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

Integrated Sensing and Communications for Real-time Avatar Control in XR over 5G

arXiv:2606.23771v1 Announce Type: cross Abstract: Extended Reality (XR) presents a challenging use case for 5G and 6G networks, requiring high data-rates and lowlatency communication to deliver a truly immersive experience. Moreover, in order to seamlessly translate physical actions to the virtual world, accurate gesture recognition and pose estimation are required. Current XR interaction solutions based on handheld controllers and cameras cannot easily capture full-body poses, inhibit the free use of hands, and require good visibility and a clear line of sight. In this work, we propose a multimodal sensing architecture for XR that combines 5G MillimeterWave (mmWave) Integrated sensing and communication (ISAC) and surface electromyography (sEMG) signals. 5G mmWave ISAC cannot only be used to deliver content wirelessly to the Head-mounted display (HMD), but also the same communication signals can be used to derive coarse body-level gestures and poses of the user, to support real-time avatar control. For fine-grained finger-level gestures, our architecture leverages lightweight sEMG sensors that capture forearm muscle activity. To illustrate the need of both modalities, we present evaluations of both sensing technologies. At the body level (5G), our architecture relies on power-per-beam-pair (PPBP), which can be computed from standard beam management or beam sweeping procedures of the 5G NR standard. PPBP-based sensing achieves 82.2$\pm$5.9% average accuracy when evaluated on users not seen during training. For fine-grained finger-level interactions, we show that surface electromyography (sEMG) carries strong discriminative information achieving consistent promising performance across different movement settings. Thus, combining the two modalities enables multi-scale gesture recognition, at the body level via existing 5G signals and finger level via lightweight sEMG sensors, forming a complete XR framework.

02.
bioRxiv (Bioinfo) 2026-06-16

scIsoAgent enables autonomous isoform-resolved characterization and sequence-informed interpretation of long-read single-cell transcriptomes

Alternative isoform usage can alter gene function independently of total gene expression, creating a need to resolve transcript isoforms at single-cell resolution. Long-read single-cell RNA sequencing meets this need by linking cellular identity to transcript isoforms and sequence-level features. Realizing its full biological value requires reproducible workflows that connect specialized long-read analysis with biological interpretation. Existing large language model (LLM)-based biomedical agents support general omics analysis, but are not designed for isoform-resolved long-read single-cell workflows. Here, we present scIsoAgent, an autonomous LLM-powered scientific agent for long-read single-cell RNA-seq analysis. scIsoAgent turns heterogeneous long-read single-cell inputs into traceable isoform-resolved workflows, using stage-aware planning and persistent computational context to support both execution and interpretation. Across complementary evaluations, this design improved the continuity from analysis planning to executable, interactive workflows compared with general-purpose LLM baselines. In real-data reanalysis, scIsoAgent recovered major findings from published long-read single-cell resources and extended a representative differential transcript usage event into a sequence-informed functional hypothesis. By linking full-length isoform sequences with model-inferred transcript properties, scIsoAgent connects observed isoform usage with potential sequence-level functional consequences. These results demonstrate that autonomous scientific agents can transform fragmented long-read single-cell analysis into coherent, reproducible workflows for isoform-resolved discovery and biological interpretation.

03.
arXiv (CS.CL) 2026-06-12

Attention Expansion: Enhancing Keyphrase Extraction from Long Documents with Attention-Augmented Contextualized Embeddings

Pre-trained language models (PLMs) have achieved strong performance in keyphrase extraction (KPE), largely due to their ability to generate rich contextualized representations. However, long-document KPE remains challenging because salient keyphrase evidence may be scattered across distant document sections that cannot be jointly captured within the limited context window of most PLMs. Although long-context large language models (LLMs) can process broader textual contexts, their computational cost limits their practicality for efficient and high-throughput KPE. To overcome this limitation, we propose an attention expansion mechanism that augments PLM token representations with information from surrounding out-of-context chunks using pre-trained word embeddings. The proposed mechanism expands the effective contextual scope of PLM-based KPE models without requiring full-document attention or expensive LLM-based inference. We evaluate our approach across five PLM backbones, including general-purpose, scientific, task-specific, and long-context encoders, using two training regimes and five benchmark corpora from scientific and news domains. Experimental results demonstrate that attention expansion consistently enhances KPE performance across all evaluation settings, outperforming state-of-the-art models and yielding notable improvements in F1 score. The improvements extend to domain-specific, task-specialized, and native long-context models, showing that the proposed mechanism provides complementary information rather than merely compensating for limited input length. These results establish attention expansion as an efficient and effective strategy for long-document KPE.

