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01.
bioRxiv (Bioinfo) 2026-06-11

OMIO: A policy-driven Python library for reproducible microscopy image I/O

Modern fluorescence and multiphoton microscopy workflows operate within a heterogeneous ecosystem of file formats, partially overlapping metadata standards, and reader-specific conventions. In practice, this frequently leads to silent axis misinterpretations, loss or corruption of physical voxel size information, and laboratory-specific glue code that is fragile, poorly documented, and difficult to reproduce. OMIO, short for Open Microscopy Image I/O, addresses these issues by providing a lightweight, policy-driven image I/O layer for Python that enforces a canonical, OME-compatible data representation at the API boundary. The central contribution of OMIO is the explicit separation of low-level format access from semantic normalization. Existing reader libraries are used as interchangeable backends for extracting pixel data and available metadata, while OMIO enforces axis conventions, metadata interpretation, and fallback decisions in a centralized and auditable policy layer. This design allows heterogeneous microscopy inputs to be converted into a stable representation without propagating backend-specific assumptions into downstream analysis code. The core design principles of OMIO include canonical axis semantics (TZCYX), robust metadata normalization with explicit and auditable fallbacks, memory-aware operation via optional Zarr-based backends, and workflow-level semantics that extend beyond individual files to folder stacks and BIDS-like project structures. This architecture allows OMIO to orchestrate existing reader libraries into a coherent and reproducible I/O pipeline without replacing or duplicating their functionality. OMIO is implemented as an open-source and community-oriented system in which support for additional file formats and metadata conventions can be added incrementally through modular reader backends. By encouraging the contribution of example datasets, backend extensions, and feature requests, OMIO is designed to evolve alongside emerging acquisition systems while preserving strict semantic guarantees at the interface level. The resulting standardized OME-TIFF outputs are immediately suitable for downstream quantitative analysis and interactive inspection in scientific Python workflows, including workflows based on ImageJ and Napari.

02.
arXiv (CS.AI) 2026-06-16

RollArt: Disaggregated Multi-Task Agentic RL Training at Scale

arXiv:2512.22560v2 Announce Type: replace-cross Abstract: Agentic Reinforcement Learning (RL) trains LLMs through multi-turn interactions with environments, producing workloads that mix compute-bound prefill, bandwidth-bound decoding, CPU-heavy environment execution, and bursty reward evaluation. Existing systems either colocate all stages on a single GPU cluster or decouple them only at a coarse granularity, overlooking hardware heterogeneity and incurring substantial synchronization overhead across stages. We present ROLLART, a system for multi-task agentic RL on disaggregated infrastructure. ROLLART maps each pipeline stage to best-fit hardware, routing prefill-heavy tasks to compute-optimized GPUs, decode-heavy tasks to bandwidth-optimized GPUs, and environments to CPU clusters. It decouples rollout at the trajectory level, allowing generation, environment interaction, and reward scoring to proceed independently, so that slow or failed environments never block the others. ROLLART offloads stateless reward computation to serverless infrastructure and overlaps rollout with training via staleness-bounded asynchronous weight synchronization. Our results demonstrate that ROLLART effectively improves training throughput and achieves 1.31–2.05 \(\times\) training time reduction compared to various RL systems. We also evaluated ROLLART by training a hundreds-of-billions-parameter MoE model for Qoder product on an Alibaba cluster with above 3,000 GPUs, demonstrating its stability and scalability.

03.
Nature (Science) 2026-06-17

Towards autonomous medical artificial intelligence agents

Authors:

Large language models (LLMs) show great potential for clinical decision-making, yet most applications remain narrow, task-specific chat tools rather than systems integrated into clinical workflows1,2. However, building physician copilots will require models that operate within the electronic health record (EHR), with governed access to patient data and the ability to initiate permitted EHR actions within defined safety constraints. Yet it remains unproven whether such a system can manage patient cases with physician-level performance. Here we show that MIRA (Medical Intelligence for Reasoning and Action), an autonomous artificial intelligence agent operating in a sandboxed EHR environment, can navigate a large clinical action space to obtain patient histories; order and interpret laboratory, imaging and microbiology tests; generate differential diagnoses; and formulate treatment plans such as prescribing medications, scheduling surgical procedures and planning admissions. In simulations on real patient cases spanning multiple diagnoses, MIRA outperformed physicians in diagnostic accuracy and made guideline-concordant, medication-safe and appropriate admission decisions. Compared with previous LLM applications that addressed isolated subtasks or provided free-text advice, these results suggest that an EHR-integrated artificial intelligence agent can turn clinical intent into structured, actionable EHR operations, possibly making it a more effective decision-support partner for physicians. Further work is needed to establish generalization, safety and governance through prospective, real-world studies. A large language model artificial intelligence agent operating in a sandboxed electronic health record system can autonomously take patient histories, order tests, interpret findings, diagnose conditions and propose treatments, outperforming experienced clinicians while adhering to safety standards and clinical guidelines.

