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

Learning to Trigger: Reinforcement Learning at the Large Hadron Collider

arXiv:2606.23993v1 Announce Type: cross Abstract: High-throughput scientific facilities such as the Large Hadron Collider depend on real-time event filtering (triggering) under tight constraints on bandwidth, latency, and storage. In practice, trigger menus are largely static and hand-tuned and can become suboptimal as detector conditions, pileup, and background composition drift over time. We cast online threshold tuning as a sequential decision-making problem: a reinforcement learning agent ingests streaming summaries of recent rates and signal-sensitive features and updates trigger thresholds to maximize signal efficiency while tracking a target background rate within a tolerance band. We adapt Group-Filtered Policy Optimization (GFPO) to streaming control and introduce two variants (GFPO-F, GFPO-FR) that enforce background rate feasibility during training. On a benchmark that emulates realistic collider operation, we study two representative triggers: a total transverse energy ($H_{T}$) trigger sensitive to pileup variation, and an anomaly-detection (AD) trigger based on reconstruction loss for rare or non-standard signatures. On Monte Carlo streams, our agent increases the fraction of in-tolerance time intervals by 48\% ($H_T$) and 28\% (AD), with a cumulative gain of up to 2\% in signal efficiency on those in-tolerance intervals. Transferring from simulation to real collision data (CMS Run 283408), the same agent, without fine-tuning, achieves a 56\% ($H_T$) and 28\% (AD) in-tolerance improvement over baselines, with further signal-efficiency gain on both triggers. To our knowledge, this is the first demonstration of RL-based trigger control on real Large Hadron Collider collision data. Code is available at https://github.com/Zixind/GFPO\_LHC.

02.
medRxiv (Medicine) 2026-06-11

Neighborhood socioeconomic status associated with post-stroke cognitive impairment: a retrospective cohort study

Background: Late complications after stroke (LCAS), including cognitive symptoms, impact quality of life and recovery. It is not known if neighborhood-level measures of socioeconomic status (SES) influence LCAS. This study assessed associations between SES measures, including neighborhood income inequality (Gini) and area deprivation index (ADI), and cognitive symptoms after acute ischemic stroke (AIS) in a hospital leveraging active surveillance of LCAS. Methods: This retrospective cohort study included 512 patients hospitalized with AIS at Tufts Medical Center with subsequent follow-up (between zero and three months or between three and twelve months) in the Stroke Clinic from 1/1/2018 - 12/31/2022. Using ZIP code data, patients were characterized as low Gini (low inequality) and high ADI (high deprivation) (Gini = 5) by state medians. These variables were combined, indicating patients who were living in both a low Gini and high ADI neighborhood to evaluate the effects of living in a homogeneously deprived area. There were 206 and 281 patients in the low Gini and high ADI groups respectively. 140 patients lived in a low Gini and high ADI neighborhood. The multivariable logistic analysis assessed the likelihood of cognitive symptoms, adjusting for age, race, ethnicity, sex, NIH Stroke Scale (NIHSS), thrombolysis, active LCAS surveillance, poverty, and ADI-Gini combination. Results: There were no associations between high ADI (OR: 1.03, 95% CI: 0.67 ? 1.57) or low Gini (OR: 1.74, 95% CI: 0.98 ? 3.07) alone and cognitive symptoms after AIS. However, the combined variable demonstrated increased likelihood of cognitive symptoms in the high ADI-low Gini group (OR: 1.82, 95% CI: 1.08 ? 3.06). Conclusions: This study suggests that individuals living in homogeneously deprived neighborhoods report higher likelihood of cognitive symptoms after AIS. Further studies with increased power are needed to investigate the underlying causes of these disparities and to develop interventions to reduce these complications.

