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01.
arXiv (CS.CV) 2026-06-16

DifferAD-R1: A Difference-Guided IndustrialAnomaly Localization with Multimodal LargeLanguage Models

Industrial anomaly localization aims to accurately identify and localize abnormal regions in industrial products, addressing the critical challenge of detecting unseen defect categories in real-world scenarios. Traditional closed-set methods often suffer from poor cross-scenario generalization, while existingMultimodal Large Language Model (MLLM)-based approachesface two core limitations: they either adopt QA-style paradigmsmisaligned with the practical demands of localization, or relyon standard optimization techniques such as Group RelativePolicy Optimization (GRPO), which fails to deliver effectivelearning signals for subtle defects. To tackle these issues, thispaper proposes DifferAD-R1, an MLLM-augmented reinforcement learning framework tailored for industrial anomaly localization. We design a Difference-Guided dual-image paradigm,which reformulates the localization task as a one-shot difference grounding problem to effectively explore cross-scenarioanomalies. A Dual-Consistency Localization Reward is developedfor hard-to-detect anomalies, enhancing optimization stabilityand robustness. Additionally, we integrate a difficulty-awarestrategy with adaptive reweighting and group-wise resamplingto prioritize learning on challenging instances. To facilitateevaluations in real-world industrial settings, we construct theAD-DualDiff dataset, comprising 13K paired images across 20categories. Experimental results demonstrate that DifferADR1 significantly outperforms existing baselines and achievescompetitive performance compared to large-scale models likeQwen3-VL (235B parameters). Our code is publicly availableat: https://github.com/Rong2026/work-1.

02.
arXiv (CS.LG) 2026-06-19

Quantile of Means: A Bonus-Free Ensemble Method for Minimax Optimal Reinforcement Learning

arXiv:2606.20107v1 Announce Type: new Abstract: Optimal Reinforcement Learning (RL) algorithms typically rely on carefully constructed count-based uncertainty estimates to drive exploration. Although theoretically sound, such estimates are hard to compute in practical settings and therefore offer limited insight for designing exploration heuristics. Meanwhile, ensembling has emerged as a practical approach, but remains without theoretical justification. Building on a recent ensemble-based method for Multi-Armed Bandits, we propose a quantile-based ensemble method for finite-horizon Markov Decision Processes (MDPs). Our simple count-free approach achieves optimal variance-dependent regret bounds, providing theoretical grounding for ensemble-based exploration in RL.

03.
arXiv (quant-ph) 2026-06-19

Universality in Ionic Three-body Systems Near an Ion-atom Feshbach Resonance

arXiv:2511.00325v3 Announce Type: replace-cross Abstract: We calculate bound and scattering properties of a system of two neutral atoms and an ion near an atom-ion Feshbach resonance. Our results indicate that long-range atom-ion interactions lead to significant deviations from universal behavior derived from contact or van der Waals potentials. We find that ionic systems display an overall suppression of inelastic transitions leading to recombination rates and lifetimes of Efimov state orders of magnitude smaller with respect to those for neutral atoms. We further characterize the dense spectra of triatomic molecular ions with extended lifetimes. Our results provide a deeper insight on the universality and structure of three-body ionic systems and establishing them as a promising platform for exploring novel few- and many-body phenomena with long-range interactions.

04.
arXiv (math.PR) 2026-06-19

The t-Split Two-Periodic Aztec Diamond Model

Authors:

arXiv:2606.19507v1 Announce Type: new Abstract: In this work we consider an Aztec diamond model split into two unequal regions which are asymptotically fixed in size. Each region is weighted with a distinct two-periodic weighting. We refer to this model as the t-split two-periodic Aztec diamond, to signify its difference from the previous work title Split Two-Periodic Aztec Diamond, where the model was split into two equal regions. We derive an integral expression for the correlation kernel of the model and give a partial description of the scaling limit behavior, along with a conjecture for the remainder. We refer to the larger and smaller sides of the model as the dominant and non-dominant sides, and to the location of the weight change as the interface. The dominant side exhibits a limit shape that depends only on its own weighting and is identical to that of the two-periodic Aztec diamond, while the non-dominant side appears to have a novel limit shape that depends on both weightings and the location of the interface. Lastly, we consider the complete limit shape in the case where the dominant side two-periodic parameter goes to 0.