04.
arXiv (CS.CL) 2026-06-17

Evidence of Layered Positional and Directional Constraints in the Voynich Manuscript: Implications for Cipher-Like Structure

The Voynich Manuscript (VMS) exhibits a script of uncertain origin whose grapheme sequences have resisted linguistic analysis. We present a systematic analysis of its grapheme sequences, revealing two complementary structural layers: a character-level right-to-left optimization in word-internal sequences and a left-to-right dependency at word boundaries, a directional dissociation not observed in any of our four comparison languages (English, French, Hebrew, Arabic). We further evaluate two classes of structured generator against a four-signature joint criterion: a parametric slot-based generator and a Cardan grille implementing Rugg's (2004) gibberish hypothesis. Across their full tested parameter spaces, neither class reproduces all four signatures simultaneously. While these results do not rule out generator classes we have not tested, they provide the first quantitative benchmarks against which any future generative or cryptanalytic model of the VMS can be evaluated, and they suggest that the VMS exhibits cipher-like structural constraints that are difficult to reproduce from simple positional or frequency-based mechanisms alone.

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

Thinking with Visual Grounding

arXiv:2606.16122v1 Announce Type: new Abstract: Visual thinking should not only sound right; it should show its evidence. While recent vision-language models (VLMs) can produce natural-language reasoning traces, these traces often leave the supporting image regions implicit, making them hard to verify and difficult to supervise. We introduce visually grounded thinking, a reasoning process in which models interleave natural-language thoughts with explicit point or box groundings of the visual evidence used at each step. This lets the model express intermediate reasoning in language while grounding key objects in the image regions they refer to. To train this behavior, we construct a scalable synthesis pipeline that distills correct visual reasoning traces, extracts the visual objects required by the traces, grounds them with a SAM3-based agent, and derives aligned point and box supervision from the resulting masks. We further propose grounding-aware reinforcement learning, which combines answer correctness rewards with dense grounding rewards that score whether generated object references match the correct image evidence. Across two counting benchmarks and four spatial reasoning benchmarks, adding visually grounded thinking to Gemma3-4B-IT consistently improves performance over the original model and the non-grounded thinking baseline. On spatial reasoning, the visually grounded thinking 4B models match, and in some cases surpass, Gemma3-27B-IT from the same model family. Our analysis shows that point grounding is well suited to counting, while box grounding benefits most from explicit grounding rewards on spatial tasks. Overall, our results show that VLMs think better when their intermediate thoughts are tied to the image regions that make them true.

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

Canonical Variates in Wasserstein Metric Space

arXiv:2405.15768v2 Announce Type: replace-cross Abstract: In this paper, we address the classification of instances represented by distributions on a vector space rather than single points. We consider classification algorithms based on pairwise distances, specifically, the Wasserstein metric between distributions. Central to our investigation is dimension reduction within the Wasserstein metric space to enhance classification accuracy. We introduce a novel approach grounded in the principle of maximizing Fisher's ratio, defined as the quotient of between-class variation to within-class variation. The directions in which this ratio is maximized are termed discriminant coordinates or canonical variates axes. In practice, both between-class and within-class variations are defined as the average squared Wasserstein distances between pairs of distributions, with the pairs either belonging to the same class or to different classes. This ratio optimization is achieved through an iterative algorithm, which alternates between optimal transport and maximization steps within the vector space. Empirical studies are conducted to assess the algorithm's convergence; and experimental results demonstrate that the dimension reduction technique substantially enhances classification performance. Moreover, the new method outperforms well-established algorithms that operate on vector representations derived from distributional data. It also exhibits robustness to variations in how instances are summarized by distributions, such as the number of components in a Gaussian mixture model (GMM) representation.

