting three components of spatial understanding: depth-ordered occlusion (probed via three independent counterfactual operationalisations), optical-geometry inference over visible reflections, and volumetric rearrangement planning. Six frontier and open-weight VLMs, scored by trained annotators on 18,204 responses with no LLM-as-judge, reveal a sharp dissociation: models that plan rearrangements over visible layouts at 53–97% accuracy and rarely violate collision constraints fall to 6–45% on occlusion and below 7% on reflections. An embodied-reasoning model reproduces the same profile. White-box analysis on Qwen3-VL-8B-Thinking localises the failure to the visual-token merger: spatial information recoverable throughout the vision encoder becomes inaccessible after token compression and only stabilises again when clean post-merger activations are patched into the language decoder.

02.
bioRxiv (Bioinfo) 2026-06-22

HTS-Oracle X: AI-Guided Prospective Discovery of Small Molecule Immune Checkpoint Binders

Targeting immune checkpoint protein-protein interactions (PPIs) using small molecules remains limited by the shallow, featureless binding surfaces of co-stimulatory and co-inhibitory receptors and the characteristically low hit rates of conventional high-throughput screening against these interfaces. Here we report HTS-Oracle X, a multimodal deep learning platform that integrates bidirectional cross-attention fusion of ChemBERTa SMILES embeddings with extended RDKit descriptors, trains on continuous biophysical binding signals rather than binary labels, and employs Monte Carlo Dropout uncertainty quantification for uncertainty-adjusted compound selection. Trained on 45,760 Dianthus TRIC-screened compounds per target under scaffold-aware cross-validation, HTS-Oracle X was applied prospectively to a 100,160-compound Enamine library against CD28, TIM-3, and VISTA. From 150 model-selected compounds, 45 dose-response confirmed binders were identified (30.0% overall hit rate), yielding enrichment factors of 234-408x over experimentally established random prospective baselines and 16 sub-micromolar hits. The top hits, HX-CD28-1 (KD = 233 nM), HX-TIM3-1 (KD = 249 nM), and HX-VISTA-1 (KD = 345 nM), demonstrated on-target functional activity in immune cell and tumor co-culture assays. HTS-Oracle X represents a scalable AI-guided framework for small molecule discovery against non-enzymatic immune checkpoint targets.

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

Progressive Pixel-Neighborhood Deformable Cross-Attention for Multispectral Object Detection

Effective cross-modal feature alignment and interaction are central challenges in multispectral object detection. Although global cross-attention provides strong long-range modeling ability, its quadratic complexity with respect to feature size limits deployment on resource-constrained platforms. We therefore propose Progressive Pixel-Neighborhood Deformable Cross-Attention for multispectral feature fusion, termed PNAFusion. The proposed framework is motivated by two observations: weak misalignment between visible and thermal images is usually concentrated around local neighborhoods, and semantic correspondence across modalities often follows non-linear spatial mappings that fixed receptive fields cannot model well. To address these issues, PNAFusion incorporates local spatial priors into its architectural design to concentrate feature interaction and alignment on the most relevant neighborhoods. Specifically, a Pixel-Neighborhood Cross-Attention (PNCA) module is introduced to avoid redundant global feature matching and suppress background noise. Meanwhile, an Adaptive Deformable Alignment (ADA) module captures non-linear spatial correspondences through learned pixel-wise offsets. These components are further integrated through an iterative feedback mechanism to progressively refine cross-modal feature alignment. Experiments on FLIR, M3FD, and DroneVehicle show that PNAFusion achieves 84.2, 90.5, and 85.5 mAP@0.5, respectively, under the YOLOv5 detector, and further reaches 86.8 mAP@0.5 on FLIR and 90.8 mAP@0.5 on M3FD when transferred to Co-DETR. Efficiency analysis indicates that PNAFusion reduces allocated GPU memory by 33.0\% compared with ICAFusion and reduces theoretical FLOPs from 194.8 G to 156.4 G, although the deformable sampling and iterative refinement introduce additional latency. Our code will be available at https://github.com/DanielQiuTian/PNAFusion.