04.
arXiv (CS.AI) 2026-06-19

DataMagic: Transforming Tabular Data into Data Insight Video

arXiv:2606.20388v1 Announce Type: cross Abstract: Data videos integrate dynamic charts, voice narration, and synchronized animations to communicate data insights as temporal narratives, making them an effective medium for improving data consumption efficiency in the data management lifecycle. However, producing high-quality data videos requires expertise spanning data analysis, narrative design, and video production. Existing approaches fall short: static visualization tools (e.g., BI dashboards) lack narrative logic and animation; authoring tools require users to pre-prepare visualizations rather than working from raw data; pixel-level video generation models cannot guarantee data fidelity or provenance. We demonstrate DataMagic, an end-to-end interactive system that transforms raw tabular data and natural language queries into narrative data-insight videos. To ensure data fidelity, DataMagic introduces the declarative specification DVSpec, which binds visual and animation elements to underlying data fields through data-driven semantic references. To address the combinatorial explosion of the design space, DataMagic adopts a Generate-then-Orchestrate multi-agent architecture that generates candidate scenes in parallel and then optimizes narrative coherence through global orchestration. Leveraging DVSpec's decoupling of logic and rendering, the system further supports three interaction modes and structured provenance-based data Q&A, transforming one-way videos into explorable interactive data interfaces. Evaluation on 109 real-world samples validates the effectiveness of the DataMagic. Homepage: https://datamagic-home.github.io/

05.
bioRxiv (Bioinfo) 2026-06-18

ScriptManager: a platform for scalable and reproducible high-resolution analysis of genomics datasets

Background: The growing diversity of genomic and epigenomic assays has driven a parallel expansion in data formats, analysis workflows, and figure-generation tools. However, tools for analyzing data and assembling publication-quality figures are often specialized to a specific assay, dramatically limiting their interoperability and reproducibility. Results: We present the v1.0 release of ScriptManager, a Java-based framework for modular and reproducible analysis and visualization workflows of genomics and epigenomics data. Unlike existing tools specialized for individual assay types, ScriptManager provides a unified and extensible framework for cross-assay visualization and workflow reproducibility. The v1.0 release adds novel analytical modules, GUI session logging, automated unit and integration testing, tutorials, and expanded documentation. It also integrates with the broader reproducibility ecosystem through Singularity containers, Anaconda packaging, and Galaxy XML wrappers. We demonstrate ScriptManager's TagPileup scaling from local single-core execution to a 10,305-job analysis distributed across the Open Science Grid (OSG), with the full workload completing in

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

PACUTE: Phonology-, Affix-, and Character-level Understanding of Tokens for Filipino

Large language models (LLMs) process text as sequences of subword tokens, which can obscure the character-level and morphological structure that underlies word formation. This limitation is most acute for languages with non-concatenative morphology, where standard tokenizers systematically misalign token boundaries with morpheme boundaries. We introduce PACUTE, a diagnostic benchmark of 4,600 tasks designed to evaluate morphological understanding in Filipino, a language characterized by productive infixation, reduplication, and diacritic-driven lexical distinctions that are typically absent from written text. PACUTE includes a hierarchical diagnostic framework of six compositional levels that localizes where morphological understanding breaks down. Evaluating open-weight LLMs and frontier commercial models, we find that open-weight models perform near chance on morpheme decomposition regardless of scale. Frontier models perform much better, often recovering individual affixes under contains-match scoring, but remain far below their character-level ceilings on compositional tasks of morpheme transformations and syllabification. These results identify productive morphological composition, rather than character access alone, as the persistent bottleneck for Filipino word-structure understanding.

