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01.
bioRxiv (Bioinfo) 2026-06-19

SteerAF: Distogram-based Steering of AlphaFold2 toward Alternative Conformations

End-to-end structure predictors, such as AlphaFold2, typically output only the dominant conformational state of a given protein, which is biased by the training data set. Existing strategies for recovering alternative conformations are often computationally expensive and offer limited biological interpretability. Here, we present SteerAF, an inference-time optimization framework based on AlphaFold2 that leverages information encoded in the distogram derived from deep multiple sequence alignments (MSAs) to predict alternative protein conformations. Across four benchmark datasets, SteerAF matches or surpasses existing methods in predicting alternative conformations for the majority of systems. Sparse MSA-feature modifications generated via block gradient ascent exhibit a strong correlation with experimentally characterized functional residues, recovering them with approximately 50% precision in the tested proteins. Furthermore, SteerAF enables effective decoy selection in the absence of experimental structures, and its predictions can serve as seed structures for molecular dynamics simulations to map conformational landscapes. Thus, SteerAF provides an efficient and interpretable approach for predicting alternative conformations, offering a framework that can be extended to other similar predictors and problems.

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

Reducing Learner Redundancy in Boosting via Residual Orthogonalization

arXiv:2606.17567v1 Announce Type: new Abstract: While sequential residual fitting is the bedrock of standard boosting frameworks, it inherently breeds learner redundancy by repeatedly revisiting correlated error components. To address this bottleneck, we propose a shift from residual fitting to residual orthogonalization and introduce SCBoost. Our framework tackles redundancy through two complementary mechanisms: Spectral Residual Projection (SRP) and Covariance-Regularized Weighting (CRW). During training, SRP projects each residual target onto the orthogonal complement of the historical prediction subspace, forcing successive learners to capture only novel empirical innovations. During aggregation, CRW optimizes ensemble weights on a validation set with an explicit covariance penalty to mitigate remaining correlations. Theoretically, we provide a finite-sample geometric characterization proving that SRP yields an exact additive residual-energy decomposition. Furthermore, under an isotropic-noise assumption, we rigorously establish the conditions under which this projection improves the effective Signal-to-Noise Ratio. Extensive experiments across ten benchmark datasets demonstrate that SCBoost delivers strong out-of-the-box performance, particularly in accuracy and F1 score. This work reinterprets boosting through a geometric lens, suggesting that explicit redundancy control is a principled and necessary step toward more efficient ensemble architectures.

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

A Neuromorphic Reinforcement Learning Framework for Efficient Pathfinding in Robotic Mobile Fulfillment Systems

arXiv:2606.20031v1 Announce Type: cross Abstract: Dynamic environmental changes, confined workspaces, and stringent real-time constraints make pathfinding in Robotic Mobile Fulfillment Systems (RMFS) a challenging problem for conventional search- and rule-based methods, which typically suffer from high computational complexity and long decision latency. While reinforcement learning (RL) has emerged as a powerful alternative, deploying learned policies with extreme energy efficiency on resource-constrained hardware remains an open challenge. We present SDQN-RMFS, an end-to-end framework that achieves high-fidelity deployment of an RL-trained policy from a full-precision artificial neural network (ANN) through to a neuromorphic chip. By computing only when triggered by sparse events, this framework unlocks ultra-low-power RMFS pathfinding. Our full-stack pipeline operates as follows: an ANN policy is first efficiently trained via a collision-allowing strategy to densify informative trajectories, and then converted into a spiking neural network (SNN) via a hard-label knowledge distillation approach. This effectively addresses the output distribution mismatch, preserving policy capability across the ANN-to-SNN pipeline while substantially reducing inference latency. Hardware experiments demonstrate up to 11,281$\times$ energy savings and a nearly two-fold reduction in latency compared to a high-performance GPU baseline, while maintaining decision quality on par with the original trained policy. These results establish physical neuromorphic inference as a practical and energy-sustainable pathway for large-scale RMFS operations.