03.
arXiv (CS.AI) 2026-06-19

Beyond Accuracy: Measuring Logical Compliance of Predictive Models

arXiv:2606.20208v1 Announce Type: new Abstract: Machine learning models are predominantly evaluated through predictive performance metrics such as ranking quality, prediction error, or classification accuracy. While these metrics effectively quantify how closely predictions match the ground truth, they do not assess whether model outputs respect predefined logical or domain-specific constraints. In high-stakes applications, including healthcare, finance, and autonomous systems, logical consistency can be as critical as predictive accuracy, yet no standard metric captures this dimension. We introduce the Rule Violation Score (RVS), a complementary evaluation metric that quantifies the extent to which a predictive model respects a given set of logical rules, independently of predictive accuracy. RVS treats hard rules (strict constraints) and soft rules (statistical regularities) differently, can be evaluated on any dataset and on any predictive model expressed over a relational vocabulary, and can be computed using SQL queries that are automatically generated for Horn rules. Beyond evaluating models, RVS can also evaluate the logical consistency of training datasets and help identify poorly defined rules. We evaluate RVS on three benchmarks covering knowledge graph link prediction and relational regression, including rule-based, embedding-based, and neuro-symbolic predictive models. Our results demonstrate that two models achieving comparable predictive accuracy can exhibit substantially different levels of logical compliance, revealing differences in model behavior that standard metrics fail to capture.

04.
arXiv (CS.CL) 2026-06-18

The Personalization Trap: How User Memory Alters Emotional Reasoning in LLMs

When an AI assistant remembers that Sarah is a single mother working two jobs, does it interpret her stress differently than if she were a wealthy executive? As personalized AI systems increasingly incorporate long-term user memory, understanding how this memory shapes emotional reasoning is critical. We investigate how user memory affects emotional intelligence in large language models (LLMs) by evaluating 15 models on human-validated emotional intelligence tests. We find that identical scenarios paired with different user profiles produce systematically divergent emotional interpretations. Across validated user-independent emotional scenarios and diverse user profiles, systematic biases emerged in several high-performing LLMs where advantaged profiles received more accurate emotional interpretations. Moreover, LLMs demonstrate significant disparities across demographic factors in emotion reasoning and supportive recommendations tasks, indicating that personalization mechanisms can embed social hierarchies into models' emotional reasoning. These results highlight a key challenge for memory-enhanced AI: systems designed for personalization may reinforce social inequalities. To mitigate these disparities, we curate a general-purpose preference dataset designed to reduce demographic profiles' influence on emotional understanding.

05.
arXiv (CS.CV) 2026-06-12

Towards More General Control of Diffusion Models Using Jeffrey Guidance

A key strength of diffusion models lies in their flexibility, since their outputs can be controlled at sampling time through guidance. However, beyond simple cases such as conditional sampling, the target distribution is often left implicit, defined only through a sampling rule or a heuristic energy function. To address this, we propose Jeffrey guidance, a principled framework that extends diffusion-model control to applications beyond what standard guidance can express. It leverages Jeffrey's rule of conditioning to update marginal distributions towards a prescribed target, preserving the conditional structure and minimally perturbing the joint distribution. We first demonstrate Jeffrey guidance by targeting a prescribed embedding distribution. With Inception embeddings as the target, this leads to substantial reductions in FID on both CIFAR-10 and FFHQ. We further apply Jeffrey guidance to fairness on CelebA-HQ, updating an unconditional diffusion model to enforce independence between attributes.

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

A Machine-Learned Comorbidity Index

arXiv:2606.17450v1 Announce Type: new Abstract: Traditional comorbidity scores (e.g., Charlson and Elixhauser) are widely used for risk adjustment and patient stratification, but they have two key limitations: (i) they are largely mortality-centric and do not align well with other clinical outcomes, and (ii) their linear, rule-based structure cannot capture nonlinear, outcome-specific risk relationships. We propose a Machine-Learned Comorbidity Index (MLCI) that maps diagnosis codes to a single scalar by maximizing the normalized Hilbert-Schmidt Independence Criterion (nHSIC) between the learned score and multiple clinical outcomes. MLCI captures nonlinear risk-outcome dependence and is supported by a theory that characterizes when a unified, informative admission-level ordering can be achieved across outcomes. Empirical results on multiple benchmark electronic health record (EHR) datasets show that MLCI outperforms strong baselines across multiple evaluation metrics.

