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01.
arXiv (CS.CV) 2026-06-25

A cross-process welding penetration status prediction algorithm based on unsupervised domain adaptation in laser and TIG welding

Supervised deep learning has been widely used for weld penetration state classification; however, its performance often degrades significantly under domain shift, such as when transferring models between welding processes with distinct physical mechanisms:for instance, from arc-dominated tungsten inert gas (TIG) welding to keyhole-based laser welding. To overcome this limitation, we propose an unsupervised domain adaptation (UDA) framework integrated with a gradual source domain expansion (GSDE) strategy. Evaluated on dedicated TIG and laser welding datasets, our approach achieves high accuracy in both same-process and cross-process transfer tasks. Specifically, it attains average accuracies of 90.65% on TIGFH and 90.72% on LSPS in same-process settings, surpassing a supervised baseline by 35.83% and 38.87%, respectively. More notably, in cross-process scenarios, it reaches 80.48% for TIG to Laser and 81.13% for Laser to TIG, improving upon the baseline by 43.39% and 43.40%. UMAP visualizations verify that the model learns domain-invariant features while maintaining discriminative class boundaries. This method considerably lowers the relabeling cost for new welding processes and enhances the versatility of intelligent monitoring across different welding systems.

02.
arXiv (CS.CV) 2026-06-17

When LLMs Analyze Scars: From Images to Clinically-Meaningful Features

Medical image classification faces a fundamental dilemma: while deep learning models achieve remarkable performance at scale, real-world clinical scenarios often suffer from severe data scarcity due to annotation costs, privacy constraints, and disease rarity. This challenge is particularly pronounced in pathological scar classification, where differentiating keloids from hypertrophic scars requires subtle expert knowledge and labeled images are extremely limited. We propose a novel paradigm that repositions large language models (LLMs) as knowledge-driven feature engineers rather than end-to-end classifiers. We call this framework ScaFE (Scar Feature Engineering). Our key insight is that LLMs encode rich medical knowledge that can be externalized as executable feature extraction code, enabling the transformation of high-dimensional images into low-dimensional, clinically interpretable representations. Specifically, we prompt an LLM with established scar assessment criteria to generate deterministic Python code that extracts features aligned with clinical scoring systems such as the Vancouver Scar Scale. Our approach offers three key advantages: (1) data efficiency, achieving robust performance with limited training samples by decoupling knowledge acquisition from statistical learning; (2) privacy preservation, as raw images are processed locally without exposure to external LLMs; and (3) interpretability, through explicit features grounded in clinical reasoning. Extensive experiments on scar classification demonstrate that our method consistently outperforms end-to-end deep learning baselines or using LLMs as black-box classifiers under limited data conditions, establishing a promising direction for integrating LLMs into data-efficient and clinically transparent medical AI systems.

03.
medRxiv (Medicine) 2026-06-24

Factors associated with the uptake of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine: The experiences of postpartum women attending child welfare clinics in three rural districts in the Western Region of Ghana.

Background Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is a key preventive strategy. However, optimal uptake remains inconsistent despite high antenatal care (ANC) attendance. This study assessed factors associated with IPTp-SP uptake and explored the experiences of postpartum women in rural Ghana. Methods A mixed-method study was conducted among 1,155 postpartum women attending child welfare clinics in Jomoro, Prestea-Huni Valley and Ellembelle districts of the Western Region of Ghana. Quantitative data were collected using structured questionnaires and analysed using descriptive statistics and chi-square tests. Qualitative data from in-depth interviews and focus group discussions were analysed thematically to explore womens experiences and perceptions. Results Overall, 73.5% (812/1105) of respondents received at least three doses of SP during pregnancy, in line with WHO recommendations. The most common number of doses received was three doses (31.5%, 348/1105), followed by four doses (26.4%, 292/1105), while a smaller proportion (8.1%, 90/1105) received only one dose. Knowledge of malaria in pregnancy was generally high: 92.7% (1027/1155) of respondents correctly identified its mode of transmission, while 75.1% (830/1155) and 83.5% (923/1155) were aware of the effects of malaria on pregnancy and the foetus, respectively. Uptake was not significantly associated with socio-demographic characteristics, including age, education, occupation, marital status, gravidity, and parity (p > 0.05). However, number of ANC visits was significantly associated with uptake (p = 0.006). Although not statistically significant, lower uptake was observed among peri-urban residents and uninsured women. Qualitative findings indicated that while women recognized the benefits of IPTp-SP, side effects such as nausea, dizziness, and discomfort, as well as challenges with tablet formulation and dosing negatively influenced adherence. Conclusions IPTp-SP uptake was high and largely independent of socio-demographic factors but strongly influenced by ANC attendance. Addressing experiential barriers and strengthening patient-centered counselling during ANC may further improve uptake and adherence.