07.
arXiv (CS.CV) 2026-06-18

Rethinking Air-Ground Collaboration: A Progressive Cross-Task Benchmark and Socialized Learning Framework

Air-ground collaborative perception is crucial for robust visual understanding in real-world dynamic environments. However, existing studies typically formulate collaboration as single-task cross-view fusion, overlooking the functional dependencies among localization, target association, and fine-grained parsing. In addition, the heterogeneous nature of aerial and ground views introduces substantial geometric, scale, and occlusion discrepancies, making uniform feature sharing vulnerable to negative transfer. To tackle these issues, we model air-ground perception as a progressive cross-task collaboration task and construct the Air-Ground Progressive Collaboration (AGPC) benchmark, a spatio-temporally aligned benchmark comprising more than 745K raw video frames. Built upon this benchmark, we propose Socialized Co-Perception (SCP), a coarse-to-fine framework that organizes collaboration progressively from aerial global localization to ground target association and identity-aware parsing. Its core module, the Dual-Layer Router (DLR), decouples input-side multi-scale expert selection from output-side task-conditioned modulation, enabling selective cross-view and cross-task interaction while suppressing harmful interference. Extensive experiments demonstrate the effectiveness of SCP. It achieves a 3.73\% coevolutionary gain and a 7.86\% improvement in average downstream performance. These results show that task-conditioned collaboration is more effective than uniform fusion for heterogeneous air-ground perception. The code is available at https://github.com/g1136639260-spec/AGSCP.

08.
bioRxiv (Bioinfo) 2026-06-19

Geometric Deep Learning Reveals Ligandable and Cryptic RNA Binding Small Molecule Pockets (SMARTPocket)

RNAs are important therapeutic targets, however identifying ligandable small-molecule binding pockets remains a major barrier to RNA-targeted drug discovery. Here, SMARTPocket, an atomic-level geometric deep learning framework for predicting RNA-small molecule binding pockets directly from three-dimensional structure is introduced. SMARTPocket represents RNA as full-atom point clouds and uses transfer learning from more than 110,000 protein binding interface structures to overcome the limited number of experimentally elucidated RNA-ligand complexes. Across four established single-chain benchmarks and three broader curated benchmarks, SMARTPocket consistently outperforms existing RNA pocket predictors and general biomolecular modeling approaches. The model generalizes to apo RNA structures when conformational changes are modest, identifies cryptic ligandable pockets, and recapitulates experimentally validated binding sites in the SARS-CoV-2 frameshifting element and an RNA aptamer evolved to bind small molecules. SMARTPocket-guided docking further improves near-native RNA-ligand pose recovery and computational efficiency compared with blind docking. These results establish SMARTPocket as a generalizable framework for structure-based identification of ligandable RNA pockets and for accelerating discovery of RNA-targeted small molecules.

09.
arXiv (CS.CL) 2026-06-11

Evaluating Factual Density in Multi-Source RAG: A Study in Medical AI Accuracy

Retrieval-Augmented Generation (RAG) is the current industry standard for grounding AI in real-world facts. Traditional retrieval methods rely on keyword matching and topic proximity, ranking content based on how closely it sounds like the user's query. What they do not measure is how many verified facts the content actually contains. This structural gap, termed the Expert Blindness Effect, causes standard RAG pipelines to consistently bury high-density factual evidence in favor of lexically dominant text on the same topic. To address this gap, this paper introduces Factual Density (FD*), a novel retrieval optimization signal that measures the proportion of verified atomic claims relative to total token count. Using the NexusAgentics Ghost Audit preprocessing pipeline, raw text is scored for factual specificity using probabilistic factuality analysis to filter content before corpus ingestion. An initial formulation introduced a severe document-length confound (Pearson R = -0.8636, p = 2.27e-07). Implementing Z-score normalization within length bins resolved this bias, validating FD* as a length-independent density signal (p = 0.0749). Evaluated against the HealthFC benchmark (750 health claims labeled Supported, Refuted, or No Evidence by medical experts), FD*-optimized retrieval was the only condition to achieve 100% systematic review saturation in top-5 results, surfacing Cochrane evidence that standard cosine similarity ranked outside the top ten. Ground truth verification confirmed 25 mappings across seven HealthFC-supported claims. While full statistical validation across n=50 queries remains future work due to constraints on corpus-benchmark alignment, these findings establish factual density reranking as a low-cost, high-impact intervention for improving factual precision in health RAG architectures.

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

Evaluative Judgement in Teaching AI-based Translation: A Class-room Case Study of AI-Mediated Translation and Post-Editing

Authors:

Drawing on 23 anonymized student pro-jects from a fourth-year Machine Transla-tion and Post-editing course in a BA-level translation programme, this paper exam-ines how structured comparison of gen-eral-purpose LLMs and online MT sys-tems can elicit evaluative judgement in AI-mediated translation. Students translat-ed short specialised English Wikipedia texts into Catalan or Spanish, generated four system outputs, evaluated them using automatic metrics and human adequa-cy/fluency assessment, selected one output for post-editing, and justified their deci-sion in written reports. Descriptive counts are reported for all 23 projects, while qualitative interpretation is based on the 22 cases accompanied by written reports. Results show that students did not treat automatic metrics as final authority: final post-editing selections often diverged from metric rankings and were justified through adequacy, fluency, terminology, naturalness, and expected post-editing ef-fort. The study therefore does not bench-mark systems under controlled conditions; it analyses how students justified system choice within an authentic classroom as-signment.