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

Amnesia: A Stealthy Replay Attack on Continual Learning Dreams

Continual learning (CL) models often use experience replay to reduce catastrophic forgetting, but their robustness to replay sampling interference remains underexplored. Existing CL attacks alter inputs or training pipelines (poisoning/backdoors) and rarely include explicit auditable constraints, limiting realism. Here, auditability means a monitor can verify compliance from sampler-visible telemetry - e.g., logged replay index/label statistics - by checking that the realized replay class histogram stays close to a nominal baseline and that replay rate is unchanged per batch and/or over a rolling window. We study a limited-privilege insider who controls only replay index selection, not pixels, labels, or model parameters, while staying within auditable limits such as queue priorities. We introduce Amnesia, a replay composition attack that maximizes degradation under two budgets: a visibility budget delta bounding the TV/KL divergence from a nominal class histogram p0, and a mass budget f fixing the replay rate. Amnesia has two steps: (i) compute lightweight class utilities, such as EMA loss or confidence, to tilt p0 toward harmful classes; and (ii) project the tilt back into the delta-ball using efficient KL (exponential tilt) or TV (balanced mass redistribution) optimizers. A windowed scheduler enforces rolling audits. Across challenging CL benchmarks and strong replay baselines, Amnesia consistently lowers final accuracy (ACC) and worsens backward transfer (-BWT). The KL variant delivers high impact while remaining largely undetected under multiple audit schemes, including per-batch and rolling-window checks. The TV variant is more damaging but easier to detect, especially under tight per-class constraints. These results expose index-only replay control as a practical, auditable threat surface in CL systems and establish a principled impact-visibility trade-off.

08.
arXiv (CS.AI) 2026-06-16

Adaptive inference and function vectors in deep transformers

arXiv:2606.16694v1 Announce Type: cross Abstract: Transformers are widely used as a general-purpose substrate for learning complex correlations between a large collection of coupled variables, but their internal mechanisms have remained mysterious. We introduce a theory of a deep transformer as a mean-field interacting system that implements distributed inference, subject to constraints on communication, locality and depth. We show that such a system can exploit internal state representations ('function vectors') to infer a latent context variable at increasingly finer scales over its layers. In an in-context regression task, the theory predicts a non-trivial relationship between non-Gaussian, hierarchical structure in the latent context variable, and transformer depth. Predictions are tested using constrained linear attention transformers and demonstrate adaptive inference in deep architectures. Feedforward blocks and depth enable transformers to implement a much richer class of in-context learning algorithms than previously described.

09.
arXiv (CS.AI) 2026-06-18

Speaker Verification with Speech-Aware LLMs: Evaluation and Augmentation

arXiv:2603.10827v2 Announce Type: replace-cross Abstract: Speech-aware large language models (LLMs) can accept speech inputs, yet their training objectives largely emphasize linguistic content or specific fields such as emotions or the speaker's gender, leaving it unclear whether they encode speaker identity. First, we propose a model-agnostic scoring protocol that produces continuous verification scores for both API-only and open-weight models, using confidence scores or log-likelihood ratios from the Yes/No token probabilities. Using this protocol, we benchmark recent speech-aware LLMs and observe weak speaker discrimination (EERs above 20% on VoxCeleb1). Second, we introduce a lightweight augmentation that equips an LLM with ASV capability by injecting frozen ECAPA-TDNN speaker embeddings through a learned projection and training only LoRA adapters. On TinyLLaMA-1.1B, the resulting ECAPA-LLM achieves 1.03% EER on VoxCeleb1-E, approaching a dedicated speaker verification system while preserving a natural-language interface.

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

Detecting Hate and Inflammatory Content in Bengali Memes: A New Multimodal Dataset and Co-Attention Framework

Internet memes have become a dominant form of expression on social media, including within the Bengali speaking community. While often humorous, memes can also be exploited to spread offensive, harmful, and inflammatory content targeting individuals and groups. Detecting this type of content is exceptionally challenging due to its satirical, subtle, and culturally specific nature. This problem is magnified for low-resource languages like Bengali, as existing research predominantly focuses on high-resource languages. To address this critical research gap, we introduce Bn-HIB (Bangla Hate Inflammatory Benign), a novel dataset containing 3,247 manually annotated Bengali memes categorized as Benign, Hate, or Inflammatory. Significantly, Bn- HIB is the first dataset to distinguish inflammatory content from direct hate speech in Bengali memes. Furthermore, we propose the MCFM (Multi-Modal Co-Attention Fusion Model), a simple yet effective architecture that mutually analyses both the visual and textual elements of a meme. MCFM employs a co-attention mechanism to identify and fuse the most critical features from each modality, leading to a more accurate classification. Our experiments show that MCFM significantly outperforms several state-of-the-art models on the Bn-HIB dataset, demonstrating its effectiveness in this nuanced task. To facilitate reproducibility and future research, the Bn-HIB dataset has been made publicly available through Mendeley Data. Warning: This work contains material that may be disturbing to some audience members. Viewer discretion is advised