04.
arXiv (quant-ph) 2026-06-16

Generative modelling powered by room-temperature polariton condensates

arXiv:2606.15344v1 Announce Type: cross Abstract: Generative modelling requires efficient stochastic nonlinear transformations and physical platforms that can naturally realise them. We experimentally demonstrate that nonlinear optical systems operating in the strong light-matter coupling regime can serve as physical transformation layers for conditional generative modelling. Specifically, we develop a workflow in which room-temperature exciton-polariton condensates formed in organic dye microcavities act as a physical stochastic transform within a generative adversarial network and enable conditional digit-to-image translation. By using the nonlinear many-body dynamics and intrinsic stochasticity of polariton condensates, the workflow outperforms baseline approaches based on digitally injected perturbations. We find that polariton-enabled sampling via generative adversarial network (Polariton GAN) yields improved inception score, digit preservation accuracy and structural similarity compared with both digital sampling and laser-based systems. We further show that spatially correlated output variations can naturally regularise adversarial training and enhance output diversity. Our results establish polariton condensation as a new computational resource for generative modelling, opening a pathway towards physics-enhanced machine learning systems.

05.
arXiv (quant-ph) 2026-06-16

Black Hole–Entropy Container or Creator

arXiv:2603.18374v3 Announce Type: replace-cross Abstract: Do black holes possess entropy or do they create it? The dominant assumption is that they possess entropy, and a they evaporate that entropy is emitted and decreases. In this paper I use a model of a linear amplifier, in which I argue that the amplifier has not entropy and yet it emits entropy in the process of it operation. This model is closely related to behaviour of black holes, resulting in answer the question of that title that black holes do not have entropy, but nevertheless them create and emit entropy with the total entropy emitted being the same as the usual expression proportional to the square of the mass of the black hole.

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

Flood Mapping from RGB imagery using a Vision Foundation Model

Timely, high-resolution maps of flood extent around settlements are essential for emergency response and damage assessment. We consider airborne RGB imagery for flood mapping as it can be collected rapidly at low cost. To produce flood maps, deep learning models for water segmentation are often used. CNN based and small vision transformer models are used. However, they need much data for adaptation to a change of scenery, i.e., another flooding event. Vision foundation models or large vision transformers are known to generalize across domains. Recently, foundation models for Earth observation became available. They are pretrained on satellite data, whose spatial resolution, viewing geometry, and radiometry differ from nadir RGB imagery. Thus, adaptation is required. We investigate how a satellite-pretrained Earth observation foundation model can be adapted to centimeter-scale floodwater mapping from RGB imagery. Specifically, we fine-tune a model we call Prithvi-2.0-UPN consisting of the Prithvi-EO-2.0-600M Vision Transformer combined with a UPerNet decoder for binary water segmentation on two RGB datasets (BlessemFlood21, NeuenahrFlood). In a first experiment we observe that Prithvi-2.0-UPN reaches state-of-the-art results on BlessemFlood21 and NeuenahrFlood, when trained on their datasets. In a second experiment we show that Prithvi-2.0-UPN performs better than state-of-the-art baseline models for transfer to a new flood event (trained on BlessemFlood21, tested on NeuenahrFlood) in a zero-shot setting. However, the performance indicates room for improvement. In this respect, we investigate in a third experiment how performance improves when further fine-tuning the models with small shares of NeuenahrFlood training data: Prithvi-2.0-UPN improves the fastest and reaches almost the performance level when fully trained on NeuenahrFlood, indicating transfer capabilities.