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

MiroBench: Benchmarking Realism in Agentic Simulation of Real-world Discussions

arXiv:2606.14715v1 Announce Type: cross Abstract: LLM agents are increasingly used to simulate real world interactions, but it remains unclear whether simulated behaviors preserve the content patterns and interaction dynamics of real human behaviors. Existing evaluations remain fragmented, which makes it difficult to compare systems or measure progress. In this paper, we focus on Reddit discussions as a concrete first step toward evaluating real-world social simulation. Reddit threads provide public, topic-grounded, multi-party interactions where people share experiences, debate, seek advice, express emotion, and collectively respond to products, events, and social issues. These discussions offer an observable window into broader social behavior, making them a useful setting for testing whether LLM agents can reproduce not only fluent text, but also the distributional patterns and interaction dynamics of real online communities. We introduce MiroBench, a benchmark for Reddit discussion simulation built from 4,292 real Reddit threads. MiroBench uses statistical tests to compare generated and real discussions across four major aspects: repetition and semantic uniformity, narrative content, toxicity and aggression, and structural complexity. Experiments across five domains and five models show that current simulators remain distributionally mismatched with real Reddit threads, while a lightweight prompt-based improvement procedure provides only limited gains. MiroBench offers a concrete benchmark for measuring, diagnosing, and improving realism in LLM-based social simulation.

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

SPHINX: First Explain, Then Explore

Generating adversarial driving scenarios is critical for evaluating and improving autonomous vehicle decision-making systems in simulation. Recent approaches, such as ChatScene and LLM-Attacker, rely primarily on the prior knowledge of Large Language Models and Vision-Language Models to generate driving scenarios procedurally. We argue that adversarial scenes should be generated based on the failure diagnosis (e.g., indecisiveness, multi-frame inconsistency) of the driving policy to specifically address the policy's weaknesses instead of relying on prior assumptions. In this paper, we propose SPHINX, a closed-loop framework for adversarial scenario synthesis guided by a simple principle: first explain, then explore. Beyond blindly exploring the scenario space, SPHINX leverages explainable artificial intelligence methods to analyze the policy, identifying key visual concepts and their influence on policy outputs, and the uncertainty of the decisions. Given the interpretable evidence extracted from the policy's own decision process, we use a vision language model to rationalize and criticize failure modes of the current policy. These critics are then used to generate targeted adversarial scenarios for policy retraining and improvement. We demonstrate that SPHINX can highlight an interpretable account of policy failures while other adversarial scene generation cannot. Across the evaluated benchmarks and test suites, SPHINX can be applied to diverse state-of-the-art autonomous vehicle architectures and yields consistent robustness improvements over existing scenario-generation methods.

07.
arXiv (CS.AI) 2026-06-24

OrbitForge: Text-to-3D Scene Generation via Reconstruction-Anchored Video Synthesis

arXiv:2606.24799v1 Announce Type: cross Abstract: Generic text-to-video models can be used as rich open-world scene priors. Despite the high quality of today's generated videos, they do not directly yield reliable 3D assets: camera motion is difficult to control, view coverage is partial, and frames often contain inconsistencies across time. We introduce OrbitForge, an adapter built from frozen video priors and per-prompt Gaussian Splatting reconstruction optimization that converts a single text-generated video into a canonical closed-orbit 3D Gaussian Splatting scene. We use 3D reconstruction as an anchor to improve the 3D consistency of the generated video. We obtain a preliminary 3D reconstruction from a first generated video via Deformable Gaussian Splatting with a robust MedianGS proxy. We render views from a prescribed orbit to detect missing viewpoints. OrbitForge uses the text-to-video model to complete only the missing views, and reconstructs the completed orbit into a final Gaussian Splatting scene. This design requires no task-specific video or multiview fine-tuning, avoids per-prompt score-distillation optimization, and does not progressively generate views one step at a time. We further argue that this setting demands coverage-aware evaluation: local smoothness alone rewards methods that never attempt a full orbit. On a frozen 300-prompt T3Bench-derived audit, OrbitForge reconstruction attains a 359.0-degree measured median span, raises originally unsupported-bin Q10 ImageReward from 8.07 to 16.36 relative to MedianGS-only reconstruction, while remaining competitive with VideoMV on the coverage-quality.