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

Efficient Test-time Inference for Generative Planning Models with OCL Search

arXiv:2606.00618v2 Announce Type: replace Abstract: Generative models have emerged as a powerful paradigm for AI planning, yet their performance remains constrained by the training data distribution. One approach is to improve generated solutions during inference by scaling test-time compute. A more efficient alternative is to optimize the inference process itself. In this paper, we show that a modified version of a classical Open-Closed List (OCL) search provides just such an efficient inference procedure. Our algorithm synergizes two learned components: a generative model that performs fast rollouts from intermediate states and a heuristic model that prioritizes among candidate reasoning paths. Key contributions include novel exploration control mechanisms and integration of learned models within the OCL framework. Across multiple combinatorial planning domains, our approach outperforms both neurosymbolic search baselines and classical solvers in computational efficiency and solution quality.

13.
Nature (Science) 2026-06-17

Analysis of 173,303 exomes and genomes in the Pakistan Genome Resource

Naturally occurring loss-of-function variants in human genes enable drug target discovery because they mimic pharmacological inhibition of proteins. However, the study of these genetic variants is constrained by their rarity. Sequencing of diverse populations, particularly those enriched in familial relatedness, has been postulated to promote discovery of rare genetic variants1–3. Here we present the Pakistan Genome Resource, a South Asian biobank with high familial relatedness comprising 173,303 participants, who collectively carry naturally occurring homozygous loss-of-function variants in 6,476 genes. We describe the genetic architecture of this population, associations between genes and biomarkers, the distribution of loss-of-function variants across molecular pathways, and recall-by-genotype studies of therapeutically relevant genes. The Pakistan Genome Resource expands the catalogue of human genetic variants, provides a comprehensive genetic reference resource for the Pakistani population, and demonstrates the value of studying diverse cohorts to advance human health. The Pakistan Genome Resource compiles biobank data from 173,303 individuals with high familial relatedness, broadening the catalogue of human genetic variation and establishing a population-specific genomic reference for Pakistan.

14.
arXiv (CS.CV) 2026-06-12

Dual-Constrained Diffusion Image Compression for Operational Rate-Distortion-Perception Optimization

The rate-distortion-perception (RDP) trade-off extends classical rate–distortion theory by imposing a distributional constraint on reconstructions, providing a unified framework for neural image compression that jointly governs fidelity and perceptual realism. While prior work achieves near-optimal rate–perception trade-offs, practical frameworks explicitly realizing the full RDP surface remain scarce, primarily due to the difficulty of introducing common randomness at the decoder. We propose DCIC (Dual-Constrained Diffusion Image Compression), which integrates a learned codec with a diffusion-based decoder governed by joint distortion and idempotence constraints. The distortion constraint bounds reconstruction fidelity relative to the base codec output; the idempotence constraint – requiring that re-encoding the restored image recovers the base codec reconstruction – serves as a tractable surrogate for the distributional perception requirement. Together, they steer the reverse denoising process via iterative optimization with consistent noise injection, realizing common randomness without additional rate overhead. At fixed rate, dual attenuation factors $(K_D, K_P)$ jointly navigate the Pareto frontier of the distortion-perception plane, enabling continuously adjustable fidelity-realism trade-offs from a single bitstream. DCIC$_{RD}$ ($K_P{=}0$) and DCIC$_{RP}$ ($K_D{=}0$) arise as boundary curves, with DCIC$_{RDP}$ ($K_D = K_P=1$) realizing the optimal interior operating point. Experiments on CelebA-HQ, CLIC2020, and ImageNet-1K across CNN, Transformer, and hybrid architectures confirm that DCIC$_{RDP}$ achieves superior BD-PSNR over all perceptual codecs, while DCIC$_{RP}$ matches dedicated perception-oriented methods in BD-FID, validating the practical value of full RDP surface navigation.