04.
medRxiv (Medicine) 2026-06-10

Human-centred design approaches to health facility design: Evidence from perinatal care settings in Ethiopia and Bangladesh

While significant progress has been made in perinatal outcomes over recent decades in low- and middle-income countries (LMICs), maternal and newborn quality improvement initiatives often fail to account for the spatial conditions in which they are implemented. Health systems are increasingly deploying evidence-based care models into built environments that are not optimally structured to meet the needs of its patient population. As the principal users, patients and health care workers can offer pragmatic insights about improving these structural designs. Our objective was to gather insights from patients, providers, and companions about how the physical design of their health facilities influenced their experience receiving or delivering perinatal care. We conducted a prospective observational study using a human-centred design (HCD) approach to analyse perceptions of the quality of perinatal care across two low resource settings: Ethiopia and Bangladesh. Using engagement and assessment tools, we conducted interviews, focus groups, facility walk-throughs, co-design workshops, and infrastructural assessments with patients, companions, providers, and Ministry of Health representatives. Descriptive statistics and thematic analysis were used to identify key learnings and develop recommendations. Across both countries, participants identified the need for facility layouts that better support privacy, mobility during labour, alternative birth positions, companion involvement, cultural and religious practices, sanitation, and provider visibility. Based on these insights, we developed six recommendations to better align health facility infrastructure with maternal and newborn care delivery needs. Our findings suggest that investments in health facility infrastructure may improve care experiences and help enable respectful, safe, and evidence-based maternal and newborn care. Alongside targeted spatial improvements, government authorities responsible for health facility planning should incorporate participatory design processes to ensure infrastructure reflects the needs of patients, companions, and providers and supports high-quality care delivery.

06.
medRxiv (Medicine) 2026-06-18

Distinct Neuronal, Proliferative, and Secretory Pathways are Perturbed in Cancer Survivors with Depressive Symptoms

Introduction Depression is highly prevalent among cancer survivors and may be biologically distinct, although clinical studies investigating these mechanisms remain limited. Thus, the aims of this study were to (1) identify perturbed biological pathways associated with depressive symptom severity in cancer survivors, and (2) investigate whether these pathways are common or distinct to those perturbed in an age-matched non-cancer cohort. Methods We analyzed cross-sectional self-reported and transcriptomic data from the Multi-Ethnic Study of Atherosclerosis (PHD #39341). Cancer survivors and an age-matched non-cancer cohort (target ratio 1:2) were identified. The 20-item Center for Epidemiologic Studies Depression Scale (CES-D) was used to split participants into low (CES-D

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

Agentomics: Economic Foundations for the Valuation, Attribution, and Pricing of AI Agents in Human-AI Workflows

Authors:

arXiv:2606.14769v1 Announce Type: cross Abstract: Agentic AI systems are increasingly being deployed as productive resources in organizational workflows, yet existing evaluation methods primarily measure isolated technical performance rather than economic contribution. This paper introduces Agentomics, a workflow-based framework for valuing, attributing, and pricing human and artificial agents. The framework models a workflow as a configuration of heterogeneous agents whose collective performance determines gross value, deployment cost, reliability, and expected failure loss. Workflow value is treated as a team-level quantity that may include complementarities, substitution effects, bottlenecks, and nonlinear production; additive stage-level value is only a special case. Building on this workflow model, the paper formulates AI deployment as a coalition-formation problem and defines coalition value as the incremental net surplus generated relative to a benchmark human workflow. The Shapley value is then used to attribute economic surplus among participating AI agents, yielding a principled connection among valuation, accountability, and market pricing. The resulting Shapley pricing equilibrium provides a normative benchmark for assessing whether agent prices reflect expected marginal contribution. A security-operations case study illustrates how the framework accounts for productivity gains, deployment costs, reliability losses, and coalition-level complementarities in hybrid human–AI workflows.

08.
arXiv (CS.LG) 2026-06-12

From Parameters to Feature Space: Task Arithmetic for Backdoor Mitigation in Model Merging

arXiv:2606.12498v1 Announce Type: cross Abstract: Model merging (MM) has gained significant attention as a cost-effective approach to integrate multiple task-specific models into a unified model. However, recent work reveals that MM is highly susceptible to backdoor attacks. Existing defenses based on task arithmetic often fail to eliminate backdoors without substantially degrading clean-task performance, owing to their reliance on direct parameter-space editing. To address this gap, we propose Linear Feature Path Minimization (LFPM), a backdoor mitigation framework for model merging, which introduces an anti-backdoor task vector into the backdoored merged model. Unlike prior approaches, LFPM formulates the backdoor robustness of the merged model from a unified feature-space perspective under the Cross-Task Linearity (CTL) framework, which leverages the approximate linearity of features across tasks. This perspective guides the optimization of the anti-backdoor task to suppress backdoors while preserving clean-task performance. Furthermore, we introduce an effective optimization mechanism based on gradient accumulation and loss path-integral, ensuring robust backdoor suppression along the interpolation path. Extensive experiments demonstrate that LFPM consistently exhibits strong robustness against backdoor attacks in both full fine-tuning and Parameter-Efficient Fine-Tuning (PEFT) settings.