07.
arXiv (CS.CL) 2026-06-16

Attention, not scale, drives human-AI alignment in multimodal language prediction

Humans routinely draw on visual context to predict upcoming words. To what extent current vision-language models produce comparable behaviour is unclear. Here we placed five state-of-the-art pretrained systems side-by-side with 600 human participants in a web-based Visual-World Paradigm. On each of 100 six-second movie clips, models and participants received either text only or synchronised video and text and judged how likely a specified target word was to appear next; human eye movements were tracked throughout. Adding visual context increased model-human alignment in predictability ratings across all architectures (average Delta r = 0.18) with no impact of parameter size. When visual context was informative, transformer attention significantly increased alignment. Attention maps from two transformer models corresponded with human gaze, explaining up to 70% of the inter-participant variance when the scene contained informative cues. Notably, cross-modal attention reliably tracked anticipatory human fixations on semantic cues. These results suggest that current transformer-based vision-language models can approximate human behaviour exploiting visual context during language prediction - and that selective attention to informative cues, not sheer model scale, is the principal driver of this alignment.

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

Heterogeneous 2D/1D Signal Representation Fusion for Underwater Acoustic Modulation Recognition Under Distribution Shift

arXiv:2606.23702v1 Announce Type: cross Abstract: Modulation recognition systems rely on heterogeneous signal representations. 2D signal-image modalities such as time-frequency and cyclostationary maps capture structural patterns, while 1D statistical descriptors such as higher-order power spectra encode complementary cues. Under distribution shift, these modalities degrade unevenly, making robust fusion a central challenge for practical deployment. Progress is further limited by the lack of a unified evaluation protocol that systematically separates different shift types. This paper addresses both challenges through a joint benchmark-and-model study in underwater acoustic modulation recognition. UAMR-ShiftBench is the first benchmark to jointly cover in-distribution, low-SNR, unseen-environment, unseen-communication-parameter, and measured sea-trial evaluation under a single matched protocol, with two independent real-world subsets collected during two sea-trial campaigns conducted in March and November in the South China Sea. SCP-TriCA fuses STFT, cyclostationary, and P2/P4 (second- and fourth-order power spectra) modalities hierarchically: the two 2D modalities are first aligned through bidirectional cross-attention, and the 1D statistical modality is then incorporated through a sample-adaptive selective gate. On UAMR-ShiftBench, SCP-TriCA achieves 95.33% in-distribution accuracy and 74.59% simulated OOD average, outperforming the strongest baseline by 5.12 percentage points, and reaches 91.14% and 94.86% on the two sea-trial subsets, exceeding the best baseline by 15.71 and 23.00 percentage points respectively. Ablation results confirm that the gains stem from modality complementarity and the hierarchical fusion design. Code and models are available at https://github.com/ronglaiqian/UAMR-ShiftBench.

09.
arXiv (CS.AI) 2026-06-19

VCG: A Multimodal Retrieval Framework for E-Commerce Video Feeds under Extreme Cold-Start Conditions

arXiv:2606.19627v1 Announce Type: cross Abstract: The digital commerce landscape is shifting from static, search-driven catalogs to dynamic, immersive video feeds. This transition introduces an ``extreme cold-start'' problem: unlike traditional items, new short-form videos lack the dense interaction history required for collaborative filtering. Furthermore, immersive feeds introduce strong position and duration biases that distort standard engagement signals. In this paper, we demonstrate the Video Candidate Generation (VCG) system, a scalable multimodal retrieval engine designed to solve these challenges in a large-scale e-commerce environment. By leveraging a domain-adapted vision-language model (based on CLIP), we map users and videos into a shared semantic space, enabling zero-shot retrieval based on visual content rather than behavioral history. We detail the system's architecture and present a rigorous evaluation comparing generative (LLM) vs. discriminative (CLIP) embeddings. Our results show that while generative models excel at attribute prediction, they suffer from embedding space collapse in retrieval tasks. Online A/B testing demonstrates that VCG effectively mitigates engagement biases, yielding a 50\% uplift in deep video completion. To showcase the system's capabilities, we present an interactive demonstration featuring three bi-directional retrieval scenarios: Product-to-Video, Video-to-Product, and Zero-Shot Semantic Search.