04.
arXiv (CS.AI) 2026-06-24

JupOtter: Cell-Level Bug Detection in Jupyter Notebooks

arXiv:2606.23877v1 Announce Type: cross Abstract: Jupyter Notebooks are an increasingly popular coding environment used across many domains, especially in Python-based data science and scientific computing. Originally used for prototyping and interactive exploration, notebooks are increasingly used to develop more complex programs, leading to a rapid rise in buggy notebooks on platforms like GitHub. To address this trend, we present JupOtter, a bug detection system designed specifically for Jupyter Notebooks. JupOtter features three novel contributions: (1) a notebook-specific tokenization strategy that preserves cell structure, (2) a cell-level bug prediction technique, and (3) a new labeled dataset, OtterDataset, containing over 21,000 notebooks annotated for fine-grained cell-level bug detection. JupOtter achieves cell-level bug detection F1 scores that surpass static analyzers and large language models in two out of three evaluation datasets.

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

Reasoning as Intersection: Consensus-Frame Alignment for Visual Focus in Video-MLLMs

Reinforcement learning has improved the reasoning ability of large language models, but applying outcome-only rewards to video multimodal large language models (Video-MLLMs) provides limited guidance on which visual evidence should support the answer. Inspired by multisensory integration, where consistent cues can enhance the salience and reliability of perceptual estimates, we introduce Consensus Frame GRPO (CF-GRPO), a temporal-annotation-free process-level reward framework for evidence-aware video reasoning. CF-GRPO constructs a consensus frame prior from intrinsic video cues, including temporal coverage, scene-transition cues, and query-conditioned visual relevance. It then computes a model-side frame-use score from visual and response representations and optimizes their agreement through the Consensus Frame Reward (CFR). With salience-aware sparse aggregation and distribution sharpening, CFR provides a high-contrast reward signal without requiring human temporal annotations. Experiments show that VideoCFR achieves competitive performance across complex video reasoning benchmarks and improves several metrics over representative Video-MLLM and RL baselines, while the consensus prior provides an interpretable view of the evidence frames emphasized during training. The implementation is available at https://github.com/1Pansy/VideoCFR.

07.
arXiv (CS.CL) 2026-06-15

The Holistic Storage of Verb+Up Phrases in Text-based and Audio-based Language Models

A crucial aspect of linguistic capability is the ability to trade off between stored representations and abstract knowledge: one must retrieve learned representations, but also generate novel ones by applying productive rules. While recent work has examined abstract knowledge in language models, holistic storage of multi-word units has received far less attention. We probe internal representations in text-based LLMs and an ASR model, testing whether V+up phrasal verbs develop distinct representations as a function of frequency and predictability. All models show evidence of holistic storage driven by frequency and predictability, further supporting usage-based theories of language.

08.
arXiv (quant-ph) 2026-06-11

Quantum thermodynamics, quantum correlations and quantum coherence in accelerating Unruh-DeWitt detectors in both steady and dynamical state

arXiv:2512.18123v2 Announce Type: replace Abstract: We investigate the interplay between quantum thermodynamics, quantum correlations, and quantum coherence within the framework of the Unruh-DeWitt (UdW) detector model. By analyzing both the steady and dynamical states of various quantum resources (including steerability, entanglement, quantum discord, and coherence), we study how these resources evolve under Markovian and non-Markovian environments. Furthermore, we investigate the impact of both the Unruh temperature and the energy levels on three key quantum phenomena: thermodynamic evolution, quantum correlations, and quantum coherence, considering different initial state preparations. The hierarchical structure relating quantum correlations and quantum coherence is determined. We further examine the thermodynamic performance of a quantum heat engine, highlighting the influence of memory effects and classical correlations on heat exchange, work extraction, and efficiency. Our results reveal that non-Markovian dynamics can enhance the preservation of quantum correlations and improve the engine's efficiency compared to purely Markovian regime. These findings provide insights into the role of quantum correlations and quantum coherence in quantum thermodynamic processes and open avenues for optimizing quantum devices operating in relativistic or open-system settings.