11.
arXiv (CS.CL) 2026-06-18

Evaluating Prompting-Based Defenses Against Domain-Camouflaged Injection Attacks

Authors:

Domain-camouflaged injection attacks embed malicious instructions in retrieved content using domain-appropriate vocabulary, evading standard detectors that rely on syntactic injection markers. When detection fails, practitioners need to know which defense architectures reduce attack success. We evaluate five prompting-based defenses (spotlighting, paraphrasing, prompt sandwiching, and two combinations) against domain-camouflaged injection across three model families (Claude Haiku, Llama 3.1 8B, Gemini 2.0 Flash) and three deployment domains (financial, legal, general) using 3,510 trials. Paraphrasing retrieved content before agent processing is the most consistently effective defense in this benchmark, reducing camouflage attack success rate by 55-84\% depending on model, and achieves lower attack success rates than our Llama Guard 4 configuration on every model tested. Defense effectiveness is strongly model-dependent: spotlighting halves attack success on Claude Haiku but provides no benefit on Llama 3.1 8B. Financial domain deployments face the highest residual risk at 26-33\% baseline attack success rate, with no prompting-based defense fully eliminating the threat on weaker models. These results provide the first systematic evaluation of prompting-based defenses specifically against camouflage-class injection attacks and establish benchmark-based recommendations for practitioners. All tasks use synthetically constructed professional documents; whether these benchmark rankings generalize to real enterprise documents remains an open question.

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

Traits Run Deeper: Trait-Specific Asymmetric Fusion for Personality Assessment

Personality assessment aims to infer stable personality traits from dynamic behaviors across language, voice, and facial cues. Since different personality dimensions are revealed through distinct behavioral perspectives, modeling trait-specific evidence is challenging. However, most existing approaches adopt a uniform multimodal fusion strategy across all dimensions, assuming identical modality contributions. This overlooks trait-specific modality preferences and introduces cross-modal interference. To address this issue, we propose a novel personality assessment framework called Traits Run Deeper, which consists of three components. Specifically, the Multimodal Foundation Representation (MFR) module constructs personality-oriented multimodal inputs and leverages psychology-informed semantic templates as anchors, enabling foundation models to capture trait-relevant information. Building upon MFR, the Trait-Specific Modality Fusion (TSMF) module acts as an asymmetric fusion mechanism, allowing each dimension to selectively exploit different modality pathways from modality-specific modeling to complementary fusion. Thus, TSMF captures heterogeneous modality preferences while reducing cross-modal contamination. Furthermore, the Distribution-Calibrated Personality Regression (DCPR) module mitigates label imbalance and central tendency bias through target distribution calibration, improving robustness and stability. Experimental results on the AVI Challenge 2026 validation set demonstrate the effectiveness of the proposed framework, reducing mean squared error (MSE) by approximately 25% compared with the baseline. Consistent improvements are observed on the official test set, where our method achieves the best performance and ranks first in the Personality Assessment Track. The source code will be made available at https://github.com/MSA-LMC/AVI2026.

13.
arXiv (CS.CV) 2026-06-18

PEFT-MedSAM: Efficient Fine-Tuning of Medical Foundation Models for Explainable Skin Lesion Segmentation

Automated segmentation of skin lesions using deep learning models for dermoscopic images can be very helpful in finding melanomas earlier than they would normally be detected. However, most deep learning methods available do not perform well. The aim of this paper is to present a parameter-efficient fine-tuning method called PEFT-MedSAM for adapting the Medical Segment Anything Model (MedSAM) to automatically segment dermoscopic skin lesions. The PEFT-MedSAM method uses only the lightweight mask decoder for training the model while keeping the pre-trained image encoder and prompt encoder frozen. The experiments performed on the ISIC 2018 benchmark dataset shows that PEFT-MedSAM obtains a dice coefficient of .9411 and an intersection over union value of .8918 when compared to both a fully trained U-Net baseline (.8715 dice coefficient) and zero-shot MedSAM inference (.8997 dice coefficient). The external validation of the model using PH2 dataset shows .9467 dice coefficient with +/- .0310 standard deviation. Supportive evidence for these claims include a p-value less than .0001 for Wilcoxon signed rank tests comparing the two datasets and bootstrap-estimated 95% confidence intervals of [.9364,.9447] that represent the estimated range of possible values for the average dice coefficient obtained by repeating the test. To increase clinical trustworthiness, we used Grad-CAM explainability along with a pointing game based evaluation methodology to evaluate the CNN baseline model on the validation set. The results showed that we had an accuracy rate of 98.27% on the validation set of 519 images and confirmed that the model classified regions containing skin lesions.