07.
arXiv (CS.AI) 2026-06-12

Contextual Invertible World Models: A Neuro-Symbolic Agentic Framework for Colorectal Cancer Drug Response

arXiv:2603.02274v3 Announce Type: replace-cross Abstract: Precision oncology is currently limited by the small-N, large-P paradox, where high-dimensional genomic data is abundant but pharmacological response samples are sparse. While deep learning achieves predictive accuracy, it frequently fails to provide the mechanistic clarity required for clinical adoption. We present the Contextual Invertible World Model (CIWM), a Neuro-Symbolic Agentic Framework that bridges this gap by integrating a quantitative machine learning emulator with a Large Language Model reasoning layer. Utilising a stringently curated, high-fidelity data engineering pipeline on the Sanger GDSC dataset (\( N=83 \)), we isolate true biological signals from in vitro artifacts to establish a rigorous baseline predictive correlation for complex transcriptomics (\( r=0.268 \)). Through Inverse Reasoning, we perform in silico CRISPR perturbations across the colorectal landscape. The framework autonomously overturns classical mechanistic assumptions, identifying a hierarchical dominance of mutant KRAS over the APC/Wnt-axis in driving 5-fluorouracil resistance (\( \Delta=-0.0469 \)) via a "KRAS Shield" mapped to MAPK/PI3K networks. Furthermore, the agentic layer identified a "PIK3CA Paradox", revealing that repairing PIK3CA inadvertently increases chemoresistance (\( \Delta=+0.0085 \)) by triggering a compensatory feedback loop that hyperactivates the dominant MAPK survival pathway.

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

Verifiable Foundation Models for Robot Safety

arXiv:2606.23754v1 Announce Type: cross Abstract: Deploying foundation models for robot control raises a central challenge: the expressive power that enables rich, multimodal perception also makes these models opaque and difficult to analyze formally, rendering them intractable for existing verification tools. In this paper, we present FEARL (Foundation-Enabled Assured Robot Learning), a framework that addresses this tension through a modular architectural decomposition. FEARL separates the policy into a large Controller (C) responsible for high-dimensional perception and task reasoning, and a small Safety module (S) that receives low-dimensional observations from dedicated safety sensors together with a bounded context embedding from C and produces the final action. Since many robot safety requirements, such as collision avoidance and workspace boundary constraints, can be expressed over these safety sensor observations, formal verification can be applied to S rather than to the full foundation-model backbone. This makes formal analysis tractable with existing tools while preserving the Controller's expressive power for task reasoning. To show that the decomposed policy remains capable of solving diverse tasks, we evaluate FEARL on three simulated robotic domains using multiple Controller backbones and training procedures, including pretrained off-the-shelf vision-language-action models. We further transfer the learned policy from one of our simulated tasks to a physical robot, suggesting that the low-dimensional safety interface supports practical sim-to-real transfer.

09.
arXiv (CS.CL) 2026-06-12

From Benchmarks to Skills: Low-Rank Factors for LLM Evaluation

Current evaluations of large language models (LLMs) rely heavily on a growing collection of benchmarks and on aggregate benchmark scores, yet it remains unclear what this comparison actually captures, and what these scores reveal about models' underlying capabilities. Here, we propose a new paradigm for LLM evaluation, by asking whether benchmark performance reflects many independent abilities, or rather relies on a small number of shared dimensions. To answer this, we apply Factor Analysis (FA) to a massive performance matrix of LLMs versus benchmarks \((60\times44)\) revealing an intrinsically low-rank structure of that matrix. That is, a small number of latent factors captures most of the structure in the full task space. This low-rank geometry reveals substantial redundancy across existing tasks and explains why many benchmarks appear to be measuring overlapping abilities. We further show that these latent factors correspond to coherent, skill-like, dimensions of LLM behavior. Leveraging this latent skill-space, we deliver three practical tools for LLM evaluation and downstream users: (i)~identifying redundant tasks, (ii)~profiling new models using a small subset of tasks, and (iii)~selecting models aligned with desired skill profiles. Our method provides a solid alternative to the de-facto standard of a single aggregate score, and establishes an interpretable and practical framework for understanding and benchmarking LLM core capabilities.

10.
medRxiv (Medicine) 2026-06-22

The direct economic impact of surgical non-response in orthopaedic hip, knee, and spine surgery for osteoarthritis: a cost-utility analysis