09.
arXiv (CS.CL) 2026-06-24

What's Missing in Vision-Language Models? Probing Their Struggles with Causal Order Reasoning

Despite the impressive performance of vision-language models (VLMs) on downstream tasks, their ability to understand and reason about causal relationships in visual inputs remains unclear. Robust causal reasoning is fundamental to solving complex high-level reasoning tasks, yet existing benchmarks often include a mixture of reasoning questions, and VLMs can frequently exploit object recognition and activity identification as shortcuts to arrive at the correct answers, making it challenging to truly assess their causal reasoning abilities. To bridge this gap, we introduce VQA-Causal and VCR-Causal, two new benchmarks specifically designed to isolate and rigorously evaluate VLMs' causal reasoning abilities. Our findings reveal that while VLMs excel in object and activity recognition, they perform poorly on causal reasoning tasks, often only marginally surpassing random guessing. Further analysis suggests that this limitation stems from a severe lack of causal expressions in widely used training datasets, where causal relationships are rarely explicitly conveyed. We additionally explore fine-tuning strategies with hard negative cases, showing that targeted fine-tuning can improve model's causal reasoning while maintaining generalization and downstream performance. Our study highlights a key gap in current VLMs and lays the groundwork for future work on causal understanding.

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

JEDEL: Zero-Shot DNA-Encoded Library Design for Early-Stage Drug Discovery

arXiv:2606.23745v1 Announce Type: cross Abstract: We present JEDEL, a framework for generating synthesis-ready DNA-encoded libraries (DELs) directly from three-dimensional pharmacophore representations of active ligands. JEDEL is the first model to map pharmacophore interaction patterns to actionable, scalable synthesis instructions, enabling the design of targeted libraries comprising potentially millions of molecules. Unlike existing generative approaches that produce virtual compounds requiring downstream synthesis planning, JEDEL operates within the space of purchasable building blocks and validated reactions, ensuring that every output is experimentally realizable by construction. JEDEL learns a predictive alignment between pharmacophore geometry and molecular structure and decodes this into combinatorial synthesis routes at scale. Across 18 protein targets, it generates focused libraries that outperform random and diversity-based baselines in predicted binding affinity, pharmacophore recovery, and sample efficiency, without target-specific retraining. JEDEL enables a shift from virtual molecule generation to experimentally deployable library design.

11.
arXiv (math.PR) 2026-06-18

Random Schrödinger operators on manifolds and abstract bounds for multiplier-type operators

arXiv:2606.19075v1 Announce Type: cross Abstract: We study random Schrödinger operators on closed Riemannian manifolds with Anderson-type potentials. We prove high-probability spectral inclusion bounds showing that eigenvalues remain close to those of the Laplacian, with deviations controlled by a norm of the potential coefficients. Compared with deterministic bounds, this yields a square-root cancellation gain. The proof is based on a general principle showing that randomisation improves operator norm bounds for multiplier-type operators, which we formulate in both discrete and continuous settings.

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

Less is More: Improving LLM Reasoning with Minimal Test-Time Intervention

Recent progress in large language models (LLMs) has focused on test-time scaling to improve reasoning via increased inference computation, but often at the cost of efficiency. We revisit test-time behavior and uncover a simple yet underexplored phenomenon: reasoning uncertainty is highly localized-only a small subset of high-entropy tokens dominantly affects output correctness. Motivated by this, we propose Minimal Test-Time Intervention (MTI), a training-free framework that enhances reasoning accuracy and stability with minimal overhead. MTI includes: (i) Selective CFG intervention, applying classifier-free guidance only at uncertain positions; and (ii) Lightweight negative-prompt guidance, reusing the main model's KV cache to approximate unconditional decoding efficiently. MTI yields consistent gains across general, coding, and STEM tasks-e.g., +9.28% average improvement on six benchmarks for DeepSeek-R1-7B and +11.25% on AIME2024 using Ling-mini-2.0-while remaining highly efficient.