10.
arXiv (CS.AI) 2026-06-18

A Taxonomy of Mental Health and Technology Needs for Alzheimer's and Dementia Caregivers

arXiv:2606.19247v1 Announce Type: cross Abstract: Family members caring for individuals with Alzheimer's disease and related dementias (AD/ADRD) provide the foundation of long-term care worldwide. In 2023, more than 11 million U.S. family and friends contributed 18 billion hours of unpaid care, often at the cost of their own physical and mental health. These informal caregivers – also referred as the "invisible second patients" – experience elevated rates of mental health problems. Yet research commonly reduces their complex psychosocial experiences to a single construct of caregiver burden, obscuring which specific needs are unmet or effectively supported. At the same time, digital and AI-enabled technologies are rapidly expanding, from smartphone apps and videoconferencing to sensor platforms and AI chatbots. However, the absence of shared frameworks across medicine, psychology, and technology research limits cumulative progress. This study introduces a Caregiver Mental Health and Technology Taxonomy that systematically links AD/ADRD caregiver needs with corresponding classes of technology-based interventions. Drawing from an interdisciplinary literature review and two qualitative studies with caregivers, the taxonomy identifies mismatches between caregiver priorities and existing technological support, highlights under-served domains such as relational strain and compassion fatigue, and proposes design directions for adaptive, responsive systems. The framework offers a shared vocabulary to guide clinicians, researchers, and technology designers in developing more person-centered and clinically grounded innovation in dementia care.

11.
arXiv (CS.AI) 2026-06-24

T2D-Bench: Evidence-Gated Evaluation of LLM Outputs for Type 2 Diabetes Using a Multi-Layer Clinical-Lifestyle Knowledge Graph

arXiv:2606.24145v1 Announce Type: new Abstract: Large language models (LLMs) can produce clinically fluent recommendations for type 2 diabetes while failing to satisfy guideline constraints or explicitly justify lifestyle-related glycemic claims. We present T2D-Bench, a reproducible benchmark and evidence-gated evaluation framework for testing whether LLM outputs satisfy explicit, graph-checkable evidence requirements. T2D-Bench is built on a multi-layer clinical-lifestyle knowledge graph that combines a biomedical spine (UMLS, DrugBank, SIDER), computable ADA Standards of Care rules, and lifestyle knowledge connected through a mechanistic bridge to glycemic laboratory effects. Across 100 structured vignettes spanning diagnosis, medication safety, and adversarial lifestyle conflicts, baseline outputs failed benchmark-defined evidence-path checks in 35% of cases for GPT-4o-mini and 33% for GPT-4o. The evidence gate detects unsupported omissions and uses constrained revision to bring outputs into verifier-level compliance with benchmark-defined evidence requirements. These results show that computable evidence constraints can make unsupported clinical omissions explicit, measurable, and correctable in diabetes-focused LLM outputs.

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

Beyond Predefined Schemas: TRACE-KG for Context-Enriched Knowledge Graph Generation

arXiv:2604.03496v2 Announce Type: replace Abstract: Knowledge graph generation typically relies either on predefined ontologies or on schema-free extraction. Ontology-driven pipelines enforce consistent typing but require costly schema design and maintenance, whereas schema-free methods often produce fragmented graphs with weak global organization, especially in long technical documents with dense, context-dependent information. We propose TRACE-KG (Text-dRiven schemA for Context-Enriched Knowledge Graphs), a framework that jointly constructs a context-enriched knowledge graph and an induced schema without assuming a predefined ontology. TRACE-KG captures conditional relations through structured qualifiers and organizes entities and relations using a data-driven schema that serves as a reusable semantic scaffold while preserving full traceability to the source evidence. Experiments show that TRACE-KG produces structurally coherent, traceable knowledge graphs and offers a practical alternative to both ontology-driven and schema-free construction pipelines.

13.
arXiv (quant-ph) 2026-06-11

Expressivity of Quantum Reservoir Computers

arXiv:2501.15528v3 Announce Type: replace Abstract: Using Hamiltonian encoding to inject an input into parameterized quantum circuits (PQCs), the output of the PQC can be written as truncated Fourier series. In recent years, the expressivity of PQCs was established as the number of frequencies contained in this Fourier series. While this concept has also been applied to other quantum machine learning (QML) paradigms, a clear notion of expressivity for temporal information processing with quantum systems is still lacking. Here, we introduce such a notion to the field of quantum reservoir computing (QRC). We analytically derive an expression for the readouts showing that the output of a QRC can be interpreted as a multi-dimensional Fourier series. We give a formula for the growth of expressivity induced by the sequential information injection, which we corroborate with numerical simulations, calculating explicitly the number of multi-dimensional output functions which can be generated from the readouts. Our results show that the specific interplay between system size, input encoding, and memory time gives rise to a boundary on the system size beyond which it is obstructive to further increase the reservoir size in extreme scrambling systems. We propose a recipe for determining this maximal system size for a given QRC setup.