15.
arXiv (CS.LG) 2026-06-19

Evaluating deep learning models for fault diagnosis of a rotating machinery with epistemic and aleatoric uncertainty

arXiv:2412.18980v2 Announce Type: replace Abstract: Uncertainty-aware deep learning (DL) models recently gained attention in fault diagnosis as a way to promote the reliable detection of faults when out-of-distribution (OOD) data arise from unseen faults (epistemic uncertainty) or the presence of noise (aleatoric uncertainty). In this paper, we present the first comprehensive comparative study of state-of-the-art uncertainty-aware DL architectures for fault diagnosis in rotating machinery, where different scenarios affected by epistemic uncertainty and different types of aleatoric uncertainty are investigated. The selected architectures include sampling by dropout, Bayesian neural networks, and deep ensembles. Moreover, to distinguish between in-distribution and OOD data in the different scenarios two uncertainty thresholds, one of which is introduced in this paper, are alternatively applied. Our empirical findings offer guidance to practitioners and researchers who have to deploy real-world uncertainty-aware fault diagnosis systems. In particular, they reveal that, in the presence of epistemic uncertainty, all DL models are capable of effectively detecting, on average, a substantial portion of OOD data across all the scenarios. However, deep ensemble models show superior performance, independently of the uncertainty threshold used for discrimination. In the presence of aleatoric uncertainty, the noise level plays an important role. Specifically, low noise levels hinder the models' ability to effectively detect OOD data. Even in this case, however, deep ensemble models exhibit a milder degradation in performance, dominating the others. These achievements, combined with their shorter inference time, make deep ensemble architectures the preferred choice.

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

Uncertainty-Aware Longitudinal Forecasting of Alzheimer's Disease Progression Using Deep Learning

arXiv:2606.24604v1 Announce Type: new Abstract: Longitudinal modelling of Alzheimer's disease progression is clinically useful only if it can describe not just the most likely next diagnosis, but how a patient may evolve over time and how reliable that forecast is. Most deep learning approaches reduce this problem to single-step classification, treating cognitively normal, mild cognitive impairment, and dementia as flat categories while providing limited insight into how uncertainty accumulates across future visits. We propose a probabilistic framework that combines ordinal diagnosis prediction, multi-horizon trajectory generation, and decomposed uncertainty estimation. A Temporal Fusion Transformer encoder is adapted with a CORAL ordinal output layer, asymmetric loss weighting, and converter oversampling to respect disease-stage ordering and improve sensitivity to MCI-to-dementia transitions. Conditioned on the learned patient-context representation, an autoregressive Mixture Density Network generates five-year probabilistic trajectories for diagnosis state, CDR Sum of Boxes, MMSE orientation, and hippocampal volume. On ADNI, the model outperforms linear, recurrent, and transformer baselines for next-visit diagnosis prediction, with the strongest gains on MCI-versus-dementia discrimination. Generated trajectories achieve near-nominal 90% credible interval coverage, widening uncertainty across the forecast horizon, and biomarker dynamics consistent with expected Alzheimer's disease progression. We further separate aleatoric from epistemic uncertainty using analytic mixture variance and a five-member bootstrap ensemble, which provides the strongest encoder diversity and output-level epistemic signal. Epistemic uncertainty is higher for rare progression archetypes, MCI and dementia patients, and under external evaluation on OASIS-3, where it increases alongside prediction error.

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

Epistemic Constitutionalism Or: how to avoid coherence bias

Authors:

Large language models increasingly function as artificial reasoners: they evaluate arguments, assign credibility, and express confidence. Yet their belief-forming behavior is governed by implicit, uninspected epistemic policies. This paper argues for an epistemic constitution for AI: explicit, contestable meta-norms that regulate how systems form and express beliefs. Source attribution bias provides the motivating case: I show that frontier models enforce identity-stance coherence, penalizing arguments attributed to sources whose expected ideological position conflicts with the argument's content. When models detect systematic testing, these effects collapse, revealing that systems treat source-sensitivity as bias to suppress rather than as a capacity to execute well. I distinguish two constitutional approaches: the Platonic, which mandates formal correctness and default source-independence from a privileged standpoint, and the Liberal, which refuses such privilege, specifying procedural norms that protect conditions for collective inquiry while allowing principled source-attending grounded in epistemic vigilance. I argue for the Liberal approach, sketch a constitutional core of eight principles and four orientations, and propose that AI epistemic governance requires the same explicit, contestable structure we now expect for AI ethics.