14.
medRxiv (Medicine) 2026-06-22

A Drug-Specific, Half-Life-Adjusted Framework for Classifying CNS-Active Systemic Therapy Exposure During and After Radiotherapy

Clinical oncology datasets often store systemic therapy as a regimen label with a start date and an end date. Those records are clinically recognizable but can be analytically incomplete when the research question concerns whether a patient was exposed to a concurrent CNS-active drug (cCNS-aD) or an adjuvant CNS-active drug (aCNS-aD) around radiotherapy. Contemporary CNS-oncology studies usually define CNS activity by empiric drug lists and define concurrency by fixed calendar windows, although the literature shows substantial heterogeneity across both concepts. This paper proposes a generalizable framework for converting raw systemic therapy records into reproducible cCNS-aD and aCNS-aD variables, useful in subgrouping for clinical studies. The framework uses a transparent CNS scoring model based on three clinical evidence components: intracranial objective response rate, consensus CNS endorsement, and intrathecal route of administration. It then defines a pharmacokinetic exposure proxy as the recorded end date plus five half-lives. Concurrent exposure is classified by overlap with the radiotherapy interval, while post-radiotherapy exposure is classified by overlap with a prespecified post-RT attribution window. The framework separately identifies post-RT pharmacokinetic persistence and post-RT treatment initiation, allowing investigators to distinguish continued exposure from true adjuvant initiation. This is a methodological framework and reference implementation. Implementation audits and endpoint-specific sensitivity analyses remain necessary before use as a definitive exposure classifier

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

Efficient Time Series Clustering from Multiscale Reservoir Dynamics with Granular-Ball Anchoring Graph Optimization

arXiv:2606.12077v1 Announce Type: new Abstract: Time-series clustering remains challenging due to the inherent trade-off between clustering effectiveness and computational efficiency. Similarity-based methods often suffer from quadratic complexity caused by pairwise distance computations, while deep learning-based approaches typically rely on costly iterative training and a large number of trainable parameters. In this paper, we propose MSRGC-Net, an efficient time-series clustering framework that integrates multiscale reservoir computing, granular-ball-based anchoring graph construction, and consensus learning. MSRGC-Net adopts a training-free reservoir computing paradigm to extract multiscale temporal representations from raw time series without backpropagation, significantly reducing computational overhead. To capture the intrinsic structure of the resulting representations, granular-ball computing is employed to adaptively model data distributions via density-consistent regions, yielding compact and robust anchor graph representations. Furthermore, a consensus-based anchoring graph optimization strategy is introduced to effectively align multiscale reservoir representations and integrate complementary information across temporal scales. Extensive experiments on widely used univariate and multivariate benchmark datasets demonstrate that MSRGC-Net consistently outperforms state-of-the-art methods in clustering performance while maintaining superior computational efficiency.

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

Estimating Individualized Treatment Effects in Acute Ischemic Stroke with Causal Transformation Models (TRAM-DAG): A Multi-Centre Observational Study with External RCT Validation

arXiv:2606.12623v1 Announce Type: cross Abstract: Personalized medicine in acute ischemic stroke requires moving beyond average treatment effects (ATE) to individualized treatment effect (ITE) estimates to support treatment decisions. In acute ischemic stroke, mechanical thrombectomy has been shown to be more effective on average than lysis in randomized controlled trials (RCTs), such as the MR CLEAN study. We aim to identify which individual patients benefit most from mechanical thrombectomy compared to lysis. The outcome of interest is the modified Rankin Scale (mRS) at three months, an ordinal measure of functional disability (0: no symptoms, 6: death). We demonstrate that causal transformation models on directed acyclic graphs (TRAM-DAG) can be used for ITE estimation after being fitted on observational MAGIC multi-center stroke patient data. To ensure comparability with the MR CLEAN population, which we use for validation, we train the TRAM-DAG on a MAGIC sub-population with NIHSS at admission >= 6, corresponding to one inclusion criterion of MR CLEAN. The fitted model is then used to estimate ITEs for stroke patients in the MR CLEAN population. While these ITE estimates cannot be confirmed experimentally, we show that their average is consistent with the trial's reported ATE. Furthermore, the ITE estimates correctly rank trial patients by their observed frequency of a good outcome (mRS at three months

17.
arXiv (CS.CV) 2026-06-15

How do Self-Supervised Remote Sensing Vision Models Transfer to Downstream Tasks?