Background Annually, nearly 2 million hip, knee, and spinal inpatient surgeries are performed in Canada and the US for osteoarthritis (OA), costing over $37 billion in hospital expenditures. However, 15-30% of patients experience limited or no improvement, resulting in poor value for money. This study evaluated the one-year cost-utility of joint and spine procedures for OA by comparing non-responders to responders, considering various responder definitions. Methods Individual micro-costing data were collected for 1,175 elective hip, knee, and spine patients enrolled in the Longitudinal Evaluation in the Arthritis Program - Osteoarthritis (LEAP-OA) between 2014 and 2018. Quality-adjusted life years (QALYs) were derived using the SF-6D utility index. One-year incremental cost-utility ratios (ICURs) were calculated from the hospital perspective. Results Responder rates varied by definition, ranging from 78%-94% for hip replacements, 64%-90% for knee replacements, 60%-64% for spine fusions, and 50%-68% for spine decompressions. Corresponding ICURs were: $45,956-$51,773/QALY for responders versus $108,593-$485,762/QALY for non-responders for hip replacements; $54,831-$71,151/QALY for responders versus $200,486-$1,203,596/QALY for non-responders for knee replacements; $65,980-$74,422/QALY for responders versus $262,039-$729,686/QALY for non-responders for spine fusions; and $29,947-$42,168/QALY for responders versus $63,195-$662,586/QALY for non-responders for spine decompressions. Conclusions While surgical response rates were highly dependent on the responder definition, ICURs for non-responders were significantly higher than those for responders across all definitions. Beyond the negative impact on patients, there is a compelling economic argument for investment in improved pre-operative identification of patients at risk of surgical non-response. Such efforts could enable more personalized, value-based care pathways and reduce the provision of low-value surgical interventions.

11.
arXiv (CS.CL) 2026-06-15

UP-NRPA: User Portrait based Nested Rollout Policy Adaptation for Planning with Large Language Models in Goal-oriented Dialogue Systems

To address the challenge that current dialogue policy planning methods struggle to dynamically adapt to diverse user characteristics, this paper proposes a User Portrait based Nested Rollout Policy Adaptation (UP-NRPA) online framework with Large Language Models. In contrast to conventional approaches dependent on model training and require offline reinforcement learning policy models for user groups, UP-NRPA enables dynamic customization of dialogue strategies through an adaptive mechanism. This is achieved by leveraging real-time user feedback alongside personality, preferences, and objectives mapped from the current user portrait, thereby adapting to user characteristics without offline reinforcement learning. In collaborative and non-collaborative dialogue benchmarks, UP-NRPA demonstrated considerable benefits, achieving an impressive 100% success rate in multiple dialogue tasks. Particularly in negotiation tasks, the sale-to-list ratio (SL) increased by 56.41%. This demonstrates that UP-NRPA can adapt to diverse user needs without requiring a training mechanism, enabling the dialogue system to adapt to user characteristics.

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

UniDexTok: A Unified Dexterous Hand Tokenizer from Real Data

Dexterous hands are essential for fine-grained manipulation, but their hardware designs vary substantially across embodiments. Differences in kinematics, joint definitions, and degrees of freedom make it difficult to define a shared state representation compared with parallel grippers. As a result, dexterous-hand data remains fragmented and difficult to use for joint training. In this work, we propose the Unified Dexterous Hand Model (UDHM), which maps human and robot hand states into a shared 22-DoF semantic interface. Based on UDHM, we introduce UniDexTok, a retargeting-free state tokenizer that learns embodiment-conditioned discrete tokens from standardized real joint states. UniDexTok provides a unified representation for heterogeneous dexterous hands without relying on retargeting or simulation data. Compared with the recent baseline UniHM, UniDexTok reduces MPJAE from 15.63 degrees to 0.16 degrees and MPJPE from 18.51 mm to 0.18 mm, corresponding to error reductions of 98.98% and 99.03%, respectively. These results improve reconstruction from centimeter-scale to sub-millimeter accuracy. Experiments further show that data from other embodiments improves target-embodiment reconstruction accuracy, demonstrating the benefit of cross-embodiment tokenization. UniDexTok also shows strong zero-shot and few-shot reconstruction ability when new dexterous hands are introduced.

13.
arXiv (quant-ph) 2026-06-17

Twin-beam advantage in quantum LiDAR under correlated noise

arXiv:2606.17908v1 Announce Type: new Abstract: Quantum light promises improved precision in optical remote sensing, but its practical advantage depends critically on whether nonclassical resources remain useful under realistic noise and experimentally accessible detection. This question becomes especially relevant for LiDAR systems, where a quantum advantage has been demonstrated for target detection and joint range-velocity estimation, but mostly under idealized conditions or simple noise models, such as optical loss and thermal background. A key open point is whether entanglement provides an operational advantage when the dominant disturbance is not independent noise, but structured interference across sensing modes. Here, we address this question by studying the joint estimation of target range and velocity with bright two-mode Gaussian probes and homodyne detection, comparing coherent, separable squeezed, and twin-beam states at a fixed resource budget. Our results reveal a hierarchy of quantum resources set by the noise structure: separable squeezing provides a robust advantage over coherent illumination under loss and thermal background, whereas twin-beam probes become superior under correlated jamming when the receiver is adaptively optimized. These results establish correlated noise as the operational regime in which entanglement provides a robustness advantage beyond local squeezing, opening a receiver-aware route to quantum-enhanced LiDAR in realistic and potentially adversarial environments.