14.
arXiv (CS.LG) 2026-06-15

On the Generalization Bounds of Symbolic Regression with Genetic Programming

arXiv:2604.17402v2 Announce Type: replace Abstract: Symbolic regression (SR) with genetic programming (GP) aims to discover interpretable mathematical expressions directly from data. Despite its strong empirical success, the theoretical understanding of why GP-based SR generalizes beyond the training data remains limited. In this work, we provide a learning-theoretic analysis of SR models represented as expression trees. We derive a generalization bound for GP-style SR under constraints on tree size, depth, and learnable constants. Our result decomposes the generalization gap into two interpretable components: a structure-selection term, reflecting the combinatorial complexity of choosing an expression-tree structure, and a constant-fitting term, capturing the complexity of optimizing numerical constants within a fixed structure. This decomposition provides a theoretical perspective on several widely used practices in GP, including parsimony pressure, depth limits, numerically stable operators, and interval arithmetic. In particular, our analysis shows how structural restrictions reduce hypothesis-class growth while stability mechanisms control the sensitivity of predictions to parameter perturbations. By linking these practical design choices to explicit complexity terms in the generalization bound, our work offers a principled explanation for commonly observed empirical behaviors in GP-based SR and contributes towards a more rigorous understanding of its generalization properties.

15.
arXiv (CS.CV) 2026-06-24

BenchX: Benchmarking AI Models for Cancer Detection and Localization with Demographic and Protocol Biases

Artificial intelligence (AI) has achieved remarkable success in medical imaging, but it is widely recognized that these models often perform inconsistently across real-world clinical settings. Such inconsistencies occur when patient demographics and imaging protocols vary, for example, in detecting small tumors, analyzing scans from different contrast phases, or evaluating patients of different ages or sexes. To quantify these inconsistencies, we develop a large-scale, open benchmark of 85,355 CT scans that systematically evaluates 12 tumor-detection AI models across tumor size, location, patient subgroup, and imaging protocol. We leverage large language models (LLMs) to extract and organize subgroup information from clinical data, which makes the analysis both scalable and reproducible. Our benchmark reveals that current state-of-the-art AI models, optimized for average accuracy, perform poorly in rare or underrepresented subgroups, such as young, female African Americans. However, collecting sufficient annotated data for these rare cases is often impractical. The benchmark provides a foundation for building more reliable and robust AI models for tumor detection and highlighting the need for rigorous, subgroup-level evaluation in medical imaging and computer vision. Datasets, code

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

Fast and high-fidelity transfer of edge states via dynamical control of topological phases and effects of dissipation

arXiv:2505.16606v2 Announce Type: replace-cross Abstract: Topological edge states are robust against symmetry-preserving perturbations and noise, making them promising for quantum information and computation, particularly in topological quantum computation through the braiding operations of Majorana quasiparticles. Realizing these applications requires fast and high-fidelity dynamic control of edge states. In this work, we theoretically propose a high-fidelity protocol for transferring topological edge states by dynamically moving a domain wall between two regions with different topological numbers in one dimension. This protocol fundamentally relies on Lorentz invariance and relativistic effects, because moving the domain wall at a constant speed is described by a mass term with the uniform linear motion in the Dirac equation. We demonstrate the effectiveness of our protocol in transferring edge states with high fidelity using a one-dimensional quantum walk with two internal states, which is feasible with current experimental technology. We also investigate how bit-flip and dephasing dissipation to the environment affect transfer efficiency. Remarkably, bit (dephasing) dissipation does not affect the fidelity at the slow (fast) transfer limit, which can be explained by the relativistic effects on the edge states.