09.
arXiv (CS.LG) 2026-06-17

Conditional Local Importance by Quantile Expectations

arXiv:2411.08821v4 Announce Type: replace-cross Abstract: Global variable importance measures are commonly used to interpret the results of machine learning models. Local variable importance techniques assess how variables contribute to individual observations. Current, popular methods, including LIME and SHAP, provide useful measures of feature contribution in the prediction space, while leaving opportunities for improved characterization of local structure in the model loss space. Additionally, they are not natively adapted for multi-class classification problems. We propose a new model-agnostic method for calculating local variable importance, CLIQUE, that highlights locally dependent relationships, provides improved stability over permutation-based methods, and can be directly applied to multi-class classification problems. Simulated and real-world examples show that CLIQUE emphasizes locally dependent information, captures interaction behavior beyond what can be evaluated by correlations, and assigns zero importance in regions where the response is invariant to changes in variables.

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

MambaRaw: Selective State Space Modeling for Efficient 4K Raw Image Reconstruction

In-camera JPEG previews are ubiquitous in raw image formats and provide an sRGB reference at negligible storage cost. Although existing metadata-based reconstruction frameworks can exploit this side information when recovering raw images, their context models often become computationally expensive especially at high resolution, eg, 4K raw image, given that attention mechanisms scale quadratically with feature maps, hindering its practical application. To address these limitations, we propose MambaRaw, a JPEG-conditioned metadata-based raw image reconstruction framework that uses State Space Models (SSMs) to estimate entropy parameters efficiently. Our key contribution comprises a Spatial-Energy Coupled Context Modeling mechanism with two lightweight modules: (1) TileMambaBlock, which performs Mamba-style selective scanning only on information-dense tiles to improve the efficiency; and (2) Energy-Aware Refinement (EAR), an identity-initialized residual module that enhance feature representation to match the long-tail energy distribution of raw signals. Extensive experiments on three camera datasets (Sony, Olympus, Samsung) show consistent improvements over strong metadata-based baselines and set a new state of the art for JPEG-guided raw reconstruction with great efficiency. Notably, at low metadata bitrates, MambaRaw increases PSNR by 1.2–1.4 dB and reduces end-to-end coding latency by about 9%. Code is released at https://github.com/Peizeli1/MambaRaw.

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

Characterization of Gaussian Universality Breakdown in High-Dimensional Empirical Risk Minimization

arXiv:2604.03146v3 Announce Type: replace-cross Abstract: We study high-dimensional convex empirical risk minimization (ERM) under general non-Gaussian data designs. By heuristically extending the Convex Gaussian Min-Max Theorem (CGMT) to non-Gaussian settings, we derive an asymptotic min-max characterization of key statistics, enabling approximation of the mean $\mu_{\hat{\theta}}$ and covariance $C_{\hat{\theta}}$ of the ERM estimator $\hat{\theta}$. Specifically, under a concentration assumption on the data matrix and standard regularity conditions on the loss and regularizer, we show that for a test covariate $x$ independent of the training data, the projection $\hat{\theta}^\top x$ approximately follows the convolution of the generally non-Gaussian distribution of $\mu_{\hat{\theta}}^\top x$ with an independent centered Gaussian variable of variance $\mathrm{tr}(C_{\hat{\theta}} \mathbb{E}[xx^\top])$. This result clarifies the scope and limits of Gaussian universality for ERMs. Additionally, we prove that any $\mathcal{C}^2$ regularizer is asymptotically equivalent to a quadratic form determined solely by its Hessian at zero and gradient at $\mu_{\hat{\theta}}$. Numerical simulations across diverse losses and models are provided to validate our theoretical predictions and qualitative insights.