14.
arXiv (CS.CV) 2026-06-11

Learning Instance-Adaptive Low-Rank Orthogonal Subspaces for Clothes-Changing Person Re-Identification

Clothes-changing person re-identification (CC-ReID) aims to recognize individuals despite drastic appearance changes caused by clothing variation. While existing methods rely on adversarial learning to disentangle clothing features, we propose Ortho-ReID, which explicitly models a low-rank clothing subspace from VLM text descriptions and extracts clothing-invariant representations via direct geometric constraints. A critical component is our transformer-based Basis Maker, which refines a shared, low-dimensional clothing prior into an instance-adaptive low-rank subspace through cross-attention with image patches, enabling robust clothing feature extraction even under varying visibility conditions. This instance-adaptive subspace is supervised via alignment with clothing text embeddings, while identity features are extracted via a learnable projection head and geometrically constrained to be strictly orthogonal to it. Extensive experiments demonstrate state-of-the-art performance on PRCC (+5.9% top-1), Celeb-reID-light (+3.5%), and LaST (+5.3%), with competitive results on LTCC.

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

Scalable Peptide Design via Memory-Efficient Equivariant Transformer

arXiv:2606.25006v1 Announce Type: new Abstract: Target-specific peptide design requires sequence and structure co-design under full atom geometric constraints. Latent generative frameworks offer an effective route for this problem by compressing fine grained atomic structures into block level latent representations and performing conditional generation in a compact latent space. However, the scalability of such systems depends heavily on the geometric backbone used throughout their encoding, decoding, and denoising components. We introduce MEET (Memory Efficient Equivariant Transformer), an E(3) equivariant backbone for scalable atomistic peptide modeling. MEET maintains coupled invariant scalar and equivariant vector feature streams, while reformulating geometric computation around memory efficient attention. It initializes vector features through global coordinate aggregation, incorporates pairwise distances through augmented query and key dot products, and injects covalent bond information through sparse bond adaptation. Integrated into a VAE and latent diffusion pipeline for full atom peptide generation, \model{} achieves linear memory scaling with atom count and improves generation quality over existing peptide design methods. Experiments on large scale AFDB derived datasets further show that the proposed backbone supports systematic model and data scaling, leading to better binding affinity, physical validity, and sample diversity.

16.
arXiv (CS.CL) 2026-06-24

Matching Tasks to Objectives: Fine-Tuning and Prompt-Tuning Strategies for Encoder-Decoder Pre-trained Language Models

Prompt-based learning has emerged as a dominant paradigm in natural language processing. This study explores the impact of diverse pre-training objectives on the performance of encoder-decoder pre-trained language models across generation and question answering tasks, with a focus on commonsense knowledge retrieval and completion. We highlight the benefits of incorporating multiple objectives during both pre-training and fine-tuning stages. We introduce the Match Task to Objective (MTO) framework and methods for determining the appropriate objective for a given task. This framework offers automated methods to prepare task-related data for adaptation through unsupervised training, based on the identified objective. In the fine-tuning stage, we design novel templates that align with the objectives of the pre-training and adaptation stages. When aligned with task requirements, these strategies can achieve a performance gain of over 120\% compared to conventional methods in few-shot settings. They significantly outperform related works in few-shot settings and exceed the baseline even in full-dataset scenarios. Furthermore, we extend this approach to include prompt-tuning methodologies, providing guidance for more effective soft prompt engineering and optimization. Our strategies significantly enhance prompt-tuning performance as well. These insights hold substantial value, precisely guiding the selection and optimization of models customized for specific tasks. Code is available at https://github.com/puraminy/MTO/