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

LineageMark: Multi-user White-box Watermarking for Contribution Tracing in Model Derivation Chains

arXiv:2606.17123v1 Announce Type: cross Abstract: In open large language model (LLM) ecosystems, models are frequently adapted across multiple domains and applications, forming multi-stage derivation chains. Consequently, tracking and verifying historical contributions is essential for model provenance and intellectual property protection. However, existing watermarking methods are mainly designed for single-user, one-time embeddings, often fail under repeated model derivation and incremental updates. To address this problem, we propose LineageMark, a multi-user white-box watermarking framework for model derivation chains. The framework encodes watermarks in model parameters using a projection-based approach. Stable carriers are first selected to reduce sensitivity to model changes, each watermark bit is then represented as a projection statistic over these carriers. Additional watermark insertions introduce only bounded perturbations in the projection space, and margin constraints are used to maintain signal integrity. We evaluate the effectiveness of LineageMark in multi-stage model derivation chains. Experimental results show that LineageMark preserves contributor watermarks across multi-stage derivation and supports incremental multi-user watermark insertion. Furthermore, it exhibits robustness against perturbations such as re-watermarking, fine-tuning, quantization, and pruning.

18.
arXiv (CS.CL) 2026-06-16

Understanding, Detecting, and Repairing Real-World In-Context-Learning-Based Text-to-SQL Errors

Large language models (LLMs) have been adopted for text-to-SQL tasks, utilizing their in-context learning (ICL) capability to translate natural language questions into SQL queries. However, such a technique faces correctness problems. In this paper, we conduct the first comprehensive study of text-to-SQL errors of ICL-based techniques. Our study covers four representative ICL-based techniques, five basic repairing methods, two benchmarks, and two LLM settings. We find that text-to-SQL errors are widespread and summarize 27 error types of 7 categories. We also find that existing repairing attempts have limited correctness improvement while having high computational overhead and many mis-repairs. Based on these findings, we propose MapleDoctor, a novel text-to-SQL error detection and repairing framework. The evaluation demonstrates that MapleDoctor outperforms existing solutions by repairing 13.8% more queries with a negligible number of mis-repairs and reducing 67.4% repair latency. The artifact is publicly available at GitHub.

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

MotionVLA: Vision-Language-Action Model for Humanoid Motion

Generating realistic humanoid motion from scene images and text involves both low-frequency pose semantics and high-frequency physical dynamics. However, many existing methods tokenize motion with a single shared codebook, forcing heterogeneous motion signals into the same quantization space. Our frequency-domain analysis of human motion data reveals a clear mismatch between single-codebook quantization and motion statistics: five DCT coefficients capture 93% of joint-position energy but only 37% of joint-velocity energy, which can bias quantization toward pose statistics and under-represent high-frequency velocity components. A second challenge lies in adapting a standard autoregressive model to effectively model high-frequency physical signals in motion sequences. Therefore, we propose DSFT, a dual-stream frequency tokenizer that separates motion into Base and physical streams and compresses them independently with DCT truncation and BPE. Furthermore, we present MotionVLA, a Qwen3.5-based model that arranges Base and physical tokens in a unified sequence, where Phys tokens are predicted after Base tokens. Experiments on HumanML3D and MBench show that, despite using a lightweight 2B backbone, MotionVLA reduces the Diversity gap to real data by over 50% on HumanML3D and improves Motion-Condition Consistency by 3.8% on MBench, supporting frequency-aware dual-stream decoupling as an effective formulation for autoregressive motion generation. Code: https://github.com/AIGeeksGroup/MotionVLA. Website: https://aigeeksgroup.github.io/MotionVLA.

20.
medRxiv (Medicine) 2026-06-22

Referral pathways, ETAT triage acuity, and inpatient outcomes among children presenting to a national tertiary paediatric emergency unit in Ghana: a prospective cohort study