18.
arXiv (CS.LG) 2026-06-24

Parallel Manifold Steering: Efficient Adaptation of Large Associative Memories via Residual Energy Shaping

arXiv:2606.24396v1 Announce Type: new Abstract: Large Transformer models function as Dense Associative Memories (DAMs), retrieving knowledge via high-dimensional attractor dynamics driven by the self-attention mechanism \citep{ramsauer2020hopfield, wu2024attention}. However, adapting these frozen memory systems to new tasks presents a fundamental ``Plasticity-Stability'' dilemma. Current methods either risk catastrophic interference by modifying synaptic weights directly (e.g., LoRA) \citep{hu2021lora} or degrade associative capacity by clogging the retrieval buffer with static prompt tokens (e.g., VPT) \citep{jia2022vpt}. In this work, we propose H-Res (Hierarchical Residual Steering), a mechanism that modulates the effective energy landscape of the Transformer without altering its global equilibrium or expanding its sequence length. By formulating adaptation as a control problem on the activation manifold \citep{chen2018neuralode}, H-Res learns a state-dependent vector field that steers token trajectories into task-specific basins of attraction. We formally prove that H-Res preserves the attention entropy of the foundation model and facilitates Neural Collapse \citep{papyan2020prevalence}. Empirically, Manifold Steering outperforms global weight modification by 26\% on associative retrieval tasks and eliminates the computational overhead of prompt-based methods, scaling effectively to structured domains \citep{zha2023vtab}.

19.
medRxiv (Medicine) 2026-06-15

International Consensus Guideline on Management of Genitourinary Adverse Events Associated with Prostate Cancer Radiotherapy

Purpose/Objective: Genitourinary (GU) adverse events (AEs) are common during and after pelvic radiation therapy (RT) for prostate cancer and can substantially impact quality of life. We convened an international committee to establish consensus in the prevention, mitigation, and management of radiation-related acute and late GU AEs, as there are no relevant evidence-based consensus guidelines to inform treating providers. Materials/Methods: A systematic evidence review focused on mitigation and management of radiation-related acute and late GU AEs was performed in PubMed, Embase and Cochrane. The following topics were addressed: management of acute GU AEs in the intact and post-operative settings; RT techniques; bladder outlet obstruction procedures; and indications for urology referral or hyperbaric oxygen therapy (HBO). Evidence-based consensus recommendations were developed using a Delphi process. We highlight the current state of evidence and evidence gaps worthy of future study. Results: Consensus was reached for 31 key questions. For management of lower urinary tract symptoms (LUTS), most evidence comes from trials in patients without cancer and not undergoing RT. A consensus algorithm for medical management of acute GU AEs was developed with the following highlights: (a) alpha blockers as 1st-line for obstructive symptoms in the intact setting, (b) anti-spasmodics as 1st -line for irritative symptoms in the intact setting, and (c) anti-spasmodics as 1st -line in the post-operative setting. The consensus algorithm provides an ordered list of medications to offer if 1st -line options afford inadequate relief. For RT fractionation, randomized clinical trial (RCT) data are available. 40% of panelists rarely or never use standard fractionation over moderate hypofractionation for patients with baseline LUTS, but most consider moderate hypofractionation over SBRT for AUA IPSS > 15. For patients with severe obstructive LUTS (most commonly AUA IPSS >20), the panel recommends a prophylactic bladder outlet obstruction procedure and, if obstructive symptoms improve, consideration of moderate hypofractionation or SBRT, based on retrospective data. There is one RCT supporting use of HBO for late radiation cystitis. Conclusions: The consensus guideline synthesizes available evidence and expert opinion across key clinical decision points to provide practical guidance in the prevention, mitigation, and management of radiation-related acute and late GU AEs in prostate cancer RT. Envisioned as a living document with periodic updates, this guideline serves as a resource for practicing radiation oncologists by outlining expert-derived consensus recommendations of evidence-based care in areas where high-quality data is limited.

20.
medRxiv (Medicine) 2026-06-22

''Circumstantial Determinants'': An Efficient Approach to Reaching People in Need of HIV Prevention?

HIV prevention and testing programmes primarily reach people who self-refer or attend routine health services. Higher-risk individuals are missed if they are healthy, under-estimate their risk of infection or under-report sexual risk-behaviours. We assess a new approach to address limitations in existing programmes by targeting HIV services on ''Circumstantial Determinants'' (CDs) of HIV risk - the social circumstances, settings, and norms associated with behaviours that increase risk of HIV acquisition. Data on potential CDs and sexual behaviour were collected in a population survey in Zimbabwe in 2018/19 (N=9141). HIV-negative individuals reporting [≥] 1 sexual risk-behaviours were defined as the 'priority population' for HIV prevention. For each sex, six circumstantial determinants were associated with being in the priority population (aOR [≥] 1.30; p [≤] 0.01). Reach and efficiency of CDs (and combinations) were calculated; ROC curve algorithms evaluated their ability to identify priority population membership; and HIV prevention condom cascades were compared between CD-defined priority population subgroups. Example findings include that targeting men at bars and beerhalls could reach 48.5% of the priority population and 25.1% of lower-risk men. These percentages increase to 77.1% and 53.7% if men with poor mental health, no religious affiliation, negative social capital, or living on agricultural estates are also targeted. Targeting women with poor mental health could reach 32.0% of the priority population and 21.3% of lower-risk women. Targeting additional circumstantial determinants increases these percentages to 54.1% and 37.5%, respectively. Cascade barriers to condom use differed between CD-defined subgroups. The Circumstantial Determinants approach demonstrates proof-of-concept potential to strengthen HIV prevention services.