13.
arXiv (quant-ph) 2026-06-16

How Many Shots Are Enough for a Quantum Circuit?

arXiv:2606.16965v1 Announce Type: new Abstract: Quantum algorithms require repeated circuit executions, known as shots, to estimate output distributions accurately. Determining the minimal number of shots needed to meet a target accuracy is crucial to reduce costs and resource usage, especially on today's noisy and expensive quantum hardware. In this paper, we address the shot optimisation problem in a black-box setting, where no assumptions are made about the structure of the quantum circuit or the noise model of the backend. We introduce IncrementalExecution, a novel online framework that dynamically determines when to stop executing shots based on the principle of point of diminishing returns: the point at which additional shots no longer significantly alter the empirical distribution of a fixed circuit. The framework supports customisable policies for shot management, enabling flexible trade-offs between execution cost and result fidelity within static execution scenarios. We assess our proposal through an extensive experimental evaluation spanning 33,750 framework configurations across 180 unique static quantum circuit-backend combinations, for a total of 7.3M independent experiments. Unlike prior work that relies on problem-specific knowledge or algorithm-dependent assumptions (e.g., variational or adaptive workflows), our approach is applicable to a large set of static circuits and immediately deployable on current quantum cloud platforms.

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

Hubs or Fringes: Pretraining Data Selection via Web Graph Centrality

The performance of modern language models depends critically on pretraining data composition. Yet existing data selection methods rely on auxiliary classifiers for document scoring or mixture optimization, adding computational overhead and dependence on labeled data. We propose WebGraphMix, a lightweight data selection framework that computes structural centrality scores over the Common Crawl host-level web graph and uses them to vary the proportion of central versus peripheral documents in the pretraining mixture. We hypothesize that central hosts expose models to reusable abstractions, while peripheral hosts encode specialized, long-tail knowledge. WebGraphMix computes centrality scores efficiently at web scale, requiring no model training, labeled data, or downstream supervision. We integrate WebGraphMix into the DataComp-LM pipeline and train models at 400M and 1B parameter scales with 8B and 28B tokens respectively, evaluating on 23 tasks ranging from factual knowledge to symbolic reasoning. Our experiments show that central and peripheral web regions encode complementary capabilities. Mixture combining both at a ratio of 1:1 achieves 41.4% on average, compared to 39.8% for uniform sampling. Combining structural scores with document-level quality classifier scores further improves performance to 43.8%. These findings demonstrate that web graph topology is a meaningful axis for pretraining data curation, capturing information that is largely orthogonal to existing content-based approaches.

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

Understanding Latent Diffusability via Fisher Geometry

arXiv:2604.02751v2 Announce Type: replace Abstract: Diffusion models often degrade in latent spaces, yet the formal causes remain poorly understood. We quantify latent-space diffusability via the rate of change of the Minimum Mean Squared Error (MMSE) along the diffusion trajectory. Our framework decomposes this MMSE rate into contributions from Fisher Information (FI) and Fisher Information Rate (FIR). We demonstrate that while global isometry ensures FI alignment, FIR is governed by the interplay between encoder and data geometries. Our analysis decouples diffusion degradation into four penalties: dimensional compression, tangential distortion, high-frequency encoder curvature, and intrinsic data curvature. We derive theoretical conditions for FIR preservation to ensure stable diffusability. Experiments across diverse autoencoding architectures demonstrate the implications of our theoretical bounds. We establish FI and FIR as a comprehensive analytical framework for understanding latent diffusability.