Emergency referral systems in sub-Saharan Africa are fragmented, and children reaching tertiary facilities through different referral pathways often arrive in advanced clinical states. Prospective data simultaneously characterising referral patterns, triage acuity at presentation, diagnostic case mix, and inpatient mortality at a national tertiary paediatric emergency unit are lacking from West Africa. This prospective cohort study enrolled 675 consecutively presenting children aged one month to 12 years at the Paediatric Emergency Unit of Korle Bu Teaching Hospital, Accra, Ghana, from February to December 2019. The primary outcome was all-cause inpatient mortality. Key variables collected included referral status and facility tier, Emergency Triage Assessment and Treatment (ETAT) triage category, ICD-10 diagnostic classification, Oyedeji socioeconomic classification, and time from symptom onset to PEU registration. Crude odds ratios were computed for all candidate predictors. Multivariable logistic regression was conducted using complete case analysis (n = 613). Of 675 children, 63.0% (n = 425) were referred from another health facility; referred children had higher ETAT emergency triage category rates than self-presenting children (32.7% vs 27.6%, p < 0.001). Overall inpatient mortality was 9.9% (67/675). Mortality varied by referral source: 16.7% among secondary/regional hospital referrals, 11.0% among lower-tier facility referrals (district, municipal, CHAG, polyclinic, private, health centre, and maternity home facilities combined, n = 356), 7.6% among self-presenting children, and 7.4% among tertiary referrals. Overall, 30.8% of children were classified as ETAT emergencies on arrival, with case fatility rate of 21.6%. The three most common diagnostic domains were respiratory conditions (17.2%), blood and haematological disorders (17.0%), and digestive presentations (16.4%). Inpatient mortality was highest in neoplastic disease (33.3%, n = 30) and circulatory presentations (31.0%, n = 29). In the primary multivariable analysis (n = 613, 51 events; events-per-variable ratio 4.2), no referral tier was independently associated with inpatient mortality after adjustment. Referral from secondary/regional hospitals showed a borderline non-significant association (adjusted odds ratio 3.09, 95% CI 0.96 to 9.90, p = 0.058). School going children (60-119 months) had higher odds of inpatient death than infants (adjusted odds ratio 5.56, 95% CI 1.16 to 26.53, p = 0.032), as did adolescents (adjusted odds ratio 10.01, 95% CI 2.15 to 46.69, p = 0.003). ETAT emergency category and lower socioeconomic status were not independently significant in this model. A pre-specified sensitivity analysis using the full analytic cohort (n = 674, events-per-variable ratio 6.7) with collapsed referral categories did not confirm any referral tier association; ETAT emergency category and lower SES were independently associated in the sensitivity model. All multivariable estimates should be regarded as exploratory. This prospective cohort provides simultaneous characterisation of referral patterns, ETAT triage acuity, diagnostic case mix, and inpatient mortality at a national tertiary paediatric emergency unit in West Africa. The referral-mortality gradient and high ETAT emergency category proportion document the severity of illness arriving through different referral pathways at this facility. The association between secondary/regional hospital referral and inpatient mortality is hypothesis-generating and requires replication in an adequately powered multicentre study before any service-level conclusions can be drawn.

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

Agentic MPC for Semantic Control System Resynthesis

While MPC effectively handles structured, diverse, and low-level specifications, it lacks the capability to dynamically incorporate high-level contextual information such as social norms, user intent, or natural language instructions. To address this limitation, this manuscript introduces an agentic MPC framework that enables context-aware, semantically adaptive control synthesis by integrating with large language model-based agents. The agent interprets heterogeneous inputs, including natural language messages, environmental observations, and external knowledge, to resynthesize the control specifications. The effectiveness of the framework is demonstrated in an autonomous driving scenario, where the system aligns with personal preferences or responds to social situations such as emergency vehicle yielding.

22.
arXiv (CS.LG) 2026-06-19

Semantic-Anchored Evidential Fusion for Domain-Robust Whole-Slide Survival Analysis

arXiv:2606.19966v1 Announce Type: cross Abstract: Whole-slide images (WSIs) are widely used for computational cancer prognosis. However, most existing methods primarily focus on in-domain performance and fail to generalize across clinical centers. This limitation stems from their reliance on pixel-derived representations that are highly susceptible to domain-specific artifacts caused by staining protocols and scanner hardware. We hypothesize that high-level pathology semantics, such as tumor grade and micro-environmental architecture, provide a domain-invariant semantic representation that mirrors the robust diagnostic logic of human pathologists. Therefore, we propose a Semantic-Anchored Evidential Fusion Survival (SAEFS) framework, where SAEFS derives semantic anchors from WSIs via Visual Question Answering (VQA), employs a dual-stream WSI evidence extraction architecture, uses Dirichlet-based Subjective Logic to model uncertainty, and fuses semantic and visual evidence through a cautious conjunction rule to avoid overconfident fusion from correlated sources. Trained exclusively on one source domain and evaluated zero-shot across four unseen domains, SAEFS consistently outperforms state-of-the-art models both in prediction accuracy and reliability, improving the average C-index by 10.2%. Quantitative analyses further show that VQA-derived semantic features exhibit significantly lower cross-center divergence than pixel-derived features, highlighting their robustness for cross-center clinical applications.