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

An Adaptive Data cleaning Framework for Noisy Label Detection

Deep neural networks (DNNs) excel in computer vision tasks given large annotated datasets. In real-world applications, however, labels are often corrupted by ambiguity, human error, or dynamic environments. Over-parameterized DNNs easily memorize these noisy labels during training, degrading model accuracy and generalization. Existing data-cleaning and sample-selection strategies often rely on manually specified thresholds, prior knowledge of the noise ratio, or a single metric (either learning dynamics or geometric structure), making them unstable in complex data regimes. This paper proposes a self-adaptive data-cleaning framework that integrates local, global, and learning dynamics cues for robust noisy-label detection. Samples are mapped into a unified low-dimensional feature space through a modular feature concatenation paradigm. We provide two instantiations: a 2D metric integrating class-adaptive KNN-based local disagreement with k-means-based global centroid distance, and a 3D multi-metric that additionally incorporates a z-normalized score. Unlike conventional 1D Gaussian Mixture Models applied to a single scalar metric, our framework performs multi-metric clustering on the feature space to adaptively partition samples into clean-dominant and noise-dominant components without requiring manual thresholds or noise priors. Experiments on CIFAR-10, MNIST, and ImageNet-100 with 5% to 40% symmetric label noise show high recall across settings, including near-perfect recall (>=98%) on ImageNet-100 at 40% noise. Subsequent training yields accuracy gains across evaluated settings, especially under severe corruption on ImageNet-100. These findings suggest that multi-metric integration provides a threshold-free, practical, and low-tuning strategy for noisy label detection.

18.
arXiv (CS.AI) 2026-06-17

A Unified Framework for Context-Aware and Relation-Aware Graph Retrieval-Augmented Generation

arXiv:2606.18075v1 Announce Type: new Abstract: Retrieval-Augmented Generation (RAG) has emerged as a paradigm for enhancing large language models (LLMs) with external knowledge, yet existing graph-based methods face a fundamental limitation: entity-centric and chunk-centric approaches operate on representations anchored to original text without true knowledge fusion. While entity-centric methods connect logically related content and chunk-centric methods preserve context, both retrieve information separately through similarity search, missing emergent understanding from their synthesis. In this paper, we propose HyGRAG, a hierarchical graph RAG framework that transcends source documents by addressing three core challenges: constructing summaries that genuinely integrate contextual and relational information, leveraging these synthesized representations to access emergent knowledge during retrieval, and efficiently updating hierarchical structures for dynamic corpora. Specifically, we design hierarchical index structures over hybrid graphs with both chunk and entity nodes, then iteratively cluster them and generate LLM-based summaries. Then, we design context and relation-aware retrieval that searches across all abstraction levels while expanding through community membership. Moreover, we enable dynamic knowledge update through attachment-based algorithms with only local re-summarization. Experimental results show that HyGRAG improves the average accuracy of multi-hop reasoning tasks by 9.7%, while maintaining reasonable efficiency.

19.
medRxiv (Medicine) 2026-06-16

High-Risk Anti-Seizure Medication Use in Childbearing-Age People with Epilepsy in a Taenia solium Endemic Region

Background: People of childbearing potential with epilepsy in regions endemic for Taenia solium, where neurocysticercosis (NCC) is highly prevalent, represent a vulnerable population due to the elevated burden of epilepsy and resource limitations. Clinical practice in these settings remains poorly characterized. This study characterized anti-seizure medication (ASM) prescribing patterns by medication risk profiles among people of childbearing potential with epilepsy in Northern Peru, a region highly endemic for T. solium. Methods: Participants were drawn from a prospective, population-based epilepsy cohort in Tumbes, Peru (2006 to 2020). The analytic population included females with epilepsy aged 15 to 49 years. The primary outcome was pregnancy-associated ASM risk of congenital malformations and adverse neurodevelopmental outcomes. ASMs were classified as ''Established Low Risk'' (lamotrigine, levetiracetam), ''Possible Risk/Inadequate Data'' (carbamazepine, phenobarbital, phenytoin), and ''Established High Risk'' (valproic acid). Prescription patterns were examined in relation to demographic and clinical characteristics. Results: Among 1,975 individuals with epilepsy, 685 were people of childbearing potential. Approximately 34.9% met criteria for probable or definite NCC. Most ASM prescriptions were in the ''Possible Risk/Inadequate Data'' category (87.0%), and 12.8% received ''Established High Risk'' medications. In multivariable analysis, high-risk prescribing was associated with prior ASM use and polytherapy. Discussion: People of childbearing potential with epilepsy were predominantly treated with carbamazepine, phenytoin, phenobarbital, and valproate, reflecting local ASM availability. Despite evidence supporting lamotrigine and levetiracetam in pregnancy, prescribing patterns reflect local formulary constraints. These findings highlight a gap between guideline recommendations and real-world prescribing in resource-limited settings, underscoring the need for context-specific treatment strategies.