08.
arXiv (CS.AI) 2026-06-18

DeFAb: A Verifiable Benchmark for Defeasible Abduction in Foundation Models

arXiv:2606.18557v1 Announce Type: new Abstract: A rule-based logic solver resolves every instance in our benchmark in under 50 microseconds with 100% accuracy; the best frontier language model reaches 65% at best and drops to 23.5% under rendering-robust evaluation (worst case over four surface renderings). We introduce DeFAb (Defeasible Abduction Benchmark), a dataset and generation pipeline that converts four decades of publicly funded knowledge bases into formally grounded instances for defeasible abduction: constructing hypotheses that explain anomalies by overriding defaults while preserving unrelated expectations. Because every hypothesis must pass polynomial-time checks for valid derivation, conservativity, and minimality, DeFAb makes logical rigor the instrument for measuring creativity and theoretical reasoning, scoring the disciplined construction of theory revisions rather than fluent but theory-destroying prose. The pipeline pairs taxonomic hierarchies (OpenCyc, YAGO, Wikidata) with behavioral property graphs (ConceptNet, UMLS) to produce 372,648+ instances across 33.75M materialized rules from 18 sources, in three levels with polynomial-time verifiable gold standards. Four frontier models do not reliably internalize defeasible reasoning: rendering-robust Level 2 accuracy is 7.8-23.5%; chain-of-thought variance (~36 pp) exceeds any inter-model gap; and a matched contamination control isolates a +19.4 pp Level 3 gap. We further release DeFAb-Hard (a 235-instance Level 3 difficulty variant; best model 53.3% vs 100% symbolic) and CONJURE (a kernel-verified transformative-creativity variant of 560 Lean 4/Mathlib instances whose gold answers are definitions the proof kernel did not previously contain, judge-free verifier; a pilot finds zero novel concepts). The same verifier doubles as an exact reward for preference optimization (DPO, RLVR/GRPO). Released under MIT at https://huggingface.co/datasets/PatrickAllenCooper/DeFAb.

09.
medRxiv (Medicine) 2026-06-22

Characteristics and Outcomes of Gene-Elusive Dilated Cardiomyopathy

Background and Aims Genetic testing in dilated cardiomyopathy (DCM) guides risk stratification and family screening. Likely pathogenic or pathogenic (LP/P) variants are identified in approximately one-third of patients, leaving many without a genetic diagnosis. Cohort studies suggest that "gene-elusive" patients have a lower risk of adverse events. This study aims to better characterise this group and identify factors associated with adverse outcomes. Methods Consecutive and unrelated DCM patients undergoing genetic testing and returning no LP/P variants were retrospectively recruited and compared to two control cohorts of DCM patients carrying LP/P variants in LMNA and TTN for a primary composite endpoint of end-stage heart failure (ESHF) or malignant ventricular arrhythmia (MVA). Results Among patients without prior MVA, the composite endpoint occurred in 36/423 (8.5%) gene-elusive, 14/39 (35.9%) LMNA and 11/100 (11%) TTN cardiomyopathy patients (log-rank p

10.
arXiv (CS.AI) 2026-06-16

Trust-Region Diffusion Policies for Massively Parallel On-Policy RL

arXiv:2606.15260v1 Announce Type: cross Abstract: Reinforcement learning with massively parallel simulations has become a standard framework for developing robust, deployable policies; however, most existing approaches still rely on simple Gaussian policy parameterizations. Diffusion models provide a more expressive policy class and have shown strong performance on challenging control problems, yet most diffusion-based RL methods are designed for offline or off-policy training. In this work, we ask whether diffusion policies can be trained effectively in the massively parallel, on-policy regime. To this end, we introduce Trust-region Diffusion Policies (TruDi), which enables diffusion policies for on-policy RL with massively parallel simulations. This setting is particularly challenging because the data distribution changes quickly across updates, making stable training with complex policies difficult. TruDi addresses this by integrating a trust-region optimization rule to enforce a KL-divergence constraint over the entire diffusion trajectory. Empirically, we evaluate TruDi on a diverse set of 4 massively parallel RL benchmarks comprising a total of 73 tasks. Across these tasks, TruDi consistently outperforms or is on-par with strong baselines on standard tasks and achieves clear gains on more challenging humanoid control tasks, establishing a strong new baseline for massively parallel on-policy RL.