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

Where's the Plan? Locating Latent Planning in Language Models with Lightweight Mechanistic Interventions

arXiv:2605.07984v2 Announce Type: replace-cross Abstract: We study planning site formation in language models – where internal representations of structurally-constrained future tokens form during the forward pass, and whether they causally drive generation. Using rhyming-couplet completion as a clean test of forward-looking constraint, we apply two lightweight methods (linear probing and activation patching) across Qwen3, Gemma-3, and Llama-3 at more than ten scales. Probing shows that future-rhyme information is linearly decodable at the line boundary, with signal that strengthens with scale in all three families. Activation patching reveals that only Gemma-3-27B causally relies on this encoding, exhibiting a handoff in which the causal driver migrates from the rhyme word to the line boundary around layer 30. Every other model we test conditions on the rhyme word throughout generation, with near-zero causal effect at the line boundary despite strong probe signal. We localize the Gemma-3-27B handoff to five attention heads through two-stage path patching that recover ~90% of the rhyme-routing capacity at the newline.

13.
arXiv (quant-ph) 2026-06-11

Diffusive Relaxation of Participation Entropy in U(1)-symmetric Dynamics

arXiv:2606.11561v1 Announce Type: new Abstract: Participation entropy (PE) quantifies the spread of a many-body wavefunction across configuration space. While PE relaxes rapidly in generic chaotic systems, we show that $\mathrm{U}(1)$ conservation laws slow it down by imprinting with the slow hydrodynamic modes. Using a cluster expansion around equilibrium, we show that, after local density inhomogeneities decay, the leading PE deficit is dominated by squared connected density correlations. The long time relaxation is therefore controlled by diffusive correlation spreading, giving $\Delta S(t)\sim t^{-1/2}$ in the hydrodynamic regime and crossing over to $\sim \exp[-O(t/L^2)]$ when $t\geq L^2$. We confirm this entropy correlation relation using exact computation and infinite system tensor network simulations in various quantum $\mathrm{U}(1)$ conserving circuits. Our results establish PE as a sensitive probe of hydrodynamic memory and suggest that slow relaxation is a generic consequence of conservation laws.

14.
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.

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

From Task-Guided Conversational Graphs to Goal-Oriented Dialogue Runtimes

Graph and multi-agent orchestration frameworks make production large language model (LLM) workflows practical, but they do not by themselves solve conversational continuity when users maintain several interdependent objectives. This conceptual systems paper focuses on the high-complexity end of that design space, where goals can be suspended, resumed, revised, and invalidated by actions in other goals. We introduce the Goal-Oriented Dialogue Runtime (GODR), a framework-neutral design pattern that treats goals, task frames, lifecycle state, invalidation rules, and resumption contracts as first-class runtime objects while delegating bounded execution to graph runtimes, agents, tools, or application programming interfaces (APIs). GODR is not proposed as a replacement for workflow graphs in simple guided processes; it is intended for complex, multi-domain, interruptible conversations where objective continuity cannot be recovered reliably from agent identity, chat history, or execution-graph position alone. The paper formalizes the problem, proposes runtime objects and architecture-selection criteria, and frames evaluation as an agenda for future empirical validation rather than as a measured performance claim.

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

Encode Errors: Representational Retrieval of In-Context Demonstrations for Multilingual Grammatical Error Correction

Grammatical Error Correction (GEC) involves detecting and correcting the wrong usage of grammar. While large language models (LLMs) with in-context learning (ICL) capabilities have shown significant progress on various natural language processing (NLP) tasks, their few-shot performance on GEC remains suboptimal. This is mainly due to the challenge of retrieving suitable in-context demonstrations that capture error patterns instead of semantic similarity. In this paper, we demonstrate that LLMs can inherently capture information related to grammatical errors through their internal states. From these states, we extract the Grammatical Error Representation (GER), an informative and semantically neutral encoding of grammatical errors. Our novel GER-based retrieval method significantly boosts performance in ICL settings on multilingual GEC datasets, improving the precision of correction. For high-resource languages, our results on 8B-sized open-source models match those of closed-source models such as Deepseek2.5 and GPT-4o-mini. For low-resource languages, our $F_{0.5}$ scores surpass the baseline by up to a factor of 1.20. This method provides a more precise and resource-efficient solution for multilingual GEC, offering a promising direction for interpretable GEC research.