Self-supervised geospatial foundation models (GeoFMs) learn transferable representations from remote sensing data, but their downstream behavior is difficult to characterize. We study six representative GeoFMs spanning joint-embedding, reconstruction, and multimodal pretraining families, and evaluate transfer across classification, regression, and segmentation benchmarks under different label availability and downstream pipelines. We find that model rankings change across tasks and adaptation settings. Layerwise probing shows that, in most cases, task-relevant information is more accessible in intermediate transformer blocks compared to final-layer embeddings, and that GeoFMs exhibit distinct depthwise profiles. In segmentation case studies on PASTIS and Sen1Floods11, downstream adaptation settings such as decoder design and fine-tuning can be as impactful as the choice of GeoFM, and standard dense-prediction heads may be poorly aligned with how GeoFMs organize information over depth. Finally, CKA analysis on case studies shows that fine-tuning does not rewrite GeoFMs uniformly across depth, and the strongest changes are localized to the first linear layer of the MLP in ViT blocks. These results help explain why GeoFM rankings shift across benchmarks and motivate more representation-aware evaluation and adaptation strategies.

18.
arXiv (quant-ph) 2026-06-12

A ribbon ZX calculus for gauge theory

arXiv:2606.13551v1 Announce Type: cross Abstract: ZX calculus provides a graphical formalism for reasoning about quantum processes, built from two interacting Frobenius algebras associated with the Z and X bases of a qubit. While it has found widespread application in quantum information and computing, its relationship to quantum field theory has only recently begun to be explored. In this work, we further develop this connection by providing a generalization of ZX calculus to two-dimensional Yang Mills theory with a compact gauge group. The key observation is that both frameworks can be organized around the Hopf Frobenius algebraic structure associated with a group algebra, which can in turn be described by the diagrammatics of two dimensional topological quantum field theory. Given the well known relationship between gauge theory and gravity in two and three dimensions, our work paves the way for applications of ZX to low dimensional gravity.

19.
arXiv (quant-ph) 2026-06-11

Entanglement preservation and Clauser-Horne nonlocality in electromagnetically induced transparency quantum memories

arXiv:2507.15453v4 Announce Type: replace Abstract: Entanglement preservation in noisy quantum memories represents a central challenge in quantum information science. While experiments have shown that electromagnetically induced transparency (EIT) memories can store entangled photons, a quantitative theoretical analysis of whether nonlocal quantum correlations can survive storage loss induced by ground-state decoherence remains limited. Here we combine the dark-state polariton formalism with a reduced density-operator treatment to derive an EIT-specific effective pure-loss description for the retrieved photonic state in the ground-state-decoherence-limited regime. The analysis reveals that decoherence transforms an initially pure Bell state into a mixed state with a vacuum component and predicts a protocol-dependent storage-efficiency benchmark of 89.7% for violating the chosen unconditional Clauser-Horne (CH) inequality. Above this benchmark, the retrieved photonic state violates the CH inequality without post-selection, whereas below it, this unconditional CH violation is no longer obtained. This framework provides a quantitative theoretical description of entanglement retention, retrieved photonic density operators, and protocol-dependent Bell-test benchmarks in EIT quantum memories.

20.
medRxiv (Medicine) 2026-06-17

Cross-Device Adaptation of Mirai for Mammography-Based Breast Cancer Risk Prediction

Fine-tuning can adapt pretrained medical imaging models to new clinical datasets, but device-specific domain shifts may limit generalizability. We evaluated Mirai, a mammography-based deep learning model for breast cancer risk prediction, in a large screening cohort containing Hologic and General Electric (GE) full-field digital mammography systems, including GE Premium View (GE PV) and Tissue Equalization (GE TE) post-processing software. Native Mirai showed lower performance on TE images than on Hologic or PV images. Fine-tuning on TE images improved TE performance, particularly for short-term risk prediction, but substantially reduced performance on Hologic images, consistent with catastrophic forgetting. To mitigate this effect, we developed a device-invariant model using interleaved multi-device sampling and conditional adversarial training. This approach largely restored Hologic performance while maintaining improved TE performance, providing better robustness across heterogeneous imaging platforms. Comparison of cumulative and annual risk AUCs over a five-year time horizon further showed that performance gains were driven mainly by short- and intermediate-term predictions. These findings highlight both the value and dangers of device-specific fine-tuning and support balanced domain-adaptation strategies for deploying mammography-based risk models across diverse clinical imaging environments.