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

Temporally Consistent and Controllable Video Generation of 2D Cine CMR via Latent Space Motion Modeling

Cine cardiac magnetic resonance is the gold standard for assessing cardiac function, but the scarcity of public datasets limits the development of advanced data-driven models. To address this limitation, we propose a generative method for synthesizing temporally coherent and anatomically consistent cardiac sequences. Our text-to-video framework decouples cardiac spatial structure from temporal motion. First, a fine-tuned diffusion model synthesizes an initial frame from a clinical text prompt, controlling anatomical features. Then, a latent flow model conditioned on a cardiac phase embedding generates the complete cardiac motion, ensuring spatial consistency and temporal control. Our model generates anatomically and pathologically diverse sequences with high temporal coherence and strong fidelity to input prompts, achieving a FID of 31.68 for image realism and a CLIP score of 31.04 for text-image alignment. These experimental results highlight its potential to produce high-fidelity, on-demand medical data, offering a scalable solution to data scarcity.

12.
arXiv (CS.LG) 2026-06-24

Reasoning as Attractor Dynamics: Latent Memory Retrieval via Gibbs-Weighted Energy Minimization

arXiv:2606.24543v1 Announce Type: new Abstract: Large Language Models (LLMs) are traditionally viewed as autoregressive generators. However, from the perspective of collective computation, they function as high-dimensional Dense Associative Memories that store complex reasoning patterns as latent attractors. In this work, we investigate the energy landscape of mathematical reasoning. We posit that correct reasoning chains correspond to deep, wide attractor basins ("flat minima") in the model's output distribution, whereas hallucinations manifest as sharp, unstable local minima. To exploit this geometry, we introduce a retrieval mechanism based on a Gibbs measure of the trajectory's spectral entropy. By sampling multiple reasoning paths and weighting them by their inverse energy ($P \propto e^{-\beta E}$), we approximate the equilibrium distribution of the associative memory, effectively ``relaxing'' the system into a robust solution. Empirically, this physics-inspired mechanism improves Microsoft Phi-3.5 performance on GSM8K by 5.38\% (84.7\% $\to$ 90.1\%), demonstrating that inference is better modeled as a dynamic settling process into an attractor basin rather than greedy next-token prediction.

13.
arXiv (CS.LG) 2026-06-12

Is Stochastic Gradient Descent Effective? A PDE Perspective on Machine Learning processes

arXiv:2501.08425v3 Announce Type: replace Abstract: In this paper we analyze the behaviour of the stochastic gradient descent (SGD), a widely used method in supervised learning for optimizing neural network weights via a minimization of non-convex loss functions. Since the pioneering work of E, Li and Tai (2017), the underlying structure of such processes can be understood via parabolic PDEs of Fokker-Planck type, which are at the core of our analysis. Even if Fokker-Planck equations have a long history and a extensive literature, almost nothing is known when the potential is non-convex or when the diffusion matrix is degenerate, and this is the main difficulty that we face in our analysis. We identify two different regimes: in the initial phase of SGD, the loss function drives the weights to concentrate around the nearest local minimum. We refer to this phase as the drift regime and we provide quantitative estimates on this concentration phenomenon. Next, we introduce the diffusion regime, where stochastic fluctuations help the learning process to escape suboptimal local minima. We analyze the Mean Exit Time (MET) and prove upper and lower bounds of the MET. Finally, we address the asymptotic convergence of SGD, for a non-convex cost function and a degenerate diffusion matrix, that do not allow to use the standard approaches, and require new techniques. For this purpose, we exploit two different methods: duality and entropy methods. We provide new results about the dynamics and effectiveness of SGD, offering a deep connection between stochastic optimization and PDE theory, and some answers and insights to basic questions in the Machine Learning processes: How long does SGD take to escape from a bad minimum? Do neural network parameters converge using SGD? How do parameters evolve in the first stage of training with SGD?

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

video-SALMONN-R$^3$: Learning to ReWatch, ReAsk, and ReAnswer for Efficient Video Understanding