21.
arXiv (quant-ph) 2026-06-15

Physics-Informed Variational Quantum Classifier for Phase Detection in Strongly Correlated Matter

arXiv:2606.14489v1 Announce Type: new Abstract: The characterisation of quantum phases in strongly correlated systems is a crucial milestone for the deployment of quantum sensors. In this work, we present a Physics-Informed Variational Quantum Classifier (VQC) designed to detect the topological phase transition between the Fermi polaron quasiparticle and the molecular bound state. Unlike conventional Machine Learning approaches, our quantum architecture is constructed via the Trotterised time-evolution of an effective Hamiltonian, ensuring that the learnable parameters correspond to interpretable physical quantities. We show that the VQC efficiently discovers the optimal interferometric protocol, specifically the evolution time and effective bath interactions required to maximise the visibility of Ramsey fringes, thereby clearly distinguishing the Bose-Einstein Condensate (BEC) and Bardeen-Cooper-Schrieffer (BCS) regimes. Furthermore, we report the validation of this classifier on the QRed superconducting quantum processor (BSC-CNS). Despite the intrinsic hardware noise and decoherence, the VQC preserves the relative ordering of the topological phases. We demonstrate that the physics-informed architecture achieves a linear gate complexity $\mathcal{O}(N)$, bypassing the exponential memory wall of classical simulation and ensuring scalability to many-body regimes.

22.
arXiv (CS.CV) 2026-06-12

GeoCFNet: Geometry-Aware Confidence Field Network for Robot-Assisted Endoscopic Submucosal Dissection

Advanced surgical robotics has made robot-assisted endoscopic submucosal dissection (ESD) a promising approach for the en-bloc resection of large lesions, with the potential to reduce recurrence and improve long-term outcomes. However, the technical complexity and risk of complications in ESD demand stable and precise visual guidance to maintain an accurate dissection corridor and a safe tissue margin. Dense confidence fields provide an effective representation for this purpose by describing both the preferred dissection region and its spatial transition to surrounding tissue. However, reliable confidence field estimation remains challenging in dynamic endoscopic scenes due to smoke, specular highlights, tissue deformation, weak texture, and the thin geometric structure of the target region. To address these challenges, we formulate dissection guidance as a geometry-aware confidence field estimation problem and propose GeoCFNet, a geometry-aware confidence field network built on a pretrained DINOv3 backbone. GeoCFNet integrates a Token-Differentiated Fusion module to aggregate class-token context with dense patch representations, a SegFormer decoder for confidence regression, and Geometry-Aware Spatial Regularization (GASR) to preserve spatial coherence and local geometric transitions. Experimental results show that GeoCFNet achieves RMSE 0.0480, PSNR 27.1995, SSIM 0.3397, and CC 0.2466, indicating accurate and geometrically stable confidence field estimation for robot-assisted ESD guidance.

23.
arXiv (CS.CL) 2026-06-17

FeedEval: Pedagogically Aligned Evaluation of LLM-Generated Essay Feedback

Going beyond the prediction of numerical scores, recent research in automated essay scoring has increasingly emphasized the generation of high-quality feedback that provides justification and actionable guidance. To mitigate the high cost of expert annotation, prior work has commonly relied on LLM-generated feedback to train essay assessment models. However, such feedback is often incorporated without explicit quality validation, resulting in the propagation of noise in downstream applications. To address this limitation, we propose FeedEval, an LLM-based framework for evaluating LLM-generated essay feedback along three pedagogically grounded dimensions: specificity, helpfulness, and validity. FeedEval employs dimension-specialized LLM evaluators trained on datasets curated in this study to assess multiple feedback candidates and select high-quality feedback for downstream use. Experiments on the ASAP++ benchmark show that FeedEval closely aligns with human expert judgments and that essay scoring models trained with FeedEval-filtered high-quality feedback achieve superior scoring performance. Furthermore, revision experiments using small LLMs show that the high-quality feedback identified by FeedEval leads to more effective essay revisions. We release our code and curated datasets at: https://github.com/BBeeChu/FeedEval.git.