20.
medRxiv (Medicine) 2026-06-15

Cost-Performance Evaluation of Large Language Models for Aspect-Based Sentiment Analysis of HCAHPS Patient Comments: A Validation Study

Background: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) free-text comments contain actionable feedback, but timely, scalable, and affordable sentiment analysis remains challenging for health systems that rely on third-party vendors. Objectives: To evaluate cost-performance tradeoffs between a cost-optimized and a flagship large language model (LLM) for aspect-based sentiment analysis of HCAHPS comments, using human inter-rater agreement as a reproducibility benchmark. Methods: We analyzed 512 free-text HCAHPS comments collected from two community hospitals in calendar year 2023. Six trained reviewers (medical students, recent medical graduates, and practicing internists) independently assigned positive, negative, or neutral labels to each comment-aspect pair; the majority label among three reviewers formed the consensus reference standard. Two OpenAI models - GPT-5-nano (cost-optimized) and GPT-5 (flagship) - were prompted in a zero-shot setting via the OpenAI API. We calculated pairwise Cohen's {kappa} to establish a human inter-rater baseline, then compared each model's labels to the consensus using Cohen's {kappa}, accuracy, weighted F1, and per-call cost and latency. Results: Mean human inter-rater agreement was {kappa} = 0.79 (substantial). Both LLMs exceeded this baseline (cost-optimized {kappa} = 0.85; flagship {kappa} = 0.85) with nearly identical accuracy (0.92) and weighted F1 (0.93 vs. 0.93). Performance was strong on positive (F1 ~ 0.97) and negative (F1 ~ 0.90) classes but poor on the underrepresented neutral class (F1

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

Comparing Human Gaze and Vision-Language Model Attention in Safety-Relevant Environments

Human visual attention plays an important role in how people perceive and respond to environments containing potential risks. This study investigates whether large vision-language models can identify the same regions of a scene that attract human attention in safety-relevant environments. Eye-tracking data were collected from ten participants viewing 33 scene images representing environments with varying levels of potential risk using Pupil Invisible wearable glasses. Gaze coordinates were mapped onto stimulus images to generate population-averaged human gaze heatmaps. In parallel, GPT-4o was prompted through the OpenAI Vision Application Programming Interface (API) to generate spatial predictions of visual attention, which were converted into saliency maps for comparison with human gaze patterns. Spatial alignment between human gaze heatmaps and model-generated saliency maps was evaluated using four complementary metrics: Pearson correlation (r = 0.515 +- 0.117), Normalised Scanpath Saliency (NSS = 0.988 +- 0.323), Kullback-Leibler divergence (KL = 1.766 +- 0.844), and Area Under the Receiver Operating Characteristic Curve using the Judd formulation (AUC-Judd = 0.806 +- 0.076). A cross-model comparison with Gemini Pro, Gemini Flash, and Claude showed that all models exceeded the AUC-Judd chance baseline of 0.5 and achieved positive NSS scores. Gemini Pro demonstrated the strongest spatial localisation according to three of the four metrics, whereas GPT-4o produced the closest distributional match to human attention as measured by KL divergence. These findings suggest that large vision-language models can identify regions that broadly correspond to where humans direct visual attention in safety-relevant scenes without requiring eye-tracking training data. The results highlight the potential of vision-language models as a scalable tool for approximating human attentional patterns.

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

Simplifying the Modeling of Arbitrary Conditionals in Natural Language

Causal Transformers model sequences through an autoregressive factorization of the joint distribution, which enables efficient left-to-right decoding and conditional likelihood computation. However, they cannot tractably sample from or evaluate arbitrary conditionals – e.g., a block of text conditioned on past and future tokens. Recent work aims to solve this problem through novel architectures, but they often lead to sub-optimal modeling of such conditionals and degraded generations. We propose Arbitrary Conditionals GPT (AC-GPT) which introduces a simple modification to standard causal Transformers to enable evaluating and sampling from arbitrary conditionals – including past, future, and mixed contexts – within a single forward pass. Unlike prior approaches, our method preserves the standard left-to-right ordering and next-token prediction objective essential for both strong performance and efficient training on natural language. Crucially, this compatibility allows existing LLMs to be fine-tuned for arbitrary conditioning. Our empirical results indicate that our method outperforms baselines on modeling arbitrary conditionals, without degrading standard left-to-right performance.