arXiv:2606.24477v1 Announce Type: cross Abstract: Video large language models (LLMs) are often constrained by computation and memory budgets, leading them to use reduced frame rates and spatial resolutions, which may cause them to miss critical information for question answering (QA). A practical and efficient solution is a two-stage paradigm: first perform coarse video understanding to localize relevant segments, and then re-watch these segments at higher temporal or spatial fidelity. In this paper, we present video-SALMONN-R$^3$, the first end-to-end video-LLM that enables re-watch through reinforcement learning without relying on chain-of-thought (CoT) cold-start. This design removes the need for costly CoT data annotations and avoids CoT-based supervised fine-tuning (SFT), which can otherwise degrade the pretrained video understanding abilities. To address the mismatch between the reasoning-first behavior induced by re-watch and the answer-first tendency of pretrained video-LLMs, we propose a re-answer strategy, in which the model first produces a direct answer in the first watch and then refines it after re-watching. Finally, to improve question adherence during re-watching, we propose a re-ask mechanism that re-injects the query when revisiting localized segments. Experimental results show that video-SALMONN-R$^3$ consistently outperforms both the base model and the QA-SFT baseline, while surpassing prior re-watch-based approaches with significantly lower computational cost. Code, models, and data will be publicly released upon acceptance.

15.
arXiv (CS.CL) 2026-06-16

Measuring Whether LLM Tutors Teach or Solve: A Diagnostic for Educational Impact

Large language models are increasingly proposed as educational tutors, yet stronger task-solving ability does not necessarily imply stronger learning support. Motivated by recent calls to measure the social impact of NLP systems in practice, we study whether public LLM tutoring benchmarks distinguish learning-supportive behavior from mere answer production. We propose a lightweight diagnostic based on the gap between solving-oriented and pedagogy-oriented benchmark performance. Using public MathTutorBench leaderboard results, we show that these dimensions are only partially aligned: across eight publicly reported models, the correlation between solving and pedagogy composites is 0.421, and several models shift meaningfully in rank when evaluation moves from solving to pedagogy. We then analyze the public TutorBench sample and show that agency-relevant behaviors are explicitly encoded in benchmark rubrics, especially in active-learning settings that reward guiding questions, calibrated hints, and non-disclosive scaffolding. Together, these findings suggest that educational-impact evaluation should not treat task success as a sufficient proxy for learning support. We argue that public tutoring benchmarks can better support positive-impact evaluation by reporting solving-oriented and pedagogy-oriented scores separately and by making disclosure-sensitive, student-agency-preserving criteria more explicit.

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

P-MTP: Efficient Document Parsing via Multi-Token Prediction with Progressive Depth Scaling

Vision-Language Models (VLMs) have revolutionized document parsing by enabling end-to-end mapping from images to structured text, imposing a significant latency bottleneck, particularly for token-dense documents. While Multi-Token Prediction (MTP) has emerged as a promising approach for accelerating inference, its potential is constrained by optimization instability when scaling to deeper look-ahead depth. In this paper, we propose P-MTP, a framework that leverages Progressive Multi-Token Prediction with a lightweight MTP module to scale the look-ahead depth for high-throughput document parsing. Specifically, we introduce Progressive Curriculum Loss that adaptively re-weights different look-ahead depths using cumulative path reliability and retrospective target consistency. By effectively suppressing gradient noise in long-range predictions, P-MTP, facilitates an automated easy-to-hard optimization transition, enabling the model to master increasingly distant look-ahead depths. Furthermore, we propose Confidence-Gated Dynamic Drafting to maximize the effective look-ahead depth and acceptance rate by adaptively calibrating speculative length during inference, thereby minimizing computational waste and further pushing the boundaries of inference speedup. Experimental results across multiple benchmarks and architectures demonstrate that P-MTP, achieves up to a $5\times$ speedup with negligible loss in accuracy, providing the first successful validation of extensive look-ahead MTP in the document parsing domain.

17.
arXiv (CS.CL) 2026-06-12

PolyAlign: Conditional Human-Distribution Alignment

Post-training methods such as supervised fine-tuning (SFT) and preference optimization typically align language models toward a single global assistant behavior. While effective for improving average helpfulness, this can suppress the natural variation of human responses across languages, tasks, and dialogue settings. We study this problem as conditional human-distribution alignment: models should match the human response distribution appropriate to the current interaction context, rather than a universal response style. We introduce PolyAlign, a distribution-aware alignment framework that organizes bilingual interaction data into bucket-specific human reference distributions defined by language, interaction track, response family, and length. PolyAlign combines Bucket-Aware SFT, which balances optimization across heterogeneous buckets, with Human-Distribution Preference Optimization (HDPO), which regularizes preference learning using critic-estimated distance to bucket-specific human support. Across a bilingual evaluation suite covering English and Chinese single- and multi-turn settings, PolyAlign improves conditional naturalness and distributional faithfulness while preserving competitive task utility. The results suggest that post-training should move beyond global alignment objectives toward interaction-aware alignment with human response distributions.