23.
medRxiv (Medicine) 2026-06-18

Cardiac rhythm development: A wearable device index of risk for physical and mental illness in adolescence

Objective. The autonomic nervous system, which regulates cardiac rhythm, undergoes pronounced maturation across adolescence. How cardiac rhythm develops over this period, however, and whether individual differences in its development forecast mental and physical illness, remain open questions. We used three waves of Fitbit data from the Adolescent Brain Cognitive Development (ABCD) Study to characterize the developmental trajectory of the cardiac rhythm and to test whether variation in that trajectory predicts onset of psychopathology and cardiometabolic disease. Methods. 8,301 adolescents contributed 242,811 valid Fitbit wear days across Waves 2 (Mage=12), 4 (Mage=14), and 6 (Mage=16). Cosinor mixed-effects models yielded three rhythm parameters per session: mesor (24-hour mean), amplitude (diurnal swing), and acrophase (peak timing). We first characterized age- and sex-specific trajectories, cross-wave stability, and factors shaping the rhythm. We then used parallel-process latent growth models to test whether within-person changes in rhythm tracked symptom trajectories, and hierarchical logistic models to test whether rhythm parameters predicted the first clinical onset of psychopathology and of obesity and hypertension. Results. The cardiac rhythm changed substantially across adolescence: mesor decreased, amplitude flattened, and acrophase shifted later. Within-person change in the rhythm tracked change in blood pressure, BMI, and trajectories of depression and ADHD symptoms. Higher mesor predicted incident onset of all five outcomes controlling for demographics, baseline symptoms, and behavior (ORs 1.36-1.54); amplitude, acrophase, and rhythm instability conferred additional risk. Conclusions. The 24-hour cardiac rhythm is a passively measurable substrate of adolescent autonomic development that indexes transdiagnostic risk for psychiatric and cardiometabolic illness.

24.
arXiv (CS.CV) 2026-06-17

Response-Aware Multimodal Learning for Post-Treatment Visual Acuity Forecasting

Long-term visual acuity (VA) forecasting after anti-VEGF therapy is important for counseling and follow-up planning in diabetic macular edema (DME), yet remains challenging when only early post-treatment findings are available. While prior OCT-based methods mainly focus on short-term response or single-endpoint prediction, multi-horizon VA forecasting from early longitudinal data remains insufficiently under-explored. In this study, we assembled a real-world cohort of 188 anti-VEGF–treated DME patients with paired baseline and month-1 OCT scans, along with tabular OCT-derived biomarkers and non-imaging clinical variables. Using only these early data, we formulate a multi-horizon VA forecasting problem aimed at predicting visual outcomes at 3, 6, 12, 18, and 24 months, reflecting clinically meaningful follow-up intervals. We propose ReVA, a response-aware multimodal framework that combines baseline and month-1 OCT features with tabular variables to capture disease status and early treatment response. ReVA integrates spatial OCT attention, dependency-aware tabular encoding, and cross-modal fusion to predict patient-specific long-term VA trajectories. The proposed framework achieves MAE=0.1246, RMSE=0.1621, and R^2=0.6064 for 24-month VA prediction, with consistent performance across all forecast horizons. Our findings show that incorporating early treatment-response signals enables clinically meaningful long-term visual acuity forecasting, supporting data-driven decision support for routine anti-VEGF management. Code and pretrained models will be released on https://github.com/nguyenpbui/ReVA.

25.
arXiv (CS.CL) 2026-06-11

ALIGNBEAM : Inference-Time Alignment Transfer via Cross-Vocabulary Logit Mixing

Domain fine-tuning degrades the safety of large language models: fine-tuned specialists readily comply with harmful prompts framed in domain language. Existing inference-time defenses that mix logits from a safe anchor model require both models to share a vocabulary, which rules them out for the cross-family specialists where safety is most degraded. We present ALIGNBEAM, a training-free method that lifts this restriction by translating anchor logits into the target model's vocabulary token-by-token at each decoding step; a small LLM judge then selects the safest among K candidate continuations. No weights are changed, and the safety-utility trade-off can be tuned at deployment without retraining. Across both cross-vocabulary and same-vocabulary evaluation pairs, ALIGNBEAM substantially raises refusal on adversarial benchmarks while keeping task accuracy and inference overhead within practical bounds. The results show that safety alignment can be transferred between model families at inference time, without touching either model's weights.