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

BrainWorld: A Structural-Prior-Conditioned Generative Model for Whole-Brain 4D fMRI Dynamics

Whole-brain 4D fMRI generation is valuable for modeling functional brain dynamics, yet existing fMRI foundation models mainly target representation learning and downstream prediction rather than conditional predictive generation. We introduce BrainWorld, a structural-prior-conditioned generative model for whole-brain 4D fMRI dynamics. BrainWorld uses sMRI as subject-level anatomical context to guide future fMRI generation, integrating structural information into the denoising process rather than treating it as a parallel modality. Evaluated on 22 datasets spanning diverse cohorts and brain states, BrainWorld generates stable 4D fMRI trajectories up to 400 frames, improves downstream performance through generated-example augmentation, and learns transferable multimodal representations that outperform baselines. Together, these results establish BrainWorld as a condition-aware generative framework for long-horizon brain dynamics modeling and multimodal representation learning.

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

MinhwaNet: Faithful but Insufficient Object Grounding in Korean Folk Painting

Authors:

Korean folk painting (minhwa) is built from a small vocabulary of auspicious symbols, a tiger for protection, a pair of birds for marital harmony, a peony for wealth, that recur across many of its painted genres. This suggests an obvious computational approach, identify which symbols appear in a painting and read the genre from the inventory. Working with a public corpus that pairs whole paintings, eight-field bilingual curatorial captions, and a separate set of expert object crops, we find that this approach does not work. A model given only a list of which symbols a painting contains predicts the genre far worse than a model that fuses the image with the curatorial text, and forcing the genre representation to be object-grounded actively hurts accuracy. The visual evidence on which the genre prediction rests is nonetheless localized and inspectable. A leakage-safe object evidence map projected from a part-level detector is spatially faithful to where curators isolated symbolic objects and to a patch-based surrogate's own gradient saliency. We name this configuration a faithful-but-insufficient dissociation. The part-level explanation is honest about what the part-level model sees, yet the genre target turns on how symbols are arranged rather than on which ones appear. The same lens separates a content label that survives transfer to held-out source institutions, genre, from a style label that does not, era, a prediction we confirm on two further labels in the corpus. We release the multimodal system, a worked-example reading of one painting's evidence map against its catalogue, and a set of evaluation cautions that recur in long-tailed heritage collections.

18.
Nature (Science) 2026-06-24

AI tool spots antibiotics that fight drug-resistant gonorrhoea

Authors: Unknown Author

The bacterium Neisseria gonorrhoeae has evolved resistance to most antibiotics used to treat it, but a machine-learning screen reveals potential therapies. The bacterium Neisseria gonorrhoeae has evolved resistance to most antibiotics used to treat it, but a machine-learning screen reveals potential therapies.

19.
arXiv (CS.CL) 2026-06-24

CORE-BREW: LLR-Based Soft Decoding for Robust Multi-Bit LLM Watermarking

Reliable provenance for LLM outputs requires multi-bit watermarks that remain robust under editing while maintaining strict false-positive control. Existing ECC-based LLM watermarks rely largely on hard-decision decoding, discarding token-level reliability information. We propose CORE-BREW, a Constant-hit-Rate Embedding extension of block-wise BREW for robust multi-bit watermarking. CORE-BREW calibrates the watermark channel by targeting a fixed hit rate p-star, yielding closed-form per-token log-likelihood ratios (LLRs) for principled soft-decision decoding. It supports two detection modes: Strict-Safe, which preserves the bounded-distance designated-codeword acceptance region, and FPR-Calibrated, which uses likelihood-based scoring and lightweight list decoding to characterize the FPR-TPR trade-off. Experiments on open-source LLMs under token-level edits and paraphrasing demonstrate improved low-FPR discrimination and robustness over prior multi-bit watermarking baselines while maintaining comparable semantic quality.