18.
arXiv (quant-ph) 2026-06-19

Locally Gentle State Certification for High Dimensional Quantum Systems

arXiv:2602.04550v3 Announce Type: replace Abstract: Standard approaches to quantum statistical inference rely on measurements that induce a collapse of the wave function, effectively consuming the quantum state to extract information. In this work, we investigate the fundamental limits of locally-gentle quantum state certification, where the learning algorithm is constrained to perturb the state by at most $\alpha$ in trace norm, thereby allowing for the reuse of samples. We analyze the hypothesis testing problem of distinguishing whether an unknown state $\rho$ is equal to a reference $\rho_0$ or $\epsilon$-far from it. We derive the minimax sample complexity for this problem, quantifying the information-theoretic price of non-destructive measurements. Specifically, by constructing explicit measurement operators, we show that the constraint of $\alpha$-gentleness imposes a sample size penalty of $\frac{d}{\alpha^2}$, yielding a total sample complexity of $n = \Theta(\frac{d^3}{\epsilon^2 \alpha^2})$. Our results clarify the trade-off between information extraction and state disturbance, and highlight deep connections between physical measurement constraints and privacy mechanisms in quantum learning. Crucially, we find that the sample size penalty incurred by enforcing $\alpha$-gentleness scales linearly with the Hilbert-space dimension $d$ rather than the number of parameters $d^2-1$ typical for high-dimensional private estimation.

19.
arXiv (CS.AI) 2026-06-16

AutoDojo: Adaptive Attacks Expose Superficial Defenses and User-Underspecification Limits in LLM Agents

arXiv:2606.15057v1 Announce Type: cross Abstract: Indirect prompt injection (IPI) is a major security threat to LLM-powered agents. Thus, a growing body of work have proposed a variety of defensive approaches against IPI. These can be grouped into three broad categories: 1) prompt-based (using prompting as a way to prevent agents from following malicious instructions), 2) detection-based (identifying and filtering malicious instructions), and 3) system-level (using systems insights, such as control and data isolation, for defense). However, commonly used benchmarks for evaluating defense, such as AgentDojo, are inherently static, generating a fixed distribution of IPI attacks. Consequently, static benchmarks do not usefully evaluate defense robustness to adaptive threats. We address this issue by developing AutoDojo, an adaptive extension of AgentDojo that optimizes IPI against a given defense. Using AutoDojo against state-of-the-art IPI defenses across three task suites and five target models, we make two key observations. First, many defenses offer only limited protection: a cheap, black-box adaptive attack using a frontier LLM to iteratively optimize the injection raises attack success rate (ASR) well above the level achieved by static injections against nearly all evaluated defenses. Against a filter that reduces static ASR to 0\%, AutoDojo recovers 28\% overall and 64\% on action-open tasks. Second, for prompt-level and filter-based defenses, ASR is substantially higher on action-open tasks – where the user's request delegates the action itself to attacker-controlled content – than on precisely specified tasks. This is a structural limit: on such tasks the injection can pose as ordinary data rather than an explicit instruction, bypassing defenses that rely on detecting instruction-like text. AutoDojo is publicly available at https://github.com/xhOwenMa/AutoDojo.

20.
medRxiv (Medicine) 2026-06-23

Default Handling of the Non-Assessable Verbal Glasgow Coma Scale Misclassifies Illness Severity in Mechanically Ventilated Patients: A Retrospective Analysis