23.
arXiv (CS.CL) 2026-06-11

Food4All: An Agentic Framework and Benchmark for Food Resource Navigation with Adaptive User Understanding

Food assistance referral requires conversational agents to translate underspecified, often noisy help-seeking dialogues into locally valid resource recommendations. We present Food4All, an agentic food-resource referral framework and benchmark grounded in 686 structured Indiana food resources. Food4All couples a food-specific search tool with 300 multi-turn evaluation tasks spanning single food needs, composite cases with access or document constraints, and five non-ideal user interaction traits: unreasonable demands, rambling responses, impatience, incomplete answers, and inconsistent information. We evaluate six Large Language Models (LLMs) on requirement grounding, resource retrieval, final referral correctness, and interaction efficiency. Although the strongest model achieves 96.33% referral accuracy, our diagnostics reveal persistent failures in grounding schedule, eligibility, intake, and document constraints, as well as failures to preserve valid retrieved resources in the final recommendation. Trait-level analysis further shows that different non-ideal behaviors stress different parts of the referral pipeline. Food4All provides a controlled testbed for studying tool-calling agents in constraint-sensitive food assistance referral under realistic user interaction challenges.

24.
medRxiv (Medicine) 2026-06-15

Nocturnal Respiratory Rate and Variability Predict Long-term Mortality in Stable Outpatients with Cardiovascular Disease

Background: Respiratory rate (RR) predicts short-term mortality in acute care settings, yet its prognostic significance in clinically stable outpatients remains poorly defined. Objectives: To determine whether the median and variability of nocturnal respiratory rate (NRR) are independently associated with long-term cardiovascular and all-cause mortality in outpatients with cardiovascular disease. Methods: We analyzed overnight chest belt waveforms from elective polysomnography in 5,679 older adults with cardiovascular disease enrolled in the Sleep Heart Health Study (SHHS). NRR was quantified at 30-second resolution, and per-subject median NRR and within-night variability (standard deviation) were derived. Kaplan-Meier survival analysis and Cox proportional hazards models were used to evaluate associations with cardiovascular and all-cause mortality over 3-year and 15-year follow-up periods, adjusting for demographic characteristics, cardiopulmonary comorbidities, and sleep apnea severity. Results: Higher median NRR and greater NRR variability were each associated with increased cardiovascular and all-cause mortality. Combining these metrics identified a high-risk group characterized by elevated median and high variability of NRR, with approximately five-fold higher 3-year all-cause mortality compared with a low-risk group; this association remained significant in Cox models (unadjusted HR: 2.61; 95% CI: 1.65, 4.14; p

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

MMRINet: Efficient Mamba-Based Segmentation with Dual-Path Refinement for Low-Resource MRI Analysis

Automated brain tumor segmentation in multi-parametric MRI remains a critical yet underserved challenge in resource-constrained clinical settings, where deep 3D networks requiring high-end GPUs are not viable. This is particularly acute across sub-Saharan Africa (SSA), where low-field scanners, heterogeneous patient demographics, and severe data scarcity compound the difficulty of applying standard deep learning pipelines. We present MMRINet, a lightweight segmentation architecture purpose-built for these constraints. At its core, MMRINet replaces quadratic-complexity self-attention with linear-complexity Mamba state-space models, enabling efficient long-range volumetric context modeling without the computational overhead of Transformer-based approaches. We combine two lightweight refinement components:Dual-Path Feature Refinement (DPFR), which extracts complementary detail and contextual representations to improve feature diversity under limited data, and Progressive Feature Aggregation (PFA), which hierarchically fuses multi-scale decoder outputs for sharper segmentation boundaries. Evaluated on the BraTS-Lighthouse SSA 2025 challenge dataset, comprising 3D MRI scans from Nigerian clinical sites, MMRINet achieves an average Dice score of 0.752 and an average HD95 of 12.23 mm with only ~2.5M parameters, outperforming all evaluated baselines, including UNETR, Swin-UNETR, SegMamba, and SegResNet3D. These results indicate that strong validation-set segmentation performance can be achieved with substantially reduced computation, offering a practical step toward AI-assisted neuro-oncology in low-resource clinical environments. Our GitHub repository can be accessed here: BioMedIA-MBZUAI/MMRINet.