17.
arXiv (CS.CV) 2026-06-16

DriveReward: A Comprehensive Dataset and Generative Vision-Language Reward Model for Autonomous Driving

Reward models play a pivotal role in reinforcement learning (RL) and multi-modal trajectory selection for autonomous driving. However, acquiring such rewards typically relies on hand-crafted rule-based objectives or perception ground truth, which hinders generalization for data-scaling. While Vision-Language Models (VLMs) have demonstrated feasibility as reward models in other domains, their effectiveness in driving tasks remains underexplored. In this work, we bridge this gap by (1) introducing DriveReward, a reasoning trajectory evaluation dataset rigorously labeled via temporally-grounded visual guidance, and augmented with counterfactual driving behaviors., (2) alongside a specialized Vision-Language Reward Model. To address the scarcity of failure cases in conventional datasets, we propose a counterfactual data annotation scheme to construct cases encompassing diverse driving styles and erroneous behaviors. Evaluations on our proposed benchmark reveal that even leading open-source and proprietary VLMs fail to excel across all tasks, highlighting significant room for improvement in existing models. Building on these findings, we subsequently tailor a specialized 1B reward model that outperforms larger VLMs on task-specific reward alignment. Finally, we validate our reward model's effectiveness by integrating it into RL finetuning and multi-modal trajectory scoring across multiple baselines, achieving performance comparable to rule-based reward calculations in both open-loop and closed-loop evaluation.

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

Iterating Toward Better Search: A Two-Agent Simulation Framework for Evaluating Agentic Search Architectures in E-Commerce

arXiv:2606.12924v1 Announce Type: new Abstract: We present a modular two-agent simulation framework for evaluating conversational shopping assistant architectures. An independent buyer agent, configured with personas, missions, and patience levels, is paired with an interchangeable responder that integrates with a real e-commerce search API. Holding the buyer constant across experiments enables controlled comparison of responder designs on identical scenarios. Using 2011 conversations across 14 persona buckets, we establish four empirical findings. First, rolling-window memory outperforms intent-extraction memory on all quality metrics while being 35% faster per query. Second, illustrating rapid evidence-driven iteration, a systematic failure analysis of a responder version enables targeted fixes that reduce failure and near-failure rates by 62% across the full dataset. Third, swapping the responder LLM backbone from Gemini~2.5 to Llama~3.3~70B costs 0.16–0.45 points despite identical architecture. Finally, we document systematic philosophical disagreement between frontier LLM judges: Gemini rewards process correctness while Claude demands concrete outcomes, despite using the same evaluation prompt.

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

A theory of learning data statistics in diffusion models, from easy to hard

arXiv:2603.12901v2 Announce Type: replace-cross Abstract: While diffusion models have emerged as a powerful class of generative models, their learning dynamics remain poorly understood. We address this issue first by empirically showing that standard diffusion models trained on natural images exhibit a distributional simplicity bias, learning simple, pair-wise input statistics before specializing to higher-order correlations. We reproduce this behaviour in simple denoisers trained on a minimal data model, the mixed cumulant model, where we precisely control both pair-wise and higher-order correlations of the inputs. We identify a scalar invariant of the model that governs the sample complexity of learning pair-wise and higher-order correlations that we call the diffusion information exponent, in analogy to related invariants in different learning paradigms. Using this invariant, we prove that the denoiser learns simple, pair-wise statistics of the inputs at linear sample complexity, while more complex higher-order statistics, such as the fourth cumulant, require at least cubic sample complexity. We also prove that the sample complexity of learning the fourth cumulant is linear if pair-wise and higher-order statistics share a correlated latent structure. Our work describes a key mechanism for how diffusion models can learn distributions of increasing complexity.

20.
arXiv (CS.CV) 2026-06-24

ObsGraph: Hierarchical Observation Representation for Embodied Reasoning and Exploration

Embodied reasoning and exploration are increasingly considered crucial abilities for robots operating in complex and unfamiliar environments. To accomplish tasks in such settings, an agent must identify and acquire the information necessary for the task through exploration. We propose ObsGraph, an observation-centric hierarchical scene graph that unifies scene representation, retrieval, and exploration. It retains visual evidence and organizes it into room-view-object layers: rooms provide coarse semantic anchors, views preserve contextual object covisibility, and objects store fine-grained details. On top of this representation, we perform coarse-to-fine hierarchical retrieval under a bounded budget, and crucially use retrieval outcomes to structure the exploration candidate space–activating room-level exploration, view refinement, or frontier exploration–thereby tightly coupling representation, retrieval, and adaptive multi-scale exploration. Experiments across embodied reasoning and exploration benchmarks demonstrate improved success and efficiency, highlighting the benefits of structured scene representation and more targeted information gathering driven by identified evidence gaps.