Background: The Glasgow Coma Scale (GCS) is a universal neurologic severity score in the intensive care unit and is incorporated into APACHE, SOFA, mortality prediction models, ICU benchmarking, and quality metrics. In mechanically ventilated patients, however, the verbal component cannot be assessed. Common conventions, including assigning a normal total GCS of 15 or excluding patients with missing verbal scores, may misclassify the sickest patients as neurologically normal or remove them from analysis. Objective: To quantify non-assessable verbal GCS examinations after acute brain injury and determine how different handling conventions affect severity scoring and mortality-model performance across two independent critical care databases. Materials and Methods: We conducted a retrospective cohort study of adults with acute brain injury during their first ICU stay in MIMIC-IV, with replication in eICU-CRD. A verbal examination was considered non-assessable when documented as No Response-ETT. We measured the burden and determinants of non-assessability, compared the MIMIC-IV derived GCS convention with a component-aware GCS, and evaluated mortality-model handling strategies. Results: Among 14,230 patients, 45.2% had a non-assessable verbal examination, and 47.5% of ventilated patients had no assessable verbal score in the first 24 hours. Non-assessability was strongly associated with mechanical ventilation and mortality. The MIMIC-IV derived GCS assigned a score of 15 to 42.9% of patients and placed 11.6% in the lowest severity category despite eye and motor findings consistent with GCS [≤]9. Complete-case handling excluded 28.5% of patients, who accounted for 50.2% of deaths. Similar distortions were observed in eICU-CRD/APACHE across 171 hospitals. Discussion: Default-to-normal scoring can make severely ill intubated patients appear neurologically normal, while complete-case analysis removes the highest-risk patients. Conclusion: Non-assessable verbal GCS in mechanically ventilated patients should be explicitly flagged and reported in ICU severity scores, risk-adjusted mortality models, and benchmarking systems.

21.
medRxiv (Medicine) 2026-06-16

Non-invasive Detection of Fasciculation Using Surface EMG with a Wavelet-Based Analytical Method (DEWCS)

Objective: Needle electromyography (nEMG) is essential for diagnosing neuromuscular disorders but is invasive and often painful. We employed single-channel bipolar surface EMG (sEMG) analyzed with a novel wavelet-based analytical approach, Detecting and Extracting Elemental Wave Components based on a Wavelet Coefficient Set (DEWCS) and investigated whether fasciculation-related activity could be identified. Methods: In this prospective study, 28 patients undergoing nEMG for suspected neuromuscular disorders and 13 healthy controls were included. Resting-state sEMG was recorded from selected muscles using single-channel bipolar active electrodes at a high sampling rate. DEWCS was used to extract indices reflecting fast- and slow-type motor unit (MU)-related activity. These standardized indices were evaluated against nEMG-detected fasciculation potentials using generalized estimating equation logistic regression to account for within-subject clustering. Diagnostic performance was assessed by receiver operating characteristic analysis. Results: A total of 67 muscles from 38 participants were analyzed. Indices of fast- and slow-type MU-related activity were significantly associated with fasciculation potentials (slow: OR 5.10, p = 0.0041; fast: OR 2.38, p = 0.0162). The combined model showed excellent discrimination (area under the curve = 0.97), outperforming either index alone. Muscle region had no significant effect. Conclusions: A single-channel bipolar sEMG setup combined with DEWCS detected fasciculation-related activity with promising accuracy. This method may serve as a non-invasive surrogate marker of lower motor neuron involvement. Further validation in larger cohorts is warranted. Significance: This non-invasive sEMG approach may help detect fasciculation-related activity and complement nEMG in neuromuscular diagnostics.

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

Information Leakage Detection through Approximate Bayes-optimal Prediction

arXiv:2401.14283v4 Announce Type: replace-cross Abstract: In today's data-driven world, the proliferation of publicly available information raises security concerns due to the information leakage (IL) problem. IL involves unintentionally exposing sensitive information to unauthorized parties via observable system information. Conventional statistical approaches rely on estimating mutual information (MI) between observable and secret information for detecting ILs, face challenges of the curse of dimensionality, convergence, computational complexity, and MI misestimation. Though effective, emerging supervised machine learning based approaches to detect ILs are limited to binary system sensitive information and lack a comprehensive framework. To address these limitations, we establish a theoretical framework using statistical learning theory and information theory to quantify and detect IL accurately. Using automated machine learning, we demonstrate that MI can be accurately estimated by approximating the typically unknown Bayes predictor's log-loss and accuracy. Based on this, we show how MI can effectively be estimated to detect ILs. Our method performs superior to state-of-the-art baselines in an empirical study considering synthetic and real-world OpenSSL TLS server datasets.