21.
arXiv (CS.CL) 2026-06-12

From Passive Generation to Investigation: A Proactive Scientific Peer Review Agent

Large language models (LLMs) have shown promise in automating scientific peer review. However, existing approaches often struggle to generate in-depth reviews supported by concrete evidence. We argue that a key limitation is the lack of flexibility to proactively investigate suspicious parts of a paper based on accumulated evidence, as human reviewers do. In this paper, we explore how to enable an LLM-based review agent to perform such proactive investigation. We find that this can be naturally formulated as a Markov Decision Process (MDP), and propose ProReviewer, a scientific peer review agent that proactively reviews a paper guided by a maintained, structured review log. The structured review log serves as a workspace for the agent to track evidence and intermediate findings collected during review. Experiments show that ProReviewer with an 8B backbone, trained by supervised fine-tuning and optimized by reinforcement learning, achieves the highest average score across five quality dimensions, outperforming prompt-based methods with much larger frontier LLMs by up to 39% and the strongest fine-tuned baseline by 16% relatively. It also attains the highest win rates against baselines in human evaluation.

22.
arXiv (CS.CV) 2026-06-17

SegTME-UNI2: A Foundation Model-Based Framework for Generalisable Multiclass Cell Segmentation and LLM-Driven Tumour Microenvironment Characterisation in Histopathology

Characterising the tumour microenvironment (TME) from routine H&E-stained histology images requires simultaneous cell segmentation, feature extraction, and interpretable clinical reporting. We present SEGTME-UNI2, a unified framework addressing these requirements. Its core is UNI2-UPERHOVER, a dual-head segmentation model pairing the UNI2-H pathology foundation model (ViT-Giant, pretrained on >100M tiles from 100K slides) with two parallel UperNet decoders: one for six-class semantic segmentation and one for horizontal-vertical gradient regression enabling watershed-based nuclear instance separation. To address the lack of pixel-level annotations in large real-world repositories, UNI2-UPERHOVER undergoes a three-stage progressive pseudo-label curriculum. Each stage trains a fresh model without weight transfer, driving improvement entirely via increased pseudo-label quality: Stage 1: Uses human-annotated PanNuke (7,901 images, 189,744 nuclei, 0.25 um/pixel). Stage 2: Uses entropy-filtered pseudo-labels from the Stage 1 model on 271,711 TCGA-UT scale-0 patches (0.5 um/pixel). Stage 3: Uses pseudo-labels from the Stage 2 model on all 1,608,060 TCGA-UT patches across six resolution scales (0.5-1.0 um/pixel). Segmentation outputs feed a structured TME feature extraction pipeline computing 20+ per-patch compositional, morphological, spatial entropy, and intercellular distance metrics. These are encoded as JSON and passed to a fine-tuned NVIDIA BioNeMo GPT model to generate clinically interpretable TME narratives. Preliminary validation on held-out PanNuke and TCGA-UT partitions demonstrates framework feasibility and internal consistency. The pseudo-labelled TCGA-UT dataset and UNI2-UPERHOVER checkpoint are publicly released to support large-scale TME profiling and spatial biology research.

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

Fast-dLLM++: Fr\'{e}chet Profile Decoding for Faster Diffusion LLM Inference

Diffusion large language models promise parallel token generation, yet inference remains bottlenecked by deciding which masked tokens can be safely committed together. Fast-dLLM addressed this with KV caching and confidence-guided parallel decoding, but its decoding theory uses a homogeneous high-confidence assumption that effectively reduces each candidate set to its weakest selected token. We argue that this leaves speed on the table because real decoding steps exhibit heterogeneous confidence profiles. We propose Fast-dLLM++, a training-free extension that introduces Fr\'{echet profile decoding}: selecting parallel commit sets from the full sorted confidence profile rather than a single worst-case confidence. The resulting rule is a heterogeneous-confidence generalization of Fast-dLLM's factor selector and it recovers the previous rule exactly in the equal-confidence case and adds a provable heterogeneity bonus when the selected tokens have uneven confidences. Fast-dLLM++ leaves the model, diffusion process, and cache implementation entirely unchanged, making it a drop-in replacement for existing Fast-dLLM decoding. Experiments on GSM8K, MATH, HumanEval, and MBPP with the LLaDA-8B model show that the theoretical improvement translates directly into empirical gains: profile-aware selection improves the accuracy–throughput frontier by exploiting safe parallelism that weakest-token rules miss, achieving up to 37\% higher throughput at comparable accuracy. Our code release is at https://github.com/Ringo-Star/FastdLLM_plusplus.