21.
medRxiv (Medicine) 2026-06-15

Primary care practitioners preconception health literacy and information-seeking: A cross-sectional survey.

Background Parental health before pregnancy influences maternal and child outcomes. Primary care professionals, including general practitioners [GPs], midwives, and naturopaths, can provide preconception care, yet many report limited knowledge and difficulty accessing relevant information. This study described Australian GPs, midwives, and naturopaths preconception health literacy, including knowledge and ability to access information. Methods Between July and September 2022, Australian GPs, midwives, and naturopaths completed a 32-item online cross-sectional survey. Participants were recruited through professional associations, and data were analysed using descriptive and inferential statistics Results Participants (N=373) included naturopaths (40.7%), GPs (32.4%), and midwives (26.8%). Reported barriers to clinician health literacy including lack of preconception care resources (25.5%), and limited clinician knowledge (23.6%). The proportion identifying limited clinician knowledge differed significantly between professions (GP: 31.4%; midwives: 23.0%; naturopaths: 17.8%; p=0.030). The highest level of accurate knowledge regarding preconception exposures was for pre-pregnancy obesity (82.7%), while low birth weight was the most accurately identified preconception outcomes (83.7%). Incorrect responses were most common for maternal multivitamin use as an exposure (28.3%) and childhood leukaemia as an outcome (26.3%). Differences between professions were strongest for infant outcomes, with moderate associations observed for shoulder dystocia (V=.2355), precipitous labour (V=.2173), macrosomia (V=.2060), labour dystocia (V=.2018) and cryptorchidism (V=.2018). Discussion Preconception health literacy varies across primary care professions. Clinicians require greater access to targeted resources and education tailored to their differing scopes of practice and experience. Improving clinician preconception health literacy may strengthen consistent evidence-based care and support better maternal, child, and long-term family health outcomes.

22.
medRxiv (Medicine) 2026-06-22

Multisite Real-World Validation of an Electronic Health Record-Integrated Generative Artificial Intelligence Tool for Venous Thromboembolism Risk Stratification

Background: Guiding risk-appropriate inpatient thromboprophylaxis requires venous thromboembolism (VTE) risk stratification; however, reliable risk determination remains inconsistent in routine care. Health systems increasingly pilot artificial intelligence (AI) tools, yet few studies demonstrate rigorous evaluation in the context of a learning health system (LHS). We evaluated the performance of a pilot electronic health record (EHR)-integrated generative AI (GenAI) system, inHealth General Reasoner (iHGR), for VTE risk stratification versus clinician order set classifications and physician-adjudicated chart review. Methods: This multisite retrospective validation study included adult inpatient admissions at Johns Hopkins Medicine between June 21, 2025, and Dec 18, 2025 (checklist-based order set from June 21, 2025 - November 19, 2025, and clinician judgement-based order set from November 29 - December 18, 2025). From 758 eligible admissions, we randomly sampled 500 balanced by site and order set periods. iHGR and clinician-selected order set classifications were compared with the reference standard (RS). Primary outcomes were iHGR sensitivity and specificity. Secondary analyses compared the order sets with the same RS to evaluate workflow comparators and error patterns. Results: iHGR achieved 81.8% sensitivity (95% CI 77.3-85.6) and 70.9% specificity (63.6-77.3). The checklist-based order set had 61.3% sensitivity (53.7-68.5) and 86.2% specificity (77.4-91.9). The clinician judgement-based order set had 78.1% sensitivity (71.3-83.7) and 65.4% specificity (54.3-75.0). False-negative iHGR classifications were associated with missed narrative risk factors. Conclusion: iHGR showed higher sensitivity for VTE risk than checklist-based order sets and clinician judgement without introducing systematic bias. In silico evaluation of pilot AI systems within LHSs can identify clinically important performance trade-offs and implementation targets before operational scale-up. Narrative clinical data abstraction remained a key limitation, supporting the use of GenAI to support rather than supplant clinician judgement.