23.
Nature Medicine 2026-06-12

General-purpose large language models outperform specialized clinical AI tools on medical benchmarks

Specialized clinical artificial intelligence (AI) tools are entering medical practice despite scarce independent evaluation. We quantitatively evaluate two clinical AI tools, OpenEvidence and UpToDate Expert AI, built on large language models (LLMs) against three frontier LLMs: GPT-5.2, Gemini 3.1 Pro and Claude Opus 4.6. Our evaluation has three stages: (1) 500 MedQA questions testing medical knowledge, (2) 500 HealthBench items measuring alignment with clinicians and (3) the real clinical queries (RCQ) benchmark, built from 100 de-identified queries from physicians to a general-purpose language model in a live clinical environment. For the RCQ benchmark, 12 US clinicians performed randomized, blinded review of model outputs, producing 1,800 model–question annotations. Frontier LLMs outperformed clinical AI tools in all three evaluations. Clinical AI tools performed comparably to auto-enabled Google Search AI Overview on the RCQ. These findings highlight the need for independent, real-world evaluation of AI tools before they enter clinical settings. In an independent evaluation, frontier large language models outperformed specialized clinical artificial intelligence tools on medical knowledge, clinician alignment and real-world clinical queries.

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

Female-RHINO: A Real-Time Scanner-Integrated Framework for Automated Quantitative Uterine MRI Analysis and Structured Reporting

arXiv:2606.24390v1 Announce Type: cross Abstract: Standardized assessment of uterine MRI remains challenging due to anatomical variability, observer dependence, and the lack of workflow-integrated automated analysis tools. This work presents Female-RHINO: (R)eproductive (H)ealth (I)maging A(N)alysis T(O)ol, a real-time AI-assisted framework for automated quantitative uterine MRI analysis and structured reporting during image acquisition. We present an end-to-end system that integrates inline communication with the MRI scanner and deep learning-based analysis to derive quantitative uterine biomarkers from sagittal T2-weighted pelvic MRI. The framework combines segmentation and anatomical landmark detection models trained and evaluated on more than 500 multi-center datasets spanning diverse protocols, vendors, and patient populations. It performs volumetry, detects and quantifies common incidental findings such as fibroids and Nabothian cysts, and extracts six anatomical landmarks for biometric assessment. Results are compiled into a structured clinician-oriented report with integrated visualizations, without manual interaction. Evaluation on independent retrospective and prospective cohorts demonstrated robust performance across varying acquisition settings. Mean Dice similarity coefficients were 0.82 for the uterus and 0.80 for fibroids, with lower but consistent agreement for Nabothian cysts. Landmark detection achieved a mean radial error of 3.7 mm. End-to-end processing was completed in under 70 seconds, enabling availability of results during the ongoing scan. Prospective deployment yielded immediate, standardized, and reproducible analyses supported by inter-observer agreement. The proposed system enables real-time scanner-integrated AI for automated uterine MRI analysis and reporting, with potential to improve standardization, efficiency, and clinical workflow in pelvic imaging.

25.
medRxiv (Medicine) 2026-06-22

An integrated AI-microfluidic platform reveals the broad persistence and developmental potential of rare sperm in non-obstructive azoospermia

Non-obstructive azoospermia (NOA) represents the most severe form of male infertility, severely limiting a patient's prospects for biological fatherhood when surgical retrieval fails. However, the true biological limits of NOA remain obscured by the inherent limitations of conventional gamete recovery protocols: standard centrifugation frequently causes substantial cell loss, masking extremely rare sperm, while surgical interventions are constrained by spatial sampling biases. Here we report SpermSeek, an integrated AI-guided microfluidic platform for real-time, non-destructive isolation of single sperm directly from semen. Operating at scalable throughput (0.36 mL/h), the system achieves 98.3% detection precision and a 95.5% target encapsulation efficiency, suppressing background debris. In a 59-patient NOA cohort, SpermSeek detected morphologically identifiable sperm in 64.4% (38/59) of cases, spanning diverse genetic etiologies, including AZFb/c microdeletions, and severe histopathological phenotypes, such as Sertoli-cell-only syndrome (SCOS). Notably, among a sub-cohort of 41 patients who remained consistently sperm-negative despite prior medical or micro-TESE interventions, our platform identified gametes in 53.7% (22/41) of these cases. Comprehensive safety profiling in healthy human donors and wild-type mice confirmed that processed sperm retain high DNA integrity and epigenomic concordance (r=0.98), supporting transgenerational developmental stability in mice. Furthermore, in a 26-patient validation cohort, SpermSeek recovered rare sperm in 11 cases. Utilizing gametes from a subset (n=5), we demonstrated their capacity to support early human embryogenesis, yielding high-quality cleavage-stage embryos with confirmed genomic euploidy. This work establishes a highly sensitive framework for re-examining the biological limits of human spermatogenesis, laying the foundation to expand autologous reproductive options for patients refractory to conventional retrieval protocols.