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

Mining Architectural Quality Under Agentic AI Adoption: A Causal Study of Java Repositories

arXiv:2606.13298v1 Announce Type: cross Abstract: AI coding tools are now used by a majority of developers, and agentic use of these tools has popularized the practice colloquially called "vibe coding". Yet causal evidence on their effect on software architecture is scarce. Prior causal work has measured code-level outcomes (complexity, static analysis warnings); whether such degradation propagates to architecture-level outcomes remains unknown. We mine 151 open-source Java repositories, 74 with detectable agentic AI adoption (identified via configuration files and Co-Authored-By commit trailers) and 77 propensity-matched controls, across a 13-month per-repository window yielding 1,811 monthly Arcan snapshots. We estimate the causal effect of adoption on architectural smell density (ASD) with a staggered difference-in-differences design and the Borusyak imputation estimator, applying a causal design recently used for code-level metrics to the architecture level. Total smell counts are essentially unchanged (+1.1%, p = 0.82) while lines of code grow +12.8% (p = 0.003); the resulting 6.7% ASD decline (p = 0.004) is therefore a denominator effect rather than an architectural improvement. Per-type estimates and robustness checks (wild cluster bootstrap, Lee bounds, stale-observation sensitivity) corroborate the pattern; pre-trends are flat (Wald p = 0.90), consistent with parallel trends. Density-normalized outcomes can mislead when treatment affects system size: raw counts and explicit decomposition are required for causal mining studies of AI tool adoption. The complete replication package, including the curated 151-repository monthly panel, is publicly available.

25.
medRxiv (Medicine) 2026-06-18

Can Vision-Language Models See the Vital Signs? Benchmarking and Fine-Tuning for Intraoperative Monitor Reading

Background Vital-sign deterioration is a leading contributor to preventable perioperative death, yet manual monitor reading is intermittent, error-prone, and subject to alarm fatigue. Automating this perceptual step could enable continuous surveillance, but existing solutions depend on device-specific hardware integration or cloud-hosted vision-language models (VLMs), which raise privacy, cost, and connectivity barriers in resource-limited healthcare facilities. Methods We constructed a benchmark of 200 in-the-wild intraoperative monitor photographs (spanning multiple vendors, angles, and illumination conditions) annotated for eight vital-sign parameters: heart rate, SpO2, ETCO2, respiratory rate, systolic/diastolic/mean blood pressure, and temperature. We evaluated an optical character recognition (OCR)-based pipeline, nine instruction-tuned VLMs (four commercial, five open-weight ranging from [≤]4B to 31B parameters) under two prompting regimes, and a compact open model (Qwen3.5-9B) adapted via low-rank fine-tuning (LoRA, 0.46% of parameters updated). Results Under a domain-aware prompt, frontier VLMs reached 0.98-0.997 exact-match accuracy zero-shot, whereas the OCR pipeline and [≤]4B model scored approximately 0.20 lower, defining a 9B-class usable floor. LoRA fine-tuning Qwen3.5-9B on 80-120 images raised accuracy from 0.953 to 0.994 (statistically indistinguishable from the best commercial model) and reduced the critical-error rate fivefold (0.0313 [->] 0.0063). Ablations showed that performance saturated at 80 training images and rank-8 adapters. Conclusion Monitor reading is a solved perception problem for VLMs above the 9B scale. A lightweight fine-tuned open model achieves frontier accuracy while running entirely on local hardware, preserving data privacy, offline capability, and near-zero marginal cost. Residual errors stem from blood-pressure source ambiguity and are addressable with explicit disambiguation logic.