23.
arXiv (CS.CV) 2026-06-15

What Drives Test-Time Adaptation for CLIP? A Controlled Empirical Study from an Update Perspective

Vision-Language Models (VLMs) such as CLIP have become a standard backbone for open-vocabulary recognition, yet their zero-shot predictions remain vulnerable to distribution shifts encountered at deployment. Test-Time Adaptation (TTA) has recently been extended to CLIP as a lightweight solution, leading to a rapidly growing body of TTA4CLIP methods. However, empirical progress in this area has largely outpaced our understanding of what truly drives adaptation, where their gains originate, and under which shifts they remain reliable. In this paper, we take a step back from the pursuit of state-of-the-art accuracy and conduct a systematic controlled study of TTA4CLIP. We first organize existing methods into three unified paradigms according to what is updated at test time. We then introduce TTABC, an open-source TTA Benchmark for CLIP, which standardizes evaluation protocols and integrates more than 20 representative methods. Our controlled empirical analysis focuses on three key areas. First, we determine the driving factors in parameter-based methods, revealing that adaptation gains are primarily driven by test-time evidence and reliable proxies rather than heavy optimization. Second, we explore evidence utilization beyond heavy parameter tuning, showing that competitive and efficient performance can be achieved through cross- or current-sample evidence and lightweight prototype updates. Finally, we demonstrate that there is no silver bullet for TTA: no single adaptation paradigm is universally optimal, and the preferred paradigm depends on the nature of shift. We hope our benchmark and study provide a clearer understanding of the current TTA4CLIP landscape and establish a foundation for further research.

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

DiffusionBench: On Holistic Evaluation of Diffusion Transformers

Diffusion transformer (DiT) research on image generation has converged to a single evaluation setup: class-conditional generation on ImageNet. While methods improve the FID and related metrics, it is increasingly unclear whether they reflect real progress in generative modeling. The natural alternative, i.e., text-to-image (T2I) generation, is perceived as too costly or inconvenient to train and evaluate and is often skipped. We argue that this perception no longer holds. We introduce NanoGen, a unified DiT training and evaluation framework. NanoGen matches state-of-the-art DiT baselines on ImageNet and, with 12 lines of configuration change, also trains competitive text-to-image models. It currently supports RAE, VAE, pixel-space, and MeanFlow diffusion methods under both ImageNet and T2I setups. Under NanoGen, training T2I requires comparable compute to ImageNet. After training 21 latent diffusion models with NanoGen, we observe that method ranking shows no strong correlation between ImageNet and T2I generation: Pearson correlation is between -0.377 and -0.580 across three metrics. This suggests that a method which improves class-conditional ImageNet FID may show no corresponding improvement on T2I, clearly indicating the necessity of evaluating DiTs on both tasks. To this end, we summarize ImageNet and text-to-image results, which yields DiffusionBench, a holistic benchmark for DiT research. We recommend reporting DiffusionBench in place of ImageNet alone: methods that improve DiffusionBench are more likely to reflect broader progress.

25.
arXiv (CS.AI) 2026-06-24

Integrated Sensing and Communications for Real-time Avatar Control in XR over 5G

arXiv:2606.23771v1 Announce Type: cross Abstract: Extended Reality (XR) presents a challenging use case for 5G and 6G networks, requiring high data-rates and lowlatency communication to deliver a truly immersive experience. Moreover, in order to seamlessly translate physical actions to the virtual world, accurate gesture recognition and pose estimation are required. Current XR interaction solutions based on handheld controllers and cameras cannot easily capture full-body poses, inhibit the free use of hands, and require good visibility and a clear line of sight. In this work, we propose a multimodal sensing architecture for XR that combines 5G MillimeterWave (mmWave) Integrated sensing and communication (ISAC) and surface electromyography (sEMG) signals. 5G mmWave ISAC cannot only be used to deliver content wirelessly to the Head-mounted display (HMD), but also the same communication signals can be used to derive coarse body-level gestures and poses of the user, to support real-time avatar control. For fine-grained finger-level gestures, our architecture leverages lightweight sEMG sensors that capture forearm muscle activity. To illustrate the need of both modalities, we present evaluations of both sensing technologies. At the body level (5G), our architecture relies on power-per-beam-pair (PPBP), which can be computed from standard beam management or beam sweeping procedures of the 5G NR standard. PPBP-based sensing achieves 82.2$\pm$5.9% average accuracy when evaluated on users not seen during training. For fine-grained finger-level interactions, we show that surface electromyography (sEMG) carries strong discriminative information achieving consistent promising performance across different movement settings. Thus, combining the two modalities enables multi-scale gesture recognition, at the body level via existing 5G signals and finger level via lightweight sEMG sensors, forming a complete XR framework.