22.
arXiv (CS.CV) 2026-06-18

Prior-guided Fusion of Multimodal Features for Change Detection from Optical-SAR Images

Multimodal change detection (MMCD) identifies changed areas in multimodal remote sensing data, demonstrating significant application value in land use monitoring and urban sustainable development. However, literature MMCD approaches exhibit limitations in both cross-modal interaction and exploiting modality-specific characteristics. This leads to insufficient modeling of fine-grained change information, thus hindering the precise detection of semantic changes. To address these problems, we propose STSF-Net, a framework designed for MMCD between optical and SAR images. STSF-Net jointly models modality-specific and spatio-temporal common features to enhance change representations. Specifically, modality-specific features are exploited to capture genuine semantic change signals, while spatio-temporal common features are embedded to suppress pseudo-changes caused by differences in imaging mechanisms. Furthermore, we introduce an optical and SAR feature fusion strategy that adaptively adjusts multimodal feature importance based on semantic priors obtained from visual foundation models. Finally, we introduce the novel Delta-SN6 dataset, the first openly-accessible multiclass MMCD benchmark consisting of very-high-resolution fully polarimetric SAR and optical images. Experimental results on Delta-SN6, BRIGHT, and Wuhan datasets demonstrate that our method outperforms the state-of-the-art by 3.21%, 0.87%, and 1.32% in mIoU, respectively.

23.
medRxiv (Medicine) 2026-06-11

Malaria Risk among Internally Mobile Individuals and Heterogeneous Mobility Patterns in Two Hypoendemic Communities: Implications for Malaria Elimination in the Peruvian Amazon.

Background: Human mobility is increasingly recognized as a key factor influencing malaria transmission dynamics, particularly in low-transmission settings approaching elimination. This study aimed to assess mobility patterns and their association with malaria risk in two hypoendemic communities in the Peruvian Amazon. Method: A longitudinal study was conducted in the communities of Libertad and Urcomirano (Mazan River basin). Monthly population screenings were combined with weekly active and passive case detection. A total of 678 individuals were enrolled. Mobility patterns were assessed through structured questionnaires, and social network analysis was used to characterize travel connections. Log-binomial regression analysis was applied to identify risk factors associated with malaria infection. Result: Internally, mobile individuals in Libertad showed a higher malaria incidence (>32.47 cases per 1,000 person-months) than those in Urcomirano (

24.
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.

25.
medRxiv (Medicine) 2026-06-22

Modelling the decadal expansion of West Nile virus in Italy: the role of climatic, anthropogenic, and macroecological drivers

Abstract BACKGROUND West Nile virus (WNV) is a growing health burden in Italy. Anticipating human infection risk is hampered by the pathogen's complex ecology, highlighting the need for comprehensive early-warning tools. AIM We aimed to model municipal-level WNV risk in Italy and characterize its decadal expansion in Italy, providing a comprehensive ecological understanding of viral emergence. METHODS We applied a machine learning framework to annual human WNV case data from 2014 to 2024. The model integrated a suite of environmental, socio-economic, and macroecological predictors to generate risk projections. We evaluated the model's performance through multiple validation settings. We also performed an anticipation test for the 2025 epidemic season, using 2024 environmental data to assess the model's predictive accuracy against observed 2025 human cases. RESULTS Our model achieved robust performance (True Skill Statistic > 0.4) and captured WNV progressive expansion from 184 predicted positive municipalities in 2014 to 2,012 in 2024 (an 11-fold increase in 11 years). Seasonal minimum temperature was the primary risk driver, followed by monitoring year and population density, indicating active spatial spread. Environmental suitability consistently preceded clinical detection. Municipalities with cases in 2023-2024 exhibited significantly higher predicted suitability during 2018-2022 than those without cases (average risk 0.58 vs 0.20). Our model successfully identified emerging risk hotspots along the Adriatic coast and southern Italy before the official human spillover of 2025. CONCLUSION Embedding macroecological drivers into WNV risk modelling provides an improved understanding of drivers of rapid WNV expansion. Our model enables proactive risk mapping, surveillance efforts, and targeted public health measures.