24.
arXiv (quant-ph) 2026-06-16

A Gauge-Covariant Geometric Framework for Non-Hermitian Quantum Systems

arXiv:2606.15922v1 Announce Type: new Abstract: We develop a comprehensive, gauge-covariant geometric framework for non-Hermitian quantum systems in the quasi-Hermitian regime, that is, the region of parameter space where the non-Hermitian Hamiltonian admits a real spectrum and a positive-definite metric operator. We build this framework by elevating the Dyson map to a central geometric object. This map is the transformation that converts a non-Hermitian Hamiltonian into an equivalent Hermitian one. From it we construct the Dyson connection and decompose it into Hermitian and anti-Hermitian parts, identified respectively as {\it stretching } and {\it rotation } components. This decomposition cleanly separates the genuine physical metric deformations from the unitary gauge redundancies. Working with manifestly gauge-covariant states, we then derive the complex non-Hermitian Berry phase and the quantum geometric tensor (QGT), and show that the non-Hermitian geometric curvature originates from the non-commutativity of the stretching components at the operator level. We further analyse the geometric singularities near an exceptional point (EP) and uncover a distinct hierarchy of divergences. For a general two-level non-Hermitian model, the quantum metric tensor (QMT) exhibits a leading-order divergence $\sim |\epsilon_\mu|^{-2}$, while the Berry curvature shows a weaker, subleading divergence $\sim |\epsilon_\mu|^{-3/2}$, with $\epsilon_\mu$ denoting the parameter displacement from the EP along an individual parameter axis $\mu$. Finally, we examine physical realizations of this model, including the non-Hermitian Su–Schrieffer–Heeger (SSH) and Hatano–Nelson (HN) models, where exact analytical results confirm the predicted critical scaling laws and illustrate the metric-deformation-driven non-Hermitian geometries.

25.
medRxiv (Medicine) 2026-06-23

Differential Recovery Trajectories of Emergency Otolaryngologic Conditions across the COVID-19 Pandemic: A Six-year Longitudinal Study from an Urban Emergency Center

Authors:

Objective: The COVID-19 pandemic markedly altered social activity patterns, healthcare utilization, and the epidemiology of infectious diseases. However, its long-term impact on emergency otolaryngologic conditions remains incompletely understood. This study investigated long-term trends in emergency otolaryngologic conditions before, during, and after the COVID-19 pandemic using comprehensive data from a large urban emergency clinic in Osaka, Japan. Methods: All new otolaryngologic outpatients who visited the Chuo Emergency Medical Clinic (CEMC) in Osaka City between 2019 and 2024were retrospectively analyzed. Annual trends in absolute numbers and relative proportions of emergency otolaryngologic conditions were examined by anatomical region and disease category, using 2019 as the pre-pandemic baseline. Results: A total of 99,324 new otolaryngologic outpatients were analyzed. Overall emergency visits declined sharply to approximately half of baseline in 2020, followed by a gradual but incomplete recovery toward pre-pandemic levels by 2024. Most anatomical categories declined to 45-61% of baseline in 2020 and exhibited gradual yet incomplete recovery through 2023; in stark contrast, laryngeal conditions diverged sharply, surging beyond pre-pandemic levels after 2022. Acute infectious otorhinolaryngologic diseases fell to 23-50% of baseline in 2020 and showed variable recovery (69-103%) by 2024. Notably, laryngitis exceeded the baseline, reaching 132% in 2023, whereas epiglottic edema exhibited only a transient increase approaching the baseline in 2021. Non-infectious emergency conditions generally showed only a marginal decrease in 2020 and remained relatively stable throughout the study period, except for sudden sensorineural hearing loss (SSNHL), which dropped sharply to 39% of the baseline in 2020 and remained persistently reduced through 2024. Traumatic emergencies declined variably to 53-81% of the baseline in 2020, followed by an incomplete recovery, reaching only 55-69% by 2024. Conclusion: Emergency otolaryngologic conditions demonstrated heterogeneous recovery trajectories following the COVID-19 pandemic. While most infectious and traumatic conditions gradually but incompletely normalized, laryngeal conditions showed a distinct post-pandemic surge, and SSNHL remained persistently suppressed. These findings reveal heterogeneous, condition-specific recovery trajectories that reflect both genuine shifts in community pathogen burden, true traumatic incidence, and persistent alterations in healthcare-seeking behaviors, insights essential for resource allocation during future public health emergencies.